Biomedical subjects
Publications and source records attributed to I Avigad.
This is a report of a case of Sandifer's syndrome following surgery. It occurred after a partial thoracic stomach (Gavriliu's operation) and was created following a repair of esophageal atresia.
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This is the first reported case of pyloric channel duplication demonstrated preoperatively by endoscopy and contrast radiography. Endoscopically, the lesion resembled a mucosal flap overlying the pyloric orifice. On radiography the lesion presented as a polypoidal filling defect in the duodenal bulb. The infant had, in addition, postduplication stress ulcer.
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Between 1960 and 1975, 20 women aged 30 years or younger and with carcinoma of the breast were treated at the Chaim Sheba Medical Center. Eight are alive four to 12 years after the primary operative treatment, and 12 have died. The most important factor affecting the ultimate prognosis was the presence of metastasis in axillary nodes, which was found in 70 per cent of the women at surgery. On the other hand, slowly progressing circumscribed tumors of the medullary and intraductal types were more frequently found, occurring in six of the patients. This fact seems to improve the prognosis. Hence, the overall survival rate of women who are 30 years old or younger with carcinoma of the breast is comparable to that of women in other age groups with the same disease.
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Esophageal replacement continues to be a challenging surgical problem. Currently advocated methods entail using reversed gastric tube or colon for the interposition. Between 1969 and 1978, 11 children underwent esophageal reconstruction. Their ages at operation ranged from 1 to 16 years. All the operations were performed in one stage. The right colon was used in seven children and reversed gastric tube in four. There were no postoperative deaths. Temporary salivary fistula and cervical anastomotic stricture were the most common operation-related complications. On the follow-up visit, at least six months after surgery, all the children were able to eat a normal diet. The use of reversed gastric tube avoids intestinal resection, preserves the ileocecal valve, shortens the operative period and preserves the possibility of an alternative procedure (colon interposition) if technical failure occurs. On the basis of our limited experience we advocate the use of reversed gastric tube for esophageal replacement.
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Infantile/congenital hemangiopericytoma, although sharing many similar histological features with adult hemangiopericytoma, has a much better prognosis. Nevertheless, most cases described in the literature were pursued by radical surgery with or without adjuvant chemotherapy. We describe a neonate who presented with a huge mass in the right gluteus, 6 x 5 x 4 cm, and a small ventral abdominal mass. The masses were confirmed on biopsy according to light microscopy, immunohistochemistry, and electron microscopy as congenital hemangiopericytoma. They shrank spontaneously within 2 weeks and vanished within 2 months. We present a hypothesis that masses appearing in the neonatal period with this histology and with no life-endangering pressure on vital organs should routinely be dealt with conservatively.