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Petros Mirilas

Publications and source records attributed to Petros Mirilas.

At least 19 recordsLinked to original sources
PubMed2006

Groin hernia: anatomical and surgical history.

The history of surgical repair of groin hernia is a lengthy record of assorted techniques in search of a cure for an ailment that comes in many sizes and shapes and that has plagued humanity for thousands of years. Although improvements are still being sought and found, for several decades surgeons have had the means to relieve most hernia sufferers. A remaining issue is whether the wide array of surgical procedures can or should be whittled down to a few "standard" operations that are safe, effective, and cost-efficient. The history of the anatomy of groin hernia shows how much there was to learn and how much remains to be learned. It also shows how important it is for the surgeon to know and understand both the anatomy of the area and the formation of groin hernia.

Anatomy↗
PubMed2006

The monarch and the master: Peter the Great and Frederik Ruysch.

The extraordinary European journey of Tsar Peter the Great and his passage to Amsterdam, The Netherlands, allowed him to meet a great figure of medical history who offered insight into the mysteries surrounding the structure of the human body. The famous Dutch anatomist Frederik Ruysch, preeminent in dissection and anatomical preservation, impressed the emperor and inspired his love for anatomy and surgery. Peter the Great was fascinated by the study of the structure of the human body and spent many hours in the anatomical cabinet of Ruysch. This impressive collection of cadavers and anatomical specimens, described as "a perfect necropolis," was both a laboratory for teaching anatomy and a bizarre and unique form of art. The profound and enduring impression that the West made on the emperor also led him to modernize the medical services in his homeland, Russia.

Anatomy↗
PubMed2006

"To afford the wounded speedy assistance": Dominique Jean Larrey and Napoleon.

Dominique Jean Larrey (1766-1842) has been described as the father of modern military surgery and is considered even today as the model military surgeon. He developed a plan of rapid evacuation of wounded soldiers from the battlefield during combat, using flexible medical units which he named ambulances volantes ("flying ambulances"). He won the admiration of Napoleon Bonaparte (1769-1821), who was amazed by the results of Larrey's sanitary system. Larrey spent almost 18 years with Napoleon, accompanying him in 25 campaigns, 60 battles, and more than 400 engagements. Napoleon's enormous military success was due not only to his strategy and skill but also to the medical services provided by Larrey. The surgeon became a master of wound management and limb amputation. In his vivid battlefield journals, Larrey documented the course of tetanus, the pathophysiology of cold injury, the effective control of hemorrhage, the drainage of empyema and hemothorax, the aspiration of pericardial effusion or hemopericardium, and the packing of sucking chest wounds. Larrey established a categorical rule for the triage of war casualties, treating the wounded according to the observed gravity of their injuries and the urgency for medical care, regardless of their rank or nationality.

Ambulances↗
PubMed2006

Transversalis, endoabdominal, endothoracic fascia: who's who?

In Terminologia Anatomica of 1998, the fasciae of the trunk are listed as parietal, extraserosal, and visceral. Parietal fascia is defined as the fascia located outside the parietal layer of a serosa (e.g., pleura, peritoneum) lining a body wall cavity. The parietal fascia of the thorax is endothoracic fascia, and that of the abdomen is endoabdominal fascia. According to Terminologia Anatomica, endoabdominal fascia comprises: 1) transversalis fascia and 2) investing abdominal fascia: deep, intermediate and superficial. Thus, transversalis fascia is the innermost layer of endoabdominal fascia and, consequently, not synonymous with it. We assert that transversalis fascia is the inner epimysium of transversus abdominis muscle; no separate deep investing fascia exists. Embryologically, deep, intermediate and superficial layers of investing fascia are produced as muscular primordia--originating from somites invading somatopleura--penetrate somatic wall connective tissue, and thus obtain epimysium on either side, which give layers of investing fascia. In the thoracic wall, muscle layers are not separated and no distinct investing fasciae are found on them. Furthermore, in the thorax extraserosal fascia does not exist. Therefore, only endothoracic fascia is found on the inner side of the innermost intercostal muscle, which is deprived of investing fascia, to separate this muscle from pleura.

Abdomen↗
PubMed2006

Spigelian hernia: surgical anatomy, embryology, and technique of repair.

Spigelian hernia (1-2% of all hernias) is the protrusion of preperitoneal fat, peritoneal sac, or organ(s) through a congenital or acquired defect in the spigelian aponeurosis (i.e., the aponeurosis of the transverse abdominal muscle limited by the linea semilunaris laterally and the lateral edge of the rectus muscle medially). Mostly, these hernias lie in the "spigelian hernia belt," a transverse 6-cm-wide zone above the interspinal plane; lower hernias are rare and should be differentiated from direct inguinal or supravescical hernias. Although named after Adriaan van der Spieghel, he only described the semilunar line (linea Spigeli) in 1645. Josef Klinkosch in 1764 first defined the spigelian hernia as a defect in the semilunar line. Defects in the aponeurosis of transverse abdominal muscle (mainly under the arcuate line and more often in obese individuals) have been considered as the principal etiologic factor. Pediatric cases, especially neonates and infants, are mostly congenital. Embryologically, spigelian hernias may represent the clinical outcome of weak areas in the continuation of aponeuroses of layered abdominal muscles as they develop separately in the mesenchyme of the somatopleura, originating from the invading and fusing myotomes. Traditionally, repair consists of open anterior herniorraphy, using direct muscle approximation, mesh, and prostheses. Laparoscopy, preferably a totally extraperitoneal procedure, or intraperitoneal when other surgical repairs are planned within the same procedure, is currently employed as an adjunct to diagnosis and treatment of spigelian hernias. Care must be taken not to create iatrogenic spigelian hernias when using laparoscopy trocars or classic drains in the spigelian aponeurosis.

Abdominal Muscles↗
PubMed2006

Richter hernia: surgical anatomy and technique of repair.

Richter hernia (partial enterocele) is the protrusion and/or strangulation of only part of the circumference of the intestine's antimesenteric border through a rigid small defect of the abdominal wall. The first case was reported in 1606 by Fabricius Hildanus. The first definition of partial enterocele was given by August Gottlieb Richter in 1785. Sir Frederick Treves discriminated it from Littre hernia (hernia of the Meckel diverticulum). More often these hernias are diagnosed in the sixth and seventh decades of life. They comprise 10 per cent of strangulated hernias. Their common sites are the femoral ring, inguinal ring, and at incisional trauma. The most-often entrapped part of the bowel is the distal ileum, but any part of the intestinal tube may be incarcerated. These hernias progress more rapidly to gangrene than other strangulated hernias, and obstruction is less frequent. The gold standard technique for repair is the preperitoneal approach, followed by laparotomy and resection if perforation is suspected.

Hernia↗
PubMed2006

Littre hernia: surgical anatomy, embryology, and technique of repair.

Littre hernia is the protrusion of a Meckel diverticulum through a potential abdominal opening. Alexis de Littre (1700) reported ileal diverticula and attributed them to traction. August Gottlieb Richter (1785) defined them as preformed, and Johann Friedrich Meckel (1809) postulated their embryologic origin. Sir Frederic Treves (1897) distinguished between Littre and Richter hernia (partial enterocele). Embryologically, Meckel diverticulum is the persistent intestinal part of the omphaloenteric duct through which the midgut communicates with the umbilical vesicle until the fifth week. It is found at the antimesenteric border of the ileum, usually located 30 to 90 cm from the ileocecal valve, measuring 3 to 6 cm in length and 2 cm in diameter. Usual sites of Littre hernia are: inguinal (50%), umbilical (20%), and femoral (20%). Meckel diverticulum may be accompanied in the sac by the ileal loop to which it is attached; rarely, it may undergo incarceration or strangulation, necrosis, and perforation. In children, it is mostly found in umbilical hernias, and the diverticulum is more prone to adhere to the sac. Repair of Littre hernia consists of resection of the diverticulum and herniorraphy; in perforated cases, care must be taken to not contaminate the hernia field.

Digestive System Surgical Procedures↗
PubMed2005

The history of anatomy and surgery of the preperitoneal space.

Preperitoneal (properitoneal) space is the space between the peritoneum and transversalis fascia. Bogros (1786-1825) described a triangular space in the iliac region between the iliac fascia, transversalis fascia, and parietal peritoneum. In the modern concept, this space lies between the peritoneum and posterior lamina of the transversalis fascia. In 1858, Retzius described the homonymous space, situated anterior and lateral to the urinary bladder (prevesical space). In 1975, Fowler reported that the preperitoneal fascia of the groin is distinct from the transversalis fascia. Preperitoneal herniorrhaphy may be subdivided into 2 approaches: transperitoneal and inguinal. We present herein the evolution of approaches to the preperitoneal space from use of the transperitoneal (or posterior) to use of the anterior preperitoneal and posterior preperitoneal approaches. As anatomic knowledge has increased, the evolution of laparoscopic surgery has paralleled that of open procedures.

Fascia↗
PubMed2005

Benign anatomical mistakes: "ampulla of Vater" and "papilla of Vater".

The anatomy of the ampullary termination of the bile and pancreatic ducts is complex; appropriate terminology for this area is confusing and inaccurate. We examine the terms "ampulla of Vater" and "papilla of Vater" for anatomical and historical correctness. The term "ampulla" refers to a dilated part of a duct or other channel. Thus, this word is topographically correct to describe the dilatation at the confluence of the bile and main pancreatic ducts; historically, however, there is considerable reason to believe that its first description was by Santorini rather than Vater. The eponymous term "papilla of Vater" is also incorrect historically. The use of eponyms is firmly entrenched in the medical literature, but some are so problematic that they should be discarded. The eponymous terms for both the ampulla and the papilla should be replaced with the terms "hepatopancreatic ampulla" (or "biliaropancreatic ampulla") and "major [or "greater"] duodenal papilla," respectively.

Ampulla of Vater↗
PubMed2004

Plagiarism.

The theft of someone's words or thoughts--plagiarism--has long been a concern in medical literature. The phenomenon applies to unreferenced published or unpublished data that belong to someone else, including applications for grants and a publication submitted in a different language. Other acts of plagiarism are paraphrasing without crediting the source, using "blanket" references, "second-generation" references, and duplicate or repetitive publication of one's own previously published work. Does incorporating a peer reviewer's ideas constitute plagiarism? The requirement of many journals for a short list of references is problematic, as is confusion about what constitutes common knowledge. What criteria should be used for detecting plagiarism? To make an accusation of plagiarism is serious and perilous. Motivations for plagiarism are considered, and 2 striking historical examples of plagiarism are summarized. We believe that with insight into its causes and effects, plagiarism can be eliminated.

Authorship↗
PubMed2004

P-selectin and antibodies against heparin-platelet factor 4 in patients with venous or arterial diseases after a 7-day heparin treatment.

BACKGROUND: We investigated heparin influence on P-selectin (platelet adhesion molecule), and the association of P-selectin with antibodies against heparin-platelet factor 4, known mediators of heparin induced thrombocytopenia (HIT) occurring in about 5% of vascular patients. STUDY DESIGN: This cohort study included 78 patients, 22 to 90 years old (mean age +/- SD, 66.5 +/- 12.2 years), suffering from arterial thromboembolism (n = 43), deep vein thrombosis (n = 21), and peripheral arterial occlusive disease (PAOD) (n = 14). Plasma P-selectin was tested by ELISA before heparin administration (day 1), and under heparin treatment (day 7). HIT antibodies on day 7 were assayed using a sandwich-type ELISA. Platelets and fibrinogen were measured on days 1 and 7. P-selectin was also examined in 30 healthy controls, 22 to 81 years old (49.8 +/- 16.4 years). RESULTS: On day 7, patients with PAOD had increased P-selectin and HIT antibodies, and decreased platelets compared with patients with arterial thromboembolism or deep vein thrombosis, in whom P-selectin decreased, and HIT antibodies were mostly negative. Fibrinogen increased in all patients. HIT antibody titers and P-selectin were positively associated and were increased in nine patients who developed lower limb artery occlusion or bypass thrombosis, stroke, or myocardial infarction during hospitalization (days 5 to 24). Five of these patients suffered from PAOD and the majority had taken heparin in the past. CONCLUSIONS: P-selectin and HIT antibodies could be useful markers of HIT syndrome-associated thromboses during hospitalization of vascular patients receiving heparin. In arterial thromboembolism or deep vein thrombosis, P-selectin decreases without HIT antibody development. In PAOD, their concomitant increase may alert the surgeon to forthcoming life-threatening complications.

Adult↗
PubMed2004

Hepatic surgical anatomy.

The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

Hepatectomy↗
PubMed2003

Nihilism: a benign denial.

Nihilism is the belief that all possible knowledge on a given topic has been amassed and codified. Ranging from benign denial to deliberate attempts at excommunication, nihilism is often encountered in the history of medicine. Eustachius, Columbus, and Sylvius strongly criticized Vesalius and defended the authority of Galen. Riolan fervently rejected Harvey's monumental work on the circulation of blood. Gross stated that no honest and sensible surgeon would ever sanction thyroidectomy. Sandstrom's discovery of the parathyroids was met with silence. Transplantation of parathyroids by Mandl was not appreciated when announced. Aristotle's dictum that the heart cannot withstand serious injury led to Paget's statement that cardiac surgery had reached the limits set by nature, which no new techniques could overcome. The first Billroth I operation was welcomed as, "Hopefully, also the last." Pancreatic surgery was opposed because the organ was of no clinical interest and was impossible for surgeons to reach. Pancreatic transplantation was rejected for many years, despite good results. When Blundell used blood transfusion for postpartum hemorrhage, critics averred that his next exploit would be radical removal of the spleen. Bassini stated that it could be risky to publish more about radical treatment of inguinal hernias. Carcinomas of the lower sigmoid and upper rectum were deemed untreatable because of their inaccessibility. Colostomy during pediatric surgery was rejected many times. Although it is difficult for the human mind to move from a familiar point of view, this propensity should not infect science, thereby impeding advancement.

Humans↗
PubMed2003

Puberty does not induce serum antisperm surface antibodies in patients with previously operated cryptorchidism.

PURPOSE: We investigated serum antisperm surface antibody (ASA) prevalence at puberty, which is reported to be as high as 38% in the sera of males with cryptorchidism operated on before puberty. Operative technique impact, dartos pouch orchiopexy or testis fixation, was also examined. MATERIALS AND METHODS: We examined a total of 61 pubertal males (Tanner stage 2 or greater) divided into 3 groups. Group 1 consisted of 24 males with cryptorchidism 10 to 17.9 years old who underwent unilateral dartos pouch orchiopexy before puberty (median age 5.85). All of these cases were known to be negative for ASA preoperatively, and 20 before puberty. Group 2 consisted of 22 males with cryptorchidism 12.1 to 17.7 years old operated on previously (median age 10.35) by testicular fixation among other techniques. Group 3 consisted of 15 healthy males 12.2 to 17.3 years old. Prepubertal ASA status was unknown for groups 2 and 3. Operated testis was compared with counterpart before serum collection in group 1 and during operation in group 2. IgG IgM and IgA ASA were studied by the indirect Immunobead (BioRad, Clinisciences S.A., Montrouge, France) test. RESULTS: All sera tested were found negative in the 3 groups. Dartos pouch operation, testis fixation or even consecutive operations did not induce ASA production. Alterations in size or consistency were observed in operated testes in 10 patients in group 1, and in 8 patients in group 2. CONCLUSIONS: Our results suggest that dartos pouch orchiopexy, testicular fixation and/or intrinsic developmental alterations of the cryptorchid testis does not elicit an autoimmune response against sperm surface antigens at puberty.

Adolescent↗
PubMed2002

Epithelial (epidermoid) splenic cysts in childhood: surgical management of eight cases.

We report eight cases of splenic epithelial cysts in childhood to summarize our clinical experience and to discuss surgical management. Six boys and two girls, aged 8 to 14 years (mean 10.8 years) were diagnosed over a 16-year period. No patients had a history of preceding trauma or related infection. Presenting symptoms were dull (two) or acute (one) left hypochondrium pain and diffuse abdominal pain (one). In four children the cyst was an incidental finding. Ultrasound and/or CT revealed cysts of diameter 2.9 to 14 cm and radionuclide scan showed a reduced uptake in the splenic area of concern. At operation variable amounts--up to 1500 mL--of liquid were aspirated from the cysts. Splenic artery ligation was undertaken in six cases adjunctively to cystectomy. One total splenectomy was performed because the splenic parenchyma was totally replaced by the cyst. Recurrence occurred in one case, in which multiple tiny communicating cysts were detected. Histology revealed epithelial (n = 5) or stratified squamous (n = 3) lining. Five patients were seen again 0.5 to 5 years later and they were asymptomatic and with a normal ultrasound, CT, or radionuclide scan. Cyst excision was an effective treatment. Adjunctive splenic artery ligation when performed controlled hemorrhage. Other surgical methods to manage splenic cysts are discussed.

Adolescent↗
PubMed2002

Benign anatomical mistakes: right and left coronary ligaments.

Peritoneal attachments of the liver to the diaphragm include the falciform ligament, the left triangular ligament, and the coronary ligament with the right triangular ligament. It is often surgically convenient when the gastroesophageal junction is explored to refer to a "right" and a "left" coronary ligament, but this is anatomically unjustified. To reassess the issue there are no "right" and "left" coronary ligaments; there are only the left triangular ligament and the complex of coronary and right triangular ligament. The latter is the lateral unification of the layers of the coronary ligament. The liver is posteriorly connected to the diaphragm, and therefore the coronary ligament has superior and inferior layers rather than anterior and posterior layers. Embryologically these ligaments reflect the remnants of the developmental pathways of the liver in the septum transversum, and in the mature organism they are peritoneal connections. Besides the liver is suspended in the bare area mostly by fibrous attachments and by the hepatic veins. Consequently the term "ligament" for these structures has to be revised. Therefore we suggest the terms "left triangular peritoneal attachment" of the liver and "coronary peritoneal attachment" instead of "left triangular ligament" and "coronary ligament."

Digestive System Surgical Procedures↗