Papers by Bashir Attuwaybi
Clinical Case Reports, Oct 2, 2018
The diagnosis of primary malignant melanoma of the anorectum is extremely rare and carries a very... more The diagnosis of primary malignant melanoma of the anorectum is extremely rare and carries a very poor prognosis. While it is the third most common site of a primary melanoma, it accounts for <1% of anorectal malignancies. We present cases of anorectal melanoma treated with abdominoperineal resection.
International Surgery, Mar 25, 2020
Delayed Administration of ??-Melanocyte-Stimulating Hormone or Combined Therapy with Bay 11-7085 Protects Against Gut Ischemia???Reperfusion Injury
Shock, Nov 1, 2003
Gut ischemia-reperfusion (I/R) injury is a serious complication of shock. Previously we demonstra... more Gut ischemia-reperfusion (I/R) injury is a serious complication of shock. Previously we demonstrated that the administration of alpha-melanocyte-stimulating hormone (MSH) immediately before mesenteric I/R protected against postischemic gut injury. In this report, we tested the therapeutic efficacy of alpha-MSH on gut I/R (60 min ischemia, 6 h reperfusion) injury when given at different time points of reperfusion. Rats underwent sham surgery or were treated with saline or with alpha-MSH that was given 1, 2, or 4 h after superior mesenteric artery clamping. Vehicle-treated I/R rats exhibited severe mucosal injury and increased NF-kappaB DNA binding activity, myeloperoxidase (MPO) activity, and interleukin-6 and heme oxygenase-1 (HO-1) expression. In contrast, rats given alpha-MSH at 1 h of reperfusion, but not 2 h or 4 h, exhibited much less mucosal injury. Rats given alpha-MSH at 1 h or 2 h of reperfusion, but not 4 h, exhibited less MPO activity, NF-kappaB DNA binding activity, and interleukin-6 protein and even higher levels of heme oxygenase-1 than vehicle-treated rats. In addition, we found that combined use of alpha-MSH, a known inhibitor of IkappaBalpha tyrosine phosphorylation, with BAY 11-7085, an inhibitor of IkappaBalpha Ser 32,36 phosphorylation, abrogates gut MPO induction and tissue injury at early and late time points of reperfusion. Thus, alpha-MSH, an endogenous peptide with a favorable side-effect profile, is effective in treating experimental gut I/R injury when given early after the initial ischemia and may represent a candidate therapy for gut I/R in humans in whom recognition and treatment are often delayed.
Shock, Nov 1, 2005
Cyclooxygenase (COX)-2 has been identified as an important mediator elaborated during ischemia/re... more Cyclooxygenase (COX)-2 has been identified as an important mediator elaborated during ischemia/reperfusion, with pro-and anti-inflammatory properties having been reported. As the role of COX-2 in the small intestine remains unclear, we hypothesized that COX-2 expression would mediate mesenteric ischemia/reperfusion-induced gut injury, inflammation, and impaired transit and that these deleterious effects could be reversed by the selective COX-2 inhibitor, N-[2-(cyclohexyloxy)-4-nitrophenyl] methanesulphanamide (NS-398). Additionally, we sought to determine the role of peroxisome proliferator-activated receptor g (PPARg) in mediating protection by NS-398 in this model. Rats underwent sham surgery or were pretreated with NS-398 (3, 10, or 30 mg/kg) intraperitoneally 1 h before 60 min of superior mesenteric artery occlusion and 30 min to 6 h of reperfusion. In some experiments, NS-398 (30 mg/kg) was administered postischemia. Ileum was harvested for COX-2 mRNA and protein, PGE 2 , myeloperoxidase (inflammation), histology (injury), intestinal transit and PPARg protein expression, and DNA-binding activity. COX-2 expression and PGE 2 production increased after mesenteric ischemia/reperfusion and were associated with gut inflammation, injury, and impaired transit. Inhibition of COX-2 by NS-398 (30 mg/kg, but not 3 or 10 mg/kg) not only reversed the deleterious effects of COX-2, but additionally induced expression and nuclear translocation of PPARg. NS-398 given postischemia was equally protective. In conclusion, COX-2 may function as a proinflammatory mediator in a rodent model of mesenteric ischemia/reperfusion. Reversal of gut inflammation, injury, and impaired transit by high-dose NS-398 is associated with PPAR activation, suggesting a potential role for PPAR-g in shock-induced gut protection.
American Journal of Physiology-gastrointestinal and Liver Physiology, Apr 1, 2003
Clinical Case Reports, May 27, 2020
A permanent end ileostomy is indicated in patients with diseases such as ulcerative colitis (UC),... more A permanent end ileostomy is indicated in patients with diseases such as ulcerative colitis (UC), Crohn's disease or familial adenomatous polyposis (FAP) who require a total proctocolectomy and inability to restore intestinal continuity. Cancer at the ileostomy site is uncommon and pathology typically reveals adenocarcinomas, squamous cell carcinomas or lymphomas. Primary squamous cell carcinoma (SCC) at the ileostomy site is extremely rare.
Shock, Dec 1, 2005
Pulmonary hypertension (PH) is a progressive disorder whose cellular pathogenesis involves enhanc... more Pulmonary hypertension (PH) is a progressive disorder whose cellular pathogenesis involves enhanced smooth muscle cell (SMC) proliferation and resistance to apoptosis signals. Existing evidence demonstrates that the tumor suppressor, programmed cell death 4 (PDCD4) affects patterns of cell growth and repair responses in the systemic vasculature following experimental injury. In the current study, the regulation PDCD4 and its functional effects on growth and apoptosis susceptibility in pulmonary artery smooth muscle cells was explored. We previously demonstrated that pharmacological activation of the nuclear transcription factor, peroxisome proliferator-activated receptor gamma (PPARγ), attenuated hypoxia-induced proliferation of human pulmonary artery smooth muscle cells (HPASMC) by inhibiting the expression and mitogenic functions of microRNA-21 (miR-21). In the current study, we hypothesize that PPARγ stimulates PDCD4 expression and HPASMC apoptosis by inhibiting miR-21. Our findings demonstrate that PDCD4 is reduced in the mouse lung upon exposure to chronic hypoxia (10% O 2 x 3-weeks) and in hypoxiaexposed HPASMC (1% O 2). HPASMC apoptosis was reduced by hypoxia, by miR-21 overexpression, or by siRNA-mediated PPARγ and PDCD4 depletion. Activation of PPARγ inhibited miR-21 expression and resultant proliferation, while restoring PDCD4 levels and apoptosis to baseline. Additionally, pharmacological activation of PPARγ with rosiglitazone enhanced PDCD4 protein expression and apoptosis in a dose-dependent manner as demonstrated by increased annexin V detection by flow cytometry. Collectively, these findings demonstrate that PPARγ confers growth inhibitory signals in hypoxia-exposed HPASMC through suppression of miR-21 and the accompanying derepression of PDCD4 which augments HPASMC susceptibility to undergo apoptosis.
Regional hypothermia reduces mucosal NF-κB and PMN priming via gut lymph during canine mesenteric Ischemia/Reperfusion 1,2 1 This paper was presented at the annual meeting of the Association for Academic Surgery, November 7–9, 2002, Boston, MA. 2 Supported in part by NIGMS grants P50 GM38529-01, ...
J Surg Res, 2003
Hypertonic Saline Enhances Mucosal Blood Flow and Lessens Mucosal Injury Following Gut Ischemia/Reperfuison
Shock, 2003
Hypertonic Saline Induces HO-1 Expression and Abrogates Gut Inflammation and Dysfunction Following Shock-Induced Gut Ischemia/ Reperfusion
Shock, 2003
Parastomal squamous cell carcinoma
Abdominal surgery
Squamous cell carcinoma of the ileostomy is an extremely rare occurrence. These cases we report a... more Squamous cell carcinoma of the ileostomy is an extremely rare occurrence. These cases we report are among many cases reported of a primary squamous cell carcinoma originating from the ileostomy site. The first case occurred in 1966 in a 76-year-old woman 53 years after a total proctocolectomy for ulcerative colitis.1 Philips and colleague published in the Journal of Diseases of Colon and Rectum reviewed cases since 1966 until 2005 and they found 36 cases reported.4 Since 2005 four more cases reported in the English literature and in this paper we add three more cases from our practice with end ileostomy adenocarcinoma.
American journal of physiology. Gastrointestinal and liver physiology, 2003
Mesenteric ischemia-reperfusion injury is a serious complication of shock. Because activation of ... more Mesenteric ischemia-reperfusion injury is a serious complication of shock. Because activation of nuclear factor-kappaB (NF-kappaB) has been implicated in this process, we treated rats with vehicle or the IkappaB-alpha inhibitor BAY 11-7085 (25 mg/kg ip) 1 h before mesenteric ischemia-reperfusion (45 min of ischemia followed by reperfusion at 30 min or 6 h) and examined the ileal injury response. Vehicle-treated rats subjected to ischemia-reperfusion exhibited severe mucosal injury, increased myeloperoxidase (MPO) activity, increased expression of interleukin-6 and intercellular adhesion molecule 1 protein, and a biphasic peak of NF-kappaB DNA-binding activity during the 30-min and 6-h reperfusion courses. In contrast, BAY 11-7085-pretreated rats subjected to ischemia-reperfusion exhibited less histological injury and less interleukin-6 and intercellular adhesion molecule 1 protein expression at 30 min of reperfusion but more histological injury at 6 h of reperfusion than vehicle-tre...
International surgery, 2015
The objective of this study was to evaluate the short-term outcomes of synchronous hand-assisted ... more The objective of this study was to evaluate the short-term outcomes of synchronous hand-assisted laparoscopic (HAL) segmental colorectal resections. The surgical options for synchronous colonic pathology include extensive colonic resection with single anastomosis, multiple synchronous segmental resections with multiple anastomoses, or staged resections. Traditionally, multiple open, synchronous, segmental resections have been performed. There is a lack of data on HAL multiple segmental colorectal resections. A retrospective chart review was compiled on all patients who underwent HAL synchronous segmental colorectal resections by all the colorectal surgeons from our Group during the period of 1999 to 2014. Demographics, operative details, and short-term outcomes are reported. During the period, 9 patients underwent HAL synchronous multiple segmental colorectal resections. There were 5 women and 4 men, with median age of 54 (24-83) years and median BMI of 24 (19.8-38.7) kg/m(2). Two p...
Ureteral Catheter Use for Colectomy in Patients with Diverticular Disease
Journal of the American College of Surgeons
International Surgery
Approximately 5-10% of patients will harbor distant metastasis at the time of breast cancer diagn... more Approximately 5-10% of patients will harbor distant metastasis at the time of breast cancer diagnosis with about a third of these patients developing distant recurrence after optimal therapy. Breast cancer has an unusual metastatic pattern to the colon and rectum with incidence that may be underappreciated. Lobular breast cancer has a higher preponderance to this unusual metastatic pattern. Clinical manifestation is nonspecific with a long latency period and diagnosis requires a high index of suspicion. The management is not clearly defined. However, medical management with chemo and hormonal therapy seem to be favored likely because of overall metastatic burden at time of diagnosis. Radical colonic resection in selected patients with isolated colorectal metastasis has been well tolerated and may influence survival. A regimented screening colonoscopy in breast cancer patients with high-risk features may offer early diagnosis and
Primary squamous cell carcinoma at ileostomy site. Two case reports and review of literature
Clinical Case Reports
JSLS : Journal of the Society of Laparoendoscopic Surgeons
Introduction and Hypothesis:In the United States, vesicovaginal fistula (VVF) most often results ... more Introduction and Hypothesis:In the United States, vesicovaginal fistula (VVF) most often results from gynecologic surgery causing significant morbidity and distress to both the patient and surgeon. The use of tissue interposition at time of primary repair has been advocated to decrease the risk of recurrence. The aim of this study is to describe our experience with interposition of sigmoid epiploica during robotic extravesical repair of supratrigonal VVF.Methods:This is a retrospective case series from June 2015 to September 2016. Features of the surgical technique include 1) cystoscopic ureteral catheterization, 2) cannulation of the fistula, 3) mobilization of the bladder from the vagina, 4) removal of the epithelialized edges of the fistulous tract, 5) single-layer closure of the vagina, 6) tension-free layered closure of the bladder, 7) retrograde fill of the bladder to ensure water-tight repair, 8) interposition of sigmoid epiploica appendage(s), and 9) prolonged bladder drainage with indwelling transurethral catheter.Results:In total, 5 women underwent successful robotic VVF repair with epiploic appendage interposition. Mean surgical time was 218 minutes with an average console time of 147 minutes and an estimated blood loss of 49 mL. Most the patients were discharged to home on postoperative day 1 with no untoward effects due to the epiploica interposition. There have been no recurrences to date.Conclusions:Robotic repair of VVF with sigmoid epiploica interposition is efficient and well tolerated. Use of this technique may increase the number of patients eligible for tissue interposition.
Regional hypothermia reduces mucosal NF-kappaB and PMN priming via gut lymph during canine mesenteric ischemia/reperfusion
Journal of Surgical Research, Nov 1, 2003
Mesenteric ischemia/reperfusion (I/R) activates pro-inflammatory mediators that exacerbate gut re... more Mesenteric ischemia/reperfusion (I/R) activates pro-inflammatory mediators that exacerbate gut reperfusion injury and prime circulating neutrophils that cause remote organ injury. We have shown that regional intraischemic hypothermia protects the intestinal mucosa during I/R in rats. In this study, we examined the effects of regional hypothermia on I/R-induced transvascular protein clearance, NF-kappaB DNA binding activity, and polymorphonuclear neutrophil (PMN) priming via gut lymph in a canine mesenteric lymphatic fistula model. Conditioned dogs underwent 60 min of mesenteric ischemia, with or without regional intraischemic hypothermia, and 3 h reperfusion. A mesenteric lymphatic fistula model was used to measure transvascular protein clearance and harvest lymph. Biopsies of distal ileum were obtained at baseline and 0, 180 min of reperfusion for NF-kappaB DNA binding activity using electrophoretic mobility shift assay (EMSA). A kinetic spectrophotometric assay was used to determine fMLP stimulated PMN superoxide production after priming by gut lymph obtained at baseline and 180 min reperfusion. Transvascular protein clearance increased during reperfusion compared to baseline, and hypothermia had no significant effect on this I/R-induced protein clearance. NF-kappaB activity increased three-fold at the end of ischemia and hypothermia prevented this early activation. PMN superoxide production increased 19-fold during I/R (0.06 +/- 0.04 versus 1.14 +/- 0.50 nmol O(2), P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), but only 2.5-fold during I/R + hypothermia (0.28 +/- 0.09 versus 0.70 +/- 0.32 nmol O(2), P = 0.2). Regional intraischemic hypothermia prevented early intestinal NF-kappaB activation, partially abrogated PMN priming via gut lymph, but had no significant effect on increased transvascular protein clearance during mesenteric I/R in dogs.
Clinical Case Reports
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Papers by Bashir Attuwaybi