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Biomedical subjects

M Adloff

Publications and source records attributed to M Adloff.

At least 55 records · Page 3Linked to original sources
PubMed1987

Biliary elimination of ceftazidime.

When five normal subjects were given ceftazidime 2 g iv, antibiotic concentrations in aspirated duodenal fluid increased progressively during 4 h to a value of 21.2 +/- 9.2 mg/l (mean +/- S.E.M.); 0.05% of the dose given was recovered in duodenal fluid. The same dose was given to 12 patients with an external biliary drain. The mean peak ceftazidime concentration of 36.3 +/- 4.0 mg/l was reached in the collected bile during the second hour after administration. The 12-h biliary recovery was 0.21% of the dose. The respective ceftazidime concentrations in choledochal and gallbladder bile sampled peroperatively in ten patients 1 h after ceftazidime 2 g iv were 78.3 +/- 12.0 and 17.9 +/- 7.5 mg/l. These data compare favourably with the results achieved with other beta-lactam compounds.

Adult↗
PubMed1987

A prospective study of current diagnostic procedures for assessment of hepatic metastases in colorectal cancers.

In a prospective study of 305 patients with colorectal cancers, we assessed the diagnostic value of ultrasonography and laboratory tests. In each case laparotomy was carried out and the presence of liver metastases was established in 47 patients. The results show that the laboratory tests alone are not sufficiently accurate to detect liver metastases. Additional accuracy can be obtained by the combined use of a single liver imaging test (echography) and selected laboratory tests (C.E.A., gamma GT, Alkaline Phosphatase).

Adult↗
PubMed1987

[Congenital cystic dilatation of the common bile duct, anomaly of the biliopancreatic junction and cancer of the bile ducts].

The choledochus and pancreatic duct ordinarily enter the duodenum either separately or via a common channel located in the duodenal wall. The usual maximal length of the common channel is approximately 0.5 cm. An anomalous junction of the pancreaticobiliary tract is defined by the presence of an unusually long common channel whose length is 1 cm or longer. During the last 8 years, we studied 9 cases of congenital dilatation of the bile duct. Besides the choledochal cyst, all patients had a common channel which measured 1.5 cm or longer. The mean age of patients (6 females, 3 males) was 36.5 years. Three patients had extrahepatic bile tract carcinoma. One patient, a 51-year old man, had gallbladder carcinoma without stones while the two other patients, a 43-year old woman and a 32-year old man, had carcinoma arising from the wall of the cystic dilatation. These two patients had undergone a simple internal drainage procedure 16 and 8 years before, respectively. Our study suggests that the anomalous junction of the pancreaticobiliary tract, an embryonic anomaly which allows the reflux of pancreatic juice into the bile duct and gallbladder, may be responsible for congenital bile duct dilatation and biliary tract carcinoma. Total excision of the cystic dilatation and the gallbladder with hepaticojejunostomy is the appropriate surgical treatment.

Adolescent↗
PubMed1987

[Treatment of a vesicorectal fistula associated with a neurogenic bladder].

In the case reported a large vesicorectal fistula associated with a neurogenic bladder was closed using an original surgical approach, involving the use of Kraske's approach which allows the rectum to be opened posteriorly while avoiding sphincter structures. This is the fundamental difference that distinguishes it from York-Masson's approach which cuts the anal sphincter. Even though it is indicated only exceptionally, this new approach is therefore one that should be known.

Adult↗
PubMed1987

Surgical management of large incisional hernias by an intraperitoneal Mersilene mesh and an aponeurotic graft.

The surgical repair of large midline incisional hernias must respect, in part, the loss of abdominal wall substance created by the lesion while, at the same time, recreating a strong abdominal wall. The combination of an intraperitoneal mesh, reinforced by a plasty of the anterior layer of the rectus sheath, fulfills these conditions and provides a good functional result in 130 instances.

Adolescent↗
PubMed1987

Does the histologic appearance at the margin of resection affect the postoperative recurrence rate in Crohn's disease?

Is there a role for radical surgery in the management of Crohn's disease or is it feasable to perform limited resections without increasing the risk of recurrence? Fifty eight patients with Crohn's disease underwent resection with subsequent anastomosis. A follow-up of at least 3 years (range, 3-15 years) was undertaken in all cases. All resected specimens at primary surgery were reviewed by one gastrointestinal pathologist to evaluate, retrospectively, the influence of residual microscopic disease at resectional margins on recurrence rate. No statistically significant difference was reported between patients with involved margins and those without such findings as to recurrence rate, interval between primary surgery and reoperation at site of recurrent disease. This review does not provide evidence for adverse influence of residual microscopic disease at the margins of resection. Therefore, limited resection of macroscopically diseased bowel is recommended. One must bear in mind the high rate of recurrence with the necessity of reresection.

Adolescent↗
PubMed1986

Colorectal cancer in patients under 40 years of age.

In a review of 1037 patients with colorectal cancers, there were 32 patients below the age of 40 years (3 percent). Rectal bleeding and abdominal pain were the most common presenting symptoms. The average delay between the onset of symptoms and treatment was 6.5 months. An analysis of tumors according to Dukes' staging revealed no significant difference between young and elderly patients. The younger patients had a greater frequency of mucinous and poorly differentiated carcinoma. When compared by clinical staging, however, the young patient did as well or better than his older counterpart. Clinical staging was the most important prognostic factor, irrespective of age. No inherent difference was found in the virulence of the cancer in the young, and five-year survival rates were not significantly different in young and old patients (59 percent vs. 49 percent).

Adenocarcinoma↗
PubMed1986

Facilitating low colorectal anastomosis. Preliminary results.

Low anterior resection with a stapled anastomosis is the operation of choice for almost all rectal lesions in which the sphincter can be safely preserved. We have reported the results of a new technique using the EEA stapler. This method is easy and safe, it eliminates the use of a low pursestring suture, avoids spillage, and keeps contamination to a minimum. It also allows the joining of bowel segments of disparate sizes. The results of this technique used in 16 patients with colorectal anastomoses are encouraging.

Adenocarcinoma↗
PubMed1985

Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum.

Pelvic and perineal recurrences of cancer after rectal amputation are frequent, often isolated, and thus directly responsible for a fatal outcome by local decompression accidents or infection. This study explores the patterns of recurrence after "curative" operation for rectal cancers. One hundred thirteen patients who underwent abdominoperineal resection are reviewed: there were 36 local recurrences, i.e., an incidence of 31.8 percent. About 70 percent of these recurrences occurred within two years after surgical treatment. Low level of tumor in the rectum, local spread into perirectal fat or serosa, lymph node involvement, and histologic grade of malignancy were the only factors that were statistically related to local recurrence. The strategy for careful follow-up of patients at risk is outlined and a plea is made for a controlled trial of postoperative radiotherapy.

Adenocarcinoma↗