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Biomedical subjects

J Belák

Publications and source records attributed to J Belák.

11 recordsLinked to original sources

[Tracheal tumor--a case review].

Tracheal tumors make a histologically variant group of tumors. Our case review describes a case of a forty-five year-old female patient with an endoscopically and CT- diagnosed tracheal tumor. The patient was hospitalized at the IInd Surgical Clinic of the UPJS LF, the Faculty Hospital of L. Pasteur in Kosice, with symptoms of dyspnoea and stridor, in the orthopnoic position. Following the neccessary pre- operative procedures, her trachea was resected, followed by end-to-end anastomosis. The histological examination of the resected tissue revealed an inflammatory myofibroblastic tumor. The postoperative course was positive with no complications.

Female↗

[Postintubation stenosis of the trachea--case reviews].

Stenoses of the respiratory tract are life threatening conditions of various origins. The authors give referrence on 21 patients operated for postintubation stenoses of their trachea at the IInd Surgical Clinic of the UPJS Medical Faculty, the Faculty Hospital of L. Pasteur in Kosice, from 01. 01. 1999 to 30. 06. 2005. All patients had a tracheobronchoscopic examination and a CT examination completed prior to the procedure. Within 24 hours of their admission, 9 patients were operated, 7 underwent resection procedures and 2 patients had Montgomery's T-cannula introduced. 12 patients had their procedures planned, and were operated later than 24 hours after their admission. 10 patients underwent resections of the trachea, 2 had Montgomery's T-cannula implanted. The postoperative course following the resection of the trachea was without complications in 14 patients, 1 patient experienced transitional oedema in the anastomosis and 2 patients suffered restenoses. In this patient group, no fatal case was recorded. The authors stress up multidisciplinary approach in the diagnostics and treatment of the postintubation stenoses of trachea. In cases of postintubation stenoses of trachea, resection of the trachea with primary anastomosis represents the most advantageous treatment approach for the patient.

Adult↗

[Mediastinal cysts].

Mediastinal cysts, described also as homoplastic dysembryomas, account for 20% of mediastinal lesions. There are bronchogenic, oesophageal, gastrogenic and enterogenic, pericardial, non-specific cysts and cystic lymphangiomas. The authors present 6 patients with mediastinal cysts from a total number of 96 patients with mediastinal tumours subjected to surgery during a 14-year period (from Jan. 1 1987 to Dec. 31 2001). The group comprised 5 adults and one child. In four patients the authors selected thoracotomy as the route of access to the mediastinum, in one instance total sternotomy and once upper partial sternotomy. The cysts were removed as a whole. Histological examination revealed in four patients the diagnosis of a bronchogenic cyst, once a connective tissue cyst with respiratory epitheliumm and once a cyst lined with squamous epithelium. The postoperative course was in all patients free from complications. In the conclusion the authors emphasize the importance of complete removal of mediastinal cysts as relapses occur if part of the secretory eoithelium is not removed.

Adolescent↗

[Surgical treatment of paraesophageal hernia].

Four types of hernia may occur in the area of esophageal hiatus. Type I is represented by hiatus slipping hernia. Type II is represented by hernia, which is generally known as paraesophageal hernia. In this type of hernia, cardia and distal stomach remain under diaphragm. The weakened tissue in phreno-esophageal membrane is the place, where stomach fundus penetrates into thorax above the diaphragm. The authors present 10 patients with paraesophageal hernia, who were operated on at the 2nd Surgery Clinic of Medical Faculty, UPJS, Faculty Hospital L. Pasteur in Kosice. These were adult patients, five man and five women. In four patients, so called "upside-down stomach" was the case. Hernias were operated on in all cases by laparotomy, after reposition of the stomach into abdominal cavity the area of hiatus and diaphragm was reconstructed. One patient was operated on under emergency conditions for bleeding from stomach ulcer. Immediate postoperation results were good, the postoperation course was favorable in all patients, no complications occurred. In conclusion, the authors are of the opinion that every diagnosed paraesophageal hernia should be indicated for surgical intervention. An anti-reflux operation should be executed in symptoms of gastro-esophageal reflux. The question of operation approach (thoracotomy or laparotomy) is a matter of continuous discussion, each of them having its advocates. However, in recent years laparoscopic solution of paraesophageal hernia is getting increasing attention.

Adult↗

[A "dumbell" tumor of the mediastinum--case report].

Tumours situated in the posterior mediastinum and spreading to the spinal canal via the intervertebral opening are described as "dumbbell" tumours. The authors submit the case-history of a 44-year-old patient admitted to the Second Surgical Clinic Pasteur Faculty Hospital, Safarík University Kosice after repeated laminectomy and extirpation of the intraspinally spreading part of a mediastinal tumour. The mediastinal part of the tumour was removed surgically, the histological result was described as a melanotic schwannoma. The postoperative course was without complications, the patient was discharged home in a good condition on the 8th day after the operation. In the conclusion the authors emphasize the necessity to remove the tumour in toto. A one-stage operation in collaboration with a neurosurgeon seems appropriate.

Adult↗

[Actinomycosis of the small intestine--an unusual cause of acute abdomen].

Actinomycosis is subacute or chronic disease manifested by a defined granulomatous inflammation with the development of infiltrates, abscesses and fistulae. A 35-year-old female patient was admitted and operated at the Second Surgical Clinic because of symptoms of diffuse peritonitis. Laparotomy revealed a duplicit tumour of the small intestine, an abscess of the abdominal wall in the left mesogastrium and pyoovarium bilaterale. 70 cm of the small intestine were resected, incision of the abscess and bilateral adnexotomy were performed. Histological examination revealed a suppurative, partly fibroproductive inflammation with an actinomycotic etiopathology. After antibiotic treatment the patient was discharged home, the gynaecologist removed an intrauterine device. Three months after the first operation the patient in a serious septic condition was readmitted to the clinic with signs of diffuse peritonitis. A double perforation of the small intestine was found and an end-to-end anastomosis was made after resection of the small intestine. The postoperative course was complicated by respiratory failure and failure of the circulation associated with septic shock and subsequent death. In the conclusion the authors emphasize the problem of preoperative diagnosis of the abdominal form of actinomycosis, its possible development in relation to intrauterine contraceptive devices and its clinical manifestation as acute abdomen.

Abdomen, Acute↗

[Mediastinal teratomas--diagnosis and therapy].

The authors present an account on patients with a teratoma of the mediastinum who were operated at the Second Surgical Clinic, L. Pasteur Faculty Hospital in Kosice. In the course of 10 years (Jan. 1, 1990-Dec. 31 1999) 73 patients with tumours of the mediastinum were operated. In four the diagnosis of teratoma of the mediastinum was confirmed by histological examination (5.47%): three adult patients and one child. In two patients the tumour of the mediastinum was diagnosed accidentally during X-ray examination of the chest. In one female patient surgical revision was indicated on account of a relapse of the process. In the conclusion the authors emphasize that teratomas of the mediastinum are frequently asymptomatic, and in case the process is in the anterior or upper mediastinum, teratomas must be taken into account and removed as a whole during surgical intervention.

Adolescent↗

[Pleural exudate as a complication of inflammatory pancreatic disease].

The authors present an account on six patients with a pleural exudate associated with inflammatory pancreatic disease, treated during the six-year period from 1992-1998. The authors succeeded after two-week conservative treatment which involved complete parenteral nutrition and repeated thoracocenteses that the pleural exudate disappeared in five patients with chronic pancreatitis. In one instance, a female patient with haemorrhagic necrotic pancreatitis, the bilateral exudate disappeared only after surgical removal of the necrotic portions of the pancreas. The authors discuss diagnostic and therapeutic possibilities of treatment of these conditions.

Adult↗

[Spontaneous pneumothorax. Actual aspects].

Based on a group of 77 patients with 93 attacks of spontaneous pneumothorax the authors submit some unconventional views on this entity and recommend an algorithm of therapy. They assume that the "gold standard" of treatment is tubular drainage of the chest, and only if it fails, surgery is the method of choice.

Adolescent↗

[Antibiotic prophylaxis in thoracic surgery].

On a group of patients operated during the last three months under standard precautions the authors explain their views as regards antibiotic prophylaxis in thoracic surgery. They justify not only "short-term prophylactic administration of antibiotics" but also prolonged prophylaxis with antibiotics. Useful in this respect proved Mandol, cefalosporin of the 2nd generation, which is used as a standard drug without preoperative examination of the bacterial flora in sputum. Their patients did not develop infectious complications.

Adolescent↗