C. Dzsinich | Central Military Hospital (original) (raw)
Papers by C. Dzsinich
Archives of Surgery, 1970
Perspectives in Surgery
Introduction: Thrombosis of inferior vena cava (IVC) is an important complication amongst oncolog... more Introduction: Thrombosis of inferior vena cava (IVC) is an important complication amongst oncological patients. Tumor thrombus of IVC is characteristic for patients with renal cell carcinoma, occurring in 10−18%. The aim of the work is to analyze of surgical treatment in patients with cancer thrombosis of inferior vena cava in kidney cancer. Methods: Between 2010 and 2019 we treated 32 patients with kidney cancer complicated by thrombotic infiltration of the inferior vena cava. According to Nesbitt classification the levels of thrombotic infiltration of the inferior vena cava were: I–8 (25%), II–14 (43.8%), III–6 (18.8%), and IV–4 (12.5%). Nephrectomy with thrombectomy of the cancer thrombus in the inferior vena cava was performed in all patients. In addition to laparotomy, sternotomy was approached in 4 patients with Nesbitt IV and in 2 patients with Nesbitt III. Results: Primary suture of IVC was performed in 26 patients; angioplasty of IVC was performed in 4 patients; and resecti...
Thoracic and Cardiovascular Surgeon - THORAC CARDIOVASC SURG, 1976
European Journal of Vascular Surgery, 1993
Acta paediatrica Academiae Scientiarum Hungaricae
Digestion
Pancreatitis was induced in rats with sodium deoxycholate or sodium taurocholate and they receive... more Pancreatitis was induced in rats with sodium deoxycholate or sodium taurocholate and they received intravenously 5 μCi/g or 0.55 μCi/g body weight of 2,3–3H-DL-valine, respectively, and the pancreas was removed. The number of grains counted per 1,000 μm2 was 298, 196 and 112 over the acini in the intact, the saline-treated, and the deoxycholate-treated glands, respectively. The differences are statistically
European Journal of Vascular Surgery, 1990
Orvosi hetilap, Jan 11, 1979
Acta morphologica Academiae Scientiarum Hungaricae, 1979
Incorporation of Solcograft was studied experimentally and clinically. The graft was found to fac... more Incorporation of Solcograft was studied experimentally and clinically. The graft was found to facilitate the formation of continuous endothelium which starts at the vessel graft boundary and from newly formed capillaries. Transmission and scanning microscopical investigations revealed neointima, neomedia and neoadventitia formation in 3--4 months. Complications such as obliteration were unfrequent. Aneurysm formation did not occur, the potency rate was satisfacory. Experience in 20 clinical cases are reported in detail. As to its usefulness in reconstructive vascular surgery, Solcograft is placed behind the saphenous graft. The graft is particularly suitable for patch plastics.
Orvosi hetilap, Jan 10, 2004
This paper deals with a novel chapter of aneurysm surgery, the stent-graft implantation. The inte... more This paper deals with a novel chapter of aneurysm surgery, the stent-graft implantation. The interdisciplinary cooperation between angio-radiology and surgery made available a much less invasive therapeutic option. The new technique was first applied in 1991.The authors present the technique, conditions and results of the procedure and also give a survey on the domestic situation. In general anaesthesia using inguinal approach a self-expanding stent-graft (diameter: 8 mm) equipped with barbs was inserted in the aorta and deployed into the aneurysm under X-ray guidance. Vanguard (Boston-Scientific Co.), Talent (Medtronic Co.) and Exluder (Gore-Tex Co.) instruments were used. In 40 patients (29 men and 11 women, mean age: 59.7 years) 55 stent-grafts were implanted. Thirty-one thoracic and 9 infrarenal aneurysms were treated. In 3 patients ruptured aneurysm, in 3 other instances covered ruptured aneurysm, and in 3 persons symptomatic aortic aneurysm were treated. Thirty-one patients un...
Acta chirurgica Belgica, 2002
Despite remarkable progress in both, diagnostic and therapeutic development in treating aortic di... more Despite remarkable progress in both, diagnostic and therapeutic development in treating aortic dissections, this continues to be one of the most severe vascular disorders and is subject to high mortality rates. While aortic dissections of Type A can be treated surgically today, in the majority of patients with Type B dissections hypotensive treatment is the method of choice, providing a better chance of survival and the effective prevention of aneurysm formation and rupture at the site of the intimal tear. However in certain cases, Type B dissection generates either isthmic aneurysm formation, or, with distal progression, may result in long segmental thoracic, thoraco-abdominal or abdominal deterioration of the aorta and its side branches. The spinal, visceral, renal and lower limb ischemia threatens the viability of these organs and hypotensive medication may enhance this risk. Emergency diagnostic work-up and selective surgical reconstruction could lead to reduced mortality. In ou...
Magyar sebészet, 2001
Inspite of remarkable progress in both diagnostic and therapeutic development in treating aortic ... more Inspite of remarkable progress in both diagnostic and therapeutic development in treating aortic dissections this continues to be one of the most severe vascular catastrophies complicated by high mortality. While aortic dissections Type A are to treat surgically in our days, in majority of patients with Type B dissections hypotensive treatment is the method of choice providing better chance for survival preventing effectively aneurysm formation and rupture at the site of intimal tear. However in certain cases Type B dissection produces either isthmic aneurysm formation, or with distal progression may afflict long segmental thoracic, thoracoabdominal or abdominal deterioration of the aorta and its side branches. The spinal, visceral, renal and lower limb ischemia threatens viability of these organs and hypotensive medication may enhance risk. Prompt evaluation and selection of these cases with proper surgical reconstruction help us to reduce mortality. At our department we have perfo...
Magyar sebészet, 2000
The most feared complication of thoracoabdominal clamping is the paraplegia or paraparesis follow... more The most feared complication of thoracoabdominal clamping is the paraplegia or paraparesis following ischemic injury of the spinal cord. Early intraoperative recognition of this complication has not been solved yet. In our earlier experiment we found significant alterations of CSF glucose, lactate, pCO2 and Neuron Specific Enolase (NSE) levels during 60 minutes thoracoabdominal aortic clamping in dogs. The analysis of these parameters proved to be proper to follow metabolism of the spinal cord during this type of surgery. In our present paper we studied protective effect of regional hypothermia using peridural cooling by registration of above parameters. Statistical analysis of our data showed prevention of production of anaerobe metabolites in animals with icy peridural irrigation. The biochemical approach is appropriate for monitoring effectiveness of regional hypothermia of the spinal cord during aortic surgery.
Orvosi hetilap, Jan 28, 1997
During a ten-year period 16 patients were seen with aortic rupture and false aneurysm secondary t... more During a ten-year period 16 patients were seen with aortic rupture and false aneurysm secondary to blunt trauma. One patient underwent an acute operation, 4 patients had operative therapy elective delayed and 11 patients were operated on for chronic traumatic false aneurysm. Operative delay was done in case of simultaneous multisystem injury (e.g. shock caused by abdominal injuries, cerebral contusion or pulmonary contusion on the right side). The shunt bypass method of repair was used in the case of 3 patients, cardiopulmonary bypass in 6 cases and simple aortic cross-clamping in 6 patients. One operation was performed without aortic cross-clamping. Primary repair was achieved in three patient, in 3 more cases a patch was inserted and in 9 cases interposition Dacron grafting was accomplished. One "wrapping" operation was performed. In 2 cases, reoperation was necessary because of postoperative bleeding. One patient died in the perioperative period. Right sided hemiparesis...
Orvosi hetilap, Jan 31, 1997
Bilateral renal artery stenosis was diagnosed noninvasively in the 17th gestational week, in a ch... more Bilateral renal artery stenosis was diagnosed noninvasively in the 17th gestational week, in a chronically hypertensive pregnant woman, by renal artery duplex ultrasound examination, MRI and MR angiography. Continuous monitoring of the mother and the fetus was performed. Blood pressure was stabilized by complex antihypertensive therapy, but from the beginning of the third trimester superimposed preeclampsia developed gradually. In the 34th gestational week a 1600-g newborn was delivered by elective cesarean section. The case report draws attention to the significance of the thorough examination of hypertensive women before pregnancy.
Archives of oral biology, 1970
Orvosi hetilap, Jan 24, 1985
Orvosi hetilap, Jan 10, 1985
Acta morphologica Hungarica, 1986
Aorto-coronary bypass made by implanting the patient's own saphenous vein may exhibit a tende... more Aorto-coronary bypass made by implanting the patient's own saphenous vein may exhibit a tendency to early and late occlusion. This phenomenon is influenced by a number of factors including intraoperative damages of the graft. To determine preferable techniques for preserving vein integrity, various human graft preparation techniques were compared. Endothelial damage may occur during the preparation of the saphenous vein; the extent of damage depends on the preparation technique. In our studies the endothelium was best preserved by Rheomacrodex filling at 100 water cm pressure. Early occlusion seems to be best avoided in certain conditions using Gore-tex (polytetrafluoro-ethylene) prostheses due to the fact that the structure of Gore-tex simulates the normal endothelium covering of the luminal surface of the vessels and renders quick "re" endothelialization. This may reduce the hazard of early graft occlusion. In the present study experimental models and grafts implante...
International angiology : a journal of the International Union of Angiology
Paraplegia from spinal cord ischemia during thoracoabdominal aneurysm repair remains an unpredict... more Paraplegia from spinal cord ischemia during thoracoabdominal aneurysm repair remains an unpredictable and unpreventable complication. In an effort to prevent spinal cord ischemia during aortic cross-clamping, preoperative angiographic localization of the blood supply to the spinal cord was performed in dogs. Sixteen animals underwent 60 minutes of thoracoabdominal aortic cross-clamping either without (control, n = 8) or with (shunted, n = 8) a selective shunt. Shunting was performed from the aortic arch to that isolated aortic segment angiographically shown to supply the thoracolumbar anterior spinal artery. Spinal cord blood flow was measured with microspheres just prior to cross-clamping, at 5 and 60 minutes after cross-clamping and at 5 minutes after restoration of aortic blood flow. Functional neurologic outcome was evaluated in animals at 24 hours postoperatively. Shunting did not decrease spinal cord injury. Seven of the 8 animals in the control group and 7 of the 8 in the shu...
Archives of Surgery, 1970
Perspectives in Surgery
Introduction: Thrombosis of inferior vena cava (IVC) is an important complication amongst oncolog... more Introduction: Thrombosis of inferior vena cava (IVC) is an important complication amongst oncological patients. Tumor thrombus of IVC is characteristic for patients with renal cell carcinoma, occurring in 10−18%. The aim of the work is to analyze of surgical treatment in patients with cancer thrombosis of inferior vena cava in kidney cancer. Methods: Between 2010 and 2019 we treated 32 patients with kidney cancer complicated by thrombotic infiltration of the inferior vena cava. According to Nesbitt classification the levels of thrombotic infiltration of the inferior vena cava were: I–8 (25%), II–14 (43.8%), III–6 (18.8%), and IV–4 (12.5%). Nephrectomy with thrombectomy of the cancer thrombus in the inferior vena cava was performed in all patients. In addition to laparotomy, sternotomy was approached in 4 patients with Nesbitt IV and in 2 patients with Nesbitt III. Results: Primary suture of IVC was performed in 26 patients; angioplasty of IVC was performed in 4 patients; and resecti...
Thoracic and Cardiovascular Surgeon - THORAC CARDIOVASC SURG, 1976
European Journal of Vascular Surgery, 1993
Acta paediatrica Academiae Scientiarum Hungaricae
Digestion
Pancreatitis was induced in rats with sodium deoxycholate or sodium taurocholate and they receive... more Pancreatitis was induced in rats with sodium deoxycholate or sodium taurocholate and they received intravenously 5 μCi/g or 0.55 μCi/g body weight of 2,3–3H-DL-valine, respectively, and the pancreas was removed. The number of grains counted per 1,000 μm2 was 298, 196 and 112 over the acini in the intact, the saline-treated, and the deoxycholate-treated glands, respectively. The differences are statistically
European Journal of Vascular Surgery, 1990
Orvosi hetilap, Jan 11, 1979
Acta morphologica Academiae Scientiarum Hungaricae, 1979
Incorporation of Solcograft was studied experimentally and clinically. The graft was found to fac... more Incorporation of Solcograft was studied experimentally and clinically. The graft was found to facilitate the formation of continuous endothelium which starts at the vessel graft boundary and from newly formed capillaries. Transmission and scanning microscopical investigations revealed neointima, neomedia and neoadventitia formation in 3--4 months. Complications such as obliteration were unfrequent. Aneurysm formation did not occur, the potency rate was satisfacory. Experience in 20 clinical cases are reported in detail. As to its usefulness in reconstructive vascular surgery, Solcograft is placed behind the saphenous graft. The graft is particularly suitable for patch plastics.
Orvosi hetilap, Jan 10, 2004
This paper deals with a novel chapter of aneurysm surgery, the stent-graft implantation. The inte... more This paper deals with a novel chapter of aneurysm surgery, the stent-graft implantation. The interdisciplinary cooperation between angio-radiology and surgery made available a much less invasive therapeutic option. The new technique was first applied in 1991.The authors present the technique, conditions and results of the procedure and also give a survey on the domestic situation. In general anaesthesia using inguinal approach a self-expanding stent-graft (diameter: 8 mm) equipped with barbs was inserted in the aorta and deployed into the aneurysm under X-ray guidance. Vanguard (Boston-Scientific Co.), Talent (Medtronic Co.) and Exluder (Gore-Tex Co.) instruments were used. In 40 patients (29 men and 11 women, mean age: 59.7 years) 55 stent-grafts were implanted. Thirty-one thoracic and 9 infrarenal aneurysms were treated. In 3 patients ruptured aneurysm, in 3 other instances covered ruptured aneurysm, and in 3 persons symptomatic aortic aneurysm were treated. Thirty-one patients un...
Acta chirurgica Belgica, 2002
Despite remarkable progress in both, diagnostic and therapeutic development in treating aortic di... more Despite remarkable progress in both, diagnostic and therapeutic development in treating aortic dissections, this continues to be one of the most severe vascular disorders and is subject to high mortality rates. While aortic dissections of Type A can be treated surgically today, in the majority of patients with Type B dissections hypotensive treatment is the method of choice, providing a better chance of survival and the effective prevention of aneurysm formation and rupture at the site of the intimal tear. However in certain cases, Type B dissection generates either isthmic aneurysm formation, or, with distal progression, may result in long segmental thoracic, thoraco-abdominal or abdominal deterioration of the aorta and its side branches. The spinal, visceral, renal and lower limb ischemia threatens the viability of these organs and hypotensive medication may enhance this risk. Emergency diagnostic work-up and selective surgical reconstruction could lead to reduced mortality. In ou...
Magyar sebészet, 2001
Inspite of remarkable progress in both diagnostic and therapeutic development in treating aortic ... more Inspite of remarkable progress in both diagnostic and therapeutic development in treating aortic dissections this continues to be one of the most severe vascular catastrophies complicated by high mortality. While aortic dissections Type A are to treat surgically in our days, in majority of patients with Type B dissections hypotensive treatment is the method of choice providing better chance for survival preventing effectively aneurysm formation and rupture at the site of intimal tear. However in certain cases Type B dissection produces either isthmic aneurysm formation, or with distal progression may afflict long segmental thoracic, thoracoabdominal or abdominal deterioration of the aorta and its side branches. The spinal, visceral, renal and lower limb ischemia threatens viability of these organs and hypotensive medication may enhance risk. Prompt evaluation and selection of these cases with proper surgical reconstruction help us to reduce mortality. At our department we have perfo...
Magyar sebészet, 2000
The most feared complication of thoracoabdominal clamping is the paraplegia or paraparesis follow... more The most feared complication of thoracoabdominal clamping is the paraplegia or paraparesis following ischemic injury of the spinal cord. Early intraoperative recognition of this complication has not been solved yet. In our earlier experiment we found significant alterations of CSF glucose, lactate, pCO2 and Neuron Specific Enolase (NSE) levels during 60 minutes thoracoabdominal aortic clamping in dogs. The analysis of these parameters proved to be proper to follow metabolism of the spinal cord during this type of surgery. In our present paper we studied protective effect of regional hypothermia using peridural cooling by registration of above parameters. Statistical analysis of our data showed prevention of production of anaerobe metabolites in animals with icy peridural irrigation. The biochemical approach is appropriate for monitoring effectiveness of regional hypothermia of the spinal cord during aortic surgery.
Orvosi hetilap, Jan 28, 1997
During a ten-year period 16 patients were seen with aortic rupture and false aneurysm secondary t... more During a ten-year period 16 patients were seen with aortic rupture and false aneurysm secondary to blunt trauma. One patient underwent an acute operation, 4 patients had operative therapy elective delayed and 11 patients were operated on for chronic traumatic false aneurysm. Operative delay was done in case of simultaneous multisystem injury (e.g. shock caused by abdominal injuries, cerebral contusion or pulmonary contusion on the right side). The shunt bypass method of repair was used in the case of 3 patients, cardiopulmonary bypass in 6 cases and simple aortic cross-clamping in 6 patients. One operation was performed without aortic cross-clamping. Primary repair was achieved in three patient, in 3 more cases a patch was inserted and in 9 cases interposition Dacron grafting was accomplished. One "wrapping" operation was performed. In 2 cases, reoperation was necessary because of postoperative bleeding. One patient died in the perioperative period. Right sided hemiparesis...
Orvosi hetilap, Jan 31, 1997
Bilateral renal artery stenosis was diagnosed noninvasively in the 17th gestational week, in a ch... more Bilateral renal artery stenosis was diagnosed noninvasively in the 17th gestational week, in a chronically hypertensive pregnant woman, by renal artery duplex ultrasound examination, MRI and MR angiography. Continuous monitoring of the mother and the fetus was performed. Blood pressure was stabilized by complex antihypertensive therapy, but from the beginning of the third trimester superimposed preeclampsia developed gradually. In the 34th gestational week a 1600-g newborn was delivered by elective cesarean section. The case report draws attention to the significance of the thorough examination of hypertensive women before pregnancy.
Archives of oral biology, 1970
Orvosi hetilap, Jan 24, 1985
Orvosi hetilap, Jan 10, 1985
Acta morphologica Hungarica, 1986
Aorto-coronary bypass made by implanting the patient's own saphenous vein may exhibit a tende... more Aorto-coronary bypass made by implanting the patient's own saphenous vein may exhibit a tendency to early and late occlusion. This phenomenon is influenced by a number of factors including intraoperative damages of the graft. To determine preferable techniques for preserving vein integrity, various human graft preparation techniques were compared. Endothelial damage may occur during the preparation of the saphenous vein; the extent of damage depends on the preparation technique. In our studies the endothelium was best preserved by Rheomacrodex filling at 100 water cm pressure. Early occlusion seems to be best avoided in certain conditions using Gore-tex (polytetrafluoro-ethylene) prostheses due to the fact that the structure of Gore-tex simulates the normal endothelium covering of the luminal surface of the vessels and renders quick "re" endothelialization. This may reduce the hazard of early graft occlusion. In the present study experimental models and grafts implante...
International angiology : a journal of the International Union of Angiology
Paraplegia from spinal cord ischemia during thoracoabdominal aneurysm repair remains an unpredict... more Paraplegia from spinal cord ischemia during thoracoabdominal aneurysm repair remains an unpredictable and unpreventable complication. In an effort to prevent spinal cord ischemia during aortic cross-clamping, preoperative angiographic localization of the blood supply to the spinal cord was performed in dogs. Sixteen animals underwent 60 minutes of thoracoabdominal aortic cross-clamping either without (control, n = 8) or with (shunted, n = 8) a selective shunt. Shunting was performed from the aortic arch to that isolated aortic segment angiographically shown to supply the thoracolumbar anterior spinal artery. Spinal cord blood flow was measured with microspheres just prior to cross-clamping, at 5 and 60 minutes after cross-clamping and at 5 minutes after restoration of aortic blood flow. Functional neurologic outcome was evaluated in animals at 24 hours postoperatively. Shunting did not decrease spinal cord injury. Seven of the 8 animals in the control group and 7 of the 8 in the shu...