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Biomedical subjects

S Hussain

Publications and source records attributed to S Hussain.

At least 145 records · Page 8Linked to original sources

Does standing up improve the predictive value of the supine pressor test for gestational hypertension?

Fifty-six primigravid women at 28-32 weeks' gestation were studied prospectively to compare the roll-over test with the stand-up pressor test in the prediction of gestational hypertension. Blood pressures were measured in the different positions continuously using an automated machine. Twenty patients developed gestational hypertension; two of these were accurately predicted by roll-over test and six by stand-up pressor test (P less than .001). However, there was no significant difference between the tests in the rates of false negatives, specificity, and negative and positive predictive values. Concomitant measurement of blood pressures in the standing position may increase the sensitivity of the roll-over test for the prediction of gestational hypertension.

Adolescent↗

Interposition of extensor digitorum tendon in distal radius fracture mimicking a compartment syndrome.

A 14-year-old boy sustained a dorsally displaced Salter-Harris Type II fracture of the distal radius. A single attempt at closed reduction failed. After this closed reduction, the patient was unable to passively or actively extend or flex his fingers. He had increasing pain and compartment pressures were abnormally elevated. Dorsal fasciotomy was done, and during the open reduction, entrapment of the dorsal extensor retinaculum and extensor digitorium communis within the fracture was found. After removal of these structures, fracture reduction was easily accomplished and his fingers had a full range of motion. Postoperative recovery was uneventful.

Adolescent↗

Host response to autologous endothelial seeding.

Dacron and expanded polytetrafluoroethylene grafts, seeded with autologous venous endothelial cells at the time of implantation, subsequently develop endothelial linings. However, it has not been shown whether the endothelial cells in these linings are derived from the seeded cells, or whether the seeding process itself stimulates host endothelial cells to proliferate and cover the grafts. As a first step in testing this hypothesis, bilateral end-to-side aortoiliac expanded polytetrafluoroethylene grafts with an internal diameter of 6 mm, an internodal distance of 22 microns, and an average length of 9.2 cm were placed in 10 adult mongrel dogs weighing 20 to 25 kg; the aorta was ligated just distal to the origin of the grafts. The graft on one side, chosen at random, was seeded with autologous endothelium that was harvested by enzyme single-stage technique from external jugular veins; the other side was not seeded. After 4 weeks the animals were anesthetized and heparinized, and the grafts were fixed by perfusion in vivo with 2.5% glutaraldehyde solution before they were removed. Both grafts occluded in two animals, and both grafts were patent in five animals. In two animals the seeded grafts were open and the unseeded grafts were occluded. In one the seeded graft was occluded and the unseeded graft was patent. There was no significant difference in clot-free surface area between seeded (29% +/- 18%) and unseeded (31% +/- 11%) grafts. Scanning electron microscopy showed the presence of an endothelial monolayer that averaged 39% +/- 20% and 36% +/- 26% coverage, respectively, in the clot-free midgraft portions of all seeded and unseeded patent grafts.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗

Penetrating atherosclerotic ulcers of the thoracic aorta.

Penetrating ulcer of the thoracic aorta is defined as an atherosclerotic lesion of the descending thoracic aorta with ulceration that penetrates the internal elastic lamina, allowing hematoma formation in the media. There is controversy whether this lesion differs from classic acute type III aortic dissection, based on its location, radiographic findings, natural history, and recommended therapeutic approach. Of 47 patients with a diagnosis of aortic dissection seen at our hospital during a 2-year period, five patients had clinical and radiographic findings of penetrating ulcer. Each of the five patients had characteristic computerized tomographic (CT) findings and two patients had angiographic confirmation. In all patients CT showed subintimal hemorrhage, aortic wall enhancement, absence of a double lumen, and contrast extravasation through the ulceration. In both patients who underwent angiography, ulceration, subintimal hematoma, and absence of a false lumen were demonstrated. The clinical presentation in four patients simulated acute aortic dissection or expanding thoracic aneurysm. The other patient, who was normotensive, did not have symptoms referable to the thoracic aorta but was studied because of an abnormal chest x-ray film. None of these five patients required surgical intervention. All five patients were alive and free of symptoms at 6 months, 8 months, 14 months (two patients), and 30 months after the original diagnosis. Follow-up CT scans in four patients showed resolution of subintimal hematoma and some dilatation of the lumen but no progression to rupture or aneurysm. Other authors stress the importance of differentiating symptomatic penetrating atherosclerotic ulcers from acute type III aortic dissection because of the higher incidence of rupture of penetrating ulcers and therefore recommend early surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

The effect of tumor size and axillary lymph node metastasis on estrogen and progesterone receptors in primary breast cancer.

We evaluated the estrogen receptors (Er) and the progesterone receptors (Pr) in 209 female patients with primary breast cancer. There is statistically a very highly significant negative correlation between the size of the tumor and the Pr (p = 0.007); large tumor contains low Pr. The same correlation was found with Er, but it was not statistically significant (p = 0.40). There is also a negative correlation between the number of axillary metastatic lymph nodes and Er and Pr, but this was not statistically significant.

Axilla↗

CT diagnosis of adrenal abnormalities in patients with primary non-adrenal malignancies.

Fifty-seven patients with primary non-adrenal malignancy were found to have unsuspected adrenal abnormality on CT. In 33, comparison of histopathologic findings and/or the patients' hospital course or follow-up lead to the diagnosis of adrenal metastases (23), benign non-functioning adenomas (7), metastasis with hyperplasia (1), benign hyperplasia (1), and fatty infiltration (1). The analysis of CT findings indicated that: I) A heterogeneous adrenal mass showing contrast enhancement was always metastatic, II) Nonfunctioning adenomas were always 3 cm or smaller in diameter, III) Bilateral adrenal masses and growth of adrenal mass on follow-up CT or regression on treatment indicated metastases, and IV) metastatic disease could not be excluded purely on the basis of the size of the adrenal mass.

Adrenal Gland Neoplasms↗

Ultrasonography of pancreatic schistosomiasis: a case report.

A 10 year old girl presented with fever, pain, anaemia, hepatosplenomegaly and eosinophilia. No schistosomal ova were found on stool examination. Abdominal ultrasound revealed a mass in front of the portal vein conforming to the shape of an enlarged pancreas. Laparotomy revealed a firm, granular, whitish mass involving the pancreas. Examination of biopsy samples showed granulomata of Schistosoma mansoni in the pancreas, liver and lymph nodes. The patient responded to therapy with oxamniquine.

Child↗

Incidentally discovered mass of the adrenal gland.

Increasing numbers of asymptomatic masses of the adrenal gland are being discovered by high resolution computed tomography (CT) scanning. The significance of these masses and the question of further evaluation or treatment, or both, have posed a dilemma. From 1976 to 1983, an incidental finding of adrenal gland mass was identified in 88 patients undergoing abdominal CT scanning for unrelated problems. Adrenelectomy was performed upon 23 patients (26 per cent), including three adenomas (2.5, 3.0 and 6.5 centimeters), five carcinomas of the adrenal gland (6 to 20 centimeters), two hyperplasias and three adenocarcinomas of unknown origin. Thirty-eight (43 per cent) of the nonfunctioning masses were observed with repeat scans for an average of 25.1 months (three to 60 months), revealing no change in size. Twenty-seven patients (31 per cent) were lost to follow-up study. Silent primary (nonmetastatic) masses 3.5 centimeters or less manifested benign behavior without exception. Based upon these data, we conclude that all solid metabolically inactive lesions in the adrenal glands greater than 3.5 centimeters on CT abdominal scan deserve exploration. Lesions less than 3.5 centimeters may be safely followed with serial CT scans.

Adenocarcinoma↗

The effect of age on estrogen and progesterone receptor in primary breast cancer.

We evaluated the estrogen receptors (Er) and progesterone receptors (Pr) in 228 female patients with primary breast cancer by Dextran-Charcol method. Their ages vary from 30 to 91 years. Mean age 60.7 years. (SD: 13.6 years). Er mean was 70.31. (SD:103); there exists a statistically significant correlation between age and Er at p less than .001; older patients have higher Er. Pr mean was 60.73, (SD:128). There is statistically significant correlation between age and Pr at .01 less than p less than .025; older patients have higher Pr. There is also very statistical significant correlation between Er and Pr at p less than 0.1; when Er is high Pr is high.

Adult↗

Long-term ureterostomy with suprapubic intravesical drainage used to bypass severe schistosomal obstructive uropathy--preliminary report.

Severe obstructive uropathy due to infection with S. hematobium often requires reconstructive surgery. Recent reports, have emphasized that many lesions will disappear after specific chemotherapy given the necessary time. Time for effective chemotherapy may be impossible to allow in severe obstruction. The necessary surgical procedures range from ureteric dilatation to ureteric resection with ileal loop replacement. We suggest that temporary long-term bypass of the diseased ureter using silastic tubes may offer an alternative to resection in many cases while the effect of specific chemotherapy is awaited. One case is described in which ureterostomy with suprapubic intravesical drainage adequately bypassed the diseased and obstructed lower two thirds of the left ureter. In the following six months specific chemotherapy had encouraging effects on the bypassed area.

Adult↗

Differentiation of malignant from benign adrenal masses: predictive indices on computed tomography.

CT findings in 43 adrenal masses were analyzed to see which features correlated most significantly with malignancy. Size, contrast enhancement, and consistency emerged as important discriminators of malignant from benign adrenal masses. These three factors were further analyzed by logistic regression technique to examine the joint influence of computed tomographic (CT) features in prediction of malignancy. As a result of logistic regression analysis, a table of estimated probability of malignancy as a function of tumor size alone and another table of estimated probability as a joint function of size and contrast enhancement were developed. Given a similar patient sample and by using the data given, it would be possible to predict chances of malignancy in an adrenal mass if its CT features are known; for example, a 5-cm adrenal mass without enhancement has a 0.31 probability of malignancy; with enhancement, a 0.68 probability.

Adenoma↗

Diagnostic criteria of hydatid disease on hepatic sonography.

Ultrasound findings in 31 patients proven to have hydatid disease of the liver are presented. Four distinct patterns are described: a single spherical cystic area; a flattened, spherical, cystic area; the appearance of a cyst within a cyst; and a complex cystic mass. In 21 cases (68 per cent), previously described pathognomonic appearances are encountered. The presence of an echogenic rim usually suggests hydatid infestation; however, it may also be seen in an amebic liver abscess. Delineation of daughter cysts within the complex internal echoes is diagnostic of an infected hydatid cyst.

Echinococcosis, Hepatic↗