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J Girona

Publications and source records attributed to J Girona.

At least 37 records · Page 2Linked to original sources
PubMed1997

Low plasma vitamin A concentrations in familial combined hyperlipidemia.

As many as 20% of the survivors of acute myocardial infarction present with the heritable form of hyperlipidemia, termed familial combined hyperlipidemia (FCHL). Some of the genes reported to be involved in this disorder, such as those for lipoprotein lipase (LPL) and apolipoprotein (apo) C-III, are controlled by a peroxisome proliferator-activated receptor (PPAR)/retinoic acid receptor X (RXR) regulatory system, which is retinoic acid dependent. If, as we hypothesized, the availability of retinoic acid or its precursor retinol (vitamin A) could be altered in FCHL, this could help explain some aspects of the phenotypic expression of the disease. We therefore measured plasma retinol concentrations in 30 FCHL subjects and 56 controls. Plasma retinol concentrations in FCHL subjects were significantly lower than that of control subjects (1.96 +/- 0.83 mumol/L vs 2.91 +/- 1.23 mumol/L, respectively; P < 0.0001). This novel finding of significantly decreased concentrations of plasma retinol in FCHL relative to control subjects gives support to the hypothesis that vitamin A might be involved in the expression of this disorder.

Adult↗
PubMed1996

[Fistula, fissure, abscess].

Anal fistulas, anal fissures and anal abscesses are common disorders of the anorectal region that can often only be cured durably by operation. The acute anal fissure can usually be treated successfully by conservative means, whereas the chronical anal fissure can be cured by local fissurectomy as a rule. Primary anal abscesses and anal fistulas are different phenomena resulting from an infection of the proctodeal glands. The acute form, the anal abscess, always requires wide opening and drainage. Caudal intersphincteric and -trans-sphincteric anal fistulas can be cured by the division method. Types of anal fistulas that occur higher can be treated effectively by a special operative technique developed on the basis of the method of Parks.

Abscess↗
PubMed1995

[Left aorto-ventricular tunnel. Diagnosis with transthoracic and transesophageal echo-Doppler].

Aortic-left ventricular tunnel is an infrequent congenital heart lesion consisting of an abnormal tubular-shaped communication between the aortic root and the left ventricle that bypasses the aortic valve. It is clinically undistinguishable from aortic insufficiency. Its prompt and precise diagnosis is crucial since early surgical treatment is definitely indicated, in contrast to aortic insufficiency. In our case, two-dimensional and pulsed color-flow Doppler imaging established the diagnosis, and the transesophageal approach was a great aid in detecting the aortic opening with its turbulent diastolic flow, and in tracing its intramyocardial course. This paper may be of interest not just as a new case-report but insofar as it stresses how importantly the transthoracic and transesophageal echocardiographic and Doppler scanning contributes to its diagnosis and therapeutic indication.

Adolescent↗
PubMed1995

[The follow-up of transposition of the great arteries corrected by Senning's technic].

INTRODUCTION AND OBJECTIVES: The incidence of late complications after a physiological correction of the patients with transposition of the great arteries (D-TGA) is very significant, due to the alternative operation of the arterial switch. METHODS: We studied 125 patients with D-TGA, treated with Senning surgical correction between december of 1978 and november of 1990. Surgery was performed at a mean age of 11.7 months (from 7 days to 11.2 years), and the postoperative mean follow-up was 7.3 years (from 1.4 to 14.3 years). We analyzed their evolutive clinical condition, ECG, Holter and echocardiogram-Doppler. Four groups were defined: A) Simple, 48.8%. B) Associated with ventricular septal defect, 22.4%. C) With pulmonary stenosis, 15.2%. D) Both anomalies, 13.6%. RESULTS: Sixteen children died (12.8%), 11 of them on the postoperative period. The remaining 5 patients died, at a mean time of 34.3 months after surgery, because they were in cardiac failure. All of patients had enlargement of right ventricle and tricuspid regurgitation was observed in 39 children. There were 3 reoperations. Atrioventricular block was observed in 5.7% of the patients, 33.3% were not in sinus rhythm, 6.6% had atrial flutter-fibrillation, sinus node dysfunction was observed in 24.7%, and five permanent pacemakers were implanted (4.7%). CONCLUSIONS: The later mortality is not high, and the clinical outcome is good, but the frequent rhythm disturbances and enlargement of the right ventricle could let us conclude the hypothesis that anatomical correction is an optimal alternative procedure.

Analysis of Variance↗
PubMed1994

[Anatomical correction in transposition of the great arteries and double-outlet right ventricle. Our initial experience].

INTRODUCTION AND OBJECTIVES: Anatomical correction of transposition of great arteries and double outlet right ventricle with subpulmonary ventricular septal defect is a surgical approach that has not been generally adopted in our clinical environment. Our aim with this paper is reporting on our initial experience with this technique. METHODS: The clinical data and additional investigations are reviewed from 15 infants with transposition of the great arteries and 2 with double outlet right ventricle who underwent anatomical repair, with a postoperative follow-up of one year. RESULTS: The survival rate has been 76% (13 out of 17 cases). The 13 survivors are in good hemodynamic condition, with no treatment whatsoever. Thirteen patients are in sinus rhythm with normal repolarization patterns and 5 patients show a right bundle branch block. Neither aortic nor pulmonary gradients have been detected on Doppler examination, and slight valvular insufficiencies are found at aortic level in 4 patients, pulmonary in 2 and mitral in one. CONCLUSION: Anatomical correction is the method of choice for transposition of the great arteries and double outlet right ventricle with pulmonary-related ventricular septal defect.

Double Outlet Right Ventricle↗
PubMed1993

[Therapy of anal incontinence from the surgical viewpoint].

Surgery of anorectal incontinence includes two essential forms: the traumatic lesion of the sphincter and the spontaneous proceeding incontinence. Both forms of incontinence require a surgical therapy that is concerned to its cause. Fresh traumatic lesions of the sphincter can be reconstructed directly by primary suture, elder, cicatrized lesions can be treated by doubling the sphincter or single reconstruction of internus and externus. In spontaneous proceeded incontinence, that requires a very detailed preoperative diagnostic, "post anal repair" and pubo-rectalis-plasy are therapeutic possibilities. By these surgical methods in most patients with incontinence it's possible to avoid a colostomy.

Adult↗
PubMed1993

[The mesorectum in surgery of rectal cancer].

47 patients with a carcinoma of the middle and lower third of the rectum, all in tumor stage pT2 and pT3, underwent a low anterior resection with total excision of the mesorectum and preservation of continence. In histological examinations, 27.3% of tumors in stage pT3 N2-N3 showed a descending lymphatic spread in the distal mesorectum. In radical tumor surgery, the size of the distal safety margin in the bowel does not seem to be as decisive as total mesorectum excision. In the case of a rectum carcinoma at stage pT3, a multidirectional lymphatic tumor spread can be expected. In rectum surgery appropriate for this tumor stage, such carcinomas require a total mesorectum excision.

Adult↗
PubMed1992

[Diagnosis and therapeutic possibilities of descending perineum syndrome].

The Descending-Perineum-Syndrome (DPS) is a quite common disease in the coloproctological outpatient clinic. In some cases it is difficult to get the correct diagnosis. The treatment success is depending on the condition of the muscle of the floor of the pelvis and on the condition of the sphincter internus- and externus muscle and on the various operation methods. One of these operation-methods is the rectopexy with suspension of the anterior wall of the rectum and in some cases in combination with a colon-resection. After this kind of operation 75% of these patients had no pain and less defecation problems.

Female↗
PubMed1991

[Ultrasonic diagnosis of tumors of the cecum and ascending colon].

The results of preoperative ultrasound investigations were compared with the intraoperative findings in 42 patients (27 women, 15 men) operated on because of tumours of the cecum or colon ascendens. In 34 of 42 patients (i.e. 81%) the tumour could be correctly diagnosed by ultrasound. In 3 cases the investigator was not sure about imaging the tumour. Only in 5 cases (i.e. 12%) the tumour was not identified by ultrasound scanning. 4 out of these 5 patients had attended the hospital to be operated on because of a carcinoma of the rectum and the second carcinoma of the large bowel was found by chance intraoperatively. In 16 patients in whom the diagnosis of a large bowel carcinoma had not been established before, the tumour could be primarily diagnosed by ultrasound.

Adult↗
PubMed1989

[Diagnostic measures in anal and rectal prolapse].

As incontinence and outlet obstruction are major problems for patients with anal and rectal prolapse, the following diagnostic procedures are used in addition to the usual examination to plan a more selective therapy and followup: measurement of anal pressure, EMG, anal reflex latency and proctogram.

Diagnosis, Differential↗
PubMed1987

Fistula-in-ano.

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Colorectal Surgery↗