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Biomedical subjects

I Rozsos

Publications and source records attributed to I Rozsos.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Treatment of recurrence and complications following non-surgical management of cholelithiasis].

The authors performed cholecystectomy on 9 patients either while on oral BAT, or after the termination of oral BAT. Five cases of the operation were due to hydrops, 3 cases due to obstructive cholecystitis, and one case due to contraction of the gallbladder in the absence of gallstones. Two patients underwent operation after PTCL, while one patient was operated on after ESWL. In all 12 cases serious adhesions were noticed around the gallbladder. Cholecystectomy was made complicated by the fact that in 11 cases there was cicatrized thickening of the wall of the gallbladder: one of the cases was even coupled with Mirizzi syndrome. After ESWL, the wall of the gallbladder did not thicken, however the adhesions left impressions on the hepatic duct which caused diagnostic problems. In ten cases, micro-, and in two cases mini-laparotomy was employed. The patients were discharged from hospital 24-72 hours after cholecystectomy. It is obvious that after the non operative treatment of cholelithiasis, with the preservation of the gallbladder, the reoccurrence of the gallstones is always coupled with complications which then render cholecystectomy more difficult to perform. In such cases the gallbladder is much more safely removed by employing micro- and modern mini-laparotomy.

Adult↗
PubMed1994

[Ileal intussusception, caused by fibroma, after cholecystectomy performed under microlaparotomy].

The development of minimally invasive surgery for the management of cholelithiasis has been based on the premise that abdominal exploration during cholecystectomy is unnecessary. In the current study, 575 patients undergoing micro- and modern mini-laparotomy cholecystectomy were evaluated to assess the incidence and significance of undetected intra-abdominal pathology. In one instance an intussusception occurred from an ileal fibroma. This patient required a reoperation on the 20th postoperative day, after the removal of the porcellaneous gallbladder. After the primary resection of the tumor and affected bowel area, the patient recovered completely. During 575 cholecystectomy, performed with the micro- and modern minilaparotomy method, only in one patient (0.17%) was significant pathology not detected.

Adult↗
PubMed1994

Micro- and modern minilaparotomy cholecystectomy.

The issue minilaparotomy cholecystectomy has not been clearly defined. For the purpose of discussion, microlaparotomy cholecystectomy (MLC) is less than 4 cm coeliotomic incision, modern minilaparotomy cholecystectomy (MMLC) from 4.1 to 6 cm and the conventional minilaparotomy cholecystectomy (CMLC) from 6.1 to 8 or 10 cm long abdominal incisions. The object of our paper is a presentation of our experiences during 607 MLC and MMLC developed as alternatives to laparoscopic cholecystectomy (LC) as well as conventional cholecystectomy (CC). There were 435 women and 172 men. The youngest patient was 15 years old, and the oldest 87 years old. (Death rate: 0.16, early reoperation: 0.49%, conversion rate: 0.49.) Only 156 of the 607 patients were designated as simple cases. The most complicated patients were encountered in the obstructive cholecystitis group. The 9 significant complications of the 11 encountered during 607 MLC and MMLC belonged to the delayed group. MLC and MMLC did not require sophisticated expensive technology or specialized skill, and therefore it could be available in any general hospital. The MLC and MMLC are designated as safe, less expensive alternatives to LC as well as CC.

Adolescent↗
PubMed1994

The applicability of micro- and minilaparotomy in the management of obstructive cholecystitis.

There are conflicting opinions concerning the management of acute cholecystitis, with particular reference to the optimal time for surgical intervention in the course of minimally access surgery. The present study was undertaken to elucidate the applicability of micro- and modern minilaparotomy in the management of obstructive cholecystitis and to ascertain the optimum time for surgical intervention. A total of 607 consecutive cholecystectomies were performed by micro- and modern minilaparotomy between 11 December, 1990 and 11 December, 1993 at our department: 202 (33.3%) with obstructive cholecystitis. The patients were divided into five groups on the basis of time passing from the onset of the acute symptoms to surgery. Comparing the data of the first 3 groups to the 4th and 5th groups, data demonstrate that those operations which were done up to 10 days following the onset of acute cholecystitis were technically difficult in 16% of the patients. However, the technical difficulties increased up to 56% (group 4) and 59% (group 5) by the delay of surgical intervention to more than ten days or six weeks after the onset of the acute symptoms of obstructive cholecystitis.

Acute Disease↗
PubMed1993

[Antibiotic prophylaxis in cholecystectomy performed by micro- and modern mini-laparotomy].

The authors review the results of the use of antibiotic prophylaxis (AP) during 412 cases of micro (MLC) and modern mini-laparotomy cholecystectomy (MMLC). 2 gr of Mandokef (M) or 1.5 gr of Zinacef (Z) were the employed antibiotics, administered intravenously 30 minutes before the commencement of the operations. In the case of patients above the age of 50 AP was given on routine basis. Apart from cases of obstructive cholecystitis (OC), a single shot of Mandokef or Zinacef proved effective; there was no occurrence of suppuration. Out of 94 under fifty patients--where in accordance with the accepted standpoint applied to traditional cholecystectomy AP would not have been necessary--AP was administered in 43 cases: no suppuration occurred. 51 patients did not receive AP; here 2 cases of suppuration occurred (4%). In 99 patients suffering from obstructive cholecystitis (OC), the single-shot AP was supplemented and continued with cover therapy where necessary. On the basis of the time elapsed between the presentation of the OC and the operation, the cases were classified in the following groups: 1.27 patients operated on within 10 days: no cases of suppuration or other complications II. 34 patients operated on between 10 days and 6 weeks: 2 cases (5.9%) III. 38 patients operated on after 6 weeks: 3 cases (7.9%) of suppuration or other complications were encountered. After MLC and MMLC the patients are emitted form hospital within 24-72 hours. However, 80% of the bacteria resoiling in the gallbladder can cause wound suppuration 4-10 days post-operatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Alternatives to minimally invasive cholecystectomy].

Open endoscopic minimally invasive cholecystectomy procedures were developed as alternatives to laparoscopic as well as conventional cholecystectomy. The procedures: 1. Open endoscopic microsurgical removal of gallbladder (with or without laser) a 2-2.5 centimeters verticular median incision between the xiphoid and umbilicus. 118 operations with this technique has been performed. 2. Open endoscopic minimally invasive removal of gallbladder with 2.6-4 cms verticular median incision (63 patients) and 4.1-6 cms verticular median incision. Eighteen operations with this technique have been performed (7 choledocholithiasis, 4 accessory bile duct to the right liver lobe etc). Since 1990 we performed 200 consecutive open endoscopic minimally invasive cholecystectomy with no death and a morbidity rate of 1%. There were 161 women and 39 men (19 to 82 years). All gallbladder diseased patients are candidates for this procedures including patients with acute cholecystitis, empyema of the gallbladder, choledocholithiasis, large gallstones or previous abdominal surgery. These procedures are designed as safe, less expensive alternatives to laparoscopic or conventional cholecystectomy.

Adult↗
PubMed1991

[Data on possibilities of rehabilitation of lower limb amputees].

The authors investigated ways to improve the results of rehabilitation during the course of their clinical practice. During the last 2 years, amputation was performed on 136 patients and 50 patients were supplied with temporary protheses. 38 patients out of 50 answered the question form supplied. After analysis of the question form, the authors summarized the possibilities to improve the results of prolonged mobilisation and rehabilitation. This programme stresses the need for 1. early mobilisation-teaching to walk and 2. care of body and soul.

Amputees↗
PubMed1991

[The use of an isolated jejunum segment in gastric surgery].

The author summarizes the possibilities of the employment of isolated jejunum segment in gastric surgery. After a short historical review, the author tries to indicate the site of the surgical method in the treatment of gastroduodenal peptic ulcers, corrosive internal injuries of the stomach and gastric cancers, and surgical correction of the operated stomach. In gastric surgery today, besides the use of the "traditional" Billroth-type resections, vagotomies, and the Roux-type surgical methods, gastric resection performed with jejunum interposition has practically sank into oblivion. However, with the implementation of selective surgical principles this method can stand its place in gastrointestinal surgery. With proper judgement of its employment, the attained level of success could probably be improved.

Gastrectomy↗
PubMed1990

[The role of autotransfusion in vascular surgery].

Use of autotransfusion has recently come into the limelight of clinical practice especially because of the AIDS-risk and financial considerations. Authors have analysed data of 20 patients with peripheral arterial disease at whom hemodilution were carried out before the operation with the aim of using autotransfusion. Attention is called to the importance of autotransfusion and its applicability in the practice of other sorts of surgery.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Central nervous regulation of pituitary TSH response induced by thiouracil treatment or by thyroidectomy.

The serotoninergic neuron system of the midbrain and hypothalamus was previously shown to inhibit the basal secretion of the TRH-TSH-thyroid axis. The aim of the present study was to investigate the influence of the serotoninergic system on the TSH response of the adenohypophysis to specific loads. Serum TSH levels were determined 7 days after thyroidectomy or the beginning of thiouracil administration. Animals were simultaneously treated either by intrahypothalamic implantation of serotonin-containing needles or by intraventricular or daily subcutaneous injections of the same drug. The thiouracil-induced goitre formation and increase in serum TSH concentration were significantly diminished by serotonin treatment. Similarly, the thyroidectomy-induced rapid rise in TSH blood level was also remarkably inhibited in the serotonin-treated animals. Serotonin was proved to influence rather TRH-output than pituitary TSH secretion, since exogenous TRH, injected to serotonin-pretreated animals had the same TSH-mobilizing potency as found in the not premedicated group. It is concluded that besides the inhibition of the basal secretion of the TRH-TSH-thyroid axis by serotonin, there is an integrative role of the serotoninergic system in the mediation of the reactivity of this circuit in reply to specific influences loading pituitary-thyroid function.

Animals↗
PubMed1979

[Theoretical and practical aspects of ileogastric reflexes].

Pathologic manifestations of the ileo-gastric reflex are infrequent. In the case of terminal intestinal angulation the pathologic reflex-situation can cause misleading gastric symptoms, which earlier have been supposed to be of reflectory origin but have not been investigated experimentally. On the basis of experience gained with patients suffering from terminal intestinal angulation it has been demonstrated in animal experiments that impulses generated by the strain of the wall of the terminal intestine acts on the stomach like a sympathetic stimulation. This reflex relationship is decisively of a nervous type. The anatomy of the reflex path has also been clarified. Animal experiments support the possibility of a reflex are acting via the coeliac ganglion and that the effect of the viscero-visceral reflex takes place through that reflex are on gastric acid secretion and on the blood content of the gastric mucosa.

Animals↗
PubMed1977

[Prevention of reflux esophagitis after total gastrectomy].

The experience gained in animal experiments and on human material with the surgical modification used to ensure the prevention of reflux oesophagitis and improved functioning of the residual stomach, is presented. In animal experiments it was possible to prevent reflux oesophagitis and the weight gain was also more favorable than after oesophago-duodenostomy and Longmire's operation after which reflux-oesophagitis developed without exception. Seven such operations have been performed on man; one of the patients operated upon more than 7 years ago is still free from complaints. In order to assess the true value of the operation, conditions of absorption, conditions of absorption have to be studied in animal experiments and more experience has to be gathered on human material.

Adult↗