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Biomedical subjects

M Casillas

Publications and source records attributed to M Casillas.

At least 19 recordsLinked to original sources
PubMed2002

[Bronchocentric granulomatosis and pulmonary hydatidosis].

Bronchocentric granulomatosis is a non-specific necrotizing granulomatous reaction in the bronchi and bronchioles. In asthmatic patients, bronchocentric granulomatosis is considered a hypersensitivity reaction to intrabronchial fungi. However, in non-asthmatic patients the possible etiology has not been identified. We report the case of a 46-year-old woman with bronchocentric granulomatosis associated with pulmonary hydatidosis. The likely immuno-pathogenic mechanisms leading to bronchial lesions are briefly discussed.

Bronchi↗
PubMed2000

Malignant triton tumor in the thoracic spine.

We present a 15-year-old patient diagnosed with peripheral neurofibromatosis (NF-1), who was admitted with paraparesis caused by a large intrathoracic tumor with an intracanalicular component that affected the spinal cord. After surgery his condition improved, but a year later he suffered a relapse and died. Histologically the tumor was diagnosed as malignant with neurogenic and myogenic differentiation ("malignant triton tumor"). Malignant triton tumors (MTT) are infrequent; those found in the head and neck and the upper or lower extremities have a better prognosis than those in the retroperitoneum, buttock, or trunk. It is not clear whether this variation is due to a difference in tumor grade, stage, or resectability, or whether it is a consequence of therapy.

Adolescent↗
PubMed2000

Bilobectomy and amphotericin B in a case of endobronchial mucormycosis.

Lung mucormycosis is a rare fungal infection that has been described mainly in oncologic and diabetic patients. We here report the case of an endobronchial lesion caused by this fungus in an immunocompetent person. Prompt diagnosis, and therapy with Amphotericin B and surgery, permitted the complete resolution.

Aged↗
PubMed1998

Indications for intertrochanteric osteotomy after periacetabular osteotomy for adult hip dysplasia.

Residual hip dysplasia in the adult is characterized by deficient anterior and lateral acetabular coverage with subsequent hip joint incongruity and instability. The frequency of periacetabular osteotomy for the treatment of residual hip dysplasia is increasing. In certain morphologic conditions preoperative abduction or intraoperative radiographs reveal that congruency after a periacetabular osteotomy is not optimum; at this point the surgeon may consider the addition of an intertrochanteric osteotomy. In a retrospective study, the radiographs of 25 patients who had a femoral osteotomy with or after periacetabular osteotomy were analyzed and the results were compared with a control group of 34 patients who had periacetabular osteotomy without a femoral osteotomy. The analyzed parameters included: the femoral head extrusion index and the acetabular index, before and after periacetabular osteotomy; the femoral neck shaft angle; the presence of femoral head deformity; the presence of osteoarthrosis; the presence of a secondary acetabulum; the influence of previous ipsilateral hip surgery; the effect of hip adduction or abduction on joint congruency; and the age of the patient. The variables that had a statistically significant association with the performance of an intertrochanteric osteotomy included a femoral head extrusion index and an acetabular index after periacetabular osteotomy outside the normal limits, a neck shaft angle outside the limits of the control group, a deformed femoral head, an osteoarthritic hip, a secondary acetabulum, and a joint space height and congruency dependent on position of the proximal femur. When using statistically significant variables, a discriminant analysis predicted the correct group (periacetabular osteotomy with femoral osteotomy, or periacetabular osteotomy without femoral osteotomy) for 89% of the cases.

Acetabulum↗
PubMed1997

Fixation methods in contaminated wounds and massive crush injuries of the forearm.

This article presents a critical review of the current literature on the stabilization methods of severe open fractures or crush injuries of the forearm. Due to the complexity of the problem, the advantages and disadvantages of the different fixation methods are presented in order to provide the reader with a combination of possibilities for timing and decision-making when confronted with such fractures in clinical practice.

Bone Transplantation↗
PubMed1990

Management of non-tumoral tracheal stenosis in 112 patients.

From January 1973 to August 1989, 112 patients with non-tumoral tracheal strictures were treated in our unit. In 102 patients, the stenosis followed respiratory support. Eighty-one patients were treated surgically; the rest required only endoscopic therapy. In 28 patients, surgical treatment followed failure of endoscopic management. Of the patients submitted to surgery an isolated tracheal stenosis was present in 54 cases while a laryngotracheal stricture was the lesion in the other 27. Tracheal resection and end-to-end anastomosis was performed in the former group. Rethi, Pearson and Couraud procedures, respectively, were carried out in the latter. We emphasize the difference in the results achieved in the first 5 years and those obtained in the last 10 years. In the former period, 7 reoperations were needed. On the other hand, although the overall mortality of both series was 9%, it decreased to 2% during the last 10 years. Excellent or good ultimate results were achieved in 92% of survivors. Finally, we stress the differences in the proportion of reinterventions and definitive failures in the surgical treatment of isolated tracheal stenosis compared to laryngotracheal strictures.

Adolescent↗
PubMed1989

Surgical treatment of lung carcinoma involving the chest wall.

From 1969 to 1986, 97 patients with chest wall invasion by lung carcinoma (excluding superior sulcus tumours) underwent surgical resection in two hospitals, La Paz (Madrid) and La Fé (Valencia). The same surgical policy was used in both thoracic surgical units: extrapleural pulmonary resection when tumour involved only the parietal pleura (N = 36), and en bloc chest wall resection when the carcinoma extended into the ribs and intercostal muscles (N = 61). The tumour histology was classified according the WHO criteria. Lobectomy or bilobectomy was carried out in 72%, pneumonectomy in 18% and segmentectomy or wedge resection in 10% of the patients. The perioperative mortality was higher in the en bloc resection group 9/61 (15%) versus 2/36 (6%) for extrapleural dissection. The node staging was NO in 58/97 (60%), N1 in 16/97 (16%) and N2 in 23/97 (24%). The probability of survival was calculated by the Kaplan-Meier method collecting data from the perioperative survivors only. The overall 5-year survival was 23% with no significant differences between the en bloc resection and the extrapleural lung resection groups. The most important predictor of survival was the node stage. The 5-year survival for N1 and N2 were 8% and 6%, respectively. These percentages increased to 34% when N0 patients were considered. Other predictors of survival were not significant. The authors conclude that either extrapleural or en bloc chest wall resection are both valid procedures which may be used depending on the depth of local invasion.

Adenocarcinoma↗
PubMed1979

The surgical treatment of cancer of the esophagus. Summary of replies to a questionnaire.

In an attempt to assess the different methods of treatment of tumors of the esophagus we contacted 170 surgeons (in 1975-1976). Seventy-six (45%) answered a questionnaire concerning the surgical management of esophageal tumors, the reasons for non operability and non resectability, the place of radiotherapy, the validity of palliative procedures, the exposure and type of resection for tumors at various levels in the esophagus, the technical details of the operations, the resectability and mortality rate, the anastomotic leak rate and its treatment, and the five-year survival rate after operation. The replies to the questionnaire are summarized.

Esophageal Neoplasms↗
PubMed1977

Thoracoscopy in the diagnosis of pleural effusion.

The technique, indications, and complications of diagnostic thoracoscopy are described. Two hundred and eight explorations have been performed in our service in the last seven years. From 137 pleural malignancies we have obtained an unequivocal positive biopsy in 129 (94%) with a minimum number of complications and no mortality. From our experience we conclude that thoracoscopy, when porperly performed, is diagnostic in most pleural conditions.

Biopsy↗
PubMed1975

Mediastinoscopy in the surgical management of lung carcinoma.

Up to December 1973, we had performed 100 mediastinoscopies for lung carcinoma. Fifty-two were positive and 48 negative. In 80 cases there was clinical or radiological suspicion of mediastinal invasion. With radiological evidence of mediastinal node involvement exploration was positive in 32 out of 35 cases, when chest radiography findings were equivocal in 19 out of 45, and when radiology of the mediastinum was normal in only one of 20 cases. Mediastinoscopy was more frequently positive when the carcinoma was oat-cell or anaplastic. Of 48 patients with negative biopsies, 41 were explored. In 26 the carcinoma extended beyond the lung. In 1973 we circularized 83 thoracic surgeons concerning (1) the use of mediastinoscopy for patients with lung carcinoma assessed for surgery, (2) the significance of mediastinal node involvement, (3) the results of radiotherapy alone in patients rejected for surgery, and (4) the survival rate in patients with positive mediastinal nodes treated with surgery alone or together with radiotherapy. The replies to the questionnaire are summarized. The authors emphasize the usefulness of mediastinoscopy but state that care must be taken when deciding to withhold operation for a possible cure.

Biopsy↗
PubMed1975

Surgical stabilization of traumatic flail chest.

Since 1970 we have stabilized the ribs to correct paradoxical movement of the chest wall in chest injuries, using an original technique, in order to avoid as far as possible the need for long-term chest wall stabilization by intermittent positive pressure respiration (IPPR). The technical details of surgical stabilization are described, and the different types of stainless steel struts are shown. Type I was originally used either as an intramedullary nail or as an external brace. Types II and III were designed for external fixation of the strut to the rib. Treatment of 29 patients with severe flail chest, classified into four groups is shown: group I was treated by IPPR, group II by IPPR plus surgical stabilization, group III by surgical stabilization only, and group IV by surgical stabilization after exploratory thoracotomy. The clinical results are discussed. We conclude that surgical stabilization of the paradoxial movement of the chest wall can avoid the use of the respirator or at least reduce the interval of IPPR to a short period during the initial recovery from trauma. Using type III struts, we have obtained stabilization of the flail chest in all cases even in patients with severe anterior paradoxical movement. The patients' tolerance of surgical stainless steel struts was good.

Humans↗