Biomedical subjects

M Hutan

Publications and source records attributed to M Hutan.

14 recordsLinked to original sources

PubMed2003

Injuries of the intraabdominal organs at patients with polytrauma.

The authors analyse group of 77 patients with several injuries of the intraabdominal organs by polytrauma and intraabdominal continuing bleeding. The injuries were classified in compliance with the classification of the American Association for the Surgery of Trauma (AAST), 1994. At hemodynamically stable patients, the authors accept selective non-operative forms of treatment, however are aware of the risk of delaying the therapy of severe polytrauma. (Tab. 4, Fig. 2, Ref. 3.).

Abdominal Injuries↗

PubMed2002

Current palliative treatment of malignant jaundice.

When selecting the most suitable palliation of malignant jaundice, the following factors are to be considered: 1) patient's overall condition, 2) presumption of patient's survival, 3) technical, personal, and economic factors, 4) effectiveness of procedure, 5) morbidity and mortality of palliative treatment. (Tab. 2, Ref. 3.).

Biliary Tract Neoplasms↗

PubMed2002

Stabilisation of thoracic wall in patients with chest injury.

The authors analyse a group of 38 polytraumatised patients with unstable thoracic injury who were subdued to internal surgical stabilisation of the thoracic wall during the period from 1st October 1994 to 30th September 2001. The average period of controlled pulmonary ventilation (CPV) was 3 days and the average period of hospitalisation at the Anaesthesiology and Intensive Care Department (AICD) was 10 days. In indicated cases, the authors recommend an active surgical approach in the treatment of patients with unstable thoracic injuries. (Tab. 2, Fig. 2, Ref. 3.).

Adult↗

PubMed2001

[The current approach to liver injuries].

PURPOSE OF THE STUDY: The authors analyze their own three-year material within the treatment (both surgical and conservative) of the injury of liver. MATERIAL: During the given period 18 patients with the injury of liver were treated, of which 15 (83%) surgically and 3 (17%) conservatively. The group included 13 men (72%) and 5 women (28%), the average age at the time of injury was 30 years (range, 19-44 years). Ten patients (56%) suffered a blunt injury and 8 patients (44%) a penetrating injury, of which in 5 patients it was the case of a stab wound and in 3 patients a gunshot wound. METHODS: Indicated to operation were patients with a continuous intraabdominal bleeding, multiple organ injury of the abdominal cavity, simultaneous injury of diaphragm and gunshot wounds in the abdominal cavity. The method of treatment of the liver was determined by the extent of the injury. The authors accept the selective non-surgical treatment of hemodynamically stabilized patients which was developed on the basis of modern imaging methods. The condition of patients is also limited by the extent and severity of associated injuries. Hepatic injuries were classified according to American Association for the Surgery of Trauma, 1994. RESULTS: The average amount of hemoperitoneum in the patients operated on amounted to 1 550 ml. (200-4000) of blood, the average number of transfusion units 9 (4-20), the average duration of hospitalization at the intensive care unit was 7 (1-44) days and at the surgical department 10 (1-24) days. The average amount of hemoperitoneum according to Federle classification in the nonoperated on patients was 250 ml (200-375), the average number of transfusion units was 1.2 (1-2) of erythrocyte mass, the average duration of the stay in the intensive care unit of the surgical department was 2.3 (2-3) and at the surgical department 6.9 (6-8) days. Complications were recorded in 5 (28%) patients. During resuscitation 6 patients (33%) died due to hemorrhagic shock and in 2 (11%) patients we introduced during the resuscitation intracaval shunt. DISCUSSION: Non-surgical treatment has become a standard method of the treatment of a blunt hepatic, injury in the adult population and it is used in the extent of 50-82%. Failure of conservative treatment at present leads to a surgical intervention. Surgery is indicated in patients which continuously require transfusions, whose vital indicators have deteriorated and where there are evident growing signs of peritoneal irritation. CONCLUSION: Non-surgical treatment of blunt hepatic injuries should be initial in all patients with a secured hemodynamic stability. As it is impossible to find out in which patients non-surgical treatment will fail, the initial period of observation at the intensive care unit is a guarantee of a selective approach. If all its principles are observed the percentage of success of this treatment should exceed 90%.

Adult↗

PubMed2001

Penetrating cardiac injury.

Penetrating cardiac injury is still a diagnostic problem at this time. The authors want to show the breadth of problems on the case histories of two patients. It is important to classify the patients according to their risk group, and then to proceed. In each suspicion of cardiac injury we started with thoracotomy. It is an important "life endangering thoracotomy in emergency room". The hypotension with abdominal symptoms was started with laparotomy. Transdiaphragmatic pericardiotomy is a helpful adjunct in the decision as to whether proceed to median sternotomy. (Tab. 2, Fig. 3, Ref. 7.)

Adolescent↗

PubMed2000

[Resuscitation operations in patients with multiple injuries].

The authors analyze a group of 15 patients with polytrauma during a 4-year period. The patients had the clinical signs of severe bleeding. Despite the complex resuscitation care, the patients died due to consequences of haemorrhagic shock already during the operation or very soon after operation. All patients were after initial resuscitation and diagnostic procedures (apparatus breathing, aggressive volumotherapy, proved continuous bleeding) performed for the use of further resuscitation actions, namely surgical control and stoppage of bleeding, surgical indications. This pathophysiological consideration is reflected also in the title of this study. The study further discusses the modern injury conception of resuscitation at a operating theatre which in frame of surgical intervention attempts to achieve homeostasis. At the same time, the surgical approach frequently must prefer the methods which enable the physiological stability on the behalf of incomplete solution of post-traumatic anatomic integrity. The definite solution can be possibly performed by subsequent operation. (Ref. 5.)

Adolescent↗

PubMed1999

[Carcinoids--personal experience with surgical therapy].

The authors retrospectively studied a group of 8 patients in the period of 7 years (1990-1997). Most frequent surgical procedure performed was appendectomy (4 cases), right-sided hemicolectomy (2 cases), gastric resection (1 case) and small intestine resection (1 case). The most frequent side of carcinoid localization was appendix followed by small intestine. In 3 cases the tumours were macroscopically detectable, the remaining only histologically. Patients were without clinical manifestations of carcinoid syndrome. (Tab. 1, Ref. 9.)

Adolescent↗

PubMed1999

[Aortoesophageal fistulae as a cause of fatal hemorrhage].

Aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding, ranging from 0 to 2.3% in literature. The authors studied a group of 266 patients with upper gastrointestinal bleeding during the period of three years (1996-1998). According to two patient cases and the data from literature diagnostic methods, causes of aortoesophageal fistulas are analysed and the necessity of urgent closure of the fistulas is stressed. (Tab. 2, Fig. 2, Ref. 15.)

Aged↗

PubMed1995

[Prevention and treatment of lymphatic fistulas after arterial reconstruction in the lower extremity].

Lymphatic fistula is a complication of 2% of surgical vascular reconstruction in the groin especially in the critically ischaemic limb. We investigated the incidence of lymphatic fistula, its prevention and treatment in patients at the Department of Surgery of the Ruzinov Hospital in Bratislava during the period of 5 years. 7 patients out of 162 (4.44%) had lymphatic fistula in the groin. The patients underwent 172 operation involving 209 groin incisions. Lymphatic fistula developed in 7 groin incisions--3.34%. Operations included 36 aortobifemoral bypass procedures, 2 unilateral bypass procedures, 76 femoropopliteal bypass procedures or profundoplastic surgeries, 48 embolectomies. The diagnosis was based upon the clinical findings of the characteristic persistent watery discharge in the groin after vascular operation. Conservative treatment was successful in all patients, the average duration of lymphatic fistula was 27.2 days. Lymphatic fistula may be complicated in 25% of patients by wound infection but it shouldn't be regarded as the first degree of infection in vascular surgery. (Ref.12)

Adult↗

PubMed1995

[Reasons for conversion in laparoscopic cholecystectomy].

Laparoscopic cholecystectomy (LCH) is a surgical method which is minimally invasive thus enjoying an increasing popularity among both patients among the patients surgeons. Conversion of laparoscopic cholecystectomy is comprehended as a retrieve to the classical surgical method based on laparotomy in any phase of operation. The study deals with reasons for conversion of the initial one hundred LCH which were performed by 7 surgeons at the Department of Surgery in Ruzinov Hospital in Bratislava during the period from 27.11.1992 to 31.3.1994. Out of one hundred cases, 5 LCH required conversion to open laparotomy--5%. The most frequent rate of conversion is from 3 to 8%. Reasons for conversion in our patients include. Impossibility to introduce safety the trocar with the video camera (1x), unclear anatomic situation (1x), bleeding from the cystic artery (1x), perforation of the gallbladder and subsequent leakage of bile and stones in to the peritoneal cavity (1x), technical failure (1x). We cannot comprehend the conversion of LCH as a failure of the operating surgeon. It insinuates that the surgeon is careful and responsible for his patient. It is a sign of his good surgical judgement.

Adolescent↗

PubMed1994

[31P NMR spectroscopy in acute experimental pancreatitis].

In order to investigate the changes in phosphoglucose metabolism in acute experimental pancreatitis, the authors utilized the measuring cell NMR spectroscopy. The experimental pancreatitis had been evoked by both the method of ligature of lateral pancreas ducts and that of the duodenal blind loop. These methods evoke a morphological response, namely edematous and necrotizing pancreatitis. Gradual reduction of macroergic phosphate binds and augmentation of anorganic phosphates represent the principal change in NMR spectrum. The clinical picture provides evidence of the exhaustion of highly energetic phosphate compounds which are necessary for the maintenance of integrity of the pancreas tissue in acute experimental pancreatitis. The discussion includes the possibilities and limitations of the NMR spectroscopy.

Acute Disease↗

PubMed1994

[Corium transplantation in reconstruction of ventral hernias].

The authors present a group of 28 patients who after utilization of corium grafts were analyzed by means of a retrospective fill-in-form method. The most frequent plastic surgery is s. Mayo, larger defects required s. Chorváth. Utilization of corium grafts from resected skin requires to include the removal of epiderma and subcutaneous fat, and suture under traction. On the basis of the presented results, the authors recommend this type of repair of abdominal wall defects.

Abdominal Muscles↗

PubMed1994

[Retrorectal and presacral tumors].

The group of patients with retrorectal and presacral tumours is presented. Their clinical picture, CT examination, results of biopsy and surgery treatment are analysed. The authors present the recent procedures of diagnosis and therapy of tumors in this location.

Adult↗

PubMed1993

[Morphologic findings in models of acute experimental pancreatitis].

Morphological changes found in two models of acute experimental pancreatitis are presented. Acute pancreatitis was induced in rats by the method of ligation of the lateral pancreatic ducts and by the method of the blind duodenal loop. After four hours the animals were sacrificed and processed for light and electron microscopic examination. Changes indicative of edematous and necrotizing pancreatitis were recorded. In the electron microscopic picture the predominant findings were disintegration of organelles of acinar cells and the appearance of numerous vacuoles and autophagosomes. The presented models of pancreatitis are considered to be suitable for further research into the pathogenesis and therapeutic intervention of acute pancreatitis in rats. (Fig. 15, Ref. 8.)

Acute Disease↗