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Biomedical subjects

E Bastounis

Publications and source records attributed to E Bastounis.

71 records · Page 4Linked to original sources
PubMed1989

Somatostatin as adjuvant therapy in the management of obstructive ileus.

The adjuvant use of somatostatin in the clinical management of obstructive ileus was studied prospectively. Fifty-four consecutive patients suffering from total obstructive ileus were managed over a period of one year. A double-blind clinical trial involving the administration of somatostatin for two days was carried out. Twenty-seven non-selected patients received somatostatin, while the other twenty-seven did not. Of the 27 patients who did not receive somatostatin, 12 (44%) were operated on, while only 6 (22%) of those who had received the agent required surgery. As little as 16% of the patients who received somatostatin pre-operatively exhibited severe dilatation and necrosis of the intestine proximal to the area of destruction as compared with 83% of those patients who did not receive somatostatin before the operation. It was concluded that while the administration of somatostatin to patients suffering from obstructive ileus may not be directly related to a reduction in surgery, it does reduce the effects of intestinal dilatation on the healthy gut proximal to the area of destruction.

Adult↗
PubMed1985

Primary malignant melanoma of the esophagus in a young adult.

A 31-year-old white man presented with a 30-day history of dysphagia without weight loss. Esophagogram revealed a lobulated mass at the junction of the middle and lower third of the esophagus. Esophagoscopy showed the presence of a pigmented tumor at that level. Histological examination indicated that the tumor was a primary malignant melanoma. Partial esophagectomy was performed through a right thoracotomy incision, revealing hilar lymph nodes invaded by tumor. One month postoperatively, the patient died from extensive brain metastases.

Adult↗
PubMed1977

Papillary cystadenocarcinoma of the pancreas.

Papillary cystadenocarcinoma is a rare lesion of the pancreas. A case is reported in a 38-year old female where radical resection of an extensive lesion resulted in a four-year survival without evidence of recurrence.

Adult↗
PubMedDate not supplied

Expression patterns of the novel catenin p120cas in gastrointestinal cancers.

p120cas is involved in signal transduction upon src or growth factor stimulation as well as in E-cadherin mediated cell adhesion and may play an important role in carcinogenesis. In this study, we evaluated immunohistochemically the expression and cellular localization of p120cas in 40 gastric, 43 colorectal and 20 pancreatic carcinomas, and examined the relationship between p120cas expression and pathological features. Altered p120cas expression was observed in 70%, 65% and 60% of gastric, colorectal and pancreatic cancers, respectively. The most common abnormality was of cytoplasmic expression associated with loss of membranous distribution found in 37% of gastric, in 25% of colorectal and in 25% of pancreatic cancers. Heterogeneous staining was noted in 15%, 19% and 20%, and complete loss of expression in 18%, 21% and 15% of gastric, colorectal and pancreatic cancers, respectively. There was no correlation between p120cas staining pattern and tumour grade or stage. Aberrant expression of p120cas which may reflect changes in signal transduction pathways occurs frequently in human malignancies.

Catenins↗
PubMedDate not supplied

Carcinoid of the ampulla of Vater: presentation of a new case.

The appendix is the most common location for carcinoid tumors within the gastrointestinal tract. Carcinoid tumors of the ampulla of Vater is an extremely rare entity; only 71 cases of carcinoid of the ampulla of Vater have been reported in the literature to date. The clinical picture is non-specific, and endoscopy is the main diagnostic procedure; but large and deep biopsies are often needed to verify the histological nature of the tumor. Surgery is the treatment of choice. We report a new case of this rare tumor, and a review of the literature concerning the clinical findings, diagnosis, therapeutic challenge and results.

Ampulla of Vater↗
PubMedDate not supplied

Pulmonary embolectomy (answered and unanswered questions).

Pulmonary embolectomy under total cardiopulmonary bypass was carried out in 16 patients with cardiogenic collapsus and hypotension not responding to vasopressors or cardiac arrest. Eleven patients (68.75%) survived and were followed up for years. Our observations are presented with special emphasis on the early and accurate diagnosis, the exact timing of the therapeutic methods, the use of the portable cardiopulmonary bypass-even in the ward, and the possibilities of decreasing the operative mortality rate in less than 30% (from 40% to 22% in our series). Despite the fact that in many countries, especially European, pulmonary artery embolectomy is no more carried out as a primary therapy for massive or submassive embolism since thrombolysis is today considered as the best therapy with a low mortality rate of 8-11%, we still believe that there is a number of patients who could benefit only from surgical intervention. Based on our own experience and that presented in the international literature, an attempt was made to discuss the existing problems, mainly diagnosis and treatment of this formidable condition, reevaluating pulmonary embolectomy.

Algorithms↗
PubMedDate not supplied

Emergency thrombectomy of the inferior vena cava and total colectomy in a patient with ulcerative colitis.

Patients with chronic inflammatory bowel disease, particularly ulcerative colitis, have a greater thrombotic tendency. An effective management of a patient with established ulcerative colitis complicated with acute arterial occlusion of the right lower extremity and inferior vena cava thrombosis is presented. The episodes of thrombosis usually occur in the active phase of the disease. It is suggested that in patients with diseases such as UC, predisposing to thrombosis, the identification of abnormalities in the coagulation profile may predict those particularly at risk.

Colitis, Ulcerative↗
PubMedDate not supplied

Superficial venous thrombosis of the lower extremities co-existing with deep venous thrombosis. A phlebographic study on 57 cases.

The incidence of deep venous thrombosis (DVT) coexistent in patients suffering from superficial venous thrombosis (SVT) has not been well documented. In a series of 57 consecutive patients with SVT of the lower extremities treated in our Department in the last five years without any obvious clinical signs of co-existing DVT, an ascending phlebographic study was performed. Co-existent DVT was disclosed in 19.6% of the patients. There was no correlation between the location or the length of thrombus and the co-existence of DVT. Patients in whom SVT developed in existing varicose veins were younger in age and the incidence of co-existence of DVT was lower. Our findings show that SVT does not always have a benign course. The disclosure of a high incidence of co-existing DVT in our series suggests the necessity of the examination of the deep venous system in all the cases of SVT by using ultrasonic technics, triplex and preferably of the ascending phlebography. The disclosure of DVT in those cases makes the application of anticoagulant treatment mandatory.

Adult↗
PubMedDate not supplied

Polyarteritis nodosa. An unusual cause of acute abdomen.

Two cases of acute abdomen operated on twice and biopsy specimens confirmed are presented. The diagnosis of a systemic necrotizing vasculitis group of polyarteritis nodosa was established. The syndrome affects predominantly males between the second and forth decade of life. The gastrointestinal tract is involved in approximately 50% of the cases. While a negative laparotomy may be considered as a surgical pit-fall, nevertheless, it is the only way of establishing the diagnosis and treating the complications of the disease in some of the cases.

Abdomen, Acute↗
PubMedDate not supplied

Prophylactic fasciotomy of the legs following acute arterial occlusion procedures.

During the 3-year period, 1983-86, 194 procedures for acute arterial occlusion were performed in our Clinic. In 43 cases following revascularization procedures, decompression fasciotomy of the leg for a developed or impending compartment syndrome was performed. Of these, three fasciotomies were done as a prophylactic procedure, before the development of the syndrome. Adequate and early fasciotomy should be considered by the vascular surgeon in every case of embolectomy when the ischemic time is greater than 6 hours, when the patient is young without sufficient collateral circulation, the history of acute arterial occlusion is precipitous, the patient is hypotensive and the back-flow is inadequate intra-operatively, despite the passage of the Fogarty's catheter down to the malleolus. Skin closure after fasciotomy has to be done early, mainly with approximation of the skin edges, or to cover early the exposed viable muscles with a free split-thickness autogenous skin graft. This was done in our series between the 8th and 14th postoperative days. In the case of muscle necrosis of the anterior compartment, skin coverage of the cavity has to be done later, after 2-3 weeks, as in some of our patients.

Adult↗
PubMedDate not supplied

Long-term results and current indications in femoropopliteal vascular reconstructions.

The current indications to and long-term results of the femoropopliteal by-passes are analysed. The absolute indication is critical ischaemia with rest pain or trophic change i.e. ulcers and gangrene. The most important factor influencing the long-term results is the nature of the graft per se. The indications, arteriographic run-off, site of anastomosis, earlier femoropopliteal operations all exert a major influence on the late results, particularly prosthetic grafts are used. The results indicate the need for more prospective studies with careful monitoring of different variants in order to better understand the role of the femoropopliteal by-pass in the palliation of infra-inguinal atherosclerotic occlusive disease.

Blood Vessel Prosthesis↗
PubMedDate not supplied

Perioperative myocardial protection in severe coronary artery and valvular heart diseases with impaired ventricular function.

One hundred patients with severe coronary artery disease, and impaired left ventricular function were studied. Thirteen of these required valve replacements. Eight required repair of a left ventricular aneurysm. In addition, all these patients had three or more coronary artery diseases. The patients underwent aortocoronary bypass using saphenous vein grafts. For myocardial protection, general and topical hypothermia was used during the procedure, along with perfusion of the root of the aorta, with a cardioplegic solution. Additional cardioplegic perfusion was achieved by perfusing the vein graft anastomosed to the left anterior descending coronary artery below the obstruction, or other vein grafts anastomosed to the circumflex artery or the right coronary artery (or its branches if dominant), during total aortic clamping. No mortality occurred in these patients. Only two patients developed perioperative myocardial infarction, but they recovered. The authors believe that this method can offer further myocardial protection during ischemic arrest.

Adult↗
PubMedDate not supplied

The value of profundoplasty for the revascularization of the lower extremities.

During a nine-year period, 201 profundoplasties were performed on 152 patients; of these, 83 were simple and the remaining 132 combined with other inflow or outflow by-pass procedures. Immediate postoperative results were satisfactory whereas late results of 63 simple profundoplasties carried a patency rate of 78% and a limb salvage of 70% was detected eight years postoperatively. Profundoplasty alone or in combination with proximal or distal angioplastic procedures is a very effective method for the revascularization of ischemic lower extremities.

Adult↗
PubMedDate not supplied

Aberrant E-cadherin expression associated with loss of differentiation and advanced stage in human pancreatic cancer.

E-cadherin is a cell-cell adhesion molecule involved in tumour invasion and metastasis. We evaluated E-cadherin expression immunohistochemically in 43 formalin-fixed, paraffin-embedded specimens of pancreatic cancer and investigated its relationship to histopathological features. In non-cancerous pancreatic cells E-cadherin immunoreactivity was localized at the cell membrane, particularly at the intercellular junctions. Abnormal E-cadherin expression was found in 18 (42%) cases. A significantly higher proportion of poorly-differentiated tumours (71%) showed abnormal E-cadherin expression compared with moderately (50%) and well (19%) differentiated tumours (P = 0.037). There was a significant correlation between abnormal E-cadherin expression and lymph node involvement (P = 0.013), the presence of distant metastases (P = 0.034) and advanced tumour stage (P = 0.025). These findings suggest that loss of normal E-cadherin expression is involved in the progression of pancreatic cancer.

Cadherins↗