Biomedical subjects
D Rădulescu
Publications and source records attributed to D Rădulescu.
[Neoplasms of the principal biliary passages].
The authors make an analysis of factors which led to a late diagnosis, and to the choice of various surgical procedures used in the treatment of neoplasms of the main biliary pathway. The classical picture of "nodose jaundice" was encountered in only 24% of the cases, and this explains the wrong interpretation of the jaundice etiology in the early stages. A series of diagnostic difficulties are stressed, especially during the surgical intervention, related to some macroscopic forms of the neoplasm, the localization in ares which are difficulty accessible, and the bioptic sampling which is only rarely possible. The advanced stage of the lesions explains the fact that therapeutic attempts were limited in 52% of all patients to laparotomy performed for exploratory purposes, while exeresis of the neoplastic formation was possible in only 3% of the cases. Palliative interventions were used in 45% of the cases. Trans-tumoral intubation was used for draining purposes in the internal derivations. This was applied in 9 cases since it is simple and easy to perform, providing results which are similar to those obtained with other types of derivations. When no such possibilities existed external draining of the bile was achieved, a minimal procedure which assured the solution for the jaundice problem.
[Idiopathic multiple stenoses of the small intestine. Case report].
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[Foreign body in the gastric wall associated with antral polyposis].
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[Myasthenia gravis--surgical treatment (indications and results)].
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[Desmoid tumors of the abdominal wall].
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[Calcified adrenal cyst].
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Gastrobiopsy in the diagnosis of gastric stump carcinomas.
An endoscopic and histopathologic observation made on 152 cases with gastric symptoms occurring 5-35 years of free interval after gastric resection revealed a gastric stump carcinoma in 14 (9 per cent) of the cases. Research pointed out that previous duodenal ulcer prevailed as compared to the gastric one, and the stomal located carcinomas co-existed with severe dysplasia of the gastric mucosa in six cases.
[Anastomotic procedure and reflux esophagitis following total and upper pole gastrectomies].
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[Gardner syndrome associated with a periampullary tumor. Presentation of a case].
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Gastrin cells in stomach and duodenal ulcers.
By means of cytochemical and electron microscopy methods, the behavior of gastrin cells in ulcers of the stomach and duodenum were investigated. The study was performed on specimens of surgical resection from stomach and duodenal ulcers with gastric normacidity. The results point out a significant decrease of gastrin cells in stomach ulcers in comparison with the duodenal ones. These findings in stomach ulcers were attributed to the high intensity of gastritis lesions, histopathologically evidenced. Electron microscopy revealed that gastrin cells were loaded with secretion granules presenting suggestive images of synthesis activity.
[The Hartmann type of operation].
In spite of the contemporary progresses in the field of surgical therapies, of the use of antibiotics, and of resuscitation techniques, resection of the colon with closure of the distal end and terminal colostomy, as suggested by Hartmann at the start of the century, has still some indications. Moreover, beside the original indications, this type of intervention can also be aplied in the case of some other benign lesions, and extension of the colon resection may involve other areas beside the recto-sigmoid zone. The specific indications of the intervention are the severe, very extensive and usually complicated lesions of the colon, frequently associated with a general biologic deterioration, conditions that make highly improbably the success of other surgical procedures. In a group of 28 patients (4,6 percent of the total number of cases in which interventions on the colon have been performed), of which 15 neoplasies and 13 benign lesions, the following resections have been carried out: 19 sigmoid resections, one resection of the transverse colon, 3 rectosigmoid resections, one left hemi-colectomy, 2 sub-total colectomies, 2 interventions for dehiscence of anastomoses. Considering the critical condition of the patients the high post-operative mortality appears to be easy to explain, as well as the non-lethal septic post-operative complications. In 7 patients (25 percent of the survivors) secondary restoration of the transit was carried out (4 benign lesions, and 3 cases of neoplasy). Reconversion raises some tactical and technical problems concerning the time of the intervention, the route, the attitude in front of colostomy, the mobilization of the segments and the type of anastomoses.
The ultrastructure of malignant melanomas. Observations on seven cases.
Seven cases of human cutaneous malignant melanomas, some of them associated with distant metastases, were analyzed by electron microscopy. The obtained results indicate that the polymorphism of melanosomes can not be used to distinguish between melanomas developed on Dubreuilh's precancerous melanosis and those formed on nevi. The features of tumoral cells in pigmented tumors were different from those of cells within unpigmented tumors, and there were no cytologic differences between the primary tumor and metastases.
[Digestive lipomas: clinical and therapeutic aspects].
The authors present 6 cases of lipomas of the digestive pathways, five in females and one in a male. The patients were aged between 31 and 75 years and an average age of 51 years. The benign lipomatous tumor was unique in all the cases. It was located in the antrum in 3 of the patients and in the ileum, the right segment of the colon and on the sigmoid in each of the three other patients respectively. In all the cases the radiological examination confirmed the clinical diagnosis of digestive tumour. The radiological aspects were typical for benignity in four of the cases and suggested malignancies in the other two. Gastric lipomas were characterized from the clinical viewpoint by dyspeptic disturbances that were not systematized, as well as by bleeding while the ileal and the colic tumours were accompanied by repeated invagination. The sigmoid tumour was accompanied by colic and disturbances of the transit. The surgical solution consisted in 3 of the cases in a simple exeresis of the lipoma (two gastric lipomas and the sigmoid tumour). In one of the gastric lipomas a limited resection was performed, and for the colic and ileal tumours, complicated by invagination a right hemicolectomy was carried out.
[Clinical and therapeutic aspects of subphrenic abscess].
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[Cephalic pancreato-duodenectomy in neoplastic and sclero-inflammatory diseases].
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[Multiple colonic cancers: simultaneous and successive].
The authors attempt an approach of a controversial problem of contemporary surgery and stress the following significant aspects:--the frequency of multiple colon cancers is of 3%, approximately 25% of the cases being associated with benign proliferative lesions:--the intra-operatory diagnosis of multiple colon cancers is difficult (3 out of 12 cases); intrasurgical exploration may give rise to problems in connection with the insufficiency of the exploration, or the inaccessibility of unique tumors, thus existing the risk of leaving in place a developing tumor, that can be discovered at a new intervention (one case); the operability of multiple colon cancers is similar to that of the unique malignant lesions, depending on the extension, the variety and the focal distribution of the neoplastic lesions.
Spindle and epithelioid cell nevus (Spitz nevus). Observation on nine cases.
Nine cases with spindle and epithelioid cell nevus occurred in children were analysed clinically and morphologically. The results indicate that Spitz nevus is composed of cells resembling those of a malignant melanoma. There are some morphological aspects such as: discontinuous junctional proliferation, the sparse mitotic activity, the process of maturation of the cells with increasing depth, considered as valuable markers for the benign character of this type of tumour.