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Biomedical subjects

E Hradec

Publications and source records attributed to E Hradec.

At least 19 recordsLinked to original sources
PubMed1990

[Problems with indications for extracorporeal lithotripsy in urolithiasis].

Extracorporeal lithotripsy is a modern noninvasive method for the treatment of urolithiasis. The morphological and functional state of the urinary pathways, the localization of concrement and their size and number call in 35% of the patients for additive and auxiliary operations. Such comprehensive treatment can be provided by departments where all methods for the treatment of lithiasis are readily available. Repeated lithotripsy and combined therapeutic methods of more complicated conditions protract hospitalization and reduce the number of patients. The authors tested in more than 2500 lithotripsies the possibility to apply this treatment in the great majority of lithiases. However, because of the limited capacity they had to reduce the spectrum of indications to a minimum. Retardation of treatment by a protracted waiting period could damage the patient and it is then better to indicate another therapeutic approach; or to provide adequate treatment. We hope that patients who will need treatment after a year's time, will have the opportunity to be treated sooner by lithotriptors which should be installed before long in other departments.

Humans↗
PubMed1989

[Nephrolithotomy using Doppler and dynamic sonography].

In open operations of coralliform or multiple small nephrolithiasis frequently the problem of peroperative localization of residual concrements arises. A simple, reliable, accurate and non-aggressive peroperative detection of concrements in the kidney is made possible by ultrasonography. The method was used in 25 cases, a probe with a frequency of 7.5 MHz makes it possible to detect even minute fragments. On the screen we can see not only the size of concrements but also their distance from the surface, and their position can be accurately assessed three-dimensionally. The surgeon thus can make nephrotomy aimed directly on the concrement. The course of major blood vessels can be detected by means of a Dopplers probe. This procedure makes it possible to make the incision in a relatively avascular zone without the necessity of the application of cooling or ischaemia of the kidney. In the investigated group no false positive finding was obtained, a false negative finding can result from non-systematic examination.

Humans↗
PubMed1989

[Percutaneous extraction of concretions from the kidney].

The authors submit a report on 225 patients operated by the percutaneous approach on the kidney during the period between March 1985 and February 1987. From 231 operations on account of lithiasis concrements were removed in 94.8%. No major complications were observed. The mean period which elapsed from operation to discharge was 8 days in one-stage operations and 19 days in multiple-stage operations. The authors discuss the indications and some technical conditions of the method.

Adolescent↗
PubMed1989

[Urolithiasis. Review of present knowledge of epidemiology, pathogenesis, metaphylaxis and treatment].

The incidence and prevalence of urolithiasis in the Czechoslovak Socialist Republic is as high as in other countries of Central and Western Europe, and lower than in the Scandinavian countries. Apart from its high incidence, urolithiasis is characterized by its high tendency to recurrence. New knowledge of its pathogenesis helps to diagnose metabolic disorders responsible for increased excretion of concretion-producing substances and/or for deficiency in protective factors. In case of calcium oxalate lithiasis, with the highest incidence, attention is to be paid to its various forms of hypercalciuria, and, more recently, to moderate hyperoxaluria, and as regards protective factors, to magnesium, citrates, pyrophosphates and mucopolysaccharides. The determination of the type of metabolical disorder in patients with lithiasis enables to modify the diet and/or medication leading to causal prophylaxis against recurrence, i.e. metaphylaxis. At our Prague urological clinic, a consultation centre for lithiatic patients has been in operation since 1977. Long-term experience has shown that it has been successful especially in preventing recurrence or a in a substantial reduction in recurrence in 94% of the followed-up patients. Although the centre's activity is demanding both on the personnel and laboratory, even first sufferers from ilthiatic attacks should take advantage of it. At this early stage, such patients were found to have a metabolic disorders in 60%. In the past 7 years of treating nephrolithiasis and ureterolithiasis, new methods have been introduced which substantially improve the results and are less invasive than a classical operation. Among others, they comprise percutaneous endoscopic methods of disintegration and concrement extraction from the kidney and ureter, uteroscopy and extracorporeal shock-wave lithotripsy. It is to be expected that these methods will replace classical operations at a rate of 90%.

Humans↗
PubMed1989

[Extracorporeal shock-wave lithotripsy].

Concrement lithotripsy in the kidney and ureter using extracorporeal shock waves (ESWL) was performed with the aid of a 2nd-generation lithotriptor--Lithostar Siemens. Over a period of 11 months ESWL was applied in 526 patients aged 7 to 80 years, 10 of these were children. 19 patients had bilateral lithiasis so that the treatment was applied to a total of 545 renoureteral units and 698 concrements were disintegrated. In the ureter 34 concrements were disintegrated, the remainder being in the kidney. 12 patients had solitary kidney lithiasis; 62 subjects prior to ESWL, had been operated on the same kidney for lithiasis or on the ipsilateral ureter. Most patients had only local infiltration anaesthesia of the relevant intercostal nerves sometimes supplemented with mild opioid analgesia. Children were operated on in general anaesthesia. More than one ESWL application was needed in 33% cases, 54 disintegrated concrements measured more than 30 mm. Cystine concrements in 2 patients remained unaffected, in 1 woman with apatite lithiasis the disintegration was unsatisfactory. Auxiliary interventions had to be performed in 22% cases, prior to ESWL, and in 13% patients after ESWL, in 1 case following ESWL, open ureteromy was performed. The patient's exposure to radiation is negligibly low, the paramedical personnel is exposed to none. The noise level both for the patient and personnel is within the hygienic limits and is lower than in the case of 1st--generation lithotriptors. The average hospitalization period in patients with unilateral lithiasis lasted 7 days, 8 patients were treated in out-patient departments. When released from the clinic, 39.5% patients had no concrements, the remainder had only minute residual concrements. Three months upon the release, 77.6% patients were found with no demonstrable signs of concrements.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Blood group antigens in epithelial tumours of the urinary bladder.

The occurrence of blood isoantigens, demonstrated using an immunofluorescence technique in urothelial tumours of 40 blood group A, B, or AB patients who had been treated and followed up during the years 1977-1983, has been compared with their histological grading and clinical course. In both of the 2 papillomas and 35 grade I papillocarcinomas, a positive expression of the relevant isoantigens could be demonstrated, while all of the 19 grade III papillocarcinomas just as the 22 anaplastic carcinomas always proved negative. In a group of 34 grade II papillocarcinomas, 21 of the tumours proved positive and 13 negative; with all tumours showing signs of invasiveness being always negative. Correlation of these results with the clinical courses of the disease did not exhibit such unequivocal results, even though, in a group of 7 patients who had died of a generalized urothelial carcinoma verified by post-mortem, all of the 19 examinations that have been performed proved, with the exception of one, to be negative. These results confirm the fact that identification of blood isoantigens may help to reach a more accurate prediction of the biological behaviour and prognosis of urothelial carcinomas, especially, among grade II papillocarcinomas since loss of the antigen expression appears to be related to the tumour's capacity of invading the mucous stroma.

ABO Blood-Group System↗
PubMed1987

Long-term results of surgical and conservative treatment of patients with primary aldosteronism.

The long-term results of surgical and specific drug therapy were compared in a group of 57 patients with primary aldosteronism (PA) (46 with aldosterone-producing adenoma (APA), 11 with idiopathic hyperaldosteronism (IHA) and bilateral adrenal hyperplasia). Unilateral adrenalectomy completely normalized blood pressure (BP) in 77.1% of surgically treated APA, evidently improving hypertension in remaining 22.9%. No recurrence of the adenoma in the remaining adrenal was seen in any of the surgical APA cases. In 19 of the non-surgical patients (11 with APA, 8 with IHA) monotherapy with spironolactone reduced blood pressure in 73%, though total BP normalization was an exception. The treatment normalized hypokalemia, low total exchangeable potassium, tendency to hypernatremia, and high total exchangeable sodium. Surgical as well as conservative therapy increased to normal or above-normal levels plasma renin activity suppressed prior to treatment. Pre-operatively high urine and plasma aldosterone levels normalized in all adrenalectomized patients, but remained above the normal range during spironolactone therapy in spite of a small decline in its absolute values. The disturbances of maximum renal concentrating capacity due to impaired nephron responsiveness to sufficiently high endogenous vasopressin concentrations were completely eliminated after kaliopenic nephropathy had been repaired. The other renal functions remained within normal values. Echocardiographically diagnosed left ventricular hypertrophy was seen less often than in the other types of arterial hypertension, tending to regress after APA management. Our longitudinal study (2-16 years) showed primary aldosteronism as a well curable, albeit rare, cause of hypertension. As regards BP and laboratory tests normalization, better results were achieved in surgical APA cases than in patients treated with spironolactone. Older age, longer history of hypertension and more frequent incidence of obesity, nephrosclerosis and pyelonephritis may be responsible for hypertension persisting after surgical treatment.

Adrenalectomy↗
PubMed1986

Correlation between mass of parathyroid adenoma and biochemical indicators of bone turnover in patients with primary hyperparathyroidism.

We related the weight of the parathyroid adenoma to biochemical variables of bone turnover in 53 patients submitted to parathyroidectomy for primary hyperparathyroidism. There was a positive correlation (r = 0.61, p less than 0.01) between iPTH (c-assay) and adenoma weight. No correlations were found between either concentration of circulating iPTH or weight of parathyroid adenoma and severity of skeletal change expressed by total activity of serum alkaline phosphatase and its bone isoenzyme and urinary excretion of hydroxyproline. We conclude that the severity of bone changes in individual patients with primary hyperparathyroidism does not result from the direct tissue effect of a single hormone (parathyroid hormone).

Adenoma↗
PubMed1985

Chronic sclerosing ureteritis and nephrogenic adenoma of the ureter in analgesic abuse.

A 44-year old women with 8 years of analgesic abuse developed bilateral ureteral stenosis with urine congestion and manifestations of renal insufficiency. The resected parts of the ureters were affected by chronic productive inflammation with pronounced capillarosclerosis characteristic of analgesic abuse and largely responsible for the stenosis of the lumina. In addition there was a nephrogenic adenoma in the left ureter, so far almost exclusively described in the urinary bladder and prostatic urethra. Its relation to the analgesic abuse is under discussion.

Adenoma↗
PubMed1982

Serum and urinary amylase isoenzymes in carcinoma of the prostate.

Serum and urinary amylase isoenzyme activities were evaluated in 70 patients with carcinoma of the prostate. The results were compared with amylase isoenzyme activities fo 20 healthy man and 30 patients with benign prostatic hypertrophy. Increased serum S-type amylase activity was found in 13 patients (18%) with carcinoma of the prostate, whereas no changes of this isoenzyme was found in benign prostatic hypertrophy. No significant changes of serum P-type amylase activities were observed in our patients.

Aged↗
PubMed1980

Carcinoma of the prostate in specimens removed for benign hyperplasia.

Unexpected carcinoma was found in 69 cases (7.7%) our of 891 patients subjected to surgery for clinically benign hyperplasia. The incidence was higher in specimens removed by suprapubic or retropubic approach (10.2%) than by transurethral resections (2.7%). Carcinoma was found most frequently in patients aged 70 to 80 years (50.8%), next being the age group 60 to 70 years. A statistically significant prevalence of carcinoma was in th medium sized prostases (30-40 grams = 12.4%) well compared to smaller or larger prostates. The principles for a systematic topographically oriented microscopic examination are described. Morphological categories of latent carcinoma are defined as microcarcinoma, focal, multifocal or diffuse carcinoma. Adenocarcinoma was the uniform pattern of these latent carcinomas. The therapeutic attitude towards the microscopically diagnosed clinically latent prostatic carcinoma is discussed.

Age Factors↗
PubMed1978

Calcitonin activity of the thyroid gland in primary hyperparathyroidism.

The thyroidal content of calcitonin was investigated in patients with euthyroid goitre, patients undergoing laryngectomies or neck operations and finally patients with primary hyperparathyroidism using method of biological titration. Patients with primary hyperparathyroidism had markedly decreased content of calcitonin in the thyroid gland when compared with the content of calcitonin of both groups of patients without calcium metabolism disturbance. Decreased content of calcitonin in patients with primary hyperparathyroidism can be explained by long lasting hypercalcaemia during which the rate of biosynthesis of calcitonin in the C cells does not keep up with the rate of release of calcitonin into the circulation.

Adult↗
PubMed1978

Human urinary bladder carcinoma cell line (T24): immunological studies and search for oncornavirus in T24 cell population and derived clones.

Cytotoxicity of mononuclear cell (MNC) preparations isolated from peripheral blood of patients with urinary bladder carcinomas of a transitional (BTCC) or squamous (BSCC) type and from blood of control subjects was examined on the target cells of T24 cell line. In pilot experiments the percentage of cytotoxic MNC preparations was found to be similar in patients with tumors of BTCC (European, 56%;African, 60%) and BSCC (54%) type. Cytotoxicity of MNC prepared from control subjects was detected in 10% of cases or less. These data suggest an antigenic cross-reactivity between urinary bladder carcinomas of transitional and squamous cell type. The cytotoxic MNC from peripheral blood of patients with BTCC and control subjects were fractionated by adherence in nylon wool columns, and the cytotoxicity of adherent and nonadherent MNC subpopulations was examined. In the majority of cytotoxic MNC preparations from both donors with and without BTCC, the cytotoxic activity was associated with nonadherent MNC. Comparison of immunosensitivity of T24 cell population with the cloned T24 subpopulations indicated that clones with various digrees of immunosensitivity are present in the T24 cell population. However, immunosensitivity of the clones was never higher than the immunosensitivity of the T24 cell population. A search for oncornavirus particles produced spontaneously or after treatment with virus production activators performed with regard to the possible association of oncornaviruses and antigens responsible for cell-mediated cytotoxicity gave thus far negative results.

Adult↗