Experience with the management of mesenteric aneurysms

Mesenteric artery aneurysms represent a rare but very interesting clinical entity. Despite their rarity they comprise a challenging vascular problem as regards diagnosis and treatment. We have managed six mesenteric anuerysms, four involving the SMA and the other two involving the IMA. There were five males and one female patient. The presentation included acute abdominal pain in four cases, haematemesis in one case and abdominal mass in the remaining aneurysm. Surgical treatment was carried out in all six including ligation of the two IMA aneurysms, as well as two SMA aneurysms. Reconstruction was performed in the remaining two SMA aneurysms. Surprisingly, no complications [apart from ARDS in one patient] were recorded in all six cases

effect of population density food level and competition on growth and metamorphosis in larval Egyptian toad, bufo regularize

Growth and metamorphosis of Bufo regularis tadpoles under two levels of population density, two levels of food and with or without competitors [the green toad, Bufo viridis] were investigated using a replicated pond system. High food supplements accelerated growth with or without competitors. The presence of competitors depressed growth, even under conditions of high food. Also, the larvae grew much better under conditions of low population density than high one in either high or low food levels with or without competitors. The tadpoles raised under high food metamorphosed earlier than those raised under low one. Survival was variable within treatments, and also was highest in high food levels. Field observations as well as laboratory treatments with competitors revealed that B. viridis commenced metamorphosis and left water before B.regularis

Pollution of ground water by mercury and its residues in chicken tissues

The aim of this study was to investigate the relationship between mercury concentration in well water and its residues in chicken tissues in particular areas of Abees, Alexandria Governorate. The concentration of mercury in ground water, beside in liver, kidney, muscle tissues and blood samples of 12 chickens from four poultry production farms was estimated using atomic absorption spectrophotometer. The highest mercury concentration levels were observed in the kidney followed by the liver in detectable levels samples. The level of mercury in ground water was undetectable of 81 micro g/L. There is no doubt that the relationship of mercury accumulation levels in kidney and those in liver tissues were proportionally correlated. The rate of mercury accumulation is independent of the intake level and the toxic level could be reached eventually, even at a very low intake level. It is evident therefore that even very small concentration of mercury in environment may cause health risks affect exposures

Effect of environmental pollution by some pesticides on the mortality rate and behaviour of the Nile bolti, tilapia nilotica

Adult Tilapia nilotica were exposed to water containing different concentrations of three types of insecticides pollutants including methomyl, cypermethrin and malathion. These pollutants are currently used and contaminate the Egyptian waterways. Survival and behaviour were the responses used for measuring the toxic effects. The data indicate that the mortality rate increased with the increase of toxic dose and exposure time and therefore, the survival percentage decreased with the increase of insecticide concentration. The order of toxicity of the three used pesticides is arranged in a descending manner as methomyl, cypermethrin and malathion repectively. From the TLm measurements, the 24 h. LC[50] in Tilapia nilotica was 0.16, 0.58 and 0.80 mg.l[-1] for methomy1, cypermethrin and malathion respectively. The behaviour pattern of the toxicant fishes was found to be in the form of hyperexcitation followed by a state of unbalance and a reduction in activity till death occurred

Infection in the ischemic diabetic foot: optimum management

46 diabetic patients with lower limb ischemia and superadded foot infection [group 1] were managed by an aggressive approach of revascularization and foot debridement. They were compared with two groups of patients: An equally matched group of diabetic patients with limb threatening ischemia and without foot infection [group 2] and an equally matched group of non-diabetic patients with limb threatening ischemia [group 3]. There was no significant difference in the limb salvage rates among the 3 groups: Group 1 [65.6%], group 2 [63.8%] and group 3 [70.1%] at 2 years. Moreover, foot infection in the diabetics was not accompanied by a higher incidence of wound infection at the sites of vessel exposure. This justified the aggressive approach though the hospital stay was longer [average 46.6 days] than if they had done a primary amputation

Upper extremity ischemia [acute and chronic]

88 patients with upper extremity ischemia [acute and chronic] were the subject of this work. They included 3 groups: - Acute embolic ischemia [59.1%]. - Arterial non embolic occlusive disease [27.3%]. - Thoracic outlet syndrome [13.6%]. Embolic cases were easily diagnosed, due to the presence of the cardiac cause, and were managed by catheter embolectomy. Arterial occlusive lesions were more commonly due to arteritis [54.2%] than atherosclerosis [45.8%]. For central lesion [innominate and subclavian arteries] extra-thoracic procedure as axillo-axillary and carotid subclavian by passe were prefered over the direct intra-thoracic procedures. Axillobrachial occlusions were manged by saphenous vein by passes. 4 cases were managed conservatively they had very mild ischemic symptoms. Compression of the subclavian artery at the thoracic outlet was managed via the supraclavicular approach, by excision of the stenosed segment and the post stenotic dilatation and prosthetic graft replacement. The results of management was satisfactory

Acute mesenteric ischemia

A retrospective study of 38 cases with mesenteric ischemia is presented. It included 12 cases [31.6%] with embolism, 9 cases 23.7% with arterial thrombosis, 3 cases [7.9%] with non occlusive infarction and 14 cases [36.8%] with venous occlusion. Preoperatively the main problem was delay in diagnosis as the classic clinical picture was present in only 52.6% of cases. The plan of treatment was to revascularize the intestine, whenever possible in mesenteric arterial occlusion by embolectomy or bypass graft and, to resect frankly gangrenous bowel with primary anatomosis. A second look was done after revascularization of long bowel segments especially when bowel of questionable viability was left behind and in selected cases of mesenteric venous occlusion. The overall mortality was 47.4%, highest in nonocclusive mesenteric ischemia and lowest in mesenteric venons occlusion

role of doppler ultrasound in the management of chronic venous insufficiency of the lower limb

The role of the Doppler flow meter in the management of chronic venous insufficiency was assessed by comparing its results with those of venography. The two main parameters were the detection of venous incompetence and obstruction. The sensitivity of the Doppler to detect patency of the deep system was 100% for the femoral vein. 95.5% for the popliteal vein and 77.79%.for the posterior tibial vein. The sensitivity to detect incompetence of the saphanofemoral junction and the below knee perforators were 75% and 94.1% respectively. By identification of obstruction and incompetence of the deep system, with a high degree of accuracy it aided in the differentation between primary and secondary varicose veins.This is important since the management of both conditions are different

Juxta-renal aortic occlusion

This study deals with the experience met with in 21 cases of juxta-renal aortic block. Special stress was laid upon the methods of identification of the runoff vessels including digital intravenous angiography and the doppler ultrasound. The technical points as regards aorto-femoral reconstruction. In such patients. Without suprenal clamping as well as the results were presented in full details

Arterial injuries in civilian practice

This study deals with the experience met with in the management of 115 cases of arterial injuries in civilian practice. A high incidence of iatrogenic injuries was noted [42.6%], due to the increased use of arterial cathetirisation for diagnostic purposes. Diagnosis of these cases proceeded mainly on clinical grounds. Arteriography was reserved for doubtful cases [exclusion arteriograms], or when there was a need for localisation of the site of the injury. Success in the management of these cases was attributed in the first place to the wide use of autogenous vein grafts [57.3%] as opposed to end to end anastomoses or synthetic vascular grafts. In addition to this, was the proper coverage of the vascular grafts by the use of myocutaneous flaps, doing an adjunctive fasciotomy when needed, as well as the proper evaluation and management of associated venous [8.7%], orthopedic [13.04%] and nerve [4.3%] injuries. The amputation rate, as well as the mortality rate in this series [5.2% and 2.6%, respectively], were low