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Biomedical subjects

S Duca

Publications and source records attributed to S Duca.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[Gadolinium DTPA in magnetic resonance. Clinical experience in intracranial pathology].

Sixty-seven patients with various intracranial pathologies were studied using Gd-DTPA as a contrast medium applied to MRI. This paramagnetic substance was well tolerated by all patients, and proved particularly useful in improving the diagnosis of extra-axial tumors, in which a rich enhancement was always present. Gd-DTPA allowed a better definition of the tumor outlines, as well as its differentiation from edema, and the demonstration of its relationship to brain parenchyma and cerebral vessels. This was particularly true for meningiomas, which often display poor contrast enhancement at MRI. Even though acoustic neuromas had, as a rule, high signal intensity, Gd-DTPA was useful to precisely recognize the intracanalar part of the tumor. The value of Gd-DTPA was less evident in intra-axial lesions. It proved nonetheless useful in demonstrating the portions of the tumor where, due to alterations in BBB, enhancement was present. This allowed both to characterize the lesion and to perform accurate biopsies.

Brain Neoplasms↗
PubMedDate not supplied

Roux-en-Y gastrectomy: early and late results.

Results obtained in 16 patients by Roux-en-Y gastrectomy (Moskowicz procedure) are presented. According to Langhans a high gastrectomy ascending on the lesser curvature to 2 to 3 cm below the cardia and unaccompanied by a sectioning of the vagal branches was performed. The Roux-en-Y resection was used only in exceptional situations, being preferred to the standard Billroth II operation in order to avoid the biliopancreatic reflux into the gastric remnant. It was performed as a primary intervention in 13 cases (penetrating gastric or duodenal ulcers, gastritis due to biliar reflux) and as a revisional surgery in three patients with disturbances of the operated stomach. The best results were obtained in gastritis due to biliar reflux, in gastric ulcers Johnson I type, and when the method was used as a revisional surgery. When it was used as a primary operation in duodenal ulcers, the main risks depend of two things: the duodenal fistula and the ulcerous recurrence. Duodenal stump disruption has not specific causes and as well as in all the Billroth II resections may results from less than satisfactory duodenal closure. This complication was noted in one patient. Concerning the risk of the anastomotic ulcer, it is particularly increased in the Billroth II-Roux gastrectomy compared with the other types of gastric resections. When the operation is unaccompanied by vagotomy, the risk has maximum values. In this clinical material the ulcerous recurrence was noted in four patients.

Adult↗
PubMedDate not supplied

Choledochoduodenostomy in the treatment of benign biliary tract disease.

Of 3656 surgical interventions in benign biliary tract diseases performed over 8 years, 58 were choledochoduodenostomies. The assessment of the results reveals that after having performed the Finsterer procedure, 7 fistulae and two anastomotic stenoses have been encountered. The operative mortality was 6.8% (four patients). In three cases death was subsequent to anastomotic fistulae; the fourth patient died of bronchopneumonia. During the last three years the choledochoduodenostomy with triangular onlay flap (Stuart technique) was almost exclusively used, and this procedure obviously improved the postoperative results. Intraoperative control of the anastomosis tightness was done by the Clotteau's technique.

Adult↗
PubMedDate not supplied

[Improvement of the conditions of rat liver preservation by concomitant perfusion of the liver and kidney].

One of the factors limiting the duration of rat liver storage is the excessive accumulation of catabolites in the perfusion medium. In view of obtaining of an efficient depuration the authors have introduced a new circuit allowing for the concomittant perfusion of the liver and of the kidneys. The excretion effort of the kidneys is assessed by the estimation of urea nitrogen in the perfusion medium and in the urine collected over the entire duration of the experiment. The results have confirmed the good function of the system which provides possibilities for improved storage conditions of rat liver.

Animals↗
PubMedDate not supplied

[Liver transplantation. Experimental aspects].

Following an overview of the data published in the specialized literature in connection with liver transplantation the author presents original experimental studies in this field. One of the first aspects considered is the stage of obtaining the graft of liver tissue. The selective perfusion was used, in situ, of the dog liver, and conditions were achieved which were similar to those obtained in other methods of graft preparation. Two washing solutions were used: a simple one, currently used in the practice, and another one which was enriched with various substrates. Biochemical parameters of tissue sampled by bioptic puncture have demonstrated that the first solution induces a lowering of the glycogen contents of hepatocytes, and this alters the biological qualities or the graft. The fact is stressed that the obtention of the hepatic tissue for grafting should be considered in fact as an in situ conservation. With regard to the liver transplantation proper it is shown that the author has performed the sector heterotopic procedure in the rat. Vascular anastomoses have been made with histoacryl-N-blau by the method of prosthesis with lost tubing. Problems raised by the vascular re-connection of the auxilliary hepatic tissue, and those related to the space where this tissue should be placed are also discussed in detail. The survival time was not longer than 30 hours.

Animals↗
PubMedDate not supplied

[Oddi's sphincterotomy or sphincteroplasty. Considerations on the results obtained with a personal sphincteroplasty technic].

A total of 21 cases are presented, of patients in whom Oddian sphincteroplasty was performed, according to an original technique. In 19 cases the indication was due to Oddian stenosis associated to lithiasis or hepatic hydatic cysts which had ruptured in the biliary pathways. In two other cases security sphincteroplasty of the Oddi sphincter was performed for lithiasis of the choledocus. The decision was based on macroscopic changes of the biliary pathways, on the control of the main biliary pathway. Sphincteroplasty was achieved with the aid of an original probe, and the incision of the ampullary area was in the average 25 mm in length. The postoperative control, made by tube cholangiography and barium examination, has evidenced the presence of a wide, open choledocoduodenal orifice. Duodenal fistula was one of the complications which followed duodenostomy. This however was fully repaired in 14 days after conservative treatment. After a confrontation of the results achieved with this method, and the data published in the literature the authors support oddian sphincteroplasty, and stress its advantages by comparison with the results provided by sphincterotomy.

Adult↗
PubMedDate not supplied

[Acute ischemic hypoxia of the liver].

The author studied some aspects related to the acute ischaemic hypoxia of the liver using an original methodology based on the selective in situ perfusion of the liver of dogs. Hypoxia was obtained by clamping the liver pediculum for a duration of 30 minutes. In a first group of experiments the dynamics of the carbohydrate metabolism during hypoxia was followed. On this occasion was established the use of some washing solutions containing large amounts of substances involved in the protection of the hepatocytes from the viewpoint of their glycogenic stores in the course of the sampling of the liver grafts. This has important effects in maintaining the biological qualities of the organ. In a second group of experiments the involvment of the Kupffer-cell system was investigated, as a result of ischaemic hypoxia. A colloidopexia test was used, which employed 198Au. In view of obtaining an increased tolerance to hypoxia selective perfusions were carried out, with a solution containing cortison hemisuccinate and Essentiale 303. The results confirmed the lysosome-protecting effects of this solution when perfusion preceded ischaemia by 90-120 minutes. It also confirmed the test value of the colloido-pexia method. For the first time it was confirmed that there is a significant increase in the 198Au fixation in the spleen in the animals the liver of which was exposed to ischaemia.

Animals↗
PubMedDate not supplied

[Preservation of the liver (accomplishment, difficulties and prospects)].

The low tolerance of the hepatic tissue to conservation in artificial conditions represents one of the major reasons limiting the application of hepatic transplantation in the clinic. An analysis is carried out of the factors which limit the duration of conservation of the potential graft, by alteration of its biological qualities. These include: ischaemic hypoxia, failure of devices presently used for conservation, spontaneous and progressive reduction of the perfusion flow of the hepatic tissue, insufficient coverage of the metabolic necessities of the organ and the incomplete depuration of the storage medium. Possible remedies are also discussed, in view of improving conservation parameters. The authors's studies can be included in this effort, since they are aimed at improving the perfusion flow of the isolated liver under the effect of streptokynase. Other studies are mentioned, concerned with simultaneous perfusion of the liver and the kidney in view of an efficient depuration of the storage environment.

Animals↗