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Biomedical subjects

M Pardela

Publications and source records attributed to M Pardela.

At least 19 recordsLinked to original sources

[Causes of peri-operative mortality in patients with esophageal cancer treated surgically (personal material)].

99 surgical procedures of thoracic part of esophagus resections were performed between 1985 and 1995. All thoracotomies were right-sided and alimentary canal continuity were substituted with a stomach (or with a small intestine or a colon in only a few cases) transposed inside a thorax cavity. Almost all cases there were planoepitheliale cancers. The sex index (men to women) was 6:1. The main reason of perioperative mortality were pulmonary complications (almost 90%): a respiratory insufficiency, an atelectasias, infections, and a broncho-pleural leakage. The nutrition state, stapler-using, anastomosis leak, and wound-healing way had no influence on mortality rate. Other mortality reasons there were a pleural hemorrhage, a mediastinitis as a result of esophago-gastric anastomosis disruption, a heart infarct, and a thrombo-embolic complications.

Adult

[The role of Shouldice's operation in treating inguinal hernia].

Clinical estimation of Shouldice procedure in the surgical treatment of inguinal hernia was performed in the group of 95 patients (102 operations) treated in the Second Department of General and Vascular Surgery Clinic at Zabrze between 1994 and 1996. Their ages ranged from 18 to 78 years with an average 53.6. The sex index (men to women) was 11:1. The bilateral hernia was found in seven cases and all of them were treated surgically at the same time. The most treated hernias was considered as type II and V by Gilbert classification. Among treated patients there were six cases of recurrence hernia earlier operated according to other procedures (mainly Bassini, Girard, Halsted, and artificial knitted-graft placed up intraperitoneally). In 28 cases of fascia transversalis large deficiency (the third and fourth type of Gilbert classification) authors used the two-layer modification method of reconstruction instead four layer of hernial canal posterior wall reconstruction the typical for Shouldice procedure. It was sufficient in all cases without respect to hernia size and fascia transversalis deficiency. There were no complications in postoperative periods. The recurrence of hernia, appeared only in one patient (0.98%) nine months after operation. In authors opinion, the Shouldice procedure is the most effective among all classical ways of inquinal hernia repairs.

Adult

[A case of ectopic breast tissue located in the axilla].

Authors have presented a very rare case of young woman favourable surgically treated for morphologically correct breast tissue in the unilateral axilla. They have paid the peculiar attention to possibility of ectopically placed breast tissue malignancy of every that case.

Adult

[Rare foreign body in the lumen of the small intestine].

The pathologic conditions caused by forgotten surgical gauze give rise to many different clinical pictures and are very hazardous for the patient. Such patient are seldom reported in the medical literature, mainly due to legal implications. That's why authors describe a case of surgical gauze forgotten after gynecologist procedure. The interval between the causative operation and the admission in our hospital was 7 months. The tentative diagnosis was jejunal tumor. Definitive diagnosis was made intraoperatively, we find surgical gauze 25 cm x 30 cm of diameter in jejunum with jejuno-jejunal fistula which protect patient against ileus.

Diagnosis, Differential

[About the matter of injury to the superior laryngeal nerve during strumectomy].

The attention is paid to the frequently overlooked in clinical practice problem of diagnosis and strumectomy, in the light of literature data on peripheral nerve regeneration. The authors point to important causes of frequent failures in the treatment of such complications. They conclude that at the present level of knowledge, the only practical way to avoid the aforementioned complication is the change of surgical technique in routine strumectomy.

Goiter

[Restoration of alimentary tract continuity due to of fever of unknown origin after surgical treatment of extreme obesity with partial intestinal bypass].

A case is presented of a female patient in whom after the operation of partial small intestinal bypass 45 + 15 + PV for extreme obesity, extreme emaciation developed caused by episodes of hectic fever of not completely explained aetiology, refractory to conservative treatment. Complete permanent regression of symptoms and signs was achieved after restoration of physiological continuity of the alimentary tract.

Adult

[Level of copper in plasma and tissue of patients with esophageal and large bowel cancer].

Using the technique of atomic absorption spectrophotometry copper level was determined in cancerous tissues and in unchanged homologous tissues and in the plasma of 32 patients with digestive tract cancer (17 patients with squamous oesophageal cancer and 15 with large bowel adenocarcinoma). For examination the tissues were used, removed during operation. In the control group plasma copper concentration was determined. The purpose of the work was to establish whether the increased metabolism of cancerous tissue caused cumulation of copper in cancerous cells (as it was found in cases of many other microelements), and whether it caused a significant fluctuation of plasma copper level. It was found that in patients with large bowel cancer and oesophageal cancer the mean copper concentration in cancerous tissues was lower than that in unchanged homologous tissue. It was also found that the plasma copper level in patients with cancer was not differing from normal values.

Adenocarcinoma

[Level of beta endorphins and insulin in blood of obese subjects. Effect of surgical treatment for obesity on higher exchange parameters].

The basal and hyperglycaemia-stimulated secretion of glucose, IRI and beta-endorphin (BE) were studied in subjects who had gone surgical treatment for obesity few years ago and the results were compared with those of obese subjects and lean controls. 58 persons were divided into the following groups: A-obese subjects BMI > 30, B--obese subjects 25 < BMI < 30, C--subjects treated by truncal vagotomy and gastric banding, D--subjects treated by jejunoileostomy, E--control group BMI < 25. Oral glucose (75 g) tolerance test was performed in all subjects. Blood concentration of glucose, and serum concentration of IRI and BE were studied before and 30, 60, 90 and 120 minutes after ingestion of glucose. The basal levels and areas over basal values (AOBV) of investigated parameters were evaluated. Both the basal and glucose stimulated levels of IRI and BE were higher in the obese subjects than in the control group. Truncal vagotomy and gastric banding or jejunoileostomy resulted in reduction of IRI secretion without any decrease in BE levels. The alteration of the opioid system may play some role in the pathogenesis of obesity.

Adult

Erythrocyte glutathione peroxidase in patients with colon cancer.

Erythrocyte activity of glutathione peroxidase (GSH-Px) was measured in 26 patients with colon cancer and in 26 sex, age, height and weight matched controls. The patient group had a lower mean GSH-Px activity than the control group (p < 0.001). No correlation was found between glutathione peroxidase activity and sex, age, height, or weight, or between glutathione peroxidase activity and duration of the disease. The inverse correlation between the activity of this enzyme and the extent of the disease may be caused by a decreased absorption of selenium from the diseased colon. The significance of decreased GSH-Px in patients with this disease is unknown, but the possibility exists that this may further increase their risk of developing colonic cancer.

Adult

[Diagnostic value of the analysis of alpha fetoprotein levels in malignant neoplasms of the digestive system].

The concentration of alpha-fetoprotein (AFP) in serum was determined in 58 patients (35 males and 23 females) aged from 38 to 87 years treated surgically for malignant tumours of the digestive tract, including colonic carcinoma in 30, gastric carcinoma in 11, pancreatic carcinoma in 10 and oesophageal carcinoma in 7 cases. In 33 patients the tumour was disseminated (into the liver in 22 cases). On the ground of AFP concentration determinations in 40 patients (19 males and 21 females) aged 22 to 80 years operated on for non-neoplastic abdominal diseases the upper normal range was accepted as 9.42 ng/ml. Raised AFP concentration was found in only patient with advanced pancreatic carcinoma and multiple metastases to the liver and lymph nodes. The study showed that serum AFP level in cases of digestive tract malignancies is of limited diagnostic value.

Adult

[Concentration of selenium in serum of patients with ulcerative colitis].

Selenium deficiency may be implicated in the pathogenesis of some human diseases, including colon cancer. The incidence of carcinoma of the colon is increased in patients with ulcerative colitis. We measured the serum concentration of selenium in 22 patients with ulcerative colitis and 22 sex-, age-, height and weight-matched controls. Although no significant difference was found in mean serum selenium between patients and controls (patients: 0.92 mumol/l, controls: 0.79 mumol/l), the serum selenium level decreased with increasing extension of the disease. The differences between serum selenium concentrations in patients with proctitis-sigmoiditis, left-sided colitis and pan-colitis were statistically significant. No correlation was found between serum selenium concentrations and the sex, age, height, or weight of the patients. The inverse correlation between serum selenium concentration and the extension of the disease may be caused by a decreased absorption of selenium from the diseased colon in ulcerative colitis.

Adult

Abnormal effect of sera from patients with atherosclerosis on calcium influx into normal erythrocytes.

The rheology of red blood cells in patients with atherosclerosis is abnormal. To investigate this further, the authors examined the effect of sera from patients with atherosclerosis on the handling of calcium by the erythrocyte membrane. Normal erythrocytes were filled with a photoprotein (aequorin) which emits light on contact with calcium. These photoprotein-loaded normal erythrocytes were then incubated overnight with the serum from normal subjects (n = 34) and from patients with atherosclerosis (n = 30). There was a significant decrease in basal calcium leakage, as measured by the amount of light produced following the addition of triton X-100. Induced calcium influx, as measured by the amount of light produced following the addition of ionophore A23817, was significantly greater in the photoprotein-loaded erythrocytes incubated overnight with the serum from patients with atherosclerosis compared with those incubated with the serum from normal subjects (p < 0.01). This modulation of Ca2+ handling in erythrocytes by a serum factor from patients with atherosclerosis could account for the alterations in erythrocyte function, such as red cell deformability, observed in atherosclerosis.

Adult

[Acute appendicitis in pregnancy].

A retrospective analysis is reported of 110 pregnant women with acute appendicitis on the basis of inquiry with participation of 23 surgical centres in the period 1979-1989. Attention is called mainly to diagnostic difficulties and peculiarities of the clinical course of this acute abdomen syndrome in pregnancy. The authors found that acute appendicitis was most frequent in primiparae in the 1st and 2nd trimester of pregnancy and the always high mortality was caused mainly to delay of operation.

Acute Disease

[Preliminary evaluation of the usefulness of vascular prostheses Protegraft DV 1900 manufactured by B. Braun Melsungen AG].

The authors carried out preliminary clinical evaluation of usefulness of the knitted vascular prostheses Protegraft DV 1900 of B. Braun Melsungen AG's firm. 10 prostheses of that firm were used for investigation implanting biforked protheses to six patients and single prostheses to four patients. Such qualities were taken into account: their behaviour in the operation field during the operation so blood percolating through the wall, shredding of the edges, passing of the suture through the prostheses as well as wall rigor after blood coagulation. It was observed that the vascular prostheses Protegraft DV 1900 together with the advantages ascribed until now to prostheses from woven materials and, first of all, a very short period of bleeding through the wall after releasing the clip.

Adult

[Vitamins A and E and vitamin A-binding proteins in the blood serum of patients with esophageal cancer].

The mean values of the vitamin A and the beta-carotene in the blood serum of patients with oesophageal cancer are lower than that in patients with nonmalignant oesophagus diseases and those with diseases other than malignancies and oesophageal diseases. The total protein and the albumin concentration in the blood sera did not differ when the above three groups of patients were compared. The concentration of vitamin E in the blood serum was similar in all three groups studied. The concentration of vitamin A in the group of patients with oesophageal cancer showed a marked correlation with the concentration of the vitamin A-binding proteins in the blood serum.

Adult