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Biomedical subjects

M Angelescu

Publications and source records attributed to M Angelescu.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[The remaining indications for open surgery in common bile duct lithiasis].

Once with the continuous development of mini-invasive procedures, the open surgery indications in the treatment of CBD stones are decreasing. Between January 1986 and December 1987, 514 patients with average age 60 years old (18-94) were treated for suspected or confirmed CBDS. Three distinctive periods were studied function of how the conventional surgery were either exclusive (group I), either together with the beginning era of laparoscopy (group II), or together with institutionalised laparoscopy (group III). Group I had 110 cases, group II--207 cases and group III--197 cases. The conventional surgery were 100% performed in group I, 26% (52 cases) performed in group II, 14% (28 cases) performed in group III. If the laparotomy was the only therapeutical option in patients with CBDS from group I, the therapeutical procedures become more various after 1990. It was done endoscopic sphincterotomy in 59% (124 cases) in group II and in 64% (126 cases) in group III. The laparoscopic extraction of CBDS was 12% (cases) in group II and 19% (37 cases) in group III. The overall mortality in conventional surgery was 1.5% with 1.8% in group I and 0% in group II and III. The complications rate was 13% with 8% in group II and 21% in group III. The postoperative hospitalisation time average was 16 days for laparotomy of the 3 groups. The conventional surgery is main indicated when laparoscopic surgery for CBDS extractions or endoscopic sphincterotomy is contraindicated or failed; also it is useful in some complicated forms of CBDS.

Adolescent↗
PubMedDate not supplied

[Late results after the Mark Belsey IV antireflux procedure in achalasia].

Cardial achalasia (cardiospasm, megaesophagus) represents the failure or lack of relaxation capacity of the inferior esophageal sphincter; it is the second esophageal disease and is considered a premalignant lesion. Treatment of achalasia is surgical but palliative, considering the lack of an etiopathogenic therapy for this moment. We present a retrospective study done on 19 patients (10 males and 9 females, with a mean age of 49 years) operated in "Colentina" Surgical Clinic in the period of 1996-1999 for achalasia (presenting symptoms-dysphagia, regurgitation, weight loss) by extramucosal esocardiomyotomy practiced on a length of 5-10 cm, by thoracic approach, followed by the Mark Belsey IV antireflux procedure. Results were good, without reflux pathology or dysphagia in the postoperative evolution.

Adult↗
PubMedDate not supplied

[Pancreatic insulinomas].

In the period of 1980-1999 (20 years) were operated 18 patients (8 males and 10 females) in "Colentina" Surgical Clinic, the average age being of 45 years, with hystopathologically confirmed insulinomas. The topography of these lesions was in the head of the pancreas (4), in the isthmus (5), in the body and tail (9). The classical clinical and biochemical signs were presented in 13 cases, the rest of the patients presenting atypical signs of disease. These patients had benefit from the surgical treatment. The approach was bi-subcostal in 11 cases and by upper and lower midline incision in the rest of cases. We practiced enucleation in 5 cases, corporeal-caudal pancreatico-splenectomy in 10 cases and cephalic pancreatico-duodenectomy in 3 cases. The malignancy of the tumour was hystopathologically confirmed in 30% of the situations. The postoperative mortality was in 3 cases, by acute pancreatitis, MSOF and myocardial infarction. We consider that in case of these generally benign tumours the most efficient therapy is the surgical one.

Adult↗
PubMedDate not supplied

[Cefepime (maxipime), large spectrum 4th generation cephalosporin, resistant to beta-lactamases].

As a result of the appearance of bacterial strains resistant to 3rd generation cephlosporin, since 1993 cephalosporins of 4th generation have been developed and introduced in therapy; among them are: cefepime and cefpirome. Cefepime is the most active 4th generation cephalosporin possessing the following advantages over the 3rd generation cephalosporins: high intrinsic potency due to rapid penetration into the periplasmic space; an extended spectrum of activity that includes many Gram-positive and Gram-negative organisms; Activity against multi-resistant Gram-negative bacteria, including Enterobacter and Klebsiella species; Low potential for beta-lactamase induction, especially Bush group 1 beta-lactamases, even ar low periplasmic concentrations; Minimal selection of resistant mutant strains. Its spectrum is very large being very active against Gram-negative bacilii: Enterobacter, Pseudomonas aeruginosa, Klebsiella pneumoniae, Serratia, Citrobacter, Proteus mirabilis and less active against Bacillus fragillis. Cefepime is also very active against Gram-positive cocci: Staphylococcus aureus (methicillin-susceptible strains only), Streptococcus pneumoniae, Streptococcus pyogenes. Some of the methicillin-resistant strains of staphylococcus are susceptible to cefepime; Enterococcus is resistant. Due to its high resistance against beta-lactamases Cefepime (Maxipime) is the best choice in life threatening nosocomial infections occuring in patients in the intensive care units. Cefepime can be synergically associated with aminoglycosides and fluoroquinolones.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Surgical procedures in penis cancer].

In the period of 1980-1999 (20 years) in Colentina Surgical Clinic were admitted and operated 16 patients with the diagnosis of pennial cancer (histopathology--squamocellular carcinoma), 13 of whom being from Colentina Dermatological Clinic. The mean age was about 64 years old, 10 cases presenting phimosis. Surgical procedures undergone were represented by partial pennial amputation with bilateral superficial inguinal lymphadenectomy (10 cases), total pennial amputation with superficial inguinal lymphadenectomy (4 cases), respectively emasculation with bilateral inguinal-iliopelvic lymphadenectomy (2 cases). In the postoperative period 3 patients presented lymphedema and lymphorrhagia, solved by conservative management. All the patients benefited of favorable evolution on the period they have responded to the controlled postoperative follow up (1-3 years).

Adult↗
PubMedDate not supplied

[Sugiura's procedure--a treatment modality for esophageal varices].

This study present the "N. Gh. Lupu" surgical experience with Sugiura technic for bleeding caused by oesophageal varicose. Is a 5 years retrospective study with 30 patients who are submitted of this operation. After the results analysis our opinion is to do this operation in stabilised patient, but she is possible even in emergency.

Digestive System Surgical Procedures↗
PubMedDate not supplied

[Therapeutical options in pancreatic pseudocysts].

This paper presents the "N.Gh.Lupu" surgical clinic's experience, that consists in 65 cases of pancreatic pseudocysts operated in the last 10 years (1989-1998), 30 females and 35 males, with a mean age of 52 years old. The diagnosis was mainly based on the classical echography and CT-scanner, the clinical picture being non specific in the majority of cases. Although the predominant use of the nonsurgical interventional procedures is recommended, this presents the maiden attempts of the authors in this field, the surgical techniques used being as it follows: cephalic pancreaticoduodenectomy, distal pancreatectomy, cystodigestive anastomosis, external drainage. The perioperative mortality was null, the postoperative one consisting in 3 cases (2 cases in the early period and 1 case in the later period).

Adult↗
PubMedDate not supplied

[Surgical treatment of pelvic subperitoneal tumors].

In the last 5 years in our hospital was operated 25 patients with pelvisubperitoneal tumors. Major clinical symptoms are compression and body mass effect. The localization and tumors dimensions, are established by CT and RMI. Surgical resection, difficult by the relations with iliac vessels and nerves, was do it in sub capsular manners and followed by chemo and radiotherapy. Our results are good, with 6 patients who passed 4 years postoperatively.

Female↗
PubMedDate not supplied

[Klatskin unresectable tumour. Palliative treatment or no surgical operation?].

The Klatskin tumor is a neoplasy of the proximate main biliary duet whose initial manifestation, and most of the time, the single one, consist in the appliance of an obstructive nature jaundice. This usually coincides with the spreading of the tumor beyond the walls of the tumors that have reached this state with a usually intraoperating made diagnosis, certain palliative technical surgery solutions could still exist. The author submits to your attention a retrospective survey on 85 tumors out of which only 3 were removable. For the remaining 82 he performed only exploratory laparotomy. Of these biopsy was made for 11 cases and palliative surgery for the other 71 (biliodigestive derivations on one or both liver lobes, or Huguet, Terblanche or Kehr tube surgery prosthesis operations). If the patient's living conditions are very good, his survival chances might be extended from 2 to 18 months, with no appearance of jaundice or pruritus. There is no doubt that if the pre-operations imagery testing results in the diagnosis "inoperable medical condition", the retrograde endoscopic transtumoral surgery prosthesis operation or the transparietal liver one, is recommended.

Adult↗
PubMedDate not supplied

[The rectal cancer--between resection and amputation. Surgeon's decalogue].

The surgeon has the opportunity to use a lot of treatment choices taking into account the site, the progression and the aggressiveness of the rectal tumors. If the treatment of anal cancer have been the same over the last years there are a few problems regarding the rectal cancer, especially for the one, which is distal and locally advanced. The therapeutic choice must take into account the following factors: the site of the tumor, the circumferential invasion, the local and distant spread, the complications and loco-regional recurrences, the anatomical shape of the pelvis, the possibility of developing tumor implants on the residual rectum, the equipment of the hospital, the experience of the surgical team, the accuracy of stoma technique, and the previous results in patients survival. In a trial of 381 patients with recto-sigmoidian and anal cancers we performed 171 rectal amputations, 29 Hartmann procedures and 76 laparotomies and colostomies. From the 276 patients with colostomy 172 (62.31%) were followed. The survival rate was: 6-10 months for the patients with laparotomy and colostomy, 16-24 months for those with palliative procedures (55.8%) and 5-17 years for those with radical procedures. From the point of view of the authors the rectal amputation with colostomy it is an alternative between oncological safety and patients comfort. This kind of surgical procedure must be done in specialized centers excepting the emergencies.

Aged↗
PubMedDate not supplied

[One case of multiple abdominal hydatidosis].

It is presented the case of a 45 years old female patient transferred in our clinic from Parasitology Clinic with the diagnosis of hepato-splenic hydatidosis. Preoperative echography presented 3 abdominal hydatid cysts (hepatic, splenic and free in the peritoneal cavity--greater omentum). Intraoperative exam confirmed the preoperative evaluation. The operation consisted in two ideal cystectomies associated with one partial cystectomy with evacuation and drainage. Postoperative evolution was simple.

Echinococcosis↗
PubMedDate not supplied

[Therapeutic approach in locally advanced and complicated rectosigmoid and genital cancers].

Locally advanced and complicated rectosigmoidian and genital cancers raise many therapeutic problems for surgeons. The most frequently used therapeutic methods nowadays are: radiotherapy, chemotherapy, surgical procedures, immunotherapy and other modern methods that aren't in the current clinical use yet. In a trial of 456 patients with locally advanced and complicated rectosigmoidian cancers and 632 patients with genital cancers we performed 573 (52.6%) radical surgical procedures and 515 (47.4%) palliative procedures, 301 (27.6%) of these being permanent colostomy (257 terminal and 44 in continuity). All of the patients received radiotherapy or chemotherapy pre and/or after surgery. The survival was between 5-7 months in the trial of patients with permanent colostomy, between 12-36 months in the trial of patients with palliative surgical procedures and adjuvant treatment and between 5-17 years in the trial of patients with radical surgical procedures and neo- and adjuvant therapy.

Adult↗
PubMedDate not supplied

Concentration of serum immunoglobulins in acute and chronic hepatic diseases. I. Serum-levels of IgG, IgA, IgM and IgD in young patients with viral hepatitis.

Concentrations of IgG, IgA, IgM and IgD were measured against WHO Reference Preparation 67/97 and British Standard 67/37 in sera from 105 patients with viral hepatitis and 110 "current" controls. To allow comparison at different ages and between sexes, constants previously determined on sera from a large "laboratory" group of controls were used to calculate "scores" for all Ig values. The patients' IgM scores were remarkably higher than those of controls and were bimodally distributed. About 68% of the patients had IgM scores more than 2 SD above the expected mean for laboratory controls. The distribution of IgG and IgA scores appeared unimodal, but schifted to the right of controls. The mean values of IgG and IgA scores were significantly greater in patients than in controls, and in female patients compared with males. Moreover, 16% (12 of 73) of the male and 47% (15 of 32) of the female patients had Ig G scores more than 2 SD above the expected mean. With regard to IgD, no significant difference between patients and controls was observed.

Acute Disease↗
PubMedDate not supplied

Concentration of serum immunoglobulins in acute and chronic hepatic diseases. II. Viral hepatitis; time-dependent changes in immunoglobulin concentration.

Immunoglobulin (Ig) concentrations were determined on blood samples drawn of 6 occasions over a 2-month period from 38 young patients with viral hepatitis. The main and joint effects of sex and day factors on mean Ig levels were studied by using a 2-way ANOVA model. No distinct pattern of variation was observed for IgA, IgG and IgD, whereas the mean values of IgM showed a statistically significant variation throughout the study period. Female patients had significantly higher mean Ig values than males; for each Ig-class, however, the day-to-day variation was very similar in the two sexes, as reflected by an unsignificant sex-day interaction. The results suggest that serial measurements of IgM levels can be useful for identifying those patients at risk of developing chronic hepatitis and for an early detection of viral hepatitis in persons at very high risk of contracting this disease.

Acute Disease↗