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Biomedical subjects

J Cerný

Publications and source records attributed to J Cerný.

At least 91 records · Page 5Linked to original sources
PubMed1990

[The effect of aortofemoral bypass in the immune status of patients].

Changes in the immunity of 10 patients were studied during aortofemoral bypass surgery. A marked drop in the level of transferrin and of C 3 and C 4 components of complement was observed in the course of the operation and on the first postoperative day. Transferrin levels exhibited a statistically significant difference even on the 7th postoperative day (p less than 0.05). The orosomucoid response was less pronounced. In cell mediated immunity the most remarkable change was recorded in the drop of T-lymphocytes which persisted all over the first postoperative week. Alterations in immunoglobulins were most prominent in the immediate postoperative period and persisted up to the 7th postoperative day. The authors discuss some factors which, in addition to the surgical load, may be involved in immunodepression.

Adult↗
PubMed1990

[The importance of interventional endoscopy in biliary tract surgery].

The authors give an account of their favourable experience with endoscopic treatment of choledocholithiasis in 414 patients (320 cholecystectomies and 94 with the gallbladder in situ). Removal of concrements from the ductus choledochus was achieved on the first attempt in 80% of the patients, during the second to fourth attempt in 20%. Immediate complications (acute pancreatitis, haemorrhage, perforation) were recorded in 4.1% of the patients, the mortality was 1.2%. The authors emphasize the importance of endoscopic treatment of choledocholithiasis with obstructive jaundice in particular in old and risk patients.

Endoscopy↗
PubMed1990

[Solitary hepatic cysts--a therapeutic problem].

The authors give an account of the therapeutic procedure in 22 patients with solitary cysts of the right liver lobe. In 13 pyogenic cysts (abscesses) drainage of the abscess was made under CT control, in four cysts anatomical or non-anatomical resection of the liver was performed, in three cysts enucleation, in one biliary cyst cystojejunostomy with a Roux-Y loop of the jejunum. Aetiopathogenesis of the cysts: pyogenic cysts 14, echinococcal cysts 2, inborn parenchymatous cysts 3, posttraumatic cysts 3.

Adult↗
PubMed1990

[Follow-up of newly diagnosed patients with diabetes in the Prague population. II. Changes in the group of new diabetics after a 2-year follow-up].

From the total number of 1551 new diabetics and patients with PGT 85 subjects died in the course of two years. Treatment was changed 118 times, failure of PAD treatment was recorded in 11 type 2 diabetics. Three patients originally classified as type 1 were later included in type 2. In three diabetics (of 14) who had sings of diabetic retinopathy already during manifestation of DM marked deterioration of the finding on the fundus occurred. The incidence of macroangiopathic complications did not change.

Adult↗
PubMed1989

[Therapy of venous hypertension in animals with an artificial heart and long-term survival].

1. The authors elaborated an original concept for the interpretation of vasomotor disorders in subjects with an artificial heart. 2. This concept is based on the regeneration of nervous elements in the walls of the atria (in particular the right one) after implantation of the artificial heart and on comparison of their activity with the venous pressure which revealed the interrelationship of the two phenomena. 3. Both therapeutic methods based on this concept, the method of influencing the afferentation and efferentation of vasomotor nervous regulations leading to a reduction of the central venous pressure proved valid and effective. 4. Evaluation of the effectiveness of this therapy is based on regular assessment of the central venous pressure, on the laboratory assay of enzymes (AST, ALT, GMT and LDH), on the assessment of serum albumin and finally on the morphological and histological examination of the liver incl. assessment of the hepatic index. 5. The nervous pathogenesis is closely linked with hormonal factors. The latter are conceived as the participation of associated factors in the pathogenesis of venous hypertension in recipients with an artificial heart.

Animals↗
PubMed1989

[Present possibilities of surgical treatment of chronic pancreatitis].

The author gives an account of his experience with 54 operations in the algic form of chronic pancreatitis in 1982-1986. Based on examination of patients by modern visualization methods of the pancreas (USG, CT, ERCP), the ductal or parenchymatous form of chronic pancreatitis was diagnosed. In the ductal form of chronic pancreatitis (enlarged pancreatic duct) drainage operations were performed in 43 patients (pancreatojejunostomy in 24 patients and cystogastrostomy in 19 patients). In the parenchymatous form (a senotic pancreatic duct) resections were made (distal resection duodenopancreatectomy and 95% - pancreatectomies). Check-up examinations 1-5 years after operation revealed disappearance of pain in 90% of the patients.

Adult↗
PubMed1989

Therapy of venous hypertension in calves with total artificial heart (TAH).

Vasomotor disregulation, preponderantly expressed by a pathological increase of central venous pressure (CVP) in calves with total artificial heart (TAH), starts to be evident from about the 50th day of pumping. The main cause of this state is an imbalance in cardiac receptor areas. Ventricular vasodepressor mechanisms are eliminated with the ventricular tissue, which is replaced by the artificial blood pump. In the stumps of both atria, which remain in situ, all neural elements disappear immediately after TAH implantation, but within two months they are fully regenerated. Regenerated atrial receptors are the starting points of afferent neural stimuli, which in the vasomotor center of the brainstem, increase the activity of the vasoconstricting functional component. A general tendency to vasoconstriction, now not well counterbalanced, increases, and the progressive venous hypertension causes loss of liver function and morphology. Two therapeutic approaches were tried: afferent therapy by atrial electrical stimulation, and efferent therapy by the administration of antihypertensives. Both kinds of this therapy were sufficiently effective in reducing CVP, protecting the liver, and prolonging average survival.

Animals↗
PubMed1989

[Experience with the dipyridamole test in the diagnosis of coronary insufficiency].

In 1980-86 263 dipyridamole tests were made before or after ergometry on account of the diagnosis of coronary insufficiency and possible indication for coronarography. The sensitivity and specificity was evaluated in a group of 101 subjects where both examinations had been made. As a reference method the authors used ergometry with more strict criteria of positivity of the two tests (deviations of segment ST 0.2 mV, incl. stenocardia) which are in good agreement with coronarography. The sensitivity was 58.2 and the specificity 96% (in men 61.4 and 100%). On combination of 98 dipyridamole tests with immediately following ergometry of 39 negative ergometries 23 (58.6%) changed to positive. Of 38 coronarographies the dipyridamole test was positive in 73% and in some patients with affections of the three main branches it was negative. There was also one serious complication: a new myocardial infarction. Because of lower sensitivity the dipyridamole test does not replace ergometry, except when the latter cannot be performed. The combination of the two tests sensitizes ergometry. On account of the high specificity ergometry can be omitted when the test is positive, in particular in men. For diagnostic purposes the stricter variant of criteria for evaluation of the test is more reliable and almost specific.

Adult↗
PubMed1989

[Surgical and endoscopic papillosphincterotomy in surgery of the bile ducts].

Surgical transduodenal papillosphincterotomy (TPS) on 119 patients was compared with endoscopic papillosphincterotomy (EPS) on 507 patients for rate of success and directly related complications. No major differences were found to exist between both approaches with regard to frequency or pathologico-anatomic nature of complications. Satisfactory experience has been obtained by the authors primarily from EPS on patients in advanced age or high-risk patients with choledocholithiasis following cholecystectomy (n = 320), benign and malignant stenosis of Vater's papilla (n = 97), and choledocholithiasis with gall-bladder in situ (n = 94). Intervention endoscopy of bile ducts is preferred primarily for patients in advanced age or for high-risk patients.

Aged↗
PubMed1989

[Replacement of the mitral valve with preservation of the posterior leaflet, papillary muscles and chordae tendineae].

The authors used in 11 patients with chronic mitral regurgitation Lillehei's method of replacement of the mitral valve by a mechanical valve preserving the posterior leaflet of the mitral valve, papillary muscles and chordae tendineae. None of the operated patients died. The authors proved marked functional improvement in the patients, reduction of the size of the left ventricle and left atrium, where by the ejection fraction did not change markedly. These results support the hypothesis that the continuity between the mitral anulus and the left ventricular wall through the valvular leaflet, chordae tendineae and papillary muscles assists the left ventricle on its systolic function.

Adult↗
PubMed1989

[Intravenous use of a derivative of metronidazole in abdominal surgery].

The authors give an account of a group of 11 patients with diffuse or circumscript peritonitis, treated by an intravenous derivate of metronidazol - Tiberal. Improvement was recorded in eight patients, three patients died. Based on their results, the authors recommend to administer metronidazol by the parenteral route combined with antibiotics effective against aerobic bacteria. In treatment they emphasize repeated bacteriological check-up examinations and an effective contact of the clinical and bacteriological department.

Abdomen↗
PubMed1989

[A bone cement containing methotrexate in an experiment and in clinical practice].

The authors submit their initial experience with the use of bone cement with methotrexate in the treatment of primary and secondary malignities of bones. As a basis they use the analogy of using bone cement with gentamycin the molecular structure of which is similar to that of methtrexate. In the experimental part of the work in vitro evidence was provided of methotrexate stability when exposed to heat or oxidation; and the kinetics of its release from pores of bone cement were revealed. In experimental dogs the effect of cement with methotrexate on neighbouring bone was investigated in the early period in the immediate vicinity necrosis of the trabeculae was found, during the late period healing processes. The clinical use of bone cement with methotrexate was started in 1986. In 17 surviving patients only in one case local progression of a tumour in the vicinity of cement with methotrexate was found. The aim of the work is to find a possible local treatment of bone malignities, in particular metastatic ones, which will be not only an emergency solution but will extend our therapeutic possibilities.

Animals↗
PubMed1989

[Reconstructive surgery in post-operative strictures of the extrahepatic bile ducts].

The authors made in 1982-1988 in 24 patients with iatrogenically conditioned strictures of the extrahepatic biliary pathways reconstruction operations, most frequently hepaticojejunostomy Roux-Y. Within four weeks after operation three patients died (12.5%): two were repeatedly re-operated previously, one 71-year-old female patient died as a result of hepatic coma and renal failure. The authors discuss conditions for successful reconstruction operations in iatrogenic strictures of extrahepatic biliary pathways, in particular the importance of the localization and duration of stricture, mucosobiliary anastomosis, internal drainage, solution of the stricture already during the first operation.

Adult↗
PubMed1989

[Maximal dilatation of the coronary bed using dipyridamole in the diagnosis of coronary insufficiency].

The authors give an account of the mechanism of action of dipyridamole. Via adenosine it produces selective and maximal vasodilatation of resisting coronary vessels in the non-ischaemic area. Thus redistribution of the blood flow from the ischaemic to the non-ischaemic portion of the heart muscle occurs along with clinical and electrocardiographic manifestations of cardiac angina which can be used for its diagnosis. The pharmacological dipyridamole test makes detection of myocardial ischaemia possible in a fundamentally different way as compared with other loading tests. The authors mention pharmacodynamic, metabolic, haemodynamic and associated phenomena of the action of dipyridamole and the mechanism of the opposite effect of aminophylline and nitroglycerin.

Coronary Circulation↗
PubMed1988

Surgical aspects of the implantation of a left ventricle assist device.

The authors have summarised their experience with short-term use of a left ventricle assist device (LVAD). Nine experiments were carried out in healthy calves. A polyurethane pump of their own design, placed extracorporeally, was used. Its in-flow cannula was placed in the left atrium, the outflow one in the initial segment of the descending aorta. The LVAD was operated for a period of 5 days. Fourteen days after its disconnection, the animal was sacrificed and both the bypass system and parenchymal organs were examined. No surgical complications were observed during the experiments. Macro- and microscopical pictures showed minor infarctions in the renal tissue which, however, did not impair renal function. The findings in other organs were related to anaesthesia, the operative procedure and way of animal sacrificing. The experiments have proved the safety of the bypass system used over a short period and, consequently, its potential for future clinical application.

Animals↗
PubMed1988

Endoscopic sclerotherapy of oesophageal varices.

The authors present their experience with the outcome of gastrofibroscopic sclerotherapy of oesophageal varices, performed in a total of 70 patients with portal hypertension. All patients were classified in classes B and C according to Child's criteria, and 68 of them had variceal bleeding before receiving sclerotherapy. Acute bleeding was successfully arrested in seven cases, and elective sclerotherapy in between bleeding episodes was carried out in 60 cases. To date, complete obliteration has been noted in 34 patients. An effect of previous sclerotherapy was observed during the next therapeutic session in 18, and eight patients died from progressive hepatic insufficiency. In the discussion section, the authors analyse current concepts on the technique of sclerotherapy related to complications, on instrumentarium and sclerosing solutions, and on the significance of prophylactic, acute and elective sclerotherapy, with the importance of endoscopic sclerotherapy of oesophageal varices perceived mainly in comparison with the results of surgery from the point of view of long-term patient survival.

Adolescent↗