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Biomedical subjects

J Babala

Publications and source records attributed to J Babala.

At least 19 recordsLinked to original sources
PubMed2004

Separation of Siamese twins in Bratislava.

At the pediatric surgical clinic in Bratislava, in the year 2000, we successfully carried out the separation of Siamese twins, which we classified as "ischiopagus tetrapus"+. The pelvic ring, the gastrointestinal tract and the urogenital system were all malformed. There was a common terminal ileum and only a short segment of the large intestine with a blind end. This was a case of non-developed anal segment and rectum. Each of the twins had two kidneys and two commonly shared urinary bladders. There were two uteruses, which were both bicornuate in nature with a fallopian tube arising from each of the horns as well as an ovary. The orifices of both urinary bladders and those of the two uteruses joined into a common urogenital sinus. The external ostia of this sinus represented a bizarre fissure with a single skin fold similar to the labium majus, located dorsally at the point of fusion of the pelvic structures. The act of separation was performed in two stages. Separation of the gastrointestinal tract was urgent due to the severe ileus caused by aplasia of the anus and the rectum. This first stage procedure was performed on the third day of admission (24.2.2000) after the babies had spent a month in other health institutions. The definitive separation was carried out a month after the first procedure (28.3.2000) following the optimal stabilization of the functions of the gastrointestinal tract. The uropoietic and genital systems were separated. A new pelvic ring and a pelvic floor were formed. The anterior abdominal wall was reconstructed and plastic correction of the skin in the gluteal and perineal regions was performed. The colostomies are functioning well and the twins pass well-formed stools. Lucia has long dry intervals between mictions. Andrea has shorter dry intervals. The girls have recently celebrated their third birthday. Their mental development is excellent; they speak Slovak and Hungarian languages. They have a well-developed locomotive apparatus, without any movement impairments. (Tab. 1, Fig. 16, Ref. 10.)

Female↗
PubMed2004

[Exchange amnioinfusion in conceptus with laparoschisis (first experience)].

OBJECTIVE: During amnioinfusion exchange (AE) a certain amount of amniotic fluid is repeatedly extracted and the same amount of physiological solution is consequently instilled into the amniotic fetal cavity. The aim of this procedure is to dilute the amniotic fluid that surrounds the eviscerated organs of fetuses with laparoschisis so as to avoid the genesis of fibrous coating on these organs. DESIGN: Prospective study. SETTING: Gynekologicko-pôrodnícka klinika SZU, FNsP akad. L. Dérera, Bratislava, Slovakia. METHODS: We have executed AE in five fetuses with laparoschisis since June 2002. Two patients underwent the treatment 2 times during the 32nd and 36th weeks of gestation. Two other patients were treated once during the 32nd week and one patient once during the 36th week. Under ultrasound control we used a spinal needle to extract 120-180 ml of dense, cloudy amniotic fluid. Consequently, we instilled the same amount of physiological solution warmed up to the temperature of 37 degrees C into the amniotic cavity through antibacterial filter. The fetuses were monitored cardiotocographically and with the help of ultrasound flowmetry in umbilical vessels, before and after the treatment. RESULTS: The AE were successful and without complications in all five cases. All patients delivered via elective caesarean section during the 36th - 37th gestation week. One patient delivered 24 hours after second AE due to the danger of intrauterine fetal hypoxia that was verified cardiotocographically. The other patients delivered 1-4 weeks after AE. CONCLUSION: The significance of AE lies primarily in the reduction of the occurrence of fibrous coating on eviscerated organs. It enables postnatal primary surgical closure of the defect in the front abdominal wall, an earlier onset of intestine peristalsis, transition from parenteral to peroral nutrition and shorter hospitalization.

Amniotic Fluid↗
PubMed2002

[Maffucci's syndrome--case report of a 5-year-old female patient].

Maffucci's syndrome is a congenital non-hereditary syndrome characterized by a combination of dyschondroplasia (enchondromatosis) and haemangiomatosis. It is a rare disease. During the last 140 years only 200 cases were described [5]. 109 cases are described in the literature by other authors [21]. This disease is associated with a high risk of development of neoplastic processes, in particular sarcomatous transformation of enchondromatoses as well as other mesodermal and non-mesodermal malignities [13]. Based on the incidence of spinocellular haemangioendothelioma with other congenital syndromes, the presence at a young age of patients and the multicentric incidence support the assumption that spinocellular haemangioendothelioma may be the manifestation of genetically based mesodermal disease which may be associated with the picture of Maffucci's syndrome [6]. In their case-history the authors present a 5-year-old patient. They describe the clinical course and findings taking into account possible manifestations and risks associated with the disease. With regard to the low incidence of the disease and its interdisciplinary character the authors pen the question of possible causal, symptomatic or palliative treatment.

Child, Preschool↗
PubMed2002

[A pediatrician's views on the treatment of extensive hemangiomas in childhood].

Haemangiomas are the most frequent tumours of child age. They are found in 10-12% of infants. The authors summarize contemporary knowledge of the treatment of haemangiomas as well as their own experience with their treatment. They follow-up 18 children with haemangiomas at different sites, incl. ten with extensive haemangiomas. The latter were treated conservatively with prednisone and interferon alpha.

Angiogenesis Inhibitors↗
PubMed2001

[Diastematomyelia and the tethered spinal cord syndrome. Case report].

The authors present a patient with diastematomyelia and associated congenital malformations of the spinal cord. They caused tethering of the spinal cord. Patient had cutaneous marks of malformation from birth. The congenital malformation was operated at the age 5 years. MRI and surgical findings confirm the existence of diastematomyelia together with thick tethered filum terminale and lipoma of filum terminale. On surgery the bony septum was removed, the filum terminale was resected and the lipoma was excised. Each of the anomalies caused the tethering of the spinal cord and restricted its physiological ascent. Only careful surgical revision with subsequent removal of all causes of the tethering of the spinal cord produced good result. Diastematomyelia is a congenital malformation with some morphological variations and coexistence of other malformations. The presented case is a typical example of malformations associated with diastematomyelia.

Cauda Equina↗
PubMed2001

[Supracondylar fractures of the humerus and disorders of circulation].

Supracondylar fractures (SF) of the humerus are the third most common type of fractures in childhood. The highest rate of pulselessness fracture of the distal humerus is the extension-type. The aim of our treatment is to minimize potential complications. Our management of pulselessness supracondylar fracture is more aggressive compared with other dpts. 223 (100%) patients with SF were treated at the dpt. of Paediatric Surgery, University Children's Hospital in Bratislava, in the 5-year period of (1995-1999). 11 (4.93%) patients remained pulseless after reposition of bone fragments. These patients underwent surgical revision of the brachial artery. Spasms of the brachial artery (BA) occurred in six patients, a lesion of BA in three patients and thrombosis of BA in two patients. We performed revision of the brachial artery by a Fogarthy catheter in six patients--in four cases with thrombectomy. In two cases we released the vessel from bone fragments. In two patients was replaced the injured segment of the brachial artery by a venous allotransplant. Peroperative angiography was performed in six patients. We reoperated three patients with early postoperative complications. We did not record any case of Volkmann's contracture.

Brachial Artery↗
PubMed2000

[Treatment of blunt injuries of the spleen in children].

The authors report study of patients with blunt splenic trauma treated at Paediatric Surgery Department in years 1991-1999. During 9 years period 50 patients (36 males, 14 females) with demonstrated rupture of the spleen were analyzed. 46 patients (92%) were treated conservatively (group A). Complications appeared in 7 patients (15.22%), rebleeding in two patients, arterio-venous fistula in early posttraumatical period in one patient and during control in one patient, fluidothorax in two patients and posttraumatic pseudocyst of the spleen in one patient. Four patients (8%) were operated (group B). Two of them submitted splenectomy, one patient was treated by splenorrhaphy and one patient by partial splenectomy. Period of the hospitalization in average lasted in group A 12,67 days, in group B 15 days. With regard to the immunologic functions of the spleen especially in childhood authors prefer conservative treatment, in case that laparotomy is inevitable authors try to preserve the spleen.

Child↗
PubMed2000

[Personal experience in the treatment of medial cervical cysts in children].

Twenty-five patients with thyreoglossal cysts were treated during a 7 years long period. Most of the cysts (in 64 of patients) were typically located between the hyoid bone and the thyreoid gland. The complete Sistrunk's operation was performed in 40% of the patients and 48% patients underwent an extirpation of thyroglossal cyst with a resection of the hyoid bone body. Three of the patients (12%) suffered a relapse. In one of the patients, this was due to the lateral cyst swapping and in two patients an incomplete extirpation of the ductus thyreoglossus remnant happened. In another patient, an iatrogenic hypothyreossis occurred. To avoid relapse, authors recommend to resect at least 10 mm of the hyoid body and 5 mm of the ductus thyreoglossus remnant behind the hyoid bone.

Adolescent↗
PubMed1999

[An abdomino-scrotal hydrocele].

Abdominoscrotal hydrocele is encountered rarely in child age. The authors present an account on two patients with abdominoscrotal hydrocele in a three- and fifteen-year-old boy. They discuss its development, draw attention to the not very marked clinical manifestations, diagnostic pitfalls and the contribution of sonography to diagnosis.

Abdomen↗
PubMed1999

[Subacute appendicitis in children].

Over the period of 4 years from 1993 to 1996 the authors recorded a 6% incidence of patients with periappendicular mass (PM) in a group of 786 patients with acute appendicitis. The aim of the study is to compare the two methods in the management of patients (operation-A, conservative treatment-B) by applying the same criteria. In the subacute phase of the disease 22 patients (group A) were operated on, while 24 patients (group B) were successfully treated conservatively, with recommendation of elective appendectomy after 6 months. In group A indication for operation was PM in 7 patients, diagnostic problems (tumour, hydronephrosis) or complications (peritonitis, intestinal obstruction) in 15 patients. Antibiotic therapy was nearly the same in both group. Peritoneal drainage in postoperative care was performed in 10 patients of group A for 4.7 days on the average. In this group, secondary wound healing was recorded in 3 patients. In group B, elective appendectomy was performed only in 12 patients (50%). In 2 patients, however, a diagnostic error was revealed, i.e. Crohn's disease and an ovarian cyst had been suspected to be a periappendicular mass. Conservative treatment with subsequent elective appendectomy after 6 months seems to be an effective method in the treatment of patients with a typical clinical picture and well bordered periappendicular mass. Appendectomy in the subacute phase of the disease appears to be a safety technique of PM treatment in patients with complications or diagnostic problems.

Acute Disease↗
PubMed1994

The effect of dietary protein and sucrose on the diabetic rat kidney.

The effect of 3 months feeding with diets of different protein and sucrose content (9% casein + 70% sucrose vs. 18% casein + 61% sucrose) on the development of diabetic nephropathy and changes in serum lipid spectrum was investigated in rats with insulin-dependent diabetes (streptozotocin 45 mg.kg-1). Metabolism of diabetic animals (before the nutritional regimen) was characterized by hyperglycaemia, moderate hyperlipidemia, lipid accumulation in the liver and elevated creatinine concentration in the blood. Kidney weight and protein content were not significantly changed. Histological picture of kidneys showed initial changes of glomerular structure. After three months hyperlipoproteinaemia was more accentuated in animals given either of the two diets, the kidneys were hypertrophic with a higher protein content and displayed morphological changes of diabetic nephropathy. Animals given the low-protein diet developed smaller morphological changes both in glomeruli and tubuli. The study indicates that dietary protein and not hyperlipoproteinaemia is the major factor, which may significantly influence the progress of diabetic nephropathy.

Animals↗
PubMed1990

Effect of dehydrated apple products on the serum and liver lipids in Syrian hamsters.

The effect of two dehydrated apple products (10% in diet)--apple pulp (crude fibre 3.5%, pectin 1.4%) and apple pomaces (crude fibre 13.5%, pectin 7%)--on the serum and liver lipids of growing Syrian male hamsters were studied. The animals were fed a natural diet (38% of energy substituted by milk fat; the diet contains 53 mg of cholesterol (CH) per 100 g) which resulted in an accumulation of CH and triacylglycerols (TG) in the serum as well as in the liver, and CH-rich very low density lipoproteins (VLDL) in the circulation. After two months both apple products decreased the levels of CH and TG in serum (by 40-70%) and the content of CH in VLDL with similar efficiency. Both products reduced CH content in the liver, and the apple pulp also decreased TG content. Up to the 6th month the apple pulp studied suppresses accumulation of CH and TG in both the serum and the liver. A complete analysis of lipoproteins of main density class at the time showed that the decrease of serum CH and TG to a decisive extent is due to the decrease of their concentration in VLDL (by more than 50%). Therefore, the concentration of VLDL and the whole lipoprotein pool decreased by 50%. The apple pulp doubled the amount of CH transported by HDL. Three months after the replacement of butter in the diet by corn germ oil the CH and TG levels in the serum and TG also in the liver decreased to the physiological level.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Long-term hypolipaemic effect of apple pulp on golden hamsters with alimentary hyperlipoproteinaemia.

Golden hamsters with alimentary hyperlipoproteinaemia (fed on a diet in which 44% of the energy was accounted for by fats, 52 mg cholesterol (CH)/100 g) were given apple pulp (10% of the diet) for six months. From the end of the first month up to the end of the experiment, elevation of serum CH, triacylglycerol (TG) and phospholipid (PL) levels and CH and TG accumulation in the liver were effectively inhibited. At the close of the experiment, hyperlipoproteinaemia was characterized by an increase in the amount of very low density lipoproteins (VLDL), which carried 60-80% of all circulating lipids, accounted for over 70% of the total lipoprotein pool and transported almost 60% of the serum CH (high density lipoproteins--HDL--only 16%). The apple diet markedly reduced (by 50-80%) the amount of all lipids in the lipoproteins within density limits of 1,006-1,063 kg/m3 and lowered the total lipid concentration in these density classes and in the lipoprotein pool as a whole (by 50%). The proportion of the individual lipoprotein classes in the lipoprotein pool was not significantly affected. The apple diet did not affect either the chemical composition of HDL or their participation in the lipoprotein pool, but raised the proportion of serum CH transported in this lipoprotein class. Neither the lipoprotein lipase activity of the adipose tissue nor lecithin:cholesterol acyltransferase activity were influenced by the apple diet.

Adipose Tissue↗
PubMed1985

[Fetal high risk period during the 2d half of pregnancy].

25.8% of the 500 fetuses that died in utero after the 20th week of amenorrhoea died between the 28th and 32nd week, which is the 8th lunar month of the pregnancy. Among the factors that could have brought about this result at that time of pregnancy that we examined it was shown that there were important changes in the circulation, the metabolism and the immune system in the mother. In the fetus, autonomic functions started to appear and these were especially liver, hypothalamo-pituitary, and adrenal cortex functions. The placenta itself underwent changes in its quality which were necessary to compensate for fetal growth retardation. Every change that occurred in the placenta, such as immaturity, inflammation and blood flow changes, were shown to be remarkably frequent between the 28th and 32nd week and were contributory to causing fetal death. So it appears that the 8th lunar month is a very important time for the successful development of the fetus and requires more attention if morbidity and perinatal mortality are to be lowered.

Female↗
PubMed1982

[Congenital defects of neurohypophysis with adrenal hypoplasia].

Congenital adrenal hypoplasia without expressive diencephalic malformation is rare. Autopsy findings in two newborn girls with hypoplasia of the neurohypophysis or aplasia of neurohypophysis combined with severe cortical adrenal hypoplasia, resp., are reported. The weight of both adrenals in the case with neurohypophyseal hypoplasia was 0,39 g, and in the case with aplasia of neurohypophysis it was 0,27 g. In both cases the adenohypophysis was poorly differentiated and the number of R and S cells was considerably reduced. In the case with aplasia of neurohypophysis, R cells were identified only by use of the immune fluorescence staining technique. Moderate hypoplasia and interstitial fibrosis were also found in thyroid gland and gonads. In both cases, the hypothalamic-pituitary connection, i.e., the infundibulum and pituitary portal system were missing and, consequently, the supply of secretion-stimulating hypothalamic substances to adenohypophysis via portal system was disturbed.

Adrenal Cortex↗