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Biomedical subjects

D Kosuta

Publications and source records attributed to D Kosuta.

At least 19 recordsLinked to original sources
PubMed2000

Three-dimensional ultrasound and power doppler improve the diagnosis of ovarian lesions.

OBJECTIVE: The aim of this study was to determine whether three-dimensional power Doppler can improve the ability to differentiate benign from malignant ovarian masses. METHODS: Transvaginal color Doppler and three-dimensional power Doppler were performed on 120 patients with ovarian lesions. All patients underwent both ultrasound examinations during the day prior to laparotomy or laparoscopy. Scoring systems combining morphological and Doppler parameters were adopted for two- and three-dimensional ultrasound examinations. RESULTS: In each of 11 ovarian malignancies, preoperative diagnosis by three-dimensional power Doppler was confirmed by histopathology. Transvaginal color Doppler missed 1 case of serous cystadenocarcinoma, while 3 benign lesions were considered false positive. In 1 case of cystadenofibroma both transvaginal color Doppler and three-dimensional power Doppler were falsely positive. Qualitative analysis of the tumor vascularity architecture added to morphological parameters had a sensitivity and specificity of 100 and 99.08%, respectively. CONCLUSIONS: Better results achieved by three-dimensional ultrasound can be explained by improved recognition of the ovarian mass anatomy, characterization of the surface features, detection of the tumor infiltration, and precise depiction of the size and volume. Three-dimensional power Doppler imaging can detect structural abnormalities of malignant tumor vessels, such as arteriovenous shunts, microaneurysms, tumoral lakes, disproportional calibration, coiling, and dichotomous branching. Three-dimensional power Doppler can enhance and facilitate the morphologic and functional evaluation of both benign and malignant ovarian masses.

Adolescent↗
PubMed2000

Three-dimensional ultrasonographic and power Doppler characterization of ovarian lesions.

OBJECTIVE: To determine whether three-dimensional ultrasound (3D US) and 3D power Doppler can improve the ability to differentiate benign from malignant ovarian lesions. METHODS: Transvaginal ultrasound, transvaginal color Doppler, 3D US and 3D power Doppler were performed on 90 patients with ovarian lesions during the week prior to surgery. Four independent sonographers were blinded to the results of other ultrasound studies. RESULTS: Color Doppler studies added to transvaginal gray-scale characterization of ovarian lesions resulted in sensitivity of 88.89% and specificity of 97.53% in diagnosing ovarian malignancy. Qualitative analysis of tumor vascularity by 3D power Doppler added to morphological features obtained by 3D US is clinical pertinent and reached sensitivity and specificity of 100 and 98.76%, respectively. CONCLUSION: Three-dimensional ultrasound and power Doppler can enhance and facilitate the morphologic and functional evaluation of both benign and malignant ovarian lesions. Introduction of the 3D quantitative technique for measurements of blood flow and vascularization may increase clinical relevance of these studies.

Adolescent↗
PubMed1998

Preoperative diagnosis of primary fallopian tube carcinoma.

INTRODUCTION: Transvaginal color and pulsed Doppler can detect areas of neovascularization within the tubal carcinoma and can distinguish it from other benign adnexal pathology. SUBJECTS AND METHODS. During a 7-year period eight cases of Fallopian tube carcinoma were detected using transvaginal color and pulsed Doppler. RESULTS: Transvaginal sonography revealed complex, sausage-shaped, and/or cystic structures in the adnexal region. Additional color Doppler examination depicted low vascular impedance (RI ranged from 0.29 to 0.40). Histopathology reported different types of Fallopian tube carcinoma. CONCLUSION: Transvaginal color Doppler may aid in diagnosis of Fallopian tube malignancy more reliably than using other costly diagnostic procedures.

Adenocarcinoma↗
PubMed1996

The sigmoidorectal pouch (Mainz pouch II).

A sigmoidorectal pouch was constructed in 20 patients (18 with invasive bladder cancer, 2 with complete urethral destruction with multiple vesicovaginal fistulas). The rectal-dynamic studies showed that by detubularization and reconfiguration of the sigmoid colon and rectum, we obtained a low-pressure reservoir, with the high-pressure contractions eliminated. Preoperatively, the basal rectum pressure was 21.4 cm H2O; rectum contractions reached a mean of 27.6 cm H2O (maximum 48 cm H2). Postoperatively (9-36 months) the mean basal pressure of the pouch was 19.3 cm H2O (p > 0.05; t test comparison with the preoperative value), with a mean contraction value of 19.1 cm H2O (p < 0.05). All the patients experienced continence day and night with a pouch emptying frequency of four times during the day and once at night, after 9 months. By fixing the pouch to the promontory or psoas muscle, without compromising the blood supply to the pouch, the risk of ureteral kinking and upper urinary tract dilatation were considerably decreased. The price to be paid for almost perfect continence was hyperchloremic acidosis in most patients.

Acidosis↗
PubMed1995

Uterine sarcoma: a report of 10 cases studied by transvaginal color and pulsed Doppler sonography.

OBJECTIVE: To evaluate the role of transvaginal color Doppler in differentiating uterine sarcoma from myoma. STUDY DESIGN: A group of 2010 women were examined by transvaginal color Doppler ultrasonography 1 day before planned hysterectomy. Ten cases with uterine sarcoma were analyzed with respect to their color Doppler sonographic patterns and compared with 150 normal and 1850 myomatous uteri. Analysis of variance was used to test the significance among the subgroups. RESULTS: All cases of uterine sarcoma (100%) revealed abnormal tumoral blood vessels. The mean resistance index (RI) of these vessels was 0.37 +/- 0.03, ranging from 0.32 to 0.42, which is statistically significantly lower than that of the normal and myomatous (P < 0.001) uteri. There was no significant difference between RI in the right and left uterine arteries in each separate group; however, there was a decline in these values from normal, through myomatous, to sarcomatous uteri. Using a cutoff point of 0.40 for RI we were able to distinguish between benign and malignant myometrial tumors with a sensitivity of 90.91%, specificity of 99.82%, positive predictive value of 71.43%, and negative predictive value of 99.96%. CONCLUSION: Color Doppler sonography has the potential to distinguish uterine sarcoma from benign uterine lesions.

Adolescent↗
PubMed1994

An attempt to screen asymptomatic women for ovarian and endometrial cancer with transvaginal color and pulsed Doppler sonography.

Several screening procedures have been proposed to detect ovarian and endometrial cancer. However, none of them is sensitive and specific enough to be used in population-based screening programs. During our 5 year long study, 5013 asymptomatic women (44% premenopausal and 56% postmenopausal women) were scanned by transvaginal color and pulsed Doppler ultrasonography in an attempt to detect malignancy. These women had 404 adnexal cysts; 70 had resolved spontaneously on follow-up scans and 18 persisted. Another 316 sonographically benign cysts are still in the procedure of follow-up second scans. Of 5013 women, four women had stage I ovarian carcinoma and six had stage I endometrial carcinoma. There was one false-positive case encountered with an endometrioma. Only 14 women were subjected to major operative intervention; others underwent minor procedures based on the benign scan findings. No medical or surgical complications were reported. Transvaginal color Doppler ultrasonography, a noninvasive procedure, can detect ovarian and endometrial carcinoma in asymptomatic women and may be used as a screening procedure for these diseases.

Endometrial Neoplasms↗
PubMed1993

In vivo modulating effects of bacterial peptidoglycans on PHA-induced responses of porcine PBL and splenocytes.

The modulating effect of Brevibacterium divaricatum cell wall derivatives, i.e. peptidoglycan monomer (PGM) and peptidoglycan polymer (PGP) on phytohemagglutinin (PHA)-induced responses of peripheral blood lymphocytes (PBL) and spleen lymphocytes (SPL) from neonatal pigs farrowed to gilts or sows was tested. Both, PBL from progeny of sows and SPL from progeny of gilts responded significantly lower (P < 0.01) when PGM (14 mg/kg) was given by intraperitoneal (IP) route at Day 0 and Day 7 after farrowing as compared to the respective controls. When the same amount of PGM was given i.p. at Day 7 and Day 14, the responses of PBL and SPL from offspring of gilts were much higher (P < 0.01) than those of nontreated controls. The treatment with PGP (2.5 mg/kg) by the same route at Day 7 and Day 14 strongly stimulated (P < 0.01) the responses of PBL and SPL of pigs originating from litters of either gilts or sows, respectively.

Adjuvants, Immunologic↗
PubMed1981

An evaluation of netilmicin, 150 mg BID, in systemic infections.

The efficacy and tolerance of netilmicin administered in a simplified dosage schedule (150 mg BID) were evaluated in an open study of 20 patients with acute systemic infections. Duration of therapy ranged from 6 to 11 days. All isolated causative organisms were eradicated; 85% (17/20) of the patients experienced complete clinical resolution, and the remaining 15% (3/20) experienced definite improvement. No patients developed nephrotoxicity of ototoxicity. The results of this study demonstrate that netilmicin is both effective in the treatment of serious systemic infections and well tolerated when administered at 150 mg twice daily.

Adolescent↗
PubMedDate not supplied

Preoperative evaluation of cystic teratoma: what does color Doppler add?

The aim of this prospective study lasting 4 years was to develop a scoring system using clinical parameters, sonographic findings, and transvaginal color and pulsed Doppler impedance values for the preoperative recognition of cystic teratoma. A total of 887 benign and malignant adnexal masses, among which 102 were histologically proved to be cystic teratomas, were evaluated. Using morphological criteria, cystic teratoma was successfully predicted in 95 patients. The sensitivity and specificity of a morphological scoring system were 93.1% and 99.4%, respectively, while positive and negative predictive values were 95.0% and 99.1%. A scoring system using both morphology and vascular assessment demonstrated higher sensitivity and specificity (99.02%, 99.75%). The application of a scoring system combining morphology and vascularity improves the accuracy of diagnosing cystic teratoma and of separating this entity preoperatively from other benign and malignant ovarian conditions.

Adnexa Uteri↗
PubMedDate not supplied

Suppression of rat tumor colonies in the lung by oxygen at high pressure is a local effect.

The effect of hyperbaric oxygen (HBO) on the growth of anaplastic carcinoma colonies in rat lungs after intravenous tumor cell injection was studied. From the first day after tumor cell injection, the rats were exposed to HBO for 16-21 days, 90 min per day. Oxygen at a pressure of 300 kPa (3.0 ATA) significantly decreased the number of lung tumor colonies and increased the survival of tumor-bearing rats, whereas the application of oxygen at a pressure of 100 kPa had no effect. An oxygen-nitrogen normoxic mixture balanced with nitrogen to 300 kPa (3.0 ATA) did not affect the number of colonies, suggesting that the effect was specific for oxygen and not for the increased pressure itself. A 6-day application of oxygen at a 300 kPa pressure suppressed the growth of lung tumor colonies when applied on days 1-6 and 7-12 after intravenous tumor cell injection, but had no effect when applied on days 13-18. In contrast to dramatic effects of HBO on the development of artificial lung metastases, the oxygen at the same 300 kPa pressure had no effect on the growth of tumor cells injected in the hind foot. Thus it appears that the suppression of lung tumor colonies by HBO was due to local oxygen effects in the lungs.

Animals↗
PubMedDate not supplied

[High frequency current in endoscopic surgery and a new bipolar hook for endoscopic surgery].

High frequency current is used in surgery for cutting the tissue and stopping bleeding. Its usage is more frequent in endoscopic than open surgery. "Polarity" (monopolar and bipolar) marks the number of the electrical poles on the application place. Monopolar current has been used more often. With its usage thermal injuries are possible: coagulation outside of the laparoscopic view, direct coupling, capacitive coupling, sparking, skin combustion, activity on the heart rhythm. Because of these complications, the bipolar current is more and more in usage, which reduces the number of complications or avoids them completely. Many bipolar instruments are available today. Bipolar hook for endoscopic surgery is a new instrument which unites the good characteristics of the hook and bipolar current.

Electrosurgery↗