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J Boix-Ochoa

Publications and source records attributed to J Boix-Ochoa.

At least 19 recordsLinked to original sources
PubMed1995

[Management of primary congenital megaureter with early diagnosis].

We present our follow-up protocol of congenital megaureter (PCM) diagnosed early thanks to showing prenatal ultrasound the dilatation in the urinary system. 47 PCM were studied retrospectively in 35 babies, out of 240 cases of prenatal renal dilatation, from 1984 to 1993. The final diagnosis was established with the early use of ultrasound, cystography, intravenous urography (IVU) and isotope test. The latter two gave hints as to the existence of obstruction, which was the main criterion for early surgery to be prescribed. The surgical treatment, when it was necessary, consisted of ureter reimplantation (Cohen type), following the resection of the stenotic segment. When it was necessary short distal tapering (3-4 cm) was performed. For the follow-up ultrasound, IVU and isotope test were used. Out of the 35 patients observed, 11 were girls and 24 boys, 9 (25.7%) of the PCM were from the right side, 14 (40%) from the left side and 12 (34.2%) bilateral. 36 PCM (76.6%) were non-obstructive and only follow-up was performed. 5 of them, in 3 patients, had infections and were operated on together with the 11 obstructed PCM. In total, 16 PCM were reimplanted, and associated tapering was need in 7 of them. Other 3 patients were operated on for associated pathology. The post-surgical complications were 2 cases or reflux and 1 uric stone that did not need surgery. The development of all cases was favorable. The protocol has been useful for the selection for early surgical intervention of the subsidiary megaureters from those that can be develop without risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1995

[Esophagogastroplasty in childhood: experience in 4 patients].

The most common indications of esophageal replacement in childhood are the esophageal atresia with long gap and caustic strictures. Several techniques has been described, using different components of the digestive tract. Total gastric transposition was performed in 4 children. The indications were esophageal atresia without tracheoesophageal fistula in 3 cases and a caustic stricture in other patient. Follow-up was 12 to 32 months. All patients are normally feed. One patient presented an anastomotic leak that closed spontaneously with total parenteral nutrition but ultimately led to an anastomotic stricture requiring pneumatic dilatation. Other patient presented stricture by sternal compression and required surgical repair. Total gastric transposition is a easy and physiologic technique, with low morbidity and good functional results.

Age Factors↗
PubMed1994

[Lymphoproliferative disease in pediatric liver transplantation].

Post-Transplant Lymphoproliferative Disorders are due to continuous B-lymphocyte proliferation induced by Epstein-Barr Virus (EBV) infection which is recovered in 88% of transplanted patients. These disorders may present clinically as lymphadenopathic syndrome with lymphoid tissue hyperplasia, systemic as a mononucleosis-like syndrome and lymphomatous syndrome, indistinguishable from non-Hodgkin's lymphoma. We present 10 patients of PTLD classified as 7 lymphadenopathic, 1 systemic (this patient had both syndromes) and 3 lymphomatous tumours. At present, PTLD treatment consists of surgical removal of accessible masses or post-chemotherapy (ChT) tumour rests, total or partial withdrawal of immunosuppressive drugs and ChT following the Sociéte Française d'Oncologie Pédiatrique (SFOP) protocol for non-Hodgkin's lymphoma.

Adolescent↗
PubMed1994

[Nitric oxide and Hirschsprung's disease: a causal relation biochemically, immunohistochemically and functionally demonstrated].

UNLABELLED: Hirschsprung's disease may be due to impaired nonadrenergic-noncholinergic inhibitory input in the aganglionic segment of the colon. It has been suggested that nitric oxide (NO) might be the lacking neurotransmitter. Thus, our specific aims were to determine in ganglionic and aganglionic segments: 1. The activity of the NO synthetase (NO-S); 2. The location of this enzyme; and 3. The "in vitro" basal motor activity of the muscle strips and their responses to an NO donor and to an NO antagonist. METHODS: NO synthetase activity was quantified in samples of tissue from both aganglionic and ganglionic segments obtained during surgery in 6 patients with Hirschsprung's disease by the transformation of 14C-L-arginine into 14C-L-citrulline in tissue homogenates. Immunohistochemical staining of the tissues was performed using a polyclonal antibody raised against a peptide sequence of rat brain NO synthetase. Furthermore, in 2 patients we measured "in vitro" the tonic response of muscle strips to an exogenous NO donor (sodium nitroprusside) and to an NO antagonist (L-NAME). RESULTS: NOS activity was undetectable in every aganglionic segment whereas it was present in all ganglionic segments (0.49 +/- 0.09 pmol citrulina/mg.min; mean +/- SE). Immunohistochemically, NO-S was absent in the myenteric plexus of aganglionic segments and it was present in ganglionic segments. "In vitro" basal motor activity of ganglionic segments was normal, with presence of low-frequency contractions (LFC) and summation contraction (SC); in aganglionic segments SC were absent. Sodium nitroprusside induced a marked relaxation (90% from basal) in muscle strips, both aganglionic and ganglionic, precontracted with bethanocol.(ABSTRACT TRUNCATED AT 250 WORDS)

Arginine↗
PubMed1994

[Adenomatous cystic pulmonary malformations: presentation of 26 cases].

We present our experience of 26 cases of cystic adenomatoid malformations of the lung (CAM), treated in the Department of Pediatric Surgery in our hospital between 1967-1991. There were two clinical pictures: one neonatal severe respiratory distress and successive repeated pulmonary infection appearing after the patient's first year of life and requiring both urgent diagnosis and treatment. Embryological development determines the pathologic classification of this entity in 3 types. Basic examinations by image are analyzed, bearing in mind their diagnostic value and the patterns they show. After analysing all the conditioning factors, no explanation has been found to the different course that this affectation (< 1 month and > 1 year of age respectively). Normally, neonatal mortality is closely related to other malformations, particularly to cardiovascular ones. Differential diagnosis is very important in the neonatal period, especially with regard to diaphragmatic hernia, lobar emphysema and pulmonary cysts. All these cases have been verified and classified by means of a pathologic study, which has shown the need for surgical operation. In the follow up of the patients no alteration has been noticed in the pulmonary function.

Child↗
PubMed1994

[Does Bolande's malignant tumor exist?].

Congenital mesoblastic nephroma (CMN) is a rare renal neoplasm which Bolande differentiated from Wilms tumour given its benign nature. We describe 7 cases of CMN which have been treated over the last ten years, in order to highlight to what extent a tumour which is generally considered to be benign can have an aggressive behaviour. 5 patients were diagnosed during their neonatal period (3 of them prenatally) and 2 after the third month of life. Clinical presentation, simple abdominal radiology, echography and abdominal CT scan, which showed characteristic images, led us to a final diagnosis. Tumoral resection was carried out in the 6 typical CMN. The atypical or aggressive CMN was urgently operated under critical circumstances due to spontaneous tumoral rupture. The pathological study showed a CMN of cellular variety with a sarcomatous component. Despite adjuvant chemotherapy, there was a tumoral recurrence which required a surgical second-look and subsequent chemotherapeutical treatment. Bolande's tumour is generally benign, but there is an aggressive cellular variant that fits into the intermediate zone of a pathological spectrum. This aggressive variant have different clinical, radiological and anatomo-pathological features and therefore it involves radical surgical treatment and additional chemotherapy with a rigorous follow-up in the short and the long term.

Abdomen↗
PubMed1993

[Prognostic factors in congenital diaphragmatic hernia. Can they modify our therapeutic approach?].

Mortality rate from congenital diaphragmatic hernia (CDH) is still high despite current therapeutic advances. For some time now we have been looking for prognostic parameters which be enable us to determine, in the prenatal and postnatal period, the patients who will die from their pulmonary hypoplasia in spite of treatment and those who will survive. The authors review 94 newborns with CDH diagnosed during the first 24 hours of life. The following prognostic parameters were studied: preoperative arterial gases, position of stomach, right or left sided hernia, liver in thorax and presence of postoperative pneumothorax. All these factors were related to mortality. The arterial gases were the most sensitive factor. Eighty per cent of patients with poor gasometric prognosis died. Thoracic stomach is also a poor prognostic parameter with a 76.7% mortality rate, however we think this does not justify prenatal surgical measures. The remaining parameters were not significant with regard to mortality.

Blood Gas Analysis↗
PubMed1993

[Surgical technique in reduced hepatic transplantation in children].

The lack of availability of pediatric donors for liver transplant has resulted in a high mortality rate among children awaiting transplantation, especially in patients weighing less than 10 kg. Knowledge of techniques of liver reduction allows liver transplantation in low-weight children with an adult liver graft, although with increased risk. The authors studied 70 pediatric liver transplants, 14.3% of whom received a reduced-size organ. Maximal difference between donor and recipient weight was 7.7. Segments II, III and IV (right hepatectomy) were transplanted in eight cases while segments II and III were transplanted in two cases. Transfusional requirements during the 48 hour postoperative period were not significantly different between patients with reduced-size liver and patients who received the full-size organ. There was not morbi-mortality secondary to surgical technique in reduced liver transplant group of patients.

Body Weight↗
PubMed1993

[Bronchiectasis in early childhood. Its surgical treatment].

We discuss the measures used, including physical examination, radiology, scintigraphy, T.A.C. and bronchography, to diagnoses 34 patients with bronchiectasis. In addition, the treatment used up until the time where the decision to perform surgery is also presented. Ten patients were submitted to surgical intervention and their operations, as well as the effected lobes, are described. The guidelines for surgical preparation, surgical difficulties encountered, postoperative care and the results of the surgeries are all discussed. Due to the age of some of these patients, obvious difficulties prevented functional testing. In those patients in whom it was possible, no loss in respiratory capacity has been observed.

Bronchi↗
PubMed1992

Paediatric liver transplantation: life after portoenterostomy in biliary atresia.

Seventy-five percent to 80% of patients with biliary atresia (BA) will be candidates for paediatric liver transplantation (PLTx) throughout the first 14 years of life. They form the main group of recipients in our Paediatric Liver Transplant Unit. Of 48 children transplanted, 21 (44%) had BA. These patients present particular features, average weight of 12 kg, mean age of 3 years, and severe malnutrition prior to PLTx, which distinguish them from other paediatric candidates. With the advent of PLTx, portoenterostomy (PE) has ceased to be the only recourse for treating the majority of patients with BA. Different factors converge in these patients: some, including haemorrhage and adhesions, may present technical difficulties, and others, such as infections (19% in this series) due to severe malnutrition and malabsorption and consequent chronic rejection (14% in this series), often lead to death in the postoperative period (33% in this series). BA is treated by all paediatric surgeons, but the overall success rate now depends not only on PE but also on PLTx. In an attempt to facilitate possible later PLTx in pts with BA, the authors as paediatric surgeons performing PE or PLTx present surgical modifications and emphasize the most important medical aspects conducive to the improved general status of these pts. Our aim was to establish guidelines for taking full advantage of PE while preventing posterior problems and facilitating future transplant surgery.

Biliary Atresia↗
PubMed1992

[Piriform sinus fistula, a new disease].

Pyriform sinus fistula has recently been described as a new, rare and little known pathology. The process develops as latero-cervical suppurative adenitis or acute suppurative thyroiditis, usually on the left side. Radical surgery is mandatory to avoid recurrence. This congenital malformation must be present in the differential diagnosis of recurrent infectious cervical processes, especially in acute thyroiditis. The only curative treatment is complete exeresis of the fistula after meticulous dissection of the fistulous tract. We present three cases of this pathology. The diagnostic approach and surgical treatment are discussed. The recent literature on this topic is reviewed.

Branchial Region↗
PubMed1992

[The surgical treatment of gastroesophageal reflux (GER)].

From 1960 to 1990, a total of 2,476 instances of cardio-hiatal abnormalities were treated. The cause of the abnormality was achalasia (cardio-esophageal dilatation) in 2.244 instances, sliding hernias in 167 and hiatal hernias in 65. Only 213 patients underwent operations, 8,%. Gastroesophageal reflux in children has characteristics different from those of gastroesophageal reflux in adults. Knowledge of the forces that influence the closing mechanisms of the lower esophageal sphincter (LES) is the cornerstone for rational and logical intervention. The philosophy in pediatrics is that a child is a being in evolution and that the anomaly in children originates from a displaced healthy LES that has not had the opportunity to demonstrate its function because it is not in its proper place. An operation that helps to provide essential anatomic conditions immediately leads the LES to normal physiology. The A.A. discussed and presented in which cases the surgical procedure has to be taken.

Child↗
PubMed1990

[Our experience in the treatment of cervico-facial adenitis caused by non-tuberculous mycobacteria (atypical mycobacteria)].

The authors believe that the greater part of chronic cervicofacial adenitis actually observed in our hospitals, are not caused by M. tuberculosis or M. bovis but by scrofulaceum mycobacterium, M. avium, M. fortuitum and M. Kansasii, and above all, by the first two of these. They present their experience with 16 cases of cervico-facial adenitis due to atypical mycobacterium (CAAM) treated in our centre during the last years, in which period no case of cervical tuberculosis (CT) was observed. It is important to establish an early differential diagnosis between both etiologies, seeing as treatment is different. Whilst tuberculostatics can solve the phymic infection, surgical extirpation is the only solution for CAAM. The diagnosis of these types of infection is achieved by means of a very characteristic clinical procedure and by cutaneous tests specific for each bacteria. Faced with the clinical suspicion, the total extirpation should be effected of the adenopathic block affected. The exact diagnosis can only be made by the culture of the operatory mass.

Child↗
PubMed1990

[Follow-up and evolution of 10 cases operated on for total colonic aganglionosis].

One hundred sixty-one cases of HIRSCHSPRUNG's disease have been operated on by us between 1966 and 1988. Of these, 19 were total colonic aganglionosis. Of eleven that underwent surgery before 1982, five are still alive. The eight that were operated on after 1982 have a good evolution. This report is a retrospective study of the clinical evolution in ten of the thirteen survivors. The ages are comprised between 21 and 2 1/2 years. We have reviewed their general condition, weight, height, tolerance to oral intake, stool frequency, general laboratory determinations, circulating iron, transferrin, transferrin saturation, absorption of vitamin B12 and folic acid, hydrogen test and stool examination. Except for one case, the others are in a perfect nutritional and growth condition. DUHAMEL's technique was employed in eight cases and REHBEIN's technique, in two. Given our good results, we think that LESTER-MARTIN's technique is unnecessary, except for that cases with extensive small bowel involvement due to the serious problems of absorption that this represents.

Colon↗
PubMed1990

[Meconial peritonitis: conclusions based on 53 cases].

The study of 53 patients with neonatal meconium peritonitis (MP) over a twenty-two year-period, the largest surgically-treated series at a single centre, is presented. Three different types of MP were established: Generalized, Localized and Cystic. Prognosis and surgical techniques to be used were determined by each MP type. The following survival rates achieved: for Generalized MP, 70% with "one stage" and 89% with "two stage"; for Localized MP, 80% with "one stage" and 100% with "two stage" and for Cystic MP, 57% with "two stage". The overall survival rate was 77%, rising to 85% in the last fifteen years, probably due to the advent of parenteral nutrition and advances in neonatal intensive care.

Cystic Fibrosis↗
PubMed1989

[Surgical approach in persistent neonatal pneumothorax].

837 neonates required mechanical ventilation at the Neonatal Intensive Unit in the last five years. 136 of them developed tension pneumothorax. Authors report our experience in these patients, who underwent next protocol: 1. Early diagnosis. 2. Underwater-seal drainage. 3. Suction drainage. 4. Selective intubation of contralateral bronchus. 5. Surgical closure. We explain step to step the protocol, specially in the 15 neonates who needed surgery. In such cases, surgical survival was 100%, in the postoperative phase 93% and total survival reached 78.5%. Therefore, we recommend surgery closure in patients who maintain pulmonary fistula in spite of an aggressive conservative treatment.

Female↗