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Biomedical subjects

J Breza

Publications and source records attributed to J Breza.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Complications of continent urinary diversion].

Continent urinary diversion over its advantages, in comparison with incontinent urinary diversion, has serious complications. The authors analyse results and complications, which they registered in 26 patients 10-50 (average 20) months after supravesical continent urinary diversion. The commonest complications were in connection with the continent mechanism, these lead in 8 patients to urinary incontinence. Other serious complications were reservoir perforation during catheterisation in 3 and development of stones in the reservoir in 2 patients. All these major complications necessitated reoperation.

Adolescent↗
PubMed1992

[Advantage of conversion of a uretero-ileostomy to a continent reservoir].

The authors refer their own experience in conversion of incontinent urinary diversion to a continent one. In 6 patients with ureteroileostomy they constructed continent reservoir. Reservoirs were formed from isolated ileocecal segment of the intestine together with the previous ileal loop. Continence was ensured by construction of a valve by method of ileal intussusception. After operation patients were followed-up clinically, biochemically and urodynamically, their subjective feelings and objective findings were analysed. Serious early or late complications were not registered during follow-up.

Humans↗
PubMed1990

Cavernous vein arterialization for vasculogenic impotence. An animal model.

We designed acute and chronic animal models to evaluate a new procedure of arterialization of the cavernous vein. In the acute study, arteriogenic impotence was induced in 6 dogs by bilateral ligation of the penile arteries just proximal to the crus of the penis. The cavernous vein and penile artery were anastomosed proximal to the site of ligation, and the pudendal vein was ligated proximally to prevent the diversion of arterial blood away from the penis. Erection was induced either by electrostimulation of the cavernous nerves or by intracavernous injection of papaverine, and the erectile response was studied before and after cavernous vein arterialization. Four dogs were followed up for two months to evaluate the long-term effects of the procedure. Shortly after arterialization of the cavernous vein, the basal flow rate in the internal pudendal artery increased dramatically to almost six times the control rate, and the erectile response to neurostimulation was approximately 85 percent of control. Selective pudendal arteriography at two months confirmed the patency of all arteriovenous anastomoses. However, scanning electron microscopy and histologic examination revealed sinusoidal damage most probably consequent to the chronically elevated arterial flow.

Animals↗
PubMed1990

The effect of venous incompetence and arterial insufficiency on erectile function: an animal model.

We designed an animal model to elucidate the effect of venous leakage and arterial insufficiency on erectile function. In 10 dogs, electrodes were implanted around the cavernous nerves for electroerection and blood flow in the internal pudendal artery was recorded. Venous leakage was mimicked by inserting needles of varying gauges (30 to 16G) into the corpus cavernosum and the erectile response to neurostimulation was recorded before and after the creation of the leak. The relationship between the size and the amount of the venous leakage, the changes in the intracavernous pressure (peak and drop), and the changes in the peak and maintenance arterial blood flow were documented. Arterial blood flow was then reduced by 25 and 50 per cent by means of a screw clamp on the terminal aorta. The erectile response to neurostimulation was again determined, with the same electrical parameters, first with reduced blood flow alone, then in combination with leakage of varying size. Our results showed that minor cavernous vein leakage in the presence of normal arterial flow and a healthy sinusoidal system had a minimal effect on erectile function owing to a compensatory increase in penile blood flow. However, when reduction of arterial blood flow was superimposed on venous leakage, even of a minor degree, the erectile response to neurostimulation was markedly impaired.

Animals↗
PubMed1990

[Use of semirigid penile prosthesis in the treatment of erectile dysfunction].

Implantation of a pair of semirigid penile prosthesis is a simple and satisfactory mode of treatment for erectile dysfunction in selected patients. Though the functional cavernous tissue is destroyed by implantation of the prosthesis into the cavernous body, the sensitive nerves are not damaged by the procedure. Therefore, the sensitivity of the penis, as a factor important for further sexual life, remain intact. The authors report their own clinical experience with implantation of semirigid silicone penile prostheses, made in Czechoslovakia. In 26 out of 28 patients they observed good functional and cosmetic results and the treatment allowed the patients to return to the active sexual life. The advantages of the used Czechoslovak prostheses, which are not to be neglected, are their availability and relatively low price.

Adult↗
PubMed1989

Blood lymphocyte magnesium in kidney stone formers.

Blood lymphocyte, serum and urinary magnesium analyses were performed in a randomized group of 36 kidney stone-formers with the aim to determine the incidence of intracellular and extracellular magnesium depletion in urolithiasis. Lymphocyte magnesium depletion was found in 10 patients, serum magnesium depletion in 5 and concomitant lymphocyte and serum magnesium depletion in another 3 patients. Thus intracellular and/or extracellular magnesium depletion was found in 15 patients (41.7%). Oral magnesium supplementation (5-10 mmol Mg2+ daily) was found in some patients ineffective in both lymphocyte and/or serum magnesium repletion.

Adolescent↗
PubMed1989

Local and systemic effects of chronic intracavernous injection of papaverine, prostaglandin E1, and saline in primates.

To compare the local and systemic effects of chronic intracavernous injection of papaverine, prostaglandin E1, and saline on erectile tissue, eight pigtail monkeys underwent 75 injections over a nine-month period. Monkeys were divided into three groups; each group received papaverine (10 mg.), prostaglandin E1 (20 micrograms.), or saline (one ml.). The erectile response was closely observed for two hours after each injection to monitor the onset, degree, and duration of erection. Liver function tests were performed every three months to detect early systemic metabolic changes. After sacrifice, the simian penises were perfused in situ and examined histologically with both light and electron microscopy. Papaverine resulted in an initially strong erectile response, but this was maintained throughout the length of the study in only two monkeys. In contrast, prostaglandin E1 resulted in tumescence that was maintained in all monkeys over the nine-month period. In addition, the papaverine group had elevated liver enzymes and significant histologic changes with loss of normal architecture on both light and electron microscopy. The other two groups showed only minimal histologic changes or none.

Alprostadil↗
PubMed1989

Erectile response to acute and chronic occlusion of the internal pudendal and penile arteries.

We designed two animal experiments to elucidate the effect of obstruction of the internal pudendal artery on erectile function. In five dogs the internal pudendal or penile artery was acutely clamped unilaterally or bilaterally with a non-crushing vascular clamp. In eight dogs, the internal pudendal or penile artery was ligated, unilaterally or bilaterally, and occlusion was maintained for two months. In both models, electrodes were implanted around the cavernous nerves for electroerection. In unilateral occlusion, blood flow in the contralateral internal pudendal artery was recorded via an ultrasonic probe. In both unilateral and bilateral occlusion, intracavernous pressure in both corpora cavernosa was recorded through a 21-gauge butterfly needle connected to a Statham transducer. In the chronic model, selective pudendal angiography was done after the erection study was completed; the dogs were then sacrificed and the penile tissue was examined histologically under light microscopy. Unilateral acute clamping of the internal pudendal or penile artery caused a compensatory increase in arterial flow in the contralateral pudendal artery with only moderate impairment of intracavernous pressure on the ipsilateral side, but bilateral occlusion resulted in a marked reduction in the intracavernous pressure response to neurostimulation. In contrast, chronic obstruction of penile vessels had a minimal effect on erectile function due to the development of a rich network of collaterals around the penis. Histological evaluation revealed mild local changes in the cavernous tissue with characteristic compensatory enlargement of branches of the cavernous artery on the control side in cases of unilateral occlusion.

Animals↗
PubMed1989

Detailed anatomy of penile neurovascular structures: surgical significance.

In 10 formalin-preserved adult male cadavers, dissection of the penile veins, arteries and nerves revealed information of clinical importance. The main venous drainage of the corpora cavernosa is via the cavernous veins, with additional drainage through the circumflex, deep dorsal, and crural veins. The arterial supply of the cavernous bodies varied remarkably, and the incidence of an accessory internal pudendal artery was high. The cavernous nerves, previously believed to be microscopic structures, were in fact identifiable grossly, and we were able to follow them from the region of the hilum of the penis to the prostate. The nature of these nerves was then confirmed by serial histologic sectioning. This detailed knowledge of the venous drainage and arterial and nervous supply of the penis, as well as of the relationships among the cavernous structures in the hilum of the penis, can elucidate the cause of erectile dysfunction and provide a valuable guide for surgical correction of vasculogenic and neurogenic impotence.

Adult↗
PubMed1989

Penile venous drainage in erectile dysfunction. Anatomical, radiological and functional considerations.

To elucidate further the penile venous anatomy and its role in the haemodynamics of erection, we performed pharmacological cavernometry and cavernography in 95 patients with venogenic impotence and in 12 patients with psychogenic impotence. The findings were correlated with those of dissection in 10 adult male cadavers. Cavernography confirmed that the main venous drainage of the corpora cavernosa is via the cavernous veins, with additional drainage through the crural, circumflex and deep dorsal veins and demonstrated that, in patients with venogenic impotence, the cavernous veins are the common site of leakage. Cavernometry provided valuable parameters for the quantification of the degree of venous leakage. Detailed knowledge of the penile venous system and cavernometry and cavernography are essential for the proper diagnosis and treatment of patients with venogenic impotence.

Erectile Dysfunction↗
PubMed1989

[Antegrade pyeloureterography in the transplanted kidney].

Antegrade pyeloureterography performed via fine puncture needle yields detailed imaging of the anatomy of the renal pelvis, calices, and ureter of the transplanted kidney. It is a simple and safe examination method providing information which, as a rule, can not be obtained by urography, radioisotope gammagraphy or ultrasonography. Puncture of the collecting system of the transplanted kidney with subsequent pyeloureterography is indicated for determining the site and nature of the obstruction in the ureter in urinary stasis in the transplanted kidney, for diagnosing urinary fistulas, for functional examination of the dilated upper urinary tract, as well as for percutaneous treatment of urological complications after kidney transplantation.

Humans↗
PubMed1986

The role of tumour markers and lymphography in determining clinical stage of non-seminomatous testis tumours.

Findings established by means of tumour markers examination and lymphography were compared with histological findings in retroperitoneal lymph nodes removed during lymphadenectomy. Overall accuracy of tumour markers was 70.1%, sensitivity was 71.4% and specificity was 67.9%. Overall accuracy of lymphography was 79.4%, sensitivity was 80.7% and specificity was 77.5%. Combined results of tumour markers and lymphography showed overall accuracy 73.1%, sensitivity 93% and specificity 37.5%. Since neither the results of tumour markers examination, nor lymphography are sufficiently sensitive in order to determine exactly the presence of metastases in regional lymph nodes, retroperitoneal lymphadenectomy must be considered in the present for a method which is not only of therapeutic, but also of diagnostic and prognostic importance.

Chorionic Gonadotropin↗
PubMed1986

Construction of fistula between a. brachialis and v. basilica transposed into subcutaneous tissue of the arm as a preparation for haemodialysis treatment.

Technique and tactics of the construction of arteriovenous fistula between a. brachialis and v. basilica transposed into the subcutaneous tissue of the arm are described. It is advantagenous to use this fistula construction in "problematic" patients when there are no other possibilities for an arteriovenous shunt. In comparison with arteriovenous fistulas of vascular grafts and of artificial vascular prostheses the described method has an advantage only in one vascular anastomosis, since straight fistula form is involved, kinking of the arterialized vein cannot occur and, finally, fistula is formed from an autologous vessel which is always thick enough even in little children and gracile women.

Adult↗
PubMed1986

Occurrence of adenocarcinoma in the colon sigmoideum following Maydl's operation for urinary bladder exstrophy.

Two cases of colonic adenocarcinoma appearing 44 and 25 years, respectively, following an operation for urinary bladder exstrophy done according to Maydl are reported. A need for regular controls of patients with inner urine derivations has been emphasized. In the case of a suspected tumour it is necessary to alter the inner derivation to an outer one and also a resection of the colon at the site of the urinary bladder trigone is required. The Czech surgeon Karel Maydl was the first to implant the trigone of a splitted urinary bladder into the colon sigmoideum in 1892. This type of operation is used even today by several European urologists with excellent long-term results with respect to the preservation of an intact ureterovasical passage which prevents the reflux of the intestinal contents into the ureter, and also prevents the formation of strictures in the terminal parts of the ureter. In two patients who had been living for 25 and 44 years since they were operated on for urinary bladder exstrophy according to Maydl, a colonic adenocarcinoma was diagnosed. The tumour directly affected the implanted trigone wall and also involved the surrounding parts of the colon wall.

Adenocarcinoma↗