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Biomedical subjects

S Ariyan

Publications and source records attributed to S Ariyan.

At least 127 records · Page 7Linked to original sources
PubMed1976

Cholecystitis and cholelithiasis masking as abdominal crises in sickle cell disease.

A case of sickle cell (HbSS) disease is presented in a patient with a history of recurrent admissions for abdominal pain, jaundice, and abnormal liver function tests. Although he was believed to have a sickle cell abdominal crisis, his abdominal X-ray films revealed three calcified stones. Each of these stones progressively passed through the common duct and into the duodenum while awaiting surgery. He has been followed for two years since his cholecystectomy without further hospitalizations. This case led to the investigation of cholelithiasis in sickle cell disease to dispel the following misconceptions. Some physicians and pediatricians believe that (1) cholelithiasis and cholecystitis are uncommon in sickle cell disease; (2) the complications of gallstones are not significant; (3) the operative risk in patients with sickle cell disease is high; (4) these patients with HbSS disease do not live long enough to get into trouble with gallstones. A review of the literature on cholelithiasis and HbSS disease presents adequate evidence to cause us to urge investigation of the gallbladder in all patients with HbSS disease and abdominal crises, and cholecystectomy as an elective procedure should stones be present.

Adolescent↗
PubMed1975

The hepatorenal syndrome: recovery after portacaval shunt.

Reversal of the morbid hepato-renal syndrome has been achieved in a cirrhotic patient with ascites following successful side-to-side portacaval shunt. The hepatorenal syndrome is defined as progressive unresponsive renal failure with previously normal kidneys in the presence of impaired hepatic function. Although the etiologic mechanism has not been defined, it is suggested the relationship of increased intrahepatic sinusoidal pressure on the thoracic duct and subsequent decreased lymph flow are interrelated to increased levels of aldosterone and manifested by (chylous) ascites. Laboratory and clinical evidence suggest that cirrhotics with ascites have remarkably high levels of aldosterone secretion via the rennin-angiotensin-adrenal cortex mechanism. This is the group that develops hepatorenal syndrome. Reduction of the intrahepatic pressure and decompression of the portal hypertension can be successfully achieved with a side-to-side shunt which should return the aldosterone-rennin-angiotensin axis to normal and subsequently reverse the hepatorenal syndrome.

Acute Kidney Injury↗
PubMed1975

Successful treatment of hepatic artery aneurysm with erosion into the common duct.

A patient with an hepatic artery aneurysm is presented with preoperative angiographs, and intra-operative photographs demonstrating erosion and fistulazation into the common duct. The aneurysm was ligated and excised, and the erosion of the common duct was treated successfully with a Roux-en-Y choledochoduodenstomy. This is the fourth case with erosion into the common duct to be treated successfully by surgery. The other three cases are discussed. A review of the literature reveals that hepatic artery aneurysms are rare, and successful treatment is based on several different techniques. Ligation of the hepatic artery, with or without excision of the aneurysm, is discussed as a method that may in fact be the safest treatment in a group of patients who because of their disease are already in a high risk category.

Aged↗
PubMed1975

The role of BCG vaccination in producing tumor immunity. An experimental study.

A transplantable hamster lymphoma was investigated to determine the role of BCG-immune macrophages in killing tumor cells. The suppression tumor cell growth was tested by the transfer of different combinations of lymphoid and tumor cells into 162 normal inbred (LHC) hamsters. The results demonstrated that the transfer of a combination of BCG-immune macrophages and tumor-immune lymphocytes to normal hamsters suppressed the growth of these tumor cells. We suggest that immunization with BCG increases the killing potential of macrophages, and that tumor-immune lymphocytes may cause these "activated" macrophages to release their toxic enzymes to cause necrosis of adjacent tumor cells.

Animals↗
PubMed1975

Tropical ulcers.

We review 230 cases of tropical ulcers, includied reports of 7 cases with squamous cell carcinoma. We think the etiology may be a combination of the hot, humid environment, trauma, local infection, and malnutrition. Agressive treatment of these ulcers is advocated, to heal the wounds and to prevent malignant transformation.

Adult↗
PubMedDate not supplied

Myocutaneous flaps for head and neck reconstruction.

The recent development of myocutaneous flaps has ushered in an era of one-stage reconstructions, which have changed the patterns of surgery for head and neck cancer. This article reviews the development of these flaps and the clinical applications at various sites of the head and neck. Personal experience with 31 consecutive myocutaneous flaps confirms the versatility and reliability of these new techniques.

Head and Neck Neoplasms↗
PubMedDate not supplied

Facial fractures: Hippocratic management.

Hippocrates, the famous Greek physician of the fifth century B.C., is considered to be the "Father of Medicine." Little, however, is known about his principles for the management of facial trauma. In this article, the Manuscripts in Ancient Greek, which deal with the management of mandibular fractures and dislocations, and with nasal and midfacial fractures have been translated and discussed. Hippocrates' methods for reducing mandibular dislocations and treating fractures of the mandible by wiring the teeth and immobilizing the jaw are described. His technique of closed reduction and immobilization of deviated nasal fractures with internal packing and rigid dorsal splints remains timeless. Hippocrates has taught us how to achieve medical wisdom through accurate clinical observation and practical creative ideas. The discovery of x-rays and antisepsis only furthered his established sound principles for the management of facial trauma.

Facial Bones↗
PubMedDate not supplied

Cranioplasty with a silicone prosthesis and split rib grafts.

A method to reconstruct visible cranioplasty defects involving the anterior cranium with the durability of bone and the exacting contours of the custom silicone implant is described. This technique is simple, quick, and does not require intraoperative assessment of subtle contours. The patient has a rigid underlying bony support with a perfectly contoured external surface. In patients with cranioplasty involving the cranium anterior to the hairline, we take advantage of both split rib grafts and a silicone prosthesis in one stage to obtain optimal results.

Adult↗