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Biomedical subjects

M Famos

Publications and source records attributed to M Famos.

17 recordsLinked to original sources
PubMed1999

[Primary extramedullary plasmacytoma of the duodenum].

INTRODUCTION: Primary extramedullary plasmacytoma (EMP) is a solitary tumor that arises outside the bone marrow in patients without clinical evidence of coexisting multiple myeloma. EMP represents only 4% of all patients with plasma cell malignancies. The tumor generally occurs in the submucosal tissue of the upper airway or oral cavity. 10% of all EMP occur in the gastrointestinal tract. Only 8 cases of EMP in the duodenum have been reported in literature. METHOD: The authors present a case of EMP in the duodenum in a 53 year old men. The tumor was initially misdiagnosed as desmoid tumor. With a combined treatment of surgery and chemotherapy complete remission for 2 years was achieved, followed by a dissemination of the tumor in the testis, mandibular bone and ribs. CONCLUSION: EMP is a rare differential diagnosis of an intraabdominal tumor. Diagnosis is difficult, and in most reported cases it is confirmed only postoperatively after immunohistochemical staining. Combined treatment of surgery and chemotherapy seem to offer the best potential for cure.

Diagnosis, Differential↗
PubMed1997

[Frozen section diagnosis using telepathology].

DEFINITION: Since 1992 we transfer digitalized frozen section images by means of videomicroscope and a personal computer through the public telephone network (ISDN) to the Institut of Pathology at the University Hospital in Basel. The aim of this study is to determine whether the quality of frozen section diagnosis obtained by telepathology is comparable to the conventional one. METHOD: The frozen section diagnoses by telepathology from Oct. 1992 to May 1996 (n = 94) are compared to the paraffin sections performed in each case after the primary examination. The result is then compared to the well documented data of conventional frozen section diagnosis in the literature. RESULTS: From Oct. 1992 to May 1996 we performed 94 frozen sections. In 84 cases the diagnosis was correct compared to the paraffin section (89%). The sensitivity to detect a malignant tumor was 92%, the specifity 100%. Four examinations were not conclusive and one examination had to be canceled because of technical problems. DISCUSSION: In the literature, 92% of malignancy is diagnosed by conventional frozen section [1]. Telepathology gives the same result.

Frozen Sections↗
PubMed1995

Telepathology: frozen section diagnosis at a distance.

Telepathology may be used to provide a frozen section service to hospitals without a department or institute of pathology. We have developed a telepathology system using the commercially available Integrated Services Digital Network (ISDN). The main software and hardware elements of our system are: Apple Macintosh workstations, a program for simultaneous transfer of image, voice and data, and a data bank for storage of patients' data and microscopic images. A picture instrument manager (PIM) makes remote control of microscopes or other instruments possible. The system connects the Department of Pathology of the University of Basel with the Regional Hospital of Samedan, 250 km away, and the Regional Hospital of Burgdorf, 100 km away. During a period of 20 months, frozen sections with the hospitals in Samedan and Burgdorf were performed in 53 patients. Between 54 and 58 s were required for the transfer of a diagnostic 8-bit grey level image containing 341 +/- 26.1 (standard error) kbytes (n = 13) or a diagnostic 24-bit colour image containing 165 +/- 16.9 kbytes (n = 40). Frozen section diagnosis was completed in 20-40 min. True-positive diagnoses of malignant tumours were achieved in 85.7% of cases (sensitivity = 0.857). No false-positive diagnosis was made. In 3 of the 53 cases telepathological diagnosis was not possible for technical reasons.

Frozen Sections↗
PubMed1993

Telepathology with an integrated services digital network--a new tool for image transfer in surgical pathology: a preliminary report.

We describe a low-cost telepathology system working via a commercial integrated services digital network (ISDN) and consisting of modular software and hardware elements. The main elements are Apple Macintosh workstations; a software program for the simultaneous transfer of pictures, voice, and data; and procedures for image processing and general administration of all the information generated. Additionally, the system allows remote control of any peripheral instruments by a "picture-instrument manager." The transfer rate is currently 64 kbit/s; it will be extended to 128 kbit/s (ISDN basic rate) in the near future and to 2 Mbit/s (ISDN primary rate) in the next 2 years. The system was tested by the regional hospital in Samedan, Switzerland, and the Department of Pathology, University of Basel, Basel, Switzerland, a distance of 250 km, by offering a remote frozen section service to the regional hospital in 16 cases. Fifty-four to 58 seconds were needed for the transfer of a diagnostic 8-bit grey-level image containing 341 (median value) +/- 26.1 (standard error) kbytes (n = 13) or a diagnostic 24-bit color image containing 165 (median value) +/- 16.9 (standard error) kbytes (n = 3). The time required for a diagnostic session was between 25 and 35 minutes.

Adult↗
PubMed1990

[Selective intraoperative cholangiography].

300 consecutive cholecystectomies performed from 1984 through 1986 were studied retrospectively to answer the following questions: which are suitable preoperative indicators for selective operative cholangiography, and which is the failure rate to detect biliary concrements by selective cholangiography? Patients with a history of jaundice, suspected concrements from preoperative intravenous cholangiography or ultrasound examination, a common bile duct wider than 8 mm, and elevated serum levels of bilirubin, alkaline phosphatase, ALAT (GPT) or ASAT (GOT) all had significantly higher rates of biliary concrements. Of these indicators, preoperative radiologic studies, serum levels of ALAT (GPT) and serum levels of alkaline phosphatase showed the best sensitivity, specificity as well as positive and negative predictive value. If two criteria, preoperative radiology and serum levels of ALAT (GPT), had been used, intraoperative cholangiography would have been performed in 34% of the cases. 82% of all biliary concrements would have been detected; in 3% of all cholecystectomies, the diagnosis of concrements would have been missed. We conclude that prospective studies should be performed to better define necessity and benefit of routine operative cholangiography still widely performed today.

Cholangiography↗
PubMed1989

[Surgical intraoperative complications in simple cholecystectomy].

In a retrospective analysis of all simple cholecystectomies performed between 1970 and 1987, we were particularly interested in the incidence of intraoperative surgical complications and their long-term follow-up. We analyzed 2441 consecutive simple cholecystectomies and found 60 major intraoperative complications with 55 patients (2.25%): there were 31 vascular lesions (1.27%) and 26 lesions of the biliary tract (1.06%). Amongst the patients with biliary tract lesion but one had to be reoperated one year later due to a stricture which occurred as a consequence of an end-to-end-hepatico-choledochostomy over a T-tube. Intraoperative technical complications may happen. Their early recognition and treatment are of utmost importance.

Cholecystectomy↗
PubMed1989

[Postcholecystectomy syndrome after simple cholecystectomy].

In a long-term follow-up, we were particularly interested in the incidence and cause of postoperative abdominal pain following simple cholecystectomy and in the incidence and etiology of reoperations of the biliary tract. For tat we analyzed 1539 patients who were operated by simple cholecystectomy between 1970 and 1979. Thereafter 875 (68.8%) were checked by us. We found 37.4% symptomatic patients, but in most cases no organic cause was detected. The major organic causes were scar problems and extrabiliary disorders; bilio-pancreatic disturbances were rare, but they needed a reintervention in most cases.

Abdomen↗
PubMed1983

[When should cholecystectomy in acute cholecystitis be planned?].

Acute cholecystitis may be treated either by removal of the inflamed gallbladder during the acute stage of the disease or by conservative measures followed later by cholecystectomy. Many authors recommend delayed operation in view of the possibly higher postoperative mortality with early operation. 394 early cholecystectomies for acute cholecystitis have been performed between 1970 and 1979 at the University Hospital of Basle. 14 patients died postoperatively, representing a mortality rate of 3.5%. Large series in the literature show similar mortality of 3.2-4.5%. In four prospective randomized studies no significant difference of the mortality rate has been demonstrated. One retrospective study of the two methods showed a reduction in mortality rate from 7.4% for late operation to 2.7% for early cholecystectomy. Based on our own studies and on the literature, we have come to the conclusion that early cholecystectomy must be recommended for acute cholecystitis. Its advantages are shorter hospital stay, less patient discomfort since there is only one hospitalization, and reduction of costs. These advantages are also coupled with a similar or even lower mortality rate.

Acute Disease↗
PubMed1982

[Femoral neck fractures: conservative or operative therapy in view of therapeutic results and rehabilitation].

The analysis of late results of 75 consecutive cases of abduction fractures of the femoral neck gave the following results: One third (24/75) of the patients must be operated because of a secondary dislocation. This secondary dislocation cannot be predicted. All the patients successfully treated conservatively can walk like before the accident. This confirms our therapeutic concept for abduction fractures of the femoral neck: Primary conservative treatment with immediate mobilization and weight bearing. Secondary operation for the cases with varus dislocation (one third).

Adult↗
PubMed1980

[Residual pneumothorax following lobectomy].

Residual pneumothorax may result in spite of correct pleural drainage after lobectomy, segmental or wedge resection. This is due to persistent alveolar or bronchiolar air fistula particularly often in combination with a discrepancy between the size of the pleural cavity and the remaining lung tissue as in bilobectomy. The management of this problem is dealt with on the base of experiences with 56 cases in a consecutive series of 250 patients. It is shown that in a stabilized situation - mostly after 10 to 14 days - pleural drainages safely can be removed and spontaneous resorption of a residual pneumothorax can be expected without further treatment even after intervals of several months on an outpatient base. Bronchopleural fistula formation must be ruled out and absence of atelectasis or compressing effusion confirmed.

Drainage↗