Biomedical subjects

A Utíkalová

Publications and source records attributed to A Utíkalová.

At least 19 recordsLinked to original sources

PubMed1998

[Methods of surgical treatment of advanced hydronephrosis in children].

For the establishment of the therapeutic procedure in advanced hydronephroses the basic criterion is the functional state of their damaged kidney which can be assessed best by scintigraphy. The results of plastic repair of the damaged pelviureteral portion depends on the stage of hydronephrosis and the child's age. The best results were achieved in less damaged kidneys (hydronephroses I and II) in all age groups and in advanced hydronephroses (IV and V) in children under the age of one year. Early assessment of the diagnosis is important for achievement of good results. This is made possible by ultrasound screening. Early surgery can reduce the percentage of nephrectomies.

Adolescent↗

PubMed1997

Familial hydronephrosis unlinked to the HLA complex.

Clinical findings, management, and possible linkage of congenital hydronephrosis caused by ureteropelvic junction stenosis to the HLA complex were studied in four families. These families provide evidence of possible autosomal dominant inheritance. HLA class I antigen studies in all four and class II (HLA-DR) in three families were performed. These studies failed to show close linkage to the chromosome 6 markers in two families but there was consistent inheritance in the other two. Although formal linkage calculations are not presented, it is apparent that in some families HLA haplotyping is not useful in predicting prevence of renal obstruction.

Child↗

PubMed1996

[Prenatal and postnatal ultrasonic screening in the early diagnosis and treatment of congenital developmental defects of the kidneys and urinary tract].

The author presents a group of 97 children with congenital developmental malformations of the kidneys and urinary pathways diagnosed by ultrasound screening in 1990-1994. In 15 children the diagnosis was established prenatally, in 67 children by early postnatal screening and in 15 children during examination of the hip joints. The majority was formed by obstructive uropathies. In more than 50% of these children advanced uropathies were involved with a renal function reduced to 40% and less. A total of 129 operations were performed, incl. 94 (72.8%) reconstruction operations and 11 temporary derivation operations (9.1%). Nephrectomies were performed only in 9 children because of multicystic dysplasia, and in 9 children with duplicated upper urinary pathways resection of the kidneys was performed on account of dysplasia and advanced atrophy of the renal parenchyma. 80% of all operations was performed in infants under 6 months, 21.7% of the operations at the age under 1 month. The best results were achieved in children after plastic operations made before the age of 1 month. The highest yield was obtained by early postnatal screening. It should therefore become an integral part of neonatal examinations. Prenatal ultrasonographic screening is indicated in particular in pregnant women with a family-history of anomalies of the urinary pathways.

Congenital Abnormalities↗

PubMed1996

Large prostatic utricle--unusual cause of urine infection.

A large prostatic utricle is a rare anomaly of the urinary tract. In individuals with scrotal or perineal hypospadia and cryptorchism it occurs even in 34%. The author reports on two children diagnosed for a large prostatic utricle which caused urine infection and obstruction of low urinary tract. The first child with polymalformation syndrome had a bilateral retention of testicles and scrotal hypospadia. The second child with normally developed external genitals was found to have a functionally solitary right kidney with large prostatic utricle of the 3rd grade and cystic dysplasia of the left kidney. The diagnosis was made on the basis of cystourethrography, cytoscopy and sonography. A large prostatic utricle where both gonaducts terminated was removed from the suprapubic retrovesical approach. It was completely removed in the first child and partial resection was made in the second child.

Abnormalities, Multiple↗

PubMed1996

Doppler ultrasonography in evaluation of renal hemodynamics in hydronephrosis in children.

Resistence index (RI) measurement by the Doppler sonography is a noninvasive diagnostic method which was introduced in the diagnosis of hydronephrosis in children in 1989. In 1991 Palmer modified this method by administering furosemide (Diuretic Doppler ultrasonography) in order to distinguish an obstructional and nonobstructional dilatation of the upper urinary tract. The method is based on the fact that an obstruction of the upper urinary tract results in increasing of the intrarenal arterial resistence and therefore in decreasing of vascular flow. RI value shows the importance of obstruction. The authors performed this method on 37 children aged 2 to 16, 12 children with a significant ureteropelvic obstruction, 15 children with a nonsignificant obstruction (hydronephrosis of grades I-II and persisting dilatation of the ureteropelvic system after pyeloplasty); the control group consisted of 10 children with normal sonography and scintigraphy findings in the kidneys. The results were compared to the results of dynamic scintigraphy -99m Tc DTPA with furosemide. Elevation of RI values in clinically significant hydronephrosis was proved. The authors see the utility of Doppler ultrasonography as being in the diagnosis of nonsignificant obstructions, in the screening of children with ureteropelvic system dilatation, and in follow-up examinations of children after pyeloplasty.

Adolescent↗

PubMed1996

Importance of sonography with furosemide in continuing dilatation after pyeloplasty.

The continuance of collecting system dilatation after plastic repairing of the ureteropelvic junction in children progressed hydronefrosis may have two causes, the first one is a great progress of the process, that do not allow to repair the dilatation, the second one is to be a failure with the operation. Another treatment depends on differentiating there two causes. Authors used ultrasonography with furosemide test. By comparing sonogram before and after giving furosemide. They described whether the continuance of collecting system dilatation can be caused by a urodynamic obstruct. The result is that the ultrasonography with furosemide is a simple of orientation noninvasive method, which can be used several times without risks for the children. According to experience of the authors more precise is the method with oral furosemide application that the intravenous. It is a method of orientation which can be filled by dynamic scintigraphy in case of suspicion on bad evacuation with furosemide. Then if the obstruction is confirmed, we can indicate the excretory urography with furosemide.

Administration, Oral↗

PubMed1995

[Ultrasonographic examination in the follow-up of patients after kidney transplantation].

The authors followed-up in 1988-1994 a total of 134 patients after renal transplantation by ultrasonographic examinations in the B mode, Doppler frequency analysis and coloured Doppler mapping. They summarize the basic sonographic pictures during a normal development after transplantation and in case of surgical and non-surgical complications. They evaluate sonography as the basic examination method which is not quite specific for different complications but makes it possible to detect them in the initial stage and to indicate in time further examinations and treatment.

Graft Rejection↗

PubMed1993

Indications to surgery of primary vesicoureteral reflux.

The authors report on their experience with surgical treatment of primary vesicoureteral reflux in 315 children in whom 358 operations were performed. Indications to surgical management of the congenital defect are defined. The frequent familial occurrence of this disease is pointed out.

Adolescent↗

PubMed1992

[Vesicoureteral reflux: a familial study].

In order to assess the familial incidence of vesicoureteral reflux (VUR) the authors examined a group of 54 families of children treated on account of this disease. Genealogical analysis revealed the same defect in two parents (1.8%), i.e. mothers and in five siblings (7.6%). Other urological abnormalities were found in 11 (6.3%) grade I relatives of children with VUR. Screening of the kidneys was made in 156 (91%) of grade I relatives. VUR was thus revealed in three siblings, incl. one where it was detected prenatally. In 18 families further abnormalities of the kidneys and urinary pathways were detected. Most frequently it was duplication of the urinary pathways which was detected in 12 grade I relatives (7%). The authors diagnosed furthermore: in mothers once right-sided hydronephrosis, once a dystopic kidney with pyelonephritic changes, once sponge kidneys, twice kidneys altered by pyelonephritis. The finding of hitherto clinically not manifested abnormalities which were thus revealed in 21 (12.1%) grade I relatives leads to the recommendation of ultrasound screening of the kidneys in families with VUR. The presence of VUR in eight (12.3%) siblings indicates the important role of genetic factors in the development of this defect.

Child↗

PubMed1991

[Tuberous sclerosis from the viewpoint of the urologist].

Renal lesions in patients with tuberous sclerosis are angiomyolipomas which are found in 47-73% of patients and cysts which are less frequent and are encountered in 18-53%. Usually they are multiple and bilateral. In the majority they are asymptomatic, sometimes they cause however by their invasive growth renal damage and serious clinical manifestations. The greatest diagnostic asset is ultrasonography, CT and magnetic resonance. In patients with tuberous sclerosis and suspected angiomyolipoma it is always necessary to rule out a malignant renal tumour, which may be sometimes quite difficult. Asymptomatic lesions do not call for treatment. Surgery is indicated in case of complications--haemorrhage threatening life, dangerous compression of neighbouring organs and suspect malignant disease. The authors describe experience with two patients where surgery was necessary, in one instance unilateral nephrectomy and in the other patient consecutive bilateral nephrectomy.

Adult↗

PubMed1990

Heredity and origin of duplication of the pelvicalyceal collecting system.

The present study was undertaken in an effort to prove the significance of genetic factors and their role in the origin of one of the most commonly occurring anomaly, i.e. the duplication of the pelvicalyceal collecting system. Our aim was to test foreign data on autosomal dominant inheritance of low penetrance in this anomaly and to try to find whether a preventive examination of the kidneys and urinary tract (sonography or intravenous urography) can be justified in 1st degree relatives. On intravenous urography made in 44.4% of 1st degree relatives a pathological finding was seen in 20%, one half of which having been estimated as serious requiring further examination and therapy. The above mentioned data in principle coincide with reports in literature abroad. Drawing on the results obtain the pediatrician or urologist can be advised to send the family, in which the pelvis et ureter duplex was discovered, to the genetic consulting centre. Here the 1st degree relatives could be recommended for the examination of their kidneys and urinary tracts on the evidence of the family tree and discussion with parents. The literature assumption that this anomaly is an autosomal dominant defect could not be quite confirmed. The fact that the defect was found in 10.7% of parents and 15% siblings indicates that it could represent the autosomal dominant trait type of low penetrance. An exact definition of the inheritance type is influenced by impossibility of examining the children' grandparents and by retrospective selection of the group. Although the type of heredity cannot be accurately stated yet, we believe the main contribution of our results to consist in the discovered importance of preventive examinations of the urinary tract in 1st degree relatives.

Child↗

PubMed1989

[Duplication of the urethra in boys].

Duplicity of the urethra as an isolated unit is found only in men. According to the classification of Williams and Kenawi of 1975 most frequently sagittal duplicity is involved. As to the site of the orifice of the ectopic urethra different types are found - epispadic, hypospadic, spindle-shaped type of urethra and Y-shaped duplicity. The authors discuss three patients where they diagnosed and treated three different types of duplicity.

Child↗

PubMed1985