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Biomedical subjects

M Georgiev

Publications and source records attributed to M Georgiev.

At least 19 recordsLinked to original sources
PubMed2005

Sciatic nerve varices.

OBJECTIVE(S): To describe patients presenting with sciatic nerve varices (SNV), presenting pitfalls in diagnosis and management. DESIGN: Case series. METHODS: Patients were investigated using duplex ultrasonography pre-operatively in three cases. Treatment was undertaken both by surgery and by foam sclerotherapy. RESULTS: Clinically, SNV appeared just below the popliteal skin crease, lateral to the small saphenous vein (SSV). In two cases SNV occurred alone, in two further cases SNV occurred in conjunction with varices from other sources. Symptoms of 'sciatic' pain were present in all. Foam sclerotherapy (1% Polidocanol) was undertaken in one case with a varix. Complete obliteration of the vein and resolution of all symptoms was achieved at the 1-month follow-up examination. Surgical management was used in the other cases. CONCLUSION: The sciatic nerve vein follows the fibular saphenous nerve (lying superficial to the fascia in the leg). This nerve arises from the common peroneal nerve (in the popliteal fossa), and is a major branch of the sciatic nerve. Varices of the associated vein appear to be the result of a dysplasia. This condition may be more common than is currently recognised.

Humans↗
PubMed2001

Giacomini's observations on the superficial veins of the abdominal limb and principally the external saphenous.

Carlo Giacomini, later Professor of Anatomy at the University of Turin, Italy, presented a thesis on superficial and deep lower limb venous anatomy in July 1873. This resulted in his name being associated with a vein that he described in detail that passes up deep to the fascia on the back of the thigh. However, the precise nature of his detailed and insightful observations have not previously been presented, at least for the past century. The Authors were able to find and translate the original manuscript, and the first section on the superficial veins is presented here. Giacomini documented the several variations in the origin and terminations, and anterograde and retrograde flow in this vein that have only recently been rediscovered by duplex ultrasound scanning. Much can be learned from his descriptions by all who are involved in treating chronic venous disease.

Anatomy↗
PubMed2000

[A modification of Freyer's typical prostatectomy].

Adenomectomy in its present-day modality has a millennium-long history. Chronologically, its development, justly or not, is marked by a great number of names among which it is worth noting Sir Peter Freyer (London) and his paper published in 1901, dealing with the radical treatment of the hypertrophied prostate by urinary bladder exposure. E. Fuller (USA) claims that the first practical implementation of the method six years previously is credited to him. Since then, there are no different opinions on the need of total gland enucleation, with some differences remaining in terms of operative access and hemostasis. Over the period 1998-1999, thirty-two adenotomies are performed according to Freyer's original method in the Department of Urology--University Hospital "Alexandrovska". An indwelling catheter with inflated balloon is inserted into the prostate bed for hemostasis without using packs or placing sutures. The obtained results are estimated as good.

Adult↗
PubMed2000

["Fossa" carcinoma - a relapse or "rest" carcinoma of the kidney?].

The local relapse represents a unique variant of the advanced stage of a disease (A Esrig et 1992). Presumably, "fossa" carcinoma may result from incomplete resection or persisting tumor in the regional contiguous lymph nodes (JB D Kernion 1978). The average time interval for a relapse to occur is 31 months after nephrectomy, and in most patients it becomes manifest with symptoms, such as losing weight, fatigability and lumbar discomfort (D Esrig et al 1992). In cases with local recurrence a long-term survivorship may be attained by resorting to aggressive surgical intervention (S Tanguag et al 1996). This is a report on twenty-three patients with "fossa" carcinoma covering the period 1994 through 1999, with a total of 425 patients with renal carcinoma operated during the same period of time. All patients undergo operation--lumbar access is used in 22 cases, and transperitoneal--in one. In one patients resection of colon is necessitated, whereas in five the neoplastic mass hardly lends itself to complete excision, with enucleation alone being done. At follow-up study the survival terms are as follows: up to 1 year--18 patients, up to 3 year--16 patients, up to 5 year--12 patients.

Adult↗
PubMed1999

[Post-cystectomy derivations - a rule or control of technical skills?].

Limitations in gaining better understanding of bladder tumor responsiveness do exist, and accordingly the therapeutic interventions undertaken in diverse forms of the disease are conspicuous for discrepancies (M. J. Droller, 1990). E. Bricker in 1950 is the first to practically implement ileal conduit for urine derivation, and thus initiates the new and newest continent derivations. Over the period 1992-1998, in the Chair of Urology are performed 76 cystectomies with different urine derivations, using seven methods for the purpose: [table: see text] Also discussed are the conditions a derivation should mandatorily meet. Emphasis is laid on the fact that the choice of derivation is still largely dependent on the skill and experience of urologists.

Adult↗
PubMed1999

[Continent derivation of urine (a Modo) Mainz II].

The improved intestinal dissection technique and antibiotic agents, and the development of new resorptive suture materials have led to renewed surge of interest in ureterosigmoidostomy as a practicable procedure for continent derivation. Based on data from urodynamic assessment of diverse forms of urinary derivation, M Fisch and R Hohenfellner in 1991 propose a modification of the classical technique of ureterosigmoidostomy, coined with the term Sigmarectum pouch or Mainz pouch (M Fisch, R. Wammack, R Hohenfellner 1991). Over the period 1992 through 1999, 46 operations type "Mainz II" are performed in the Department of Urology--University Hospital "Alexandrovska". The series includes 41 men and 5 women with age range 42 to 80 years. All patients present urinary bladder tumors. The usual surgical technique is used. The severest postoperative complications include: urinary fistulae--3 (6.52%), local relapse--4 (8.69%) and distant metastases--2 (4.35%). In six patients the outcome is fatal (0.7%). This type of continent derivation following cystectomy is recommended since it is convenient, practically atraumatic and well tolerated by the patients. Complications encountered seldom necessitate operative intervention.

Adult↗
PubMed1998

The preoperative duplex examination.

BACKGROUND: Duplex evaluation of varicose veins has been described since 1986, but is still not used as routine examination prior to surgery. OBJECTIVE: To illustrate the importance of preoperative duplex varicose vein scan for the selection of operation and as a guide to surgery. METHODS: Illustration of varicose patterns and anatomical details provided by duplex but difficult or impossible to obtain by other means. CONCLUSION: Routine preoperative duplex evaluation is mandatory if varicose vein surgery is to be done on patients with accurate diagnosis.

Humans↗
PubMed1998

Late results after transurethral bladder neck incision.

OBJECTIVES: To assess the long-term results of transurethral bladder neck incision with regard to symptoms and urodynamic findings. PATIENTS AND METHODS: Between September 1986 and September 1992, 73 patients were studied. The patients were examined preoperatively and 2, 6, 12, 18 and 64 months postoperatively. Evaluation of subjective symptoms according to Madsen's and Iversen's symptom score and uroflowmetry were performed. RESULTS: At the 64-month follow-up, 1 patient had died and 11 patients were lost to follow-up. A mean symptomatic improvement was documented in 74% of the cases (range: 60-93%) for the whole period of the follow-up. Subjective assessment showed a statistically significant reduction of the voiding complaints. Postoperative measurements of peak urinary flow rate (PFR) were above 15 ml/s in 78% of the patients. We did not find any statistically significant decrease in residual volume within the group of patients with a preoperative residual urine volume below 50 ml. Such a difference was found in patients which presented with complete urinary retention or residual volume of 150-250 ml. CONCLUSIONS: Urodynamic and subjective improvement remained durable up to 64 months after bladder neck incision.

Adult↗
PubMed1997

[The treatment of severe and complicated urethral strictures].

Stricture of the urethra is produced by a cicatrix causing narrowing of the urethral lumen subsequent to trauma or inflammation. The strictures are considered as serious whenever the meatus is involved, and total--in the event of obliteration of the urethra (H. Sachse, 1978). The complications are associated with perineal, scrotal or suprapubic fistulae (C. Devine, P. Devine 1989). This is a report on 37 men presenting severe complicated strictures of the urethra, treated over the period 1981-1995 in the Clinical Center of Urology. According to underlying cause the strictures are divided in: postoperative--7 cases, iatrogenic--6, inflammatory--1, traumatic--23, and patients with scrotal fistulae--3. The patients are operated using a combined method through open and endoscopic manipulation; in 3 cases plastic repair of the urethra with a preputial flap is done. The overall results are estimated as good.

Acute Disease↗
PubMed1996

The femoropopliteal vein. Ultrasound anatomy, diagnosis, and office surgery.

BACKGROUND: The femoropopliteal vein (FPV) is evidenced by several anatomic and phlebographic studies, but its pathology and treatment are not sufficiently described in clinical and surgical textbooks. OBJECTIVE: To raise awareness of the existence of the FPV and describe its anatomy, involvement in varicose vein disease, diagnosis, and treatment. METHODS: Literature review and description of 12 illustrative cases diagnosed by duplex ultrasound. In six patients the FPV was avulsed by ambulatory phlebectomy. RESULTS: Duplex scan allows easy diagnosis and precise marking of the incompetent FPV and permits its avulsion by stab incision phlebectomy. CONCLUSIONS: The FPV is a specific anatomic vein with standard relations to other anatomic structures and may become involved in varicose vein disease. FPV incompetence escapes clinical diagnosis but is easily detected by duplex ultrasound. The incompetent FPV can be avulsed by ambulatory phlebectomy (Muller technique) in an office setting under local infiltration anesthesia.

Adolescent↗
PubMed1993

Stab avulsion of the short saphenous vein. Technique and duplex evaluation.

BACKGROUND: Stab avulsion, largely employed for removal of superficial collateral varicosities, is generally considered unsuited for surgical removal of the varicose short saphenous vein. OBJECTIVE: To describe the technique of stab avulsion of the short saphenous vein and objectively validate it by demonstrating the exact site of short saphenous vein division in the popliteal fossa. METHODS: Postoperative duplex scan of popliteal fossa in 18 limbs, 3.5 months after stab avulsion of the short saphenous vein. RESULTS: No short saphenous vein stump in 4 limbs (22%). An average 1.7-cm (range 1 to 4 cm) stump in the remaining 14 limbs. CONCLUSIONS: High (not flush) ligation of the standard short saphenous vein, considered adequate by experts who practice traditional (open field) surgery, can also be achieved by stab avulsion without a large incision, and dissection in the popliteal fossa. The stab avulsion technique is therefore adequate for removal of the standard short saphenous vein. However, because of the short-term follow-up of this study, in which cases high ligation is as efficacious as flush ligation cannot be indicated.

Adult↗
PubMed1993

Postsclerotherapy hyperpigmentations. Chromated glycerin as a screen for patients at risk (a retrospective study).

BACKGROUND: Chromated glycerin reportedly causes less post-sclerotherapy hyperpigmentations than polidocanol. OBJECTIVE: To investigate whether replacing polidocanol with chromated glycerin lowers the incidence of postsclerotherapy hyperpigmentation. METHODS: Retrospective study of 134 records of patients treated for leg telangiectasia. At the first session only chromated glycerin was injected. From the second session on treatment was continued--according to the response--either with chromated glycerin or with the stronger polidocanol. RESULTS: Chromated glycerin caused strong sclero-inflammatory reaction in 27% of patients, who were therefore treated with chromated glycerin only; in the remaining 73%, chromated glycerin was replaced with polidocanol, because of mild (or absent) reaction. Postsclerotherapy hyperpigmentation developed in three patients, all treated with chromated glycerin, while no postsclerotherapy hyperpigmentation developed in the patients treated with polidocanol. CONCLUSIONS: Single "trial" session with chromated glycerin permits to select patients at risk of developing postsclerotherapy hyperpigmentation, and treat these with a milder sclerosant. This approach also reduced the incidence of early postsclerotherapy hyperpigmentation compared with similar series treated with polidocanol alone.

Adolescent↗