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Biomedical subjects

M Florescu

Publications and source records attributed to M Florescu.

At least 19 recordsLinked to original sources
PubMed1997

[The development of the pigment epithelium and its interrelation with uveal pigment cells].

Authors propose one study of retinal cells population in different stages of ontogenesis and one study of the pigmentogenesis process at the level of uveal tract and external retinal stratum. The study was achieved with embryonic and fetal technique of paraffin inclusion. Concomitantly with loading with pigment of the external retinal stratum and so pigmentary uveal tract is present. Dynamics of the retinol cells population varies with stages and chronological age, the number of pigmented uveal cells increasing proportionally but at different parameters with the pigmented retinal stratum one simultaneous with age under influence specially of humoral factors.

Gestational Age↗
PubMedDate not supplied

[Thoracic esophageal neoplasm-therapeutical problems and post-surgery evolution].

The authors are presenting a few considerations on Thoracic Esophageal Neoplasm, as resulted from an 18-cases study performed on patients that were operated between 1994-1999. The esophageal resection rate was of 50%, as follows: 7 Esophageal Resections and 2 Superior Polar Esogastric Resections. The digestive transit was reestablished by means of intrathoracic transposition of the stomach (6 cases) or of the right ileo-colon (2 cases). In one of the cases an Esogastric Anastomosis was performed at the neck level (cervical-right). Immediate post-op mortality after Esophageal Resection (1 case) was due to an acute respiratory distress syndrome (ARDS). The post-op complications were as follow: one anastomotic fistula associated with a purulent pleurisy, 4 non-infectious pulmonary complications and 2 cardiac complications (paroxysmal supraventricular tachycardia). The Discussions and Conclusions of the present work are presenting samples of surgical techniques, post-op complications and prognosis.

Aged↗
PubMedDate not supplied

[Post-operative temporary enteral nutrition methods].

THE AIM: Of the present work is to promote duodenostomy as the postoperative enteral nutrition way, when surgery ends in an anastomosis in which one of the partners is the esophagus (esophagectomies, esogastrectomies and total gastrectomies). MATERIAL AND METHOD: Consisted of 45 cases 815 total gastrectomy, 14 esogastrectomy, 6 esophageal resections and 10-esophageal plasty) in which we used: nasofaringoesogastric or nasofaringoesojejunal probes (14 cases); Witzel jejunostomy (11 cases); gastrostomy (10 cases); duodenostomy (10 cases). THE CONCLUSIONS: Show the many advantages of duodenostomy as compared to other enternal nutrition methods: technical simplicity, patient's comfort, avoidance of complications involved by the use of nasopharingoesodigestive probe or by jejunostomy, etc.

Aged↗
PubMedDate not supplied

[Analysis of various gastric carcinoma classification systems, through the prism of a study performed at Craiova IV surgery clinic].

INTRODUCTION: The aim of this work is to analyze the various gastric carcinoma classification systems, trying, at the same time, to establish connections between the anatomopathologic evolutionary and prognostic aspects. CASE MATERIAL AND METHODS: The study was performed on a series of 66 patients who undergone excision surgery for gastric carcinoma. The study material are 31 cases of gastric cancer diagnosed in Clinical Hospital CFR Craiova, and another 35 cases diagnosed at the "I.V. Babeş" Pathology and Medical Genetics Institute in Bucharest. The excised pieces underwent anatomopathological investigation using histopathological, histochemical and immunohistochemical methods. RESULTS: From the macroscopic point of view, the most common tumor pattern was Bormann 2 ulcerovegetative, targeting patients over 60 years of age. In what the invasion level is concerned, most carcinomas were sanctioned at the time when the tumor was invading the serous fluid (pT3) or even the perigastric tissue (pT4). The microscopic criteria was approached by us using Goseky's method, the most common being Goseky stages 2 and 4, in equal rations. The distribution of cases depending on the OMS differentiation degree, shows a preeminence of low differentiated carcinomas (G3). CONCLUSIONS: The abundance of classification methods in gastric cancer shows the complexity of the matter but none of the classifications is perfect.

Carcinoma↗
PubMedDate not supplied

[Microbiology of nosocomial infections in a general surgery department].

This paper aim is to outline the importance of nosocomial infections, characterized by great incidence, great mortality rate and specific bacteriology, in a surgery clinic. The study include 566 patients that developed 665 nosocomial infections (10.65% incidence), among the 5950 patients that underwent surgical operations in 5 years (1992-1996); 54 patients developed two or three nosocomial infections, which explain the incidence of nosocomial infection greater than number of patients. From bacteriological point of view predominance of Gram negative bacilli (especially E. coli) and pathogen staphylococcus characterized the nosocomial infections. The infection source was the patient himself, previously colonized with hospital specific microorganisms. Every clinical form of nosocomial infections was characterized by the present of specific pathogen microorganisms; the knowledge of these pathogen agents is very important for the antibiotic treatment applied before the bacteriological exam.

Cross Infection↗
PubMedDate not supplied

[Causes of failure in the treatment of postoperative peritonitis].

The authors analyze a group of 49 postoperative peritonitis, which represent 0.57% of a total of 8550 surgical interventions performed over the last 7 years and 1.19% of 4100 laparotomies carried out in an elective operation orientated general surgery department. The mortality rate was 28.57% (14 patients) among the 49 studied cases, which represents 25% of all deaths recorded in our department over the same time interval. A full account on postoperative peritonitis vital prognostic factors is given, insisting on: specific bacteriology (nosocomial infections), peculiar etiologies (10 out of 14 fatalities were originally operated on for digestive cancers), different associations of postoperative peritonitis with other infectious and noninfectious postsurgical complications (as encountered in all 14 deaths), type of postoperative peritonitis (13 death out of 14 were due to generalized peritonitis), postoperative peritonitis secondary to ignored lesions at the original operation (3 cases--3 deaths), surgical treatment limitation (late operative timing which was responsible of 9 deaths); treatment inadequacies of peritonitis and its cause--5 fatalities.

Adult↗
PubMedDate not supplied

[Guided digestive fistula. Complementary method in prophylactic and curative postoperative peritonitis].

Guided fistula (or sinus tract) techniques, which are a nowadays a controversial topic, comprise a group of simple surgical methods of postoperative peritonitis treatment. This retrospective study is an attempt to bring further insights into the literature debate on the utility of the aforementioned techniques by presenting Craiova C.F.R. General Surgery Department 7 years (from 1991 through 1998) experience with 26 operated on patients, who underwent digestive guided fistulas too. In 16 of our study patients sinus tracts were created for postoperative peritonitis prophylactis purpose, whereas digestive guided fistulas, which were performed in the other 10 patients, were meant to treat peritonitis secondary to anastomosis breakdown. In 87% of pur series of digestive guided fistula patients the postoperative outcome was satisfactory. Three deaths were recorded only among the nonprophylactic sinus tract patients. Guided fistula method is an useful adjunct of the complex, well-codified management of postoperative peritonitis including its efficient prevention.

Adult↗
PubMedDate not supplied

[Esophagoplasty with right ileocolon, technical problems].

The authors present their experience with 14 cases of esophagoplasty by right ileocolon interposition which were performed to re-establish the digestive continuity in 12 patients operated on for caustic burns induced esophageal strictures and 2 patients with esophageal neoplasm managed by esophagectomy. The current study aims to pin/point both the anastomotic risk and the technical difficulties related to the colon interposition graft anatomic trajectory and vascular supply. Given the utmost importance of both the preoperative correction of the nutritional deficit and the improvement of pulmonary function the authors suggest that esophagoplasty should bu preceded by a "preoperative intervention", consisting of ileocolic artery ligation, gastrostomy and pleural drainage. The acute respiratory failure was the immediate main threat following esophagoplasty, whereas cervical anastomotic breakdown was the complication which dominated the early postoperative period in terms of frequency and gravity, but the death rate was nil. When esophagoplasty by right ileocolon interposition simplicity and efficacy are taken into account it appears as the surgical therapy of choice whenever the local and general status of the patients allows it.

Adolescent↗
PubMedDate not supplied

[Breast conserving surgery --7 years of experience].

The breast cancer treatment is based nowadays on a new surgical option: breast-conserving surgery, which is reliable at least for the first and second stage of cancer, with radical intention, obviously. We have started to practice the breast-conserving surgery in our surgical clinic (at CFR Hospital, from Craiova) for 7 years; until now we have performed 159 breast-conserving operation and, as results, we have recorded 3 local recurrences (2.12%) and 1 death due to cancer evolution. Our protocol includes removal of the primary tumor with enough surrounding tissue to ensure negative margins of resectable specimen, associated with total axillary lymph-node dissection and postoperative breast irradiation. Our oncologist on different postoperative conditions indicated the chemotherapy: tumor size, axillary lymph node involvement, patient age, etc. The purpose of this paper is to emphasize our unassuming experience but especially to draw attention on important results, obtained by long-term monitoring the patient who underwent breast-conserving surgery, in a two prospective protocols, which demonstrate the importance and applicability of breast-conserving therapy. The conclusion of this study is that breast-conserving surgery followed by breast irradiation is reliable, as the results are similar with the radical mastectomies; the main objective is to obtain a good cosmetic result, which depends on tumor size/size of the breast ratio.

Adult↗
PubMedDate not supplied

[Tumour-host interaction and prognosis in patients with gastric cancer].

The study analyzed the prognostic significance of a group of three histologic markers belonging to intra- and peritumorous stroma as derived from a series of 66 patients with gastric adenocarcinoma operated upon in Craiova CFR General Surgery Clinic. To this end we attempted to uncover any possible correlation between the three stromal parameters represented by type of angiogenesis, peritumorous inflammatory infiltrate and desmoplastic reaction and both the depth of malignant invasion through the gastric wall and the histologic type of gastric cancer. The results of our investigation highlighted that type A2 angiogenesis is displayed mostly by gastric carcinomas with well-differentiated tubular and secretory structure (class 2 Goseky) whereas type A3, angiogenesis is mainly a feature of gastric cancer with a poorly-differentiated tubular morphology (classes 3 and 4 Goseky). Moreover there was no statistically significant correlation between the intensity of inflammatory infiltrate and both the Goseky classes and the depth of neoplastic spread. Finally a clearly desmoplastic reaction was encountered in less than 50% of our patient series and represented almost a characteristic of both poorly-differentiated tubular structured malignancies and serosa invading tumors.

Adenocarcinoma↗
PubMedDate not supplied

[Functional secondary megaduodenum].

This paper aim is to present the case of a 72 year old male, diagnosed with functional secondary megaduodenum. We intend to discuss the pathogenic and positive diagnostic difficulties (the presence or absence of a mechanical obstructive factor or the participated of the megaduodenum in an intestinal pseudo-obstruction syndrome). Also we outline the rare frequency of this disease and especially the therapeutic difficulties: inefficiency of conservatory treatment, delicate problems of surgical tactics and technique.

Aged↗
PubMedDate not supplied

[Clinical course of an ileal carcinoid with mesenteric metastasis].

This paper aim is to present the case of a male patient, age 63 admitted in hospital for non-specific gastroenterologic symptoms easily attributed to colecyst calculosis; the anamnesis and careful clinical examination have avoided a useless cholecystectomy and permitted to establish indication for laparotomy; during that was found an ileal tumor with massive metastasis in the base of mesentery. The surgical attitude was dictated by histological diagnostic difficulties (prostate adenocarcinoma metastasis), so it has given up the idea of tumor excision (unjustified intraoperative risk for a metastasis), performing a bypass of the ileal tumor by an enteroenterostomy, then the patient was sent to the Oncological Department. Postoperative evaluation of the patient finally permitted to establish the neuroendocrine origin of the tumor; after oncological treatment (chemotherapy), about 10 months after operation the patient didn't present any sign of tumor (tumor markers and CT scan within normal). The paper emphasizes the problem of practicing an aggressive surgical treatment for carcinoid intestinal tumors with mesenteric metastasis but also brings attention to nonsymptomatic forms of cholecyst calculosis that may hide associated malignant tumors undetected by laparoscopic cholecystectomy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Locoregionally advanced rectosigmoid cancer: diagnosis, surgical approach, late results].

The colorectal cancer continues to be diagnosed in advanced stages in our country, mainly due to unapplying of a programmer of active diagnosis through screening on the population with risk for colorectal cancer, and inefficiency of primary care system. In the department of General Surgery CFR Craiova Hospital between 1991-2001 were operated a number of 231 patients with colon cancer and 104 patients with rectal cancer. The results, showing an increased number of recurrences in cases of resection performed for advanced loco-regional tumors of rectosigmoid, made us to reconsider the attitude of avoiding the abdominoperineal resection even when the distance between the inferior limits of the tumors and the anal edge exceeded the distance considered being standard for a low anastomosis performing. The follow-up of the patients with paraclinic technique that didn't prove efficient led in the most cases to a delaying in diagnosis of local recurrences until the moment of resectability was exceeded. The applying of efficient methods in early diagnosis of colorectal cancer and follow-up could provide in the future better results for anterior resections with low anastomosis.

Adolescent↗