Biomedical subjects

A Hrívó

Publications and source records attributed to A Hrívó.

4 recordsLinked to original sources

PubMed1999

[The role of intraoperative gamma-probe-guided sentinel lymph node biopsy in the treatment of malignant melanoma and breast cancer].

In the treatment of malignant tumors regional lymphadenectomy is used for two purposes. It is used partly for staging the regional lymph nodes which is a significant and independent prognostic factor and determines the need for adjuvant oncologic treatment and partly for achieving locoregional disease control. Removal of tumor-free lymph nodes by regional lymph node clearance is unnecessary according to our current knowledge. Since the sensitivity and specificity of non-invasive clinical examinations are insufficient in predicting the nodal status the histological study of the regional lymph nodes cannot be abandoned. A new and minimally invasive surgical procedure, the mapping and removal of the first tumor draining lymph node, the sentinel node provides the possibility of pathological nodal staging without performing formal lymphadenectomy. Mapping of the sentinel node can be performed by the use of a radioisotope and intraoperative hand-held gamma-probe or a vital blue dye or a combination of these two. This latter method was used by the authors in 73 patients (25 with malignant melanoma and 48 with breast cancer). Sentinel lymph node biopsy was performed successfully in 92% of patients with melanoma and 90% of patients with breast cancer. In three breast cancer patients the sentinel node inaccurately predicted the axillary status as negative, but is was in 93% accurate in predicting the histologic nodal state. According to our preliminary experiences intraoperative gamma-probe guided sentinel lymph node biopsy is considered a feasible procedure in both malignant melanoma and breast cancer. More experiences are needed before introducing this method in the routine clinical practice.

Biopsy↗

PubMed1999

[Amyloid goiter].

Amyloid goitre is at an extremely rare occurrence. Authors review the origin of disease and its symptoms, diagnostic and therapeutic tools. The disease may be due to either primary or secondary systemic or local amyloidosis. Diagnosis may be made even before surgery on anamnestic data, on very rapid growth of thyroid glands, on diffuse appearance, on other symptoms of systemic amyloidosis, on findings of iconographic procedures and on detection of amyloid in aspirates. Final diagnosis is based on histology. Surgical therapy is aiming at avoidance of the existing and the threatening consequences of expanding mass. The outcome is independent from thyroid surgery, it is related to other manifestations of amyloidosis. Concerning with the present case the chronic superior vena cava syndrome and chylous pleural effusion as first described symptoms and asymptomatic hyperthyroxinaemia is emphasised. Neither other organ involvement, nor primary amyloidogenous molecula was found during the 18 months follow up, so patient has secondary and localised amyloidosis.

Amyloidosis↗

PubMed1998

Changing diagnostic and therapeutic approaches to the 'Ogilvie syndrome'.

The only thing that has remained unchanged about the genuinely described 'Ogilvie syndrome' is its name. Recently it was considered to be an acute colonic pseudoobstruction, a clinical entity mimicking the mechanic ileus of the distal large intestine, without organic obstruction. It is almost always secondary to other diseases. Not all details of the pathogenesis are known, but it has become clear that the direct factor leading to the disturbance of the motility is a vegetative imbalance. X-ray findings are highly characteristic and critical in the planning of treatment. The danger for the patients is the progression of the state or the long duration of the process. Conservative treatment is suitable only for early cases, without complications. In case of failure non-invasive endoscopic or endoscopically assisted minimally invasive procedures may be mandatory. These methods have seen rapid advance in recent years. Uncertain diagnoses or complications call for open surgery. Cecostomy is the solution of choice anyway. The mortality is high in this group of elderly polymorbid patients. Authors compare six of their cases with data collected from the literature.

Adult↗

PubMed1996

[Central bronchoplastic procedures in Hungary and their outcome (198-1993)].

Bronchoplastic procedures involving the main carina are declared as central bronchoplasties. A nation-wide collection of these interventions performed between 1980 and 1993 is analysed. The study is on a total of 154 operations, that were 16 bifurcation resections and 14 stem bronchus resections without parenchyma sacrifice, 61 sleeve or wedge pneumonectomies and 63 tracheal sleeve or wedge right upper lobectomies or carina-plasties. Surgery alone-without multimodality therapy-was the choice of treatment almost exclusively. About 90% of these interventions were performed for highly malignant, histologically peripheral-type, but centrally located bronchial cancers. The hospital mortality and morbidity were found up to 30% (an average of appr. 17%), depending on surgical subsets. Cause of death were surgical at 11% (leakage, anastomotic dehiscence and bleeding) and non surgical at 5.8% respectively. Complications at another 9% were related to surgery. Data of survival suggest, that nodal state is the strongest predictor, but the unfavourable N2 group comprises longer survivors as well. Certain part of this kind of interventions is to be chosen without alternatives (isolated tracheobronchial resections without parenchyma-resection, extended pneumonectomies) while extended lobectomies are alternatives of the extended pneumonectomies in strict conditions. A central bronchoplastic procedure is justified only with hope of complete resection for its high complication rate.

Anastomosis, Surgical↗