Search PubMed⌕ Search

Biomedical subjects

H Aletras

Publications and source records attributed to H Aletras.

At least 19 recordsLinked to original sources
PubMed1998

Uncommon sites of hydatid disease.

Echinococcosis remains an endemic surgical problem in many Mediterranean countries. We report our experience with such cases when the disease is located in uncommon sites, outside the liver and lungs. This study was an effort similar to a previous one but with more cases and additional information. Between 1967 and 1994 a total of 49 patients suffering from hydatid cysts located in various organs other than the liver and lungs presented to our clinic. There were 28 men and 21 women, with their ages ranging from 10 to 66 years and 22 to 80 years, respectively. Among these patients, 25 had the parasitic cyst in the peritoneal cavity, 10 in the spleen, 5 in the kidney, 3 in the spinal column, 2 in the retroperitoneal space, 1 in the abdominal wall, 1 in the myocardium, 1 in the thoracic wall, and 1 in the thigh. Their hospital stay was 9 to 88 days (average 27 days). Only two patients--one with cardiac hydatidosis and one with spinal hydatidosis--died postoperatively. Three patients with multiple cysts in the peritoneum and one with cysts in the thigh had recurrences of the disease and were reoperated successfully.

Adult↗
PubMed1998

External biliary fistula.

We report 210 cases of external biliary fistula treated in our clinics between 1970-1992. In 7 cases, fistulas were formed after iatrogenic bile duct injury, in 4 cases after exploration of common bile duct, in 4 cases due to disruption of biliary-intestinal anastomosis, and in 2 cases due to liver trauma. In 85 cases bile leak was observed after cholecystomy, in 103 cases after hydatid disease surgery, and in 4 cases after the passage of P.T.C. catheter. In one patient the appearance of the fistula was due to spontaneous discharge of a gallbladder empyema. 173 cases were managed conservatively, and 37 cases surgically.

Biliary Fistula↗
PubMed1996

[Noninvasive mucinous cystic pancreas carcinoma with a 16-year course].

A 26-year-old woman was operated on because of a suspected infectious pseudocyst of the pancreas. A large cyst was found on the body of the pancreas. During laparotomy a biopsy specimen was taken from the cystic wall, but no evidence of a tumor was obtained. On the basis of these intraoperative findings, a cystogastrostomy was performed and the patient had an uneventful postoperative course. The patient presented 8 years later with a recurrent cyst and was operated. As there was a suspicion of a cystic neoplasm, total resection of the cyst was performed. Based on the histological findings a noninvasive mucinous cystadenocarcinoma of the pancreas was diagnosed. We believe that from the beginning this cyst was a noninvasive mucinous cystadenocarcinoma. Following the complete resection the clinical course was favorable for 8 more years without evidence of recurrence or metastases.

Adenocarcinoma, Mucinous↗
PubMed1996

Subtotal cholecystectomy.

Subtotal cholecystectomy has been carried out in 34 patients from 1972 to 1992. In the same period 1620 total cholecystectomies were performed. The indications were severe inflammation and/or severe fibrosis in 31 patients, and Mirizzi syndrome type 1 in 3 patients. The morbidity was insignificant, but one patient died, due to severe sepsis. In follow up studies ranging from 6 months to 9 years, there was one patient with retained stones in the common bile duct. No other post cholecystectomy sequelae were noticed in the remaining 32 patients. Subtotal cholecystectomy is a safe, feasible and definitive operation in patients for whom the standard operation could be dangerous. This operation is less burdensome to the patient, and is accompanied by fewer complications than ordinary cholecystostomy.

Adult↗
PubMed1996

Acute cholecystitis in aged patients.

The aim of this study is the analysis of the results in 62 patients over 70 years of age with acute cholecystitis treated in our Department from 1970 to 1990. The clinical picture in 47 patients was mild and in 15 severe. In 14 cases (10 calculous, 4 acalculous) the acute cholecystitis subsided with antibiotics (Group A). In 48 more cases (45 calculous, 3 acalculous) following 1-3 days conservative treatment, operation was undertaken. Besides acute cholystitis there was gangrene of gallbladder in 10, choledocholithiasis in 7 and choloperitoneum without perforation in 7 cases. Cholecystostomy in 25, cholecystectomy in 15 and cholecystectomy with exploration of the bill duct in 8 cases was performed (Group B). There was one death in group A and 3 deaths in group B. The hospital stay was 20 days. In conclusion the clinical findings in acute cholecystitis in the aged are usually mild. In the case of failure of medical treatment, after 2-3 days emergency surgery should be performed.

Acute Disease↗
PubMed1996

Hanging noncalculous gallbladder.

The removal of acalculous and not acutely inflamed gall-bladder in patients with typical biliary pain remains a questionable procedure. This study was conducted to present our experience. In the period 1982-90, 1089 cases of calculous and acalculous gallbladder disease were treated in our clinic. In this period, 27 patients were subjected to cholecystectomy because of an acalculous, non inflamed gallbladder which was elongated lying in an abnormal position with a long cystic duct. The mean duration of symptoms supportive of cholelithiasis, was 5 years. Oral cholecystogram and ultrasonography led to the diagnosis and other causes of chronic abdominal pain were excluded. There were 13 lumbar, 9 pelvic and 5 iliac gallbladders, with poor function in 20 of them. During cholecystectomy, the organ was invested by peritoneum and suspended in 7 cases from a mesentery. On pathological examination mild chronic inflammation was reported in 19 cases and minimal changes in 8. The minimum follow up was one year and the maximum 9 years. Complete relief of symptoms was achieved in all the cases. In conclusion, cholecystectomy should be offered in these symptomatic "hanging" gallbladders.

Adult↗
PubMed1995

Increased capillary endothelial leakage in portal hypertensive gastric mucosa: fluorescence microscopy in CCl4-induced cirrhotic rats.

Since portal hypertension affects the gastric mucosa, leading to congestive gastropathy and thus to increased incidence of bleeding, it is one of the possible causes of increased permeability of gastric mucosal capillaries. The aim of this study was the quantitative assessment of the permeability of the gastric mucosal endothelial cells. Eight CCl4-induced cirrhotic rats and eight matched controls were subjected to i.v. injection of FITC-albumin, and a morphometric evaluation of fluorescence in serial histological sections of the gastric mucosa was performed by a video image analysis system. Fluorescence was found to be 0.351 +/- 0.01% of the area scanned in experimental animals versus 0.073 +/- 0.005% in controls, i.e. it was significantly increased by the treatment, which implies a significant endothelial leakage into the extravascular space.

Albumins↗
PubMed1994

[Sarcoidosis of the large intestine].

A 68-years old female patient suffering over a period of several weeks from fatigue, weight loss, recurrent diarrheas and mild fever was admitted in our clinic. A few months ago, sarcoidosis of a cervical lymph node had been diagnosed and had been treated with steroids. During the present admission, the extensive study of the gastrointestinal system revealed a tumor of the ascending colon, obstructing the lumen. The patient was subjected to laparotomy due to persistent symptomatology of intestinal obstruction. A right hemicolectomy was performed. The pathological findings were persistent with sarcoidosis of the large bowel. Post-operatively, the patient has been symptom-free over a period of more than one year.

Aged↗
PubMed1993

The influence of hemorrhage on liver microcirculation of the cirrhotic rat.

Bleeding from esophageal varices is highly lethal in cirrhotics, the main cause of death being liver failure. Because adequate hepatic perfusion is a prerequest for the maintenance of liver function, the present study was designed to evaluate the influence of hemorrhagic shock on liver microcirculation in rats with portal hypertension due to cirrhosis of the liver induced by CCl4. In 16 cirrhotic rats and an equal number of controls, hepatic microcirculation was continuously assessed--by means of laser-Doppler flowmetry, through a self-adhesive probe attached to the liver surface, before and during a 15 min period of arterial hypotension (40 mmHg) induced by blood withdrawal. Our findings revealed that immediately following hemorrhage there is a statistically significant reduction of microcirculation in cirrhotics versus controls. The results of this study assist in the better understanding of the hemodynamic conditions which prevail in the cirrhotic liver during the first minutes of hemorrhage.

Acute Disease↗
PubMed1993

The significance of dysplasia in colorectal adenomatous polyps associated with carcinoma.

The relation of colorectal carcinoma and adenomatous polyps was studied retrospectively in 72 patients. Severe dysplasia was found in 47.8% and malignant transformation in 18.2% of the patients with adenomatous polyps and coincidental colorectal carcinoma. The incidence decreased to 21.4% and 7.1%, respectively, in patients with adenomatous polyps only. This difference between the two groups constitutes indirect evidence of malignant potential of adenomatous polyps associated with colorectal carcinoma. Moreover, when severe dysplasia of an adenomatous polyp is found, the patient should be carefully examined for synchronous colorectal carcinoma.

Adult↗
PubMed1992

Experimental and clinical evaluation of capsular and parenchymal total liver perfusion. Liver microcirculation.

Liver blood flow measurements obtained from both the liver surface and deep within the parenchyma, were correlated in an effort to assess the usefulness of laser-Doppler flowmetry for non-invasive monitoring of total liver blood flow, the probe being positioned on either the surface or within the liver parenchyma. In 23 Wistar rats and 10 biliary surgery patients, anaesthetized prior to gallbladder removal, liver microcirculation was measured at 4 points on the capsular surface, and consequently at 4 points deep within the parenchyma, using probes connected to a laser-Doppler flowmeter. The findings revealed that laser-Doppler measurements on the liver surface and within the parenchyma were well correlated, as no statistically significant differences were found either in rats or humans. It is concluded that laser-Doppler flowmetry for monitoring of total liver perfusion can be applied either on the capsular surface or within the hepatic parenchyma.

Animals↗
PubMed1992

Gastric mucosal blood flow in portal hypertension patients--a laser Doppler flowmetry study.

Gastric mucosal blood flow was evaluated endoscopically by means of laser Doppler flowmetry in an attempt to explore microcirculatory changes in different areas of gastric mucosa in portal hypertension patients as compared with controls. Twenty male--Child B--cirrhotics and seven healthy subjects were assessed, the recordings being performed at ten defined points of the stomach. Statistical evaluation revealed that blood flow in the body of the stomach was decreased in cirrhotics. Bearing in mind that congestive gastropathy, found mainly in the gastric corpus, is due to changes in gastric vascularity leading to congestion and stasis, we consider that the decrease in gastric mucosal blood flow may be attributable to these vascular alterations.

Gastric Mucosa↗
PubMed1991

Colloidal bismuth subcitrate-induced changes on gastric mucosal hemodynamics in the rat: gastric mucosal blood flow after CBS treatment.

The belief that blood flow plays a central role in cytoprotection and there being no data available, at present, regarding the possible action of Colloidal bismuth subcitrate (CBS-DENOL) on the gastric mucosal blood flow (GMBF), led us to investigate its influence on mucosal hemodynamics in the rat stomach. Measurements of GMBF were performed in 32 male Wistar rats, treated by either CBS or placebo in drinking water for a 3-wk period, by the use of a laser-Doppler flowmeter, at 14 defined points of the stomach. CBS treated animals revealed a highly statistically significant increase (P less than 0.0005, upaired t-test) of GMBF in comparison with the placebo treated. These findings lead us to suggest that CBS exerts its antiulcer action via the mechanism of increased gastric mucosal blood flow. Additionally the increased blood flow may be associated with the previous findings of increased synthesis of prostaglandins, gastric mucus and bicarbonate secretion by CBS.

Animals↗
PubMed1990

Effects of famotidine on gastric mucus of the rat.

The influence of famotidine on the production of gastric mucus was studied at experimental level. We measured the quantity of the intracellular mucus, the surface adherent mucus gel thickness, and the biosynthesis of prostaglandin E2 (PGE2) by the rat gastric mucosa, in pretreated animals. Both the intracellular mucus accumulation and the adherent mucus gel thickness revealed a highly statistically significant increase (P less than 0.0002). PGE2 assay showed that famotidine also led to a statistically significant increase (P = 0.02) of PGE2 in treated versus control animals. These findings raise the question of whether despite its common antisecretory pathway of action this H2-receptor antagonist could play a role in the protection of gastric mucosa. Further research is necessary to determine this.

Animals↗
PubMed1990

Desmoid tumor in Gardner's syndrome.

Desmoid tumors are often associated with familial polyposis of the colon with or without Gardner's syndrome. Recurrence rate and the invasive, aggressive character of these tumors is emphasized. The authors present three cases and discuss surgical and conservative treatment.

Abdominal Muscles↗
PubMed1990

The influence of sclerotherapy on gastric mucosal blood flow distribution.

Hemodynamic events and structural vascular changes of the gastric mucosa in cirrhotics have caught the attention of investigators in the recent past, but as yet it is not known whether therapeutic interruption of variceal blood flow at gastroesophageal level alters such portal hypertensive mucosal features. The newly developed endoscopic laser-Doppler technique was used to assess whether variceal eradication by means of endoscopic sclerotherapy influences the gastric mucosal congestion in portal hypertension patients. Gastric mucosal blood flow was determined at ten defined sites of the stomach, before the first session of sclerotherapy and after complete variceal eradication had been achieved in 15 patients. A statistically significant decrease (P less than 0.01 to 0.05) in microcirculation was found at the gastric antrum and corpus, an increase at the pylorus (P less than 0.05), but no change in the fundic area. An important question following these findings is: What are the consequences of such aggravation of gastric congestion on the integrity of the gastric mucosa?

Adult↗