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Biomedical subjects

P Gatzinsky

Publications and source records attributed to P Gatzinsky.

At least 19 recordsLinked to original sources
PubMed1999

The significance of oral health and dental treatment for the postoperative outcome of heart valve surgery.

The objective of this study was to evaluate the significance of preoperative dental treatment for the development of complications in the form of infections during the first postoperative weeks after heart valve surgery. In one group of patients (n = 149), oral health was examined and dental treatment performed 3-6 months prior to heart valve surgery. In a second group (n = 104), oral health was examined postoperatively and these patients did not receive any dental treatment before surgery. Infections were recorded for all patients during the first three weeks after surgery and correlated to the dental status at the time of surgery. Sepsis or endocarditis occurred in 5.4% of the first group and in 1.9% of the second group. Freedom from all infections for the two groups was 55% and 56%, respectively. The results did not reveal any significant differences between the groups regarding patients' oral health at the primary oral examination. The frequencies of postoperative complications such as focal infections, fever and increased CRP were also found to be similar for both groups. The combined scores of complications were 2.1% and 1.8%, respectively. Data from the present study do not support the suggestion that dental intervention will decrease the rate of early complications following heart valve surgery.

Aged↗
PubMed1994

Intrathoracic extrapulmonary hemangiopericytoma. Late local recurrence after radical extirpation of a large tumor.

A 39-year-old woman was operated upon for an extremely large hemangiopericytoma located in the right hemithorax. During intensive follow-up a local recurrence was observed 8 years after the radical extirpation of the well-encapsulated tumor, histologically assessed as generally benign. This and other observations give reason to suspect that the well-recognised puzzling clinical behavior of this rare tumor is a result of a potential pathological capacity of the abnormally vascularised fatty connective tissue through which the tumor is connected to the body. This tissue, if not radically extirpable, must be completely destroyed in some way during or after the operation in order to prevent recurrence.

Adult↗
PubMed1993

Surgical treatment of a large eventration of the left diaphragm.

Total eventration of the left diaphragm is a rare condition in adults. It is now generally accepted that surgery is indicated only in cases of distinct complaints involving abdominal or thoracic organs which can be related to this pathological condition. The accepted routine surgical procedure for treatment of the eventration is plication of the diaphragm without incision or excision of the pathologically changed part of the diaphragm. In rare cases, reinforcement of the very thin membrane with some foreign material may be necessary. We describe an adult patient with extensive eventration and severe symptoms in whom we used a special technique for restoration of the diaphragm with very good results.

Aged↗
PubMed1990

Pneumothorax in pregnancy.

Since 1957, only 15 cases of isolated spontaneous pneumothorax in pregnancy have to our knowledge been reported in the English literature. The treatment of pneumothorax in pregnancy is more difficult than in non-pregnant patients. A case is reported and therapy discussed.

Adult↗
PubMed1988

A case of carcinoma in intralobar pulmonary sequestration.

A case of intralobar pulmonary sequestration with the unusual origin of an abnormal artery from the ascending aorta and with cancer localised in the sequestrated lung tissue is presented. The preoperative investigation failed to diagnose the cancer.

Adenocarcinoma↗
PubMed1987

Pathogenesis of shrinking pleuritis with atelectasis--"rounded atelectasis".

The pathogenesis of "shrinking pleuritis with atelectasis" or "rounded atelectasis" is discussed on the basis of 37 operated patients and on experiments on cadaver lungs. Peroperative dissections with microscopic examinations and the results of experiments with the cadaver lungs support the concept that the lesion is caused by an inflammatory reaction in the visceral layer of the pleura, caused by asbestos fibers. The inflammation occurs in stages, with deposition of connective tissue that shrinks and causes considerable atelectasis of the underlying pulmonary parenchyma. Compression of the lung due to fluid collecting in the pleural cavity involved was not noted.

Asbestos↗
PubMed1986

Treatment of benign strictures and injuries of the oesophagus with a permanent oesophageal tube introduced through a cervical oesophagostomy. II. Clinical observations.

Eighty-four patients with severe benign oesophageal strictures and/or oesophageal perforation have been managed with a permanent oesophageal tube (POT) introduced through a cervical oesophagostomy. Sixty-eight patients had severe strictures of varying etiology. In these patients, the conservative treatment by bouginage could not be continued due to a stricture unyielding for dilatation or early recurrence of the stricture after a number of dilatations. Eleven of these patients had iatrogen oesophageal perforation at the time the treatment with POT was started. In 16 patients indication for treatment with POT was a severe injury of the oesophagus and in 15 of them it was transmural. The results of the treatment are considered to be satisfactory. The mortality rate, the final results and the factors determining poor results of the treatment are discussed. The treatment with POT introduced through a cervical oesophagostomy is considered to be a valuable method which can be used in cases with stricture and injuries of the oesophagus in which conventional conservative treatment is futile or impossible and resection of the oesophagus undesirable.

Adolescent↗
PubMed1985

Long term results of operation for shrinking pleuritis with atelectasis.

During 14 years 34 patients were operated on for shrinking pleuritis with atelectasis. They were followed up after one to 14 years (mean 6.0) by interview, chest radiography, and spirometry. Most were in good condition, but a reduction in vital capacity had occurred in eight and in FEV1 in 15 patients. Radiographs were normal in 28 patients except for small pleural or parenchymal fibrotic changes. One patient had a suspected recurrence of shrinking pleuritis with atelectasis after nine years, suggesting continuation of the disease process despite operation.

Adult↗
PubMed1985

Resectional operations and long-term results in carcinoma of the esophagus.

The 5 year survival rate after resectional operations for carcinoma of the esophagus is still very low. Many factors have been identified as contributing to these poor long-term results. The main factor found in this study, comprising 102 patients undergoing resection out of 125 patients operated upon during a 10 year period, was nonradical resection. The main cause of nonradical resection was invasion of the tumor into the mediastinum, which was observed in 80% of the patients. In 43 of the 102 patients undergoing resection, the penetration of the carcinoma into the tissue surrounding the esophagus was observed only histologically. Thirty-three of the 38 hospital survivors in this group died within 2 years of the operation of recurrence of carcinoma. Fourteen of 17 survivors after resectional operations in whom the tumor growth was still limited to the esophagus were alive from 2 to 9 years (mean 6 years) after the operation, without evidence of recurrence.

Adult↗
PubMed1985

Surgical treatment of symptomatic gastroesophageal reflux recurring after hiatal hernia repair.

Experience of 30 cases with reoperation for recurrent symptoms after hiatal hernia repair is reported. The primary operation had been transabdominal in 21 cases (11 simple cruroplasty, 7 Nissen, 3 Hill) and transthoracic in 9 (5 Husfeldt, 4 simple cruroplasty). Stenosis and/or esophageal shortening were present in at least 8 patients at the primary operation. Symptoms recurred within a year in 26 of the 30 patients. A transthoracic approach was used for all reoperations. At the time of reoperation, 14 patients had no reflux complications or had esophagitis only. At follow-up (2-12 years) 13 were symptom-free and 1 was improved: X-ray showed hernia in one case and 3 had positive standard reflux test. Of the 16 patients with severe reflux complications before reoperation, 12 had shortened esophagus, combined with stricture in 6 cases, and 4 had isolated stricture. The results were less satisfactory in this complicated group, though all were postoperatively improved. There was no operative mortality. Initial failure to recognize esophageal shortening and inadequate repair were common causes of recurrent hernia. Symptomatic relief after reoperation was comparable with that after primary repair.

Adult↗
PubMed1984

Foreign bodies in the mediastinum perforating the oesophagus.

A patient attempting suicide put four unsterile objects into a stab wound in his neck. These objects remained in the tissues unnoticed for about three months before they were removed from the upper mediastinum by operation. Owing to penicillin treatment, no diffuse mediastinitis developed but the oesophagus was perforated by the objects. In spite of severe damage to the gullet by the perforation and by operative incision, the oesophagus could be repaired without development of stenosis. The method of preventing stenosis is presented.

Adult↗
PubMed1983

Aortic cross-clamping for more than 2 hours in open-heart surgery. Early results in 87 patients.

Myocardial protection with cold cardioplegia has made it possible to prolong the time of aortic cross-clamping during open-heart surgery. Myocardial ischemia for up to 120 minutes is considered acceptable under these conditions. Eighty-seven patients operated upon for various heart lesions with cardiopulmonary bypass and aortic cross-clamping for more than 2 hours (mean time 146 minutes) were reviewed. Myocardial protection was achieved with cold cardioplegia, in some cases with additional topical cooling of the heart. Ten patients died and 77 were discharged from the hospital. Perioperative and early postoperative deaths could not be correlated to aortic cross-clamping time or the method of myocardial protection. Aortic cross-clamping can be safely performed for a period far longer than 2 hours with myocardial preservation by cold cardioplegia.

Adult↗