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M Havelka

Publications and source records attributed to M Havelka.

36 records · Page 2Linked to original sources
PubMedDate not supplied

[Biliary mucinous cystadenocarcinoma of the liver].

Biliary mucinous cystadenocarcinoma is an extremely rare tumour. Less than 50 cases have been reported. It is usually a multilocular cystic tumour covered with mucous producing epithelium, with papillary excrescences containing mucinous mass arising from bile ducts. The size of the tumour varies from 3.5 to 25 cm in diameter. It is more frequent in women. The majority of patients belong to the middle age population. We present a 63-year-old man who had been suffering from an epigastric and right subcostal pain of unknown aetiology for over 35 years. During the last 10 years he suffered from multiple attacks of cholangitis with high temperature, rigor, chills, pain and obstructive jaundice. Five years ago he had the attack of pancreatitis with retroperitoneal fatty necrosis for which he was operated on in another institution and cholecystectomy and pancreatic necrectomy were carried out. The attacks of cholangitis continued they were more serious and more frequent until June 1987, when the "cyst" in the left lobe of the liver, dilated bile ducts and "polyps" in the common bile duct were diagnosed by ultrasonography. During the operation advanced biliary cirrhosis, portal hypertension, splenomegaly, very dilated common bile duct full of jelly and the "cyst" in the liver filled with jelly, were found. The removal of the jelly and choledochojejunostomy resulted in temporary relief. Two months later he was reoperated for recurrent obstructive jaundice during which left lobectomy, partial excision of the cyst and cystojejunostomy between the rest of the cyst and another Roux-en-Y jejunal limb, were carried out.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholestasis↗
PubMedDate not supplied

[Preoperative preparation and the quality of postoperative recovery in surgery patients: an experimental study].

The authors describe the methods, content and main effects of an experimental program in education of surgical patients. The material used was obtained in a study of 32 patients who had been admitted for cholecystectomy at the Surgical Ward of Veterans Hospital, Split. The program has been organized according to basic principles of a communication approach in controlling surgical stress via informing and teaching patients in pain control and other active coping skills. Informed patients (n = 16), in contrast to the control group (n = 16), showed better psychophysiological condition and less situational anxiety while facing the episode, and later, in the course of 5-day follow-up, they showed shorter, and overall better quality of post-operational recovery. In discussion, the authors call attention to the need of further systematic investigations concerning the quality and effects of patient education programs at surgical wards in Yugoslavia as necessary basis for implementation and standardization of such programs in everyday clinical practice.

Adolescent↗
PubMedDate not supplied

[Carotid body tumor].

INTRODUCTION: The carotid body tumour was first described by von Haller in 1743. The first two, unsuccessfully surgically treated carotid body tumours, were done by Reinger in 1880 (his patient died), and by Maydel in 1886 (his patient developed hemiplegia). Scudder made the first successful surgical removal of the carotid body tumour in 1903. Using data from the Cologne (Germany) Medline Research Centre, surgical treatment of carotid body tumour was not reported in Yugoslav medical literature. The aim of this study is to present 6 surgically treated carotid body tumours. MATERIAL AND METHODS: Over the period from 1982 to the end of 1996, 6 patients with carotid body tumours were operated on in the Centre of Vascular Surgery of the institute of Cardiovascular Diseases of the Clinical Centre of Serbia in Belgrade. Four of them were female and two male patients, average age 43.4 years. In all cases the tumour was an asymptomatic neck mass. Color-Duplex ultrasonography and selective carotid arteriography were used to establish the diagnosis in 5 cases. The pathohistological examination of all 6 patients revealed the benign character of tumors. Patient 1. A 52-year old man. The suspicion of symptomatic carotid artery aneurysm, was the indication for urgent operation. The intraoperative finding showed a carotid body tumour which compressed carotid arteries. The subadventitial removal of the tumour was done. The patient was followed for 14 years without signs of local recidivation. Patient 2. A 38-year old man. During the operation the tumour was removed subadventitially, without clamping or injuring the carotid arteries. The patient was followed for 8 years and 3 months, and there were no signs of local recidivation. Patient 3. A 48-year old woman. Intraoperative findings showed an infiltration of the carotid arteries and tumour was removed together with parts of internal and external carotid arteries. The internal carotid artery was reconstructed using saphenous vein graft. The follow-up period was 4 years and 6 months, without signs of local recidivation. Patient 4. A 61-year old woman was operated on (neck exploration) in other hospital 4 years before the admission to our Centre. During the primary operation, an internal carotid artery was ligated without neurological consequences. Also, histological examination was performed. We removed a tumour together with the ligated internal carotid artery without its reconstruction. Three years after the operation the patient was without signs of local recidivation. Patient 5. A 40-year old woman. After subadventitial surgical removal of the tumor without clamping or injuring the carotid arteries, the patient was followed-up for 2 years and 2 months, and was without signs of local recidivation. Patient 6. A 30-year old woman was operated on (neck exploration only) in other hospital two months before the admission to our Centre. Intraoperative findings showed tumour infiltration to the carotid arteries, and therefore, internal and external carotid arteries were removed together with the tumour. The internal carotid artery reconstruction was performed using aaphonous vein graft. The early postoperative period was unremarkable. However, 48 hours after the operation cerebrovascular insult developed with hemiplegia. There was no sign of graft thrombosis. The patient was followed-up for 2 years postoperatively. There were no signs of local recidivation. The same patient had also a small asymptomatic tumour at the other side of the carotid arteries. DISCUSSION: The carotid body tumour originates from the paraganglious tissue at the carotid artery bifurcation. There are angiomatous and adenomatous forms. All of our 6 cases had adenomatous form. It grows slowly, and can compress and/or infiltrate carotid arteries and nerves. Three of our 6 cases showed signs of carotid artery compression and 3 showed infiltration to the carotid arteries. Malignant alteration of this tumour is uncommon. (ABSTRACT T

Adult↗
PubMedDate not supplied

[Anaplastic carcinomas of the thyroid gland].

Anaplastic carcinoma of the thyroid gland is a tumor of great malignant potential. The majority of the patients die in the period of 6-24 months after diagnosis is made. A review of 90 cases of anaplastic carcinoma of the thyroid gland surgically treated in the Department for Endocrine Surgery of The Second Surgical Clinic and Center for Endocrine Surgery of the Clinical Centre of Serbia revealed that anaplastic carcinomas were 11.3% of all the thyroid carcinomas (796) diagnosed in the cited period. The patient's age varied from 40 to 80 (mean 63.7 years). The incidence in women is twice as large as in men (2.1:1). Intraoperative histopathologic diagnosis was made in all the patients. The variations in histological structure were noticed. Dominant histopathologic features included pleomorphic giant and spindle cells, with irregular hyperchromatic nuclei and many aberrant mitotic figures with necrosis and infiltration of blood vessels by neoplastic tissue in most of the cases.

Adult↗
PubMedDate not supplied

Immunohistochemical localization of galectin-3 in malignant and benign human thyroid tissue.

BACKGROUND: Galectin-3 is an endogenous beta-galactoside binding lectin with putative roles in development, immunomodulation, transformation and metastasis. The purpose of this study was to analyze galectin-3 expression in a series of human thyroid neoplastic lesions. METHODS: A total of 76 cases, including 47 specimens of thyroid malignancies, 14 follicular adenomas and 15 specimens of normal thyroid tissue, were analyzed immunohistochemically using a monoclonal antibody to galectin-3 and avidin-biotin-peroxidase complex (ABC) method. RESULTS: The immunohistochemical staining results showed galectin-3 expression in neoplastic cells of all 20 cases of papillary carcinoma, 11 out of 15 follicular carcinomas, both oxyphilic carcinomas, all 10 anaplastic carcinomas and 5 out of 14 follicular adenomas. Galectin-3 localization was mostly cytoplasmic, but also membraneous or nuclear in some cells. Follicular cells in normal thyroid tissue were negative. CONCLUSIONS: The results of this study indicate that galectin-3 gene is expressed at the protein level in most thyroid carcinomas and some adenomas. Galectin-3 expression was not clearly correlated with histopathological aggressiveness, dedifferentiation state or determination of malignancy of the follicular tumour. The role of galectin-3 in thyroid tumour biology remains to be elucidated.

Adenoma↗