Surgery Commons^™

Evaluating The Sensitivity Of The Nanostrong Ncounter® Analysis System To Determine Gene Expression Changes Associated With Chemotherapy Treatment, Katerina Dukleska, Md, Christopher W. Schultz, Bs, Mahsa Zarei, Phd, David Mckeown, Md, Charles J. Yeo, Md, Jonathan Brody, Phd, Jordan M. Winter, Md

Department of Surgery Posters

Introduction

• Pancreatic ductal adenocarcinoma (PDA) remains a deadly disease with a 5-year survival of 8% for all stages combined (Siegel RL et al.). Currently, it’s the third leading cause of cancer-related deaths in the United States and by 2020 it is projected to become the second leading cause (Rahib L, et al).
• The poor prognosis in PDA is in part due to the limited therapies that are currently available.
• This highlights the importance of high-throughput technologies for gene expression analyses and drug screens.
• A recently developed NanoString Technologies nCounter® analysis system, an example of high-throughput technology, utilizes a color-coded barcode …

Differential Expression Of Chemokines In A Mouse Model Of Wound Healing, Susan H. Jackman, Matthew B. Yoak, Shivaleela Keerthy, Bonnie L. Beaver

Biochemistry and Microbiology

Macrophages have a multifaceted role in wound healing. While their initial activity may be in the degradation and elimination of damaged tissue, macrophages also produce and secrete a variety of mediators that can participate in the repair process as well. To perform these functions, macrophages must be recruited to a wound site. Our purpose was to examine the temporal and spatial expression of macrophage chemoattracting cytokines (chemokines) at a surgical wound site. A surgical wound was prepared on the dorsal aspect of B6AFI/J mice. Biopsies were obtained from the wound and a comparable nonwounded area between 6 and 72 hr …

Laparoscopic Cholecystectomy At The Aga Khan Hospital, Nairobi, S. C. Patel, J. R. Bhatt

General Surgery, East Africa

Objective: To evaluate our experience of laparoscopic cholecystectomies at the Aga Khan Hospital, Nairobi over a three-year period from the inception of the technique, and to assess its value and advantages to the patients.

Design: A prospective case series study.

Setting: The Aga Khan Hospital, Nairobi.

Patients: One hundred and thirty five cases operated from February 1996 to April 1999. All patients were subjected to the American method of laparoscopic cholecystectomy, which is described in detail in this paper.

Main outcome measures: Clinical presentation, age and sex demographics, average hospital stay, intraoperative and postoperative complications and outcome.

Results: There was …

Diagnosis And Management Of The Neonatal Cloaca, A Samad, S Hussain, M Arshad, F Moazam

Department of Surgery Docs

No abstract provided.

Sirolimus-Tacrolimus Combination Immunosuppression., Vivian Mcalister, Zu-Hua Gao, Kevork Peltekian, Javier Domingues, Kamran Mahalati, Allan Macdonald

Data and Test Instruments

A series of 32 recipients of liver, kidney, or pancreas transplants who were treated with sirolimus and low-dose tacrolimus experienced a low rate of rejection and excellent graft function without drug-related toxic effects.

Canadian Medical Officers In The Royal Navy (Book Review), Vivian Mcalister

Data and Test Instruments

CANADIAN MEDICAL OFFICERS IN THE ROYAL NAVY -- WORLD WAR II. Harry Stafford Morton. 112 pp. Illust. Canadian Naval Memorial Trust, HMCS Sackville, PO Box 99000, Stn Forces, Halifax NS B3K 5X5. 2000. Can$18.00 At the beginning of the Second World War, the Royal Canadian Navy offered 90 medical officers on loan to the Royal Navy. The author was among that group, which included leaders in Canadian surgery such as Surgeon Lieutenant McLachlin of London, Ont. The history of these medical officers has not been written because it fell between histories of the Royal Canadian Navy and the Royal Navy. …

Ultrasonographic Renal Size In Individuals Without Known Renal Disease, Niels-Peter Buchholz, Farhat Abbas, Syed Raziuddin Biyabani, Qaiser Javed, Jamsheer Jehangir Talati, Masood Afzal, Imtiaz Rizvi

Section of Urology

Objective: In order to establish some preliminary data of our population, we determined the ultrasonographic kidney dimensions in individuals withoud known renal disease. We assessed whether age, sex, side, body mass index (BMI) and presence or absence of diabetes mellitus and hypertension affect the renal size.
Methods: Ultrasonographic kidney measurements were performed on 194 adult patients without known kidney lesions. Measurements included length, width, cortical thickness and estimation of renal size which was obtained by multiplying the first three variables. The effect of age, gender, side, height, weight, BNll, hypertension and diabetes mellitus was statistically analyzed.
Results: The mean kidney …

The Use Of Intra Aortic Baloon Pump In Patients Undergoing Coronary Artery Bypass Grafting At The Aga Khan University Hospital, Karachi, Aamir M. Jafarey, Muneer Amanullah, Sajid A. Khan, Sulaiman B. Hasan

Department of Surgery Docs

Objective: To review the experience in the use of Intra Aortic Balloon Pump (IABP) in patietits undergoing Coronary Artery Bypass Grafting (CABG) at a tertiary care hospital with a new Open Heart surgery program. Design: Retrospective study. Setting: The Aga Khan University Hospital, Karachi.
Patients: Medical records of all patients undergoing CABG between November 1994 and July 1997 were reviewed and those in whom IABP device was used, were included in this study.
Results: A total of 15 patients had IABP suppOrt during the study period. Four surgeries were done urgently while two were emergencies. There were three mortalities. Ejection …

Ethnic Variability In The Treatment Of Pain, Rafael A. Ortega, Benjamin A. Youdelman, Richard C. Havel

Department of Surgery Faculty Papers

Ethnicity has been shown to be an important determinant of behavior during illness, particularly when a painful condition is present. Studies have shown that pain may be undertreated among different ethnic groups of patients. Whereas individual variations in the reaction to pain occur, available data do not support racial and/or ethnic differences in the perception of pain, leaving no justification for this discrepancy in treatment. Regardless of ethnicity, inadequate treatment of pain has been known for some time and has been referred to in recent literature as "oligoanalgesia." Lack of understanding of different ethnic and cultural groups can lead to …

Spinal Cord Compression Caused By Metastatic Epithelial Myoepithelial Carcinoma Of The Parotid Gland, I N. Soomro, A S. Hussainy, K Chishti, M H. Pui, S A. Khan, R Ahmed, S H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Global Cns Gene Transfer For A Childhood Neurogenetic Enzyme Deficiency: Canavan Disease., Paola Leone, Christopher G Janson, Scott J Mcphee, Matthew J During

Department of Neurosurgery Faculty Papers

The neurogenetic prototypic disease on which we chose to test our gene therapy strategy is Canavan disease (CD). CD is an autosomal recessive leukodystrophy associated with spongiform degeneration of the brain. At present the disease is uniformly fatal in affected probands. CD is characterized by mutations in the aspartoacylase (ASPA) gene, resulting in loss of enzyme activity. In this review, recent evidence is summarized on the etiology and possible treatments for CD. In particular, we discuss two gene delivery systems representing recent advances in both viral and liposome technology: a novel cationic liposome-polymer-DNA (LPD) complex, DCChol/DOPE-protamine, as well as recombinant …

Laser Skin Graft Harvesting Apparatus And Related Method, David S. Kirn

Surgery Faculty Patents

A laser dermatome is disclosed for harvesting and meshing grafts of skin. A roller driven by a motor lifts the leading edge of a portion of skin for cutting by a beam of light generated by a laser. Adhesive tape attached to the roller aids in lifting the portion of skin and is further utilized to secure the severed portion of skin to the roller. A stage mounted atop an axle supports the laser or a beam director. The movement of the stage is controlled by second and third motors which drive the stage along or rotate it about the …

Small Bowel Strangulation As Yet Another Complication Of The Rectus Abdominis Donor Site., Geoffrey G. Hallock Md

Department of Surgery

No abstract provided.

Insulinlike Growth Factor 1- And 2-Augmented Collagen Gel Repair Of Facial Osseous Defects, James S. Toung, Roy C. Ogle, Raymond F. Morgan, William H. Lindsey

School of Medical Diagnostics & Translational Sciences Publications

BACKGROUND: Defects of the facial bone structure are common problems for the facial plastic surgeon. Native type 1 collagen gels (T1CGs) have been shown to mediate repair of facial critical-size defects in rat models.

OBJECTIVE: To evaluate the efficacy of T1CG augmented with insulinlike growth factor (IGF) 1, IGF-2, and a combination of IGF-1 and IGF-2 on the repair of facial critical-size defects in a rodent model.

METHODS: Twenty-four retired male breeder Sprague-Dawley rats were divided into 4 groups of 6 animals. Facial critical-size defects were created by removing the nasalis bones with a bone-cutting drill. Defects were treated with …

Portocaval-Right Atrial Shunt, Bradley B. Hill

Surgery Faculty Patents

A shunt includes a tubular body having first and second legs at a proximal end and a third leg at a distal end. A fluid distensible balloon and cooperating insufflation conduit are carried on the tubular body. The first leg of the tubular body includes a longitudinal slit for receiving the second leg whereby the first and second legs may be positioned substantially coaxial so as to allow easier introduction of the shunt into the blood vessel of a patient. Similarly, the second leg having a longitudinally slit for receiving a portion of the cooperating insufflation conduit and also holding …

Trauma Outcome: Review Of Results In Urban Hospital In Southern Pakistan, Hasnain Zafar, Fuad Abid, Asad Jamil Raja, Mushtaq Ahmed, Faheem Nanajani, Yousuf Kamal Mirza

Section of General Surgery

No abstract provided.

Adenoma Of The Ampulla Of Vater: A Genetic Condition?, Francesco M. Serafini, Larry C. Carey

Surgery Faculty Publications

The etiology of adenoma of the ampulla of Vater is not well understood. Previous authors reported the association of this neoplasm with polycystic kidney disease of two fraternal sisters. They concluded that these two conditions were somehow related. We describe a case of ampullary adenoma associated with polycystic kidney disease. This presentation raises again the question of a possible link between these two diseases.

Anti-Bacterial Effect Of Hvpc In Vivo, Marc Campolo

Seton Hall University Dissertations and Theses (ETDs)

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Needle Localization For Breast Biopsy: The Patient's Experience, Marian De Walt Morgan

Psychology Theses & Dissertations

The needle localization procedure for breast biopsy (NLP) can be painful and distressing for some women. This study was carried out to learn what factors might increase or decrease NLP pain and distress, and to gain insight into possible interventions to make the procedure more comfortable for all patients. One hundred and thirty-eight women were surveyed following breast needle localization at two central Virginia hospitals. The influence of eight variables (lidocaine, self-regulation, anxiety, worry about breast cancer, breast tenderness, finding mammography painful, difficulty with surgery, and distress of blood drawing) on four outcome variables (pain incidence, pain intensity, pain unpleasantness, …

Moyamoya Disease Presenting With Intracranial Haemorrhage, Ali Akbar, Aftab Qureshi, Rashid Jooma

Section of Neurosurgery

No abstract provided.

Preoperative Work Up: Are The Requirements Different In A Developing Country?, K M. Pal, I A. Khan, B Safdar

Department of Surgery Docs

In developing countries there is a tendency to advocate routine testing in asymptomatic healthy patients to identify undocumented significant medical conditions. A retrospective review of pre- operative laboratory investigations undertaken in patients attending the General Surgical department was performed. Three hundred and twenty patients case notes were reviewed, patients were selected on the basis of common general surgical procedures. Two hundred and sixteen patients (67.5%) did not have any associated medical illness on history and physical examination. Analysis of laboratory results showed that 42/216 (19.4%) had low hemoglobin. An abnormal chest X-ray was the next common abnormality 11/103 (10.6%). Mild …

Posttransplant Recoarctation Of The Aorta: A Twelve Year Experience., Girish S. Shirali, C E. Cephus, M A. Kuhn, K K. Ogata, L K. Vander Dussen, R E. Chinnock, N F. Mulla, J K. Johnston, L L. Bailey, S R. Gundry, A J. Razzouk, R L. Larsen

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: This study was undertaken to investigate the incidence of posttransplant recoarctation of the aorta, delineate the mode of presentation, identify risk factors that predict recoarctation and examine the results of intervention for posttransplant recoarctation.

BACKGROUND: Patients with aortic arch hypoplasia require extended arch reconstruction at transplant, with an inherent possibility of subsequent recoarctation of the aorta.

METHODS: This was a retrospective review of all children (ageyears) who underwent cardiac transplantation over a 10-year period. Collected data included pretransplant diagnosis, details of the transplant procedure and posttransplant data including development of recoarctation of the aorta, interventions for recoarctation and the …

Dobutamine Stress Echocardiography For Assessing Coronary Artery Disease After Transplantation In Children., R L. Larsen, P M. Applegate, D A. Dyar, P A. Ribeiro, S D. Fritzsche, N F. Mulla, Girish S. Shirali, M A. Kuhn, R E. Chinnock, P M. Shah

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: The purpose of this study was to determine the feasibility, safety and diagnostic accuracy of dobutamine stress echocardiography (DSE) for evaluating posttransplant coronary artery disease (TxCAD) in children, and to determine the frequency of selected cardiac events after normal or abnormal DSE.

BACKGROUND: Posttransplant coronary artery disease is the most common cause of graft loss (late death or retransplantation) after cardiac transplantation (CTx) in children. Coronary angiography, routinely performed to screen for TxCAD, is an invasive procedure with limited sensitivity. The efficacy of DSE for detecting atherosclerotic coronary artery disease is established, but is unknown in children after CTx. …

Appendicitis: A Continuing Challenge, K M. Pal, A Khan

Department of Surgery Docs

Acute appendicitis is a common surgical emergency in urban setting, of a developing country. The computerised hospital patient database at Aga Khan University Hospital, Karachi, was utilised to obtain records of all adults with a histologically proven diagnosis of acute appendicitis. A review of patients treated over a 18 month period was undertaken. One hundred and three appendicectomies were performed for acute appendicitis during this period. The diagnosis was clinical in all cases. Investigations like leucocyte count and lower abdominal ultrasound scan were used to improve diagnostic accuracy without a clear advantage. A number of routine investigations like, haemoglobin estimation …

Hydatidosis: Experience With Hepatic And Pulmonary Hydatid Disease, T Pishori, R Azami, S M. Ali

Department of Surgery Docs

From 1989-1992, 35 cases comprising of 20 hepatic and 15 pulmonary hydatid cysts were seen. Four patients with pulmonary hydatid disease had previous or concomitant hepatic hydatidosis compared to no concomitant pulmonary hydatid disease in the hepatic group. Hepatic hydatid disease had a greater tendency to be right sides, infected and calcified. Anaphylactic reactions occurred in 3 of 20 patients with hepatic hydatid disease against none in 15 patients with pulmonary disease. Management consisted of evacuation, drainage and obliteration of the residual cavity by capittonage in the lung and omentoplasty in the liver. Two patients, one hepatic and one with …

Angled Snare Assembly, Bradley B. Hill

Surgery Faculty Patents

A snare assembly includes an outer, flexible sheath having a distal opening and a loop received for relative sliding movement with respect to the sheath. The loop has a proximal end and a distal end. The loop is formed from a resilient wire and includes a substantially 180° reverse bend at a midpoint forming the distal end and the ends of the wire are fastened together at the proximal end. A control handle is carried on the sheath for extending and retracting the loop out of and into the sheath through the distal opening. A flexible connector connects the control …

Primary Spinal T-Cell Rich B-Cell Lymphoma: A Case Report, Suhail Muzaffar Suhail Muzaffar, Irshad Nabi Soomro, Naila Kayani, Shahid Siddiqui, Yousuf A. Husein, Rashid Jooma

Department of Pathology and Laboratory Medicine

No abstract provided.

Acquired Arterio-Venous Fistula With Mycetoma: Two Entities Coinciding: A Case Report, Saldar Nasim Khan, Nabil Wasif, Masood Umar, Mohamrnad Umar

Section of Orthopaedic Surgery

No abstract provided.

Open Fractures Caused By High Velocity Missiles: The Outcome Of Treatment Of 39 Fractures Followed For 1-3 Years, M A. Khan, R Hussain, S H. Khan, M Umar

Department of Surgery Docs

Between 1993 and 1995, thirty-three patients having 39 fractures caused by missiles fired from a high velocity rifle were reviewed retrospectively between 1 and 3 years after injury and the outcome of treatment assessed. Majority (33 out of 39) were Grade III. Union was achieved in 35 out of 39 fractures, there was deep infection and delayed union in one case each. Non-union occurred in three fractures. The fractures were stabilized using different techniques, but highest complication rate was seen with the use of the static external fixator. This was related to the severe nature of the injury as well …

The Optimal Fontan Connection: A Growing Extracardiac Lateral Tunnel With Pedicled Pericardium., S R. Gundry, A J. Razzouk, M J. Del Rio, Girish S. Shirali, L L. Bailey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The concept of a lateral tunnel for the Fontan operation is now widely accepted. Most lateral tunnels are constructed intraatrially with the use of aortic crossclamping. Construction of extracardiac lateral tunnels with the use of homografts or other nonviable tubes eliminates aortic crossclamping but lacks growth potential in length or width. The native pericardium, which is "sealed" posteriorly along the pulmonary artery, atrium, and inferior vena cava, could be turned down onto the right atrium to form a viable extracardiac lateral tunnel.

METHODS: We designed and successfully constructed extracardiac lateral tunnels using viable autologous pericardium, pedicled on its lateral …