{"title":"[Acute Leriche syndrome in a previously healthy woman: differential diagnosis of embolic occlusion].","authors":"M Furrer, M Schüler, A F Leutenegger, T Rüedi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The case report describes an acute total ischemia of both legs in a young otherwise healthy woman. Based on the patient's history, the physical findings and further investigations, the differential diagnosis is discussed. The emergency procedure with a successful desobliteration of a strictly localized arteriosclerotic plaque by Fogarty catheter was followed by open thrombendarterectomy 10 days later because of a persistent stenosis. Finally the clinical manifestations of such rare occlusive disease of the aorta are discussed as well as the bilateral ischemic syndrome of the lower extremities originally described by Leriche in 1940.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"887-91"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18873916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O Martinet, A F Lauber, A Marx, B Frauchiger, J Landmann
{"title":"[Clinical aspects and diagnosis of arterial embolism of the upper extremity].","authors":"O Martinet, A F Lauber, A Marx, B Frauchiger, J Landmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The upper limb embolus is rarely encountered (upper limb:lower limb emboli 1:4-5). Our problem was to determine in which way the paraclinical investigations influence the operation indication. In 1992, we have seen 10 consecutive patients with an upper limb embolus. The characteristics of our patient group are the advanced age and the cardiovascular morbidity. It was always possible to diagnose the emboli clinically. 7 duplex, 6 Dopplers and 2 angiographies were performed and have confirmed the clinical diagnosis and the clinically suspected localisation of the emboli. All the patients were operated in local anesthesy. An embolectomy with Fogarty catheter was done. After the operation, all our patients were asymptomatic. No amputation was done. We do think that when the clinic is clear enough to diagnose an embolus, no other investigations are necessary to the operation indication.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"875-7"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18874004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C W Biermann, H Moch, T C Gasser, W de Riese, G Rutishauser
{"title":"[Primary detection of malignant mesothelioma of the tunica vaginalis testis using the BMA-120 monoclonal antibody].","authors":"C W Biermann, H Moch, T C Gasser, W de Riese, G Rutishauser","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor, with only 40 cases previously described in the literature. Treatment consists of inguinal orchiectomy with close-follow up [1]. Asbestose exposure, trauma and hydrocele have been implicated as risk factors. We describe a histopathological examination with the BMA antibody (Behring, Marburg, Germany) and the Lu-5 antibody (Hoffmann-La Roche, Basel, Switzerland). Furthermore, we describe the patient's history and the management according to preceding reports in the literature.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"1127-9"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18874336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Long-term follow-up of serum prostate-specific antigen after radiotherapy of prostatic carcinoma].","authors":"H P Schmid, M K Ferrari, T A Stamey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The role of prostate-specific antigen (PSA) in the follow-up of patients after radiation therapy for prostate cancer is not well defined. There are no reports on long-term follow-up with PSA and serial PSA determinations, respectively. We followed 113 patients after radiotherapy for clinical stages A through D1 prostate cancer with multiple PSA measurements. External beam radiation has been applied to 98 patients and 15 received 125-iodine implantation. Eighty-eight of the 113 patients (78%) had a precipitously rising PSA with median doubling times of 14 (stage A), 15 (stage B), 7 (stage C), and 8 (Stage D1) months, respectively, at a mean follow-up of 5 years after radiotherapy. Twenty-three of the 113 patients (20%) appeared cured with a PSA of 1.7 ng/ml or less at a mean follow-up of 9 years. Two of the 113 patients (2%) continued to have a decreasing PSA 3 years after irradiation. Among the cured patients there was no relationship to clinical stage or histological grade. We conclude that about 20% of patients with clinical stages A-D1 prostate cancer can be cured by radiotherapy. They can be identified by a very low serum PSA level which seems to persist indefinitely. The remaining 80% who fail radiation therapy appear to have an accelerated growth rate suggesting tumor clonogen repopulation during radiotherapy.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"1101-5"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18541016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Roggo, K B Brülhart, C Duff, W Schöpke, A von Hochstetter
{"title":"[Combination of surgical therapy and interventional radiology in a recurrent myxoid liposarcoma with a 37-year history].","authors":"A Roggo, K B Brülhart, C Duff, W Schöpke, A von Hochstetter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Extreme long-term survivals of low grade liposarcomas are rare. The authors present a case of a 75 year old man with a 37 year history of recurrent myxoid liposarcoma. The tumor dynamics are obviously related to the histology subtype. The clinical and radiological findings of the sixth tumor recurrence are discussed. The combination therapy of surgical tumor reduction and interventional radiology with implantation of endovascular prostheses for iliaco-femoral vein compression due to tumor recurrence is described.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"927-30"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18541018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F Degonda, L Gürke, E Pedrinis, P Luscieti, G M Solari, S Martinoli
{"title":"[Localized fibrous tumor of the pleura. 2 case reports and differential diagnoses].","authors":"F Degonda, L Gürke, E Pedrinis, P Luscieti, G M Solari, S Martinoli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The localized fibrous tumors of the pleura are rare neoplasms, also known as \"benign pleural fibromas\" or \"localized mesotheliomas\", but those names are inaccurate. The tumors are composed of undifferentiated mesenchymal cells, intermediate and differentiated fibroblasts and collagenous interstitial tissue. Their origin is normally the submesothelial layer of the visceral pleura. Mesothelial differentiation is not present. The grading of malignancy doesn't correlate with final outcome, adequacy of surgical excision being the most important factor. This neoplasm may recur but retain its basical histologic features. The positive results for vimentin and negative results for cytokeratin antibodies help to distinguish the localized fibrous tumors from the mesothelioma. We present too cases and their diagnostic possibilities.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"919-22"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18541017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Radaelli, E Massera, G Casanova, L Gürke, F Levi, P Luscieti, S Martinoli
{"title":"[Sacral chordoma: a consideration in low back pain].","authors":"A Radaelli, E Massera, G Casanova, L Gürke, F Levi, P Luscieti, S Martinoli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present the case of a sacral chordoma (S3-S5). Its diagnostic problems as well as its pathological properties and the epidemiologic situation are discussed. The therapy and the surgical procedure are outlined.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"923-5"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18873922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B Schumacher, P Pecher, M Keilich, H U Günther, T Stegmann
{"title":"[Emergency bypass operation after failed elective percutaneous transluminal coronary angioplasty].","authors":"B Schumacher, P Pecher, M Keilich, H U Günther, T Stegmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This retrospective study was performed to evaluate the clinical and angiographic characteristics and the in-hospital complications after failed percutaneous coronary angioplasty (PTCA) that necessitates coronary artery bypass graft surgery (CABG). The study population consisted of 123 patients from January 1990 to December 1992. The failed PTCA was secondary to an acute occlusion of the dilated but dissected vessel in 36.5% of the study population. 43 patients (35%) had an emergency CABG due to hemodynamic instability and a large area of myocardium at risk for infarction. 93% of these patients had an acute closure of the dissected vessel. 19 patients (15%) were operated 24 hours after failed PTCA and 61 patients (49.5%) electively 3.8 +/- 1.1 months after PTCA. Mean time interval from the acute occlusion up to the establishment of the extracorporeal circulation (ischemic interval) was 70 +/- 9 min. in patients from our cardiological department and 136 +/- 14 min. in patients from external departments. Analysis of the surgical data revealed that neither a patient of the emergency group nor of the elective group needed the intra-aortic balloon pump. Overall 2.3 +/- 0.8 bypass grafts were placed, with increased use of the internal mammarian artery in the elective (57%) versus the emergency group (17%). Postoperative peak values of CK and CK-MB were significantly higher in the emergency group as compared to the patients operated 24 hours and electively after failed PTCA. Patients with an ischemic interval up to 70 min. had considerably lower CK and CK-MB values compared to patients with longer ischemic intervals.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"1137-42"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18874338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Technique of laparoscopic descendo-rectostomy for reconstruction of intestinal continuity after Hartmann operation].","authors":"R Schmid, O Schöb, R Schlumpf, F Largiadèr","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Reestablishing bowel continuity subsequent to sigma resection with terminal descendostomy and blind closure of the rectum (Hartmann procedure) by a descendo-rectostomy (DR) is well suited for a laparoscopic approach. One part of the operation is performed extracorporally, and with the laparoscopic operation there is no need to consider radical tumor surgery or staging rules. We demonstrate our techniques for laparoscopic DR. - Operational steps. - A. conventionally: complete dissection of the descendo-stoma, insertion of a 29 or 31 mm circular stapler head secured by a purse string suture and repositioning of the colon into the abdomen; blunt dissection of reachable intra-abdominal adhesions with a finger, and placement of a 10-mm umbilical trocar using palpation; air tight closure of the abdominal wall at the original stoma site. B. laparoscopically: upon creation of a CO2 pneumoperitoneum, placement of two additional 10 mm trocars; adhesiolysis of the pelvis; preparation of the blind rectal stump; transanal insertion of the circular stapler and perforation of the rectal stump; bringing down the proximal colon into the pelvis (possible need to mobilise the splenic flexure); reconnecting the stapler head with the instrument and firing the stapled anastomosis. - The postoperative period was uneventful. Using a laparascopic approach for a DR following Hartmann's procedure is an attractive and viable method to reestablish bowel continuity.</p>","PeriodicalId":75902,"journal":{"name":"Helvetica chirurgica acta","volume":"60 6","pages":"997-9"},"PeriodicalIF":0.0,"publicationDate":"1994-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18876473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}