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Biomedical subjects

S Georgescu

Publications and source records attributed to S Georgescu.

11 recordsLinked to original sources
PubMed1991

[The hyperfunctional thyroid nodule].

Authors report their experience of 22 years regarding 284 patients with hyperfunctional thyroidal nodules (279 operated), representing 12.4% of the 2,289 cases of thyroidal (875 hyperthyroid) diseases treated during this period. The diagnosis was established on the basis of the confrontation of the anamnestic symptomatology and of that found at the clinical examination--which confirmed the pure character of thyrotoxicosis by showing the presence of a thyroidal nodule--with the study of the global glandular function and the scintigram, completed with dynamic tests. Among the typical clinical and scintigraphic, usually severe, forms (with cardiothyreosis) may be distinguished asymptomatic or atypical forms (with dissociated or intermittent manifestations). The treatment of the toxic thyroidal adenoma is surgical, except some contraindications of a general order. The surgical treatment is aimed at achieving the permanent cure of the disease, without sequelae or functional and/or morphological relapses. The subtotal lobectomy (210 cases) is preferred as an exeresis procedure to the enucleoresection (45 cases). In most operated cases (93%) the immediate clinical and biological results were favourable.

Adolescent↗
PubMedDate not supplied

[The value and limits of subtotal gastrectomy in gastric cancer].

In the interval 1970-1988, in 321 of 670 patients with gastric neoplasm admitted to the 1st Surgical Clinic of Iaşi a subtotal gastrectomy was performed. Most patients were males (68.9%), more commonly aged between 50 and 70 years and in advanced evolutive stages. The gastric neoplasm were sited in order of frequency in the antrum (46.9%), body of the stomach (34.6%), eso-cardio-tuberosity (11.5%), linitis (4%), gastric stump and malignant ulcer (3%). Surgery was possible in only 59% of the cases (25% curative and 34.1% palliative). The surgical technique and its difficulties are detailed. In the 321 subtotal gastric resections 20 complications, 4 deaths (1.2%) and 20% survivals over 5 years were recorded. It is concluded that radioendoscopic and microscopic investigations, with their possibility of an early diagnosis, may cause a limitation of the indications of total gastric resection in the treatment of gastric neoplasm in favour a subtotal resection, more satisfactory from the functional viewpoint.

Adolescent↗
PubMedDate not supplied

[Cholecystosis, the diagnostic and treatment problems].

In the interval 1981-1989 at the Ist Clinic of Surgery of Iaşi 230 cases of chronic cholecystitis were admitted and operated upon (cholesterolosis--24 cases, dysmorphosis--84 cases, dysplasia--22 cases). Most cases had a morphologic--dysmetabolic substrate--strawberry gallbladder, alone or associated with other lesions (lithiasis, cirrhosis, pancreatitis), rare cases being also found (porcelain gallbladder--1 case, calcium bile--2 cases, gallbladder diverticulosis--3 cases, longitudinal complete obstruction of cystic duct by gallstone--2 cases). This condition is more frequent in women in the 3rd dad 4th decade, the symptoms being discrete, uncharacteristic, but persistent. The diagnosis is based on duodenal catheterization, cholecysto-cholangiography and ultrasonography, the intraoperative and histo-pathologic confirmations being required. The increasing frequency of chronic cholecystitis makes necessary a more minute diagnosis and exigent surgical indication, pledges for long-term favourable results.

Adult↗
PubMedDate not supplied

[Computed tomography in establishing the therapeutic management of lung cancer].

Computer tomography (CT), a noninvasive method of high complexity, compelled recognition in pneumological practice, becoming indispensable. The present study deals with 59 patients suspected of bronchopulmonary cancer, who were submitted to computer tomography, besides other examinations. CT contribution in establishing the diagnosis, the therapeutical line (particularly in determining the surgery moment) as well as the correlations (concordance and discordance) between the information offered by CT and by other conventional (radiological, bronchological) methods are analysed. The association of thin needle trans-thoracic biopsy (TNB) to CT ensures an important histologic confirmation which amounts to 75% of investigated cases, according to our statistical data.

Adolescent↗
PubMedDate not supplied

[The cholestasis syndrome. A critical evaluation of an exploratory strategy].

The authors studied 160 cases of biliary stasis: 120 having intrahepatic cause (101 hepatic cirrhoses and 19 primitive biliary cirrhoses) and 40 extrahepatic cause (17 choledochal lithiases and 23 cancers of the pancreas head) and check up the diagnosis value of two investigation algorithms: echography, the first investigation, followed by hepatic biopsy puncture, if the intrahepatic biliary ducts are not dilated, or transhepatic cutaneous cholangiography if the intrahepatic biliary ducts are dilated in comparison with intravenous cholangiography in the first investigation. Echography has an increased diagnosis yield (96% sensitivity, 99% specificity), is cheap, noninvasive and is the first imaging exploration used in biliary stasis syndrome.

Adult↗
PubMedDate not supplied

[Differentiated thyroid cancer].

In the interval 1979-1988, out of 1070 operated goiters 77 malignant thyroid tumors were recorded, 60 of them being differentiated: papillary--32 (53.4%), vesicular--12 (20%), mixed forms--16 (26.7%). The differentiated thyroid carcinomas had peculiar clinical biological and prognostic features and were framed: stage I--60%, stage II--23.4% and state III-IV--16.6%. Only 15 cases presented lymph node metastases. In 16 cases the thyroid tumor was associated with another thyropathy: Hashimoto's thyroiditis--5 cases, Basedow's disease--1 case. The surgical intervention was performed in two times: first total lobectomy or total lobo-isthmectomy [correction of lobioistectomy] with contralateral subtotal exeresis, then total thyroidectomy. It is insisted upon a careful surveillance of postoperative evolution (clinical, biological, scintigraphy) in order to detect the recurrence and apply a proper treatment.

Adult↗
PubMedDate not supplied

[Pleural fibromas].

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

[Choristomas].

The authors present 21 cases of aberrant pancreas with gastric and duodenal location (heterotopias under the shape of inclusions, nodules or true adenomas) included besides the rare cases of adenoma developed from Brunner and Lieberkühn glands in the "choristomas" category. Asymptomatic or with clinical phenomena and complications "borrowed" from the associated peptic ulcers (15 cases) the diagnosis of pancreatic heterotopias is usually an interoperatory or even histopathological surprise, the X-ray examination with the classical image "in cocard" and the endoscopy being rarely evocative. The surgical treatment is generally conservative and is dominated by the presence or lack of the concomitant peptic ulcer.

Adult↗
PubMedDate not supplied

[The "cold" thyroid nodule].

The main problem posed by an (apparent) solitary thyroid nodule is cancer identification, present in about 10% of the nodules excised surgically. This percent might increase to 25-30% in the cold scintigraphic nodules. Therefore, a combination of all the methods for nodule assessment is necessary: anamnesis, physical examination, functional tests, therapeutic test with tyrosine and thyroid imaging, but mainly the intensive active exploration including puncture-biopsy with a fine needle and exeresis with extemporaneous and paraffin morphological checking. Starting from a two decades' experience of a group of endocrinologists, surgeons, anatomo-pathologists and specialists in nuclear medicine, in 2,289 thyropathies operated--of whom 1691 (poly)nodular goitres and 1,190 non-capturing nodules--the authors suggest an investigation algorithm for achieving a differentiated surgery in terms of the pre- and intraoperative morphological findings. This attitude permitted both the improvement of the surgeries of thyroid cancers and the exeresis of benign nodules under low-risk surgical conditions or avoidance of a "non-necessary" surgery.

Biopsy↗