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F Fekete

Publications and source records attributed to F Fekete.

At least 19 recordsLinked to original sources
PubMed2001

Impact on survival of surgery after concomitant chemoradiotherapy for locally advanced cancers of the esophagus.

BACKGROUND: To evaluate the results of chemoradiotherapy with or without surgery in locally-advanced esophageal carcinomas (T3 and/or nodal involvement). METHODS: One hundred twelve patients with locally-advanced carcinoma of the esophagus without histologically proven invasion of the tracheobronchial tree or distant visceral metastases were treated with concomitant chemoradiotherapy followed by re-evaluation; surgery was performed or chemoradiotherapy continued, based on tumor regression and the patient's general status. Chemoradiotherapy consisted of concomitant 5-fluorouracil (5FU)(1 g/m(2) day 1-3), cisplatinum (50 mg/m(2) day 1 and 2), and external beam irradiation up to a dose of 40 or 43.2 Gy. After a 4-week rest period, radical esophagectomy or a new cycle of chemoradiotherapy (up to a total dose of 65 Gy) was performed. RESULTS: A complete clinical response was obtained in 25.7% of the patients and a partial response in 45.9%. Fifty patients underwent surgery, but only 38 patients had an esophagectomy. Post-esophagectomy mortality was 5.3%. A complete histologic response rate of 23.7% was obtained. Two- and 5-year survival rates were, respectively, 41.5% and 28.6% for the whole population. According to multivariate analysis, prognostic factors for survival were Karnofsky index, esophagectomy, and response to chemoradiotherapy. Five-year survival for patients who experienced a partial response to radiation and chemotherapy was 49.1% for those who had surgery and 23.5% for those treated without surgery (p = 0.003). There was no obvious benefit for the small number of patients treated surgically after complete response to radiation and chemotherapy. Toxicity, essentially hematologic, was moderate. CONCLUSION: For locally-advanced esophageal carcinomas, esophagectomy, after concomitant chemoradiotherapy, could improve the survival rate, especially for patients who responded partially to the latter.

Adult↗
PubMed2000

[Effectiveness and adverse effects of sildenafil in erectile dysfunction].

Sildenafil is a selective and by oral administration potent type-5 phosphodiesterase (PDE 5) inhibitor, which increases the erection by corpus cavernosum smooth muscle relaxation. In a non-placebo controlled study, 134 patients with erectile dysfunction were treated with oral sildenafil. The aim of the study was to estimate the efficacy and adverse effects of this treatment. 51 patients (38%) had psychogenic, and 83 (62%) organic origin of the erectile dysfunction. 73 of them have already had some treatment for this problem before. The effective dose was 50 mg for 84 patients (63%), 100 mg for 32 (24%) and 25 mg for 4 patients. The treatment was effective for 120 patients (90%). The most common adverse effect was flushing in 18 (13%) and headache in 9 (7%) cases, two patients had headache and flushing together. Nasal congestion and visual disturbances were complained by two patients. Two patients reported prolonged (max. 2h) erections. Cardiological investigation was performed for cardiovascular patients and for patients with risk factors. Exact criteria of the cardiological opinion of sildenafil treatment are reviewed. Cardial or other serious adverse effects were not observed. It was not necessary to stop the treatment because of the adverse effects. The authors found, that sildenafil is an effective and safe treatment for the erectile dysfunction.

Adult↗
PubMed1998

[Polysomnography in the prevention of crib death].

The authors stress the importance of polysomnography--a new electrophysiologic method--in the prevention of SIDS (cot death). SIDS is the most important and frequent cause of infant mortality between 1 and 12 months of age in western countries (nowadays between 1-2/1000!). In Hungary the frequency is not so high. In the last few years the incidence declined after the "back to sleep" campaigns, but to reach further success, it is very important to seek the so called "risk" babies. The unique cause of cot death is not yet understood exactly, but some instability in respiration (mostly during the sleep) is one of the accepted principal basic factors. The mentioned new method helps in choosing the SIDS risk infants from the "normal" population, allows to examine their respiratory irregularity or even disorders during the sleep and gives possibility for the prevention of lethal apneas. The authors describe the details of the prevention in case of abnormal polysomnography in their other publications.

Birth Weight↗
PubMed1998

[Paracetamol].

Explore the source record for details and available documents.

Acetaminophen↗
PubMed1997

[Some aspects of the use of prostaglandin E1 in cases of erectile dysfunction].

The author reports about his first experience of the use of prostaglandin E1 (PGE1) for the treatment of the erectile dysfunction. Results and observations of the self injection treatment with PGE1 of 46 patients are reported. Main indications and some practical aspects of the use of PGE1 are discussed after 5 short case reports. Upon the international experience and his own first results the authors opinion is, that the PGE1 is especially useful for the self injection treatment of the erectile dysfunction because of its rare complication rate.

Alprostadil↗
PubMed1994

[Paracetamol poisoning in infancy--is paracetamol safe?].

A 5-month-old baby was observed. At the severely ill infant accidental misadministration of Paracetamol was verified. After surveying the literature the authors discussed the possible pathobiochemical ways and draw attention to the dangers of the misuse of antipyretics.

Acetaminophen↗
PubMed1994

A ten-year experience with hepatic resection in 338 patients: evolutions in indications and of operative mortality.

OBJECTIVE: To report changes in indications for, and operative mortality of, elective hepatic resection during the 10 year period 1980-1989. DESIGN: Retrospective study. SETTING: District hospital. SUBJECTS: 338 consecutive patients who underwent elective hepatic resection. INTERVENTIONS: During the first five years (1980-1984) 99 resections were done, 10 through a right thoracoabdominal incision, and the hepatic pedicle was clamped in 6. During the period 1985-1989 239 resections were done, only 7 (3%) through a thoracoabdominal incision, and the hepatic pedicle was occluded in 197 (82%). MAIN OUTCOME MEASURES: Changes in indications for operation and operative technique, and mortality. RESULTS: Indications for resection in the first period were: benign lesions (n = 39), primary hepatic cancer (n = 30-15 had hepatocellular carcinoma associated with cirrhosis), and metastatic disease (n = 30). Six patients died, five from uncontrollable bleeding during operation. Indications during the second half were: benign lesions (n = 105, 44%), primary hepatic cancer (n = 87, 36%-62 (29%) had hepatocellular carcinoma associated with cirrhosis), and metastatic disease (n = 47, 20%). There was only 1 death during operation (air embolism), and 9 cirrhotic patients died during the postoperative period. CONCLUSIONS: More hepatic resections are being done and the indications are changing, with more patients with cancer and benign tumours being operated on; increasing use of pedicle occlusion has resulted in a significant decrease in uncontrollable operative bleeding; and mortality is still related to the presence of associated cirrhosis.

Adolescent↗
PubMed1993

[Indications for organ-conserving operations in cases of kidney tumors in the age of radical surgery].

The authors analyze the experiences of 29 operations of malign renal tumors, performed during the last 10 years conservating the organs. In 20 cases the conservation of the organ was indicated by necessity due to some diseases or the lack of the contralateral kidney, and in 9 cases due to the small extension of the tumor. The authors reveal their experiences on preoperative examinations; they discuss some questions of surgical techniques and describe their system of patient control. Based upon their experiences, in selected cases they consider indicated conservation of the organ, if the tumor can be extirpated ablastically.

Decision Making↗
PubMed1993

[Dysfunction of penile erection].

Nearly 250 men with erectile dysfunction examined during the past 3 years period. Beside the examination technique development the author emphasizes on the importance of the medical history and the psychological exploration. The examinations are indicated after the analysis of the history and after the positive result of the noninvasive examination the invasive one is only indicated. Intracavernous injection of the vasoactive drugs remains important part of the diagnosis, but the combination with the Doppler examination gives more information about the origin of the dysfunction.

Adult↗
PubMed1993

Drainage after elective hepatic resection. A randomized trial.

OBJECTIVE: This prospective randomized study determined the influence of closed-suction drainage on the incidence of postoperative complications after elective hepatic resection. SUMMARY BACKGROUND DATA: Routine drainage is no longer advocated after several intra-abdominal surgical procedures. METHODS: A series of 81 patients who underwent elective hepatic resection were randomly allocated to either a nondrainage group (n = 39) and a drainage group with closed-suction drainage (n = 42). Indications for resection were 42 benign lesions and 39 malignant tumors, including 19 with cirrhosis. Major hepatic resection was performed in 25 patients and minor resection, in 56. All patients underwent ultrasonography with puncture for bacteriologic cultures of all fluid collections within the first 5 postoperative days. RESULTS: One patient died in each group. Ultrasonography found a significantly higher rate of subphrenic collections in the drainage group compared with the nondrainage group (respectively, 36% vs. 15%, p < 0.05). These collections were more frequently infected in the drainage group (n = 6) than in the nondrainage group (n = 2). After major liver resection, the rate of intra-abdominal postoperative complications (i.e., subphrenic fluid collections, hematomas, and bilomas) was similar between the two groups. CONCLUSIONS: Minor liver resection is safer without drainage. Major liver resection can be performed with or without abdominal drainage.

Adult↗
PubMed1993

Factors predictive of liver histopathological appearance in chronic alcoholic pancreatitis with common bile duct stenosis and increased serum alkaline phosphatase.

In the course of alcoholic chronic pancreatitis, increased serum alkaline phosphatase level is usually caused by common bile duct stenosis but may also be due to alcoholic liver disease. The aims of this prospective study were to investigate whether clinical, biochemical and radiological factors could predict liver histopathological appearance. The study comprised 48 patients with chronic alcoholic pancreatitis, common bile duct stenosis and increased serum alkaline phosphatase levels; clinical, biochemical, radiological and histological data were recorded in all cases. Liver biopsy examination (surgical [n = 45] or intercostal [n = 3]) showed (a) biliary obstructive liver abnormalities (n = 33), which were severe in 20 cases (biliary fibrosis in 15, secondary biliary cirrhosis in 3, secondary sclerosing cholangitis in 2) and moderate in 13 cases; (b) alcoholic liver disease in 9; and (c) normal liver in 6. Clinical, biochemical and radiological data were not statistically different between patients with biliary obstructive liver disease and those with alcoholic liver disease. Forty-five patients underwent surgery; two patients with alcoholic hepatitis died after surgery, at the beginning of this study. We conclude that in chronic alcoholic pancreatitis with common bile duct stenosis and increased serum alkaline phosphatase levels, clinical, biochemical and radiological data cannot be used to predict the type of liver lesions. Therefore liver biopsy is warranted to identify (a) alcoholic hepatitis, which increases operative risk; and (b) biliary obstructive liver disease, frequent and often severe, in which surgical biliary decompression should be considered.

Adult↗
PubMed1991

Intrahepatic recurrence after resection of hepatocellular carcinoma complicating cirrhosis.

To determine whether a careful evaluation of tumor extension by preoperative computed tomography scan after intra-arterial injection of ultrafluid lipiodol and by intraoperative ultrasound examination reduced the recurrence rate of hepatocellular carcinoma after resection, a series of 47 cirrhotic patients with a single tumor operated on from 1984 was studied. Alphafetoprotein level was less than 100 ng/mL in 26 patients (55%), size of the tumor was less than 5 cm in 28 patients (59%), and capsule was present in 30 patients (63%). The resection was performed with free margin measuring 1 cm or more. The overall cumulative survival rates at 3 and 5 years were 35% and 17%, respectively. Intrahepatic recurrence was observed in 28 patients (60%), located less than 2 cm from the resection margin in only four patients. The cumulative intrahepatic recurrence rate at 3 years was 81% and was significantly higher in patients with tumor greater than or equal to 5 cm and in patients with preoperative alphafetoprotein level of greater than or equal to 100 ng/mL. In this series the cumulative intrahepatic recurrence rate at 5 years was 100%. This high recurrence rate after resection, even with careful evaluation of tumor extension, indicates that liver transplantation might be envisaged for the treatment of cirrhotic patients with resectable hepatocellular carcinoma.

Adult↗
PubMed1991

Total duodenal diversion in patients with previous gastric surgery.

Total duodenal diversion (TDD) was performed in 19 patients with severe post-gastric surgery symptoms. Previous operations were truncal vagotomy associated with pyloroplasty or antrectomy (n = 6), proximal esophagogastrectomy (n = 8) or total gastrectomy (n = 5). Technical adjustments to the standard procedure (truncal vagotomy, antrectomy and gastrojejunal anastomosis using a 70 cm Roux-en-Y loop) were required. There were no postoperative deaths, no anastomotic leakage or anastomotic ulceration. The main symptoms were eliminated, and endoscopic gastritis and esophagitis healed in all patients. Heartburn and bilious vomiting ceased in all patients, but in five out of 14 patients with a residual stomach some symptoms persisted. TDD proved a safe and effective treatment of disabling symptoms following gastric surgery.

Adult↗
PubMed1991

[Complications of peroperative sterilization of hydatid cysts of the liver. Apropos of 6 cases].

Injection of scolicidal solution into the hydatid cysts has been used to sterilize the cyst and to prevent intra-abdominal dissemination of the parasite during surgery. We report six cases of complications of this measure. Intraoperative collapse in one patient and an immediate postoperative death occurring after injection of 10% H202. Postoperative sclerosing cholangitis occurred in 4 patients in whom 2% formalin or 20% sodium chloride was injected into the cyst. Cholangiography showed strictures affecting the intrahepatic biliary tree in 2 and both the intra and extra biliary tree in 3. Sclerosing cholangitis in these patients was likely to result from the caustic effect of the scolicidal solution having diffused from the cyst into the biliary tree. Jaundice developed in 3 patients from 2 to 5 months after operation. The intra-operative collapses is related to the injection of H202 into the cyst. The dramatic increasing of the volume of the cyst may fissure of the cyst-wall and allows the passage of gaz into the circulation. As the efficacity of intracystic injection of a scolicidal solution in preventing the dissemination of the parasite is still unproven, we recommend the rejection of this maneuver in the surgical treatment of hydatid disease of the liver.

Adult↗
PubMed1991

Mechanical sutures in perforation of the thoracic esophagus as a safe procedure in patients seen late.

Between 1976 and 1988, we treated 13 perforations of the thoracic esophagus, excluding ruptured carcinoma and intraoperative wounds, by mechanical sutures without exclusion. The delay between perforation and treatment ranged from eight to 168 hours, more than 24 hours in 11. The length of perforation was 0.5 to 15.0 centimeters. Suture was covered with a flap in ten instances; an antireflux procedure was associated with five instances. No digestive ostomies were performed. There was one death; a patient who was comatose upon arrival. The results of this small series suggest that myotomy exposing the mucosa and a flap are two essential elements of the technique; perforations of less than 6 centimeters, even when seen late, may be treated by primary surgical closure.

Adult↗
PubMed1990

Staging of esophageal carcinoma: comparison of results with endoscopic sonography and CT.

We compared the results of endoscopic sonography and CT in the preoperative staging of 46 patients with esophageal carcinoma studied prospectively. All patients had surgery and 44 had pathologic examination of the mediastinal and celiac lymph nodes. The results of CT and endoscopic sonography were compared with surgical and pathologic findings. A total of 51 tumors were found in 46 patients. Sonographic estimation of tumor extension through the different layers of the esophagus was correct in 37 (73%) of all 51 tumors and in 22 (85%) of the 26 tumors in which the examination was complete. The echoendoscope (13-mm diameter) could not pass through the tumor in 23 cases (50%). Infiltration to adjacent organs was found in 15 cases at surgery. In four of these 15, the extension was detected by CT; in seven of the 15 cases, it was detected by sonography. False-negative determination of tumor extension occurred with endoscopic sonography in patients with stenotic tumor. There were no false-positive results with either CT or endoscopic sonography. For detection of mediastinal lymph-node involvement, the sensitivity of CT was 48%. The sensitivity of sonography was 50% if metastatic nodes unexplored by sonography were included, or 84% if only cases in which stenosis was passed were considered. Statistical comparison revealed that sonography was superior to CT for the detection of metastases to lymph nodes. CT and endoscopic sonography provide complementary information. When the echoendoscope can be maneuvered past the tumor, sonography can be used accurately to define extension through the layers of the esophagus, extension to the adjacent organs, and involvement of the lymph nodes. When the tumor cannot be passed by the echoendoscope, CT is superior to sonography for detection of mediastinal extension.

Adult↗
PubMed1990

[Hepatocellular carcinoma arising in the normal liver. A clinical study and long-term prognosis after surgical resection in 12 patients].

Hepatocellular carcinoma mainly affects patients with cirrhosis or with various degrees of fibrosis. From 1979 to 1990, among 87 patients who underwent hepatic resection for non fibrolamellar hepatocellular carcinoma, 12 (14%) had a non fibrolamellar hepatocellular carcinoma developed in a normal liver. There were 8 men and 4 women, aged 29 to 74 years. In 7 patients (58%) hepatocellular carcinoma was associated with clinical manifestations. Serum hepatitis B surface antigen were absent in all patients. Serum alphafetoprotein level was less than 100 ng/ml in 10 (83%), size of the tumor was greater than or equal to 5 cm in 10 (83%) and capsule was present in 10 (83%). Resections included removal of 2 segments or more in 11 (91%). One patient died postoperatively. Actuarial survival rate at 3 and 5 years were respectively 57% and 38%. Intra or extrahepatic recurrence was recognized in 8 (67%), 2 patients were alive respectively 28 and 16 months after treatment of their intrahepatic recurrence (resection in one and intraarterial embolisation in one). In conclusion, our results suggest that aggressive surgical efforts are justified in non fibrolamellar hepatocellular carcinoma arising in normal liver.

Actuarial Analysis↗