PubMed Health⌕ Search

Biomedical subjects

Y G Adam

Publications and source records attributed to Y G Adam.

36 records · Page 2Linked to original sources
PubMed1978

Intraoperative internal spermatic vein phlebography in the subfertile male with varicocele.

Intraoperative internal spermatic vein phlebography was performed in 20 subfertile patients with a varicocele; 10 patients with varicoceles and left-sided indirect inguinal hernias without fertility problems served as controls. Phlebography was carried out during surgery with the patient supine and in a 45 degree anti-Trendelenburg position to stimulate an "erect" posture. In all 25 patients with a varicocele, valvular insufficiency was demonstrated at the renal-spermatic vein junction. When visualized, the position of the left adrenal vein in all instances was medial to or opposite the renal-internal spermatic vein confluence. This observation, reinforced by simultaneous determinations of cortisol levels in the internal spermatic and antecubital veins, practically excluded the validity of the theory of adrenal hormonal suppression of testicular tissues. In 40% of subfertile patients with a varicocele, double internal spermatic veins and reflux to the distended external spermatic (cremasteric) venous plexus were demonstrated. In no instance were such phenomena observed in the control groups. The not-infrequent failure of operative correction of varicocele seems to relate directly to such overlooked pathology. Broad clinical application of operative phlebography, especially in recurrent, persistent, or clinically advanced cases, will detect such anomalies and should reduce significantly the operative failures in the surgical correction of varicocele.

Adult↗
PubMed1978

Right-sided varicocele associated with situs inversus.

In the overwhelming majority of cases, varicocele appears in the left scrotum, the reason being the anatomical dissimilarity of the two sides. In patients with right-sided or bilateral varicocele, further investigation to rule out a retroperitoneal pathology, especially neoplastic, is indicated. On rare occasions, however, a vascular anomaly as the underlying pathology must be considered. A patient is presented with a complete situs inversus accompanied by a right-sided varicocele. Intraoperative right internal spermatic phlebography revealed that this vein drained into the right renal vein, and valvular incompetence at their confluence was the etiology of the disease. Intraoperative internal spermatic phlebography in patients with right-sided or bilateral varicoceles is recommended as the simplest and safest means to demonstrate the etiology of this disease.

Adult↗
PubMed1978

Stainless steel wire for closure of abdominal operative wounds.

In this prospective study, the abdominal wounds of 500 consecutive patients were closed with buried retention monofilament stainless steel wire. The strength of the suture material, the rapidity of the closure, the very low 0.4% dehiscence rate and the almost total lack of wound complications seems to override the relatively minor inconvenience of handling the wire. These results seem to justify the rountine use of this method of wound closure in abdominal surgery, especially in the elderly and high-risk patients.

Abdomen↗
PubMed1977

Radiation-induced fibrosarcoma following treatment for breast cancer.

A patient with radiation-induced fibrosarcoma following mastectomy and postoperative radiation for bilateral breast carcinoma is described. Only six such cases have been reported in the literature. In this patient erosion of the axillary artery produced massive hemorrhage, and emergency transthoracic ligation of the subclavian artery caused gangrene of the extremity and empyema and sepsis. Interscapulothoracic amputation not only was life-saving but offered the patient a reasonable chance for long-term survival. Only aggressive surgical management can salvage a patient with radiation-induced sarcoma.

Breast Neoplasms↗
PubMedDate not supplied

Changing concepts in treating early breast cancer. An overview.

Localized breast cancer is most effectively treated by operative resection. During the last 10 years, however, several new aspects of the disease have become evident and have had a direct influence on its management. There are indications that breast cancer is a systemic disease even in its early stages, and careful pathological observations have shown that breast cancer is a multifocal disease, although the clinical significance of this is not yet clear. The most important single prognostic factor is the status of the regional nodes. Tumor-induced immunosuppression in the host correlates with tumor burden. Removal of the primary tumor almost certainly accelerates the proliferation of residual tumor cells and so the "cell kill' of chemotherapeutic agents is increased. Several conclusions concerning therapy may be drawn from a consideration of these conceptual changes: a) local surgical control of the disease is frequently insufficient and has to be combined with systemic therapy b) for true staging, axillary node dissection has to be included with any treatment modality, and c) until proven otherwise, the whole breast has to be treated because of the multicentricity of the disease.

Axilla↗