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Biomedical subjects

D Voiculescu

Publications and source records attributed to D Voiculescu.

At least 19 recordsLinked to original sources
PubMedDate not supplied

Investigations on allergic and serological reactions following inoculation of inactivated smallpox vaccines by cutaneous scarification.

A number of 154 young adults were given a smallpox vaccine inactivated by UV (103 subjects) or by 4degrees/00 formol (51 subjects). Inoculation induced an early cutaneous reaction in 75.4% of the revaccinated subjects. The incidence of positive HAI reactions in this group increased from 30.2% before vaccination to 63.8% after inoculation, while the geometric mean titer increased from 2.88 to 10.73. This would prove the early reactions to be allergic responses of organisms sensitized against smallpox vaccine, capable of stimulating antibody formation. No cutaneous reaction was recorded in the 7 persons vaccinated for the first time (without pre-existent cutaneous scars). These subjects developed neither cutaneous nor humoral response to the killed virus, as there was no previous sensitization to the respective antigen.

Adult↗
PubMedDate not supplied

[Acute necrotizing pancreatitis following abdominal trauma].

We present 11 cases of acute necrotizing pancreatitis following abdominal trauma operated in our clinic during the last five years. All patients except one were male. All of them had obvious symptoms of acute diffuse peritonitis when they came to hospital. The diagnosis was established by CT scan in four observations. All operations were performed during 12-36 hours after they came. During surgery, there was complete pancreatic necrosis in seven cases and incomplete in the other four cases. Associated injuries following trauma were represented by: hemothorax--two cases, spleen injury--one case, lesion of mesentery--one case, intestinal lesion--one case. In all cases we performed a wide opening of the lesser sac, pancreatic capsulectomy, necrosectomy and multiple drainage of the pancreatic side (behind the peritoneum) and peritoneal cavity. The postoperative outcome was difficult in all cases. Postoperative morbidity recorded pancreatic leakage (three cases), pseudocysts (two cases) and a perforation of gastric wall. There were 10 cases cured and one patient died.

Abdominal Injuries↗
PubMedDate not supplied

[The Fitz-Hugh-Curtis syndrome in laparoscopic surgery].

The Fitz-Hugh-Curtis syndrome was diagnosed intraoperatory at 7.1% of the laparoscopic cholecystectomies in our clinic. The attitude in all cases was to perform a complete adhesiolysis. The reasons we consider that support this are: 1. the adhesions that fix the liver to the diaphragma do not allow the surgeon a comfortable access to perform cholecystectomy; 2. if these adhesions are torn accidentally during operation it could end up to the glissonian sheath rupture and uncontrollable bleeding; 3. adhesiolysis might be imposed in order to introduce the ports under visual control; 4. the traction determined by the perihepatitis process against the parietal peritoneum could be responsible for postoperative right quadrant pain; 5. the hepatodiaphragma adhesions make impossible the suction of the intraoperative secretions. A complete adhesiolysis allow a correct lavage of the suprahepatic area preventing the possible retention of clots, bile or even calculi. We didn't notice neither a longer duration of the intervention due to adesiolysis nor intra/or postoperative complications.

Aged↗
PubMedDate not supplied

[New coordinates in the pathogenesis of poststreptococcal nephropathies].

With reference to recently published data and the authors findings, the pathogeny and prophylaxis of streptococcal nephropathy is discussed from the viewpoint of streptococcal nephritogenicity, the reactive potential of the body and the efficiency of the antibiotic treatment. It is evident that extensive prevention with penicillin is imperfect since nephropathy, in the course of its development, is subordinated to the reactogenic immunopathological context rather than to the etiologic agent (which only becomes a link in the causattion of the disease). Today, the arguments appear to sustain a new preventive stage in which prolonged, exhaustive antibiotherapy is replaced by a differentiated etiopathogenic context, applied only in the cases of actual risk and delimited by a constant intra-and postinfectious complex clinicobiologic follow up. However, the various pathogenetic coordinates show that poststreptococcal complications demand separation of the cause which may cover the actual determining factors of the complications.

Humans↗
PubMedDate not supplied

[Surgical treatment of great median upper and/or lower abdominal incisional hernias with mesh placed in the rectus sheath(behind the muscle)].

We present our experience concerning surgical treatment of great upper and/or lower abdominal incisional hernias, by the technique using a mesh placed in the rectus sheath. Durind 5 years, we operated 42 cases. The features of our trial were: average age--56 years; female prevalence--40 cases (95%); great obesity rate (15 observations--35%). The early postoperative morbidity was represented by (number of cases): thrombophlebitis (2), prolonged postoperative ileus (3), seromas (7), prolongs hemorrhagic drainage (3), hematomas (2). We recorded no death. The late postoperative morbidity (number of observations) recorded granulomas (3) and recurrency (2). We obtained good and very good results in 37 cases (88%).

Adult↗
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[Technic, indications and contribution of choledochoscopy in the diagnosis and treatment of biliary diseases].

Choledochoscopy it's a common method of intraoperative exploring of the extrahepatic biliary ducts and partially of the intrahepatic ones. He is used both in the open and laparoscopic surgery. We consider the operative cholangiogram, preferably transcystic, as a first step who precedes the endoscopic exploration. The transcystic choledochoscopy has specific and relatively narrow indications: undulated biliary ducts, 1-3 gallstones. The transcholedocian choledochoscopy permit a direct and complete exploration of the biliary ducts. The important diagnostic help that fibrocholedochoscopy gives in, it's accomplished by the possibility of therapeutic maneuvers (especially the gallstones extraction), which offers the quality of a miniinvasive, elegant and harmless treatment technique.

Bile Duct Diseases↗
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[Laparoscopic cholecystectomy of cirrhotic patients].

In a period of 9 years in our clinic were performed 18 laparoscopic cholecystectomies (1.5%) at cirrhotic patients. In most of the cases (16) cirrhosis was diagnosed intraoperative. Retrospective, suggestive for a chronic hepatic disease were: patient history (9 cases), transaminases elevations (all cases), low platelet number (8 cases) and some echographic findings (6 cases). Laparoscopic cholecystectomy was difficult in all cases. Conversion to open surgery was necessary in one case because of an important hemorrhage from gallbladder bed. No diseases were recorded. Laparoscopic cholecystectomy is proven as a secure operation and with incontestable advantages comparing to open surgery.

Aged↗
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[The importance of forseeing and early diagnosis of thromboembolic disease].

The aim of this study is to assess the incidence of thromboembolism in laparoscopic cholecystectomies. 100 unselected patients undergoing laparoscopic procedures performed by the same team were studied. All patients received preoperative prophylaxis with low/molecular weight heparin (LMWH), which was continued until full mobility. Four cases of deep venous thrombosis of lower limbs were clinically identified and confirmed by means of Doppler ultrasound examination. There were no cases of pulmonary embolus. Deep venous thrombosis occurred during the prophylactic administration of LMWH in the fourth postoperative day, consequently intravenous treatment with Heparin and then with oral anticoagulants was required. In each observation the operation took more than one hour. Among the patient-dependent risk factors, we have identified: age above 40 years, obesity, history of deep venous thrombosis, localized preoperative infection, congestive cardiac failure. Although the thromboprophylaxis has been performed within the laparoscopic surgery similar to that recommended in the classical procedures, when a high risk has developed the illness started. We underline the importance of a careful postoperative clinical monitoring in order to prevent the serious accidents that may appear.

Adult↗
PubMedDate not supplied

["Rendez-vous" procedure. Mini-invasive treatment of biliary stones].

Mini invasive approach, laparoscopic and endoscopic, represents these days a therapeutically standard in treatment of concomitant biliary stones: gallbladder and extrahepatic bile ducts. Had been suggested different procedures known as "rendez-vous" procedures. When choledocholithiasis is diagnosed or supposed, using biochemical and echographic criteria, we decided to make an ERCP just before laparoscopic cholecystectomy under the same anesthesia. Using ERCP we could confirm the choledocholithiasis. The endoscopic sphincterotomy was followed by extraction of the stones using the Dormia basket catheter. The laparoscopic cholecystectomy that followed was technically made in the same way that any laparoscopic procedure is made, according to the gallbladder lesion, the ERCP making no influence to the surgical act.

Adult↗
PubMedDate not supplied

[Gallbladder leiomyoma].

Leiomyoma, benign tumor generated by wall's smooth muscle proliferation, is extremely rare revealed. In our experience we only find one case, randomly discovered on the immediate examination of the bladder at the end of the laparoscopic cholecystectomy. The echographic exam may suggest sometimes the diagnosis but the presence of the stones makes it harder, especially when the bladder has scleroathrophic lesions. The differential diagnosis with gallbladder carcinoma is necessary especially for medium dimensions tumors. Laparoscopic cholecystectomy is the sufficient and recommended procedure; only even the benignity of the tumor is pathologically established.

Aged↗