[Reconstruction of the thoracic esophagus with a rotated tubular stomach flap].
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Biomedical subjects
Publications and source records attributed to J Papadimitriou.
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A modified Childs-Phillips intestinal plication technique is described. The addition of a portion of Teflon felt at the site of the curve of the thread protects the vessels of the mesentery from direct contact with the suture and erosion.
Heat-treated and untreated sera from rats immune to Strongyloides ratti are capable of arming both immune and non-immune macrophages and eosinophils in vitro. These cells are capable of killing larvae of the parasite. Electron microscopy has indicated multi-point attachment of the cells to the epicuticular transverse grooves of the larvae within 4 and 24 h of incubation at 37 degrees.
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In 44 patients who had been operated upon for benign obstruction of the biliary tract and had undergone sphincteroplasty or choledochoduodenostomy seven to 12 years previously, patency of the new stoma was evaluated. Dynamic studies of bile flow were done by radioisotopic cholangiography, using 99mTc-pyridoxal-phenylalanine as an hepatobiliary imaging agent. Both surgical procedures seem to give equal results in the long term follow-up study regarding the patency of a new stoma. In view of the fact that choledochoduodenostomy involves less morbidity and mortality postoperatively, than does sphincteroplasty, the former is preferred unless a stone is impacted into the ampulla of Vater or if the common bile duct is less than 2 centimeters in diameter in instances of stricture.
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In this experimental study, the usefulness of a new radiotracer, Tc-99m pyridoxal-phenylalanine ("Tc-PPh"), is evaluated as a hepatobiliary imaging agent, and results are compared with those of conventional cholangiography. In the presence of a normal biliary tree or in cholelithiasis, information derived from conventional cholangiography is of better quality. The radiotracer technique, however, is very useful for the demonstration of cholopeptic bypass procedures, even in the presence of jaundice, and also in cases of intraperitoneal bile leakage.
Twenty-four patients with normal or diseased hepatobiliary systems were subjected to a clinical trial in order to evaluate Tc-99m pyridoxal-phenylalanine as a biliary imaging agent. The investigation was combined with i.v. cholecysto-cholangiography in most cases, and the results were compared. It is concluded that qualitative information derived from conventional i.v. cholangiography is better in demonstrating the normal biliary tree or gallstones. The radiotracer techniques, however, are valuable in dynamic studies of Oddi's sphincter, in showing patency of biliary by-pass procedures, and in differentiating hepatocellular from obstructive jaundice.
Ten cases of solitary bone cyst are presented. Nine of the lesions were asymptomatic and were discovered incidentally. Two patients were operated upon while eight were followed for 1 to 14 years. In spite of severe foot injuries that three patients have sustained, no fracture of the calcaneus occurred. We also showed experimentally that the strength of the calcaneus is not significantly reduced by the presence of the cyst. Therefore operative intervention in this lesion is not recommended. Acknowledgements: We wish to thank Dr. M. Carakostas, Consultant Orthopaedic Surgeon at Asclepeion Hospital, Athens, for allowing us to present Case 6 and Mr. St. Paipetis, Professor of the Polytechnic School of Athens, for his adivce during the experimental work.
In a patient with liver cirrhosis and severe hypersplenism resistent to corticosteroids splenectomy was attempted but proved impossible. Embolisation of the splenic artery with tiny fragments of absorbable gelatin sponge induced gradual restitution of haematological function to normal after 6 wk. Abdominal pain, paralytic ileus of short duration, transient pyrexia, and pleural effusion ensued but were well tolerated. The patient has remained well, 2 1/2 mo later. It is suggested that this simple method may prove rewarding and could safely be used, if necessary, more than once in patients for whom other treatments are unsuitable or have failed.
Normal outbred adult Wistar rats were resistant to infection with intratracheally administered viable spores of Aspergillus fumigatus although although they developed a subacute interestitial pneumonia. While the lesions were more severe in animals immune suppressed with Azathioprine (immuran) there was no evidence of hyphal growth in the pulmonary tissue. Significant histological involvement was found only in those animals receiving repeared subcutaneous injections of cortisone and multiple intratracheal injections of spores. Granulomatous lesions were scattered throughout the parenchyma of the lung, and many eroded the walls of adjoining bronchioles permitting entry of the material in the necrotic centre of the granuloma into the lumen of the bronchiole.
Of twenty-four dogs, fifteen survived up to two years after aortic replacement with fresh fascial graft. Surviving dogs underwent hemodynamic study and cineaortography. Histology of the graft was examined after the dogs were sacrificed. Length of the graft used is an important factor for both dog survival and graft hemodynamics. The shorter the aortic segment replaced the better the chances for long-term graft patency.