PubMed Health⌕ Search

Biomedical subjects

J Papo

Publications and source records attributed to J Papo.

At least 37 records · Page 2Linked to original sources

High ligation or embolization of varicocele.

The presence of a varicocele was confirmed in 121 of 123 patients complaining of scrotal pain or infertility, in whom radionuclide scanning was performed. In the first 29 patients (retrospective study), a high ligation of the internal spermatic vein was performed. In 94 patients, a percutaneous venography was done via the jugular vein followed by embolization by Gianturco coils (occluding spring embolus, Cook Group Company, USA) in 84 of them. In eight patients, due to technical difficulties during the embolization trial, a high ligation was performed at a later date. Eleven patients underwent embolization after failed high ligation. A posttreatment follow-up radionuclide study revealed recurrences in two of the 95 patients who underwent embolization. Embolization can be performed on an outpatient basis with minimal risks. Reembolization is feasible, and it in no way prevents a further high ligation should this be necessary.

Adolescent↗

Spontaneous breakage of a double pigtail stent and bladder stone formation.

Five years after prostate resection and hormonal treatment for carcinoma of prostate a 76 year old patient presented with bone and lung metastases and dilatation of left upper collecting system. After castration a double J stent was inserted in the ureter. Two years later he was admitted for alteration in general condition related to cholecystitis. A standard radiograph showed the catheter fractured into four pieces, although no urinary signs had been reported during this 2-year period. Cholecystectomy was performed and the patient reviewed 6 weeks later: urography showed good functioning of the kidney and the absence of obstruction of the collecting system. The process of fragmentation continued and a bladder calculus developed on fragments falling into bladder: it was extracted by lithotripsy. The patient was asymptomatic and refused further investigation or treatment. This case is one of several reported in the literature and silicone or C-flex should be substituted for polyethylene.

Aged↗

Unusual presentation of carcinoma of the vermiform appendix: a report of two cases.

Two unusual presentations of perforated mucoid adenocarcinoma of the appendix are described. One patient presented with a large periappendicular abscess that extended into the gluteal region, the other with a retroperitoneal abscess and abscesses in the right flank and groin. Recognition of the source of the abscess may be difficult but is essential for the prevention and elimination of the sepsis which may be life-threatening. The presence of mucin in the drained pus is highly suggestive for perforated bowel carcinoma. A high index of suspicion and the performance of prompt diagnostic procedures may bring early surgical treatment and better results.

Abscess↗

Failure of balloon membranotomy of the inferior vena cava.

A young woman with membranous obstruction and coarctation of the inferior vena cava is described. A balloon membranotomy was performed with a transient improvement. Three months later massive thrombosis of the inferior vena cava developed. It appears that balloon membranotomy alone is contraindicated in the presence of both stenosis and membranous obstruction of the inferior vena cava.

Adult↗

'Essential' hypertension with hypokalemia. Caused by aldosterone-secreting adrenal adenoma.

Primary aldosteronism is a potentially curable cause of hypertension; it occurs in about 1% of hypertensive patients. In the case reported here, persistent hypokalemia developed in a 72-year-old man who had been treated for 13 years for essential hypertension. Investigation revealed elevated aldosterone level and reduced plasma renin activity. Computed tomography and selective angiography showed a tumor in the right adrenal gland. Aldosterone-secreting adenoma of the adrenal gland was diagnosed, and right adrenalectomy was performed. At a six-month follow-up examination, the patient's blood pressure and potassium level were normal.

Adenoma↗

[Treatment of ureteral obstruction by a double pig-tail catheter. Our experience].

The authors' experience is based upon 39 patients treated for ureteric obstruction between March 1980 and March 1984. The obstruction was of neoplastic origin in 7 cases. In 5 cases the double pig tail catheter was inserted peroperatively as a urinary drainage method. The catheter was inserted endoscopically in 10 cases and percutaneously in 9 cases. In 15 cases a temporary or permanent nephrostomy was necessary. Indications and complications of the method are analysed and the results compared with those in the literature.

Humans↗

Smooth muscle tumors of the alimentary tract.

Smooth muscle tumors (SMT) of the alimentary tract are uncommon. A series of 32 cases (16 leiomyomas and 16 leiomyosarcomas) are presented. The most common presenting clinical signs are bleeding or obstruction. These are caused mainly by degenerative changes within the lesion or its enlargement. The endoluminal SMT cause symptoms early and are more easily detectable. However, the extraluminal SMT, producing an extrinsic mass, can remain asymptomatic for a long time. Thus, such SMT may be found incidentally during operation. The larger SMT are mostly malignant. Microscopically it is sometimes difficult to determine if the SMT is benign or malignant.

Adult↗

Computerized tomography in xanthogranulomatous pyelonephritis.

Computerized tomography offers the means to recognize changes in the kidney associated with xanthogranulomatous pyelonephritis. The preoperative extent of the inflammatory process, reaction of adjacent parenchymal structures, and extension to the muscles and abdominal wall are identifiable on computerized tomography. The presence of obstructing renal stones, thickening of the perirenal fascia and inability of the kidney to handle intravenously injected contrast medium can be assessed with computerized tomography. Low density renal areas measured on computerized tomography may indicate lipid infiltration of the kidney or incorporation of the fat of the renal bed into the tumefactive mass.

Female↗

[Persistent gluteal pain after embolization of the hypogastric arteries. An unexpected complication].

Ligation or embolization of the hypogastric arteries for control of intractable hemorrhage from the bladder has been used in the past with equal results and without ill effect. Gluteal pain following hypogastric embolization is common and was reported to be resolved in less than 48 hours. A 57 year old man in our ward underwent a bilateral hypogastric embolization. The bleeding decreased considerably but a severe gluteal pain and claudication ensued. The pain persisted over a month necessitating frequent Morphine injections. We propose to use superselective catheterization technique in the future sparing the superior gluteal artery.

Buttocks↗

[Tomodensitometry in the diagnosis of perinephritic phlegmon].

Twenty-nine patients with perinephric abscess were treated during the last 15 years. Twenty-seven abscesses were cured by drainage performed as soon as the diagnosis has been made. One patient died from septicemia in spite of the treatment. One patient died because the correct diagnosis was not revealed until the autopsy. Ten patients had a nephrectomy performed on them later on. Staphylococcus and gram negative bacilli were equally isolated. Stones were present in twenty patients. Eleven patients were diabetic. The clinical picture is not always clear, and diagnosis might be difficult. The different radiological signs help to reach a correct and prompt diagnosis. To these classical signs we can add during these last years Gallium-67 radionuclide studies, ultrasound and computerized tomography, each of these having its indication and usefulness.

Adult↗

Osteoarthritis of the hip and fracture of the proximal end of the femur.

The purpose of this investigation was to verify a long-standing clinical observation that patients with fracture of the proximal end of the femur have less evidence of osteoarthritic changes in their hip joints than would have been expected in patients of similar age groups. The radiographs of 342 patients with fractures and those of 157 controls were examined. The statistical results gave uncontroversial evidence that the incidence of osteoarthritic joints was lower in the fracture group. The difference was even greater with severe osteoarthritic changes. This suggests that patients with osteoarthritis have a "better quality" of bone. They are less likely to be suffering from osteoporosis and less liable to fractures of the proximal end of the femur.

Age Factors↗

Infarction of renal tumors using isobutyl-2 cyanoacrylate and lipiodol.

Percutaneous transcatheter embolization of the renal artery in clear cell carcinoma was performed in nine patients. The occlusive material used was a suspension of 1 ml of isobutyl-2-cyanoacrylate in 3 ml of Lipiodol. Six patients were operated on 2-5 days after the embolization, and in three patients the procedure was palliative. In one of the latter, follow-up arteriography 4 months later showed that the artery was still occluded. There were no complications attributed to the glue or to oil emboli in this series.

Bucrylate↗

Hypernephroma with nonmetastatic liver dysfunction (Stauffer's syndrome) and hypercalcemia. Case report and review of the literature.

A case of renal carcinoma with hepatic dysfunction and hypercalcemia is described. The literature on Stauffer's syndrome has been reviewed and the pathogenesis of this syndrome discussed. It is stressed that the presence of hepatic dysfunction should not be considered a contraindication to surgery since its manifestations have been observed to regress in many cases following removal of the tumor.

Hepatomegaly↗