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Biomedical subjects

S Dubecz

Publications and source records attributed to S Dubecz.

At least 19 recordsLinked to original sources
PubMed2001

[Retrospective evaluation of surgically treated cases of non-palpable breast tumor].

Between 10.01.1997 and 09.30.1999 authors performed operations on 78 patients who had nonpalpable breast tumors. If mammography was considered abnormal during breast screening program patients were recalled. Besides clinical investigation complimentary mammograms were performed. After sonogram, and if needed, aspiration biopsy cytology (ABC) if necessary core biopsy (CB) was the next investigation. 79 operations were performed on 78 patients (one was patient had synchronous breast tumor). The mean age of the patients was 56.3 years. If the radiological investigations (R4-R5) and/or the ABC (C4-C5) or CB suggested malignancy operation was performed. Mammography suggested malignancy in 60.75% of the patients, it was suggested by ABC in 30.18%, and by CB in 55.5%. The nonpalpable tumor, suspected to be malignant was marked with a wire loop and was excised under anesthesia along with the affected breast sector. The excision and tissue-border around the tumor was checked by specimen mammography performed during the narcosis. No cryohistology was performed. After the specimen mammography, the wound was closed. The final histology of the operations showed malignancy in 40.5%. In their retrospective study the authors evaluated the complete sensitivity and the positive predictive value (PPV) of the preoperative investigations regarding the final histology. They analyse the value of preoperative mammogram, the ABC and CB in malignant and in benign cases. Early diagnosis and surgical treatment is expected to improve significantly the survival of patients with breast cancer. Reduction in the number of unnecessary operations can be expected from increasing the accuracy of radiological and cytological investigations and the adequate usage of core biopsy.

Biopsy, Needle↗
PubMed1998

[Malignant schwannoma of the breast].

Authors describe a malignant solitary schwannoma observed in the left breast of a 67-year old woman. Eight months after tumour removal the patient is symptom and complaint-free. The present case of breast schwannoma is the first clinical observation in the national and the 14th one in the world literature.

Aged↗
PubMed1996

[Gigantomastia in pregnancy].

A 26 year old women presented with huge enlargement of breasts from 10th week of her first pregnancy. Both breast became very swollen and painful, more than tripled in size. The skin became oedematous, red, and subsequently ulceration and bleeding occurred. Interruption performed at the 12th week, it didn't stop the process. 3 months later bilateral mastectomy with free transplantation of the nipples and the areoles to the abdominal wall was performed. The pathologic diagnosis was hyperplasia of the connective tissue elements with fibroadenomas. 6 and 8 years later she delivered healthy babies. The authors review the literature of gigantomastia during pregnancy with discussion of the treatment.

Abortion, Therapeutic↗
PubMed1995

Adverse consequences of increased intra-abdominal pressure on bowel tissue oxygen.

OBJECTIVE: Demonstrate the effect that increased intra-abdominal pressure (IAP) has on visceral oxygen delivery and bowel tissue oxygenation (TPO2). METHODS: Six Duroch swine underwent abdominal insufflation with helium to pressures of 15 and 25 mm Hg for 1 hour. Animals were instrumented with a pulmonary artery flotation catheter to measure cardiac output and calculate systemic oxygen delivery. Fluorescence quenching optodes were implanted in the terminal ileum and the subcutaneous tissue of an axillary fold to measure bowel and systemic (control) tissue oxygen levels, respectively. RESULTS: Bowel tissue oxygen fell from 43 +/- 12 mm Hg at baseline to 31 +/- 12 mm Hg, with 15 mm Hg of abdominal pressure at 60 minutes. With 25 mm Hg IAP, bowel TPO2 fell from 24 +/- 12 to 12 +/- 8 mm Hg (p < 0.02). No change in axillary TPO2 was observed during either period of increased IAP. Cardiac output (CO), systemic oxygen delivery, and mixed-venous oxygen saturation (Svo2) also declined, although blood pressure and oxygen consumption remained constant. CONCLUSIONS: Increased IAP produces significant decreases in bowel submucosal TPO2 without similar changes in extra-abdominal (subcutaneous) TPO2. This decline is dependent on the extent and duration of the elevation in IAP. Readily accessible parameters, such as CO and Svo2, also decline with increased IAP and may be useful variables to monitor as relative indicators of bowel hypoperfusion and TPO2.

Abdomen↗
PubMed1994

Complications of therapeutic laparoscopy.

Laparoscopic surgery holds great promise as a technique for reducing hospital stay and convalescence. Although advantages in hospital cost cannot be shown for all such procedures, improvements in technique and operator experience will undoubtedly improve the situation. Analysis of the pertinent physiologic aspects and complication rates indicates that laparoscopy is not minimally invasive, but rather exposes the patient to many of the risks normally incurred by open procedures. Enthusiasm for the use of these techniques must be tempered by good judgment and scientific evidence supporting equivalent or better long-term results at equal or lower rates of morbidity and mortality.

Appendectomy↗
PubMed1993

Tissue oxygenation in hypovolemic shock.

Bowel mucosal ischemia may be related to the development of systemic sepsis. Traditional indices of oxygen metabolism are flow-weighted averages which do not reflect tissue-specific oxygen concentration. We undertook this study to examine the relationship between systemic oxygen delivery (DO2) and tissue oxygen tension (TPO2) in hypovolemic shock. A modified Wiggers model was used to produce hypotension in five swine. TPO2 was measured continuously with fluorescence-quenching 1-mm probes placed in the submucosa of the terminal ileum and subcutaneously in an axillary fold. Shock was maintained for 1 hr, followed by resuscitation. Cardiac output, systemic and pulmonary arterial pressures, and arterial and mixed venous blood gases were measured every 15 min. Data were analyzed by nonparametric ANOVA and rank coefficients, with logarithmic curve fitting and linear regression. DO2 decreased with phlebotomy (P < 0.003) as did skin TPO2 (P < 0.001) and bowel TPO2 (P < 0.0004). Skin and bowel TPO2 varied with DO2 and each other (P < 0.05). TPO2 remained low throughout the shock period and returned to or exceeded baseline levels with resuscitation (P < 0.05). The following were concluded: (1) Hypovolemic shock produces a significant and rapid decrease in subcutaneous and bowel TPO2 with concomitant change in DO2. (2) The degree of bowel ischemia, clinically inaccessible for quantitation, is paralleled by subcutaneous TPO2. (3) TPO2 provides information about oxygen availability in shock and resuscitation not available from traditional parameters of oxygen transport.

Animals↗
PubMed1993

Helium insufflation for laparoscopic operation.

Laparoscopic surgical procedures are becoming simultaneously more commonplace and complex. However, carbon dioxide (CO2) pneumoperitoneum required for these procedures causes a respiratory acidosis. We undertook this study to determine if an alternate insufflating gas, such as helium, prevents this sequelae. Twenty patients undergoing elective laparoscopic cholecystectomy were randomized to receive either CO2 or helium insufflation. Intraoperative parameters, including arterial CO2 (PaCO2), end-tidal CO2, pH, bicarbonate (HCO3-), cardiac output and blood pressure were obtained before, during and at the conclusion of pneumoperitoneum. Effects of the two gases on these variables were compared. The average CO2 rose significantly from 35.7 +/- 1.0 to 50.4 +/- 3.2 (p < 0.0001), while pH decreased from 7.434 +/- 0.014 to 7.286 +/- 0.018 (p < 0.0001) in those who received CO2. No change in PaCO2 was observed in those who received He, although a small decrease in pH from 7.428 +/- 0.011 to 7.392 +/- 0.012 (p < 0.05) was observed. HCO3- decreased slightly in both groups. Increases in blood pressure and pulse rate were independent of the gas received. The cardiac output did not change. Helium insufflation for laparoscopic cholecystectomy does not produce the respiratory acidosis caused by CO2 and, therefore, merits further investigation for use, particularly in patients with underlying respiratory disease.

Adult↗
PubMed1990

The evaluation of safety drain after cholecystectomy.

In the literature there views are controversial concerning the use of safety drain after the so-called ideal cholecystectomy. Some authors consider it necessary, while others superfluous. Authors wish to voice their opinion based on the analysis of their own material. In the last 5 years a total of 771 gallbladder operations were performed at their clinic. Of them 472 were judged retrospectively to be ideal cholecystectomies. The safety drain applied in these cases was brought out in a separate opening in 72.7% and in the line of the wound in 27.3%. In the former case healing was accompanied by wound infection in 3.2%, while in that of the drains introduced in the line of the wound in 8.5%. The quality and quantity of discharge through the drains were studied. In the majority of cases a small amount of bloody serum was conveyed by the drain tubes, this amounting on average to 45 ml. A larger amount was only noted in a few cases: 300-450 and 800 ml of bloody serum, in 3 patients. In one case there was a more serious bile leakage associated with fever, while in another patient arterial bleeding through the drain tube was observed. In diagnosing these and judging our tasks, drainage was of great help. Based on this experience, authors consider the use of safety drain justified.

Cholecystectomy↗
PubMed1989

[The role of real-time sonography in the differential diagnosis of acute appendicitis and in the detection of post-appendectomy complications].

110 urgent sonography were performed on 101 patients with suspected acute appendicitis and on subsequent 26 patients 33 echography with suspected postappendectomy abscess. Although according to a few publications in connection with acute appendicitis there are characteristic sonographic signs, the authors didn't find any typical structures at patients having non-complicated appendicitis. But at perforated appendicitis and periappendicular abscesses the fluid collection was frequently very well visualizable and the periappendicular infiltration was detectable as well. The differentation between infiltration and abscess is difficult, often unsuccessfull. The authors confirm the high sensitivity of sonography in the detection of postappendectomy intraabdominal abscesses, similarly to other abscesses of unrelated origin. They emphasize the differentialdiagnostic aid of sonography, if the clinical symptoms are atypical or the signs of acute appendicitis are imitated by other disease.

Acute Disease↗
PubMed1989

Effect of proximal selective vagotomy on gastric prostaglandin content in the Shay-rat ulcer model.

During Shay-ulcer formation damages to the barrier of the gastric mucosa develop even before the appearance of macroscopic ulceration. Proximal selective vagotomy prevents these damages. Following pyloric ligation the prostaglandin content of the mucosa changes in parallel with the injuries of the mucosal barrier: TXB2 content of the forestomach increases, while PGF2 alpha content of both the forestomach and the antrum decreases. Following PSV operation the 6-keto-PGF1 alpha content of the mucosa decreases, whereas PGF2 alpha and TXB2 contents exhibit no alteration. As a combined effect of proximal selective vagotomy pretreatment and pyloric ligation the 6-keto-PGF1 alpha and PGF2 alpha contents of the mucosa remain low and the TXB2 increase, otherwise detectable after pyloric ligation, does not take place.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

[Experimental animal studies of the effect of selective proximal vagotomy on the prostaglandin content of the gastric mucosa in the Shay ulcer model].

Mucosa damage, these appear in the Shay ulcer model before the macroscopic ulceration, can be prevented by the selective proximal vagotomy. Changes of the potential difference and the prostaglandin content were discovered after pylorus ligation, and Thromboxane was increased, PGF2 alpha and TXB2 were nearly constant, whereas 6-keto-PGF1 alpha increased clearly in the rumen. The 6-keto-PGF1 alpha and the PGF2 alpha content and Thromboxane remained unchanged and the potential difference was normalized in case of selective proximal vagotomy and pylorus ligation. The SPV is significant as you know for the secretion of H+ion and bicarbonate, but also for the normalization of increased TXB2 on the basis of our investigation results.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

The effect of truncal vagotomy on the bicarbonate-ion secretion of the stomach in rat.

The effect of truncal vagotomy on the gastric bicarbonate-ion, H-ion and chloride-ion secretions of the rat was studied experimentally. In the first half hour after truncal vagotomy, besides the known decrease of the H-ion, also the bicarbonate-ion and chloride-ion secretions were found reduced. The decrease in bicarbonate ion secretion was smaller as compared to the H-ion secretion. After two hours, there was no difference in bicarbonate-ion and chloride-ion secretions as compared to the controls and to the vagotomized groups. According to their results, following truncal vagotomy applied in the surgical management of ulcer, the bicarbonate-ion secretion of the stomach decreases immediately after operation. This decrease is, however, only transitory the bicarbonate-ion secretion becoming normal within a short time.

Animals↗
PubMed1988

[Experimental animal studies on the significance of endogenous prostaglandins in maintaining the integrity of the stomach mucosa after truncal vagotomy].

The changes of the transmucosal potential difference, the ionic flow, and the prostaglandin content were investigated after pylorus ligation, truncus vagotomy, and pylorus ligation with truncus vagotomy in Shay rats. A damage of the mucosa appeared already 10 hours after the pylorus ligation. This was presented in a clear decrease of the transmucosal potential difference and a change of the ionic flow. These damages could be prevented by simultaneous truncus vagotomy. A decrease of the PGF2 alpha content in the gastric antrum and rumen as well as an increase of the TXB2 in the gastric rumen were observed after additional pylorus ligation. The 6-keto-PGF1 alpha and the TXB2 content in the gastric antrum and rumen increased after truncus vagotomy. TXB2 in the rumen, 6-keto-PGF1 alpha in the rumen and antrum, as well as PGF2 alpha in the antrum ascended after pylorus ligation with simultaneous truncus vagotomy. The truncus vagotomy shows additionally a protective effect for the mucosa and influenced synergistically the content in prostaglandin after these results besides the notorious importance for the secretion of H+ion and bicarbonate.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

The role of endogenous prostaglandins in maintaining the integrity of the gastric mucosa in Shay's ulcer model after truncal vagotomy in rat.

The changes in the difference in the transmucosal potential of the stomach, in the ion flux of the mucosa and the prostaglandin content of the mucosa were studied after pyloric ligation combined with truncal vagotomy in rats. Results indicate that 10 hours following insertion of the pyloric ligation, and still prior to appearance of macroscopic ulceration, the mucosal barrier is damaged indicated by the decrease in PD value and by a changed ion flux. The development of these changes is prevented by truncal vagotomy performed simultaneously with pyloric ligation. Following pyloric ligation, simultaneously with the damage of the mucosal barrier, the PGF2 alpha concentration of the antrum and the rumen decreased. The 6-keto-PGF1 alpha content remained unchanged, while TXB2 content of the rumen increased. After truncal vagotomy the 6-keto-PGF1 alpha level of the antrum and the rumen and the TXB2 level of the rumen are increased. After truncal vagotomy performed simultaneously with pyloric ligation, the TXB2 content of the gastric mucosa increases with an increase also in the 6-keto-PGF1 alpha level of the rumen and the antrum and one in the PGF1 alpha content of the antrum, too. It is assumed that the beneficial effect of truncal vagotomy on the mucosal barrier is due to factors which are the known (i) decrease in H-ion secretion (ii) the unchanged bicarbonate secretion and (iii) the influencing of the prostaglandin level of the mucosa.

Animals↗
PubMed1987

Malignant teratoma of the left colon associated with chronic ulcerative colitis.

An autopsy case of a malignant teratoma of the descending colon is presented, the first observed in this site. A 41-year-old woman had suffered from chronic ulcerative colitis and was operated because of an abscess forming a mass in the left colon. However, the tumour proved to be inoperable and the patient died from septicaemia. Histologically, the tumour was a highly metastasizing malignant teratoma containing mature tissue elements (hair, cartilage, adipose tissue, squamous epithelium, bronchial, endometrial and cervical tissues). The relationship between the ulcerative colitis and the teratoma is obscure.

Adult↗