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P Delikaris

Publications and source records attributed to P Delikaris.

16 recordsLinked to original sources

Synchronous anorectal malignant melanoma and rectal adenocarcinoma: report of a case.

BACKGROUND: Synchronous neoplasms of the rectum are an uncommon condition. The situation becomes more rare when tumors are of different origin. To the authors' knowledge, synchronous anorectal melanoma and adenocarcinoma of the rectum have not been reported in the literature before. METHODS AND RESULTS: A 67-year-old female patient with synchronous anorectal malignant melanoma and adenocarcinoma of the rectum is described. She had preoperative colonoscopic diagnosis. The different neoplasms' origin was histologically proven. Surgical management consisted of abdominoperineal resection of the rectum. Postoperatively, the patient received adjuvant chemotherapy of six cycles duration. At present, the patient has completed 32 months of follow-up. There is no evidence of recurrent disease or distant metastases. CONCLUSION: Review of the literature confirms the rarity of anorectal malignant melanoma. On the other hand, the rectum represents the most common site for development of colonic adenocarcinoma. We were unable to trace synchronous presentation of these two tumors. Prognosis should be defined by the most malignant neoplasm; therefore, management should be focused on treating the melanoma.

Adenocarcinoma↗

Antral hypergastrinemia--a report of three cases.

Three patients with juxtapyloric ulcers and hypergastrinemia are presented. Fasting and food-stimulated serum gastrin concentration (SGC) were measured in 1970, 1972 and 1973 before the primary ulcer operation (selective gastric vagotomy and Jaboulay gastroduodenostomy; SGV + GD). Fasting SGC were 105, 149 and 158 pg/ml and the postprandial concentrations were 400, greater than 800 and greater than 800 pg/ml, respectively. The pentagastrin-stimulated acid secretion was within the normal range. After SGV + GD, only a slight decrease in acid secretion was observed. The hypergastrinemia persisted unchanged or decreased slightly in 1 patient. A recurrent ulcer developed and a precise antrectomy was carried out. Postoperatively, the fasting SGC was markedly reduced and the postprandial gastrin response abolished. The resected specimens were subjected to immunocytochemical gastrin cell quantitation. The number of gastrin cells was elevated in all 3 patients and the gastrin cell topography was distorted, with cells being present both in the lower and upper thirds of the antropyloric glands.

Adult↗

The type of anastomosis after selective gastric vagotomy and precise antrectomy is of no importance for basal and postprandial serum gastrin concentration.

Twenty-six patients were treated for duodenal or recurrent ulcer with selective gastric vagotomy plus precise antrectomy--that is, complete removal of the entire antrum. Sixteen had a gastroduodenal anastomosis and 10 a gastrojejunal anastomosis. Fasting and protein meal-stimulated serum gastrin concentration was measured in 10 patients before antrectomy and in all after the operation. Fasting serum gastrin concentration was reduced and food-stimulated gastrin response abolished irrespective of the type of the anastomosis. It is concluded that a postprandial gastrin rise means retained antral tissue in the gastric remnant and that neither protein nor mechanical stimulation of the passage of food through the duodenum stimulates the duodenal G-cells to gastrin release.

Adult↗

Nutritional status of thoracic surgical patients. A prospective evaluation.

The nutritional status of 102 thoracic surgical patients was studied prospectively. Fifty patients showed combined or single abnormalities of the parameters studied. Seventy per cent of the patients with empyema were found to have abnormal nutritional values. Thirteen of 20 patients with oesophageal obstruction (malignant or benign) were also found to be malnourished or to have pathological nutritional parameter values. The diagnosis and correction of malnourishment in patients who are to undergo surgical procedures should be undertaken early.

Adolescent↗

Taurolidine instillation as therapy for empyema thoracis. A prospective study of 50 patients.

Fifty patients with chronic empyema thoracis, without bronchopleural fistula, were treated by drainage and twice-daily instillations of 2% taurolidine (Taurolin; Continental Ethicals) for 14 days. No antibiotics were used. Forty-three patients completed the treatment and 7 were withdrawn from the trial, 3 because of evidence of bronchopleural fistula and 1 each because of pain during instillation, associated chest-wall cellulitis, an unexplained, acute epilepsy-like episode during instillation, and inadvertent administration of antibiotics. All 43 patients who completed the trial showed an excellent clinical response with control of the local and systemic toxic effects of sepsis. A rapid falling-off in the volume and purulence of pleural drainage fluid was noted. Twenty-four of the 43 patients (55,8%) were rendered bacteriologically sterile by the treatment. Instillation of 2% taurolidine was therefore an effective form of monotherapy in cases of chronic empyema thoracis without bronchopleural fistula.

Adolescent↗

Diverticula of the vermiform appendix. Alternatives of clinical presentation and significance.

The vermiform appendix can be the site of development of diverticula which may suffer either inflammatory complications with or without appendicitis or may only be an incidental finding in an uninflamed appendix. This is a retrospective study of 10 of 575 cases of consecutive appendices removed and examined within a year, with single or multiple appendiceal diverticula with diverticulitis and peridiverticulitis. In six of the 10, the lumen of the appendix did not show any inflammatory changes. In conclusion, one could assume that inflammatory complications of the appendiceal diverticula, although they may mimic acute appendicitis, are quite distinct clinical entities. Acute appendicitis in the presence of appendiceal diverticula may carry an earlier and higher rate of perforation and appendiceal diverticula, as an incidental finding, may justify appendectomy on occasion.

Adolescent↗

Smooth muscle neoplasms of the stomach.

We reviewed the records of 31 patients with smooth muscle tumors of the stomach seen at the First Surgical Department, Medical School, University of Athens, Greece, between the years 1961 and 1981 with special emphasis on the clinical data, diagnosis, and pathology. The majority of patients were symptomatic and were preoperatively diagnosed by radiology and/or endoscopy, but accurate histologic diagnosis was obtained in only three cases. The tumors varied in size, were relatively equally distributed throughout the stomach, and their management required 35 operations, consisting of 18 Billroth II gastrectomies, 15 local excisions, and two total gastrectomies. Histologically, the tumors proved to be leiomyoma in 23 cases, leiomyosarcoma in ten, and leiomyoblastoma in two. The difficulty of histologic classification in the absence of metastasis is clearly shown by the fact that three tumors recurred and were subsequently characterized as leiomyosarcoma one to three years after they were initially classified as leiomyoma.

Adult↗

Impaired pancreatic innervation after pyloric transsection in dogs. Reduced pancreatic polypeptide response to insulin hypoglycaemia.

Pancreatic polypeptide (PP) is released by efferent vagal impulses and its secretion is impaired after truncal and selective gastric vagotomy while remaining unchanged after parietal cell vagotomy. In three dogs an innervated antral pouch with transsection of the pylorus was constructed. After this operation the PP response to insulin hypoglycaemia was significantly reduced as compared to the preoperative response. In another four dogs an innervated antral pouch was constructed without transsecting the pylorus. Postoperatively we found that the PP response to insulin hypoglycaemia was unchanged compared to preoperatively. These results seem to indicate that vagal fibres to the pancreas run in close anatomic relation to the pylorus, and their inevitable damage during pyloric transsection results in reduced endocrine pancreatic secretion to vagal stimuli.

Animals↗

Treatment of infected surgical wounds with Varidase.

In 18 patients with subcutaneous wound infection after laparotomy the wounds were randomly treated with normal saline solution or with Varidase solution after complete opening, according to a double-blind system. Treatment was discontinued when the wound was clean enough for secondary suture or the patient could be discharged from hospital. Three patients, in whom the treatment was not completed because of intercurrent complications, were excluded from the evaluation. When the double-blind code was broken, 11 patients were found to have received saline treatment and 7 Varidase. The duration of the wound-dressing periods averaged 13.45 +/- 6.77 days in the former group and 5.00 +/- 2.16 in the latter. The difference is statistically significant.

Adult↗

Parathyroid carcinoma; a cause of recurrent primary hyperparathyroidism a few years after removal of a parathyroid adenoma.

This is a case report of recurrent hyperparathyroidism due to parathyroid carcinoma. Primarily a neck exploration revealed an adenoma of the inferior right parathyroid body but at cervical re-exploration 4 years later due to recurrence a parathyroid carcinoma at the opposite side was found. The importance of recognizing the malignancy at operation is emphasized and the author's opinion for the necessity of localizing studies in cases of reoperations at the neck for over-functioning parathyroid glands is expressed.

Adenoma↗

[Bone echinococcosis. Apropos of a case of hydatid cyst of the spine].

The authors report a case of hydatid cyst of the vertebral column (L2-L3) simulating an acute abdominal syndrome with pain in the right iliac fossa. On exploration of the abdominal cavity, they detected the presence of a fluctuating retroperitoneal collection of fluid due to the migration of a hydatid abscess into the sheath of the right psoas muscle. Three surgical operations of curetage followed by wide drainage were carried out with simple operative sequelae.

Adult↗

Recurrent aortic occlusion due to malignancy.

A 62-year-old male had repeated episodes of aortic bifurcation occlusion by malignant masses of the same histologic type as the previously excised adenocarcinoma of the ascending colon. In spite of an extensive investigation of the lungs, heart and aorta no trace of the origin and the route of dissemination of the carcinomatous masses was found. Severe suspicion arises of massive malignant direct invasion of the aorta from the local recurrence of the tumor of the descending colon excised 3 years previously.

Adenocarcinoma↗