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F Koukolík

Publications and source records attributed to F Koukolík.

At least 19 recordsLinked to original sources
PubMed1995

[Morphologic verification of neoplastic portal vein obstruction].

BACKGROUND: Tumourous invasion into the portal circulation is a frequent and typical complication of primary carcinoma of the liver. No imaging method can, however, assess unequivocally the biological nature of the vascular occlusion and rule out reliably the possibility of benign thrombosis. The objective of the present work was to evaluate the yields of percutaneous thin-needle aspiration biopsy for the verification of intraluminal growth of a tumour, which influences to a considerable extent decisions and possible subsequent therapeutic provisions. METHODS AND RESULTS: Aspiration biopsy of the thrombus was performed in 33 patients with an ultrasonographically apparent occlusion of the portal circulation associated in 29 observations with primary carcinoma of the liver and in four instances with secondaries in the liver. For puncture thin needles--0.8-0.9 mm (21-20 G) were used inserted under ultrasonographic control. The presence of tumourous cells in the portal vessels was proved in 31 patients, i.e. in 94%. An oncologically negative result of biopsy was recorded in one patient with primary carcinoma of the liver and in a female patient with secondaries. Among morphologically verified tumourous occlusions complicating primary carcinoma of the liver a multinodular variant of a tumour was found in 11 observations and a solitary form (mean size of the focus 9 cm) in 10 observations. In 7 patients the vascular occlusion and positive result of biopsy revealed the existence of a diffuse infiltrating type of tumour. In the histological structure of the tumour which was assessed in 13 primary carcinomas of the liver differentiated types of neoplasms predominated unequivocally (10 cases) over non-differentiated tumours (3 cases). CONCLUSIONS: Thin-needle aspiration biopsy is a highly sensitive method for the detection of vascular expansion of liver tumours. It can be used successfully and without risk to assess staging of the disease where necessary.

Female↗
PubMed1993

[Linkage analysis in pedigrees with Alzheimer's dementia].

Linkage analysis with three specific DNA markers was carried out on the Alzheimer's dementia pedigrees. The DNA markers used in our study, D21S1/D21S11, D21S13 and D21S16 in the 21q11.2-21q21 regions are localized. The results from different brain DNA samples and from peripheral blood samples of AD families were evaluated by two-point linkage analysis. The linkage between DNA markers and one AD pedigree was observed (D21S1/S11 and D21S13).

Alleles↗
PubMed1992

[Structural changes in the brain in schizophrenia and affective psychoses].

Kraepelin (1896) and Bleuler (1916) were convinced that schizophrenia has an anatomical basis. Evidence is provided now by visualization methods made in vivo and stereometric methods used in neuropathology. Schizophrenia is associated with enlargement of the lateral and the third ventricle, widening of the sulci between gyri of the cerebral cortex, a decline of the weight of the brain, volume of the cerebral cortex and central gray matter. Histological examination reveals reduction of the parahippocampal gyrus thickness, changes in the hippocampus are controversial. Numerical atrophy of neurons was found in the mediodorsal nucleus of the thalamus, amygdaloid nucleus, prefrontal cortex, impaired pattern of neuronal modules were found in the g.cinguli. Some anatomical changes correlate with differences revealed by neuropsychiatric examination, positron emission tomography and examination of evoked potentials. Schizophrenia can be at least in some instances the consequence of developmental disorder of the brain. The problem of continuity of schizophrenia and affective psychoses is discussed.

Affective Disorders, Psychotic↗
PubMed1992

[Creutzfeldt-Jakob disease as a cause or complication of senile dementia].

Two observations of Creutzfeldt-Jakob disease, one typical, the other atypical, recorded in a brief series of consecutively examined brains of demented patients who died at psychiatric clinics suggest that this disease occurs more frequently in psychiatric departments. The authors deal with the standard clinical and neurohistological diagnosis and the differential diagnosis. As molecular biological techniques are becoming more widely available, these examinations should be made in cases of dementia with a "negative" neurohistological finding.

Aged↗
PubMed1992

[Relation of dementia, Alzheimer's disease and aging].

Relation of dementia, Alzheimer's disease and brain aging was analyzed in a group of 50 persons who decreased at the age of 90 or more. Each of them were investigated according to 87 clinical a pathological variable features. The group has remained the world biggest for the time being. Final diagnosis of Alzheimer's disease is a histological one. Author proved that it depended on criteria lacking of world wide standardization. Various criteria could show the Alzheimer's disease as a phenomenon either not increasing in the 10th decade and differing from aging, or increasing and close or equal to aging. Statistical analysis of author's data could distinguish between non-demented and seriously demented individuals according to the number of plaques. A quasi-selective amnesia of old persons which is taken for a "benign senile forgetfulness" could be a sign of evolving Alzheimer's disease. Dementia is an unevitable condition for the diagnosis of Alzheimer's disease. This is without doubt important for a clinical diagnosis and not for a morphological expression of biological event. Author presume there exists an Alzheimer's disease under clinical threshold which combined with a clinically manifest disease does increase with the age and inflicts on 9 per cent of population in the 10th decade. Alzheimer's disease seems to be a fundamental biological event at least related to brain aging. A productive research problem might be to find out why "Alzheimer" features measured by common methods avoid 10 per cent of population in the 10th decade.

Aged↗
PubMed1991

The direct early diagnosis of cystic fibrosis by the detection of the delta F508 CFTR gene mutation in a prematurely delivered boy.

The suspicion of prenatal meconium ileus syndrome was raised in a pregnancy in a family with no history of cystic fibrosis because of significantly higher maternal serum alpha-fetoprotein in the 16th and 19th week of gestation, dispersed areas with increased echogenity in the fetal abdomen, slight fetal ascites in the 24th-25th weeks of gestation, decreased amniotic fluid gamma-glutamyltranspeptidase (GGT) activity and alpha-fetoprotein level in the 25th-26th weeks, and normal 46,XY karotype of the fetus. The detection of a homozygous deltaF508 cystic fibrosis transmembrane regulator (CFTR) gene mutation, by means of PCR from a small amount of white blood cells and urine sediment cells, substantiated the diagnosis of cystic fibrosis in a prematurely delivered boy in the 28th week of gestation. The repeated sweat test was unsuccessful. The autopsy examination confirmed the diagnosis of cystic fibrosis. Fetal meconium ileus syndrome was complicated by peritonitis and by formation of a meconium pseudocyst. Direct PCR typing improves postnatal diagnostic possibilities in the early neonatal period in prematurely delivered babies when the sweat test is difficult to perform.

Chromosome Deletion↗
PubMed1990

[Correlation of the autopsy with the clinical diagnosis].

Since Morgagni's times (1761) the purpose of autopsy is correlation of the clinical diagnosis and therapy, assessment of the cause of death, description and the diagnosis of unknown diseases, teaching and later collection of epidemiological data. The clinical and pathological correlation involves assessment of the sensitivity and specificity of the clinical diagnosis (autoptic findings are conceived as the reference value), and assessment of the frequency and seriousness of diagnostic errors. The importance of autopsies is apparent from the fact that the sensitivity and specificity of clinical diagnoses of some common diseases improved between 1930 and 1977, in others it remained the same, in others it deteriorated. Deterioration pertains in particular to the diagnosis of infectious diseases, some types of malignant tumours and diseases of the circulation, regardless of technological advances of diagnostic methods. The rate of errors in the diagnosis of basic diseases leading to death and immediate causes of death where knowledge of the autoptic diagnosis would probably changes the therapy and prognosis varies round 10%, the frequency of similar errors, where this knowledge would not alter the above procedures is twice or three times as high. If for the interpretation of autoptic results the "epidemiological" principle is used, the different incidence of common diseases in the population, as compared with official statistics becomes apparent, the official statistics being based on the collection of data from the death certificates. The latter data are biased by a high rate of diagnostic errors and selection phenomena.

Autopsy↗
PubMed1990

[Correlation of the autopsy with the clinical diagnosis in common neoplasms in a general hospital].

The author correlated in a group of 1100 autopsies made in 1987-1989 the clinical and autoptic diagnosis of malignant neoplasms of the bronchi, lungs, stomach, large intestine and rectum, liver and extrahepatic biliary pathways, pancreas and kidneys. In the case of the stomach, large bowel, liver and pancreas the diagnosis moreover with the diagnosis of non-tumourous diseases of these organs. As compared with worldwide autoptic correlations, the diagnostic standard of carcinoma of the bronchi and lungs is roughly equal, in carcinoma of the liver it is better, in carcinoma of the extrahepatic biliary pathways and stomach it is worse. The diagnostic sensitivity of malignant tumours varies from 0.6 to 0.4 and thus in 40-60% of autoptic findings of the mentioned neoplasms an accurate clinical diagnosis was not established. The rate of diagnostic errors of the first type is, however, in this group of differing clinical and autoptic diagnoses lower than in diseases caused by infectious causal agents, the rate of errors of the second type is high. Comparison of the diagnosis of tumourous and non-tumourous diseases of the stomach, large bowel, pancreas and liver revealed roughly the same diagnostic standard with the exception of cirrhosis of the liver where it is lower.

Autopsy↗
PubMed1990

[Correlation of autopsy findings with the clinical diagnosis in common diseases of the circulatory system in a general hospital].

In a group of 1100 autopsies made in 1987-1989 the author correlates the clinical and autoptic diagnosis of embolism of the pulmonary artery, acute myocardial infarction, valvular defects, chronic cor pulmonale, cardiomyopathies, cerebrovascular attacks, subarachnoid haemorrhage; the latter was compared with the diagnosis of chronic subdural haematoma. The sensitivity of the clinical diagnosis of some diseases is low, in different categories 10-80% of diseases escape the clinical diagnosis. As compared with correlations of clinical and pathological findings published abroad, the standard of diagnosis of embolism of the pulmonary artery is roughly the same (some 80% controversial clinical and autoptic diagnoses), in acute infarction it is worse (some 50% controversial diagnoses), in acute cerebrovascular attacks it is worse only when compared with some (cca 25-40% controversial diagnoses according to the categories of the international classification). Evaluation of the sensitivity and specificity of the clinical diagnosis is only orientational, more important is the frequency of diagnostic controversies with regard to severity. Errors of the first type, i.e. those where knowledge of the autoptic diagnosis before death would have most probably influenced the therapy and prognosis is in embolism of the pulmonary artery and myocardial infarction 10 and 13% resp., in the other categories errors are rare or absent, there are, however, frequent errors in the diagnosis of subdural haematoma.

Autopsy↗
PubMed1990

[Autopsy correlations in the clinical diagnosis of serious diseases caused by infections in the practice of a general hospital].

The author correlated in a group of 1100 autopsies made in 1987-1989 the clinical and autoptic diagnosis of active tuberculosis of the lungs and organs, bacterial meningitis, acute and subacute endocarditis, septicaemia, acute cholangitis, diffuse suppurative peritonitis, renal infections, and pneumonias. Class I diagnostic errors, i.e. those where knowledge of the diagnosis before autopsy would have probably changed therapy and the prognosis, were encountered in all groups of correlated diseases, however, with a high frequency in tuberculosis of the lungs and organs, septicaemia, renal infections and pneumonias. It seems that the diagnostic vigilance to some common serious diseases caused by infections declines in the practice of general hospitals. This experience was recorded also in hospitals abroad. Causes of diagnostic errors are discussed.

Autopsy↗
PubMed1990

[Neuropathology of the amnesia syndrome in old age].

In the 8-10th decade of life, people can be found who are not demented in the sense of WHO definition, but who are amnestic ("a memory problem only"). This defect is probably a result of the lesion of recent declarative memory. Immediate and remote memory are almost intact. Neuropathology of 17 such brains found numerous plaques and tangles in amygdalas and especially tangles in the IIth and IIIth strata of the entorhinal cortex and in subicula of hippocampi in 11 out of them. The number of plaques and tangles in frontal, parietal and temporal neocortex in these cases was not significant. In two other cases no significant ó "alzheimer-like" changes were found, but there was numerical atrophy of neurons of CA 1 sector of hippocampi in their caudal half perhaps due to chronic ischaemic lesion in one of them. In the other one there was an infarction of the left isthmus collateralis and retrosplenic cortex. In four cases no unequivocal structural basis for the amnesia was found--except slight numerical atrophy of large neurons of the nucleus basalis Meynerti. No significant diencephalic pathology was found. Severe "binswanger-like" changes were found in two cases of amnesia and in one case of control group, all of them were hypertonics. There exists a possibility that a part of "isolated" and relatively "benign" amnestic defects in old people is not a result of the aging of the brain but a sign of evolution of Alzheimer's disease and/or ischaemic vascular lesion of the brain destroying or disconnecting some of its information bottlenecks.

Aged↗
PubMed1989

[Thin-needle aspiration biopsy under ultrasonic control. The examination technic].

Based on experience with 298 aspiration biopsies (156 from the liver, 100 from the pancreas, 42 from other organs) made under ultrasonic control, the authors present a detailed description of the examination technique. At the same time they publish their own results with a mean sensitivity of 88%, specificity of 100% and diagnostic yield of 92%.

Biopsy, Needle↗
PubMed1989

[Structural changes in normal aging of the brain].

During normal ageing of the brain its weight and volume decrease significantly and the ventricles of the brain enlarge. The number of neurons of the brain stem in some areas does not decline, in the neocortex the number of neurons declines during the period between the age of 24 and 100 years by a maximum of 10-15%. As to neurotransmitting systems, the numeric atrophy during ageing affects mainly the noradrenergic locus coeruleus and the dopaminergic substantia nigra; the cholinergic n. basalis is probably not affected. The main change which takes place in neurons during ageing is their diminution. Dendritic systems of neurons undergo during ageing regressive as well as progressive changes; in some areas progressive changes predominate, in others regressive ones, in some areas both types of changes are in equilibrium. During ageing in neurons the nucleoli diminish at a varying rate. From this it is concluded that protein synthesis is altered and there is an increase of lipofuscin; both these changes take place in different ways in different neuronal populations, similarly as the diminution of Nissl's substance. The relationship of Alzheimer's disease and ageing of the brain is obscure from the pathogenetic aspect; there exist statistically significant but only quantitative differences. No evidence was provided that ageing of the brain per se is the cause of dementia.

Adult↗
PubMed1989

[Multi-infarct dementia--a disputed disease].

Isolated multiinfarction dementia is rare among general hospital demented patients who died and were subjected to necropsy (7.8%, i. e. 9 observations from 115 clinically and pathologically diagnosed syndromes of dementia during a period of more than four years). It is more frequently combined with Alzheimer' disease (18.3% of the same group). The development of multiinfarction dementia is suggested by cerebrovascular or cardiovascular disease in the case-history, similarly as hypertension, a varying course, focal neurological symptoms incl. impaired speech, gait and swallowing, a positive Hachinski score. Multiinfarction dementia and Binswanger's disease may be variants of the same process.

Aged↗
PubMed1989

[Binswanger's disease--a common disease of the brain and a frequent cause and component of dementia].

The author demonstrates on three selected observations clinical, radiological and neuropathological symptoms of Binswanger's disease. Its cause are changes of the long medullary arterioles which supply the white matter of the brain, most frequently in conjunction with hypertension. The basis of changes is ischaemic periventricular leucoencephalopathy. The disease is, contrary to recent ideas, very frequent and is formed by a spectrum of subclinical changes to deep dementia associated with neurological symptoms. Binswanger's disease is found isolated and combined with Alzheimer's disease or with multiinfarc dementia and is together with this unit the most frequent cause of vascular dementia in adult and old age.

Aged↗