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Biomedical subjects

Z Zachariou

Publications and source records attributed to Z Zachariou.

30 records · Page 2Linked to original sources
PubMed1994

Tumor infiltration of the vena cava in nephroblastoma.

Although operative treatment of Wilms' tumors has become more straightforward as a result of advances in preoperative treatment and precise diagnosis, vascular involvement by the tumor can cause serious problems at operation. These problems can be more easily managed if they have been identified pre-operatively and the level of the intravascular tumor thrombus has been defined. In this study we propose a classification of intravascular involvement of Wilms' tumors suggesting the clinical consequences and operative strategy. In our series of 84 patients we treated 7 (8.3%) with preoperatively diagnosed intracaval tumor thrombus using ultrasound as the most sensitive non-invasive diagnostic technique. The surgical therapy depends on the stage; stage III and stage IV should be operated in cooperation with the cardiovascular surgeon in deep hypothermic circular arrest.

Child↗
PubMed1992

Ovarian cysts in the fetus and neonate--changes in sonographic pattern in the follow-up and their management.

In a multicenter trial we retrospectively evaluated the clinical and sonographic data of 49 neonatal ovarian cysts, 44 of which were detected prenatally and 5 on the first day after delivery. Of the 44 prenatally detected cysts 39 were purely cystic, 5 echogenic or had a mixed pattern. In 20 patients the cystic appearance changed during delivery from purely cystic to a mixed pattern being independent on the size of the cyst. 26 of the 44 cysts were treated surgically. Salpingotorsion was found in 8 and was independent on the size of the cyst. In 15 a salpingo-oophorectomy or oophorectomy was performed, in 11 the ovary was saved. 23 patients were followed sonographically: 15 cysts showed complete resolution within 14 months without correlation to the sonographic pattern. The volume of these cysts varied between 5 and 71 ml. Neonatal ovarian cysts disappear spontaneously frequently and rarely cause severe symptoms. The authors recommend follow-up by ultrasound as the primary modality. Surgical intervention is recommended only if the cyst is space-occupying and percutaneous puncture can not be performed or in the case of emergency.

Female↗
PubMed1992

Does lateral bending lead to bowing fracture in an infantile lower arm?

In a postmortem study on 50 lower arms of fetuses of the 25th week of gestation and newborn we performed three-point bending experiments to find out the stability of the lower arm after bending to the resulting fracture. Lower arms with intact soft tissue show an elastic behavior when bent from the side until fracture occurs. Applying the loading deflection diagrams we could classify the fractures into three types which differ significantly by means of bending moment, maximal deflection per unit length, and force required.

Biomechanical Phenomena↗
PubMed1989

Motility malfunction of the gastrointestinal tract by rare diseases--fibrosis of the intestinal wall.

We report on two children who were admitted with chronic ileus without mechanical obstruction. In the 4-month-old female newborn, high-dose radiation was applied after extirpation of a sympathicoblastoma. Within a few years a metaplasia of the muscle coat of the small intestine developed with a resulting malabsorption syndrome. Although the damaged part of the intestine was resected, the process progressed and the child died. In the second case, a chronic ileus developed at the age of 10 years as a result of fibrosis of the intestinal tract. Repeated laparotomies were performed, and no mechanical obstruction could be found. The most probable diagnosis is a form of scleroderma affecting mainly the alimentary tract without any skin involvement. The patient died in a severe cachexia.

Child↗
PubMed1989

Three years' experience with large ovarian cysts diagnosed in utero.

Thirteen fetuses with abdominal cystic tumors were diagnosed by routine prenatal ultrasonography between the 28th and 36th week of gestation. Postnatal ultrasonography of the full-term newborns confirmed the findings. Laparotomies were performed in all cases except one. Patients who were operated on had large ovarian pseudocysts with volumes between 24 and 120 cc. In seven patients (54%), the cysts arose from the left ovary; this included four cases in which the postnatal ultrasound was interpreted as showing the cysts in the right abdomen. Very thin cystic walls threatening perforation were found in 91%. In 33%, we found salpingotorsion on the affected side. Small contralateral ovarian cysts were found in 66% of the patients. One infant required resection of 30 cm of necrotic jejunum because adhesions to the cyst had caused bowel volvulus. Histology of the cysts showed hemorrhage and calcifications, but ovarian stroma was absent in all but one patient. Serum estradiol-17 beta, progesterone follicle-stimulating hormone, and luteinizing hormone were normal in all cases, and similar levels were found in the cyst fluid. These results show that large abdominal cystic masses in full-term infant girls with normal gonadotrophin levels and normal serum estradiol-17 beta and progesterone levels are very likely to require surgery; this is in contrast to preterm neonates with elevated gonadotrophins who can be treated with medroxyprogesterone acetate in the absence of clinical signs necessitating surgery.

Female↗
PubMed1988

[Follicular ileitis (Golden syndrome). Apropos of 2 cases].

We report on two cases with the seldom diagnosis of papillary lymphoid hyperplasia. In both cases the children were boys in the primary school age. The admission was performed due to rectal bleeding, abdominal colics and vomiting. Intraoperatively we found papillary changes in the terminal ileum. Suggestions to intra-operative management and literature comparison are given in this study.

Child↗
PubMed1987

[Ovarian pseudocysts in female newborn infants: prenatal ultrasonic diagnosis and surgical consequences].

During the last year we diagnosed within the scope of preventive medical care of pregnant women in about the 30th pregnancy week, seven foetuses with abdominal cystic tumours by ultrasound examination. Postpartal ultrasound controls of the mature newborn confirmed the findings. After laparotomy we found ovarian pseudocysts with a volume up to 90 ccm. Histologically we could not identify ovarian tissue. In 66% of the cases we found small cysts on the contralateral ovary. Differential diagnosis and the possible complications must be considered. A laparotomy should be performed and only by high steroid serum level a conservative therapy with MPA should be considered. This is the case in premature newborn with an immature endocrine regulation mechanism.

Diagnosis, Differential↗
PubMed1987

[Cantrell's syndrome].

Congenital diaphragmatic hernia is associated with a high mortality, especially when combined with other defects. The unusual repeated combination of the same congenital abnormalities by a number of patients and the fact that during embryonic life these organs develop from the mesoderm implies the existence of a specific syndrome. This article summarises the available clinical data and reports on three cases with Cantrell's syndrome, showing different pattern of congenital defects such as: 1) supraumbilical abdominal wall defects; 2) a defect of the lower sternum; 3) a deficiency of the anterior diaphragm; 4) a defect in the diaphragmatic pericardium; 5) congenital intracardiac defects.

Abdominal Muscles↗
PubMed1987

[Arterial blood supply of the upper pole of the spleen in main artery occlusion].

Vascular dissections of the splenic-, gastric- and pancreatic region, corrosion specimens of the upper splenic pole and arteriographies of the superior polar artery after trunc lienal artery occlusion in human served as an answer to the question of the arterial supply of the upper lienal pole. The present results point out the importance of the upper polar artery and the existence of intersegmental anastomosis. The latter gain importance in case of trunc splenic artery occlusion. The short gastric vessels are of subordinate value.

Collateral Circulation↗
PubMed1987

[Disorders of vascularization in para-epiphyseal groove humeral fractures and their clinical significance for the growing skeleton].

We analysed retrospectively 50 humerus fractures in the vicinity of elbow joint and 40 fractures of the proximal humerus with respect to possible injuries of the vessel pattern of the epiphyseal plate. The normal vessel pattern of the epiphyseal plate was examined postmortem on 8 foetus and newborns up to 6 months. We plastinated the affected regions and could compare symmetry of the vessel pattern in the epiphyseal plates as well as therapeutic consequences, especially after injuries of the elbow joint. Vascular disturbances in the case of young children, i.e. by fractures of the lateral oder medial condyle are undoubtedly seen. A fish-tail deformity can be a complication. By older children with mature epiphyseal plate we could not register any complications. In such cases we are interested in restoring the joint stability by refixation.

Arteries↗
PubMed1986

[Fractures and cartilage injuries of the knee joint in children].

In the last decade we treated and followed up 48 children in the Department of Paediatric Surgery in Heidelberg with fractures and cartilaginous injuries of the knee joint. In 13 cases we could see severe osseous injuries localised at the epiphyseal plate. With decreasing frequency, the following conditions occurred: avulsion fractures of the intercondylar eminence, fracture of the tibia head in children, fractures of the patella and avulsions of the tuberositas tibiae. Furthermore, we report about the special problems of foreign bodies incorporated in the knee joints of children, particularly if sewing needles are involved.

Cartilage, Articular↗