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Biomedical subjects

A Valesky

Publications and source records attributed to A Valesky.

11 recordsLinked to original sources

[Management of ruptured aortic aneurysms in routine service of a surgical department].

In the year 1989 859 patients with infrarenal aortic aneurysms were treated in the Hessen county (5.6 mill inhabitants) (private survey). 64% of the ruptured aneurysms were operated in 24 departments for general surgery and 36% were operated in the 7 departments for vascular surgery. Corresponding numbers for elective operations are 55% respectively 45%. The results after resection of the aneurysms in our 22 patients with ruptured aneurysms (1986-1989) reveal a letality of 50%. No patient arriving at our clinic alive was excluded from operation. Letality in electively operated patients (n = 131) during the same period was 2.3% (n = 3).

Aged

Parathyroid localization.

Twenty-nine consecutive patients with suspected primary hyperparathyroidism were examined preoperatively using ultrasound, sonographically guided fine needle aspiration, and aspirate immunostaining for PTH. In 25 patients, localization of enlarged parathyroid glands was successful. In 2 patients, the tumors were located retrosternally and, thus, could not be detected by ultrasound. One patient had a multinodular goiter which impeded localization. In 1 patient with renal osteodystrophy, 2 enlarged parathyroid glands in the neck were not visualized preoperatively. Cytology was not diagnostic, although some cytological features were suggestive of parathyroid cells. Immunostaining of the aspirated smears for PTH, however, correctly diagnosed all preoperatively localized lesions. Ultrasound should be the routine procedure of choice for preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism. Fine needle aspiration and immunocytochemistry can supply confirmation, if necessary.

Adolescent

[Tracheoesophageal fistula after blunt thoracic trauma: recognition and treatment].

Three cases of tracheoesophageal fistula as a result of nonpenetrating chest trauma were surgically repaired. Another 31 cases were found in the literature. 'Thrown against a steering wheel' was the cause of injury in the majority of patients. Though the fistula became characteristically symptomatic 3 to 7 days after the accident, the diagnosis was often delayed for several months. No patient recovered without operation. After demarcation of the area of contusion and necrosis, especially in the esophagus wall, surgical repair is the therapy of choice.

Accidents, Traffic

[Resection for pulmonary metastases: results and prognosis (author's transl)].

From 1955 to 1975 in 25 patients lung surgery has been carried out because of intrapulmonary metastases of extrapulmonary malignant growth. 6 patients survived longer than 5 years. There was no relationship between survival time and length of the time interval between initial surgery (primary) and second operation (i.e. diagnosis of pulmonary lesion). On the other hand a definite relationship resulted for survival time and the size of the growth. In bad-risk patients surgery for metastatic lung cancer is not indicated, but it is very successful in selected cases.

Female

[Complete bilateral renal vein occlusion in a patient with right sided hypernephroma and renal insufficiency: report of successful thrombectomy and nephrectomy].

A 66 year old female patient was successfully operated following complete obstruction of the inferior vena cava and left renal vein by tumor thrombi from a right sided hypernephroma. The effect of the compensatory development of venous collaterals of the left kidney and the therapeutic consequences of a thrombectomy following long standing thrombosis of the left vein are discussed.

Adenocarcinoma

[Profundaplasty--a palliative operation in leg arterial occlusion of the aged?].

In a retrospective study the relevance of revascularisation of the deep femoral artery was evaluated in 100 geriatric patients with obliterative atherosclerosis. The results of profundaplasty were good in 91% of patients with claudication (follow-up 47 months). In patients with rest pain the limb salvage rate was 77% (follow-up 39 months). In comparison with femoropopliteal or femorocrural bypass the results were at least even but had lower lethality. In a state of gangrene the limb salvage rate was 39% overall (follow-up 31 months). Diabetics had a limb salvage rate of 28% versus 43% in non diabetics. In a state of claudication and rest pain with stenosis of the deep femoral artery its revascularisation is in our view the treatment of first choice. In a state of gangrene bypass implantation, especially in diabetics, seems to have better results, but as additional palliation before primary amputation profundaplasty should be performed.

Aged