PubMed Health⌕ Search

Biomedical subjects

A J Manouras

Publications and source records attributed to A J Manouras.

16 recordsLinked to original sources
PubMed2000

Protein expression of bax, bcl-2, and p53 in patients with non-Hodgkin's gastric lymphoma: prognostic significance.

The biologic significance of bcl-2, bax, and p53 gene expression in patients with non-Hodgkin's gastric lymphoma is unknown. We examined the prognostic value of these genes in 36 patients with gastric lymphoma treated in our clinic between 1990 and 1995. Paraffin-embedded specimens from 36 patients who underwent primary resection of the stomach for gastric lymphoma were analyzed immunohistochemically for p53, bax, and bcl-2 gene expression. Expression of bax was seen in 24 of 36 patients (66.7%), p53 expression was found in 8 of 36 tumors (22.2%), and bcl-2 cytoplasmic staining was detected in 6 of 36 patients (16.7%). We performed a univariate analysis to examine the possible correlation between the expression of these genes and the survival of our patients. Expression of bax protein proved to be a statistically significant prognostic factor (p = 0.049). Protein expression of p53 and bcl-2 did not statistically correlate with survival. In the bcl-2-negative (-) patient group (30 patients), those who were bax-positive had a statistically significant better survival than those who were bax-negative (63.3% vs. 36.7%, p = 0.03). There was also a statistically significant correlation between p53 expression and the grade of the tumor (p = 0.0014). P53 protein expression increased along with the grade. Expression of bax is a significant prognostic factor in patients with gastric lymphoma. Its prognostic value increases significantly when studied in bcl-2-negative patients; but expression of bax failed to be an independent prognostic factor. Expression of bcl-2 and p53 has no prognostic significance. Expression of p53 seems to represent a marker for loss of differentiation.

Adult↗
PubMed1995

Lipomatosis of the ileocecal valve leading to episodes of partial small bowel obstruction.

The cases of two female patients with lipomatosis of the ileocecal valve inducing episodes of intestinal obstruction are presented. A barium enema with air contrast was performed in patient 1; patient 2 was operated on to treat ileus. Resection of the fatty tissue from the ileocecal valve was performed at operation, after histologic diagnosis on frozen section. These cases suggest that limited resection removing fatty tissue is effective and preferable to more radical resection.

Diagnosis, Differential↗
PubMed1993

Peritonitis associated with continuous ambulatory peritoneal dialysis: the pseudo-surgical abdomen.

In this work, 12 patients undergoing continuous ambulatory peritoneal dialysis with peritonitis showing clinical symptomatology of "acute surgical abdomen" were studied. The infective cause of peritonitis was Staphylococcus epidermidis (eight cases) and Staphylococcus aureus (four cases). All patients, under strict and continuous observation, were managed with conventional chemotherapy and showed improvement within 6 to 24 hours. The need of prompt recognition and correct evaluation of this condition by surgeons familiar with it is emphasized in order to avoid an unnecessary surgical procedure.

Abdomen, Acute↗
PubMed1992

Combination of serum carcino-embryonic antigen and C-reactive protein--a useful test in preoperative staging of colorectal cancer.

The value of the simultaneous estimation of serum carcino-embryonic antigen (CEA) and C-reactive protein (CRP) concentrations in staging patients with colorectal neoplasias was evaluated. The study included 95 patients with benign or malignant epithelial tumors of colon and rectum. The simultaneous negative values of CEA and CRP were able to exclude stage D tumors with a specificity of 92.6% (P less than 0.001). Simultaneously positive values of CEA and CRP were able to diagnose stage C or D tumors with a specificity of 92.1% (P less than 0.001). It is concluded that the combination of CEA and CRP tests can substantially contribute to the preoperative staging and assessment of the extent of colorectal cancer.

Adenocarcinoma↗
PubMed1990

Value of serum acute-phase reactant proteins and carcinoembryonic antigen in the preoperative staging of colorectal cancer. A multivariate analysis.

In 55 patients with benign or malignant neoplasias of the large bowel, serum carcinoembryonic antigen (CEA), C-reactive protein (CRP), alpha 1-antitrypsin (AAT), alpha 1-acid glycoprotein (AAG) levels, and the percentage of serum protein electrophoretic components were measured. Statistical analysis showed significant correlations between serum CEA, CRP, AAG, and AAT levels and the percentage of serum beta-globulins with the stage of the disease. Multivariate discriminant analysis gave a final prognostic model that included serum CEA, CRP, and AAT levels and the percentage of the serum beta-globulins with a significance of P less than 0.000001. The authors conclude that the serum acute-phase protein levels, in combination with serum CEA concentrations, have a definite role in the preoperative staging of large bowel cancer.

Acute-Phase Proteins↗
PubMed1990

[Changes in free thyroid hormones after epidural anesthesia].

The changes of FT4 and FT3 hormone levels were measured in 14 patients who were submitted to various light operations after epidural anesthesia. The FT3 changes were similar to those usually detected after general anesthesia, a fact that leads to the hypothesis that the afferent stimuli are not the only responsible for the thyroid hormone changes after stress.

Anesthesia, Epidural↗
PubMed1989

[Adenosquamous carcinoma of the gallbladder].

Between 1976 and 1987, 49 patients with cancer of the gallbladder were treated. In three specimens, histologic characteristics of adenosquamous carcinoma were detected, namely blasts deriving from both squamous and glandular epithelium. These carcinomas, relatively rare, are usually found in the gastrointestinal tract, the thyroid, the breast and the female genital apparatus.

Adenocarcinoma↗
PubMed1989

Unusual primary locations of hydatid disease. Case report.

Two unusual cases of primary hydatid disease are described. In one of them a retroperitoneal cyst, presenting as a palpable abdominal mass, was strongly adherent to the inferior vena cava and dislocated the right kidney. Partial cystectomy and drainage were performed. The other cyst, of the right ischiorectal fossa, was initially misinterpreted as a perineal of sciatic hernia. It was completely removed. No other site of hydatid disease was found and the patients remain well 3 and 4 years postoperatively.

Adult↗
PubMed1985

Serum phosphate levels in acute bowel ischemia. An aid to early diagnosis.

Serum phosphate levels were studied in 18 patients with acute intestinal infarction as proved by laparotomy. Serum phosphate was increased preoperatively (6.12 +/- 0.75 mg/dl) in 94.4 per cent of cases. False-positive results were not recorded. The rise in phosphate was observed 4-12 hr (6.82 +/- 2.65) after the beginning of symptoms and was significantly higher when compared with both normal limits (3-5 mg/dl) and phosphate levels of 24 patients with acute abdominal conditions not associated with intestinal ischemia. This study suggests that determination of serum phosphate should be used as screening method for early detection and treatment of patients with acute intestinal ischemia.

Acute Disease↗
PubMed1984

Long term consequences of bacterial colonization of the biliary tract after choledochostomy.

We studied 48 patients--36 who underwent cholecystectomy and choledochotomy-choledochostomy for cholesterol gallstones and 12 patients as controls who underwent different types of extrabiliary operations. In our material, we observed that, in a high proportion of instances, infected bile during the early postoperative period remained contaminated for six months postoperatively--in an obviously unobstructed bile duct. In patients in whom Escherichia coli was isolated both early and late postoperatively, a statistical significancy was found. This phenomenon consists of a favorable condition for precipitation of calcium bilirubinate, triggering new pigment stone formation.

Bacteria↗
PubMedDate not supplied

The use of TWH catheters in CAPD patients: fourteen-year experience in technique, survival, and complication rates.

OBJECTIVE: To evaluate the technique of insertion, complication rates, and survival rates of Toronto-Western Hospital (TWH) peritoneal catheters in continuous ambulatory peritoneal dialysis (CAPD) patients. PATIENTS AND METHODS: A total of 222 TWH catheters were inserted into 203 CAPD patients (113 males and 90 females) with end-stage chronic renal failure during a period of 14 years (1 January 1982 to 31 August 1995). The mean age of the patients was 58.5 years (range 18-86 years). For the first 6 years, the peritoneal cavity approach was performed via a lower midline incision (45 insertions), various other approaches (17 insertions), and, finally, for the last 160 insertions (for approximately 8 years) the transverse paraumbilical incision was exclusively employed. The duration of CAPD ranged between 1 to 151 months (mean time 33.2 months). RESULTS: Regarding early and late complications (namely leakages, obstructions, eviscerations, tunnel infections, herniation, and others), as well as catheter survival, the transverse paraumbilical insertion, compared to other approaches, had the smallest number of complications. Thus, early leakage occurred in 5/222 (2.25%) versus 10/222 (4.5%), obstruction nil versus 2/222 (0.9%), and evisceration nil versus 1/222 (0.45%). In addition, as far as the late complications are concerned: tunnel infections 5/222 (2.22%) versus 13/222 (5.85%), herniations 1/222 (0.45%) versus 16/222 (7.3%), and cuff protrusion nil versus 7/222 (3.1%). Finally, overall peritonitis occurred with a rate of one episode every 21.2 months. Actuarial survival for 1 and 3 years was 75% and 37%, respectively. CONCLUSIONS: The transverse paraumbilical incision seems to be the most advantageous approach in inserting (by "surgical method") theTWH catheters. We found it to be a safe, simple, versatile procedure, giving good results in all parameters concerned.

Actuarial Analysis↗
PubMedDate not supplied

Perforated small bowel diverticulosis. Case report.

Three patients who presented with perforated small bowel diverticulosis were healed by resection of the perforated segment and primary anastomosis. Clinical awareness of this disease may reduce the relatively high mortality reported by most authors.

Adult↗