Biomedical subjects
O Osinowo
Publications and source records attributed to O Osinowo.
Management of tuberculous destroyed lung in Nigeria.
Between 1969 and 1979, 20 patients under-went pneumonectomy for tuberculous destroyed lungs (TDL) at the University College Hospital (UCH), Ibadan, Nigeria. Their ages ranged from 9 to 57 years, with an average age of 24 years. The left lung was involved in 16 patients (80 percent) and the right lung in four patients (20 percent). All patients had received treatment for pulmonary tuberculosis (PTB) for over three years, and all patients had negative cultures of acid-fast bacilli (AFB) at the time of operation. Pulmonary function studies were performed in 15 patients, bronchography in 18, and pulmonary angiography in four. Ninteen patients had elective resection because of mild to moderate hemoptysis without mortality. The only death occurred in a 37-year-old man who had emergency resection because of massive hemoptysis. He died intraoperatively of cardiac arrest. One patient developed bronchopleural fistula (BPF), empyema, and wound infection. The fistula closed spontaneously following prolonged chest drainage and pleural irrigation with antibiotics and antituberculous drugs. As a result of our experience with pulmonary tuberculosis in our environment, the authors now recommend elective resection for patients with TDL in order to prevent massive hemoptysis which may prove fatal.
Open pulmonary valvotomy: report of the first successful open heart surgery at the University College Hospital, Ibadan, Nigeria.
Although cardiac surgery has become the standard procedure for management of intracardiac and extracardiac defects in developed countries, it is still relatively new in Africa. This report describes our first successful open heart surgery on a 16-year-old Nigerian boy who underwent open pulmonary valvotomy under cardiopulmonary bypass for congenital pulmonary stenosis at the University College Hospital, Ibadan, Nigeria, on September 18, 1979.
Management of post-pneumonectomy empyema and bronchopleural fistula in Nigeria.
This report reviews our experience with six patients with post-pneumonectomy empyema and bronchopleural fistula over a ten-year period (1969-1978) at the University College Hospital, Ibadan. The most common indications for pneumonectomy in this environment are TB-destroyed lung and suppurative diseases of the lung complicated by massive hemoptysis. Five of the six patients who developed these complications presented with life threatening hemoptysis due to lung abscess and pulmonary aspergillosis. The sixth patient presented with TB destroyed lung.This study shows that these complications are more common following emergency pulmonary resection for suppurative lung diseases and following the removal of the right lung. We have achieved the best results with initial closed chest tube drainage followed by continuous pleural irrigation and later by Clagett procedure or open tube drainage.
Chronic constrictive pericarditis: hemodynamic changes following pericardiectomy.
Ten patients with chronic constrictive pericarditis underwent pericardiectomy at the University College Hospital, Ibadan, from July 1977 to May 1979. Preoperatively, right heart catheterization and angiocardiography were performed in seven patients. A significant decline in mean right atrial pressure occurred intraoperatively immediately after completion of decortication. Further measurements obtained in the immediate postoperative period identified two patient groups: one group of four patients with normal pressures and no mortality and one group of five patients with abnormal pressures and three deaths.Intraoperative pressure measurement at pericardiectomy is suggested as a useful parameter in identifying those patients with "reversible" myocardial dysfunction at risk from refractory cardiac failure in the postoperative period. Restoration of normal pressure after pericardiectomy is not dependent on the duration of disease.
Oesophagomyotomy for achalasia of the oesophagus: experience at the University College Hospital, Ibadan.
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Broncho-esophageal fistula presenting as bronchiectasis in a Nigerian child.
A case is presented of a five-year-old girl with history of intermittent episodes of cough and vomiting exacerbated by eating. A diagnosis of broncho-esophageal fistula was made on barium esophagography after she failed to improve on therapy for bronchiectasis and tuberculosis over a one-year period.The diagnostic considerations and management of broncho-esophageal fistula in the Nigerian child with bronchiectasis are described.
Lung abscess: a review of three-years' experience at the University College Hospital, Ibadan.
The experience with 45 patients with lung abscess over a three-year period at the University College Hospital (UCH), Ibadan, is presented. This study confirms the rarity of this disease among Nigerian children and its prevalence in young adults in the third and fourth decades of life. The most common presenting symptoms were purulent cough, chest pain, fever, and life-threatening hemoptysis which was the sole indication for emergency operation in 14 out of 16 patients who were treated surgically. The predominance of these abscesses in the right lung, especially in the superior segment of the lower lobe, supports the fact that aspiration of infected material, following depressed level of consciousness, esophageal obstruction, foreign bodies, and oral sepsis form the major causative factors in patients with lung abscess. The frequent association of sickle cell disease, bronchiectasis, hypertension, and pulmonary aspergilloma contribute significantly to the morbidity and mortality attendant to this disease in our environment. Twenty-nine patients were treated medically with five deaths and 16 patients were treated surgically with six deaths. The high operative mortality (37.5 percent) in this series was due to the extreme emergency conditions under which these patients were operated.
Results of closed mitral commissurotomy for mitral stenosis at Ibadan.
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Pulmonary embolism in Ibadan: a clinico-pathological reappraisal.
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Pneumonectomy in Nigeria: indications and results.
This report reviews the authors' experience with 35 pneumonectomies over a ten-year period at the University College Hospital, Ibadan, Nigeria. The most common indications for pneumonectomy were TB-destroyed lung and life threatening pulmonary hemorrhage due to suppurative lung disease. Malignant tumors of the lung were featured twice as the cause for pneumonectomies in this study.Results show that until 1973, when most pneumonectomies were performed for TB-destroyed lungs, the mortality rate was nine percent, but after 1973, when more pneumonectomies were performed for life threatening hemoptysis, the mortality rose to 29 percent.From this study, it will appear that penumonectomy carries a grave prognosis when performed for suppurative lung disease, when there is active and massive hemorrhage, and when performed under emergency conditions.
Experience with bronchiectasis in Nigeria.
Between April 1975 and March 1978, 54 patients were treated for bronchiectasis at the University College Hospital, Ibadan. The sex distribution was equal and ages of the patients ranged from five to 67 years with a peak incidence of the disease in the third and fourth decades of life.One third of the patients had tuberculous bronchiectasis with destroyed left lung syndrome, another third had chronic sinusitis, while nine percent had sickle cell hemoglobinopathy. One case of Kartagener syndrome, pulmonary aspergillosis, poliomyelitis, and aspiration of a foreign body were associated with bronchiectasis.Factors influencing the clinical course and prognosis of this disease in this environment include life threatening hemoptysis, bilateral disease, associated lung abscess or empyema, malnutrition, and chronic anemia.Twenty-six patients were treated conservatively with one death, while 28 patients were treated surgically with three deaths. Twenty percent of the surgical patients developed recurrent bronchiectasis within one to 31/2 years, in lobes which were bronchographically free of disease prior to surgery. These findings suggest that bronchiectasis is a progressive disease and that elective surgery for localized disease probably does not affect its clinical and natural history in this environment.
Scimitar syndrome with associated Morgagni hernia in a Nigerian infant.
A Nigerian infant with symptoms of moderate respiratory dysfunction since birth is described. The diagnosis of the scimitar syndrome was made intraoperatively. The clinical and roentgenographic features with which the patient presented are outlined together with anatomical observations. The presence of an associated foramen of Morgagni hernia has not been reported previously.The relevant literature is reviewed, with emphasis on the preoperative diagnostic investigations essential in planning and executing appropriate surgical therapy.
Surgical management of empyema in children.
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Pattern of thoracic surgical diseases in Nigeria: experience at the University College Hospital, Ibadan.
A prospective study of 595 patients treated by the Thoracic Surgical Unit (TSU) at the University College Hospital (UCH), Ibadan between July 1975 and December 1977 was carried out to determine the pattern of thoracic surgical diseases in Nigeria and to prove or disprove the rarity of certain cardiopulmonary diseases in tropical Africa. This review shows that pyogenic infections of the lung and pleura constitute the largest percentage (38.5) of the thoracic surgical diseases in Nigeria. Although pulmonary tuberculosis accounts for only 23.4 percent of our total inpatient load, it constitutes about 60 percent of our outpatient clinic practice. Cardiovascular diseases form 12.9 percent, notably congenital and acquired valvular heart diseases. An interesting finding was the occasional association of pyomyositis with pyogenic pericarditis and empyema thoracis. This triad is being investigated. Chest trauma was the most common thoracic surgical emergency accounting for 9.2 percent of the total thoracic surgical pathology. The most common causes of dysphagia are strictures from corrosive esophagitis, achalasia, and carcinoma of the esophagus. Present experience confirms the rarity of hiatus hernia, reflux esophagitis, atherosclerotic cardiovascular disease, and, perhaps, carcinoma of the lung among Nigerians.
Examination of some processing methods for freezing boar semen.
Five experiments were conducted to examine the effect of processing methods and diluents on survival and morphology of boar spermatozoa after freezing. Post-thawing survival of spermatozoa was better for Beltsville-F3 (BF3) than for tris-fructose-EDTA freezing diluent when the seminal plasma and glycerol were removed prior to freezing (method A). Both freezing diluents yielded similar viability results when the spermatozoa were frozen in the presence of siminal plasma and glycerol (method B). Viability of spermatozoa after thawing was better when glycerol concentration in the prefreezing diluent (method A) or in the freezing medium (method B) was 2-5 and 5-0 rather than 7-5%. Cooling of diluted semen to 5 degrees C beyond 4 h decreased the post-thawing survival of spermatozoa. The proportion of spermatozoa with undamaged acrosomes after processing and thawing by different methods was indistinguishable and relatively low. When the semen was frozen at cell concentrations ranging from 0-25 to 2-0 X 10(9)/ml, the viability of spermatozoa declined with increasing concentration following freezing in BF3, and S-1 diluents. Viability results were very similar for all cell concentrations examined when tris-fructose-EDTA diluent was used, indicating the possibility of freezing boar semen in a concentrated state.
Extravascular mycotic aneurysm of the intracavernous portion of the internal carotid artery.
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Extravascular mycotic aneurysm of the intracavernous portion of the internal carotid artery.
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