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Biomedical subjects

A Stanek

Publications and source records attributed to A Stanek.

At least 19 recordsLinked to original sources
PubMed2006

[Structural damage of epidural catheters during combined spinal epidural anaesthesia: a lightmicroscopical study].

BACKGROUND: The purpose of this study was to investigate whether there is a risk of epidural catheter damage during the advancement of the spinal needle through an epidural needle in clinical use. METHODS: A total of 100 catheters (50 from CSE kits with a pencil-point type spinal needle and 50 from CSE kits with a Quincke type spinal needle) which had been used for routine CSE blocks were microscopically examined for any defects within the first 150 mm of the catheter. Additionally 10 unused new catheters were investigated. RESULTS: Among 10 unused catheters 5 slight scratches were found, 92 out of 100 used catheters did not show any signs of use or scratches, 7 showed some signs of use and longitudinal scratches whereas another 1 showed a moderate scratch of less than 25% of the wall thickness. There was no difference in the prevalence of scratches between the CSE kits with pencil-point type spinal needles compared to those with Quincke-type spinal needles. CONCLUSION: The CSE technique with either pencil-point type or Quincke-type spinal needles for subarachnoidal punctures was safe and showed no relevant epidural catheter damage.

Adult↗
PubMed2005

A comparison of two invasive techniques in the management of intractable pain due to inoperable pancreatic cancer: neurolytic celiac plexus block and videothoracoscopic splanchnicectomy.

BACKGROUND AND AIMS: Pancreatic cancer is characterized by a constant deterioration in quality of life, excruciating pain and progressive cachexia. The aim of this study was to compare the effectiveness of two invasive methods of pain treatment in these patients: neurolytic coeliac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) to a conservatively treated control group concerning pain, quality of life and opiates' consumption. PATIENTS AND METHODS: Fifty nine patients suffering from pain due to inoperable pancreatic cancer were treated invasively with NCPB (N=35) or VSPL (N=24) in two non-randomised, prospective, case-controlled protocols. Intensity of pain (VAS-pain), quality of life (FACIT and QLQ C30) and opioid intake were compared between the groups and to a control group of patients treated conservatively before the procedure and after 2 and 8 weeks of follow-up. The analysis was performed retrospectively using meta-analysis statistics. RESULTS: Both methods of invasive pain treatment resulted in significant reduction of pain (VSPL effect size=11.27, NCPB effect size=7.29) and fatigue (effect sizes, respectively, 1.23 and 3.37). NCPB improved also significantly physical, emotional and social well-being (effect sizes, respectively, 2.37, 4.13 and 7.51) which was not observed after VSPL. No influence on ailments characteristic for the disease was demonstrated. Mean daily opioid consumption was significantly decreased after both procedures. There was no perioperative mortality and no major morbidity. CONCLUSION: Both NCPB and VSPL provide significant reduction of pain and improvement of quality of life in inoperable pancreatic cancer patients. They present rather similar efficacy, but lower invasiveness of NCPB, in combination with its more positive effect on quality of life, pre-disposes it as being the preferred method.

Adult↗
PubMed2004

The accession countries benefit in the field of plant protection products.

Ten candidate countries are expected to join EU in 2004. In the field of plant protection product (PPP) regulation, at EU level, acceding states will have roles in evaluation for listing of active substances in Annex I of Directive 91/414/EEC and ensuring that at national level, regulatory procedures comply with the acquis communautaire. This paper briefly outlines the impact of the acquis on the roles of Member States at both EU and national levels. It then briefly explains the current Czech Republic regulatory system as operated by the State Phytosanitary Administration and the National Institute of Public Health and the steps that the Czech Republic will have to take to implement the acquis requirements. Finally it makes an assessment as to how successful implementation of the acquis will prove beneficial to the acceding states and the parties which rely on the service that the regulatory authorities provide (i.e. the public, farmers and growers and the agrochemical industry).

Agriculture↗
PubMed2004

[Accessory spleens--diagnostic and therapeutic problem of the laparoscopic splenectomy in idiopathic thrombocytopenic purpura patients].

The preoperative detection of accessory spleens (AS) is essential in ITP patients. The aim of this study was to evaluate the reasons of failure and long-term results of laparoscopic splenectomy (LS) in patients with idiopathic thrombocytopenic purpura (ITP). Thirty-four ITP patients (27 females and 7 males) underwent LS between June 1998 and January 2001. Computed Tomography (CT) and sonography (US) were performed preoperatively to evaluate the size of the spleen and to detect the presence of possible accessory spleens which were found in two cases. AS were seen during laparoscopy in three cases. During follow-up (median time = 23 months), in three patients a low platelet count was seen after 5 months, 1.5 and 1.8 years pop. In all these cases scintigraphy was performed, which revealed in one case the residual accessory spleen. In the two other patients, inspite of thrombocytopenia no residual spleens were found. The authors conclude that laparoscopic splenectomy is a safe and effective procedure in patients with ITP. The problem of accessory spleens can be managed by careful videoscopic examination of the abdominal cavity during splenectomy. The use of the preoperative imaging techniques for detection of accessory spleens is limited by the insufficient sensitivity of the examination.

Adolescent↗
PubMed2004

Psychological factors influencing results of cholecystectomy.

BACKGROUND: Cholecystectomy is a surgical gold-standard procedure for gallbladder diseases, among which gallstones are the most frequent. Despite the introduction of minimally invasive surgery and broad access to ultrasound examination there is a group of patients in whom the surgery ailments persist. Those vague ailments can be perceived from a psychological point of view as somatization or even somatoform disorders. METHODS: The aim of the study, designed as a case-control study, was to evaluate psychological characteristics that may accompany the incidence of so-called post-cholecystectomy pain syndrome (PCPS). The study focused on 367 patients treated for gallstones in the Dept. of General, Gastroenterological and Endocrinological Surgery, Medical University of Gdańsk, Poland. At about a year after the operation, the patients received a questionnaire that included a structured interview and psychological assessment of social support and rumination. Those who revealed symptoms of PCPS were invited to the department for further medical and psychological evaluations. Psychosocial scores of PCPS and non-PCPS patients were compared. RESULTS: The PCPS patients did not present any dysfunction at the physical examination or in gastroduodenoscopy or sonography. However, they differed from the remaining. asymptomatic group in terms of lacking social support, as well as increased rumination. CONCLUSION: It is concluded that psychological variables may play an important role in the onset of subjective symptoms in at least a subgroup of the PCPS patients as a form of somatization. Psychological supportive and explanatory activities (cognitive and behavioural approach) may provide sufficient help.

Adult↗
PubMed2003

One hundred and ten consecutive uncomplicated retroperitoneal videoscopic adrenalectomies--Polish multicentre study.

AIM: The authors evaluate the effectiveness of videoscopic adrenalectomy (VA) for a variety of endocrine disorders. METHODS: One hundred and ten consecutive videoscopic adrenalectomies performed from October 1995 till December 2000 were reviewed and followed up for adequacy of surgical treatment in 2 surgical departments. There were 79 females and 31 males included in the study. The mean age was 48.0 years (range 23-71 years). Indications for the operations were: phaeochromocytomas (n=5), aldosterone-producing adenomas (n=19), cortisol-producing adenomas (n=10), Cushing's disease (n=3) and non-secreting tumours (n=72). RESULTS: There was no mortality and no morbidity both intraoperatively and in the postoperative course. In 8 cases conversion to open surgery was instituted - in 4 cases due to an unintended lesion of pertioneum without damage to the intraperitoneal organs. Mean operative time was 156 min (range 52-280 min), and estimated blood loss was 73 ml (range 20-300 ml). The average length of hospital stay was 2.9 days (range 2-7 days). None of the patients revealed either recurrence of hormonal hypersecretion or tumour mass in imaging studies during the follow-up period (range 1-34 months). CONCLUSION: 1. VA is recommended in patients with hormonally active tumours and in patients with benign adrenal masses of a diameter up to 6 cm. 2. VA is a safe and feasible procedure if performed by a team experienced in endocrine and endoscopic surgery. 3. VA is a procedure better than open adrenalectomy in management of small, non-malignant tumours because of the reduction of operative trauma.

Adrenal Gland Neoplasms↗
PubMed2002

Protein oxidation in male Syrian hamster kidney during estrogen-induced carcinogenesis.

Chronic administration of estradiol leads to generation of estrogen-dependent renal cancer in male Syrian hamsters within 9-12 months. The pathogenesis of this tumour is associated with oxygen free radicals, however, it is still not clear which metabolic pathway of estrogens is responsible for the generation of the radicals, and which part of the cell is mostly affected by it. The paper presents an experiment in which the protein oxidation measured by carbonyl groups level in 9-month estrogenization scheme. The level of carbonyl groups was significantly elevated starting from the 1st month of estrogenization until the 9th. The weight of the kidneys reflecting possible tumuorigenesis was also significantly increased in estrogenized group starting at the 2nd month of the experiment. The weight of the testes, a sign of adequate estrogenicity, was decreased dramatically in the estrogenized group from the first to the last month of experiment. The results suggest that the kidney of estrogenized male Syrian hamster suffers from oxidative stress affecting proteins.

Journal Article↗
PubMed2001

Clinical and histopathological evaluation of the adrenal incidentaloma.

Clinically silent adrenal masses (incidentaloma) are incidentally discovered lesions, when noninvasive imaging methods (USG, CT, MRI) are performed for reasons other than known or suspected adrenal disease. Most studies report on a prevalence of adrenal incidentaloma range between 1% and 10% in radiological series. Between 1994 and 1999 we observed in our Department 57 patients with incidentalomas of adrenal glands. After endocrinological evaluation silent Cushing's syndrome was found in 2 cases (3.5%). Fifty two patients were qualified for surgery. Adrenocortical adenoma was diagnosed in 73.1%; adrenocortical carcinoma in 7.7%; pheochromocytoma in 7.7% and less frequent adrenal lesions in 11.5%. All adrenal carcinomas and malignant pheochromocytomas (11.5%) were found in tumors with diameter over 4 cm.

Adrenal Cortex Neoplasms↗
PubMed2000

Experimental pancreatitis induced by synthetic prooxidant tert-butyl hydroperoxide.

The purpose of this study was to verify whether injection of tert-butyl hydroperoxide (Bu(t)OOH, a well-known prooxidant agent) into the bile-pancreatic duct can induce acute pancreatitis. A rapid blockade of the secretion was observed in the majority of the animals after 3 hours of observation. After 6 hours, the secretion reached a very low level, significantly different compared with controls. In groups of rats injected with Bu(t)OOH, pancreatic weight gain was observed compared with the rats injected with physiologic saline. Histology of pancreata removed 3 hours after injection of Bu(t)OOH showed acinar cell vacuolization, interstitial edema, focal necrosis of pancreatic acini, fat-tissue necrosis, and leukocyte infiltration of the organ. These changes were considerably greater after the 6-hour observation period. Electron-microscopic inspection revealed profound morphologic changes 3 hours after Bu(t)OOH injection. The control rats receiving physiologic saline alone had well-preserved pancreatic tissue structure. In conclusion, injection of the prooxidant agent, tert-butyl hydroperoxide, into common bile-pancreatic duct induces acute necrotizing pancreatitis, which indicates the crucial role of free radical reactions in pathogenesis of this disease.

Animals↗
PubMed2000

[Delivery with husband].

On the basis of the own questionnaire, the research concerning 60 married couples, experiencing family delivery, was made. It was stated that there is strong emotional bound between parents and strong need for experiencing the delivery together.

Adult↗
PubMed2000

[Laparoscopic splenectomy with a postero-lateral approach in patients with idiopathic thrombocytopenic purpura].

UNLABELLED: The aim of the study is presentation of operative technique and early results of laparoscopic splenectomy in 15 cases of idiopathic thrombocytopenic purpura (ITP) patients resistant to typical steroid therapy. There were 7 women and 8 men in age 16-58 years (mean 32.6 years). Preoperative investigations revealed accessory spleens in two patients. Platelets count at the time of qualifying patients to splenectomy varied from 7-35 g/L and after preoperative treatment (prednisone 1 mg/kg--6 patients, methylprednisone 25 mg/kg--5 patients, immunoglobulins 2.0/kg--2 patients, immunoglobulins and methylprednisone--2 patients) varied from 36-205 g/L. Splenic length was from 8-17 cm. The lateral approach and 4-5 ports were utilized in all cases. Pneumoperitoneum with value of 12-14 mmHg of carbon dioxide was created using an open technique. First step of the procedure was to free spleno-colic ligament, then spleno-reno attachment. In all cases the hilus artery, vein and short gastric vessels were clipped and divided by Endo GIA stapler 30 or 60 mm and clips. Spleens were removed from the abdomen cavity in the plastic bag after manual/forceps crushing inside the bag. Intraoperative bleeding occurred in 2 patients (20%). Blood loss was about 800 and 1000 ml respectively. The mean operative time was 170 min (140-300 min). Spleen weight was 210 g average. In 3 cases conversion to open approach was needed because of injury of splenic vessels (2 pts.) and difficulty in removing spleen--in 1 patient. Post operative course was uneventful in every 10 patients. Mean hospital stay was 5.8 days. Increase in platelet count was observed in 14 patients on the second postoperative day to 60-291 g/L. One patient did not response as expected. No early postoperative complications were observed. CONCLUSION: Laparoscopic splenectomy may be considered as a safe and feasible procedure in selected patients with ITP without long-term improvement after typical conservative treatment.

Adolescent↗
PubMed1999

Laparoscopic treatment of parapubic postprostatectomy hernia.

We are reporting the case of a parapubic hernia that occurred after radical prostatectomy. This kind of the hernia is caused by the weakening of the attachments of rectus muscles to the pubic bone. Because of its location, it may be misdiagnosed as a far more common direct inguinal hernia. A laparoscopic approach made it possible to precisely diagnose and repair the defect in the abdominal wall.

Follow-Up Studies↗
PubMed1999

[Laparoscopic adrenalectomy from the lateral retroperitoneal approach].

From April to November 1998 eleven patients (8 female and 3 male, mean age 48.5; range 23-69) with adrenal gland tumor underwent laparoscopic adrenalectomy from the lateral retroperitoneal approach. Authors report their primary experience; introduce their own material and describe the operative technique of laparoscopic adrenalectomy from lateral retroperitoneal approach. Besides one case of Conn syndrome, all tumors were hormonally non-active. In 10 patients the adrenal masses were incidentally discovered during such imaging examination as abdominal ultrasonography and computed tomography. All tumors were benign in postoperative histopathological examination. The localization was unilateral and suprarenal in all cases (7 right, 4 left). Both operation and postoperative course in all patients were uncomplicated. One conversion to "open" procedure had been performed due to laparoscopic equipment damage.

Adrenal Gland Neoplasms↗
PubMed1999

[Chondrocalcinosis: rarely diagnosed frequent disease. A case report].

In this paper we described a case of 56 old patient with history of joint disease. We diagnosed chondrocalcinosis with hypomagnesemia. The patient was treated for gout during last 13 years. The frequency of chondrocalcinosis is estimated about 10% in patients after 50 years of age, but it is very rare diagnosed. A correct diagnosis is possible on the basis of simple tests and it allows to avoid the drugs which are not effective in this disease.

Chondrocalcinosis↗
PubMed1998

[Plasma concentrations of bupivacaine for continuous peridural anesthesia in children].

Epidural anaesthesia is extremely useful in providing postoperative analgesia for children after surgery of the lower body. Although results on early pharmacokinetics in children have previously been reported, no data are available on the long-term effects of epidural anaesthesia. The aim of this investigation was the assessment of plasma bupivacaine levels in children with continuous epidural anaesthesia in the postoperative period. A catheter with an outer diameter of 0.63 mm was inserted through a 19G Tuohy cannula into the epidural space. A maximum dose of 0.4 mg/kg/h bupivacaine was administered for continuous epidural infusion. Careful monitoring was performed to detect early signs of local anaesthetic intoxication. Two milliliters of blood were obtained in each patient per day and nepholometric serum measurement were performed to determine alpha 1-acid glycoprotein and albumin levels. Bupivacaine plasma concentrations were assessed according to the method described by Sattler et al. [25]. Ten children were included in the investigation. The measured albumin and alpha 1-acid glycoprotein concentrations were within the range described by other investigators. At the onset of pain therapy maximum levels of 0.5 microgram/ml were recorded after a loading dose of bupivacaine and levels of up to 2.2 micrograms/ml were achieved following continuous infusion. There were no neurologic complications or signs of local anesthetic intoxication. In conclusion our results show that a dose of up to 0.4 mg/kg/h bupivacaine during continuous epidural infusion is not associated with toxic complications. Careful monitoring of the children by experienced staff is mandatory.

Anesthesia, Epidural↗