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Biomedical subjects

M Saleh

Publications and source records attributed to M Saleh.

At least 73 records · Page 4Linked to original sources
PubMed1997

External fixation of children's fractures: use of the Orthofix Dynamic Axial Fixator.

We have reviewed 48 children's diaphyseal fractures of the femur and tibia managed with the Orthofix Dynamic Axial Fixator between 1987 and 1994. The indications for external fixation included open fractures, multiple injuries, failed conservative management, and unstable fracture configurations. All fractures healed without further surgical intervention, and the incidence of serious complications was low. Although pin track sepsis was common, compromise of the fixation as a result of this occurred in only one case. We conclude that use of the Orthofix for children's fractures is a safe and effective management option.

Adolescent↗
PubMed1997

[Peroperative radiotherapy in the conservative treatment of infiltrating bladder cancers].

OBJECTIVE: Descriptive analysis of an intraoperative radiotherapy protocol (IOR) in the context of conservative management of invasive bladder cancer. METHOD: From November 1988 to September 1994, 24 patients with invasive bladder carcinoma (20 T2, 3 T3) were included in this protocol consisting of: transurethral resection (TUR), neoadjuvant chemotherapy (M.V.C.) in 14 patients, external irradiation (x 18 MV: 48 Gy/24 F/5 weeks) with concomitant chemotherapy (cisplatin 30 mg/day-3 days-2 cycles during irradiation)-follow-up cystoscopy then surgery with IOR (E 9 MeV: 15 Gy). RESULTS: The global 3-year survival was 69%. An invasive intravesical relapse developed in 3 patients (1 salvaged by cystectomy) and a superficial relapse occurred in 1 patient. One patient developed pelvic lymph node progression and 7 developed distant metastases. The early and late toxicity was acceptable with 3 cases of ureteric necrosis or stenoses resolving after medical treatment. CONCLUSION: This series shows encouraging preliminary results. IOR appears to be a technique well adapted to lesions of the fixed portion of the bladder.

Adult↗
PubMed1997

Homohemodialysis: a technique of dialysis for the uremic animal.

As an alternative to kidney transplantation in conditions of renal failure, an in situ kidney of a healthy individual may be used. The present study utilizes the kidney of a healthy rabbit as a hemoperfusion unit for another, uremic, animal. The study comprised 17 experimental models, each of which consisted of 2 adult New Zealand rabbits. One animal of each model was rendered uremic by means of bilateral nephrectomy. The blood chemistry (urea, creatinine, sodium, potassium, pH and base deficit) was examined pre- and 4-hourly post-operatively. When after 48 hours post-nephrectomy, the blood chemistry had reached a level sufficient to endanger the animal's life, homohemodialysis was performed. The anticoagulated blood was circulated from the uremic animal to the normal one and then back to the uremic animal through the femoral vessels using a tube system. The blood chemistry was determined every 10 minutes and pH and base deficit every 30 minutes. All animals died or were sacrificed within 21 hours after shunting was started, and autopsy was done. Serum sodium was the first to normalize within the first 10 minutes post-shunting, followed by serum potassium and pH in 30 minutes. Blood urea and creatinine reached normal levels in 40 minutes and base deficit in 60 minutes post-shunting. The pathologic examination of specimens from the vital organs of both the normal and uremic animals showed different degrees of cellular damage probably due to hypotension or acute effects of the unbalanced animal homeostasis. The cellular damage was much less in the normal than in the uremic animals. In conclusion, homohemodialysis proved to be effective in normalizing the concentrations of the different substances retained in the blood of uremic animals within only 60 minutes of dialysis.

Animals↗
PubMed1996

Inhibition of growth of C6 glioma cells in vivo by expression of antisense vascular endothelial growth factor sequence.

Tumor angiogenesis involves a combination of events including the production of inhibitors, proteases, and angiogenic factors that have a chemotactic and mitogenic effect on endothelial cells. Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen that promotes angiogenesis in solid tumors, including brain tumors such as astrocytomas. As an approach to the development of new strategies for gene therapy of brain tumors, we have interrupted the VEGF/VEGF receptor paracrine pathway in an attempt to inhibit angiogenesis and thereby control tumor growth. Rat C6 glioma cells were transfected with a eukaryotic expression vector bearing an antisense-VEGF cDNA. Stable transfectants were observed to express reduced levels of VEGF in culture under hypoxic conditions. When implanted s.c. into nude (nu/nu) mice, growth of the antisense-VEGF cell lines was observed to be greatly inhibited compared to control cells, despite the fact that they have a faster division time in vitro. Analysis of these tumors revealed that they have fewer blood vessels and a higher degree of necrosis, which is a plausible explanation for the reduced tumor size. We believe antisense-VEGF can be successfully used to control tumor growth and may provide the basis for the development of antiangiogenic gene therapy.

Animals↗
PubMed1996

Effect of pulsed electromagnetic fields on bone formation and bone loss during limb lengthening.

We examined the effect of pulsed electromagnetic fields (PEMFs) on bone formation and disuse osteoporosis sustained during limb lengthening in a double-blind study. Seven males (mean age 13 years, range 11-19 years) and six females (mean age 12 years, range 9-19 years) were randomly allocated to receive either an active or an inactive PEMF coil. Limb lengthening was performed by the Villarubbias technique using either a unilateral or circular frame system. Sequential bone density measurements were made using dual energy X-ray absorptiometry and compared to traditional radiographs. Ten segments (eight tibial and two femoral) in seven patients were lengthened under the influence of active coils and eight segments (six tibial and two femoral) in six patients using inactive coils. There was no difference in the rate nor the amount of new bone formed at the site of distraction between the two groups. Bone loss in the segments of bone distal to the lengthening sites was observed in both groups but was significantly more marked using inactive coils (BMD reduced by 23% +/- SEM 3% and 33% +/- 4% control values after one and two months, respectively; p < 0.0001) than using active coils (BMD reduced by 10% +/- 2% at 2 months). These differences were greater at 12 months after surgery (reduced by 54% +/- 5% and 13% +/- 4%, respectively; p < 0.0001). Stimulation with pulsed electromagnetic fields has no effect on the regenerate bone, but does prevent bone loss adjacent to the distraction gap.

Absorptiometry, Photon↗
PubMed1996

Regional distribution of organochlorine insecticide residues in human milk from Egypt.

The organochlorine insecticide residues in 60 human milk samples from 20 Egyptian governorates were analyzed by gas chromatography/electron capture and gas chromatography/mass spectrometry. The results showed that the main detected organochlorine insecticides were p,p'-DDE and lindane. Other HCH isomers, p,p'-DDT and endosulfan I residues were detected in some samples, but aldrin and endrin were not detected in most of the samples. The mean values for p,p'-DDE, lindane, endosulfan I and p,p'-DDT levels in the milk samples of the 20 governorates studied were 21.37 ppb, 8.42 ppb, 4.84 ppb and 2.93 ppb respectively, which are lower than the levels reported, a number of years ago, in most of the developed countries. Relatively higher levels of organochlorine insecticide residues were recorded in the samples from intensive agricultural activity regions.

Chromatography, Gas↗
PubMed1996

Effect of dolastatin 10 on human non-Hodgkin's lymphoma cell lines.

It is crucial to incorporate new and more potent antineoplastic agents in treating non-Hodgkin's lymphoma since standard chemotherapy fails to cause a significant increase in the survival rate. A potential chemotherapeutic agent is dolastatin 10; hence, the objective of our study is to investigate the effect of the antiproliferative agent dolastatin 10 on different grades of non-Hodgkin's lymphoma cell lines. All cell lines exposed to dolastatin 10 initiated an apoptosis process. Alteration of oncogenes and their product may direct the entry of the cells into apoptosis, among these oncogenes are bcl-2 and c-myc. All cell lines tested expressed c-myc and bcl-2 proteins. However, 24 h after exposing the cell lines to 1 ng/ml dolastatin 10, bcl-2 expression was abolished but there was no significant change in c-myc protein expression. The contradictory roles of c-myc in cell proliferation and death require that other gene(s) products regiment the outcomes of c-myc activity on a cell. A possible candidate for such a modifying gene is bcl-2, whose product prolongs cell survival and blocks apoptosis. Given the above, dolastatin 10 induction of cell arrest is the initiating signal to downregulate the antiapoptotic bcl-2 and reactivate the apoptotic pathway. The reductions in bcl-2 may stabilize the c-myc proliferative action and induce apoptosis.

Antineoplastic Agents↗
PubMed1996

Phase Ia/Ib trial of anti-GD2 chimeric monoclonal antibody 14.18 (ch14.18) and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) in metastatic melanoma.

We performed a phase Ia/Ib trial of chimeric anti-GD2 monoclonal antibody 14.18 (ch14.18) in combination with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) to determine the maximum tolerated dose as well as immunologic and biologic responses to the regimen. Sixteen patients with metastatic malignant melanoma received escalating doses of ch14.18 (15-60 mg/m2) administered intravenously for 4 h on day 1. Twenty-four hours later, subcutaneous injections of rhGM-CSF were administered daily for a total of 14 days. Significant side effects were related to ch14.18 infusion and consisted of moderate to severe abdominal and/or extremity pain, blood pressure changes, headache, nausea, diarrhea, peripheral nerve dysesthesias, myalgias, and weakness. Dose-limiting toxicity was observed at 60 mg/m2 and consisted of severe hypertension, hypotension, and atrial fibrillation in one patient each, respectively. Significant increases in white blood cell count, granulocyte count, eosinophil count, and monocyte count occurred after rhGM-CSF treatment. Significant enhancement of in vitro and in vivo monocyte and neutrophil tumoricidal activity and antibody-dependent cellular cytotoxicity along with significant elevations in C-reactive protein and neopterin were observed. Despite these immunological and biological changes, no antitumor activity was seen. In short, the combination of ch14.18 and rhGM-CSF resulted in toxicity similar to that observed with ch14.18 alone without improvement in tumor response.

Antibodies, Monoclonal↗
PubMed1996

Protocols for the care of external fixator pin sites.

Pin site care methods used in the UK are based on doctor/nurse preference rather than research. There is a diversity of opinion regarding the best method of pin site care, and no standardised classification of pin site problems. There is a need for further research, either a multi-centre trial or in units with a high volume of work.

Bandages↗
PubMed1996

[Complications of intravesical mitomycin chemotherapy, apropos of 2 clinical case reports].

Administration of intravesical chemotherapy by mitomycin C (MMC) is an adjuvant treatment of the recurrent superficial bladder cancer. Since use of MMC in 1967, many different toxicities were reported. Those are local toxicities. Systemic toxicity is rare. At the hand of 2 cases reports and recent literature, we discuss the possible complications of intravesical therapy with MMC.

Administration, Intravesical↗
PubMed1996

Management of nonunion of fractures by distraction with correction of angulation and shortening.

We present a series of ten hypertrophic nonunions in which bony alignment and length were restored and union induced by external fixation and callus distraction. The mean length gained was 3.5 cm (1 to 6) and the mean angular correction was 13.5 degrees (0 to 40). The mean treatment time was 10.2 months (3 to 15) and mean follow-up was 40 months (6 to 71). There have been no refractures or loss of correction or length. The technique of callus distraction at a site of hypertrophic nonunion can correct shortening and angulation as well as induce bony union. No extra equipment is needed beyond readily-available external fixation systems.

Adult↗
PubMed1995

Clinical recurrence of hepatitis A following liver transplantation for acute liver failure.

This paper documents clinically significant recurrence of hepatitis A virus (HAV) infection in a 63-year-old man transplanted for HAV-related acute liver failure. HAV RNA was documented in the explant and, following early clearance from the blood and graft, was again detected in post-operative biopsies at the time of an acute hepatic illness. Although the clinical and biochemical abnormalities resolved completely, the patient had a second episode of graft dysfunction 6 months later and investigations revealed hepatitis C virus (HCV)-related chronic active hepatitis consistent with acquired HCV infection at the time of transplantation. The possible interaction with hepatitis A may have delayed the appearance of hepatitis C. Administration of HAV immunoglobulin at the time of transplantation should be considered in all cases of HAV-related fulminant hepatic failure.

Base Sequence↗
PubMed1995

Adrenoleukodystrophy: CT and MRI findings.

A case of adrenoleukodystrophy (ALD) with CT and MRI findings is described. The CT scan showed low densities in the white matter of the parietal and occipital lobes. No calcifications were seen. Post-contrast CT showed an abnormal enhancement within the involved white matter. MRI showed changes of demyelination around the atria of the lateral ventricles bilaterally involving the posterior aspect of the cerebrum symmetrically. The posterior part of the posterior corpus callosum, splenium and pyramidal tracts also showed increased signal intensity. From a review of the literature, these findings are typical of the radiological changes seen in ALD. ALD can be diagnosed from typical history and biochemical changes as well as from CT and MRI findings.

Adrenoleukodystrophy↗
PubMed1995

Late-onset hepatic failure: clinical features, serology and outcome following transplantation.

A further series of 41 adult patients with late-onset hepatic failure was investigates with respect to aetiological factors, particularly hepatitis C and E, which have been identified since our earlier report of this condition. The increased use of transplantation and its impact on survival overall is assessed. Comparison is made with 64 patients admitted over the same period with fulminant hepatic failure of non-A, non-B aetiology. Screening for the hepatitis viruses revealed three cases of hepatitis A and one case of Epstein Barr virus hepatitis. There were no cases of hepatitis C or hepatitis E virus detected by enzyme immunoassay and reverse transcriptase/polymerase chain reaction techniques, although three patients had positivity for IgG anti-hepatitis E virus, demonstrating previous exposure. Serum autoantibodies in a titre greater than or equal to 1:40 were present in 29% of samples tested and in three cases, titres of SMA or ANF were greater than 1:320. In a further five cases, a potentially hepatotoxic agent had been given within 3 months of the onset of symptoms, leaving the majority of patients (29) with no identifiable cause for their disease. The frequency of symptoms, however, including nausea, abdominal discomfort with the subsequent development of ascites, encephalopathy and renal impairment suggest a similar disease process in these patients. Analysis of liver biopsy material showed similar patterns on all cases of map-like necrosis with nodular regeneration and without other additional features of aetiological significance. Differences in clinical and histological changes for the non-A, non-B fulminant hepatic failure comparison group reflect the tempo of disease process rather than the nature and cause of the liver damage. The introduction of transplantation has led to a marked improvement in survival (39% overall in the earlier series). In the 21 patients in whom transplantation was carried out, the 1-year actuarial survival is currently 55%. Treatment of late-onset hepatic failure with corticosteroids and the use of Prostaglandin E1 and interferon in individual cases has been disappointing, and the emphasis in management should be placed on teh early referral of such patients to a centre offering transplantation.

Adolescent↗
PubMed1995

Management of congenital leg length inequality: value of early axis correction.

The principles of treatment of congenital leg length inequality include three strategies: joint stabilization, axis correction, and limb length equalization. We believe that early axis correction is important for normal musculoskeletal development and that residual deformity may be self-perpetuating. Of 97 lower limbs assessed, 14 had PFFD alone, 6 fibula hemimelia alone, and 49 a combination of the two. Seventy-four limb segments were operated on, including 29 joint stabilizations, 65 axis corrections, and 62 lengthenings. Axis correction was the commonest procedure in the under-five age group and may be performed alone or in combination with another treatment strategy. The average lengthening achieved was 4 cm representing a 15.75% length increase. The mean bone healing index was 54.25 days/cm, slightly more in the tibia than in the femur. We recommend early axis correction and joint stabilization prior to lengthening. The choice of lengthening technique depends on the preexisting risk factors and lengthenings should be short and frequent.

Ankle Joint↗