Biomedical subjects

H Münzová

Publications and source records attributed to H Münzová.

9 recordsLinked to original sources

PubMed2002

[Barrett's esophagus].

Barrett's oesophagus is a premalignant metaplastic change of the oesophageal mucosa. Due to its relationship with oesophageal reflux disease and the development of adenoma-carcinoma of the oesophagus the problem arouses increasing interest. In the wide pathogenesis of the disease most probably the composite effect of the refluxed HCl content and duodenal juices play a part. In the diagnosis in addition to fundamental methods--endoscopy and histology--increasingly chromoendoscopy and fluorescent endoscopy are involved. Dispensarization of patients is essential and depends on the degree of pathohistological epithelial changes. Treatment of Barrett's oesophagus can be divided into conservative, where the drug of choice are proton pump inhibitors, and surgical treatment. Promising is endoscopic ablation of the epithelium in combination with subsequent antisecretory therapy.

Barrett Esophagus↗

PubMed2000

[Helicobacter pylori and nonspecific intestinal inflammation].

In 50 subjects with non-specific inflammations of the gut the total prevalence of Helicobacter pylori positive antibodies was 28%, while in the control group of blood donors its was 54% Patients with ulcerative colitis had lower antibodies--18%, in Crohn's disease the serum positivity was 33%. The lowest value of antibodies was found in patients taking Sulfasalazine--11%. The serum positivity was substantially higher in inactive ulcerative colitis and Crohn's disease--35% than in patients with signs of high activity--13%. In 28 patients with non-specific inflammations of the gut endoscopy was performed, in 60% with a pathological outcome. Histologically confirmed gastritis was in the majority Helicobacter pylori negative. It may be stated that in patients with non-specific inflammations of the gut there is a lower incidence of Helicobacter pylori than in the general population, in particular those subjects who were or are treated with Sulfasalazine. The explanation of this fact is however only speculative.

Adolescent↗

PubMed1999

[Endosonographic picture of the esophagus and paraesophageal lymph nodes in subjects with oesophagitis].

UNLABELLED: Echocardiographic examination (EUS) gives a good overview of the structure of the whole oesophagus and the paraoesophageal space. To the EUS picture of reflux oesophagitis and normal EUS picture of paraoesophageal lymph nodes relatively few publications are devoted. The objective of the present work is to describe ultrasonographic (USG) signs of endoscopically and histologically confirmed oesophagitis (grade III and IV) and compare them with a control group, describe the USG picture of paraoesophageal lymph nodes in subjects with oesophagitis and in controls. The authors examined, using an Olympus GIF-UM20 instrument with a radial probe (7.5 ad 12MHz), 30 patients with endoscopically and histologically confirmed oesophagitis (m/f 15/15) and a control group of 40 subjects (m/f 21/19) with a negative endoscopic and histological finding of the oesophagus, cardia and stomach, a USG finding on the hepatobiliary system and X-ray of the lungs. They assessed the thickness of the oesophageal wall and evaluated its USG structure. The authors examined also the paraoesophageal lymph nodes (number, size, shape, structure) in both groups. In oesophagitis they found in all instances less distinct outlines of the three inner USG layers of the oesophageal wall. The oesophageal wall in oesophagitis was significantly thicker than in controls (6.9 +/- 1.7 mm and 3.2 +/- 0.7, alpha=0.05). The paraoesophageal nodes could be evaluated in 21, i.e. 70% patients with oesophagtis and in 23 of 40, i.e. 30% of the controls. The mean number of lymph nodes in patients with oesophagitis was 2.1, in controls 1.8. The percentage of triangular and oval lymph nodes was 52 in oesophagitis, i.e 48%, in controls 57, i.e. 43%. The central echo was apparent in triangular/oval lymph nodes in 91/40%, in controlsin 85 and 30%. The mean dimensiion of triangular/oval lymph nodes in oesophagitis and controls was 7.3 +/- 2.3/6.3 +/- 1.6 mm and 8.5 +/- 2.3/6.5 +/- 1.7 mm. The differences of parameters recorded in lymph nodes in the two groups are not statistically significant. CONCLUSION: The oesophageal wall in portions with oesophagitis is significantly thicker. The outlines of the inner three USG layers are not sharp. There is an association between oesophagitis and the number, size, shape and structure of paraoesophageal lymph nodes. The majority of paraoesophageal lymph nodes in both groups is above the 5 mm borderline. When malignant infiltration of the lymph nodes is suspected, thin needle aspiration biopsy under EUS control is indicated.

Endosonography↗

PubMed1998

[Prevalence of Helicobacter pylori infection in the Czech Republic--the South Moravia Region].

The prevalence of Helicobacter pylori is influenced in a significant way by geographical conditions and depends to a certain extent also on the economic standard of different countries. Some published work provides evidence that Helicobacter pylori infections in eastern European countries are in general more frequent than in western European countries. It cannot be ruled out, however, that in different countries there are regional differences as far as Helicobacter pylori is concerned. In a group of 309 subjects, none of those treated previously to eradicate H.pylori, at least three weeks before blood sampling no preparations of the type of H2 blockers, proton pump blockers or drugs containing bismuth were administered. In these patients serological examinations of H.pylori antibodies were made, using kits of TEST-LINE Brno. The examined subjects were divided into six age groups by decades, starting at the age of 20 years. The general prevalence of H.pylori in the examined group was 58.8%, in the group of 20-year-old ones less than 46%. The highest prevalence was recorded in subjects aged 50-59 years and amounted to 67.3%. The authors compare their own results with findings assembled in the Czech Republic and abroad and draw attention to the necessity of an extensive epidemiological survey of H.pylori prevalence in the Czech Republic. The survey should be done by regions, using the same diagnostic method.

Adult↗

PubMed1997

[Metal stents in patients with malignant and benign esophageal stenoses].

The authors used between October 1993 and January 1997 in 131 patients with inoperable malignant or benign stenosis of the oesophagus an expansible metal stent. In 25 patients the stenosis was in the upper third of the oesophagus, in 44 in the medium part, in 53 in the lower third of the oesophagus and in 9 patients in the area of the anastomosis. All patients suffered at the time when the stent was introduced from marked dysphagia (stage 3-4 according to the international classification). In 45 patients the authors introduced more than one stent. 112 patients suffered from malignant stenosis (67 squamous cell carcinoma, 27 adenocarcinoma, 9 pulmonary or bronchogenic carcinoma, in two instances lymphoma, in two instances leiomyosarcoma and in five patients another type of tumour). Seventeen patients suffered from benign stenosis (8 complications of reflux oesophagitis, 3 stenosis in the anastomosis, in two instances corrosion by acid, 2 cases of epidermolysis bullosa oesophagi and one post-radiation stenosis). In these patients repeatedly before introduction of the stent dilatation of the stenosis by means of a balloon dilatation catheter was attempted. In two instances the etiology of the stenosis was obscure. Complications related to the procedure proper or after insertion of the stent were recorded in 49 patients-dislocation of the stent 23x, occlusion of the stent 17x, development of a fistula 6x, ulceration 16x, haemorrhage 4x, hyperplasia of the mucosa 21x, ileus 2x, inadequate expansion of the stent 8x.

Esophageal Neoplasms↗

PubMed1997

[Percutaneous endoscopic gastrostomy in nutritional therapy--personal experience].

The authors have described the indications, contraindications of percutaneous endoscopic gastrostomy (PEG) and its consecutive nutritional possibilities. They have described their own experience with 11 patients. Most common indications for the placement of a gastrostomy tube were neurological, and only in one case, esophageal diverticle. The average duration of PEG was 102 days (2-732). Besides PEG, not only polymeric diet, such as Nutrison standard sol, Fresubin, Salvimulsin, was administered, but also home-made diet, for example, mixed soup, mashed potatoes, yoghurt, juice and cocoa. The diet prepared at home was tolerated well, except for subjective data about meteorism given by one female-patient. PEG complications were minimal, in one case a dry fistula was detected after the extraction of PEG; it was closed spontaneously a week later. Another female-patient showed leukocytosis and hyperpyrexia, the etiology of which could not be proved. The patient was treated symptomatically, and three days later, leukocytosis and hyperpyrexia were normalized. A patient who has had the gastrostomy tube placed for two years, showed secretion which was treated symptomatically; now the patient is without any complications. In the last patient, there was detected an inflammation around the fixation base. Although she was treated with H2 blockers, the condition has not been improved. The authors have recommended this method in correct indications as a considerate alternative application of enteral nutrition.

Adult↗

PubMed1996

[Treatment of duodenal ulcer with pantoprazole. A multicenter study].

BACKGROUND: The inhibition of H+/K(+)-ATPase (proton pump) of gastric parietal cells by substituted benzimidazoles represents a new therapeutic approach in conditions connected with hypersecretion of hydrochloric acid. Pantoprazol is the newest member of this group of drugs. Monotherapy of duodenal ulcer with pantoprazole or ranitidine was evaluated in terms of healing rate, tolerance and compliance. METHODS AND RESULTS: A double-blind, parallel-group comparing study (double dummy technique) of treatment florid duodenal ulcer (diameter 5-20 mm) was performed in 95 subjects (age 18-74 years). The active substances were either pantoprazole (40 mg before breakfast-47 subjects) or ranitidine (300 mg before bedtime-48 subjects). The average diameter of the ulcer and subjective complaints before treatment were comparable in both groups. After 2 weeks of pantoprazole therapy 88.5% of ulcers (a) and 87.2% patients (b) were cured, whereas the corresponding values in the ranitidine series amounted to 66% (a) and 62.5% (b) only (p = 0.006 for both (a) and (b)). The rate of healing in relative values of reducing the ulcer size was significantly higher after 2 weeks of pantoprazole therapy (p = 0.026 (a) and 0.0027 (b)). All ulcers healed after 4 weeks of this regimen. The difference between the pantoprazole and ranitidine series after 4 weeks was closely above the 5% level of significance (p = 0.589 for (a) and 0.0588 for (b) respectively). This was due to the low number of patients in both groups at this time interval, particularly in the pantoprazole group. Pain during day-time and regurgitation were observed significantly more frequently after ranitidine therapy. The compliance was very good and practically no adverse effects of pantoprazole therapy were observed. CONCLUSIONS: The healing rate of duodenal ulcer with pantoprazole monotherapy (40 mg before breakfast) was significantly higher than with ranitidine (300 mg before bedtime). The compliance of patients and the tolerance of pantoprazole were very good and its administration was not associated with any side-effects.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1993

[Therapy of ulcer disease using gastrinal-sucralfate produced in Czechoslovakia].

The authors present their experience with the use of the Czechoslovak preparation Gastrinal-Sucralphate in the treatment of 40 subjects with gastroduodenal ulceration. Moreover, they compared two forms of the drug--tablets and granulate. The healing effect of the drug is very high, in tablets 77.0%, in granulate as much as 89.5%. As far as tolerance is concerned, it was obviously better after the granulate, subjective side-effects were very rare. The drug does not affect any basic biochemical parameters which were monitored during administration of the drug.

Adult↗

PubMedDate not supplied

[Helicobacter pylori after proximal selective vagotomy].

The authors examined histologically in 40 patients after proximal selective vagotomy on account of duodenal ulceration specimens of the antral mucosa for the presence of Helicobacter pylori. The latter was detected in 38 (95%) patients. The intensity of colonization evaluated semiquantitatively was not directly related to the dyspeptic complaints. No relapses of ulcers were observed and the author's experience does not confirm the theory of a direct part played by Helicobacter in the manifestation of duodenal ulceration in patients after proximal selective vagotomy.

Duodenal Ulcer↗