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Biomedical subjects

S Victor

Publications and source records attributed to S Victor.

At least 19 recordsLinked to original sources

Coarctation of inferior vena cava in situs inversus totalis.

A woman aged 28 years with situs inversus totalis presented with chronic Budd-Chiari syndrome with symptoms of 3 years' duration. The left sided inferior vena cava was occluded below the diaphragm above a patent morphologic right hepatic vein. A dorsal cavoatrial bypass was attempted but abandoned due to bleeding from extensive collaterals. The occurrence of coarctation of the inferior vena cava in situs inversus totalis lends support to the view that it is a congenital condition and occurs due to disturbance in fusion of the hepatic segment of the inferior vena cava and the hepatocardiac channel.

Adult

[Interdisciplinary treatment strategy of aneurysmal bone cyst].

In this report the management of an aneurysmal bone cyst in the cervicothoracic region of an 13-year-old girl is described. Aneurysmal bone cyst is a histologically benign lesion that is often extremely vascular. In the spine, it can cause extensive bone destruction and compress neural structures and this can result in high-grade tetraparesis. In the treatment a three-stage operation with radical total removal of the cyst from two posterior approaches and one anterior approach for osteosynthetic stabilisation gave an excellent result. The value of preoperative embolization to reduce tumor vascularity, allowing total excision without neurological deficits to the patient, is demonstrated.

Adolescent

[Malignant brain glioma--a catamnestic study of 100 operated patients].

For 100 operated patients with malignant gliomas of the brain (63 malignant gliomas WHO grade IV--including 50 glioblastoma multiforme- and 37 astrocytomas WHO grade III-IV) the average survival time is 332 days. The survival rates show 6, 12 and 24 months after operation 55%, 32% and 12% of the patients alive. In addition to therapy there are some favourable prognostic factors: Young patients age at the onset of illness, localization in the non-dominant hemisphere, minor preoperative neurological deficit. On the other side unfavourable prognostic factors are: parietal localization (average survival time = 120 days), tumorous infiltration of the brain stem (average survival time = 143 days), preoperative clouding of consciousness (average survival time = 185 days). These factors influence survival time. The most important prognostic factor of therapy is the extent of operation: In case of macroscopical total resection of the tumor the mean survival time amounts to 554 days as compared to 202 days in subtotal tumor resection. The well known positive influence of postoperative radiation therapy is demonstrated by the high mean survival time of 456 days. In case of recurrent operation of the tumor (28 patients), the average survival time amounts to 443 days. In contrast to the literature our own analysis shows no prognostic value of histological variants in case of malignant glioma WHO grade IV. Two patients, whose histological slide preparations were neuropathologically graded a second time independent from the first view (1 anaplastic ependymoma WHO grade III and 1 glioblastoma multiforme WHO grade IV), are still alive more than 8 years after operation without any neurological deficit.

Adolescent

Pre-operative and post-operative ultrasound evaluation of Budd Chiari syndrome due to coarctation of the inferior vena cava.

Coarctation of the inferior vena cava (IVC) is being increasingly recognised as a congenital and operable cause for chronic Budd Chiari syndrome. It is necessary to distinguish this entity from other causes of Budd Chiari syndrome because of a more favourable outcome after surgery. Early diagnosis would result in surgical intervention before irreversible liver damage and also possibly avoid the onset of hepatocellular carcinoma. Real time ultrasound has proved valuable in pre-operative diagnosis in nine patients with coarctation of the IVC. It has also been found useful to confirm patency of dorsal cavo-atrial bypass using polytetrafluoroethylene grafts in five patients and isthmusplasty of the IVC in one patient. Ultrasound is recommended for routine screening of high risk population.

Adult

Obscure stenosing aortitis and arteritis associated with perivascular lymphadenitis--combined angiographic and lymphographic evaluation.

A series of eleven cases of an obscure occlusive type of aortitis and arteritis is reported. These are characterised by chronic nonspecific perivascular lymphadenitis and fibrosis, constricting the lumen of the vessels. Subsequent spread of the inflammatory process produces irreversible changes in the vessel wall. Timely excision of the nodes, release of fibrous strands and decompression of the vessels may result in a permanent cure; The inflammatory process is nonspecific in nature. The etiology is obscure and is subject to speculation. Tuberculous inflammation of the lymph nodes appears to be unlikely while filarial lymphadenitis is probable. The disease is not a primary panarteritis as observed in Takayusu's disease or allergic vasculitis. Males are predominantly affected and present invariably with clinical signs and symptoms of peripheral vascular obliterative disease of the lower extremities.

Adolescent

Malignant mediastinal chemodectoma.

A 20-year-old man with a posterior mediastinal mass and erosion of the rib proved to have a malignant chemodectoma. The case is of interest because of the rare location and malignant fatal course.

Adult

Surgical correction of a rare variant of cor triatriatum.

Cor triatratum is a rare congenital malformation. Problems in diagnosis and surgery arise due to associated anomalies such as atrial septal defects and anomalous pulmonary venous drainage. A 21-year-old man proved to have a rare variant of cor triatiatum in which both the upper and lower compartments of the left atrium communicated with the right atrium through two separate atrial septal defects. In addition, he had anomalous drainage of the right superior pulmonary vein into the superior vena cava. Intracardiac repair was undertaken successfully.

Adult

Dorsal cavoatrial bypass graft for coarctation of inferior vena cava-trial of aortic occlusion technique.

Male aged 28, presented with coarctation of inferior vena cava (IVC) causing chronic Budd-Chiari syndrome (CBCS). The coarcted IVC was exposed by transthoracic, transdiaphragmatic, retroperitoneal approach. There was no evidence of inflammation or compression. Venotomy was done immediately below the coarctation after clamping the descending aorta above the diaphragm. Distal IVC was occluded with a Fogarty balloon catheter passed through the venotomy. There was no flow through hepatic veins. But a dry field was not obtained because of bleeding from the systemic collaterals draining into IVC above the venotomy. Hence the veno-tomy was sutured. Dorsal cavoatrial bypass (DCAB) was done anastomosing the graft, end to side of IVC at a lower level, after partial clamping of IVC. Cross clamping the descending aorta appears to be a useful technique for surgery of retrohepatic IVC to arrest blood flow from distal IVC and hepatic veins.

Adult