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Biomedical subjects

J Fedeles

Publications and source records attributed to J Fedeles.

At least 19 recordsLinked to original sources
PubMed2005

Reconstruction of a circular defect of the hypopharynx and cervical part of esophagus by a free jejunal flap (case report).

Patients with impaired continuity of the upper gastrointestinal tract are dependent on gastrostomy or jejunostomy tube feeds, which significantly reduce their quality of life. Reconstruction of the hypopharynx and esophagus is desirable in cases of congenital deformities, corrosive injuries, or defects after tumor resections. Free flap allows for easier reconstruction of head and neck defects. In this article, the authors present a case of complete hypopharynx closure in an oncology patient with a larynx carcinoma. The patient is a 60-year-old male diagnosed in 2002 with epidermoid carcinoma of larynx. The patient underwent laser resection of the tumor followed by radiotherapy and chemotherapy. In 2003 the patient underwent pharyngo - laryngectomy for relapse of the larynx carcinoma. Postoperatively the patient developed pharyngo - cutaneous fistula, which was reconstructed at the otorhinolaryngology department by a muscle - cutaneous flap from the pectoralis major muscle. During the course of healing the patient developed complete hypopharynx and cervical esophagus closure. Free flap of jejunum was recommended. The surgery team used a 10 cm long section of jejunum; the recipient blood vessels were arteria transversa colli and internal jugular vein. On the second day after the surgery patient developed salivary fistula in the wound. The fistula healed spontaneously in five weeks. Pharyngoscopy revealed that the transplanted jejunum was fully vital. Free flap of the jejunum allowed for upper gastrointestinal tract reconstruction and allowed the patient to restart peroral intake.

Carcinoma, Squamous Cell↗
PubMed2005

Cleft lip and palate in Western Slovakia in the years 1985-2000.

Orofacial clefts are common congenital anomalies. The aim of this study was to assess the incidence in Western Slovakia. The study material were the case records of infants from the Bratislava and Western Slovakia regions, born between 1985 and 2000, and operated on in the Department of Plastic Surgery, Faculty of Medicine, Commenius University, General Hospital Ruzinov, in Bratislava. Of 409,205 live births in this period, 670 children were born with OC (orofacial clefts) and operated in the above-mentioned department. This study found a total incidence of 1.64/1000 live births. Compared to the Western Slovakia region, the incidence was higher in Bratislava. Of the different types of OC, CLP was the commonest, with a male preponderance of OC at the rate of 1.16:1. The available data showed significant differences of clefts in some of the studied districts, which could be a base for an intensive follow-up of endemic (genetic and exogenous) factors.

Cleft Lip↗
PubMed2004

Fifty years of the Cleft Centre in Bratislava.

In our paper, we would like to present and analyse the activities in the Cleft Centre in Bratislava between 1952 and 2001. We document the gradual development of the complex treatment and the important changes in the usage of the operative techniques and in the primary and secondary operations timing, as well as the application of the new trends in the field of plastic surgery, maxillofacial surgery, anaesthesiology, orthodontics, speech therapy, paediatrics, human genetics and psychology.

Adolescent↗
PubMed2004

Giant basal cell carcinomas: a result of neglect?

Although the occurrence of giant basal cell carcinoma in clinical practice is quite rare, there are some references to these malignancies in the literature. Our study includes 12 patients without previous treatment who had giant basal cell carcinoma with no evidence of metastatic dissemination. Depending on the anatomic region, we used a primary suture, local flap and split-thickness skin grafts for the reconstruction of the defect after the wide excision of the carcinoma. All patients have been followed up and no recurrence has been detected to date. Nine lesions diagnosed on the face (69%) were obvious, and therefore they should have been diagnosed at their early stage. In our series most of the patients had had tumors for more than 3 years (except 2 cases) with no history of radiation exposure or recurrence after previous treatment. Therefore our findings suggest to us that the primary reason for a tumor to achieve this giant size was neglect.

Aged↗
PubMed2002

Polythelia is not a mere aesthetic issue.

Anomalies in breast development include an increase in the number of breast (polymastia), nipples (polythelia), areolas (polythelia areolaris) and the tissue of the breast gland. Of the many forms, the most common is an accessory nipple, polythelia. It commonly develops along the embryonic "milk line" (Fig. 1). It constitutes a diagnostic problem only sporadically. Excision is indicated for diagnostic, treatment or cosmetic reasons. In the literature, the evidence of these anomalies suggests that they could be markers for others, most notably urologic malformations and malignancies.

Adolescent↗
PubMed2002

Orofacial clefts and their influence on chosen anthropometric parameters of craniofacial part children at the age of eight.

The aim of this study was to choose and to measure craniofacial parameters that were expected to be influenced by cleft defects. Eight-year-old children (both boys and girls) with operated clefts (15 antropometric parameters) were measured. The measurements were carried out at the Department of Reconstructive Surgery, Hospital Ruzinov, Bratislava. The obtained parameters were compared to 4 types of clefts by means of modification t-test, and also with healthy population by means of normalization indices, on the base of which morphograms were performed. On the base of our results, we can say that the most significant deviations when compared with healthy population were found in children with the worst type of cleft, i.e. complete bilateral cleft.

Anthropometry↗
PubMed2002

Coxsackie viral infection and orofacial cleft.

The incidence of orofacial cleft (OC) in newborns was compared with the occurrence of virus-neutralizing antibodies to coxsackie viruses in the serum of newborns and their mothers. No significant difference was found when comparing the seropositivity rates between the group of patients and the control group of healthy newborns. If the patients were divided according to the place of residence however, marked differences occurred between the regions. The lowest incidence of both--coxsackie infection and OC was determined in the region of Bratislava and the highest in the region of Zilina. The explanation of these findings recquires a more detailed analysis of genetic background, social and hygienic status, style of life and other factors, known to influence the development of OC as multi-etiological developmental disorder. (Tab. 2, Fig. 4, Ref. 12.).

Antibodies, Viral↗
PubMed2001

New trends in the complex treatment in the Cleft Centre in Bratislava.

The last decade of the second millennium has brought some major changes into the concept of comprehensive treatment of the cleft lip and palate patients commonly accepted by the cleft center in Bratislava. Important events occurred, which surely had and in future they probably still would have an important impact on the comprehensive medical care of children with cleft lip and palate. There is beyond any doubt that an ongoing application of new trends in such fields as plastic surgery, anesthesiology, maxillofacial surgery, orthodontics, phonetics, speech therapy, paediatrics, human genetics or teratology will contribute to the progress and improvement of functional and aesthetic results and to better social adaptation of the cleft lip and palate patients. The study focuses on the following issues: cleft incidence, timing of the primary surgical repair, as well as the need of secondary operations (closures of communications, bone grafts, pharyngeal flaps, corrections of the lip and nose) and the achieved standard of speech quality and articulation, as well as on the early and late otological states and phonation. (Tab. 7, Fig. 3, Ref. 8.)

Child↗
PubMed2000

[Free nerve transplants in the reconstruction of secondary defects of the peripheral nerves of the hand].

BACKGROUND: Peripheral nerve of the hand significantly participate ub the physiological functions of the hand. A defect in the area of the peripheral nerve therefore represents a problem, the solution of which is in the field of microsurgical reconstruction. The study deals with the possibility of microsurgical reconstruction by use of free nerve draft. SUBJECTIVE: Clinical observation of patients after microsurgical reconstruction of the hand peripheral nerve defect. MATERIAL AND METHODS: 34 patients after lesions of the median nerve, ulnar nerve and mutual impairment of both nerves. The evaluation according the known and spread system system of Medical Research Council, Seddon 1954. RESULTS: We have achieved very good results after isolated lesions of the median nerve, while the results in this, as well a in other groups are better in younger patients and in patients, in whom the devastation of tissue was not too great. Standard results were achieved in the group with isolated injury of the ulnar nerve and the worst results in a small group of concommitant impairment of both median and ulnar nerves. CONCLUSIONS: The results indicate that this method is unambiquously appropriate in such a complicated clinical picture. Our results are in accord with the data from other literature sources. MEANING FOR PRACTICE: Inevitability of specialized centres which would deal with this problem thus reducing the necessity of secondary reconstruction operations and naturally the reduction of financial expenditure or social support provision.

Adolescent↗
PubMed2000

[Tendon transfer of the extensor carpi radialis longus muscle in tendon rupture of the extensor pollicis muscle].

The most common ruptures of all of the tendons of the hand are those of the extensor pollicis longus tendon (EPL). As to its etiology, the rupture of EPL can spontaneously occur tendosynovitis in rheumatic patients or rarely in result of conservative treatment of distal forearm fractures. During the last 18 months, 4 cases of EPL ruptures following the conservative treatment of distal forearm fractures have been diagnosed in our clinical material. All patients underwent the transfer of extensor carpi radialis longus (ECRL) tendon due to. We present our indications of the technique, and the clinical results. (Fig. 3, Ref. 8.)

Humans↗
PubMed2000

[Cephalometric analysis of distance x-ray images in children with orofacial clefts].

The authors with the help of cephalometric RTG analysis study the changes of facial skeleton in children with orofacial clefts and the treatment results. Cephalometric analysis was performed on distance X-rays in patients with orofacial clefts from the whole Slovak republic in the number of 178, with age of 7.8 and 9 years. According to the type of the fissure the patients were divided in four groups. The control group consisted of 46 healthy children with the same age. The method of Schwartz was used (1958). The analysis revealed some characteristic changes in patients with orofacial clefts, which document that not only local disorder of lips, alveolar process and palate develops in these patients, but the fissure defect affects also more distant parts of visceral skeleton and important growth centers. (Tab. 5, Fig. 1, Ref. 14.)

Cephalometry↗
PubMed1999

[Malignant fibrous histiocytoma of the hand].

Most soft tissue sarcomas are malignant tumors of the mesodermal tissue of the head and neck, trunk, retroperitoneum or extremities, although neurosarcomas and primitive neuroectodermal tumors are of ectodermal origin. Soft-tissue sarcomas of the upper extremity constitute 14% of all soft-tissue sarcomas, they are one third as common as those of the lower extremity. A case of patient with malignant fibrous histiocytoma of the fourth finger of the left hand is presented. (Tab. 2, Fig. 10, Ref. 15.)

Female↗
PubMed1994

[Hernias in the abdominal wall].

The authors emphasize the relapse frequency of the front abdominal wall hernias. Umbilical hernias, epigastric hernias, hernias in postoperative scars, as well as diastases of m. rectus abdominis are still not appropriately evaluated problem in surgery. Numeral surgical methods and procedures provide evidence of this fact. In spite of this, the relapses are frequent. In order to prevent relapses of hernias and to support the firmness of the abdominal wall, the authors use the corium graft technique. This study provides the description of the graft preparation. This surgical method was used in 54 patients, in whom no recurrence was recorded within the period of 1-3 years after surgery. The authors consider this procedure as being useful and effective. The methodical procedure is simple and economically advantageous, as autografts are ideal from the biological point of view. (Tab. 1, Fig. 6, Ref. 10.)

Female↗