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Biomedical subjects

L Major

Publications and source records attributed to L Major.

At least 19 recordsLinked to original sources
PubMed2002

[Complications after angioplasty and stenting of coronary arteries in ischemic heart disease patients].

The authors have made an analysis of most frequent complications of angioplasty and stenting of coronary arteries in 1900 patients with various forms of ischemic heart disease. The mechanisms, pathomorphology, angiographic and clinical manifestations of such complications as dissection of the coronary artery intima, acute occlusion of the coronary artery, "no-reflow" syndrome, perforation and rupture of the coronary artery, acute thrombosis in the stent area and other complications are considered in detail. Special medical strategy, both therapeutic and surgical, is proposed for each case. The authors propose a number of prophylactic measures allowing to avoid the complications described or to minimize them. Intraoperative lethality in this group of patients was 0.5% (10 patients), during the first week after endovascular intervention 26 patients died (1.4%).

Adult↗
PubMed2001

[Analgesics-induced chronic renal failure in patients on dialysis therapy in Hungary].

In recent years elaboration of the diagnosis of analgesic-nephropathy (ANP) with the help of imaging techniques significantly increased the possibility of diagnosing the disease. Therefore, evaluating the prevalence of ANP has become more accurate in our country as well. The prevalence of ANP has been investigated in patients who have newly been taken into the dialysis program due to renal disease of unknown aetiology in 22 dialysis centers between December 1994-December 1997. The diagnosis of ANP has been based on revealing chronic drug abuse in the history and positive results of renal imaging (decrease in length of both kidneys combined with either bumpy contours and/or papillary calcification). Among 284 patients dialysed with unknown diagnosis 42 (14.8% of all cases) proved to have ANP. All patients except 2 took analgesic mixtures containing phenacetin/paracetamol, phenason derivatives, acetilsalysilic acid, caffeine and/or codeine. According to their investigations, ANP is a common disease resulting in end-stage renal failure in Hungary as well.

Acetaminophen↗
PubMed2001

Decade-long experience with surgical therapy of myasthenia gravis: early complications of 324 transsternal thymectomies.

BACKGROUND: We studied the incidences and evaluated the management of early postoperative complications after thymectomy for myasthenia gravis. METHODS: During the period between 1987 and 1996, 324 thymectomies were performed through median sternotomy access under general anesthesia. Postoperative management was administered according to a standardized protocol of anticholinesterase medication, which was withdrawn for the 48 hours of obligatory postoperative mechanical ventilation. The mean age of patients was 34 years (range, 8 to 71 years). RESULTS: One hundred forty-nine patients made an uneventful recovery; 104 patients had only minor complications, whereas 71 patients had major complications. The mortality rate was 0.6% (2 patients). The major surgical complications were recorded as sternal bleeding (1 patient) and sternal disruption (1 patient). The major general complications were recorded as tracheal stenosis (1 patient), pneumonia (3 patients), heart failure (1 patient), gastric hemorrhage (1 patient), and respiratory insufficiency (71 patients). Forty-six reintubations were performed on 40 patients and 19 tracheostomies (6%) were performed postoperatively. CONCLUSIONS: The excessive incidence of respiratory insufficiency and airway-associated morbidity was potentially related, at least partially, to prolonged mechanical ventilation and withdrawal of anticholinesterase medication. Earlier weaning of patients with revision of 48-hour withdrawal of anticholinesterase medication is necessary.

Adolescent↗
PubMed2001

[Paraesophageal hiatal hernia complicated with stomach cancer].

The authors present the history of a 79 years old female patient who had to be operated on with paraesophageal hiatal hernia causing cahexia, hematemesis, dysphagia and pain. They found an upside down stomach with cancer inside. They emphasize that endoscopy is very important in the diagnostic process and that cancer can develop even if the stomach is located in the chest.

Aged↗
PubMed2000

[Coronary angioplasty over 70 years of age].

In the two institutions between January 1992 and December 1998 PTCA-s were done in 196 pts (123 male and 73 female) aged 70 years or more, with the 57 (20.1%) 6 months redo procedures performed out to June 1999, totally 247 interventions. The dilatations were done in 230 vessels (218 natives and 12 grafts) and in 254 stenoses, as of 1996 in 73 cases with stent deployment, too. PTCA was clinically successful in 178 (90.8%) pts, suboptimal result and/or MACE (AMI, emergency PTCA or CABG, fatal outcome) occurred in 18 (9.2%) cases. Due to unsuccessful PTCA-s, 3 (1.5%) pts underwent acute, 3 elective bypass surgery, in 1 (0.5%) case thoracal sympathectomy without revascularisation, in 1 no further intervention was done. The in-hospital as well as the 30 days mortality was 5 (2.6%). Taking into consideration the higher risk of CABG surgery at an old age, in the case of indication for coronary revascularisation the possibility of angioplasty should be considered first.

Age Factors↗
PubMed2000

Can sterile and pyrogen-free on-line substitution fluid be routinely delivered? A multicentric study on the microbiological safety of on-line haemodiafiltration.

BACKGROUND: Microbial contamination is characterized not only by the presence of bacteria, but also by high concentrations of biologically active by-products. They are potentially able to cross ultrafiltration and dialysis membranes and stimulate immunocompetent blood cells to synthesize cytokines. In turn, cytokine induction causes acute symptoms and has been incriminated in the long-term complications of haemodialysis patients. Infusion of large volumes of substitution fluids following ultrafiltration of microbially contaminated dialysis fluids may place patients on on-line therapies at particular risk. METHODS: In this study we evaluated 30 machines with a two-stage ultrafiltration system in routine clinical haemodiafiltration settings in six centres for 6 months. Microbiological safety was assessed monthly and at the last use of the filters by determining microbial counts, endotoxin concentration and cytokine-inducing activity. RESULTS: No pyrogenic episodes were observed during the study period. Double-filtration of standard dialysis fluid (range, <1-895 cfu/ml, 0.0028-4.6822 IU/ml) resulted in sterile substitution fluids with endotoxin concentrations well below the Ph.Eur. standard for haemofiltration solutions (range, 0.0014-0.0281 vs 0.25 IU/ml). Moreover, they did not differ from commercial haemofiltration solutions and depyrogenated saline. Likewise, there was no difference in the cytokine-inducing activity between the solutions tested. The high microbiological quality of the ultrafiltered dialysis fluid, which was in the same range as substitution fluid, translates into both the absence of cytokine induction by dialyser back-transport and a redundant safety mode of the on-line system by a second filtration step. CONCLUSION: On-line HDF treatment can routinely be provided with ultra-pure dialysis fluids and sterile substitution fluids at pyrogen-free levels. The online preparation of substitution fluids thus can be considered microbiologically safe.

Bacteria↗
PubMed1986

A comprehensive study of chronic schizophrenic patients. I. Quantitative computed tomography: cerebral density, ventricle and sulcal measures.

Based on recent computed tomography (CT) studies that have suggested the presence of distinct structural abnormalities in the brains of chronic schizophrenics, the authors evaluated 23 chronic schizophrenics and 23 controls by CT, using linear and area lateral ventricular measures, sulcal and Sylvian fissure widths and cerebral density measures. Technical problems inherent in CT studies and their impact on the use of data generated by such studies are discussed. Although there were few differences between groups, there emerged a distinct subgroup of schizophrenic patients with mild lateral ventricle enlargement associated with increased cortical density. The possible etiopathology for this atypical combination is discussed, including the striking parallels with a recent neuropathological study's findings.

Adult↗
PubMed1986

A comprehensive study of chronic schizophrenic patients. II: Biological, neuropsychological, and clinical correlates of CT abnormality.

There are numerous reports of lateral cerebral ventricle enlargement on computed tomography (CT) in schizophrenics, but the significance and its relationship to traditional notions of organicity remain unclear. Therefore we studied a subgroup of chronic schizophrenics who had lateral ventriculomegaly (and also cortical hyperdensity) on a battery of relevant biological, neuro-psychological, and clinical parameters such as electroencephalogram (EEG), platelet monoamine oxidase (MAO) and serum dopamine-beta-hydroxylase (DBH) activity, the Halstead Reitan Neuropsychological Battery (HRB), premorbid personality adjustment, drug response, positive and negative symptoms, employment history, and family history. Our findings support the notion that there is an "organic" subgroup of schizophrenia that has 1) CT structural abnormalities such as lateral ventricle enlargement and cortical hyperdensity; and cerebral dysfunction or deficits as evidenced by 2) an increased incidence of abnormal EEGs and also 3) greater impairment on neuropsychological tests. The biochemical measures, platelet MAO and serum DBH activity, nor any of the clinical measures could differentiate between the subgroups. The implications of these findings for the subtyping of schizophrenia are discussed.

Adult↗
PubMed1984

The ventricular system in chronic schizophrenic patients. A controlled computed tomography study.

Twenty-three chronic schizophrenic patients and 23 controls, all males between 20 and 40 years of age, were evaluated by CT scan. The lateral, third and fourth ventricles, the Sylvian fissures, and the largest sulcus from each of the frontal, parietal, and occipital lobes, were measured in order to determine whether the previously reported ventriculomegaly in schizophrenics was perhaps due to a disturbance of CSF flow or to atrophy, two common causes of ventricular enlargement. We found that in the schizophrenic group the third and fourth ventricles and both Sylvian fissures were significantly enlarged, but not the lateral ventricles or cerebral sulci. Our data suggest that these ventricular changes are not due to a disturbance of CSF flow or to cerebral atrophy. Other possible explanations are discussed.

Adult↗
PubMed1983

Cerebellar morphology in chronic schizophrenic patients: a controlled computed tomography study.

Simple, objective, linear, and density measures were used to evaluate by computed tomography (CT) the cerebellum-fourth ventricular region of 23 chronic schizophrenic patients and 23 normal controls. Our data suggest that a subgroup of chronic schizophrenic patients have cerebellar atrophy associated with a strong but nonsignificant trend toward increased cerebellar density. The implications of these findings are discussed in view of previous CT and neuropathological studies.

Adult↗
PubMed1980

[Surgical treatment of ureterectasia].

Ureterectasia can be congenital (mega-ureter) or acquired (hydro-ureter). Mega-ureters can be of reflux and non-reflux (obstructive) type. The essence of primary non-reflux mega-ureters is the presence of a prevesical adynamic segment which causes functional obstruction. The musculature of this segment is abnormal in both function and structure. A surgical solution of the malformation is recommended mainly in children and young adults. In 10 years, 17 patients were subjected to 22 operations. After removal of the obstructive segment and straightening of the ureter, it was implanted into the vesicle through an intravesical tunnel. With the exception of two cases where nephrectomy had to be done and a case with persisting reflux, the other operations were successful. Narrowing of the ureter was not done. Ureteral neo-implantation is preferred to Boari's operation. Isolated pelvis ureters are operated only in the case of complications.

Adolescent↗