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Biomedical subjects

Y G Adam

Publications and source records attributed to Y G Adam.

At least 19 recordsLinked to original sources
PubMed2001

Infectious diseases in gynecologic oncology: an overview.

The increasing trend of a multimodal therapeutic approach in gynecologic oncology in the last few years has markedly changed the nature, frequency, and clinical presentation of infectious diseases. Despite the improved diagnostic tools, refined surgical technique, and routine use of prophylactic antibiotics, the morbidity and mortality of infectious complications remain significant. The rational use of available treatment resources, the recognition of risk factors, and increased awareness of host-cancer interactions should reduce the incidence of these serious infectious complications. The improved prevention and more efficient treatment of infections in the gynecologic oncology patient will not only improve prognosis but also have a significant economic impact as well.

Anti-Bacterial Agents↗
PubMed1995

Hepatobiliary cystadenoma.

Hepatobiliary cystadenomas are rare, truly benign cystic epithelial tumors with the potential to become cystadenocarcinoma. The initial symptom is vague, nonspecific abdominal pain, frequently in middle-aged women, but patients may be asymptomatic. Abdominal ultrasonography may be diagnostic. Intracystic fluid, obtained by sonographically guided fine-needle aspiration, may contain elevated levels of carcinoembryonic antigen. Complete resection or enucleation is the treatment of choice. We present the cases of two patients with hepatobiliary cystadenoma.

Adenoma, Bile Duct↗
PubMed1990

Retroperitoneal hemangioma.

Isolated retroperitoneal hemangioma in a young child is described. Although hemangiomas are the most common of the benign tumors of childhood, a solitary, large, noncutaneous occurrence of such a tumor can present diagnostic and therapeutic problems. The clinicopathologic features and differential diagnosis of retroperitoneal hemangioma is discussed. The indication for surgical excision is presented.

Child, Preschool↗
PubMed1989

Trends and controversies in the management of carcinoma of the stomach.

The marked decrease in the incidence of carcinoma of the stomach during the past four decades has been worldwide, with a few exceptions. Dietary deficiencies or carcinogenic substances appear to be the most important environmental factor in the genesis of carcinoma of the stomach. The risk of carcinoma of the stomach appears to be determined early in life. Based on the histologic features and the distinct differences in clinical behavior, adenocarcinoma of the stomach can be divided into the intestinal and diffuse types of lesions. In high risk populations, such as the Japanese, the intestinal type is found more frequently, while white Americans tend to have diffuse carcinomas. Premalignant gastric lesions, such as adenomatous polyps, are uncommon causes of carcinoma. The symptoms of carcinoma of the stomach are not specific and there is no satisfactory noninvasive diagnostic test to detect the carcinoma early. In Japan, mass screening, using air contrast radiography and endoscopy of the upper part of the gastrointestinal tract with biopsies and cytologic sampling, leads to detection of early stages of carcinoma of the stomach in 40 per cent of patients. The postsurgical survival rate of these patients is significantly higher, compared with those who have advanced disease. Mass screening for carcinoma of the stomach would not be cost effective in North America. The only curative treatment for carcinoma of the stomach is resection, which is most successful in early stages of carcinomas of the stomach. Radical subtotal gastrectomy is the operation of choice for curative treatment of carcinomas of the body and antrum of the stomach. In Japan, a more extensive lymphadenectomy has improved the five year survival rate. Operations for carcinoma of the cardia are invariably palliative. Palliative resection of an incurable carcinoma of the stomach has been shown to be more worthwhile than a bypass procedure. Adjuvant chemotherapy seems to have improved the unsatisfactory results of radical resection in the treatment of locally advanced carcinoma in Japan, a finding that has not been confirmed in the United States or Europe. The use of intraoperative electron beam radiation to improve the surgical outcome of carcinoma of the stomach is being investigated.

Adenocarcinoma↗
PubMed1987

Current concepts and controversies concerning the etiology, pathogenesis, diagnosis, and treatment of malignant tumors of the anus.

Malignant disease of the anus is uncommon. Possible predisposing causes include chronic inflammation and a transmissible agent. Epidemiologic studies suggest an increased incidence in homosexuals. With the exception of mucoepidermoid and small-cell carcinoma, the morphology of anal carcinoma has little influence on treatment and prognosis. Site, size of the primary lesion, and the presence of groin metastases are the crucial factors in prognosis. There is no satisfactory method for staging anal carcinoma--the symptoms are nonspecific. Diagnosis is based on histologic examination of biopsy material or tissue obtained from anal operations. The treatment of infiltrating, recurrent, or residual malignant anal lesions is a radical abdominoperineal resection. The addition of a limited obturator and hypogastric lymphadenectomy may be worthwhile. Inguinal lymphadenectomy provides palliation in the treatment of synchronous groin metastases, whereas in cases of metachronous metastases, groin dissection may result in an occasional cure. Small, noninfiltrating, low-grade anal lesions are best treated by either adequate local excision or supervoltage radiotherapy. If borne out, the promising results obtained with the combined chemoradiotherapy for anal cancer followed by local excision of the residuum will radically alter the future management of carcinoma of the anus.

Anus Neoplasms↗
PubMed1984

Primary retroperitoneal soft-tissue sarcomas.

Of the 98 soft-tissue sarcomas treated between 1973-1978, 12 were retroperitoneal in origin. Fifty percent underwent one to three previous surgical procedures. All patients were operated on. In 75% (nine out of 12), the tumor was completely resected. The operative mortality for total tumor excision was 11%. There were five liposarcomas, three leiomyosarcomas, two neurofibrosarcomas, and one synovial sarcoma and one unclassified sarcoma. Six of the 12 patients survived five years and three (25%) were alive without evidence of disease at 5 years. Three of the completely resected group received no further treatment; 2/3 survived 5 years; three had postoperative chemotherapy; 3/3 survived; and three others had radiation and chemotherapy subsequent to surgery; all three have died. The two most important prognostic factors were tumor grade and surgical excision. Only one patient with high grade tumor survived. Total surgical excision of the tumor offers the only hope for cure. Aggressive surgery in treating retroperitoneal soft part sarcomas is strongly recommended.

Adult↗
PubMed1983

Cutaneous malignant melanoma: current views on pathogenesis, diagnosis, and surgical management.

Reliable cancer statistics reveal an unexplained increase in the incidence and rate of death from melanoma. Increased exposure to ultraviolet light does not seem to be a factor. Hormones may affect the incidence but do not influence survival. The recognition of the biologic evolution of different types of melanomas and the prognostic value of microstaging has had a major impact on the surgical management of cutaneous melanomas. Currently adequate excision is the only available curative treatment for melanoma and is most effective if performed on an early lesion. The extent of the excision should depend on the level of invasion and the bulk and location of the lesion. When clinically involved, dissection of the regional lymph nodes should be performed. The value of prophylactic node dissection of clinically uninvolved regional lymph nodes is unknown. Because of the low probability of regional lymph node involvement in thin lesions (less than 0.75 mm), prophylactic node dissection is not warranted. In contrast, there is a much higher incidence of spread to the regional lymph nodes reported in melanomas found to be thicker than 0.75 mm by microstaging. Prophylactic node dissection is probably worthwhile for these patients. Improved prospective randomized studies are needed to evaluate and determine the effectiveness of the various treatments that are being recommended.

Humans↗
PubMed1983

Scapulectomy revisited: soft part sarcomas of the posterior shoulder.

Scapulectomy with muscle group resection and axillary lymphadenectomy for soft part sarcomas of the posterior shoulder is described. This rarely utilized procedure gives satisfactory tumor control and good functional results in carefully selected patients. The indications and technique for the procedure are discussed.

Aged↗
PubMed1978

Calcified ballbladder (porcelain gallbladder).

Calcification of the gallbladder wall, otherwise known as porcelain gallbladder, is a relatively rare disease and is frequently asymptomatic. Symptoms suggestive of biliary disease are often absent in patients with this manifestation. Since the condition is uncommon, it is important to recognize the clinical as well as the roentgenographic characteristics of the disease because of the high frequency (22%) of adenocarcinoma in the porcelain gallbladder. To our knowledge, no pathognomic sign of symptoms of the disease have been reported so far. Of five cases of porcelain gallbladder reported, carcinoma of the gallbladder was discovered in one patient. This disease seems to appear mostly in the sixth decade of life and is more prevalent in women. Diagnosis is made in most cases by a simple flat plate of the abdomen, and workup should include other roentgenographic examinations to exclude calcification of other viscera or the thoracic wall. Surgery should not be delayed even if the patient is asymptomatic since the occurence of carcinoma in porcelain gallbladder is remarkably high.

Adult↗