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Biomedical subjects

J Antoniades

Publications and source records attributed to J Antoniades.

18 recordsLinked to original sources
PubMed2003

A new tension-free technique for the repair of umbilical hernia, using the Prolene Hernia System--early results from 48 cases.

Tension-free repair using the Prolene Hernia System (PHS) has been widely adopted for inguinal hernias with excellent results. In our department, a new technique for umbilical hernia repair, using the PHS, has been developed. Between 2000 and 2002, 48 patients underwent tension-free umbilical hernia repair, using the PHS. There were 20 male and 28 female patients, with a mean age of 54 years. The preperitoneal space was dissected to accumulate the underlay patch of the PHS. The onlay patch was placed on the anterior rectus sheath and the connector in the umbilical ring. The median operating time was 35 min (range, 28-40). Postoperative pain was minimal, and there were no complications associated with the mesh, except a seroma, which required needle aspiration. There were no recurrences after a median follow-up of 13 months (1-24). Our early results indicate that the described tension-free technique could become the standard treatment for umbilical hernia repair, but long-term results are required to establish the efficacy of the procedure.

Adult↗
PubMed2003

Randomized comparison between different insufflation pressures for laparoscopic cholecystectomy.

Laparoscopy using carbon dioxide insufflation induces adverse effects in both the cardiovascular and the respiratory function. The use of low pressure pneumoperitoneum has been shown to reduce adverse hemodynamic effects. However, its effect on tissue trauma and postoperative pain and recovery remains controversial. The aim of this study was to compare tissue trauma, postoperative pain, and recovery in two groups of patients undergoing laparoscopic cholecystectomy, one at insufflation pressure of 8 (LC8) and the other at 15 mm Hg (LC15). Forty patients were randomized, 20 in each group. The characteristics of the patients were similar in the two groups. The procedure was completed in all patients in the LC15 group, but in 2 patients in the LC8 group the pressure was increased to 15 mm Hg to complete the operation. There were no significant differences in postoperative pain scores, analgesic consumption, and the incidence of nausea, vomiting, and shoulder pain between the two groups. C-reactive protein concentrations and white blood cell count rose significantly after surgery, but the increase was similar in the two groups. The median duration of surgery was similar, 23 minutes (range 15-65) in the LC8 group and 25 minutes (range 15-80) in the LC15 group. Using our technique of laparoscopic cholecystectomy, there were no advantages to tissue damage, postoperative pain, and recovery when a low pressure pneumoperitoneum was used.

Acute-Phase Reaction↗
PubMed1981

Management of carcinoma of the uterus stage II.

A total of 34 patients with Stage II endometrial carcinoma were evaluated for treatment in the department of Radiation Therapy at Hahnemann Medical College and Hospital from January 1958 to December 1977. Nineteen patients were treated by a standard radiation therapy technique using two radium placements and external beam therapy designed to give a high central tumor dose and also to give adequate radiation to the pelvic lymph nodes. A second group of 15 patients was treated by a wide variety of treatment programs, in most cases a combination of radiation and surgery. No significant difference can be seen between the results in the two groups. Excellent local control was obtained with one failure in each group. The high rate of distant failure indicates inaccuracies in the clinical staging and the diagnostic work-up methods available during this time. A more extensive pretreatment work-up utilizing computerized tomography, lymphangiography, or surgical exploration might improve the clinical staging and allow individualization of the treatment program.

Adenocarcinoma↗
PubMed1976

The management of stage III carcinoma of the endometrium.

Ten percent of all patients with endometrial carcinoma have Stage III disease at the time of presentation. The management, the features of their disease, and their prognosis are quite different than those of patients with Stage I disease. This report is based on 37 patients with Stage III carcinomas. For their treatment, a program of definitive radiation therapy was applied. Eleven patients had a prior total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO). On the basis of the tumor extension, three main patterns were identified: 1) downward into the vagina or the vagina and the cervix; 2) lateral into the parametrium and the pelvic wall; and 3) to the ovaries. This classification carries therapeutic and prognostic significance. Ovarian extension has the best prognosis when treated by TAH and BSO followed by postoperative radiotherapy. Extension to the vagina or to the vagina and the cervix can be treated successfully by a combination of external beam and local radium placements. Patients with pelvic wall extension have the poorest prognosis. They comprise maore than 50% of all cases with Stage III tumors and have exhibited persistent or recurrent disease even when treated at high dose levels. The cumulative survival rates for the entire stage were 50% at the end of the first year, 32% at the end of the second year, and 25% at the end of the fifth year.

Adenocarcinoma↗
PubMed1976

Bone scanning in carcinomas of the colon and rectum.

Bone scanning has been shown to have a higher rate of accuracy in diagnosing osseous metastatic lesions from carcinomas of the lung and breast. In the present report, we have demonstrated this to be true for osseous metastases from carcinomas of the colon and rectum. We found that a high percentage (75%) of patients who have pelvic or back pain have positive 99mTc bone scans for metastases in spite of the negative radiographs. The previously reported incidence of 5-6% of osseous involvement from these tumors is probably lower than the actual incidence, as these studies were reported without the benefit of bone scanning.

Adult↗
PubMed1976

Subtotal mastectomy and radiation therapy in the definitive management of localized breast malignancy.

Between 1961 and 1974, 51 women with primary carcinoma of the breast were treated by external radiation following surgery that was limited to diagnostic biopsy. All patients tolerated therapy well with minimal long term morbidity. While the reported follow-up periods are brief (most patients at risk for less than 3 years), 29 patients remain alive, 25 of whom show no evidence of persistent or recurring disease. These data suggest that local-regional control rates match those obtained following mastectomy. Definitive statements as to local failures and long term survival rates are not yet available.

Adult↗
PubMed1976

Serial liver and spleen scanning in patients with malignant lymphomas.

Spleen and liver represent target organs for involvement in patients with Hodgkin's disease and with non-Hodgkin's lymphomas. Although histological examination remains the most reliable method in diagnosing the presence of disease in these organs, particularly during the early phases, exploratory laparotomy and liver biopsy cannot be repeated, for practical purposes, on a regular basis. As the incidence of splenic and hepatic involvement continues to rise in the years following the initial diagnosis, we have found that liver and spleen scans performed in a serial manner are helpful in establishing the diagnosis during the follow-up period. By comparing the later studies to the earlier ones, interval changes as related to the size, contour, homogeneity and to the presence or absence of filling defects, become apparent. These changes, should they occur, are related, in our experience to the underlying lymphoma. Conversely, through serial scanning, improvement under treatment of a previously involved organ, is well demonstrated by this noninvasive technique. The limitations imposed by the resolving power of the imaging system must be taken into consideration when interpreting the results.

Hodgkin Disease↗