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Biomedical subjects

Y Wolloch

Publications and source records attributed to Y Wolloch.

At least 19 recordsLinked to original sources

[Rectosigmoid carcinoma in an adolescent girl].

Carcinoma of the colon and rectum is very rare in childhood and adolescence. We describe a 16.5-year-old girl with rectal bleeding and constipation. She had been treated symptomatically for 6 months without being properly examined. Only with onset of weight loss was rectal examination performed. After workup a diagnosis of locally advanced carcinoma of the rectosigmoid with multiple lung metastases was reached. From review of the literature and our own case, it seems that the unfavorable prognosis in young patients is mainly due to lack of awareness of such a possibility, resulting in delayed diagnosis and treatment. An additional factor is the invasive nature of most colon cancers in this age group.

Adolescent

Prospective comparative study of magnetic resonance imaging versus transrectal ultrasound for preoperative staging and follow-up of rectal cancer. Preliminary report.

The efficiency of magnetic resonance imaging (MRI) and that of transrectal ultrasound (TRUS) were compared in preoperative staging of 15 patients with rectal cancer and in postoperative follow-up of 12 patients. Thirteen of the 15 patients evaluated for preoperative staging were operated on. Preoperative staging and pathologic finding were identical in 11 patients (84.6 percent) examined by TRUS and in 10 patients (76.9 percent) examined by MRI. Recurrent cancer was detected in 3 of 12 patients in the follow-up group. MRI was able to diagnose correctly 10 of 12 patients (83.2 percent), one patient was misdiagnosed, and in one patient the MRI could not distinguish between fibrous tissue and recurrent cancer. TRUS diagnosed correctly only 5 of 12 patients (41.6 percent). One was falsely diagnosed, and, in 6 patients (50 percent), this examination could not differentiate between fibrous tissue and recurrent tumor. According to our results, both MRI and TRUS have a place in the preoperative staging of patients with rectal cancer. The main differences between the two methods were in the differential diagnoses of fibrous tissue and recurrent cancer. MRI being more specific in detection of recurrence.

Aged

B lymphocyte changes induced by peri-operative blood transfusions and surgery in patients with colorectal cancer.

Seventy patients with Duke's C adenocarcinoma scheduled to undergo surgery were divided into two groups, those who received no peri-operative transfusion (Group I, 26 patients) and those who received an average of 2.1 units of packed red blood cells per person peri-operatively (Group II, 44 patients). Immunological parameters were tested 1 week before and 1 and 5 weeks after surgery in order to determine the influence of the transfusion of these parameters. Comparison of the mean values obtained before operation with those obtained one week post-operatively revealed a significant change in the number of B cells (P = 0.014), with a decrease in Group I and an increase in Group II, which was seen to persist for the mean values obtained 5 weeks after surgery. The higher rates of recurrence and the lower rates of survival reported in patients who received transfusion may be related to an as yet unidentified role of B cells or a subpopulation in the immune system, manifested in the suppression of activity of those components responsible for destroying micrometastases. In relation to the site of the tumor no definite conclusions can yet be drawn as to the prognostic importance of our findings concerning the immunological parameters.

Adenocarcinoma

Comparative study for preoperative staging of rectal cancer.

A comparative study of preoperative evaluation of rectal cancer is presented. Sixty-eight patients with rectal cancer were examined digitally and by computerized tomography and transrectal ultrasound. Preoperative staging was compared with pathologic findings at surgery. Digital examination and transrectal ultrasound were accurate in 82.8 and 76.2 percent, respectively and were superior to CT, which was accurate in 65.5 percent of cases for assessment of rectal wall invasion. All three modes play a role in preoperative assessment, but digital examination and rectal ultrasound appear to be more effective.

Adult

Phenol sclerotherapy for hydrocele: a study in 55 patients.

Sclerotherapy with 2.5% phenol solution was used to treat 63 hydroceles in 55 patients with a mean age of 69 years. In 51.6% of the patients (32 hydroceles) 1 treatment was sufficient, while 2 treatments were necessary in 25.8% (16 hydroceles), 3 in 13% (8 hydroceles) and 4 in 8% (5 hydroceles). One patient required 7 injections. Treatment was unsuccessful in 1 patient in whom a local allergic reaction developed. Only 1 patient complained of pain, and other complications were rare and mild. On the basis of this experience we concluded that sclerotherapy with phenol 2.5% is a painless, highly effective, safe and economical procedure that permits one to avoid an operation, anesthesia and hospitalization. Its use is warranted in adults and particularly in the elderly.

Adult

Segmental portal hypertension and polycythemia vera.

A patient known to have polycythemia vera developed recurrent melena and was found to have bleeding gastroesophageal varices. Selective superior mesenteric angiography suggested splenic vein thrombosis. Splenectomy led to the disappearance of the varices with no subsequent recurrence of bleeding. We believe this to be the first fully described case of polycythemia vera associated with segmental portal hypertension, and propose that polycythemia vera patients may develop "silent" segmental portal hypertension and that this should be taken into consideration when treating them.

Humans

Local recurrence after low anterior resection using the EEA stapling device.

Fifty-five patients underwent curative stapled low anterior resection for rectal adenocarcinomas located 5 to 15 cm from the anal verge. Two patients (3.7 percent) died postoperatively. The mean follow-up for the remaining 53 patients was 40 months. Local recurrence was diagnosed in 17 patients (32 percent), in most (88 percent) within the first two years after surgery. Most local recurrences appeared in patients classified as Dukes' C1 and C2 but, surprisingly, no significant difference was found between rectal tumors of high and low location as regards recurrence. The high rate of recurrence in this series may be attributable to the large number of patients with advanced tumors, and poorly differentiated carcinoma, or both.

Adenocarcinoma

Neutropenic enterocolitis. Case report.

Early recognition and adequate treatment of neutropenic enterocolitis, a life-threatening complication of aggressive chemotherapy for leukemia, lymphoma or other malignancy, may offer a favorable outcome. Three cases are presented, including the first reported occurrence in a child with osteogenic sarcoma. Two patients were treated surgically and the third conservatively.

Adult

A simple method for palliative diversion of the bile in patients with obstructive jaundice due to perihilar tumors.

A palliative procedure for diversion of bile in patients with obstructive jaundice due to nonresectable perihilar tumors is described. The procedure is accomplished by creating an internal fistula between a bile duct and the gallbladder and an anastomosis of the gallbladder to the jejunum. The procedure is simple and bleeding of the hepatic parenchyma is readily controlled and subsequently, there is a rapid fall in the bilirubin level.

Bile Ducts

Fused epiploic appendages simulating carcinoma of the left colon.

A 60-year old male with a history of rectal bleeding was operated upon because of the finding of a filling defect on barium enema examination. At operation it was found that the defect was produced by the fusion of two epiploic appendages. Following release of the adhesion the colon regained its normal appearance and postoperative barium enema showed no pathological findings.

Adipose Tissue