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Biomedical subjects

M Vician

Publications and source records attributed to M Vician.

At least 19 recordsLinked to original sources
PubMed2003

The abdominal compartment syndrome.

The abdominal compartment syndrome has received considerable attention only recently. It may be defined as adverse physiologic consequences that occur as a result of an acute increase in the intraabdominal pressure. The most common causes of ACS are haemorrhage, visceral oedema, pancreatitis, bowel distension, venous mesenterial obstruction, abdominal packs, tense ascites, peritonitis, tumor. The mostly affected organ systems include cardiovascular, pulmonary, renal, central nervous and splanchnic. The diagnosis depends on the recognition of the clinical syndrome followed by an objective measurement of intraabdominal pressure, preferably that of the urinary bladder. The treatment consists of adequate fluid resuscitation and surgical decompression when necessary. (Tab. 1, Ref. 29.).

Abdomen↗
PubMed2000

[The "open abdomen" as one of the possible therapeutic alternatives in postoperative complications].

The authors discuss the important problem of healing, infection of surgical wounds and causes of healing per secundam. Despite efforts on the part of surgeons to close the surgical wound, in particular in old people with polymorbidity, hypoproteinaemia and anaemia, disintegration of the surgical wound may occur which cannot be closed and healing must proceed while the abdomen is open.

Abdomen↗
PubMed2000

[Gastroduodenal hemorrhage].

Haemorrhage is a serious complication of peptic ulcer disease. It is an indication for urgent diagnostic and therapeutic endoscopy, which is at present the method of first choice. All patients with gastroduodenal peptic ulcer bleeding, who underwent endoscopy in Ist Department of Surgery in Bratislava between January 1995 and December 1999, were considered for retrospective study. A total of 291 patients (195 male and 96 female) underwent urgent endoscopy with a finding in 34.7% of patients with gastric ulcer and in 65.3% patients duodenal ulcer. The finding was Forrest I in 23%, Forrest II in 25.7% and Forrest III in 51.3% patients. Endoscopic hemostasis was used in 12.37% of patients. A first haemorrhage was found in 82.9% patients, a recurrent one in 17.1% patients. 41.5% of patients had positive peptic ulcer history. Surgical treatment was indicated in cases, when bleeding was not controlled by endoscopic means, or in cases of recurrent bleeding within 48 hours in 19 patients (6.52%).

Female↗
PubMed2000

[Surgical treatment of acute diverticulitis of the large intestine].

The authors analyze in this paper covering a ten-year period (1990-1999) a group of patients with acute perforated diverticulitis. The patients were classified according to Hinchey's classification. During this period 35 patients were operated with a high preoperative morbidity. With regard to the low number of complications of acute diverticulitis the authors do not prefer early preventive resections of non-complicated diverticulitis, but they tend to extend indications, first of all in cases of repeated recurrences, haemorrhage and in case of stenosis. In the IIIrd and IVth stage according to Hinchey's classification dominates Hartmann's operative procedure. But the authors agree with the trend to perform resection with primary anastomosis in the IIIrd stage, especially in cases of a good status of the patient and short duration of the disease. In cases of acute perforated diverticulitis operated in the first 24-hour interval the mortality rate was 23.1%.

Acute Disease↗
PubMed2000

[Compression therapy of leg ulcers].

The authors present a group of 76 patients with chronic venous insufficiency in the stage or crural ulceration. After staging of the disease (C 6, E prim, E sec, A sup. pr. ref., P re) in the first stage they used a conservative approach, the method of compressive bandages: either an elastic bandage or zinc-glue bandage (Varolast). 49 patients were cured by conservative treatment (64.5%) in the course of 5 months. 12 patients were indicated for surgery (15.8%). Thus the authors cured finally 80.2% patients. A relapse was recorded in 6 patients (7.8%) and in 9 patients treatment failed (11.8%). For treatment with zinc-glue bandages they recommend patients without obstruction in the deep venous system, with large chronic ulcers and associated oedema of the whole leg.

Bandages↗
PubMed1999

Melatonin content in plasma and large intestine of patients with colorectal carcinoma before and after surgery.

The distinct melatonin rhythm with higher concentrations during the darktime was found in plasma of both control patients and patients with colorectal carcinoma. Moderate surgery did not induce any changes in plasma melatonin levels, but a pronounced increase in both the day- and nighttime melatonin concentrations was found after surgical treatment for colon cancer. The melatonin content in the tumor tissue did not differ from that in the proximal and the distal parts of the resected gut, which were without signs of malignant changes. Neither concentrations of serotonin nor 5-hydroxyindole acetic acid differed among analyzed parts of the gut. Daytime melatonin concentrations in gut tissue (314.7 +/- 87.8 pg/g of wet tissue) were more than ten times higher than the daytime levels in circulation. It was hypothesized that increased levels of this hormone in the gastrointestinal tract may play an important protective role against the development of colorectal cancer via stimulation of the immune system, protection against free radicals, and interaction with fatty acid uptake and metabolism.

Aged↗
PubMed1999

[Quo vadis the azygo-portal disconnection].

Based on experience at their department since 1983 the authors analyze the position of the azygoportal disconnection in the treatment of complications of portal hypertension. During the observation period the number of operations declined due to extensive use of endoscopic diagnosis and treatment. However the azygoportal disconnection still remains part of surgical intervention in indicated cases, in particular in secondary hypersplenism and profuse haemorrhage.

Adult↗
PubMed1999

[Laparostomy in the treatment of severe intra-abdominal infections].

The objective of the work was to evaluate the results of comprehensive treatment of protracted primary and secondary intraabdominal infection. Retrospective analysis of a group of patients in 1994-1998 using laparostomy, peritoneal lavage, thorough repeated cleansing of the peritoneal cavity, microbiological monitoring with subsequent aimed antibiosis and comprehensive intensive care provide evidence of the rescue of almost 40% liminally curable patients. The results justify the use of comprehensive therapeutic procedures in late stages of serious peritonitis.

Abdomen↗
PubMed1999

[Occurrence of tumors of the small intestine].

The authors present in this article the occurrence of the tumors of small intestine in the group of patients operated on at the Ist Department of Surgery, Teaching Hospital of Commenius University in Bratislava in the years 1957-1997. During this period 39 primary tumors of small intestine were registered, 29 of them being malignant. Histologically, the most frequent malignant lesion was adenocarcinoma, and the most frequent benign lesion adenomatous polyp. The highest frequency of occurrence of tumors of small intestine was in the 6th and the 7th decennium. (Tab. 4, Ref. 11.)

Adult↗
PubMed1999

[Laparoscopic vagotomy in the treatment of recurrent duodenal ulcer].

The paper represents our results of laparoscopic vagotomies. In 1993 was the first successful laparoscopic vagotomy in Slovakia performed, at the 1st Department of Surgery, Faculty Hospital, Bratislava. From this time 10 operations with front superselective and dorsal truncal vagotomy were performed. Effectiveness of vagotomy was controlled after 12 months by examination of the gastric acidity. Decrease of gastric acidity in average above 61% was reached. Laparoscopic vagotomy, despite dominant conservative treatment of peptic ulcer, is the method of choice, if the conservative treatment is unsuccessful. (Fig. 3, Ref. 6.)

Adult↗
PubMed1999

[Methods of hemostasis in upper digestive tract hemorrhage].

The authors describe methods of haemostasis used nowadays in haemorrhage from the upper digestive tract. Based on evaluation of their own group of 91 patients with haemorrhage of this type they found that 13.2% of the patients with haemorrhage required surgery, when the haemorrhage was localized, 16.4%. Comprehensive treatment and endoscopic methods of haemostasis predominate while surgical treatment is used when non-surgical methods fail. The results are in favour of revision of the surgeon's position in the treatment of patients with haemorrhage from the GI tract.

Adult↗
PubMed1992

Acute development of low T3 syndrome and changes in pituitary-adrenocortical function after elective cholecystectomy in women: some differences between young and elderly patients.

From two groups of female patients (young group: 15 patients aged less than 25 years; elderly group: 15 patients aged more than 65 years) who were subjected to cholecystectomy, blood samples were obtained on the day before surgery, on the day of surgery before premedication and after waking up from anaesthesia and also on days 1, 3 and 7 after surgery. In aliquots of sera the levels of TSH, ACTH, thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (rT3) and cortisol were estimated with the aid of radio-immunoassay (RIA). The differences between the young and elderly subjects were evaluated with the aid of four different statistical tests. Though no changes in the level of T4 were found, the level of T3 was significantly decreased and that of rT3 was significantly increased on Day 1 after surgery. However, the decrease of T3 was expressed more significantly in the young group and, in addition, an increase of rT3 in the same group was found even before premedication. The level of TSH showed a sharp increase at the end of surgery, which was expressed more in the young group. Though no differences between groups were observed in a sharp peak of the ACTH level during surgery, the increase of cortisol level in the elderly group was significantly higher and remained so during the post-operative period.

Adrenocorticotropic Hormone↗