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Biomedical subjects

A Roggo

Publications and source records attributed to A Roggo.

31 records · Page 2Linked to original sources
PubMed1993

[How often does an aneurysm of the popliteal artery rupture?].

Rupture of a popliteal artery aneurysm is an unusual complication and did occur six times in our series of 252 popliteal artery aneurysms that underwent operative repair from January 1965 to December 1991. Rupture while equally serious as thrombosis of the popliteal artery aneurysm of distal embolization from the aneurysm, is reported as an exceedingly unusual complication. Reported incidence of rupture is less than 2 to 4 percent in most large series and was 2.4 percent in the present series.

Aged↗
PubMed1993

The continuing challenge of aneurysms of the popliteal artery.

This report is an analysis of 252 popliteal artery aneurysms (PAA) in 167 patients treated surgically at the University Hospital in Zurich during a 27 year period from 1965 to 1991. The predominance of male patients (95 percent) was consistent with that of other reports. PAA were bilateral in 51 percent of the patients and were associated with aneurysms at other sites in 38 percent. Atherosclerosis was by far the most common cause (98 percent). PAA were symptomatic in 75 percent of the patients, the predominant findings being ischemia from emboli, thrombosis or rupture. Primary amputation was required in 23 extremities. Surgical reconstruction with bypass was performed for 229 PAA. A secondary amputation was necessary in 18 limbs. The risk of complications from popliteal aneurysms, and the good results from surgical treatment suggest that a revascularization procedure in the asymptomatic stage should be recommended unless specific contraindications exist. We conclude that surgical treatment should be performed in symptomatic and asymptomatic PAA larger than 2 centimeters in diameter. Long term results of surgical reconstruction are improved if an autogenous saphenous vein is used and if reconstruction is performed before the occurrence of complications. Polytetrafluoroethylene prostheses should be used when an autologous saphenous vein is not available. The use of Dacron (polyester fiber) grafts is no longer indicated.

Adult↗
PubMed1992

Acute small bowel volvulus in adults. A sporadic form of strangulating intestinal obstruction.

Small bowel volvulus is an uncommon but important cause of small intestinal obstruction. It often results in ischemia or even infarction. Delay in diagnosis and surgical intervention increases morbidity and mortality rates. Based on cause, small bowel volvulus can be divided into primary and secondary type. Goals for treatment of small bowel volvulus should include physician awareness of this uncommon diagnosis, accurate workup, and advanced surgical intervention. The presentation and subsequent management of 35 patients with small bowel volvulus confirmed by laparotomy are reviewed and discussed. The incidence of small bowel volvulus in the adult European and North American is low. The resultant mortality rate, however, makes diagnosis critically important. The cardinal presenting symptom is abdominal pain. There is no single specific diagnostic clinical sign or abnormality in laboratory or radiologic finding. In practice, the diagnosis can only be made by laparotomy. The failure to perform an exploratory laparotomy cannot be justified. Early diagnosis and early surgery are the keys for successful management of strangulation obstruction of the small bowel.

Abdomen, Acute↗
PubMed1992

[Preoperative cardiovascular assessment of patients with vascular diseases].

Pathologic cardiovascular symptoms and signs were assessed preoperatively in 72 consecutive patients scheduled for vascular surgery. All postoperative cardiovascular complications were monitored and statistical relation to the preoperative pathology was tested using the X2-method. The following preoperative cardiovascular symptoms are associated with a significant incidence of postoperative complications: Angina pectoris (p < 0.05); congestive heart failure (p < 0.025); ventricular and/or supraventricular arrhythmias (p < 0.01); pathologic ECG (p < 0.01); ejection fraction < 50% in echocardiography (p < 0.05); myocardial hypokinesias in echocardiography (p < 0.025). The use of preoperative echocardiography as a reliable and accurate method is emphasized.

Aged↗
PubMed1991

[Primary volvulus of the small intestines in adults].

In our area, small bowel volvulus is a sporadic form of mechanical intestinal obstruction. Diagnostic problems may occur. The clinical presentation is that of an acute abdomen. The cause of symptoms may be due to narrowing of the bowel itself, or strangulation of the blood supply, or both. The types (primary and secondary) and incidence of small bowel volvulus are age-related and demonstrate astonishing geographical differences. Goals for treatment of small bowel volvulus should include physician awareness and accurate workup of this uncommon diagnosis.

Adult↗
PubMed1990

[Endoscopic injection therapy in acute non-varicose upper gastrointestinal hemorrhage].

Emergency esophago-gastro-duodenoscopy was performed in 45 consecutive patients (26 men, 19 women, mean age 64 [23-91] years) with non-varicose upper gastrointestinal bleeding. The bleeding was arrested endoscopically by circumferential injection of an average of 6 (2-10) ml 1% polidocanol solution. In 10 patients an injection treatment was not possible because of extensive erosion or massive arterial bleeding. Bleeding recurred in seven patients 12-48 hours after initial injection. One patient in whom injection was not possible died during operation from massive intractable bleeding from an aortoduodenal fistula after abdominal aorta aneurysm surgery with implantation of a dacron prosthesis. There were no complications of the injection treatment.

Adult↗
PubMed1990

The effect of hemodialysis on omeprazole plasma concentrations in the anuric patient: a case report.

Omeprazole, a drug suppressing gastric acidity secretion was given intravenously at a dose of 40 mg/day to an anuric patient. Pharmacokinetics data indicate that without hemodialysis treatment, the dose can be reduced by 40% without any danger of loss of effectiveness. During hemodialysis however, the full dose must be given. Controlled long-term studies will be required to determine the exact dose for continued treatment.

Adult↗
PubMed1989

[Transmural esophagus perforation. Experiences with conservative treatment].

We report on four cases of esophageal perforation - self-induced, iatrogenic and spontaneous (Boerhaave's syndrome) - treated successfully by conservative means. Based on our own experience and the data collected from the literature the clinical findings, symptoms and signs, prognosis and therapeutic guidelines are reviewed. As a general rule every esophageal perforation diagnosed within the first 24 hours should be treated surgically. After the 24-hour limit the mortality in both surgically and conservatively treated patients runs parallel. Conservative treatment is based on absolute exclusion of oral ingestion, broad-spectrum antibiotics and adequate drainage of pleural empyema and abscesses.

Adult↗
PubMedDate not supplied

Serine proteinase activation in esophageal cancer.

BACKGROUND: Activation of the plasminogen/plasmin system seems to contribute to tumor aggressiveness and shorter post-operative survival. In the present study we examined the relation of uPA (urokinase plasminogen activator), uPAR (uPA receptor) and PAI-1 (plasminogen activator inhibitor type 1) to the biological growth behavior of esophageal cancer, as well as their influence on survival in esophageal cancer. MATERIALS AND METHODS: The expression and distribution of uPA, uPAR and PAI-1 were analyzed by Northern blot analysis and immunostaining in 41 resected esophageal cancers and in normal esophagi. RESULTS: Northern blot analysis revealed a 5.0-, 3.6- and 5.4-fold increase in uPA, uPAR, and PAI-1 mRNA levels in esophageal cancer, respectively, in comparison to normal controls (p<0.01). These mRNA moieties were concomitantly increased in 86% of the tumors. uPA activity was 2.3-fold increased in esophageal cancer compared with normal controls (p<0.01). Statistical analysis revealed no differences in uPA, uPAR and PAI-1 immunoreactivity between well-differentiated, moderately-differentiated and poorly-differentiated tumors. Furthermore, survival analysis showed no difference in patients whose tumors exhibited positive uPA and uPAR immunostaining (median 11 months, range 4-36 months) versus patients whose tumors exhibited negative uPA and uPAR immunostaining (median 11 months, range 3-51 months). CONCLUSION: Our data revealed that overexpression of uPA, uPAR and PAI-1 is often present in human esophageal carcinomas. However, up-regulation of these factors is not correlated with tumor differentiation or survival. These findings indicate that, unlike other tumors, uPA, uPAR and PAI-1 seem not to be prognostic markers for esophageal carcinomas.

Adenocarcinoma↗
PubMedDate not supplied

[The ilio-caval confluence syndrome].

UNLABELLED: The venous confluence syndrome is the clinical consequence of the flows obstruction which are the main tributary of the deep venous system. The cava confluence syndrome is different from the aortic obstruction at the level of its bifurcation. Its causes are congenital abnormality, extrinsic, intrinsic and intramural compression. CLINICAL PICTURE: collaterization of the int. vertebral plexus of the Azigos and hemiozygos veins as well as episgastric and thoracic veins, in chronic cases. On the other hand, in acute cases, significant renal insufficiency, ascites and bilateral phlegmasia caerulea make up the clinical picture. In acute stage, surgery requires thrombectomy and endovascular prothesis whereas in chronic stage, surgery will tend to remove the cause with only a palliative action on external symptoms. In both cases, abnormalities bring about a surgical issue.

Acute Disease↗