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Biomedical subjects

R Kovach

Publications and source records attributed to R Kovach.

7 recordsLinked to original sources
PubMed1996

Cystic hygroma of the chest wall: a rare condition.

Cystic hygroma of the chest wall is a very rare condition. A review of the literature showed only 15 cases reported worldwide. The authors report a case of cystic hygroma of the chest wall in a male infant 2 months of age that was successfully treated with surgical excision in one stage. The diagnosis was made by physical examination with transillumination and by its typical sonographic pattern. The diagnosis was confirmed by histopathological examination and there is no evidence of recurrence after 24 months of follow-up. A review of the literature, updating the embryology, classification, and treatment of the disease, is also presented.

Humans↗
PubMed1996

Coumadin necrosis of the skin: report of four patients.

Necrosis of skin and soft tissue as a complication of oral anticoagulation therapy is a rare condition with approximately 200 cases documented in the world. Coumadin-induced skin necrosis is a painful skin lesion, sudden, localized, initially erythematous or hemorrhagic, that becomes bullous and eventually culminates in gangrenous necrosis. It develops mainly in women around 50 years of age who are usually obese and have been treated for thrombophlebitis or pulmonary embolism. There seems to be a marked predilection for areas with increased subcutaneous fat content, such as breasts, thighs, and buttocks. The injury is so significant that plastic surgery is frequently required to repair the damaged tissue. The authors present four clinical cases of Coumadin necrosis, observed in two different institutions, and perform a literature review on the mechanisms that trigger the development of the disease. This condition still remains a diagnostic-therapeutic challenge.

Adult↗
PubMed1990

Mohs micrographic surgery.

Mohs micrographic surgery has been highly successful in treating skin cancers that grow in a contiguous manner. The technique requires removal of involved tissue in thin layers and histographic mapping to pinpoint residual tumor. This process is repeated until all of the tumor is resected. This allows 100 percent of all margins to be examined and is very tissue conservative, attributing to its unsurpassed cure rates and excellent cosmetic results. Since it is done as an outpatient procedure under local anesthetic, it also is safe and efficient.

Basal Cell Carcinoma↗
PubMed1989

Surface electrocardiogram in the detection of transmural myocardial ischemia during coronary artery occlusion.

To examine whether coronary occlusion causing transmural ischemia was accurately reflected by ST-segment elevation on routine electrocardiograms, intracoronary and surface electrocardiograms were simultaneously recorded during percutaneous transluminal coronary angioplasty (PTCA). The study group consisted of 54 patients who had intracoronary ST-segment elevation during transient coronary occlusion (left anterior descending [LAD]: 25 patients, left circumflex [LC]: 19 patients, right coronary artery: 12 patients). Elevation of the ST segment on the surface electrocardiogram (greater than or equal to 0.1 mV) was recorded in 84% of patients during LAD dilatation, in 32% of patients during LC dilatation (p less than 0.01 vs LAD and right), and in 92% of patients during right coronary dilatation (not significant vs LAD). The magnitude of intracoronary ST elevation was 1.10 +/- 0.8, 1.68 +/- 1.2 and 0.8 +/- 0.6 mV for the LAD, LC and right occlusions, respectively (not significant). Thus, despite the comparable magnitude of intracoronary ST elevation, LC occlusion resulted in ST-segment elevation on the surface electrocardiogram in significantly fewer patients than did LAD or right occlusion. During LC occlusion, 9 patients had no electrocardiographic changes and 4 had only precordial ST depression. Thus, in patients with transmural ischemia during right or LAD occlusions, concordant ST elevation on the surface electrocardiogram is common. In contrast, ST-segment elevation is an insensitive marker of LC occlusion. In patients with ongoing ischemic symptoms and isolated precordial ST depression or no repolarization abnormalities, LC occlusion should be considered in the differential diagnosis.

Adult↗
PubMed1989

Interventional treatment in evolving myocardial infarction.

Residual myocardial function has been shown by many investigators to be a key factor in determining survival following acute myocardial infarction. In light of this, much effort has been undertaken to develop means of preserving myocardium in the setting of acute myocardial infarction. Acute revascularization has been approached as a logical method to reach this end. The development of more effective thrombolytic agents, better catheter dilatation systems, and improved surgical techniques have now made acute intervention possible, safe, and practical. Because of the marked clinical variability of patient presentation, as well as variability of available medical and surgical resources, a rational and logical system of approach must be developed, such that patients presenting with acute myocardial infarction can receive the most appropriate interventional therapy in any given setting.

Angioplasty, Balloon↗
PubMedDate not supplied

Diagnosing and treating congenital melanocytic nevus simulating malignant melanoma.

Many cases reported as malignant melanomas arising in benign congenital melanocytic nevi in the neonatal period have not shown evidence of metastases after several years of follow-up. These lesions were probably pathologically misdiagnosed, thus creating a controversy regarding the precise incidence. This article describes the case of an infant with a giant melanocytic nevus simulating malignant melanoma to illustrate the proper criteria for diagnosis of this condition so extensive and unnecessary therapy procedures can be avoided.

Diagnosis, Differential↗