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Biomedical subjects

G Lotan

Publications and source records attributed to G Lotan.

16 recordsLinked to original sources
PubMed2004

Laparoscopically monitored percutaneous endoscopic gastrostomy (PEG) in children: a safer procedure.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) has now become the preferred technique for facilitating enteral nutrition in children with inadequate caloric intake. Because many problems related to PEG insertion have recently been reported, we were motivated to reassess this established technique. We have therefore added a new step--laparoscopic monitoring--to the classic PEG procedure. METHODS: Fifteen children who required PEG during the previous year were studied. Their ages ranged from 2 months to 18 years. Six children were < 1 year old at the time of operation. In 11 patients, the PEG was performed at the end of a laparoscopic Nissen fundoplication. In the others, it was done as a single procedure. RESULTS: In all 15 children, the PEG was performed safely and quickly, without complications. CONCLUSION: The addition of 'laparoscopic monitoring' to the classic PEG procedure introduced by Gauderer et al. changes the first and last parts of the procedure from an almost 'blind' undertaking to a well-controlled and safer procedure.

Adolescent↗
PubMed2003

Evaluation of damage to the testicular cells of golden hamsters caused by experimental cryptorchidism using flow cytometry and confocal microscopy.

Artificial unilateral cryptorchidism was performed in golden hamsters which were then held for different periods of time. The non-operated side was used as a control. At various times from 4 to 15 days, hamsters were killed, testes were removed and weighed, single cell suspensions were prepared for flow cytometry analysis and seminiferous tubules were fixed for confocal microscopy. Using DNA staining by propidium iodide or acridine orange followed by flow cytometry analysis, a marked decrease in the haploid condensed cell fraction was detected at the beginning stages of experimental cryptorchidism. In correlation with flow cytometry results, spermiogenic arrest at stages IX and X of seminiferous epithelium was detected in these animals by confocal microscopy and there were no mature forms of haploid cells in the cryptorchid testis. In the testis with more severe damage, there were almost no haploid cells in the seminiferous tubules of cryptorchid animals. In addition, a significant decrease in tetraploid cell fraction and an increase in S-phase fraction was obtained in severe cases. This may be explained by cell arrest before entrance into meiosis. Destruction of tubule structure and cell arrangement were also observed by confocal microscopy in such cases. In conclusion, flow cytometry, combined with confocal analysis, added useful information about spermatogenesis disturbances in cryptorchid testis and it may be used as diagnostic tools in other cases of spermatogenic disorders.

Animals↗
PubMed2001

Laparoscopic evaluation and management of nonpalpable testis in children.

We evaluated the outcome of children with nonpalpable testis managed and treated laparoscopically in our department over a 6-year period. One hundred nine boys aged 12 months to 14 years were included in the study; most were between the ages of 12 months and 18 months. Diagnostic laparoscopy and eventual orchiectomy were performed in 50 patients (45.8%) with atrophic testicles. A normal sized intraabdominal testicle was found in 59 patients (54.1%). Seven of the intra-abdominal testicles were bilateral (6.4%), and 12 were located in the vicinity of the inguinal ring (11%). All patients underwent both the first and second stages of the Fowler-Stephens procedure, except for those whose testicles were located in the vicinity of the internal inguinal ring. They underwent an immediate one-stage laparoscopic-assisted orchiopexy without difficulty. Only two patients had atrophic testicles observed in the scrotal area after the complete Fowler-Stephens procedure (3.4%). The good results reported in most series establish the laparoscopic management of the nonpalpable testis as "state of the art," with results superior to those obtained with the open technique regarding morbidity, complication rate, and length of hospital stay.

Adolescent↗
PubMed2001

Epididymitis in childhood: a clinical retrospective study over 5 years.

BACKGROUND: Acute scrotal pain in children presents a major diagnostic and therapeutic challenge. Epididymitis has been considered uncommon in childhood. The clinical spectrum and therapeutic policy of the acute scrotum in children is continually being reassessed. OBJECTIVES: To determine whether there has been an increase in the incidence of epididymitis in children and to advocate a more selective surgical approach to the acute scrotum. METHODS: We conducted a retrospective review of 65 children admitted to our department of pediatric surgery with the diagnosis of acute scrotum during a 5 year period. RESULTS: Of the 65 children admitted with the diagnosis of acute scrotum, epididymitis was diagnosed in 42 (64.6%). The remaining cases included torsion of the testis in 12 patients (18.5%), torsion of the appendix testis in 5 (7.7%), scrotal pain and minimal physical findings in 4 (6.1%), and scrotal hematoma and idiopathic scrotal edema in one patient each. Doppler ultrasound of the groin, color Doppler ultrasound of the testis and testicular nuclide scintigraphy (Tc-99m scan) examinations were performed on 49, 30 and 57 occasions, respectively; the Tc-99m scan was the most effective tool. All the patients with epididymitis were diagnosed before surgical intervention and were treated conservatively. CONCLUSIONS: We observed an increasing frequency of epididymitis in children admitted with the diagnosis of acute scrotum.

Acute Disease↗
PubMed1997

Hepatic mesenchymal hamartoma: a pediatric tumor that may be diagnosed prenatally.

Hepatic mesenchymal hamartoma is a benign tumor, defined as an excessive focal overgrowth of mature normal cells and stroma native to the liver. The increasing popularity of antenatal scanning has resulted in in utero diagnosis of congenital malformations and anomalies that previously became apparent only after delivery. Herein, we present a rare case of fetal mesenchymal hamartoma of the liver, which was initially sonographically detected at 29 weeks of gestation. A brief literature survey and obstetric recommendations for management and monitoring of such rare cases are included.

Adult↗
PubMed1997

Giant omental cyst in children presenting as pseudoascites.

An unusual case of omental cyst is described. During a period of 3 years, a child was hospitalized seven times in five different hospitals for evaluation of ascites of unknown origin. Extensive and repetitive diagnostic workup did not reveal the cause of his problem, and recurrent paracentesis improved his condition partially, but for very short periods. A diagnostic laparoscopy, followed by explorative laparotomy, led to the correct diagnosis and appropriate surgical treatment, with complete relief of his complaints.

Ascites↗
PubMed1995

Intraoperative irrigation with bupivacaine for analgesia after orchiopexy and herniorrhaphy in children.

Effective postoperative analgesia is important, especially in pediatric surgery. The efficacy of intraoperative surgical wound irrigation with bupivacaine for postoperative analgesia was investigated in 90 children undergoing elective inguinoscrotal surgery. We found that this method effectively reduced postoperative pain and narcotic drug requirement. Bupivacaine irrigation was simple and complication-free. We believe that the irrigation of surgical wounds with bupivacaine should be a routine procedure in elective inguinoscrotal surgery in children.

Analgesia↗
PubMed1993

[Cloacal exstrophy: what therapeutic approach for what result?].

The authors report 11 cases of cloacal exstrophy and analyse the anatomical features and the results of surgery. The outcome of three patients aged 20, 18 and 9 years is related. Advances in prenatal assessment of malformations is likely an explanation for the lack of new cases in the recent years. However the surgical procedure now available provides a better quality of life to patients with such a disabling malformation.

Adolescent↗
PubMed1989

The feasibility of in vivo resection of the left lobe of the liver and its use for transplantation.

The anatomical possibility of resecting the left lobe of the liver (segments II and III) in living subjects and using it for transplantation was evaluated. A group of 60 cadaveric livers were dissected at autopsy. The vascular and biliary elements of the left lobe were isolated and the lobe was resected and evaluated for possible grafting. The left lobe was 12-28% (mean 19.4%) of the liver mass. An extrahepatic segment of the left hepatic vein was isolated in 95% of specimens. Arterial blood supply to the left lobe consisted of a single artery (92%) or two arteries (8%). A single portal vein segment to the left lobe (type I) was found in 35% livers. Portal vein branches originated from a common orifice (type II, 35%) or separately (type III, 30%) from the left portal vein, and in these instances, preparation of a portal segment necessitated partial section of the left portal vein wall. Biliary drainage was extrahepatic in 56 livers and consisted of a single duct (type I, 78%), or two ducts (type II, 15%). The resected left lobe was evaluated as satisfactory (single hepatic vein and artery, types I or II portal vein, type I bile duct) in 48% of cases, while a less-satisfactory lobe (type III portal vein or type II bile duct) was obtained in 33%. It was found anatomically difficult or impossible to resect the left lobe for possible transplantation in 11 (19%) liver specimens.

Adolescent↗
PubMed1989

Isolated gallbladder rupture due to blunt abdominal trauma.

Traumatic injury to the extrahepatic biliary system is rare and usually diagnosed at laparotomy when it is associated with other visceral injuries. Isolated gallbladder rupture due to blunt abdominal trauma is even rarer. The clinical presentation of gallbladder injury is variable, resulting in a delay in diagnosis and treatment. Awareness to the possibility of trauma to the extrahepatic biliary system enables early surgical intervention and eliminates the high morbidity associated with delated diagnosis. A 5 year old child with isolated gallbladder rupture caused by blunt abdominal trauma is presented.

Abdominal Injuries↗
PubMed1989

Maximal expiratory flow at FRC, adjusted for absolute lung volume: specific Vmax FRC.

Maximal expiratory flow-volume curves were recorded in 85 healthy subjects, aged from 18 to 78 years. The maximal expiratory flow was measured at 75, 50 and 25% of the vital capacity (VmaxVC), at 60 and 40% of the total lung capacity (VmaxTLC), and at the functional residual capacity level (VmaxFRC). The latter was adjusted for the lung volume at which it was measured. The new parameter was named specific VmaxFRC (SVmaxFRC) and expressed in s-1. Normal values and prediction formulas based on height, weight, age and sex were established. It was found that: (1) adjustment for lung volume narrowed the interindividual variability of SVmaxFRC from 47 to 37%; (2) did not diminish the influence of age (p less than 0.001); (3) erased the influence of height and VC; (4) reduced the correlation with FEV1 (p less than 0.05), and (5) unveiled a borderline correlation with specific conductance (p less than 0.05).

Adult↗
PubMed1989

Calcium antagonist. Effect on adhesion formation.

In view of the role of the calcium ion in the inflammatory process, the effect of Diltiazem--a calcium antagonist--on the formation of intraperitoneal adhesions was studied in rats after induced trauma to the uterine serosa. It was found that intraperitoneal application of diltiazem inhibited adhesion formation to some extent, whereas intramuscularly administered Diltiazem did not. A dual effect of calcium antagonists on the formation of adhesions is suggested.

Animals↗
PubMed1988

Aneurysmal bone cyst of the rib: a review and report of two cases.

Aneurysmal bone cyst (ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. Two cases of ABC involving the rib are reported. Its occurrence in the eight decade of life as manifested in one of our patients is extremely rare. The aetiology, clinical manifestations, pathology and treatment are briefly discussed. En bloc resection of the lesion is curative, and offers a good cosmetic and functional result.

Adult↗
PubMed1987

Treatment of avulsed clavicle and recurrent subluxations of the ipsilateral shoulder by dynamic fixation.

A new operative approach is presented for treatment of fractured distal end of clavicle associated with recurrent anterior shoulder subluxations. One case is presented in which open reduction of the fractured clavicle and stabilizing the anterior shoulder joint were accomplished by transfer of the coracoid process with its attached muscles under the subcapularis muscle onto the clavicle. The operation was followed by complete reduction of the fracture and a stable shoulder joint.

Adult↗
PubMed1985

The simultaneous coexistence of adenocarcinoma and primary malignant lymphoma in the stomach.

A case of simultaneous adenocarcinoma and primary malignant lymphoma as two independent growths of the stomach is presented. Review of the literature documented two such cases along with nine cases of the collision-tumor type. The differential criteria between this entity and collision tumor and carcinosarcoma are emphasized. Diagnosis and treatment is discussed.

Adenocarcinoma↗