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P Ondrejka

Publications and source records attributed to P Ondrejka.

At least 19 recordsLinked to original sources
PubMed2004

[The treatment of gastric tumours in our practice: a five year survey].

Between the 1st of January, 1998 and the 31st of December, 2002 we treated 111 patients for gastric cancer in the 2nd Department of Surgery, Semmelweis University, Budapest, Hungary. The majority of patients belonged to the advanced stages of the disease. In 65% of the cases a partial or total gastrectomy was performed. We combined the operation with D2 lymph node dissection if a R0 resection was possible, in the other cases with D1 lymphadenectomy. Postoperative morbidity rate ranged to 15%, the mortality 5.4%. 74 patients could be followed, 41 are dead and 33 still alive. According to the follow up examination the median survival time is 20.4 months at the moment. We observed a significantly shorter survival time, if vascular or lymphoid vessel invasion was present in the histologic specimen. The study has not been finished and the follow up will be continued.

Adenocarcinoma↗
PubMed2003

[Bone changes in patients after partial gastric resection].

Metabolic diseases of the bones may be a serious complication of gastrectomy. The pathogenesis of osseous changes is multifactorial. The most important causes include a reduced intake of dairy products, their fastened passage through the stomach and reduced calcium and vitamin D absorption. The objective of the work was to assess bone changes in patients after partial gastrectomy. From a total number of 261 patients with a minimal 10-year history of gastrectomy, in the investigation 31 patients were included (18 men and 13 women) who met the required criteria. The results were compared with a control group of 18 men and 13 women of equal age. The authors compared also groups of patients with the condition after surgery type Billroth I (8 patients) and Billroth II (23 patients). In all investigated subjects the authors examined the bone density in the area of the lumbar spine and neck of the femur and parameters of osteoresorption and osteoformation. The authors found a significant reduction of bone density in the area of the spine and neck of the femur (p < 0.001) and a significantly higher level of total alkaline phosphatase and intact parathormone in serum and N-terminal telopeptide collagen type I in urine (p < 0.001), as compared with the control group. The other parameters did not differ in the investigated groups. The authors did not find a statistically significant difference in the investigated parameters between patients after resection Billroth I and Billroth II. The results confirm the need of early diagnosis and treatment of bone changes in patients after partial gastrectomy.

Adult↗
PubMed2002

[Diurnal rhythm of endogenous somatostatin in patients with carcinoid].

AIM OF THE STUDY: Was to investigate the differences of the circadian rhythm of the endogenous somatostatin in patients with carcinoid and in healthy probands. METHODS: The group of 30 patients (16 men/14 women) was divided onto two groups. The group M of 20 (12/8) pts with metastatic disease and group B of 10 pts without known metastases at the time of investigation. The control group A included by 12 healthy probands (7/5). Plasma levels of somatostatin were determined by radioimmunoassay. Fisher periodogram and Halberg's cosinor were used for statistical evaluation. RESULTS: We confirmed the 24-hour circadian rhythm of somatostatin in group A, B and M. Patients of the M group when compared with A and B groups had higher mesor and the later 24-hour acrophase (p < 0.05) and 12-hour acrophase (p < 0.05). Treatment with lanreotide led to the significant decrease of the somatostatin mesor (p < 0.05).

Adult↗
PubMed2002

Carcinoid tumors--somatostatine in the diagnosis and therapy.

BACKGROUND: Carcinoid tumors have a neuroendocrine origin and endocrine activity is typical for them. OBJECTIVES: The main objective of the present study was to determine differences in the levels of an endogenous somatostatin, a neuron specific enolase in serum and excretion of 5-HIAA in the urine in patients with carcinoid tumors and also to determine the changes of these parameters during the treatment with long acting somatostatin analogue--lanreotide. SUBJECTS AND METHODS: 30 pts with carcinoid tumors (20 pts with metastatic disease, 10 pts after resection of the primary tumor without known metastases at the time of the investigation) and 12 healthy probands were included in the study. Circadian rhythm of endogenous somatostatin in all groups was performed. Levels of neuron specific enolase in the serum and the excretion of 5-HIAA in the urine in pts with carcinoid tumors were done. The estimation of these parameters were repeated in the group of pts with advanced metastatic disease during the treatment with the lanreotide. RESULTS: We confirmed the existence of the circadian rhythm of endogenous somatostatin in all groups. Chronogram of somatostatin in pts without known metastases shows the same characteristics as the chronogram of healthy volunteers. The chronogram of pts with metastatic carcinoid disease shows a statistically significant differences in comparison with healthy volunteers--higher mesor and later acrophase of 24-hour rhythm (p < 0.05). During the therapy with lanreotide lower mesor was observed (p < 0.05). The amount of the 5-hydroxyindolacetate acid in urine in pts with metastatic carcinoid was statistically significant higher than in the pts without metastases (p < 0.001). During therapy with the lanreotide the decrease in the 5-HIAA in the urine (p < 0.05) was observed. Neuron specific enolase in the serum was higher in group with the metastatic disease (p < 0.001). CONCLUSION: Abnormalities in the somatostatin secretion and the concentration of the neuron specific enolase in serum are useful markers for the differential diagnosis and might distinguish the carcinoid patients with and without metastases. Urine excretion of 5-HIAA is a good marker of endocrine activity of the carcinoid tumor. (Fig. 4, Tab. 3, Ref. 22.)

Adult↗
PubMed2002

[Giant cell angiofibroma of the lower eyelids].

The authors present a rare case of giant cell angiofibroma (GCAF) of the lower eyelids and the possibility of its surgical treatment. They emphasize the basic morphological indicators for assessment of GCAF and its difference from similar entities.

Adult↗
PubMed2001

[Flesh-eating bacteria infection of an immunocompromised patient].

After years of steadily declining morbidity and mortality due to group A streptococcal infections, a resurgence of severe, invasive disease has been ongoing since 1980, leading to the recognition of streptococcal shock syndrome (STSS), necrotizing fasciitis, the most severe form of invasive infection. The patients suffer from rapid local deep soft tissue destruction, severe septic shock and multi organ failure. The increased incidence of these infections has been accompanied by remarkable vigor in virulence and severity of the disease. The reason for this impressive change in the epidemiology and clinical manifestation of group A streptococcal infections remains unknown. The possible etiological factor is changing in virulence factor or the lack of protective immunity of the population (immunocompromise) against the invasive strains. We describe a severe necrotizing fasciitis of a 41-year-old previously immunocompromised woman. The patient developed severe septic shock, multi organ failure and perineal and lower abdominal skin, fat and fascia necrosis due to mixed GAS (aerob, anaerob) infection of the perineum and the Bartholini glands. After an aggressive surgical debridement, antibiotic and supportive therapy the generalised and local infection was treated.

Adult↗
PubMed2001

[Gastrointestinal stromal tumors in our practice].

The classification of tumours originating from the wall of gastrointestinal organs changed dramatically since of electronmicroscopy and immunohystochemistry were introduced. Previously these tumours were classified as leiomyomas, leiomyosarcomas or schwannomas. With the new methods these disorders can be described in more details and unified, and so the change to provide correct prognosis improved. Still, there are some unanswered questions remaining for the pathologists. In our material in the past 5 year we treated 9 patients because of GIST. Most of them were found in the stomach (6), one developed in the oesophagus, one in the small bowel and another one in the rectum. With describe our patients and look at the related articles literature about this important diseases. Though the incidence is under 1% of patients operated on because of gastrointestinal diseases, we would like to share our experiences in treatment.

Adult↗
PubMed2000

Isolated massive pleural effusion caused by pancreatico-pleural fistula.

BACKGROUND: Massive pleural effusions are uncommon but well-documented complications of chronic pancreatitis, usually caused by the development of a pancreaticopleural fistula. The mechanism of the fistula formation is thought to be rupture of the pancreatic duct or pseudocyst. MATERIAL AND METHODS: In the past 7 years we have treated 5 patients with massive pleural effusion of pancreatic origin in the Surgical Department of Semmelweis University Medical School. 4 patients were males; the average age was 52 years (range: 46-59 years). RESULTS: All 5 patients had a history of alcohol abuse and were admitted to the pulmonary department because of respiratory distress. Other symptoms such as abdominal pain, chest pain, or weight loss were not always present. The diagnosis was confirmed by a markedly elevated amylase level in the aspirated pleural fluid. Abdominal ultrasound, CT scan, and ERCP examinations were carried out in order to determine the cause of the pancreaticopleural fistula. Conservative (nonsurgical) treatment was effective within 3 weeks in only one case. The other 4 patients required surgical management. In 3 cases distal pancreatic resection with splenectomy and cholecystectomy was done. In one case cystojejunostomy was performed. All 5 patients have been cured with complete resolution of their pleural effusions. CONCLUSIONS: Patients with large pleural effusions may have underlying pancreatitis with a pancreaticopleural fistula. It is important to establish this diagnosis because treatment may require operative interventions.

Acute Disease↗
PubMed2000

[Effect of pancreatic substitutes on fecal and serum elastase and on pain in patients with chronic pancreatitis].

Views on the existence of a negative feedback between pancreatic secretion and intraduodenal of proteases in humans are controversial. The objective of the study was to find out whether enzyme substitution will have an impact on pancreatic enzyme secretion and pain in chronic pancreatitis. The preparation Panzytrate 2500 (2 x 3 capsules/day containing 1250 units of proteases per capsule) was administered for a 4-week period. In 18 patients with chronic pancreatitis (7 with the severe and 11 with the medium severe and mild form of pancreatitis) the faecal and serum pancreatic elastase was assessed one day before and one day after enzyme substitution therapy. A significant reduction of the faecal elastase concentration (p = 0.03) and serum elastase (p = 0.00375) was recorded in patients with mild and medium severe CP. The values of faecal and serum pancreatic elastase 1 were insignificantly reduced also in patients with severe chronic pancreatitis. Pain relief was statistically significant already after two weeks' administration of enzyme substitution therapy (p = 0.0233) and after four weeks' treatment (p = 0.00766). The results support the importance of the negative feedback on regulation of pancreatic secretion and the positive effect of substitution therapy on pain in chronic pancreatitis.

Adult↗
PubMed2000

[Acute gastrointestinal bleeding caused by a rare, benign tumor of the duodenum (gangliocytic paraganglioma)].

Diagnosis and treatment of massive gastrointestinal bleeding is sometimes very difficult problem in a surgical unit. Authors present a case of a 40 years old female with an atypical source of upper gastrointestinal bleeding. The origin of the bleeding was detected only by intraoperative enteroscopy. The source of the bleeding was a very rare benign tumour of the duodenum (Gangliocytic paraganglioma) which involved the papilla of Vater. During the operation resection of the pedunculated tumour was carried out, with choledochal--and Wirsungoplastyc, associated with external drainage of these ducts. According to the literature in preoperative diagnosis of this rare tumour endoscopy, angiography, and EUS are very useful. In case of malignancy, metastases radical operation-pancreatoduodenectomy--is indicated.

Acute Disease↗
PubMed2000

[Splenic rupture: a rare complication of colonoscopy].

Splenic rupture due to colonoscopy is very rare. Only a few cases have been reported previously in the English literature. Authors present their own case and they call attention to the mechanism of this complication. They conclude consequences from the literature.

Aged↗
PubMed2000

[Effect of alendronate therapy on bone turnover--results of a multicenter study].

Sodium alendronate is a bisphosphonate of the IInd generation with a strong antiresorptive effect. Its favourable effect on reduction of the incidence of vertebral and non-vertebral fractures was repeatedly confirmed. The objective of the multicentre study was to evaluate the effect of administration of 10 mg of sodium alendronate combined with 1000 mg of elemental calcium administered in the course of three months on the N-terminal telopeptide(NTx) a sensitive marker of bone resorption. The group comprised 275 postmenopausal women with densitometrically confirmed osteoporosis. After three months treatment a 53% decline of NTx values occurred as compared with baseline values. This finding confirms the favourable effect of sodium alendronate on bone remodelling. A decline of the concentration of bone markers is one of the good predictors of the effectiveness of treatment focused on reduction of atraumatic osteoporotic fractures.

Adult↗
PubMed1999

Vitamin 1,25-(OH)2 D3 concentrations in patients hospitalized long-term.

Vitamin D deficiency may be one reason for the onset and development of osteoporosis. The aim of the present study was to determine the occurrence rates of hypovitaminosis D in an unselected group of individuals presenting with common medical conditions and hospitalized for long periods. Concentrations of 1,25-(OH)2 D3 were measured in 89 patients (38 males and 51 females). Mean age was 70 years. Thirty-eight patients were tested in the spring and the remaining 51 patients in the autumn. Vitamin D3 levels were significantly reduced in patients tested in the autumn (p < 0.001). The reason for this surprising observation may have been the small number of sunny days and the long hospital stays during the study period, differences in the composition of both groups and the fact that 1,25-(OH)2 D3 reflects the actual vitamin D3 levels rather than those of its reserve in the human body. The results obtained suggesting hypovitaminosis D in an unselected group of elderly patients hospitalized with common diseases, even after the summer season, suggest the need for general supplementation of this vitamin throughout the year, regardless of the risk factors.

Aged↗
PubMed1999

[Vitamin D deficiency in hospitalized patients].

Vitamin D deficiency is one of the important risk factors for the development of osteoporosis and fractures. The high prevalence of hypovitaminosis in elderly people in old age pnesioners homes was proved in several investigations, similarly as the favourable effect of vitamin D (800 IU/day) and calcium supplementation on a decline of fracture risk. Risk factors of hypovitaminosis such as an inadequately varied diet; low exposure to sunlight, chronic liver and kidney disease and treatment affecting the metabolism and clearance of vitamin D are very frequent in elderly patients hospitalized in medical departments. In the submitted trial the authors assessed in a group of 38 patients, mean age 70 years, hospitalized at the medical department at the end of the winter period the vitamin D3 serum level. They found a significant reduction of the concentration of 1.25 hydroxyvitamin D3 (p < 0.01) in the investigated group. The results of the trial, along with data in the literature on the high prevalence of hypovitaminosis D in the European population, indicate the need to introduce this simple cheap and safe therapeutic modality into routine practice.

Aged↗
PubMed1999

[Salmon calcitonin in the treatment of osteoporosis].

Salmon calcitonin is frequently used in the treatment of osteoporosis. Via specific receptors on osteoclasts it reduces bone absorption and has also an osteogenic effect. Treatment with calcitonin leads to an increase in bone density, drop of markers of bone turnover and reduction of risk fractures. In the submitted trial the authors investigated the influence of nasal calcitonin administered in amounts of 100 IU in three-month intervals, on bone density. The group comprised 59 patients, mean age 64 years. The mean period of treatment was 2.5 years. Treatment led to a significant increase of bone density in the region of the lumbar spine and neck of the femur. Treatment was well tolerated and the authors did not record new manifest fractures or side-effects of treatment.

Administration, Intranasal↗