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Biomedical subjects

M Chifan

Publications and source records attributed to M Chifan.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[Hyperthyroidism and coexistent thyroid carcinoma].

The association between thyrotoxicosis and thyroid cancer is a classical, rare and controversial entity. Within their series of eleven such cases the authors dissociate two distinct groups from clinical and pathological viewpoint. The first category is represented by one case of follicular thyroid cancer with clinically and biologically confirmed hyperthyroidism. The second group includes ten patients with thyrotoxicosis (three cases with Graves' disease, four with toxic multinodular goiter and three with toxic adenoma) and associated unsuspected occult or nodular carcinoma. None of these patients had received previous treatment with radioiodine. In all cases the diagnosis was established by pathological examination of the surgical specimen. Surgery is the treatment of choice in these lesions, the presence of carcinoma imposing the extent of operation. Five near total thyroidectomies and three near total lobectomies with ablation of the isthmus was performed in our cases associated with appropriate additional measures: TSH suppression or 131I treatment. Post surgical results were satisfactory without morbidity or mortality. The long-term survey was good (seven cases alive after 5 years).

Adenocarcinoma, Follicular↗
PubMedDate not supplied

[Zenker's diverticulum--surgical management in a series of six cases].

Zenker's diverticulum is a protrusion of the posterior mucosal wall of the hypopharynx through the weakened muscular layer, between the oblique fibers of the inferior constrictor of the pharynx and the transverse fibers of the cricopharyngeal muscle (Killian's dehiscence). Pharyngoesophageal pulsion diverticulum is the most common of all the oesophageal diverticuli and is characterised by dysphagia, regurgitation, gurling sounds in the neck and aspiration. The current principles of surgical management includes a pharyngoesophageal myotomy accompanied by a diverticulectomy or a diverticulopexy. The same principles apply in both open approach and the endoscopic methods.

Aged↗
PubMedDate not supplied

[Cervugid ovules in cervico-vaginal infections and cervix uteri precancerous conditions treatment].

UNLABELLED: This medicine was authorized by the National Drug Agency (ANM, Bucureşti) in 2001. PURPOSE: To evaluate the effectiveness and the tolerance to Cervugid-ovules, a preparation that combines the polyvalent local antiinflammatory action of chloramphenicol, metronidazole and nystatin with the effect of hydrocortisone acetate, an unspecific anti-inflammatory agent; they all are embedded in a Lipex-403, semisynthetic fat. MATERIALS AND METHODS: The evaluation of 500 patients ages between 15 and 85 years with genital infections, registered in the files of "Cl. II Obst. and Gynecology" of the Cuza-Vodă Hospital from Iaşi has been studied. We studied the subjective manifestations (local discomfort and pelvic pains, local burning and dryness,vulvovaginal itching and dyspareunia) and objective manifestations (vaginal and cervical secretion, the cytotest performed and colored though the Papanicolaou method and reported in the Bethesda system). RESULTS AND DISCUSSION: Healing of the subjective symptoms in 98%, healing of the leukorrhea--as a main objective symptom--in 95%; The Bethesda system cytotest was one of the inflammatory type in the most of the cases and there wew found in 85 cases: 6 ASCUS, 41 LSIL, and 37 HSIL. The use of Cervugid had a healing response in most of the cases when used in acute and chronic cervico-vaginal inflammatory processes. Cervugid may be considered as an important agent in the treatment of the precancerous affections af the cervix uteri on the following reasons: zhe cure of the infections caused by chlamydia, involved in the etiology of cervical neoplasms, the cure of the HPV infection under episome form, classified in the Bethesda system within the ASCUS, AGUS or LSIL classes. When the cytotest was in the HSIL class, a conization in the LLETZ method was performed. CONCLUSIONS: Cervugid is conceived for those three main categories of pathogenic factors related to the etiology of cervico-vaginitis: microbia germs, protozoa and mycosis. In addition, it is active on chlamydia and mycoplasms, always sensitive to chloramphenicol therapy. That is why Cervugid with in local administration is indicated in the microbial, trichomoniasis and mycotic vaginitis caused by one category of pathogenic agents or by associated forms, in cervicitis, in the pelvic inflammatory processes (pelvic congestion, metritis, adnexitis, and inflammatory processes associated with benign or malignant tumors of the genital apparatus). The results obtained proved that Cervugid is highly effective medicine.

Administration, Intravaginal↗
PubMedDate not supplied

[The value and limits of subtotal gastrectomy in gastric cancer].

In the interval 1970-1988, in 321 of 670 patients with gastric neoplasm admitted to the 1st Surgical Clinic of Iaşi a subtotal gastrectomy was performed. Most patients were males (68.9%), more commonly aged between 50 and 70 years and in advanced evolutive stages. The gastric neoplasm were sited in order of frequency in the antrum (46.9%), body of the stomach (34.6%), eso-cardio-tuberosity (11.5%), linitis (4%), gastric stump and malignant ulcer (3%). Surgery was possible in only 59% of the cases (25% curative and 34.1% palliative). The surgical technique and its difficulties are detailed. In the 321 subtotal gastric resections 20 complications, 4 deaths (1.2%) and 20% survivals over 5 years were recorded. It is concluded that radioendoscopic and microscopic investigations, with their possibility of an early diagnosis, may cause a limitation of the indications of total gastric resection in the treatment of gastric neoplasm in favour a subtotal resection, more satisfactory from the functional viewpoint.

Adolescent↗
PubMedDate not supplied

[A rare neurogenic tumor with thoracic growth].

Of 70 operated mediastinal tumors, 15 were neurogenic tumors, one of them clepsydra-shaped, which manifested from the very beginning with spastic paraparesis of the legs. The treatment consisted in a two-steps surgery, the first at the Neurosurgical Clinical of Iaşi (laminectomy and ablation of the rachidian tumor) and the second one, one month later, at the I-st Surgical Clinic of Iaşi (excision of mediastinal tumor and parenchymal bridge within the conjugation hole). The microscopic examination confirmed the diagnosis of neurinoma (schwannoma) Antoni A and B with haemorrhagic areas. Examined at one year interval, the patient was clinically cured with normal thoracic aspect. The clinical peculiarities and therapeutical possibilities of the clepsydra-shaped neurogenic mediastinal tumors are detailed.

Adult↗
PubMedDate not supplied

[Cholecystosis, the diagnostic and treatment problems].

In the interval 1981-1989 at the Ist Clinic of Surgery of Iaşi 230 cases of chronic cholecystitis were admitted and operated upon (cholesterolosis--24 cases, dysmorphosis--84 cases, dysplasia--22 cases). Most cases had a morphologic--dysmetabolic substrate--strawberry gallbladder, alone or associated with other lesions (lithiasis, cirrhosis, pancreatitis), rare cases being also found (porcelain gallbladder--1 case, calcium bile--2 cases, gallbladder diverticulosis--3 cases, longitudinal complete obstruction of cystic duct by gallstone--2 cases). This condition is more frequent in women in the 3rd dad 4th decade, the symptoms being discrete, uncharacteristic, but persistent. The diagnosis is based on duodenal catheterization, cholecysto-cholangiography and ultrasonography, the intraoperative and histo-pathologic confirmations being required. The increasing frequency of chronic cholecystitis makes necessary a more minute diagnosis and exigent surgical indication, pledges for long-term favourable results.

Adult↗
PubMedDate not supplied

[Differentiated thyroid cancer].

In the interval 1979-1988, out of 1070 operated goiters 77 malignant thyroid tumors were recorded, 60 of them being differentiated: papillary--32 (53.4%), vesicular--12 (20%), mixed forms--16 (26.7%). The differentiated thyroid carcinomas had peculiar clinical biological and prognostic features and were framed: stage I--60%, stage II--23.4% and state III-IV--16.6%. Only 15 cases presented lymph node metastases. In 16 cases the thyroid tumor was associated with another thyropathy: Hashimoto's thyroiditis--5 cases, Basedow's disease--1 case. The surgical intervention was performed in two times: first total lobectomy or total lobo-isthmectomy [correction of lobioistectomy] with contralateral subtotal exeresis, then total thyroidectomy. It is insisted upon a careful surveillance of postoperative evolution (clinical, biological, scintigraphy) in order to detect the recurrence and apply a proper treatment.

Adult↗
PubMedDate not supplied

[The "cold" thyroid nodule].

The main problem posed by an (apparent) solitary thyroid nodule is cancer identification, present in about 10% of the nodules excised surgically. This percent might increase to 25-30% in the cold scintigraphic nodules. Therefore, a combination of all the methods for nodule assessment is necessary: anamnesis, physical examination, functional tests, therapeutic test with tyrosine and thyroid imaging, but mainly the intensive active exploration including puncture-biopsy with a fine needle and exeresis with extemporaneous and paraffin morphological checking. Starting from a two decades' experience of a group of endocrinologists, surgeons, anatomo-pathologists and specialists in nuclear medicine, in 2,289 thyropathies operated--of whom 1691 (poly)nodular goitres and 1,190 non-capturing nodules--the authors suggest an investigation algorithm for achieving a differentiated surgery in terms of the pre- and intraoperative morphological findings. This attitude permitted both the improvement of the surgeries of thyroid cancers and the exeresis of benign nodules under low-risk surgical conditions or avoidance of a "non-necessary" surgery.

Biopsy↗
PubMedDate not supplied

[Clinical and therapeutic aspects of some rare forms of pancreatic tumors].

A total of 198 tumours of the pancreas have been hospitalized between 1972 and 1987 in the 1st Surgical Clinic from Jassy. Only 10 of these tumours were benign, and these included: 2 gastrinomas, 2 insulinomas, 2 cystadenomas, one fibrolipoma, 1 lymphangioma, one hydatic cyst and a Wermer's syndrome. The particularities are analysed, of these 10 cases of benign tumours of the pancreas, and it is stressed that most of the clinical and therapeutic problems are determined by tumours of the endocrine pancreas, and especially those which are hormonally active. Thus the symptomatology of these last tumours which is difficult to evaluate, especially at the onset of the symptoms will determine a considerable delay in the surgical diagnosis, many of the patients being hospitalized in other departments before reaching the surgeon. Present possibilities for diagnosis and treatment have kept pace with progresses achieved in the field of investigations, which provide useful data from the morphological and functional viewpoints. All the 10 cases mentioned above have benefited from the surgical treatment, that was adapted according to particularities of each patient. The authors stress the importance of the extemporaneous morpho-histologic examination (with serial slides) and when the tumours are difficult to identify by direct macroscopic examination they recommend intraoperative echography and direct hormonal dosages on samples obtained from the portal circulation before and during surgery.

Adult↗
PubMedDate not supplied

[Megaduodenum due to aortomesenteric shunt].

Two new cases of megaduodenum by aortomesenteric shunt in young adults are presented. The role of some risk factors, the diagnostic and therapeutical elements are discussed, the importance of a thorough investigation of each case in view of individualizing the therapeutical management being underlined.

Adult↗
PubMedDate not supplied

[The surgery of intestinal obstruction in the elderly].

Out of 301 intestinal obstructions treated at the 1st Surgical Clinic of Iaşi in the interval 1970-1987, 58 patients aged between 70 and 90 years (mean age 75 years) were recorded. Anatomo-clinically these 58 cases presented: strangulated hernia (19 cases), strangulated eventration (2 cases), strangulations on cords (4 cases), small intestine volvulus (8 cases), sigmoid colon volvulus (6 cases), volvulus of cecum (1 case), intestinal investigation (1 case), colorectal neoplasm (15 cases), peritoneal carcinomatosis (2 cases). The clinical and therapeutical aspects of these particular forms of obstruction in the elderly are discussed and the severity of their prognosis, given the terrain and late admission of such patients which sometimes make impossible a surgical intervention, is underlined. Ten deaths (17.1%) were recorded, representing a lower percentage as compared to other statistics published in the literature.

Acute Disease↗
PubMedDate not supplied

[Perforated gastric ulcer].

Out of 603 patients with perforated ulcer, 40 clinical cases with type I perforated gastric ulcers (this particular anatomo-clinical form being distinguished from the perforated duodenal ulcer) were selected. The perforated gastric ulcer type I, less common, is usually found in the patients over 45 years, with old, callous ulcers; in general, when the perforations are large, a malignancy is suspected, the removal of the lesion and the systemic control of the resected specimen being required. The primary radical surgical treatment is performed only in the patients in good general state, the excision of the ulcer followed by suture being reserved to the cases at high risk, with increased mortality (10%).

Adult↗
PubMedDate not supplied

[Hepatic abscesses].

The authors analyse 16 cases of hepatic abscesses recorded in a 10-year interval. The difficulties in assessing the etiology and diagnosis, as well as in indicating an effective treatment are discussed. The clinical aspects and investigation methods, among which scintigraphy, arteriography and especially echotomography are extremely useful in making the diagnosis and in localizing the collection, are reviewed. The bacteriological examination revealed the presence of various organisms in 14 patients, the examined specimen of pus being negative in the remainder of 2 cases. The treatment was surgical in most of the cases (15) consisting in an abdominal approach or posterolateral with rib resection (1 case) and drainage. In 3 cases the intervention was extended to cholelithiasis which was the underlying cause of the abscess. The ultrasound-guided transparietohepatic drainage was performed in 2 cases. No death was recorded.

Adolescent↗
PubMedDate not supplied

[Problems of therapeutic management of cancer of the superior pole of the stomach].

This cancer is rare (17-30%) and has the worst prognosis. In the interval 1970-1987 to the I-st Surgical Clinic of Iaşi were admitted and treated 648 patients with gastric cancers of which 98 (15.2%) with adenocarcinomas of the cardiac end of the stomach. In most patients the diagnosis was late: stage II and III-40 patients; stage IV-58 patients. Given the extension of the tumoral process, the exeresis was possible but in 36 cases (36.7%), as compared to 26-70% mentioned in the literature. The therapeutical management of these cases and the obtained results are presented.

Adenocarcinoma↗