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Biomedical subjects

D Psathakis

Publications and source records attributed to D Psathakis.

10 recordsLinked to original sources
PubMed2001

[Spiral trocar--a new trocar concept].

INTRODUCTION: We would like to introduce a new trocar technique for minimal invasive surgery. The new trocar is a spiral whose coil becomes ever increasingly stronger towards the centre. Because of this, there is a smooth transition between spiral, screw and rod. The outer diameter remains the same. The spiral-trocar is screwed through the abdominal wall like a corkscrew. Because of this, the primary channel of puncture runs spirally. Furthermore, the channel is dilated and centralised so that the trocar's rod together with its sleeve can be pushed through the abdominal wall. This trocar design demonstrates the following advantages: The trocar can be screwed through the abdominal wall in a controlled manner without having to apply axial pressure. This prevents any unintentional perforation of organs. Because different layers of the tissue are penetrated at different places, they overlap, thus sealing one another after removal of the sleeve. The puncture channel was minimal, thus leaving very little risk of trocar site hernia. METHODS: The spiral-trocar was examined and compared with other types of trocars in vivo and vitro. RESULTS: During these tests, the spiral-trocar demonstrated a high level of safety and good usability. DISCUSSION: The spiral-trocar is an easily cleanable, reusable product without a mechanical sealing device and can be used together with most sleeves. This makes it very cost effective.

Animals↗
PubMed1999

Ordinary colorectal adenocarcinoma vs. primary colorectal signet-ring cell carcinoma: study matched for age, gender, grade, and stage.

PURPOSE: This study contributes to the characterization of primary colorectal signet-ring cell cancer in contrast to ordinary colorectal carcinoma. Primary colorectal signet-ring cell cancer is a rare but distinctive primary neoplasm of the large bowel with still-controversial clinicopathologic features. METHODS: Clinicopathologic features and survival data are evaluated in comparison with those of the ordinary colorectal adenocarcinoma (non-signet colorectal carcinoma) in a retrospective study matched for age, gender, grade, and stage. RESULTS: In a series of 1,600 consecutive colorectal cancer patients since 1979, 14 patients (0.88 percent) with a signet-ring cell cancer were identified. Gender ratio was balanced, and mean age was 67.5 years. The majority of patients had an advanced tumor stage at the time of diagnosis (57.1 percent Stage IV and 35.7 percent Stage III). Median survival time was only 16 months. In a study matched for age, gender, grade, and stage, a lower survival rate was found for patients with signet-ring cell cancer, but the difference did not reach statistical significance. In contrast to non-signet colorectal carcinoma, signet-ring cell cancer was characterized by a significantly higher incidence of peritoneal tumor spread (64.3 percent) and a lower incidence of hepatic metastases (14.3 percent). CONCLUSIONS: Signet-ring cell cancer represents a rare but distinctive primary neoplasm of the large bowel. It is frequently diagnosed in an advanced tumor stage, thus showing an overall poorer prognosis than nonsignet colorectal carcinoma. Usually only palliative surgery is possible. A high incidence of peritoneal seeding and a low incidence of hepatic metastasis is characteristic of signet-ring cell cancer.

Adenocarcinoma↗
PubMed1998

Blood selenium and glutathione peroxidase status in patients with colorectal cancer.

PURPOSE: It is still controversial whether a low selenium level and a reduced activity of the selenium-dependent enzyme, glutathione peroxidase, in blood are associated with an increased risk and poor prognosis of cancer in humans. This study evaluates whether colorectal cancer patients have lower serum selenium and glutathione peroxidase levels than a gender-matched and age-matched control group and whether there is a correlation to clinical data and prognosis. METHODS: In a retrospective study, serum selenium and glutathione peroxidase activity of 106 patients with colorectal cancer were determined. Clinical data were provided by our long-term follow-up program for colorectal cancer patients. RESULTS: Patients with a selenium level <70 microg/l had a significantly lower mean survival time and a lower cumulative cancer-related survival rate than patients with a selenium level >70 microg/l (P = 0.0009). When considering the different tumor stages, a decline of the mean selenium level in the T4 carcinoma group was found in the analysis of variance (P < 0.05). The lowest selenium level was found for patients with advanced tumor disease and in a preoperative situation, ie., high tumor burden. In comparison with the control group, the cancer group showed a significant reduction of serum glutathione peroxidase activity (P < 0.01) but no significant difference in selenium level. CONCLUSIONS: These results support the hypothesis of an association between low selenium level and advanced tumor disease. From our data, it cannot be decided whether this phenomenon is more likely to be a consequence or a causative factor for development and course of the disease.

Adult↗
PubMed1994

Clinical significance of duodenal diverticula.

Duodenal diverticula are found in up to 22 percent of the population. According to the literature, less than 10 percent of duodenal diverticula will cause symptoms, and about 1 percent will require definite treatment. There is no indication for treatment of asymptomatic patients with duodenal diverticula. A trial of conservative treatment is justified if the symptomatic patient is in stable condition. If symptoms persist or serious complications are present and other pathology of the abdomen that might be responsible is ruled out, definitive treatment is necessary. For intraluminal duodenal diverticula an elective endoscopic approach is possible. Our approach for extraluminal duodenal diverticula is discussed herein. The clinical presentations of 50 patients from 1986 to 1992 are summarized. In a surprisingly high proportion (12 percent), the symptoms could be clearly related to the duodenal diverticula. Eight percent were treated surgically, and postoperative mortality rates zero. In the literature, postoperative mortality rates even for elective surgery are 8 to 12 percent and reach 20 percent for emergency operations.

Adult↗
PubMed1992

[Perforated aneurysm of the left hepatic artery].

Aneurysms of the hepatic artery are second (20%) to the splenic artery the most common site of splanchnic artery aneurysms. The frequency of location in the branches of the hepatic artery is as follows: common hepatic 63%, right hepatic 28, left hepatic 5%, both left and right hepatic artery 4%. Today atherosclerosis (30 - 32%) is the most prevalent etiology, followed by trauma (22 - 28%) and inflammatory lesions (11%). The average age is 41,6 years, the male to female ratio 2:1. In 64-80% of patients rupture of the aneurysm is the first and dramatic clinical manifestation. The mortality is then about 35%. The case of a 64 years old female with perforated aneurysm of the left hepatic artery is presented and the literature is reviewed with emphasis on etiology, clinical manifestation, diagnostic and therapeutic (surgical and non-surgical) procedures.

Aneurysm↗
PubMed1992

Present management of hepatic artery aneurysms. Symptomatic left hepatic artery aneurysm; right hepatic artery aneurysm with erosion into the gallbladder and simultaneous colocholecystic fistula--a report of two unusual cases and the current state of etiology, diagnosis, histology and treatment.

A left hepatic artery aneurysm has an incidence of 0.8% among the splanchnic artery aneurysms. 20% of splanchnic artery aneurysms are hepatic artery aneurysms. Atherosclerosis (32%) is the most prevalent etiology, followed by trauma (22%) and inflammatory lesions (10%). The average age is 40 (10-83) years, the male to female ratio 2:1. In 64-80% of cases rupture of the aneurysm is the first clinical manifestation. The mortality is then about 35%. The case of a 64 years old female with a symptomatic aneurysm of the left hepatic artery and the case of a 70 years old female, who underwent emergency laparotomy for acute colorectal hemorrhage, with a right hepatic artery aneurysm, which perforated into the gallbladder, with simultaneous colocholecystic fistula is reported and the etiology, histology, and present diagnostic and therapeutic management of hepatic artery aneurysms is discussed.

Aged↗
PubMed1991

[Popliteal compression syndrome: an overproportional incidence].

From 1985 to 1990 33 patients (43 lower limbs) with politeal entrapment were diagnosed by clinical findings and Doppler-ultrasound. The described syndrome is caused by transverse fibrous bands extending between both heads of the gastrocnemius muscle, or between the lateral head of the muscle and the medial femoral condylus. Chiefly during flexion of the knee and tiptoeing, the politeal artery and vein and/or popliteal nerves, mainly the common tibial nerve, are compressed on the fibrous bands. Of 43 lower limbs, the tibial nerve was mainly involved in 21 (high proportion) of them, the politeal artery in 19 of them and the politeal vein in the remaining 3 limbs. The ratio female: male was 2.93:1, without preference of a certain age-group. The follow-up is up to 4 years. The described condition is possibly more common than thought.

Adult↗
PubMedDate not supplied

Primary carcinoid tumor of the gallbladder.

We present the clinical course of a 77-year old woman who died of tumor cachexia 26.5 months after diagnosis of a primary carcinoid tumor of the gallbladder. To our knowledge, this is the 28th case reported in the world literature. The diagnosis was established coincidentally during histologic work-up of the gallbladder resected for cholecystolithiasis. The entity of this rare tumor type is discussed with regard to the literature.

Aged↗