Biomedical subjects
Publications and source records attributed to M Ciurea.
Giant keratoacanthoma (KA) is a very rare tumor which benefits of surgical treatment. We present a case of 61-years-old man with a giant keratoacanthoma situated on the dorsum of the right hand. The diagnosis is established by routine histopathologic examination.
Explore the source record for details and available documents.
The main goal of this paper is to give an overview of the personal experience in the investigation of the hepatic biopsy. There were analyzed liver specimens from 26 children hospitalized in Clinical Hospital "Sf. Maria" Iaşi. The first clinic diagnosis was post-viral chronic hepatitis and most of the cases provided the serologic markers. Histopathological exam revealed 2 cases of active chronic hepatitis and 24 cases of persistent chronic hepatitis. The interpretation of the lesions relied on Ludwig and Metavir scoring systems. The significance of these scores is very important because they allow one to identify the grading of the necro-inflammatory/histological activity and the staging of fibrosis. Thus, the result of these scoring systems make it possible to classify the cases into aggressivity based forms, indicate the therapy approach and estimate the prognosis as well as the clinical course.
Tuberculosis, in its various forms, remains an important cause of morbidity and mortality in developing countries in immunodeficitary patients. The indicatives of epidemiology of tuberculosis show that Romania presents a fresh outbreak of the disease in the last few years. The purpose of this paper is to present from the various forms of extrapulmonary tuberculosis, the intestinal tipe which have a high incidence. The authors describe theirs preliminary experience of intraoperative small and large bowel emergencies resections in a short period (1 year) of three young patients (between 30 and 40 years old) with history of pulmonary tuberculosis. The pathology was complex (bowel obstructions, peritonitis) and so were the surgical operations (resections, devirations). The patients showed short and long term good results.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
To establish the optimal diagnosis and therapeutical strategy in severe acute pancreatitis. 94 (56.9%) severe acute pancreatitis (79 males and 15 females, aged between 26 and 81), selected from 165 acute pancreatitis admitted in the last 5 years (2000-2004) were analyzed. The disease was assigned as severe when one or more of the following criteria were present: Ranson score >3 on admission or at 48 hours, APACHE II score >8, visceral failures, Balthazar CT score C, D or E and local complications (infected necrosis, pseudocyst or pancreatic abscess). Medical treatment (aggressive supportive intensive care therapy, minimizing pancreatic secretion and antibiotic therapy) was the first therapeutical step in all cases. 49 (52.1%) patients were operated on: 20 as early surgery imposed by biliary sepsis (16 cases) or by an acute abdomen with uncertain etiology and unfavourable evolution, and 22 as late surgery (at least 12 days after onset), imposed by the presence of the infected pancreatic necrosis, visceral failures or other local complications, the necrosectomy being the main surgical procedure for infected necrosis. 77 (81.9%) cases had a fair evolution. The conservative treatment led to a complete recovery in 37 (37.2%) cases. We registered an overall mortality rate of 12.7% and postoperative mortality rate of 14%; we also registered 5 (10.2%) postoperative complications: 4 pancreatic and 1 colonic fistulae. (1) The treatment of the severe acute pancreatitis must be performed only in the specialized multidisciplinary well equipped centers with very well trained staff. (2) Medical conservative treatment (aggressive supportive intensive care therapy and antibiotic therapy) is the main therapeutical method within the acute phase (first two weeks). (3) Very restrictive surgical indications within the acute phase. (4) Necrosectomy is the main surgical procedure for the infected necrosis.
AIM: To point out the severity of the postoperative biliary peritonitis (PBP) and to established the most proper ways of diagnosis and treatment. MATERIAL AND METHODS: 14 PBP (6 males and 8 females, age between 42 and 76 years) admitted in the last 14 years were analyzed. The PBP occurred after biliary surgery in 13 cases and after gastro-duodenal surgery in 1 case. The delay between the first operation and the establishing of the diagnosis and reoperation varied between 24 hours and more than 3 days. All the patients were operated on; the operation had to fulfill 2 main objectives: the treatment of the peritonitis and to solve the biliary lesions. RESULTS: 6 patients had a fair evolution. We registered 8 complications with a morbidity rate of 57,14% and 2 deaths with a mortality rate of 14,3%. CONCLUSIONS: 1. Postoperative biliary peritonitis is one of the most severe complications of the biliary and gastro-duodenal surgery, due to preoperative unrecognized biliary lesions or occurring as postoperative accidents or complications. 2. The clinical picture, deeply modified by the complex postoperative treatment makes the early diagnosis very difficult and leads to a delay of the re-operation. 3. The treatment is exclusively a surgical one, with two main objectives: the biliary lesion repair and the treatment of the peritonitis. 4. The postoperative biliary peritonitis are charged by a high postoperative morbidity and mortality rate, the delay of the diagnosis and the time of reoperation being the main risk factor.
The paper reports on two peculiar clinical observations of diffuse acute peritonitis in which the abdominal cavity was contaminated by perianorectal suppurative acute processes, insufficiently solved surgically. The diagnosis difficulties, peculiarities of the surgical treatment, and their special seriousness are revealed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.