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Biomedical subjects

R Roka

Publications and source records attributed to R Roka.

87 records · Page 5Linked to original sources
PubMed1980

[New aspects on diagnosis and therapy of primary hyperparathyroidism (author's transl)].

26, out of them 20 surgically proven cases of primary hyperparathyroidism are presented. The value of different laboratory, radiographic and scintigraphic analysis is examined. The estimation of calcium and phosphate in serum, the iPTH-determination and fine detail hands radiographs were found to be sufficient to establish diagnosis and indication for surgery. The chloride/phosphate-ratio proved valuable in comparative statistical analysis between pHPT and two control groups. Venous sampling at present seems to be the superior method for preoperative localization of parathyroid disease. It should be performed before second surgical intervention in the cervical region, in elderly (more than 60 years old) and risk patients. Early diagnosis and therapy of pHPT is important as pHPT is a chronic disease with many organ complications. The value of calcium-screening in an age group between 40 and 60 years is discussed.

Aged↗
PubMed1980

[Anaplastic spindle and giant cell carcinoma of the thyroid (author's transl)].

77 cases of spindle and giant cell carcinoma of the thyroid were reviewed. This rapidly fata neoplasm extended beyond the capsule of the thyroid gland in all cases but one, with infiltration of the trachea or oesophagus in 3/4 of these cases at the time of diagnosis. 60% of the patients had lymph node metastases and 26% distant metastases. Due to the advanced stage of the primary tumour at the time of presentation, total resection was feasible in 13% of cases only. The prognosis is very poor; all patients died within 18 months. Correlations were demonstrated between lymph node metastases, distant metastases, tumour infiltration of trachea or oesophagus and shorter survival times. The survival time is prolonged in patients with partial tumour resection by adjuvant radiotherapy. 28% of all thyroid carcinomas seen at the 1st Department of Surgery of the University Hospital in Vienna between 1965 and 1976 were anaplastic. The high incidence in Austria is caused, in our opinion, by the higher rate of anaplastic transformation of long-standing, differentiated carcinomas in adenomatous goitres, which remain undetected clinically for years in this endemic goitre region because of their slow rate of growth.

Adult↗
PubMed1979

[The biological classifications of malignant thyroid tumours (author's transl)].

Carcinomas of the thyroid gland display large pathological and clinical variation. Favourable prognostic factors accompary well-differentiated tumours, whereas poorly differentiated or anaplastic carcinomas tend to invade early and are usually rapidly fatal. Experience has demonstrated the difference in rate of growth, subsequent recurrence and late spread even in identically well-differentiated thyroid carcinomas. Biological difference must be the underlying reason for the clinical difference in behaviour of histologically similar cancers. This report demonstrates the correlation between in vivo radioactive iodine uptake, tumour staging and recurrence-free interval in 30 thyroid carcinomas. The uptake by well-differentiated carcinomas staged T2N0M0 is significantly higher than that by tumours staged T3N1M0, whereas the latter show a higher uptake than those tumours staged T3N1M0. A high tumour uptake rate is correlated with long recurrence-free interval (up to 24 months) within all groups of staging and vice versa.

Humans↗
PubMed1979

[Factor XIII and the risk of postoperative impaired wound healing and bleeding (author's transl)].

Factor XIII concentration was investigated pre- and postoperatively in the plasma of 139 patients undergoing major abdominal surgery. Postoperative complications (impairment of wound healing and haemorrhage) were significantly more frequently seen in patients with a low concentration of factor XIII. A low preoperative concentration of factor XIII can be interpreted as a high risk factor.

Factor XIII↗
PubMed1977

[Colon transplant for oesophageal carcinoma (author's transl)].

The most suitable procedure for oesophageal replacement is colon interposition. The extent and staging of the tumour and the patient's general condition must be considered more than hitherto in the assessment of the indication for surgical intervention. Colon interposition only for the purpose of restoring the act of swallowing is not indicated because of the poor life expectation and the high operative mortality. Alternative modern methods are megavoltage irradiation and tubular prosthetics in the case of disturbance in swallowing. In accordance with the literature we elect to use one layer of interrupted sutures. With anisoperistaltic interposition the incidence of cervical fistula development seems to be higher.

Colon↗
PubMed1977

[Complications after oesophageal replacement (author's transl)].

The best procedure for substituting the oesophagus is the interposition of colon. Leakage of the cervical anastomosis is the most frequent complication. In our own material this complication was more frequent after anisoperistaltic interposition. There is no criterion for more severity with a second layer. For replacement of the cervical part of the oesophagus we used revascularized jejunal-autografts twice with success.

Colon↗
PubMed1976

[Report of 125 esophageal carcinomas (author's transl)].

This report concerns our experience in the treatment of 125 patients with carcinoma of the esophagus during 17 years (excluding the cardiac region of the stomach). In our material predisponsing factors had no effect upon the age of the patients. The symptomatology is described, the causes of postoperative complications and mortality are discussed. The principal indications are mentioned and technical considerations are summariced. Radical tumor resection resulted in a 2 year survival rate of 23 percent. Palliativ resections in cases of advanced carcinoma are refused because of the high mortality rate and the small expectation of life.

Adenocarcinoma↗
PubMed1976

[Paraneoplastic syndromes affecting the nervous system and the musculature associated with malignant tumours of the thyroid gland (author's transl)].

Two cases are presented of the paraneoplastic syndrome in patients with a malignant tumour of the thyroid gland. The first case presented with a pseudomyasthenic syndrome (in conjunction with a haemangio endothelioma) and the second case with a form of neuromyopathy (in conjunction with a partly solid and partly hormone-producing thyroid carcinoma). The pathogenesis and classification of the so-called carcinomatous neuropathies is briefly outlined and the initially atypical course taken by the first case is discussed.

Aged↗
PubMed1976

[Fractures of the olecranon; late results (authors's transl)].

140 fractures of the olecranon were treated (69 conservatively, 71 surgically), of whom 71 were followed up (28 conservative, 43 operated fractures). The fractures are classified in 4 groups (A. transverse fractures, B. oblique fractures, C. comminuted fractures and D. fractures associated with other injuries in the elbow joint). Each of these groups is devided into 3 types according to the displacement of the fragments. Good results by conservative treatment were always seen in fractures with separation of the fragments less than 2 mm. A relative indication for surgical treatment is displacement from 2 up to 10 mm. Only surgical treatment can prevent non-union in fractures with separation of the fragments more than 10 mm. A new sheme for classification of the results is proposed, and late results of the followed up cases are reported. Immobilization of the elbow in full extension is rejected in the conservative treatment. The internal fixation of prestress type by the Weber technique and the osteosynthesis with Spongiosa-screw are the preponderant methods actually used in surgical treatment.

Adolescent↗
PubMedDate not supplied

Vitamin D receptor and cytokeratin expression may be progression indicators in human colon cancer.

Epidemiological data suggest the protective role of vitamin D against the development of colorectal carcinoma in man. This could be due to the anti-mitogenic effect of the steroid hormone on human colon carcinoma cells which is mediated by a specific nuclear vitamin D receptor (VDR). Western blot analysis showed that VDR expression increases during the transition from normal mucosa to polyps and later to pT3 tumors. In later stages, however, VDR is dramatically reduced. Cytokeratin 20, which was monitored as a differentiation marker, decreases in parallel with advancing proliferation and disappears from "normal" mucosa adjacent to later stage carcinoma. Interestingly, VDR density was conspicuously higher in all tumors tested when compared to adjacent "normal" tissue. This suggest that, up to a certain degree of dedifferentiation, malignant colonocytes can upregulate the VDR, probably as a counteractive measure in response to tumor cell growth, but that this ability is finally lost in highly undifferentiated carcinoma cells.

Cell Division↗