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Biomedical subjects

I Vanĕk

Publications and source records attributed to I Vanĕk.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Surgery of infectious complications in prostheses in the abdominal aorta].

The authors describe the successful solution of a serious and feared complication, i.e. infection of a vascular prosthesis. A hitherto not used procedure was adopted-concurrent removal of the infected prosthesis and restoration of the blood flow into both extremities by an extra-anatomical axillobiiliac bypass. The authors draw attention to the advantages of this method in context with possible future solutions; and with regard to the hitherto not complicated postoperative course they assume that this type of treatment could be final. At the same time they draw attention to the complexity of the problem from the diagnostic and therapeutic aspect.

Aorta, Abdominal↗
PubMed1995

[Anaphylactic reaction to protamine in cardiovascular surgery].

The authors describe a serious anaphylactic reaction after protamine administration and its successful control. In cardiovascular surgery protamine a basic peptide, is used as a matter of routine to eliminate the anticoagulation effect of heparin. The use of this drug is associated with a number of negative haemodynamic reactions, most of them not serious, the incidence of which varies from 0 to 100%. The incidence of serious reactions associated with a life threatening drop of the blood pressure is reported to be between 0.13% to 4%, depending whether a retrospective or prospective study is involved. The pathogenesis of this anaphylactic reaction is not quite clear. Prevention in patients with known risk factors is problematic. Treatment of the allergic reaction to protamine is still symptomatic. In the authors' patient the condition was coped with by administration of colloid solutions, adrenaline and solumedrol.

Aged↗
PubMed1994

[Surgical complications in combined transplantation of a kidney and a pancreatic segment with an obliterated duct].

The surgical aspect of transplantation of the pancreas is despite its many years' history still an unresolved problem. If we summarize contemporary knowledge and achieved results, it ensues that so far unity has not be attained as regards surgical tactics and technique of the operation. The authors submit an analysis of surgical complications after combined transplantation of a kidney and a pancreatic segment with an obliterated duct. In the group of 38 patients with transplantations the moc frequent cause of loss of function of the transplanted gland during the early postoperative period was vascular thrombosis of the pancreatic graft. Infectious complications, haemorrhage, necrosis of the graft and ileus were also described. Surgical complications developed in more than half the patients of the investigated group which made the authors contemplate a change of surgical technique and after experimental preparation transplant the entire gland with drainage of the pancreatic duct into the urinary bladder.

Adult↗
PubMed1994

[Advantages of lung surgery via medial sternotomy and use of extracorporeal circulation in very advanced lung tumors].

The authors present their initial experience with surgery of pulmonary affections in 32 patients where they used medial sternotomy as the route of approach. They provide evidence of the advantages of this approach, in particular in high-risk patients, and of the favourable effect of this approach on the postoperative course. Successful radical surgery under conditions of extracorporeal circulation, although a very advanced tumour was involved where posterolateral thoracotomy was unequivocally contraindicated, indicates that there is a possibility to extend indications of surgical therapy of otherwise inoperable pulmonary tumours.

Extracorporeal Circulation↗
PubMed1992

[Directed sympathetic denervation of the heart--an actual therapeutic method or myth?].

Aimed sympathetic denervation of the heart, i. e. bilateral removal of the stellate ganglion Th 1-Th 3 was used in Czechoslovakia since 1981 in eight patients who were followed up for prolonged periods. The patients were operated on account of angina at rest which caused deterioration of the quality of their lives. In case of extensive affection of the coronary arteries surgical treatment was not feasible and pharmacological treatment did not bring relief. At the time of a five-year check up 7 patients survived. All patients reported relief and their efficiency during ergometry improved. Four of the patients worked for several years. The authors discuss whether the above treatment is still justified.

Adult↗
PubMed1992

[Coronary surgery at the Institute of Clinical and Experimental Medicine].

In 1971-1991 in the Institute of Clinical and Experimental Medicine 2386 operations on account of IHD were performed. 2154 aortocoronary bypasses, 6 Vineberg operations, 51 valvular prostheses and aortocoronary bypasses, 128 resections of left ventricular aneurysms and 47 closures of post-infarction perforations of the interventricular septum. The mortality from aortocoronary bypasses during the entire period was 6.9%. The authors discuss different periods, changes of the operative technique and contemporary views on surgical treatment of IHD.

Cardiac Surgical Procedures↗
PubMed1991

[The effect of pancreas and kidney transplantation on diabetic autonomic neuropathy].

The authors examined, using cardiovascular reflex tests, nine type I diabetics 6-48 months after combined transplantation of the pancreas and kidney with satisfactory function of both grafts. The control group was formed by 10 type 1 diabetics after transplantation of the kidney and 10 subjects free from disease causing damage to the vegetative nervous system. The results of the examination during the pretransplantation period suggested in both groups of diabetics severe affection of the vegetative nervous system. Despite long-term practical normalization of the diabetic metabolic disorder, in the patients after transplantation of the pancreas no detectable improvement of findings was recorded. Changes in the tests used were not found either in the control group of patients after isolated transplantation of the kidney. Damage of the vegetative nervous system in uraemic patients is probably irreversible and intervention studies are therefore indicated in an earlier stage of the disease.

Adult↗
PubMed1991

Diabetic autonomic neuropathy after pancreas and kidney transplantation.

We have evaluated the effect of successful pancreatic and kidney transplantation on autonomic neuropathy in nine Type 1 (insulin-dependent) diabetic subjects. Cardiovascular reflex tests were performed before and at 6-24 months after transplantation. A control group of ten Type 1 diabetic patients after kidney grafting only was examined at the same time periods. For base-line comparisons results of the tests in ten healthy subjects were used. Advanced autonomic neuropathy was present in both groups of transplant recipients and no significant changes in test results could be found at post-transplant evaluation. Lack of autonomic nerve function improvement was confirmed in seven patients of the pancreatic and kidney transplantation group who were examined again after 2-4 years. Irreversible structural autonomic nerve damage is probably present in uraemic pancreatic transplantation candidates.

Adult↗
PubMed1990

[The effect of a combined transplantation of the pancreas and kidney on the course of peripheral diabetic neuropathy].

Sixteen type I diabetics were followed up from the neurological aspect and by electromyography for 6 to 42 months following successful combined transplantation of the pancreas and kidney. Before transplantation all patients suffered from medium severe to severe peripheral polyneuropathy, grade 3-5 according to the commonly used quantitative classification. All patients reported after transplantation subjective improvement, e.g. of the muscular strength or steadiness of gait. In six patients the clinical and in eight patients the electromyographic finding improved by one grade, in four patients at least the conductivity in the nerves of the upper extremities improved. In four patients the neurological and electromyographic finding did not change; none of the patients after successful transplantation deteriorated. The authors discuss the favourable effect not only of elimination of the uraemic syndrome, but also the effect of the improved carbohydrate metabolism on regenerating processes in the peripheral nervous system.

Adult↗
PubMed1990

Transplantation of the kidneys in diabetics.

Diabetic nephropathy affects half the type 1 diabetics and is the most frequent cause of death there. While in some countries diabetics account for 25-30% of all patients newly admitted in dialysis and transplantation programmes, in Czechoslovakia the number of diabetics treated by dialysis or transplantation is small. From August 1985 to June 1988, 15 isolated kidney transplant operations were performed on 13 diabetics with serious late complications of diabetes. By the time of writing, all recipients had been surviving (for 1 up to 35 months), and only two were receiving artificial kidney treatment. Progressive vascular complications were in two cases the cause of gangrene of the lower extremity, one patient had a central cerebrovascular attack. Despite this, successful transplantation resulted in a marked improvement of the patients' general condition and quality of life. Due to intensified insulin therapy, diabetes, too, was satisfactorily compensated in the majority of the recipients. As experience so far indicates, if the patient is prepared in good time, which includes diabetological, nephrological and ophthalmological treatment, the results of transplantation in diabetics can be comparable to those achieved in non-diabetic patients. Renal transplantation in diabetics should be developed in all transplantation centres in Czechoslovakia, and uraemic diabetics should not be eliminated from the dialysis-transplantation programme except in cases of serious contraindication.

Adult↗
PubMed1989

[Kidney transplantation in diabetics].

Diabetic nephropathy affects half the type I diabetics and is their most frequent cause of death. While in some countries diabetics account for 25-30% of all newly admitted patients in dialyzation-transplantation programmes, in the CSSR the number of diabetic patients treated by dialyzation or transplantation is small. From August 1985 to June 1988 in the Institute of Clinical and Experimental Medicine a total of 15 isolated transplantations of the kidneys were made in 13 diabetics with serious late complications of diabetes. At present all recipients survive (1-35 months) and only two are treated by an artificial kidney. Progressing vascular complications were in two instances the cause of gangrene of the lower extremity, one recipient had a central cerebrovascular attack. Despite this, successful transplantation caused a marked improvement of the general condition and quality of life. The compensation of diabetes was also, due to intensified insulin therapy, satisfactory in the majority of recipients. Hitherto assembled experience indicates that when the patient is prepared in time, which includes diabetological, nephrological and opthalmological treatment, the results of transplantation treatment in diabetic patients can be comparable with results in should be developed in all transplantation centres in the CSSR and uraemic diabetics should be eliminated from the dialyzation transplantation programme only in case of fundamental contraindications.

Adult↗
PubMed1989

Insulin-pump treatment of pancreas-graft rejection.

Continuous subcutaneous insulin infusion (CSII) was combined with antirejection therapy in four diabetic recipients of pancreas and kidney grafts with persisting hyperglycemia due to pancreas rejection. In three of the patients, full function of the pancreas was restored after as many as 40, 86, and 139 days of CSII. In another patient, the dose of insulin was halved, and his graft function was classified as partial. Pancreas rejection treated without CSII was reversible only in one of four other recipients. We conclude that restoration of the function of a pancreas graft damaged by rejection can be achieved even after a long period with the help of CSII therapy.

Adult↗
PubMed1989

[Inflammatory aneurysm of the pelvic artery].

The authors describe an uncommon case of an inflammatory aneurysm of the common abdominal aorta which was successfully treated by resection and prosthesis. In the discussion the authors deal with the specific features of this type of aneurysm, as compared with common sclerotic ones. They recommend the best diagnostic procedure, surgical approach and postoperative treatment.

Adult↗
PubMed1989

[The results of a questionnaire on the status of vascular surgery in Czechoslovakia].

In 1985 an enquiry by means of questionnaires was made at all surgical departments of the CSR. Its aim was to assess the state of vascular surgery, conditions under which it is performed and to compare quantitative and qualitative data with the actual needs. In 1984 in the CSR a total of 2564 vascular operations were performed, incl. 751 urgent ones and 1813 planned operations. With regard to the estimated need of cca 500 operations per 1 million population (comparable data from Scandinavian countries), the 248 operations per 1 million population are quite inadequate. In contrast to this, 82 surgeons claim to be concerned with active vascular surgery which is almost twice the number needed to ensure an adequate number of vascular surgical operations. The authors analyze the causes of the inadequate development of vascular surgery which ensued from the enquiry and indicate possibilities of future development.

Czechoslovakia↗
PubMed1989

[Why is peroperative antibiotic prophylaxis of infectious complications most effective?].

The concentrations of oxacillin, azlocillin, temocillin, amoxycillin, cefoperazone, cefazoline, netilmicin, clindamicin, ofloxacine in serum and coagulum take a parallel course but their content in the coagulum is ten times lower than in serum--with the exception of doxycycline which reached a 40% value of the serum level in the coagulum. From this ensues that most effective are those antibiotics which can be administered in large doses and which have a long half-life. Unfavourable are antibiotics with a narrow therapeutic range and those with a short half-life. Preoperative application of such doses which create sufficiently high and prolonged levels is the optimal method of antibiotic prophylaxis of infectious complications during surgical operations.

Anti-Bacterial Agents↗