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Biomedical subjects

E Uray

Publications and source records attributed to E Uray.

At least 19 recordsLinked to original sources
PubMed2001

[Clinical importance of assessment of collateral capacity in the circle of Willis. Benefit of a mathematical blood flow model for the every-day practice of vascular surgery].

UNLABELLED: Collateral capacity of the Willisian arteries is of clinical importance during and after carotid endarterectomies. AIMS: Assessment of cerebral hemodynamics using a flow circulation model based on a mathematical formula. PATIENTS AND METHODS: Four patients suffering from ischemic stroke in moribund stage were investigated using transcranial color-coded duplex sonography. By compressing the common carotid arteries, the function of the Willisian collaterals was assessed. After the death of the patients, the circles were removed, the diameters and lengths of the arterial segments were measured. The data were analysed with the mentioned circulation model. RESULTS: The diameters of non-functioning collateral arteries were 0.4 mm, while that of the functional ones were 0.7 and 0.8 mm, respectively. In the two cases where the anterior communicating arteries did not function, a near-critical hemodynamical status was found in the end-arteries. This was especially true if the mean arterial blood pressure was 70 mmHg. The most critical hemodynamical status developed in case 4, where internal carotid occlusion on one side, a contralateral severe carotid stenosis and a non-functioning anterior communicating artery were observed. CONCLUSIONS: A special flow circulation model based on mathematical formula enables the calculation of the cerebral blood flow in the different arterial segments of the circle of Willis. Further studies are needed to clarify whether the method can be used for preoperative modeling of the cross-clamping phase of carotid endarterectomy.

Blood Flow Velocity↗
PubMed2000

Gastroesophageal reflux and diaphragmatic motility after repair of congenital diaphragmatic hernia.

At the Department of Pediatric Surgery in Graz, 31 boys and 23 girls were operated on for congenital diaphragmatic hernia (CDH) from 1978 to 1994. In 49 patients the defect was on the left, in five on the right side. In 46 cases, the hernia was diagnosed within the first week of life; in eight children at a later date. 19 children (35%) died. 25 of the 35 survivors (71%) came to a follow-up examination on average 9.4 (1-17) years after the operation. 24 h pH-monitoring or manometry and Upper G.I. series revealed pathological gastroesophageal reflux (GER) in 16 patients. Nine children were treated conservatively; in seven patients an antireflux procedure was performed. A thoracic position of the stomach or left liver lobe, presence of a hernial sac, gestational age, prenatal diagnosis, use of a patch or severity of lung hypoplasia did not significantly influence the incidence of GER. In three patients, a hiatal hernia was found. The motility of the diaphragm was documented with M-mode sonography (n = 18); a restricted motility could be demonstrated in five patients. GER is very common in patients after repair of CDH. We recommend long-term follow-up with special interest in respect of GER.

Child↗
PubMed1999

Sacrococcygeal teratoma: clinical course and prognosis with a special view to long-term functional results.

From 1976 to 1995, 23 children, 4 boys and 19 girls, were treated at our department for sacrococcygeal teratomas (SCT). Their records were analyzed retrospectively, considering age at operation, histopathology, recurrences, and long-term evolution. One died on the 1st day of life following tumor rupture with hemorrhagic shock without surgical intervention. All others were operated upon at a mean age of 4.2 days for those 19 (= 82%) who were diagnosed in the neonatal period and whose histology proved benign. In the remaining 3 children, in whom tumor manifestation did not occur before 11 months, 13 months, and 10 years of age, respectively, histopathologic evaluation revealed 2 carcinomas and 1 yolk-sac tumor, and all 3 recurred. Overall, 5 patients died, the 1 mentioned above, 1 due to volvulus after laparotomy, and 1 from multiple associated congenital malformations. Two deaths were related to malignancy, whereby only 1 was a malignant teratoma diagnosed at the original operation. Eight children had recurrences, 2 were benign and 6 malignant, with 3 of the latter having been graded benign on histology of the primary tumor. Of the 18 surviving patients, 17 (93.5%) returned for clinical review following a standardized protocol. The average interval from the primary surgery was 12.3 years (range 3.5-22 years). Four had malignant tumors with a recurrence-free period of from 9 to 14 years; 5 (29.4%) had urinary or anorectal functional impairment. One child with a patulous anus presented with fecal soiling. Two reported nocturnal enuresis, 1 associated with perineal anesthesia. One had a neurogenic bladder with overflow voiding and bilateral third-degree vesicoureteral reflux. Second-degree reflux was found in the last patient. We conclude that follow-up after surgery for SCT should not only search for tumor recurrence but include the diagnosis and treatment of possible secondary urinary and/or fecal incontinence.

Fecal Incontinence↗
PubMed1998

Postprandial tachygastria is frequent in infants with gastroesophageal reflux.

Cutaneous electrogastrography (EGG) enables non-invasive recording of gastric electrical activity (GEA). Controversial EGG and ultrasonographic (US) results have been described in infants suffering from gastroesophageal reflux (GER). It was the aim of this study to investigate GEA using transcutaneous EGG in a group of infants free of symptoms indicative of GER and a group with GER (mean age 10 months, (range 3-36 months)) and to investigate gastric emptying in both groups using US. We also investigated possible correlations between EGG and US parameters of the gastric emptying curve. The EGG was recorded over a period of at least 120 min (60 min preprandial to 60 min postprandial). US measurements were made just after completion of the meal and then every 30 min up to 180 min. In infants with GER significantly more tachygastria occurred in the postprandial period when compared to healthy infants, in whom normogastria was predominantly observed (P < 0.05). The sonographically-measured gastric emptying curve could be defined in all infants using an exponential function. No significant differences between the groups were noted; there was no significant correlation between EGG parameters and the De Meester score or parameters of the sonographically-measured gastric emptying curve. From the results of this study, transcutaneous EGG recorded within the postprandial period can be of potential clinical value for non-invasive GER screening in infants. However, the EGG cannot be utilized to investigate gastric emptying in infants.

Child, Preschool↗
PubMed1997

Hypospadias repair using a modification of Beck's operation: followup.

PURPOSE: We reviewed the results of 64 cases of hypospadias repair using a modified Beck's operation with mobilization of the anterior urethra. MATERIALS AND METHODS: Patient age at correction ranged from 10 months to 12 years (mean 3.83 years). Six patients had undergone previous surgical treatments. Uroflowmetry and evaluation of the urinary stream, meatus, glans, shaft and scar formations were used as objective criteria, and grading of management and results by parents was considered subjective criteria. RESULTS: An average of 2.1 years postoperatively 59 patients were available for this followup study. The urethral meatus was positioned satisfactorily onto the distal glans in all cases and no urethrocutaneous fistulas developed. Meatal stenosis requiring meatal dilation occurred in 2 boys. In 2 cases a curved glans, and curved penis and glans, respectively, were caused by cicatricial tissue, necessitating surgical correction. Uroflowmetry was possible in 46 cases (78%). One patient with meatal stenosis had pathological flow values. All other flow rates were within the normal range. In the second case of meatal stenosis objective evaluation was impossible. In 55 cases (93%) parents judged management and results as optimal. CONCLUSIONS: Mobilization of the anterior urethra for correction of distal hypospadias with or without chordee is highly successful, less extensive, and provides an excellent cosmetic and functional result with a minimal risk of complication. Uroflowmetry is a noninvasive, objective diagnostic tool for evaluating the functional results of hypospadias repair.

Child↗
PubMed1992

The role of sonography in the evaluation of gastro-oesophageal reflux--correlation to pH-metry.

Sonography was compared to pH-metry and/or oesophagomanometry to evaluate the accuracy of sonography in the early diagnosis of gastro-oesophageal reflux. Thirty children with a mean age of 72 days (21-252 days) were studied. The results showed that specificity of sonographic diagnosis was 87.5% and sensitivity was 100% (with P less than 0.001). Sonography also proved helpful in providing both functional and morphological data in addition to pH-metric results. This study therefore suggests that sonography is useful as the first approach in the diagnosis of vomiting babies as it is non-invasive and provides sufficient diagnostic accuracy.

Female↗
PubMed1991

[Management of lung and bone metastases from thyroid cancers of differentiated structures].

During a period of thirty years (1959-1989) 374 patients underwent surgery for differentiated thyroid carcinoma at the 1st Department of Surgery of the University Medical School in Debrecen. Distant metastases were found in the lungs or bones in 36 patients (9.6%). In 20 patients the first clinical sign of the primary disease was the distant metastasis. The aspects of surgical treatment depended on whether the metastases were solitary or multiple, capable or uncapable of radioiodine uptake. Whereas the majority of pulmonary metastases respond well to 131I-treatment the therapy of bone metastases is multidisciplinary. The 5-year survival rate was 47%, the 10-year one 19%.

Adolescent↗
PubMed1987

[Functional assessment, using micturition cystourethrography, of the unstable bladder in childhood].

The accuracy and reliability of a modified method of micturating urethrocystography for the diagnosis of uncontrolled detrusor contraction in unstable bladders (sphincter-detrusor dyssynergy during bladder filling) was studied in 100 patients aged between four and 15 years. A comparison with a urodynamic method showed an accuracy of 92%, sensitivity of 93% and specificity of 90.7%. The technique and indications are described and the clinical relevance of the results is discussed.

Adolescent↗
PubMed1986

[Problems of gastroesophageal reflux in childhood].

Gastro-esophageal reflux is common in infancy. However, in most of those children reflux disappears spontaneously at the end of the first year or during the second year of life. Thus, the authors suggest the hypothesis that gastro-esophageal reflux in infancy represents a delay in maturation of central structures for the motor function of the esophagus. Therefore conservative therapy during infancy is the treatment of choice for most of the infants. Additional factors however, such as severe cerebral or neurological damage, esophageal atresia, failure to growth and esophagitis make an early operative intervention often necessary. Likewise operative therapy is the treatment of choice in older children with symptoms of esophagitis or stenosis. Different diagnostic procedures are discussed briefly.

Child Development↗
PubMed1986

Unstable bladder in children: functional evaluation by modified voiding cystourethrography.

A slightly modified technique for voiding cystourethrography was applied in 100 patients between 4 and 15 years of age and used to study uninhibited detrusor contractions in the so-called unstable bladder syndrome. Uninhibited detrusor contractions result in a slowing or cessation of the flow of contrast material into the bladder and a simultaneous minimal or marked opening of the bladder neck, with variable filling of the posterior urethra. Comparison of the radiologic findings with the results of urodynamic studies demonstrated an overall accuracy of 92%, sensitivity of 93%, and specificity of 90.7% for the radiologic technique.

Adolescent↗
PubMed1985

Physiology and pathophysiology of the esophagus in childhood.

Gastroesophageal reflux (GER) is the most important disorder of the esophagus and the lower esophageal sphincter (LES) in early childhood. Functional disturbances with inadequate relaxation of the LES have to be considered as pathogenetic factors. In the 1st month many newborns have some disorder of motor coordination of the esophagus. After that time, persisting GER may be seen as a delay in maturation, which fades away by the end of the first half year. GER after 6-9 months is to be considered as a definitively pathological condition that will not spontaneously normalize. Nevertheless, it is important to realize that the typical clinical signs of reflux stop generally between the 6th and 12th month, and so simulate healing independent of whether spontaneous maturation occurs or there is continued existence of reflux. Reflux-induced apneic spells are severe complications of this esophageal disorder in the 1st year of life. Esophagitis, usually a late complication, occurs when the aggressive factors win their fight against clearance and mucosal resistance of the esophagus. Brachyesophagus and endobrachyesophagus are severe late complications.

Child↗
PubMed1985

Correlation between manometric and roentgenologic findings of diseases of the esophagus in infants and children.

Roentgenologic and manometric findings in diseases of the esophagus in infants and children were compared. With both procedures combined it was possible to determine the exact localization of the lower esophageal sphincter. For the demonstration of gastroesophageal reflux the roentgenologic water siphon test was used. The excellent correspondence of the results of the water siphon test with manometric findings demonstrated the reliability of this roentgenologic method for detection of reflux. In borderline cases simultaneous manometric and roentgenologic studies were also of great use for demonstration of hiatus hernia.

Child↗