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Biomedical subjects

R Palade

Publications and source records attributed to R Palade.

At least 19 recordsLinked to original sources
PubMed1995

[Paget's disease of breast--a special form of breast cancer].

The incidence of Paget's disease of the breasts (15 cases) among 701 operated breast cancer was 2.1%. All studied cases were women. Over two-thirds of the patients were at menopause at the time of diagnosis. The interval between the clinical onset of disease and the histological diagnosis was approximately of 21.4 month. The clinical diagnosis was based on the presence of the characteristic erythemato-squamous lesion. In five cases a palpable mass was found. We registered one case of bilateral metachronous Paget's disease. Four patients had axillary lymphadenopathy: three of them presented with palpable mass. Mammography, cytology and histological examination from biopsy were the principal means of diagnosis. There were 10 women in stage, two women in stage II, and three women in stage III. The surgical treatment was the major component of treatment. The best prognosis was registered in the cases without a palpable mass in the breast and axillary lymphadenopathy with 5-year survival in four of five cases.

Biopsy↗
PubMed1994

[The diagnostic and surgical treatment characteristics in gastric ulcer].

The work analyses a number of 283 patients suffering from gastric ulcer, which were hospitalised and operated between 1981-1991. In 64% of cases the surgical treatment decision was an emergency one for major complications of this disease such as: the upper digestive hemorrhage (27%), penetration (22%), perforation (11%), digestive stenosis (4%). In 36% of cases the decision of operation was taken for different reasons: unsatisfactory evolution under the conservatory treatment, the existence of an irreparable anatomic lesion, the recurrent ulcer or the difficulty of differential diagnosis between gastric ulcer and gastric carcinoma. It is important to indicate that the two of the major investigations: the barium transit and the fiber gastroscopy failed in giving a correct relation in 5 to 10% between gastric ulcer and gastric carcinoma. In 87% of patients it was performed the gastric resection type Péan. The lifting of the lesion in 7% of our observations needed the gastric resection on type Pochet. In the gastric ulcers Johnson II type, when the duodenal lesion couldn't be lifted we added to the Hoffmeister-Finsterer gastric resection type with truncal vagotomy. In 9% of patients with perforated or hemorrhagic gastric ulcer, the vital rise was a major one, so we performed only suture the lesion. We registered 3 deaths (1.06%).

Adult↗
PubMed1991

[The diagnosis and therapeutic approach in acute necrotic-hemorrhagic pancreatitis].

The work contains the clinical and therapeutic analysis of a group of 72 patients with acute necrotic-haemorrhagic pancreatitis (ANHP), admitted in the period 1979-1989 to the Ist Surgical Clinic of the Municipal Clinical Hospital of Bucharest. The etiology of ANHP, its clinical forms of manifestation, the peculiarities of shock and its dynamic course are shown and discussed. Stress is laid on the criteria of severity, on the course and on the complications occurred. The therapeutic results are commented in detail and the mortality is studied in a complex way, by analysing both the terminal clinical manifestations and the results of anatomicopathological examinations.

Acute Disease↗
PubMedDate not supplied

Stimulation of mucosal immune response following oral administration of enterotoxigenic Escherichia coli fimbriae (CFA/I) entrapped in liposomes in conjunction with inactivated whole-cell Vibrio cholerae vaccine.

In this study, we have searched for an effective mucosal vaccine. An oral enterotoxigenic E. coli vaccine containing colonization factor antigen (CFA/I) associated with inactivated whole-cell V. cholerae vaccine (WCV) has been tested for safety and immunogenicity in animals. Five groups of animals were used. The results showed the following: (a) vaccine containing CFA/I antigen entrapped in liposomes and associated with WCV (batch C) had increased titers of specific antibodies to CFA/I antigen in 15 to 18 (83.3%) animals; (b) specific Peyer's patches (PP), lymph nodes (LN) and spleen (SPL) lymphocytes proliferation was detected following in vitro restimulation with CFA/I antigen or WCV. This response gradually increased to the highest value by the 35th postimmunization day. Moreover, lower PP, LN and spleen (SPL) proliferation was observed in rabbits receiving soluble CFA/I antigen (S-CFA/I) or free liposomes (F-L) alone; (c) adhesion of E. coli H10407 strain labelled with 3H-leucine in immunized and control animals revealed the following local effects: (i) protection of rabbit intestinal mucosa against virulent E. coli cells; (ii) inhibition of adhesion of ETEC bacteria to intestinal mucosa and (iii) significantly faster release of E. coli H 10407 strain labelled with 3H-leucine from the intestinal tract of immunized animals. The histopathological and electron microscope findings confirmed the above results. The experimental results point out an efficient protection against infection with E. coli strains (ETEC), after mucosal vaccination with CFA/I antigen entrapped in liposomes associated with inactivated whole-cell Vibrio cholerae as immunological adjuvant.

Administration, Oral↗
PubMedDate not supplied

[Acute necrotizing pancreatitis following abdominal trauma].

We present 11 cases of acute necrotizing pancreatitis following abdominal trauma operated in our clinic during the last five years. All patients except one were male. All of them had obvious symptoms of acute diffuse peritonitis when they came to hospital. The diagnosis was established by CT scan in four observations. All operations were performed during 12-36 hours after they came. During surgery, there was complete pancreatic necrosis in seven cases and incomplete in the other four cases. Associated injuries following trauma were represented by: hemothorax--two cases, spleen injury--one case, lesion of mesentery--one case, intestinal lesion--one case. In all cases we performed a wide opening of the lesser sac, pancreatic capsulectomy, necrosectomy and multiple drainage of the pancreatic side (behind the peritoneum) and peritoneal cavity. The postoperative outcome was difficult in all cases. Postoperative morbidity recorded pancreatic leakage (three cases), pseudocysts (two cases) and a perforation of gastric wall. There were 10 cases cured and one patient died.

Abdominal Injuries↗
PubMedDate not supplied

[The Fitz-Hugh-Curtis syndrome in laparoscopic surgery].

The Fitz-Hugh-Curtis syndrome was diagnosed intraoperatory at 7.1% of the laparoscopic cholecystectomies in our clinic. The attitude in all cases was to perform a complete adhesiolysis. The reasons we consider that support this are: 1. the adhesions that fix the liver to the diaphragma do not allow the surgeon a comfortable access to perform cholecystectomy; 2. if these adhesions are torn accidentally during operation it could end up to the glissonian sheath rupture and uncontrollable bleeding; 3. adhesiolysis might be imposed in order to introduce the ports under visual control; 4. the traction determined by the perihepatitis process against the parietal peritoneum could be responsible for postoperative right quadrant pain; 5. the hepatodiaphragma adhesions make impossible the suction of the intraoperative secretions. A complete adhesiolysis allow a correct lavage of the suprahepatic area preventing the possible retention of clots, bile or even calculi. We didn't notice neither a longer duration of the intervention due to adesiolysis nor intra/or postoperative complications.

Aged↗
PubMedDate not supplied

[Ascites--a complication of chronic alcoholic pancreatitis].

We present the case a 44 year old patient previously diagnosed with chronic alcoholic pancreatitis with pancreatic ascites during hospitalization in the Gastro-Enterology department. As the conservative therapy performed for 21 days was not effective in diminishing the ascites, the patient was admitted in our Surgical Department and scheduled for surgical intervention. He was operated and we discovered a small dimension cyst (7/4 cm) developed in the body and tail of the pancreas, fistulized in the peritoneal cavity through an outlet positioned below the insertion of the mesocolonum transversum, fairly close to the duodeno-jejunal angle. We executed a cysto-jejunal anastomosis by using the first loop of the jejunum, secured with a politer drainage positioned as in WITZEL technique and drive out in the left upper quadrant. The postoperative evolution of the patient was difficult, but constantly positive. The patient left the hospital 32 days after the intervention. The clinical and ultrasound follow-up after three months were normal.

Adult↗
PubMedDate not supplied

[Surgical treatment of great median upper and/or lower abdominal incisional hernias with mesh placed in the rectus sheath(behind the muscle)].

We present our experience concerning surgical treatment of great upper and/or lower abdominal incisional hernias, by the technique using a mesh placed in the rectus sheath. Durind 5 years, we operated 42 cases. The features of our trial were: average age--56 years; female prevalence--40 cases (95%); great obesity rate (15 observations--35%). The early postoperative morbidity was represented by (number of cases): thrombophlebitis (2), prolonged postoperative ileus (3), seromas (7), prolongs hemorrhagic drainage (3), hematomas (2). We recorded no death. The late postoperative morbidity (number of observations) recorded granulomas (3) and recurrency (2). We obtained good and very good results in 37 cases (88%).

Adult↗
PubMedDate not supplied

[Technic, indications and contribution of choledochoscopy in the diagnosis and treatment of biliary diseases].

Choledochoscopy it's a common method of intraoperative exploring of the extrahepatic biliary ducts and partially of the intrahepatic ones. He is used both in the open and laparoscopic surgery. We consider the operative cholangiogram, preferably transcystic, as a first step who precedes the endoscopic exploration. The transcystic choledochoscopy has specific and relatively narrow indications: undulated biliary ducts, 1-3 gallstones. The transcholedocian choledochoscopy permit a direct and complete exploration of the biliary ducts. The important diagnostic help that fibrocholedochoscopy gives in, it's accomplished by the possibility of therapeutic maneuvers (especially the gallstones extraction), which offers the quality of a miniinvasive, elegant and harmless treatment technique.

Bile Duct Diseases↗
PubMedDate not supplied

[Laparoscopic cholecystectomy of cirrhotic patients].

In a period of 9 years in our clinic were performed 18 laparoscopic cholecystectomies (1.5%) at cirrhotic patients. In most of the cases (16) cirrhosis was diagnosed intraoperative. Retrospective, suggestive for a chronic hepatic disease were: patient history (9 cases), transaminases elevations (all cases), low platelet number (8 cases) and some echographic findings (6 cases). Laparoscopic cholecystectomy was difficult in all cases. Conversion to open surgery was necessary in one case because of an important hemorrhage from gallbladder bed. No diseases were recorded. Laparoscopic cholecystectomy is proven as a secure operation and with incontestable advantages comparing to open surgery.

Aged↗
PubMedDate not supplied

[Laparoscopic cholecystectomy during pregnancy].

Cholecystectomy is after appendectomy the second most frequent surgical procedure made in pregnant women. The operation is indicated in all cases of symptomatic gallbladder stones which do not respond to medical treatment and all complicated forms such as acute cholecystitis or acute pancreatitis. Laparoscopic cholecystectomy, considered in the beginning as a high risk procedure both for mother and child, is nowadays safer and useful comparing to open surgery. Our limited experience can confirm this. There were operated two pregnant (2nd and 6th month of pregnancy) with acute cholecystitis. There were no intraoperative incidents or accidents, no postoperative complications and no problems in pregnancy evolution after operation. This presentation emphasis the particular technical problems due to pregnancy during laparoscopic cholecystectomy, aspects concerning anesthesia and preoperative monitoring of mother and child.

Adult↗
PubMedDate not supplied

[Gall bladder carcinoma].

The study comprises a lot of 989 cholecystectomies for gall bladder lithiasis performed in the First Surgery Clinic of the University Emergency Hospital of Bucharest throughout three years and a half (2000-June 2003). Half out of them--493 cases (50%)--were laparoscopic interventions. All of the organ material was submitted to pathological examination. In 4 cases (0.4%), all females, the pathologist surprisingly unveiled the diagnosis of gall bladder carcinoma in the 3rd stage of evolution for all of them. None of the observations presented beforehand or per operative hints suggestive for a malignant affliction. Three patients associated multiple pathology such as acute pancreatitis (obs No2), common bile duct lithiasis (obs No3) and cholecysto-duodenal fistula (obs No4). The postoperative evolution of gall bladder neoplasia of the 4 cases studied was extremely fast, the patients soon being readmitted in our clinic for jaundice, subhepatic tumoral mass and liver metastasis, on average after 31 days after cholecystectomy. That was why the reinterventions were confined to limit at exploratory laparotomies only.

Aged↗
PubMedDate not supplied

[The importance of forseeing and early diagnosis of thromboembolic disease].

The aim of this study is to assess the incidence of thromboembolism in laparoscopic cholecystectomies. 100 unselected patients undergoing laparoscopic procedures performed by the same team were studied. All patients received preoperative prophylaxis with low/molecular weight heparin (LMWH), which was continued until full mobility. Four cases of deep venous thrombosis of lower limbs were clinically identified and confirmed by means of Doppler ultrasound examination. There were no cases of pulmonary embolus. Deep venous thrombosis occurred during the prophylactic administration of LMWH in the fourth postoperative day, consequently intravenous treatment with Heparin and then with oral anticoagulants was required. In each observation the operation took more than one hour. Among the patient-dependent risk factors, we have identified: age above 40 years, obesity, history of deep venous thrombosis, localized preoperative infection, congestive cardiac failure. Although the thromboprophylaxis has been performed within the laparoscopic surgery similar to that recommended in the classical procedures, when a high risk has developed the illness started. We underline the importance of a careful postoperative clinical monitoring in order to prevent the serious accidents that may appear.

Adult↗