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Biomedical subjects

M Pricop

Publications and source records attributed to M Pricop.

At least 19 recordsLinked to original sources

[Cancer of the cervical stump].

Subtotal hysterectomy may represent, in specific conditions, a justified alternative to total hysterectomy. Some of the reasons may be vaginal stenosis, preservation of the menstrual function, conservation of the erogene cervical zone. The main disadvantage consists in developing cancer on the cervical stump. In order to reduce the risk of developing cervical carcinoma, total hysterectomy remains the procedure of choice for most women. Our study presents 16 cases with carcinoma of the cervical stump after subtotal hysterectomy from the lot of 313 cases with cervical neoplasms operated on at the Division of Gynecologic Oncology of the 4th Clinic of Obstetrics and Gynecology in Iaşi. The main conclusion of this study is illustrated by the firm conviction of the authors that subtotal hysterectomy is an unjustified surgical procedure in women after 40 years old.

Adult↗

Abdominal pregnancy. Case report, review of the literature.

Abdominal pregnancy (AP) is a rare form of ectopic pregnancy (EP). It is a medical emergency because of high maternal and fetal morbidity and mortality. Early diagnosis is essential. Surgery is indicated as soon as the diagnosis is made. We present a case with AP in the third trimester with malformed fetus and left ovarian tumour. The fetus has been extracted at 33 weeks gestational age; the placenta and the ovarian tumour have been removed five weeks later. Pathology showed corpus luteum with hemorrhage, serous cystadenoma, follicular cyst. The fetus died, the woman successfully recovered.

Adult↗

[Phyllodes tumor. The experience of the 4th Obstetrics-Gynecology Department].

The experience of the IVth Obstretrics Gynecology Department. Between the 1st of January 1994 and the 1st of November 2001 587 operations have been performed as treatment of breast tumors in the IVth Obstetrics and Gynecology Department. The phyllodes tumor has been diagnosed in 11 cases (1.8% of the benign breast masses). The genesis is unknown. Local trauma, pregnancy, lactation, high estrogenic levels have been suggested to have an influence upon the tumoral development. The most common aspect is a round, hard, unpainful breast mass. The diameter is variable (1 to 45 cm). The mammogram shows a well defined, high density, smooth contour opacity. A four degree classification has been described. Specific evolution features may involve local recurrences and metastasis. The surgical treatment is mandatory but radiotherapy, chemotherapy and endocrine treatment protocols have been brought up.

Adult↗

[Cancer of the cervix uteri in young people].

The age-group distribution, risk factors, histopathological aspects, diagnosis, treatment and prognosis of 111 diagnosed and/or treated cervical carcinomas in women aged up to 40 years out of 478 cases with the same diagnosis were reviewed. It is considered that the incidence of 23.2% in this series is situated at the extreme of the high frequencies reported in the literature. Nineteen per cent of the cases were diagnosed in stages O and Ia, a well organize program for early detection being required. In our series, the 5-year survival rate was 73.3%. This finding, although in a small series of cases, supports the opinion that age has no influence upon the prognosis of this disease.

Adult↗

[Practical aspects in diagnosis and treatment of benign breast lesions].

We analyzed 444 patients operated on in our clinic. Triple test diagnosis is the modern trend. Surgical treatment is not justified in all cases. When needed, partial mastectomy is commonly used. Surgical principles must be respected for good cosmetic results. Histopathology only certifies the diagnostic.

Adult↗

[Malignancy risk in some benign mammary lesions].

We analyzed retrospectively 821 patients operated on in our clinic for benign mammary lesions and for breast cancer. Histopathology identified in some cases associated benign and malign lesions. Atypical hyperplasia is considered significant risk factor for malignancy. Women in this category need close surveillance.

Biopsy, Needle↗

[Reasons for conservative treatment in breast cancer].

We analyze 112 patients with breast conservative treatment operated in our clinic in the last 5 years. Breast preservation surgery represented 30.35% of all cases treated for breast cancer in this interval of time. In other 63 situations conservative treatment was attempted but finally given up due to justified motivations and decision for mastectomy was adopted as optimal. Rigorous selection of patients for conservative surgery was our care. Tumor size, excisional margins, nodal status were the main criteria. Correlation with breast volume, age, patient's opinion were also important. Preservation of breast in women interested and cosmetic results were the purposes of our attitude. Breast conserving therapy may be indicated only respecting the oncological principles and close surveillance of patients is obligatory.

Adult↗

[Carcinoid tumors, leiomyosarcoma and invasive adenocarcinoma metastasis of the Treitz angle].

Our paper studies the quite rare occurrence of the digestive superior occlusive pathology, namely some causes which might induce partial or even total obstruction of the digestive tract, at the distal anatomical limits of the duodenum, also known as the Treitz angle. The first two described cases were carcinoid tumors, obstructive and ulcerated in the lumen of the same angle. The last two cases were an obstructive leiomyosarcoma and an invasive mesenteric metastasis from a right colon cancer, which cause a total external compression of the Treitz angle, clinically manifested as a complete food intolerance, as a first symptom. Concerning the clinical evolution, these are totally different lesions, malign, metastasis and neuroendocrine tumors, which occurred at the same level, had a totally different clinical evolution and surgical approach, only three of them developing at good postoperative course. The imaging, clinical and pathological diagnosis problems, the different specific surgical solutions, the postoperative care and finally the rarity of this level of obstruction of the small bowel, are the aim of this paper.

Adenocarcinoma↗

[Choledochal cyst as a complex malformation of the intra and extrahepatic bile ducts].

The authors present the case of a 64 years woman with a choledochal cyst along with a complex malformation of both intra and extrahepatic bile ducts. The patient was admitted with a diagnosis of acute and underestimated cholecystitis, which was in fact a real acute severe suppurated angiocolitis located at the cystic cavity level along with severe hepato-renal failure. As long as the choledochal cyst evolves as a stand-alone entity, it can frequently be associated with other malformations of the bile ducts--such as choledochal duct stenosis or abnormal connection of the common hepatic duct with pancreatic ducts. The main dilatation was engulfing the whole common bile duct with a fusiform aspect, and the cranial end is opening into a long hepatic duct from which were emerging several biliary segments branches, for both hepatic lobes. This aspect of a multistage convergence with four branches which is opening into a long hepatic bile duct and then in the choledochal cyst, represents an unusual malformation which does not respect the rules described by former published authors.

Bile Ducts, Extrahepatic↗

[Classical and laparoscopic therapeutic options in surgery for hepatic abscess].

Although lots of modern surgical and imaging techniques have been developed and last generation antibiotics are in use, the difficulties in the diagnosis and treatment of hepatic abscesses are still a rather sombre reality. Our research concerning 14 patients submitted to surgery within the last ten years can be thought of as a record, considering the poor number of cases in the last decades. So, our study also includes the possible clinical or imaging errors, the technical details of the surgery, the attitude towards the abscess cavity and the still obscure etiology in most of the cases. The correlation between the surgical risk and the rest of the hepatic volume, evaluated by computed scanning technique, represents another objective of this paper. In the large or in the multiple disseminated abscesses, the small area of the remaining functional hepatic tissue, was correlated to the postoperative slow or even bad evolution in two cases. The radiological, ultrasound and scanner control showing the reducing or disappearing of the abscess cavity after drainage in all the cases, represent an argument of the correct therapeutic approach.

Adult↗

[Surgical strategy in laparoscopic repair of hiatal hernia and procedures for gastroesophageal reflux].

The authors discuss about 68 celioscopy antireflux procedures, carried out for transhiatal hernia accompanied by gastroesophageal reflux, during a period of 8 years, between 1996 and 2003. The aim of this research is a clinical and technical comparative study, in fact between the posterior total or partial fundoplication and the anatomical procedures. In order to have a complete evaluation of the risks and results, the authors discuss the indications of each procedure, a series of specific intra and postoperative complications, including conversions and reinterventions, for each procedure. The authors also refer to the difficulty degree, the time required for each procedure, to find out the ways of improving these parameters. Although the number of patients is quite small, in this experience, posterior fundoplication seems easier and safer, whenever possible. The Nissen procedure, which technique is more laborious, seems to offer a better postoperative evolution and more long - lasting results in time.

Fundoplication↗

[Assessment of prognostic factors in breast cancer].

Prognostic factors predict the long term outcome of treatment, recurrence rate and overall survival. Treatment decision is based on assessment of prognostic factors. They are classified as clinical (age, menopausal status, tumoral growth rate, inflammatory signs), histological (tumoral stage, pathological type, grading, tumoral necrosis, lymph nodes status, margins status) and biological factors (steroidal receptors pattern, ploidy etc). There are tumor markers currently evaluated, being considered conventional and new markers that are not usually evaluated. Patients with negative lymph node will show no recurrences after surgery and/or radiotherapy in 70% of the cases. Factors with specific prognostic value are used for deciding on the therapeutic strategy in negative axillary node cases.

Biomarkers, Tumor↗

[Breast conservative surgery].

Breast conservative therapy is considered an adequate therapeutical method for early stage breast cancer. Breast conservative treatment consists of partial mastectomy, axillary dissection and radiotherapy. Patient selection is based on clinical, histological and individual factors. The frozen sections examination provides prompt differentiation between benign/malign lesions and precise assessment of the oncologic margins of the specimen. Preoperative marking of nonpalpable breast lesion with hook wire represents a progress for breast conservative treatment. Sentinel lymph node biopsy represents an alternative to axillary dissection, in order to reduce subsequent morbidity.

Breast Neoplasms↗

[Endometrial carcinoma in cases under 45 years of age].

Twelve cases of endometrial carcinoma admitted to the I-st Clinic of Obstetrics and Gynecology of Iaşi in the interval 1983-1988 are presented. The patients' age ranged between 33 years (1 case) and 45 years (1 case) with a mean age of 41.3 years. This study was underwent given the increased frequency of this lesion in the premenopausal women (9.3% of all cases recorded in the interval under study). The incidence of the disturbed menstrual cycle was of 58%, that of obstetrical antecedents and obesity of 33% and 50%, respectively. In two cases there was a carcinoma "in situ", the remainder of cases presenting disease in stage I (FIGO classification). The diagnosis was made preoperatively in 7 cases, the other 5 patients being operated upon for uterine fibromatosis. Adenocarcinoma was the most common histological type. The need of ascertaining the etiology of metrorrhagias no matter of patients' age and the role of risk factors and some methods of detection (endometrial cytology, endometrial biopsy) are underlined.

Adult↗