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Biomedical subjects

V Juliá

Publications and source records attributed to V Juliá.

At least 19 recordsLinked to original sources
PubMed2004

[Transanal endorectal pull-through alone as treatment of Hirschsprung's disease].

UNLABELLED: The aim of this work is to present our experience in the treatment of Hirschsprung's disease (HD) with the technique described by De la Torre. MATERIALS AND METHODS: Seven children diagnosed with recto-sigmoid aganglionism have been treated with this surgical technique, to which a few modifications have been done. RESULTS: There were no intra- nor early postoperative complications. Surgical time ranged 150 to 240 minutes (average 198). All children began oral feedings 2 or 3 days postoperatively (average 2.4). Hospital stay averaged 5.2 days. Follow-up ranges from 6 months to 3 years (average 16 months). Two late complications were seen--one anastomotic stricture and one constipation--and successfully treated as out patients. CONCLUSIONS: The transanal only approach carries a rapid recovery. Family satisfaction is high because of the lack of scars. We believe this is the treatment of choice when confronting rectosigmoid aganglionism.

Anal Canal↗
PubMed2003

[Fetal skin allografts on newborn excisional wounds].

There is clinical and experimental evidence that skin allografts improve secondary intention wound healing, however the grafts do not take. Because of the special characteristics of the healing process in the fetal period, fetal skin allografts could be presumed to be a good alternative to adult skin allografts, and even to autografts in particular cases. In order to explore the behavior of fetal skin grafts on newborn animals, skin has been grafted to laboratory rabbits of two different ages: 26 fetal skin allografts to fetuses and newborns and 21 neonatal skin allografts to newborns. Macroscopic and microscopic features of the grafted area have been compared at the 7th, 14th and 21st postoperative days. The newborn response to a fetal skin graft was somewhat different from that to a newborn skin allograft, the first showing an earlier increase in graft bed vascularization, less edema and less foreign body reaction.

Animals↗
PubMed2002

Congenital prepubic sinus.

Prepubic sinuses are rare congenital anomalies of the urinary tract. There have been few case reports in the literature. The authors describe 2 clinical cases of this entity. A review of the 20 cases previously reported, to clarify the anatomic features and the embryology of this infrequent congenital anomaly, also is reported. Furthermore, the authors propose to classify these lesions not as dorsal urethral duplications but as fistulas of the primitive urogenital sinus, with 3 anatomic types: high, toward the urachal remnant; middle, to the bladder; and low, reaching the urethra.

Cutaneous Fistula↗
PubMed2002

[Morphologic study of the intestine in an experimental model of amnioinfusion in fetal rabbits with gastroschisis].

An experimental model of serial amnioinfusion has been developed in fetal rabbits with gastroschisis, using an intraamniotic catheter connected to a subcutaneous port. Fetuses of 4 groups were compared 7 days after surgery: group A: gastroschisis and daily amnioinfusion through an implanted catheter; group C: gastroschisis and blind amniotic catheter; group G: gastroschisis without catheter; group O: nonoperated fetuses. Survival rate, fetal body weight, lung weight, intestinal weight and length were determined. Computer aided morphometric analysis was performed, in which intestinal diameter, thickness and villi length were measured. Amniotic fluid samples were recovered along the experimental period. Intestinal length was significantly shorter and had a significantly thicker wall than nonoperated fetuses; we found no other morphometric differences between gastroschisis treated with amnioinfusion (group A) and the other gastroschisis groups (C and G). Amnioinfusion did not affect fetal survival rate; the amniotic catheter alone did not cause pulmonary hypoplasia due to significant amniotic leak. The physiological decrease in amniotic volume towards the end of gestation has not been modified by this regime of amnioinfusion.

Amniotic Fluid↗
PubMed2001

Intestinal damage in gastroschisis is independent of the size of the abdominal defect.

The intestinal damage in gastroschisis (GS) has been attributed to a narrow abdominal wall defect (AWD), among other causes, but this causal effect is difficult to prove in humans. The present experimental study was done to ascertain the damaging effect of clinically extrapolable mild and moderate constriction at the AWD on the intestine of fetuses with GS. AWDs of two different sizes were carried out in the fetal rabbit model: small-ring GS (1.5x bowel diameter, SRG) and large-ring GS (3x bowel diameter, LRG); a group of unoperated littermates served as controls. Fetal body weight, intestinal length and weight, bowel diameter and wall thickness, and histology were checked 7 days later. No statistical difference was found in body weight and bowel diameter among the groups. Intestinal length, weight, and wall thickness were significantly different in the GS groups compared to the controls, but no difference was found between the GS groups. Histology did not show venous stasis, ischemic lesions, or differences in the degree of edema between groups SRG and LRG. Mesothelial hyperplasia was seen in both GS groups. The intestinal changes in length, weight, diameter, wall thickness, and histology in GS should thus not be attributed to the diameter of the AWD.

Abdominal Muscles↗
PubMed2001

[Intraabdominal metastasis of cerebellar medulloblastoma through ventriculoperitoneal shunt].

We present a 6-year-old girl with cerebellar medulloblastoma causing obstructive hydrocephalus that was treated by ventriculoperitoneal shunting. The patient subsequently underwent surgical excision of the tumor followed by adjuvant craniospinal radiotherapy. Nine months after shunting, multiple intraabdominal metastatic lesions were found. Although the risk is low, ventriculoperitoneal shunting may facilitate the spread of malignant cells.

Abdominal Neoplasms↗
PubMed1998

[Skeletal muscle graft on the terminal ileum as a substitute for ileocecal valve: experimental study].

Behavior of a free skeletal muscle graft in contact with intestinal wall is analyzed in rats. On first phase, survival of the graft muscle in relation with previous denervation is studied. Nondenervated muscles suffer necrosis and fibrosis, whereas when denervated 4 weeks before grafting, the muscles are viable. On a second phase, the grafted muscle was studied on the long term. From 8th post-transplant week on, the structural and metabolic features of the graft were similar to normal. On the third phase the efficacy of the muscle implant as a substitute of the ileocecal valve is checked. Germs on either side of the valve (ileum and cecum) are counted in normal rats, rats after valve excision and rats with substitution of the valve by a free skeletal muscle implant. There haven been significant differences between normal and no-valve rats (P < 0.001) and between no-valve and artificial valve rats (P < 0.005). There has not been significant difference between normal rats and artificial valve rats. We conclude that free skeletal muscle survives transplant to intestine, and it prevents bacterial reflux from colon to ileum.

Animals↗
PubMed1998

[Urinary obstruction in fetal rabbits. An experimental model].

An original model of urethral ligation on 23 gestational-day fetal rabbits is described, that can be applied in studies of both urinary obstruction and oligohydramnios. The surgical technique is detailed and subsequent urinary obstruction is assessed, as well as the lung weight. In conclusion, this is an easy, mildly aggressive, inexpensive and fast model that can be used to investigate the pathophysiology of urinary obstruction and that of oligohydramnios.

Animals↗
PubMed1997

Effect of the environment on fetal skin wound healing.

Skin wound healing has been shown to be a different process in the fetus than in the adult animal. Some of these differences have been attributed to the unique fetal environment (i.e., amniotic fluid). The aim of the present study is to compare fetal skin healing in intraamniotic and extraamniotic wounds. A fetal rabbit model has been used in which three types of skin wounds were induced on 23-day-old fetuses in contact with either amniotic fluid or maternal peritoneal fluid. The wounds consisted of a sutured skin incision, a nonsutured incision, and an electrocautery burn. Seven days later all wounds were examined mechanically (scar resistance), biochemically (collagen and noncollagen protein concentration), and histologically. Biochemical and growth factor studies of both environments, the amniotic and the peritoneal fluids, were also conducted. The results showed excellent healing by first intention and absence of healing by second intention in both environments, greater scar resistance in the intraperitoneally positioned fetal wounds, and a higher concentration of insulin-like growth factor-1 (IGF-1) in the peritoneal fluid than in the amniotic fluid. It can be concluded that fetal skin wounds in contact with peritoneal fluid show the same healing pattern as in the natural fetal environment (amniotic fluid). The higher concentration of IGF-1 in the peritoneal fluid suggests that this growth factor, through its relationship with the growth hormone, plays a role in increasing the scar resistance of fetal skin wounds in contact with maternal peritoneal fluid.

Amniotic Fluid↗
PubMed1997

[Laparoscopic Nissen fundoplication in children with encephalopathy].

Conventional management of gastroesophageal reflux (GER) and hiatus hernia in children affected with encephalopathy can deteriorate their pulmonary function, already compromised by their leaning position and their spine deformations. The results after laparoscopic surgery for GER in 6 encephalopathy children are reviewed; their ages ranged from 9 to 14 years, their accompanying diseases were: spastic tetraparesia, hydrocephalus, scoliosis, epilepsy and Reye's syndrome. The laparoscopy procedures followed the same surgical steps as open surgery; the surgical time was 3 to 5 hours; the average hospital stay was 3 days. Oral intake started 8 hours after surgery. The successful results of these first cases in this group of patients with neurologic anomalies, suggest that laparoscopic Nissen funduplication is the treatment of choice for GER and hiatus hernia.

Adolescent↗
PubMed1992

[Role of the amniotic fluid in gastroschisis. An experimental study].

The short and thick bowel found in gastroschisis has been attributed to contact with amniotic fluid, among other factors. We designed an original animal model in order to isolate the effect of amniotic fluid on the fetal bowel. We created experimental gastroschisis in fetal rabbits. Extruded bowel was kept out of the amniotic sac in half of the operated fetuses. At term, seven days after surgery, 21 surviving fetuses--12 intra-amniotic (GIA) and nine extra-amniotic (GEA)--and 16 control littermates were harvested for study. Five parameters were measured in each animal: body weight, intestinal weight, intestinal length, bowel diameter and bowel wall thickness. We found no statistically significant difference in body weight, intestinal weight or bowel wall thickness. An enormous difference was found in intestinal length among the three groups. Bowel diameter was significantly different in the extreme groups (GIA and controls), with the intestine being more dilated in GIA than in GEA and controls. Gastroschisis in the absence of amniotic fluid has not been as damaging to the fetal intestine as "natural" intraamniotic gastroschisis.

Abdominal Muscles↗
PubMed1990

[Fiber colonoscopy in children under 18. Our experience with 112 patients studied in the digestive endoscopy section of a general hospital].

The aim of the study was to evaluate the indications of colonoscopy, diagnostic accuracy and efficacy treatment of procedure in young patients aged less than eighteen years using standard forward colonoscopes Olympus CF LB2, CF LBw and CF HL20. Among 5,400 procedures done along eleven years, 112 (2.07 per 100) were performed in patients aged less than eighteen years, 37.6 per 100 of which were performed in children under ten years. In this group general anaesthesia was employed without complications. The most frequent indication of colonoscopy in young patients was rectal bleeding (62.5 per 100). Related to the frequency, in this series, the control of graft versus host disease in patients submitted to bone marrow transplantation was the second indication (11 per 100), followed by the study of chronic anaemia (4.2 per 100) and control of the chronic inflammatory bowel disease (4.2 per 100). Diagnostic accuracy reached 93.75 per 100. In 6 per 100 of the cases the exploration were considered unsatisfactory because inadequate cleaning of the colon. The most frequent diagnostic was "normal colon" (29.6 per 100 of the cases). Polyp was found in 21.2 per 100 of the cases. Polypectomy was performed in all indicated cases. One patient with multiple polyposis were submitted to surgery. Colonoscopy reached the right colon in 25.4 per 100 of the cases. In 54 per 100 of the procedures reached splenic angle and in 83.8 per 100 of the cases, all sigmoid colon was explored. From this experience we suggests that colonoscopy, using standard endoscopes, is a very useful diagnostic and therapeutic technique in child and in young people.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Adrenocortical tumors in childhood: a report of four cases.

In the last 10 years, four children with adrenocortical tumors were treated in our hospital. Three of them had symptoms of adrenogenital virilizing syndrome, and another, nonfunctional, was found during a routine examination. A diagnosis of adrenocortical tumor was established given the symptoms, hormonal tests, and radiologic studies. Two of the tumors were located in the left side, and the histologic diagnosis was pleomorphic cortical adenoma; the ones that affected the right side were adenocarcinomas. All the patients were treated by surgery and none received chemotherapy. At both presurgical and postsurgical stages, the patients were treated with cortisol. All four children have had a favorable course, with normal growth and the disappearance of public hair and hirsutism; however, macrogenitals still persist.

Adenoma↗
PubMed1989

Agenesis of the trachea.

We report a case of agenesis of the trachea type III of Floyd that survived for 2 days with an esophageal intubation. Surgical treatment consisted of a distal esophageal binding, cervical esophagostomy in double-barrelled shotgun, and gastrostomy. Death occurred on the third day after surgery.

Esophagostomy↗
PubMed1989

Segmental dilatation of the duodenum.

In this article two cases of idiopathic duodenal dilation are described. These cases meet the present criteria for segmental dilations of the intestine. The onset of the clinical features was acute in one case and chronic in the other. However, the radiological images were similar in both cases and provided the diagnosis. Surgical treatment consisted of duodenal resection and tapering and was curative in one case. The other patient died shortly after surgery. The duodenal specimens showed normal three-layer duodenal architecture in the pathology study. The intramural nervous plexi were unimpaired. Angiodysplasia was found in one case. Vascular abnormalities were also found in 10 other segmentary intestinal dilatations reported in the literature. The surgical implications of this new localization of segmentary intestinal dilatation are analyzed.

Dilatation, Pathologic↗
PubMed1983

[Results and complications of CSF shunting in hydrocephalus].

Fifty four patients with hydrocephalus treated with surgical derivations were evaluated in retrospect. The total number of derivations made to this group was 76. Initially 30 valves were from VA type and the remaining 24 from VP type, but reintervention was needed in 15 and 11 respectively. The etiology of hydrocephalus was congenital in 61%; infectious, in 24%; tumoral, in 8%, and consequence of a traumatism, in 7%. Twenty-three patients (42%) followed a good evolution without any complication as much immediately as later. The other 31 patients (57%) have had some kind of postoperative complication. In 26 patients (48%) the valve had to be removed. The main causes were infection in 10 cases (18%) and obstruction in 14 cases (25%). Usually the staphylococcus was the infectious agent. Ten of the patients died (18%), eight of them by a complication directly related to the shunt.

Anti-Bacterial Agents↗