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Biomedical subjects

M Janík

Publications and source records attributed to M Janík.

18 recordsLinked to original sources

[Tracheal tumor--a case review].

Tracheal tumors make a histologically variant group of tumors. Our case review describes a case of a forty-five year-old female patient with an endoscopically and CT- diagnosed tracheal tumor. The patient was hospitalized at the IInd Surgical Clinic of the UPJS LF, the Faculty Hospital of L. Pasteur in Kosice, with symptoms of dyspnoea and stridor, in the orthopnoic position. Following the neccessary pre- operative procedures, her trachea was resected, followed by end-to-end anastomosis. The histological examination of the resected tissue revealed an inflammatory myofibroblastic tumor. The postoperative course was positive with no complications.

Female↗

[Postintubation stenosis of the trachea--case reviews].

Stenoses of the respiratory tract are life threatening conditions of various origins. The authors give referrence on 21 patients operated for postintubation stenoses of their trachea at the IInd Surgical Clinic of the UPJS Medical Faculty, the Faculty Hospital of L. Pasteur in Kosice, from 01. 01. 1999 to 30. 06. 2005. All patients had a tracheobronchoscopic examination and a CT examination completed prior to the procedure. Within 24 hours of their admission, 9 patients were operated, 7 underwent resection procedures and 2 patients had Montgomery's T-cannula introduced. 12 patients had their procedures planned, and were operated later than 24 hours after their admission. 10 patients underwent resections of the trachea, 2 had Montgomery's T-cannula implanted. The postoperative course following the resection of the trachea was without complications in 14 patients, 1 patient experienced transitional oedema in the anastomosis and 2 patients suffered restenoses. In this patient group, no fatal case was recorded. The authors stress up multidisciplinary approach in the diagnostics and treatment of the postintubation stenoses of trachea. In cases of postintubation stenoses of trachea, resection of the trachea with primary anastomosis represents the most advantageous treatment approach for the patient.

Adult↗

[Actinomycosis of the lungs mimicking a Pancoast tumor].

The authors present a case-review of a patient with a thoracic form of actinomycosis, simulating a "pancoastoid" lung tumor clinical picture- furthermore, confirmed by a false-positive cytological examination. The disorder was managed by enlarged lobectomy from the right lung, followed by postoperative antibiotic therapy, lege artis. The long-term outcome is very good.

Actinomycosis↗

[Surgical treatment of pulmonary metastases--long-term results].

A group of 103 patients operated for lung metastases in the Surgical clinic of the FNsP of L. Dérer and in the II Surgical clinic of L. Pasteur is assessed in this work. Minor operations of atypical resection prevailed among the resections. The postoperative mortality in the whole group was 1.9%. The best long-term survival rates were reached in tumors primarily treated by chemotherapy and followed by the lung metastasectomy. All patients in this group suffered from testical tumors and their long-term survival rate was 69%. In tumor cases, where the metastasis was primarily removed by surgery, the long-term survival rate correlated with the literature data of 30%. When the prognostic factors were considered, the number of removed metachrone metastases being less than 3, appeared statistically significant from the point of view of the patient survival. Based on the evaluated results, it can be concluded that surgical treatment of the lung metastases performed within the interdisciplinary oncological concept, currently remains a generally accepted therapeutic procedure.

Adolescent↗

[Mediastinal cysts].

Mediastinal cysts, described also as homoplastic dysembryomas, account for 20% of mediastinal lesions. There are bronchogenic, oesophageal, gastrogenic and enterogenic, pericardial, non-specific cysts and cystic lymphangiomas. The authors present 6 patients with mediastinal cysts from a total number of 96 patients with mediastinal tumours subjected to surgery during a 14-year period (from Jan. 1 1987 to Dec. 31 2001). The group comprised 5 adults and one child. In four patients the authors selected thoracotomy as the route of access to the mediastinum, in one instance total sternotomy and once upper partial sternotomy. The cysts were removed as a whole. Histological examination revealed in four patients the diagnosis of a bronchogenic cyst, once a connective tissue cyst with respiratory epitheliumm and once a cyst lined with squamous epithelium. The postoperative course was in all patients free from complications. In the conclusion the authors emphasize the importance of complete removal of mediastinal cysts as relapses occur if part of the secretory eoithelium is not removed.

Adolescent↗

[Cervical pulmonary hernia].

Pulmonary hernia is in general a rare affection--in particular in the cervical region. Symptoms are as a rule slight and are encountered only in exceptional cases. The diagnosis is based on physical examination and imaging techniques. The authors submit a case-history of a cervical pulmonary hernia in a young woman. It was noteworthy because of marked complaints of the patient which involved professional damage. Therefore it had to be treated by surgery which was successful.

Adult↗

[A "dumbell" tumor of the mediastinum--case report].

Tumours situated in the posterior mediastinum and spreading to the spinal canal via the intervertebral opening are described as "dumbbell" tumours. The authors submit the case-history of a 44-year-old patient admitted to the Second Surgical Clinic Pasteur Faculty Hospital, Safarík University Kosice after repeated laminectomy and extirpation of the intraspinally spreading part of a mediastinal tumour. The mediastinal part of the tumour was removed surgically, the histological result was described as a melanotic schwannoma. The postoperative course was without complications, the patient was discharged home in a good condition on the 8th day after the operation. In the conclusion the authors emphasize the necessity to remove the tumour in toto. A one-stage operation in collaboration with a neurosurgeon seems appropriate.

Adult↗

[Mediastinal teratomas--diagnosis and therapy].

The authors present an account on patients with a teratoma of the mediastinum who were operated at the Second Surgical Clinic, L. Pasteur Faculty Hospital in Kosice. In the course of 10 years (Jan. 1, 1990-Dec. 31 1999) 73 patients with tumours of the mediastinum were operated. In four the diagnosis of teratoma of the mediastinum was confirmed by histological examination (5.47%): three adult patients and one child. In two patients the tumour of the mediastinum was diagnosed accidentally during X-ray examination of the chest. In one female patient surgical revision was indicated on account of a relapse of the process. In the conclusion the authors emphasize that teratomas of the mediastinum are frequently asymptomatic, and in case the process is in the anterior or upper mediastinum, teratomas must be taken into account and removed as a whole during surgical intervention.

Adolescent↗

Benign glomus tumor of the superior posterior mediastinum.

An unusual location of a benign glomus tumour, outside of the constantly located regions, e.g. in the subungual location or deeply sited in extremities, was diagnosed in a 56-year-old white female in her posterior upper mediastinum. The single similar case report was published before the era of electron microscopy and immunohistochemistry and single cases of atypical and malignant forms in this unusual location were published only recently. The tumour measuring 5 x 4 x 2 centimeters has caused cough and was associated with occasional righ-sided chest pain. Its rich vascular supply has caused intensive intraoperative bleeding. The postoperative course was uneventful and the patient is free of neoplastic disease or symptoms six years after surgery. Numerous mast cells present within the tumour's interstices must be considered in relation to the possible pathogenesis of the up to now unexplained pain in glomus tumours.

Female↗

[Spontaneous pneumothorax. Actual aspects].

Based on a group of 77 patients with 93 attacks of spontaneous pneumothorax the authors submit some unconventional views on this entity and recommend an algorithm of therapy. They assume that the "gold standard" of treatment is tubular drainage of the chest, and only if it fails, surgery is the method of choice.

Adolescent↗

[Antibiotic prophylaxis in thoracic surgery].

On a group of patients operated during the last three months under standard precautions the authors explain their views as regards antibiotic prophylaxis in thoracic surgery. They justify not only "short-term prophylactic administration of antibiotics" but also prolonged prophylaxis with antibiotics. Useful in this respect proved Mandol, cefalosporin of the 2nd generation, which is used as a standard drug without preoperative examination of the bacterial flora in sputum. Their patients did not develop infectious complications.

Adolescent↗

[Surgery in patients with organ transplants].

Patients after successful transplantation with immunosuppressive therapy form a "new circle of surgical patients" who can develop various surgical diseases, or injuries which bring about an inevitable urgent or planned surgical treatment. The authors present the results in three patients with transplanted organs (1993-1995) who were subdued to various surgical treatments. The first patient underwent a classical cholecystectomy, choledochotomy, and extraction of concrement from the choledochus after orthotopic transplantation of the heart. The second patient underwent transplantation of the kidneys precedingly to bilateral subtotal resection of both lobes of the thyroid gland due to marked bilateral nodal goitre intervening deeply retrosternally with a severe pressure syndrome on trachea and oesophagus. The immediate and long-term results were excellent. Orthotopic transplantation of the heart in the third patient preceded to intercostal drainage of the thorax and evacuation of pus due to an extensive empyema of the thorax and septic state, and later thoracotomy and decortication with extirpation of the substantial part of the empyema sack was performed with an excellent immediate and long-term effect. The authors present the principles which must be inevitably fulfilled in coincidence with successive surgical treatment in patients with transplanted organs in a permanent immunocomplex regime. (Fig 2, Ref. 11.)

Adult↗

[Stapling in thoracic surgery].

The author presents a brief historical account on the development of automatic sewing equipment. Based on his own 30-year experience he mentions its possible use in thoracic surgery and discusses its justification in thoracic surgery with regard to various aspects.

Humans↗

[Surgical treatment of small-cell pulmonary carcinoma].

Based on their longstanding experience of a department with surgical treatment of small-cell carcinoma of the lungs, the authors give an account of their experience. During the five-year period (1988-1992), when also patients in the third stage of the disease were operated, the authors followed up the survival after operation in relation to the presence or absence of N2. During the above period 31 patients were operated on account of small-cell carcinoma. This number comprised 9 patients in stage I and II, 14 patients in stage III, and in 8 patients on account of the advanced stage of the disease explorative thoracotomy was performed. Although the patient groups during the mentioned period were not large, the results are comparable with those of other, larger investigations. Patients operated in stages without tumourous affection of the mediastinal lymph nodes survived resection of the lungs supplemented by adjuvant chemotherapy significantly longer than patients with N2 affections and a similar therapeutic procedure. Based on the achieved results the authors do not recommend resection of the lungs in the IIIrd stage of the disease as the primary or as an adjuvant therapeutic modality.

Adult↗