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Biomedical subjects

S Nazari

Publications and source records attributed to S Nazari.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Invaginated bronchoplasty: wedge resection and sleeve reconstruction].

The purpose of this report is to illustrate a bronchoplastic technique in upper right lobectomy which is equivalent to sleeve resection but allows to preserve the unaffected portion of the bronchial wall. The technique consists in the resection of the infiltrated bronchial wall, sparing the unaffected part The distal bronchial stump is then invaginated into the stem bronchus in such a way that the anastomosis line is located at the highest possible level, ideally where it would be carried out if standard sleeve resection would be performed. The anastomosis is accomplished by U-Shaped, 3-0 vicryl sutures. The major advantage of this procedure is probably due to the preservation of the systemic artery bronchial supply to the distal stump passing through the unaffected bronchial wall; the resulting more vital distal stump may reduce incidence of suture line healing problems.

Animals↗
PubMed1996

[A device for synthesis of the costal plane after posterolateral thoracotomy using transosseous incisions to prevent compression of intercostal nerves].

The purpose of this paper is to illustrate the use of a device to quickly perform little holes in the costal lateral arch for synthesis of the standard posterolateral thoracotomy. The working principle of the instrument is similar to that of a hollow punch device. Preliminary laboratory experience allowed to identify the best diameter of the costal holes (2 mm), without fracture. Absorbable suture were passed through the holes and tied to approximate the facing ribs. The modality of costal plane synthesis, very easy and quick with this device, makes possible to prevent intercostal nerve compression and accidental intercostal vessel lacerations. The so frequent, severe and often long lasting painful sequelae of thoracotomy, on the other hand so rare in other surgical wound (i.e. laparotomy, sternotomy, etc.) justify in our opinion the routine use of this costal plane synthesis technique.

Humans↗
PubMed1995

The backflow from the pulmonary circulation for identification of the aortic origin of the bronchial arteries in experimental left single lung transplantation.

The ideal solution to the bronchial healing problems in lung transplant would be the reconstruction of the bronchial arteries at time of transplantation. The problems with this approach are essentially technical being difficult to identify and preserve the bronchial arteries in humans. The purpose of this paper is to report our experience with an experimental model in dog to easily identify and preserve bronchial circulation in single lung transplantation. The technique is based on the preservation during harvesting of the aortic origin of the first five couples of arterial orifices. Identification of the orifice(s) connected with the bronchial circulation is carried out by the backflow which takes place from the pulmonary circulation after organ reperfusion is resumed. The identified orifice(s) is then anastomosed to the descending recipient aorta, tangentially clamped.

Animals↗
PubMed1994

K-ras gene mutations: an unfavorable prognostic marker in stage I lung adenocarcinoma.

Activation of K-ras gene by point mutations, a common finding in lung adenocarcinomas, has been suggested to decrease patient survival. We investigated 109 lung adenocarcinomas, mostly small, peripheral, stage I tumours (81/109) for presence of K-ras gene mutations at codons 12 and 13. Mutations were detected by denaturing gradient gel electrophoresis analysis of specific sequences amplified by polymerase chain reaction from DNA extracted from archival pathological material. Thirty-three of 109 (30.3%) tumours showed mutations at codon 12 (28/33, 84.8%) or 13 (5/33, 15.2%) of the gene. Mutations and type of nucleotide substitutions were differently distributed among cytological subtypes, being more prevalent among less differentiated (G2 and G3) tumours and among bronchial than bronchiolo-alveolar type adenocarcinomas. Survival analysis showed an adverse effect of K-ras mutation on survival, restricted to stage I tumours. Median survival for 81 stage I patients was 30 months for non-mutated tumours versus 20 months for mutated tumours (p = 0.016). Multivariate analysis showed that age of patient (p = 0.001) and K-ras mutation status (p = 0.04) were the only independent factors influencing survival significantly. These data strengthen the hypothesis that K-ras gene mutations may be useful in identifying a subgroup of patients with poor outcome.

Adenocarcinoma↗
PubMed1993

High-frequency perfusion fluorometry (HFPF): preliminary results on a new technique for assessing bronchial mucosa blood perfusion.

A new method for estimating airway mucosa blood perfusion is proposed. It is based on the use of a high-sensitivity perfusion fluorometer, which allows us to detect the first intravascular passage of injected fluorochromes. Total measuring time can be sensibly reduced with respect to standard perfusion fluorometry, allowing us to make assessments during fiberoptic bronchoscopy. In vitro studies were performed to set up the optical arrangement of the instrument. The optimal measuring distance (2.2 mm) between the probe tip and the fluorescent mucosa was established using a fluorescent film surface to simulate fluorescent mucosa. The depth of tissue layers involved in the fluorescence emission was assessed by positioning tissue sections of different thickness between the probe tip and the fluorescent film. Tissue layers at depths not exceeding 1200 microns were found to contribute to the fluorescence signal recorded by the instrument. Mucosa blood perfusion was evaluated in rat trachea, as a model, under three different experimental conditions of vascularization: (a) basal condition (BC), (b) partial devascularization (PD), (c) full devascularization (FD). Sodium fluorescein (diffusible into the interstice) and fluorescein isothiocyanate-dextran (not diffusible into the interstice) were used as fluorescent tracers. Under the BC both substances allowed us to detect the first passage of fluorochrome through the mucosa capillary network with the same accuracy. In PD the first pass peak disappeared; total emitted fluorescence decreased as well. In FD a flat tracing was recorded. Consistent results were obtained with both substances.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Radioimmuno-guided endoscopy (RIGE) in the detection of primary and recurrent rectal tumor.

The usefulness of radioimmunoguided endoscopy in the detection of primary and recurrent rectal cancer was investigated. Of the 15 patients included in our study, 4 with suspected primary rectal cancer were examined preoperatively, while the remaining 11 were studied after radical resection of rectal carcinoma with the aim of detecting local recurrence. Radioimmunoguided endoscopy was performed employing a hand-held gamma-detecting probe (mod. 2 Oris, France), after the administration of a 111In labeled monoclonal antibody to CEA. Radioimmuno-guided endoscopy results detected the presence of primary or recurrent periluminal cancer in seven cases. In four it modified the preoperative stage based on the findings of conventional investigation and it influenced the surgical decision in five cases. No toxicity was noted and none of the patients developed HAMAs.

Adult↗
PubMed1992

[Postoperative infections. A prospective analysis of 1396 cases].

Postoperative infections are the most frequent complications in surgery and are the commonest cause of the lengthening of hospital stay. The purpose of this study is to prospectively evaluate the incidence and predisposing factors of postoperative infections in 1396 surgical patients admitted to our Institute from 1984 to 1988. Patients undergoing minor surgical procedures (wound less than 2 cm) were excluded from the study. Patients were evaluated daily during hospital stay for onset of infections and results recorded on data sheet. Hemocultures in septic patients and samples of exudate at site of infection were taken whenever possible for aerobic and anaerobic cultures. 368 patients (26.36%) had at least one postoperative septic complication; (79 of them [5.65%] had two or more infections). The following infections were recorded: wound infections: 148 (10.60%); respiratory tract infections: 144 (10.31%); urinary tract infections 125 (8.95%); miscellaneous infections 11 (0.78%); thrombophlebitis 23 (1.64%); FUO 10 (0.71%). The most important predisposing factor for wound infection was endogenous contamination (wound infections: 18/499 [3.60%] in clean, 42/594 [7.67%] in potentially contaminated, 57/217 [26.26%] in contaminated and 31/86 [36.04%] in dirty operations). The duration of the anaesthesia was found to correlate with an increased incidence of respiratory tract infections (4.49% anaesthesia less than 60 min; 7.21% anaesthesia greater than 60 less than 120 min; 15.31% greater than 120 min anaesthesia). Urinary infections were more frequent when the patients where catheterized at least once in the postoperative period (24.86% vs 3.2%).

Fever of Unknown Origin↗
PubMed1990

Successful bronchial revascularization in experimental single lung transplantation.

It is the purpose of this paper to report our experience with bronchial artery revascularization in an experimental model of single lung transplantation in swine. Thirty-three large white pigs weighing 20-40 kg underwent left lung allotransplantation. In 24 animals, bronchial artery revascularization was attempted by anastomizing the aortic patch containing the bronchial artery orifice with the recipient descending aorta. Eight survivors were put to death on postoperative days 11-15; five animals were put to death or died on postoperative days 2-9; the other animals died intra-operatively or within a few hours. Preservation of left bronchial vascularization was achieved in all cases attempted, as documented by post-mortem injection of dye (methylene blue) or contrast medium. Five of the 8 animals surviving for 11-15 days showed diffuse graft hepatization, associated with diffuse vascular thrombosis. Whether this was caused by damage to the endothelium due to poor graft preservation or by rejection was unclear. In animals surviving for 11-15 days without gross lung pathology, the anastomosis and bronchial mucosa were completely normal; in contrast, bronchial ischaemic changes were found in nonrevascularized animals and in survivors with graft hepatization. Our experience confirms that re-anastomosis of the bronchial arteries can prevent bronchial healing problems in single lung transplantation. The pig is an ideal model for these experiments since the bronchial arteries have a constant common aortic origin, allowing easy identification and preservation of left bronchial vascularization.

Anastomosis, Surgical↗
PubMed1989

Clinical experience with a new right-sided endobronchial tube in left main bronchus surgery.

Clinical experience during one-lung anesthesia using a new right-sided endobronchial tube (Portex Ltd, Hythe, Kent, UK) is reported in 148 patients with cancer of the left lung. The method allowed a reliable airtight separation of the lungs as well as right upper lobe ventilation in all cases. The new tube also allowed proper upper lobe ventilation in cases with anatomical variations of the length of the right main bronchus. The intubation technique was greatly simplified when compared with commercially available double-lumen tubes. Airway pressures and arterial blood gases were similar to those obtained with standard double-lumen tubes during one-lung ventilation. There were no complications due to the new tube system.

Anesthesia, Inhalation↗
PubMed1988

Temporary intraluminal bypass for superior vena cava reconstruction after cancer invasion.

We report a case of right upper lobe bronchogenic cancer widely infiltrating the superior vena cava (SVC) in which right pneumonectomy was performed with partial resection of the SVC wall. The SVC was reconstructed by means of a pericardial patch; during reconstruction a temporary intraluminal bypass was set up to obtain a proper venous return to the right atrium.

Blood Vessel Prosthesis↗
PubMed1988

A new method for separate lung ventilation.

Separate lung ventilation is obtained with selective intubation of the main bronchus by an appropriate cuffed tube inserted through a standard orotracheal tube. Ventilation is carried out separately through the bronchial tube on one side and the residual tracheal tube lumen on the other side. This method, used in 144 patients, greatly simplifies the technique of bronchial intubation and offers many advantages over commercially available double-lumen tubes.

Bronchi↗
PubMed1986

Selective bronchial intubation for one lung anaesthesia in thoracic surgery. A new method.

A new method for one lung anaesthesia in thoracic surgery is described. Separate lung ventilation is obtained with selective main bronchus intubation, by means of an appropriate cuffed tube inserted through a standard orotracheal tube. Ventilation is carried out separately through the bronchial tube on one side and the residual tracheal tube lumen on the other side. This method greatly simplifies the technique of bronchial intubation and offers many advantages over commercially available double-lumen tubes.

Anesthesia, Inhalation↗
PubMed1985

Effect of Intralipid on some immunological parameters and leukocyte functions in patients with esophageal and gastric cancer.

This study has been undertaken to investigate if the intravenous (i.v.) infusion of fat emulsions may be associated with impairment of some immunological functions thus increasing the risk of septic complications. Fifteen malnourished patients with advanced gastric or esophageal cancer received for 2 weeks preoperatively and 1 week after surgery an isocaloric and isonitrogenous TPN treatment with Intralipid (group A: n=8) or glucose alone (group B: n=7) as energy substrate. Cluster analysis of 11 nutritional parameters and some tests of the humoral and cellular immunity (IgG, IgM, C3c, Factor B; polymorphonuclear (PMN) cells, total lymphocytes, T and B lymphocyte counts; 'in vitro' PMN chemotaxis, adherence to nylon fibers, phagocytosis of latex particles) were sequentially determined. The incidence and severity of post-operative infections were investigated and a 'sepsis score' was calculated for each patient. Pre- and postoperative TPN were not associated with an improvement of the nutritional status. The humoral and cellular immune parameters showed the same behaviour in patients receiving Intralipid and in controls. The chemotactic activity of PMN cells was constantly normal, granulocyte adherence fluctuated below the normality range in controls, whereas phagocytosis of latex was similar in both groups. Post-operative infectious episodes were less severe in patients receiving Intralipid. Our results do not confirm that Intralipid adversely affects some aspects of the humoral and cellular immune response.

Journal Article↗
PubMed1984

Silicone rubber membrane for extraction of high vapor tension toxic substances. Experiences with ammonia and ethanol.

The purpose of this study is to evaluate the permeability of a silicone rubber membrane to two toxic substances, ammonia and ethanol, under high vapor tension. A device was assembled for testing the diffusion of the substances through a silicone rubber membrane interposed between two aqueous phases. 9 experiences were carried out with ammonia at different temperatures: 3 at 11 degrees C, 3 at 24 degrees C and 3 at 37 degrees C. 8 experiences were carried out with ethanol at different temperatures: 3 at 11 degrees C, 3 at 24 degrees C and 2 at 37 degrees C. Mean transmembrane flow (mumol/m2 X h) for ammonia was 43.99 at 11 degrees C, 59.18 at 24 degrees C and 145.45 at 37 degrees C. Mean transmembrane flow (mmol/m2 X h) for ethanol was 6.48 at 11 degrees C, 12.54 at 24 degrees C and 22.51 at 37 degrees C. The results confirm that ammonia and ethanol in water solution can pass through a silicone rubber membrane. Better results could be expected with both aqueous phases in motion as in dialysis devices.

Ammonia↗