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Biomedical subjects

M Bernat

Publications and source records attributed to M Bernat.

At least 19 recordsLinked to original sources
PubMed1996

[Secondary internal osteosynthesis after external fixation for recent or old open fracture of the lower limb].

PURPOSE: The purpose of our study is to analyse the indications, results and limits of secondary internal fixation after external fixation for open fracture of the lower limb. MATERIAL: Our series covered 21 patients treated between 1991 and 1994. There were 17 men and 4 women. Tibia was affected 17 times and femur 5 times (one bifocal fracture). In Gustilo's classification, we had 1 case of type 1, 12 of type II and 8 of type III. METHODS: We used 15 times the FESSA External Fixator and 6 times a monotube external fixator in emergency. We have done secondary 11 intra medullary nailing and 11 patients were treated by plating (one patient had both) 13 patients had a bone graft (cortico-cancellous graft). In the first group of patients (10 cases), the initial treatment gave us good results for both skin and bone healing. The external fixation was replaced by an internal one in order to accelerate bone consolidation and to allow an early weight-bearing. Removal of the external fixation was made at an average of 4 months postoperative. In the Second group (11 cases) the internal fixation was proposed because of an insufficiency of the external fixation leading to complications as: non union, mal union and bone defects. External fixation was removed in a mean time of 8 months. Internal fixation was completed by local bone autograft. RESULTS: 17 patients have been reviewed. Consolidation occurred with an average of 6 months after internal fixation 1 to 24 months. We had no deep infection but only 2 superficial ones. DISCUSSION: We chose 2 types of indication, and we called them programmed and for necessity. The first group of 10 patients whose stain was moderate and whose initial setting up had permitted a perfect anatomic reduction with a rapid wound healing. Internal fixation was performed after a short duration of external fixator. An early weight bearing was allowed so that the functional recovery could be obtained quickly. The second group is represented by patients whose internal fixation was done for non union, malunion or bone defect. In such a case autogenous cancellous graft was used to fill the defect.

Adolescent↗
PubMed1996

[Circadian rhythm of cortisol in patients after reconstruction surgery of the esophagus using various intestinal segments for transplantation].

The authors determined the circadian rhythm of cortisol expressed as blood 11-hydroxycorticosteroid level (11 OHCS) in group of healthy subjects and in 3 groups of patients after the formation of an artificial oesophagus from the jejunum, large intestine and ileum and caecum. In all examined patients the normal circadian rhythm of 11 OHCS was maintained. In patients with oesophagus made up of jejunum and large intestine mean level 11 OHCS in blood was insignificantly higher in comparison with a group healthy subjects. In group patients with the oesophagus made up of ileum and caecum the 11 OHCS level in blood was significantly lower in comparison to the group of healthy subjects and to patients with oesophagus made up of jejunum and large intestine.

11-Hydroxycorticosteroids↗
PubMed1995

[Difficulties in diagnosis of esophageal achalasia].

The authors present the case of 36 years old patient with dysphagia. This symptom appeared three years ago and became more severe for six month. The endoscopic and radiologic examinations revealed achalasia of the cardia. The surgical treatment was performed. Two weeks after surgery all symptoms disappeared. We present this case because achalasia of the cardia is comparatively rare disease which diagnostic is not easy.

Adult↗
PubMed1992

Surgical treatment of cardiospasm and megaoesophagus.

Long-term results of operative treatment of cardiospasm and megaoesophagus in 111 patients are presented. There were 67 women and 44 men treated, age 4 to 65. The authors have for several years used their own, in this Department developed method of operation for cardiospasm, which joins Heller's operation with the reconstruction of the cardia to prevent reflux. In very advanced stages of the disease as megaoesophagus they use an original surgical procedure, which consists in connecting the thoracic segment of the oesophagus with the prepyloric part of the stomach by means of a pedicle jejunal graft. Clinical follow-up supported by x-ray examination and endoscopy has shown very good results of such treatment.

Adolescent↗
PubMed1990

[Late results of esophageal prostheses created from intestinal grafts].

During the last 30 years, 280 retrosternal esophageal replacements from stem intestinal grafts were performed at GIT Surgery Clinic AM in Wroclav. Both clinical and auxiliary investigations showed the small intestine grafts have been of the best function as to the food passage. In esophagi made from the large intestine, the following and mostly frequent changes occur: the dilatations of their lumina, the stop of food passage and inflammatory changes varying in both the degree and extent. Inflammatory changes as well as ulcers are rather difficult to detect by radiology. Through the last years, the Second Clinic of General Surgery AM in Wroclav provides endoscopy of artificial esophagi. Being sophisticated, this approach is of benefit in early determining pathologic changes in the esophageal wall, the collection of contents for biochemical tests, tissue biopsies for histology and the initiation of appropriate therapy.

Adolescent↗
PubMed1989

[Malignant lymphoma of the stomach].

The authors present their own experience with the diagnosis and therapy of six primary malignant gastric lymphomas. They draw attention to the pitfalls of preoperative and peroperative diagnosis. From six patients treated in the department in 1978-1985 the correct diagnosis was established before operation only in one patient. In three patients an urgent operation had to be performed on account of signs of perforation of the lymphoma. The authors discuss the possibilities of surgical treatment and supplementary postoperative radio- and chemotherapy.

Aged↗