Kurosh Paya | Medical University of Vienna (original) (raw)
Papers by Kurosh Paya
American Journal of Roentgenology, Mar 1, 2000
Klinische Padiatrie, Apr 1, 2000
Progressive familial intrahepatic cholestasis (PFIC) is a congenital liver disease. First symptom... more Progressive familial intrahepatic cholestasis (PFIC) is a congenital liver disease. First symptoms can frequently be seen shortly after birth. Quality and expectation of life are substantially reduced due to severe pruritus and the complications of progressive liver cirrhosis. PFIC is diagnosed on the basis of characteristic clinical and laboratory parameters and genetic analysis after exclusion of other liver diseases leading to intrahepatic cholestasis. Medical therapy is only effective in a proportion of children with PFIC. Partial biliary diversion (PBD) is nowadays considered the therapy of choice in patients with therapy-refractive pruritus. If performed in time, damage to the liver can be delayed or arrested, thus orthotopic liver transplantation (OLT) can be postponed or even avoided in at least some patients with PFIC. Besides providing a current overview of PFIC, we report on three patients who were successfully treated surgically. One patient was subjected to a new technique of PBD (cholecysto-appendicostomy), the other two had OLT.
Journal of Pediatric Surgery, Apr 1, 2002
Background: Angiogenesis is essential for tumor growth and relies on the production of angiogenic... more Background: Angiogenesis is essential for tumor growth and relies on the production of angiogenic factors. Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis that binds to tyrosine kinase receptors Flt-1 and KDR. The interaction of VEGF and its receptors at gene and protein levels in neuroblastoma remains widely unknown. Methods: Tumor biopsy specimens and serum were obtained
British Journal of Cancer, Dec 1, 1998
Although tissue polypeptide-specific antigen (TPS) has been described as a potentially useful ser... more Although tissue polypeptide-specific antigen (TPS) has been described as a potentially useful serum marker of tumour activity in adult epithelial tumours, few data are available for childhood malignancies. Neuroblastomas and Wilms' tumours are the commonest types of solid malignancies found in the retroperitoneum of children. At this time, a widely used marker for Wilms' tumour is not available. Using an enzyme-linked immunosorbent assay (ELISA) kit, serum TPS levels in 23 children with neuroblastomas, nine with Wilms' tumours and 22 with benign tumours were evaluated to test the usefulness of the marker in identifying malignancies. Compared with healthy children (n = 110), the preoperative least-square means (LSM) of serum TPS were considerably elevated in both neuroblastoma (LSM = 209 U l-1) and Wilms' tumour (LSM = 235 U 1-1), whereas values in benign tumours were only slightly elevated. Although the Wilms' tumours were associated with higher preoperative serum TPS levels, there was no statistically significant difference compared with neuroblastomas. Receiver operating characteristic analysis (ROC curves) showed a high sensitivity and specificity for both malignancies. Successful treatment resulted in decrease in TPS serum values. Serum TPS measurements in children presenting with abdominal masses can help in diagnosing the two commonest extracranial solid malignancies of childhood. Furthermore, TPS could acquire a pivotal role in monitoring therapy.
Journal of Surgical Oncology, 2001
Background: Solid-pseudopapillary tumor of the pancreas (SPT) is an exceptionally rare neoplasm i... more Background: Solid-pseudopapillary tumor of the pancreas (SPT) is an exceptionally rare neoplasm in children. Its origin remains enigmatic. It is of low malignant potential and occurs most frequently in young females. Patients and Methods: A cumulative review of the tumor's clinicopathological characteristics from the world's literature is presented. The clinical course, pathohistologic data and outcome of surgery of four Austrian children treated at the general hospital of Vienna are analyzed. Results: Between 1987 and 1999, four girls (age: 12±16 years) with SPT were diagnosed at our institution. All patients presented with an abdominal mass and uncharacteristic abdominal pain. Two tumors were located in the tail, one in the body and tail and one in the head of the pancreas (diameter: 7±15 cm). Surgical procedures included three distal pancreatectomies and one partial duodenopancreatectomy (Whipple procedure). One patient had two recurrences with metastases that could only be partially resected. Chemotherapy was initiated for this patient. In the follow-up period (range: 6 months to 12 years) all patients are alive with no evidence of recurrence. Conclusions: SPT is a rare differential diagnosis of a pancreatic mass in children. It is mandatory to establish this diagnosis since complete surgical removal of the tumor even in case of metastases or local invasion offers an excellent prognosis.
Although Leonardo da Vinci has already illustrated the appendix in his anatomic drawings in 1492,... more Although Leonardo da Vinci has already illustrated the appendix in his anatomic drawings in 1492, a first anatomic description of a vermiform appendix was not done before 1521 by Berengario DaCarpi. 1 Certainly much more older are descriptions of an appendicitis of an Egyptian mummy from Byzanz. Reports on an appendicitis were first published by Jean Fernel 1544 and von Hilden 1652. These were followed by impressive reports on perforations of the appendix by L Heister, Mestivier and J Hunter in the 18th century. The first appendectomy was performed 1735 by C Amyand on an eleven-year old boy who developed appendicitis in the region of a scrotal hernia. In 1827, F Melier proposed the surgical treatment of appendicitis as standard therapy but was stubbornly ignored. For a long time the treatment of appendicitis remained a domain of internists who treated the patients with opium and bed rest as well as with drainage in case of abscesses. In 1886, Reginald Heber Fitz from Boston, for a s...
Pediatric Nephrology, 1999
Partial fungal obstruction of the renal collecting system is an unusual finding among infants tha... more Partial fungal obstruction of the renal collecting system is an unusual finding among infants that poses specific management problems. We report a patient with sepsis and fungal infection of the kidneys post surgery who presented with bilateral fungus balls and was successfully managed by conservative measures. Sonography is the imaging technique of choice in the diagnosis and follow-up of such patients. The need for prompt diagnosis in high-risk patients and the role of sonography are discussed.
Journal of Pediatric Gastroenterology & Nutrition, 1999
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > February ...
Psycho-medical aspects on migrants ’ health of III ˚ world pediatric surgical patients
Zentralblatt für Kinderchirurgie
Wiener medizinische Wochenschrift (1946), 1991
We are dealing with the rare case of a cardiac arrest of a 44 year old man, who has been using sh... more We are dealing with the rare case of a cardiac arrest of a 44 year old man, who has been using shoemakers glue. It could be proved in retrospect that the cause was the inhalation of trichlorethylene due to insufficient ventilating of the working place. The problem of this case was that at first the malign disorder of cardiac rhythm as well as the patient's state of coma did not provide any hint at the aetiology of the illness. By means of differential diagnosis we had to think of a myocardial infarction or a cerebral incident in the first place. Only by means of outside and self anamnesis could conclusions be drawn revealing a chronic poisoning at the working place. In particular an organic solvent, especially trichlorethylene as well as toluol was taken into consideration, the poisoning through trichlorethylene being proved conclusively. Other causes could be eliminated considering the clinical development and diagnostic parameter.
Hamdan Medical Journal, 2018
Vascular anomalies are rare congenital anomalies partly belonging to the Orphan diseaeses. Due to... more Vascular anomalies are rare congenital anomalies partly belonging to the Orphan diseaeses. Due to the intensive collaboration of the ISSVA a common categorization based upon histopathological attributes could be established. We present a short overview of the classification, manifestations and the diagnostic and therapeutical options.
Klinische Pädiatrie, 2017
European Surgery, 2008
ABSTRACT Kotsteine und Appendektomie im Kindesalter Zusammenfassung. Grundlagen: Kotsteine der Ap... more ABSTRACT Kotsteine und Appendektomie im Kindesalter Zusammenfassung. Grundlagen: Kotsteine der Ap-pendix sind eine bekannte Ursache fü r die Appendizitis. Das Vorhandensein eines Appendikolithen per se kö nnte daher eine Indikation zur Appendektomie darstellen. Methodik: Retrospektive Untersuchung ü ber einen Zeitraum von 6 Jahren aller Blinddarmoperationen. Verlauf und Diagnose wurden in Bezug auf das Vorhandensein eines Appendikolithen fü r verschiedene pä diatrische Alters-gruppen erhoben. Diese wurden in folgende Gruppen ein-geteilt: 0–4 Jahre, 4–6 Jahre, 6–10 Jahre, 10–14 Jahre, 14–18 Jahre, sowie 3 Kategorien (keine Blinddarmentzü n-dung, Blinddarmentzü ndung, Perforation) zugeordnet. Ergebnisse: Neunhundertneunzig Patienten waren inklu-diert. Die Inzidenz eines Appendikolithen betrug 28,6%, bei 4– 6jä hrigen 37,6%. Appendikolithen fü hrten signifikant hä ufiger zur Per-foration (odds ratio 2,27; p < 0,0001), in den Altersgruppen 0–6 Jahre vs 6–18 Jahre betrug die odds ratio: 10,2; (p< 0,0001). Der prä operative Krankheitsverlauf ist signifikant hä nger in der Gruppe ohne Appendikolith (p ¼ 0,04). Schlussfolgerungen: Appendikolithen sind ein hoch sig-nifikanter Faktor fü r das Auftreten einer spontanen Perforation. Das rechtfertigt die Appendektomie zur Vermei-dung der Perforation bei zufä llig entdecktem Appendikolith. Summary. Background: Improved diagnostic tech-niques increase the number of incidental findings of appen-dicoliths even without any patient complaints. Appendicoliths are one cause for appendicitis, and seem to justify elective appendectomy. Methods: Retrospective evaluation of all patients who underwent appendectomy within a period of 6 years. Strati-fication into 5 groups: 0–4, 4–6, 6–10, 10–14 and 14–18 years and categorization into 3 possible outcomes: no ap-pendicitis, appendicitis, perforated appendicitis. Results: Nine hundred and ninety patients were includ-ed. The incidence of appendicoliths was 28.6%, rising to 37.6% in preschool children. Appendicoliths were strongly associated with appendiceal rupture (odds ratio totally: 2.27; p < 0.0001; age group 0–6 years vs 6–18 years odds ratio: 10.2; p< 0.0001). Preoperative history was significantly higher in patients without appendicolith (p ¼ 0.04). Conclusions: Appendicoliths are significantly associated with spontaneous perforation. Therefore elective appendec-tomy in the presence of an appendicolith is justified to avoid perforation.
Health, 2011
The constantly expanding world wide mobility and globalization within the pediatric community put... more The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide, forcing carers to pay attention not only on their best surgical and medical performance like in the past. In contrary, they are forced to pay much more attention on psycho-medical aspects like finance, rehabilitation, socialization and integration, culture, management and logistics, health education and language skills. Then, according to our opinion these aspects should be considered as Post Traumatic Stress Disorder (PTSD)-like syndrome and treated accordingly. Then handling this problem successfully, would be essential for the future survival of any health care system.
American Journal of Roentgenology, Mar 1, 2000
Klinische Padiatrie, Apr 1, 2000
Progressive familial intrahepatic cholestasis (PFIC) is a congenital liver disease. First symptom... more Progressive familial intrahepatic cholestasis (PFIC) is a congenital liver disease. First symptoms can frequently be seen shortly after birth. Quality and expectation of life are substantially reduced due to severe pruritus and the complications of progressive liver cirrhosis. PFIC is diagnosed on the basis of characteristic clinical and laboratory parameters and genetic analysis after exclusion of other liver diseases leading to intrahepatic cholestasis. Medical therapy is only effective in a proportion of children with PFIC. Partial biliary diversion (PBD) is nowadays considered the therapy of choice in patients with therapy-refractive pruritus. If performed in time, damage to the liver can be delayed or arrested, thus orthotopic liver transplantation (OLT) can be postponed or even avoided in at least some patients with PFIC. Besides providing a current overview of PFIC, we report on three patients who were successfully treated surgically. One patient was subjected to a new technique of PBD (cholecysto-appendicostomy), the other two had OLT.
Journal of Pediatric Surgery, Apr 1, 2002
Background: Angiogenesis is essential for tumor growth and relies on the production of angiogenic... more Background: Angiogenesis is essential for tumor growth and relies on the production of angiogenic factors. Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis that binds to tyrosine kinase receptors Flt-1 and KDR. The interaction of VEGF and its receptors at gene and protein levels in neuroblastoma remains widely unknown. Methods: Tumor biopsy specimens and serum were obtained
British Journal of Cancer, Dec 1, 1998
Although tissue polypeptide-specific antigen (TPS) has been described as a potentially useful ser... more Although tissue polypeptide-specific antigen (TPS) has been described as a potentially useful serum marker of tumour activity in adult epithelial tumours, few data are available for childhood malignancies. Neuroblastomas and Wilms' tumours are the commonest types of solid malignancies found in the retroperitoneum of children. At this time, a widely used marker for Wilms' tumour is not available. Using an enzyme-linked immunosorbent assay (ELISA) kit, serum TPS levels in 23 children with neuroblastomas, nine with Wilms' tumours and 22 with benign tumours were evaluated to test the usefulness of the marker in identifying malignancies. Compared with healthy children (n = 110), the preoperative least-square means (LSM) of serum TPS were considerably elevated in both neuroblastoma (LSM = 209 U l-1) and Wilms' tumour (LSM = 235 U 1-1), whereas values in benign tumours were only slightly elevated. Although the Wilms' tumours were associated with higher preoperative serum TPS levels, there was no statistically significant difference compared with neuroblastomas. Receiver operating characteristic analysis (ROC curves) showed a high sensitivity and specificity for both malignancies. Successful treatment resulted in decrease in TPS serum values. Serum TPS measurements in children presenting with abdominal masses can help in diagnosing the two commonest extracranial solid malignancies of childhood. Furthermore, TPS could acquire a pivotal role in monitoring therapy.
Journal of Surgical Oncology, 2001
Background: Solid-pseudopapillary tumor of the pancreas (SPT) is an exceptionally rare neoplasm i... more Background: Solid-pseudopapillary tumor of the pancreas (SPT) is an exceptionally rare neoplasm in children. Its origin remains enigmatic. It is of low malignant potential and occurs most frequently in young females. Patients and Methods: A cumulative review of the tumor's clinicopathological characteristics from the world's literature is presented. The clinical course, pathohistologic data and outcome of surgery of four Austrian children treated at the general hospital of Vienna are analyzed. Results: Between 1987 and 1999, four girls (age: 12±16 years) with SPT were diagnosed at our institution. All patients presented with an abdominal mass and uncharacteristic abdominal pain. Two tumors were located in the tail, one in the body and tail and one in the head of the pancreas (diameter: 7±15 cm). Surgical procedures included three distal pancreatectomies and one partial duodenopancreatectomy (Whipple procedure). One patient had two recurrences with metastases that could only be partially resected. Chemotherapy was initiated for this patient. In the follow-up period (range: 6 months to 12 years) all patients are alive with no evidence of recurrence. Conclusions: SPT is a rare differential diagnosis of a pancreatic mass in children. It is mandatory to establish this diagnosis since complete surgical removal of the tumor even in case of metastases or local invasion offers an excellent prognosis.
Although Leonardo da Vinci has already illustrated the appendix in his anatomic drawings in 1492,... more Although Leonardo da Vinci has already illustrated the appendix in his anatomic drawings in 1492, a first anatomic description of a vermiform appendix was not done before 1521 by Berengario DaCarpi. 1 Certainly much more older are descriptions of an appendicitis of an Egyptian mummy from Byzanz. Reports on an appendicitis were first published by Jean Fernel 1544 and von Hilden 1652. These were followed by impressive reports on perforations of the appendix by L Heister, Mestivier and J Hunter in the 18th century. The first appendectomy was performed 1735 by C Amyand on an eleven-year old boy who developed appendicitis in the region of a scrotal hernia. In 1827, F Melier proposed the surgical treatment of appendicitis as standard therapy but was stubbornly ignored. For a long time the treatment of appendicitis remained a domain of internists who treated the patients with opium and bed rest as well as with drainage in case of abscesses. In 1886, Reginald Heber Fitz from Boston, for a s...
Pediatric Nephrology, 1999
Partial fungal obstruction of the renal collecting system is an unusual finding among infants tha... more Partial fungal obstruction of the renal collecting system is an unusual finding among infants that poses specific management problems. We report a patient with sepsis and fungal infection of the kidneys post surgery who presented with bilateral fungus balls and was successfully managed by conservative measures. Sonography is the imaging technique of choice in the diagnosis and follow-up of such patients. The need for prompt diagnosis in high-risk patients and the role of sonography are discussed.
Journal of Pediatric Gastroenterology & Nutrition, 1999
Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > February ...
Psycho-medical aspects on migrants ’ health of III ˚ world pediatric surgical patients
Zentralblatt für Kinderchirurgie
Wiener medizinische Wochenschrift (1946), 1991
We are dealing with the rare case of a cardiac arrest of a 44 year old man, who has been using sh... more We are dealing with the rare case of a cardiac arrest of a 44 year old man, who has been using shoemakers glue. It could be proved in retrospect that the cause was the inhalation of trichlorethylene due to insufficient ventilating of the working place. The problem of this case was that at first the malign disorder of cardiac rhythm as well as the patient's state of coma did not provide any hint at the aetiology of the illness. By means of differential diagnosis we had to think of a myocardial infarction or a cerebral incident in the first place. Only by means of outside and self anamnesis could conclusions be drawn revealing a chronic poisoning at the working place. In particular an organic solvent, especially trichlorethylene as well as toluol was taken into consideration, the poisoning through trichlorethylene being proved conclusively. Other causes could be eliminated considering the clinical development and diagnostic parameter.
Hamdan Medical Journal, 2018
Vascular anomalies are rare congenital anomalies partly belonging to the Orphan diseaeses. Due to... more Vascular anomalies are rare congenital anomalies partly belonging to the Orphan diseaeses. Due to the intensive collaboration of the ISSVA a common categorization based upon histopathological attributes could be established. We present a short overview of the classification, manifestations and the diagnostic and therapeutical options.
Klinische Pädiatrie, 2017
European Surgery, 2008
ABSTRACT Kotsteine und Appendektomie im Kindesalter Zusammenfassung. Grundlagen: Kotsteine der Ap... more ABSTRACT Kotsteine und Appendektomie im Kindesalter Zusammenfassung. Grundlagen: Kotsteine der Ap-pendix sind eine bekannte Ursache fü r die Appendizitis. Das Vorhandensein eines Appendikolithen per se kö nnte daher eine Indikation zur Appendektomie darstellen. Methodik: Retrospektive Untersuchung ü ber einen Zeitraum von 6 Jahren aller Blinddarmoperationen. Verlauf und Diagnose wurden in Bezug auf das Vorhandensein eines Appendikolithen fü r verschiedene pä diatrische Alters-gruppen erhoben. Diese wurden in folgende Gruppen ein-geteilt: 0–4 Jahre, 4–6 Jahre, 6–10 Jahre, 10–14 Jahre, 14–18 Jahre, sowie 3 Kategorien (keine Blinddarmentzü n-dung, Blinddarmentzü ndung, Perforation) zugeordnet. Ergebnisse: Neunhundertneunzig Patienten waren inklu-diert. Die Inzidenz eines Appendikolithen betrug 28,6%, bei 4– 6jä hrigen 37,6%. Appendikolithen fü hrten signifikant hä ufiger zur Per-foration (odds ratio 2,27; p < 0,0001), in den Altersgruppen 0–6 Jahre vs 6–18 Jahre betrug die odds ratio: 10,2; (p< 0,0001). Der prä operative Krankheitsverlauf ist signifikant hä nger in der Gruppe ohne Appendikolith (p ¼ 0,04). Schlussfolgerungen: Appendikolithen sind ein hoch sig-nifikanter Faktor fü r das Auftreten einer spontanen Perforation. Das rechtfertigt die Appendektomie zur Vermei-dung der Perforation bei zufä llig entdecktem Appendikolith. Summary. Background: Improved diagnostic tech-niques increase the number of incidental findings of appen-dicoliths even without any patient complaints. Appendicoliths are one cause for appendicitis, and seem to justify elective appendectomy. Methods: Retrospective evaluation of all patients who underwent appendectomy within a period of 6 years. Strati-fication into 5 groups: 0–4, 4–6, 6–10, 10–14 and 14–18 years and categorization into 3 possible outcomes: no ap-pendicitis, appendicitis, perforated appendicitis. Results: Nine hundred and ninety patients were includ-ed. The incidence of appendicoliths was 28.6%, rising to 37.6% in preschool children. Appendicoliths were strongly associated with appendiceal rupture (odds ratio totally: 2.27; p < 0.0001; age group 0–6 years vs 6–18 years odds ratio: 10.2; p< 0.0001). Preoperative history was significantly higher in patients without appendicolith (p ¼ 0.04). Conclusions: Appendicoliths are significantly associated with spontaneous perforation. Therefore elective appendec-tomy in the presence of an appendicolith is justified to avoid perforation.
Health, 2011
The constantly expanding world wide mobility and globalization within the pediatric community put... more The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide, forcing carers to pay attention not only on their best surgical and medical performance like in the past. In contrary, they are forced to pay much more attention on psycho-medical aspects like finance, rehabilitation, socialization and integration, culture, management and logistics, health education and language skills. Then, according to our opinion these aspects should be considered as Post Traumatic Stress Disorder (PTSD)-like syndrome and treated accordingly. Then handling this problem successfully, would be essential for the future survival of any health care system.