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Biomedical subjects

S Nissan

Publications and source records attributed to S Nissan.

At least 37 records · Page 2Linked to original sources
PubMed1986

Persistent müllerian structures in infertile male.

Müllerian duct derivatives were identified in an infertile adult male patient who had long-standing azoospermia and was operated on for inguinal hernia. Persistent müllerian duct syndrome is reviewed, with special emphasis on the pathophysiologic and surgical considerations involved in the treatment of this abnormality.

Adult↗
PubMed1986

Nerve mediated responses to drugs and electrical stimulation in aganglionic muscle segments in Hirschsprung's disease.

The activity of isolated muscle strips from normal and aganglionic human large bowel was studied in vitro. The intrinsic nerves were stimulated electrically and by nicotinic agonists. The ganglionic preparations displayed a strong inhibitory response due to the release of both norepinephrine and a noncholinergic, nonadrenergic inhibitory neurotransmitter. In the aganglionic strips (obtained from patients with Hirschsprung's disease), nerve activation tended to evoke contraction, apparently due to enhancement in the release of acetylcholine. At the same time, the release of norepinephrine appeared to be less than normal. A particularly interesting finding in the aganglionic muscle strips was the presence of a substantial inhibitory response due to the release of a noncholinergic, nonadrenergic substance. These results provide further evidence for the importance of the innervation of the aganglionic segment in Hirschsprung's disease.

Child↗
PubMed1986

Bilateral congenital posterolateral diaphragmatic hernia.

A female neonate with bilateral congenital posterolateral diaphragmatic hernia is presented. The correct diagnosis was established only after repair of the left hemidiaphragm. Repair of the right hemidiaphragm failed to prevent a downhill course with progressive respiratory failure which led to her death. This extremely rare anomaly is discussed in view of the complex embryological development of the diaphragm.

Diaphragm↗
PubMed1986

Brain abscess: a complication of oesophageal dilatations.

A 16-month-old boy underwent oesophageal dilatations following an unsuccessful attempt to locally resect a 3 cm long lye stricture. He then developed a brain abscess which was surgically drained. Subsequently, a right colon interposition was performed to bypass the stricture. Following oesophageal dilatations, bacteraemia and fever are common but the occurrence of metastatic brain abscesses is rare. This serious complication should be kept in mind when long-term treatment by repeated oesophageal dilatations is planned.

Brain Abscess↗
PubMed1986

Abdominal actinomycosis.

Abdominal actinomycosis seldom occurs before puberty. The symptomatology of abdominal actinomycosis is non-specific and the diagnosis is difficult to make. Previously, this condition was associated with a high mortality rate. The following patient had a flank abscess due to actinomycosis as a late complication of perforated appendix which was diagnosed by biopsy and culture. The patient responded to a prolonged course of chemotherapy with intravenous penicillin and metronidazole. This case illustrates the problems encountered in the diagnosis and management of childhood actinomycosis.

Abscess↗
PubMed1986

Effects of serotonin on the internal anal sphincter: in vivo manometric study in rats.

The effects of serotonin (5-hydroxytryptamine, 5-HT) on the internal anal sphincter were studied in anaesthesized rats. Serotonin induced a dose dependent relaxation of the internal anal sphincter. Methysergide blocked this relaxation, but did not affect the rectoanal reflex. Methysergide did not antagonise the actions of cholinergic and adrenergic agonists on the internal anal sphincter. Other 5-HT antagonists such as cyproheptadine, ketanserin, chlorpromazine, amitriptyline and ergotamine failed to reduce or block the internal anal sphincter relaxation due to 5-HT, nor did they alter the rectoanal reflex. Adrenergic and cholinergic antagonists had no effect on the 5-HT-induced relaxation of the internal anal sphincter, suggesting that 5-HT acts upon the internal anal sphincter via a non-adrenergic, non-cholinergic mechanism. Tetrodotoxin reduced or blocked the relaxation of the internal anal sphincter produced by 5-HT, implying that 5-HT acts through neural pathways rather than directly on the muscle. It is concluded that although 5-HT relaxes the internal anal sphincter, it does not participate in the rectoanal reflex.

Anal Canal↗
PubMed1985

Cardiac assessment by first-pass angioscintigraphy in conjoined thoracopagus twins.

Dynamic computerized heart studies using 99Tc-DTPA demonstrated a joined heart in conjoined thoracopagus twins. In the case presented, the electrocardiogram, dynamic radioactive study, and the cardiac catheterization all gave basically the same results and correlated well with the postmortem examination. The dynamic study is presented in detail, stressing its advantage as a noninvasive and reliable procedure in the primary cardiac assessment of conjoined twins.

Cardiac Catheterization↗
PubMed1985

The surgical management of children with familial dysautonomia.

Familial dysautonomia (FD) is a rare incurable genetic disorder with multisystem involvement. Most of its clinical manifestations are related to disorders of the autonomic nervous system. The disease is associated with specific disturbances of the upper gastrointestinal tract: pharyngoesophageal dyskinesia, gastroesophageal reflux, and prolonged gastric emptying. About 40% of the dysautonomic children manifest repeat vomiting crises. In view of the extensive gastrointestinal symptomatology, children with FD are prone to repeated aspiration pneumonia and chronic respiratory failure, while inadequate calory and fluid intake may lead to a chronic state of hypovolemia and severe failure to thrive. Control of vomiting, prevention of aspiration due to abnormal swallowing, and the assurance of adequate calory intake are three major objectives in the treatment of the dysautonomic child. Medical treatment of the gastrointestinal disorders using different drugs has had limited success. This study reviews the surgical experience in ten children with FD. The type of the procedure used was determined by the severity of the upper GI disturbances. Nine children underwent gastroesophageal Nissen fundoplication and gastrostomy. In seven of them, a pyloroplasty was added. Gastrostomy alone was done in one patient only. Postoperative complications included transient dysphagia in four patients, gastric dilatation in four patients, and dumping syndrome in one. There has been no incidence of immediate postoperative death. One child died 6 months after operation from severe and irreversible respiratory failure. Following operation, the patients still suffered from dysautonomic crises but these were not associated with vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Hypoganglionosis of the myenteric plexus with normal Meissner's plexus: a new variant of colonic ganglion cell disorders.

A 16-year-old girl with a history of achalasia of the lower esophagus was investigated for progressive constipation since the age of five years. Normal ganglion cells of the Meissner's plexus were found in a mucosal rectal biopsy. Manometric studies showed absence of the normal rectosphincteric relaxation reflex. A long posterior rectal myectomy was performed in which no ganglion cells were found between the muscular layers. The patient underwent a rectosigmoid resection with a low anastomosis according to Duhamel. In the resected bowel, a normal Meissner's plexus was again found while marked hypoganglionosis of the myenteric plexus was evident. Intranuclear inclusion bodies in Schwann cells and scattered inflammatory cells were noteworthy. This case may be an example of an acquired hypoganglionosis localized to the myenteric plexus.

Adolescent↗
PubMed1985

Animal model for the study of internal anal sphincter activity.

This paper describes a simple and reliable model for studying the internal anal sphincter (IAS) in the rat. The activity of the sphincter was recorded by a two-balloon system. The compliance of the balloon allowed measurements of pressure changes lower than 0.1 cm H2O. The anatomical and physiological characteristics of the rat IAS were found to be in many aspects similar to those found in the human. The rectoanal reflex in the rat consists of relaxation followed by contraction. The threshold for this response is 0.4-0.6 ml of air. The response of the IAS to prolonged rectal distension showed adaptation in 50% of the animals. Intraarterial application of drugs produced rapid, dose-dependent and reproducible effects on the IAS. The results described in this work show that the rat is a useful and convenient model for studying anal function. It may be used to investigate both the physiology and pharmacology of the IAS activity.

Adaptation, Physiological↗
PubMed1985

Strangulated congenital diaphragmatic hernia in infants.

Two previously healthy children, 7 and 12 months old, respectively, presented with respiratory distress and severe sepsis. Chest x-rays were suggestive of inflammatory disease of the left lung. At operation, necrotic bowel was found to be herniated through a left congenital posterolateral diaphragmatic hernia. These patients illustrate the difficulty in establishing the diagnosis of strangulated congenital diaphragmatic hernia and the grave consequences when operation is delayed.

Age Factors↗
PubMed1985

Corrosive injury to the stomach due to acid ingestion.

Ingestion of acid often causes severe damage to the stomach. Ingestion of alkali, however, usually injures the esophagus and spares the stomach. Early complications of acid ingestion, e.g., massive gastric hemorrhage or perforation, are unusual. The absence of severe symptoms in most patients soon after ingestion of acid is often misleading. Gastric outlet obstruction is a common late result and may develop following an asymptomatic interval. The authors' experience with three patients with severe complications following ingestion of acid is presented. The initial treatment, as well as the surgical management, are discussed.

Adult↗