Biomedical subjects
D Maziak
Publications and source records attributed to D Maziak.
Pre- and postresection thoracic washings in non-small cell carcinoma of the lung: a cytological study of 44 patients without pleural effusion.
The presence of malignant pleural effusion in patients with non-small cell bronchogenic cancer has a poor prognostic significance and is indicative of advanced disease (T4, IIIB). The present study will investigate the role of cytology and identify the various cellular components seen in thoracic washings, in the absence of an effusion, and will identify the potential pitfalls in diagnosing these specimens. The sensitivity, specificity, and positive and negative predictive values will be determined, as well as the associated predictive factors. From November 1996 to July 1997, 96 thoracic washings were performed on 44 patients with non-small cell carcinoma of the lung prior to and following resection. The specimens were processed routinely. To assess the false-negative or false-positive cases, all cases were rescreened and then correlated with the surgical pathology. Seven (15.9%) patients had positive findings detected on the pre- and/or postresection thoracic washings. One (2.3%) patient had a negative preresection, but cytologically atypical cells were found on the postresection. Thirty-six (81.8%) patients had negative pre- and postresection thoracic washings. There were no false-positive diagnoses in the study; however, two false-negative diagnoses were made. The finding of positive cytology in 7 of 44 (15.9%) patients appears significant. Thoracic washings may provide evidence of cancer beyond the pleura in patients without pleural effusion which may be indicative of advanced disease.
Sudden rupture of an indirect inguinal hernial sac with extravasation in two patients on continuous ambulatory peritoneal dialysis.
Continuous ambulatory peritoneal dialysis (CAPD) is commonly used to treat patients suffering from end-stage renal failure. This method can be used on a long-term basis and in the short term for patients awaiting renal transplantation. Inguinal hernias are a potential source of morbidity for these patients. Therefore, when patients with inguinal hernias require long-term peritoneal dialysis, the hernia should be repaired if the patient's medical status will allow it. The authors report on two patients maintained on CAPD who experienced rapid enlargement and perforation of a previously undiagnosed asymptomatic inguinal hernia. The hernia was repaired successfully, without complication, in both cases.
A Jejuno-ileal Bypass Patient Presenting with Recurrent Renal Stones due to Primary Hyperparathyroidism.
In the past, jejuno-ileal (JI) bypass operations were performed for the treatment of massive intractable obesity. This procedure is known to be complicated by numerous malabsorptive syndromes, occasionally resulting in electrolyte abnormalities and oxalate renal calculi. Recurring renal stones and oxalate nephropathy are cause to reverse the JI bypass. However, investigation of recurring renal stones should be done to exclude causes that are not secondary to the bypass procedure itself. We present a patient 13 years post JI bypass with recurring renal calculi due to primary hyperparathyroidism.
Management of papillary carcinoma arising in thyroglossal-duct anlage.
Cysts of the thyroglossal duct are common congenital abnormalities. They present as asymptomatic midline cervical swellings. The risk of malignant change is low; only 103 cases have been reported in the world literature, 85% of which were papillary adenocarcinomas. The appropriate treatment for this condition remains controversial. The authors describe three patients who had papillary carcinoma contained within a thyroglossal-duct rest. All were treated by cyst resection and thyroid suppression, but without thyroidectomy and radioactive thyroid ablation. Postoperatively, all patients remained disease free, with no recurrence at follow-up ranging from 10 to 29 years. Isolated papillary carcinomas arising from primitive thyroid remnants, associated with a palpably normal thyroid gland at surgery and a negative thyroid scan, can be treated adequately by excising the thyroglossal mass.
Visceral infarction caused by cocaine abuse: a case report.
Cocaine abuse is now known to result in a wide variety of medical illnesses. We report our experience with one patient who had abdominal pain and was found to have near-total infarction of all abdominal viscera. The cause of this and other medical complications of cocaine abuse (i.e., extreme vasoconstriction) is discussed in detail. Physicians should maintain a high index of suspicion when dealing with complaints of abdominal pain by cocaine users.
A simple method for laparoscopic cholangiography.
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