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Biomedical subjects

J Kliment

Publications and source records attributed to J Kliment.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Metaphylaxis and treatment of cystine lithiasis--personal experience].

The authors presented their own experience with treatment of cystine lithiasis in 7 patients, which has been performed during the course the past of ten years. Identification of cystine was performed by concrement submitted examination, using a polarizating microscope, and x-ray difractometric structural analysis. After stone extraction the patients were treated by a high fluid intake (diuresis over 2.5 l), alcalizating treatment involving citrates (Alkalit Spofa), and Penicilamin (Spofa), or Thiola (Santen) which are currently proved to be the most optimal approach. Recurrence of stones requiring percutaneous treatment, was observed in one of the patients during five years metaphylaxy. Another patient of the same group had three times stated cystine stone recurrence which passed spontaneously.

Adult↗
PubMed1993

[Diuretic scintigraphy with 131I-hippurate and 99mTC-MAG3 in children with dilatation of the upper urinary tract].

The method of diuretic scintigraphy was used to examine 27 children, aged 2-15 years, with excretion urography findings of dilatation of the upper urinary tract. Vesicorenal reflux was excluded in all the children of the series by classical radiologic cystography. The radionuclide 131I-hippurate was used in 15 children and 99mTc-MAG3 in 12 children. In both groups the parameter T 1/2 was determined as the time of 50% decrease of activity above the kidney after administration of the diuretic. With both radionuclides the same borderline time of T 1/2 was established. In cases with T 1/2 < 10 minutes and preserved kidney function, dilatation of obstructive origin can be excluded with both substances. 99mTc-MAG3, however, has a markedly better imaging capacity and a significantly lower radiation load than 131I-hippurate. (Tab. 4, Fig. 3, Ref. 12.)

Adolescent↗
PubMed1992

Urovaginal fistulas: experience with the management of 41 cases.

In a retrospective analysis the authors have evaluated their experience with the management of urovaginal fistulas in 41 patients. Of them 34 had vesicovaginal, 3 ureterovaginal, 2 urethrovaginal, 1 ureterovesicovaginal and 1 ileovasicorectovaginal fistula. Fistulas occurred most frequently after gynaecological operations for benign and malignant diseases and after radiotherapy. Reconstructive operations were performed in 37 patients, mostly from the vaginal approach. Primary repair of fistulas was successful in 35 patients. In 2 patients reoperation was required. Due to good experience the authors recommend the transvaginal approach, which in their opinion is suitable for repair of the prevailing part of vesicovaginal fistulas.

Adult↗
PubMed1992

Squamous cell carcinoma of the penis. Analysis of 24 cases.

The authors evaluated retrospectively 24 cases of spinocellular carcinoma of the penis, trying to detect aetiological carcinogenic factors of the disease. Phimosis persisting since childhood was reported by ten men, whereby in five of them circumcision was performed during puberty. The duration of symptoms up to the time of biopsy and histological verification of differentiated spinocellular carcinoma of the penis varied from one month to thirteen years. Eight patients (33.3%) belonged to category T1, 8 (33.3%) to T2 and 8 (33.3%) to T3. Fifteen tumours (62.5%) were G1, 5 (20.8%) G2 and 4 (16.7%) G3. In 5 men print cytology was negative.

Carcinoma, Squamous Cell↗
PubMed1992

[Advantages of the new radiopharmaceutic agent, 99mTC-mercaptoacetyltriglycine (99mTc-MAG3), in the diagnosis of kidneydiseases. A comparative study with 131I-OIH, 99mTc-DTPA and 99mTc-DMSA].

The properties of 99mTc-mercaptoacetyltriglycine (MAG3), a new radiopharmaceutic for dynamic renal scintigraphy, were assessed in a series of 138 patients with different diseases of the uropoietic system. The physiological values of renographic curves were determined as well as the characteristics of MAG3 excretion, which closely resembled the values for 131I-OIH. On comparing the values of separate MAG3 clearance with standard radiopharmaceutics in 26 subjects examined, very good correlation coefficients (r) were obtained: 0.98, 0.96, and 0.92 for 131I-OIH, 99mTc-DMSA, and 99mTc-DTPA, respectively. Global MAG3 clearance reached 0.64 of the OIH value. The higher quality of scinfigraphic imaging than seen with the substances used so far, the favorable pharmacokinetic properties and the low radiation load (H(E) = 0.51 mSv in adults) of MAG3 determine the indication spheres in which it can best be used to advantage. Of the radiopharmaceutics used to date, MAG3 yields the best results. It can well substitute 123I-OIH, which is not readily available in our conditions, and can thus be expected to be widely used in clinical practice.

Adolescent↗
PubMed1992

[Non-palpable testes--diagnosis and therapy].

The authors subject to a retrospective analysis a group of 522 boys operated on account of retention of the testes during 1982-1991, whereby they focused attention on cases where the testis was not palpable before operation. In 57 (10.9%) of the boys with a non-palpable testis in three instances the finding was bilateral and in 54 cases unilateral. Surgical revision of 60 testicles revealed anorchia in 14 instances (23.3%), inguinal retention in 25 (41.7%) and abdominal retention in 21 (35.0%). Orchiopexy was performed in 31 boys and orchiectomy in 15. The therapeutic results are unfavourable in particular in the group of boys with intraabdominal retention. The mentioned state of affairs can be improved only by initiating treatment at the age of 1 year, making use of microsurgery and laparoscopy in the diagnostic and therapeutic process.

Adolescent↗
PubMed1992

[Treatment of vesicovaginal fistulas].

The authors evaluated in a retrospective analysis their experience with treatment of vesicovaginal fistulae in 36 patients. Most frequently--almost in 90%--the fistulae developed after a gynaecological operation, in particular surgery on account of benign, but also malignant disease. The authors used for surgical correction of the fistulae a transvaginal approach in 28 (77.8%) patients, a transvesical approach in 5 (13.9%) patients and a transvesical and transperitoneal approach in two (5.5%) patients. One fistula receded spontaneously during drainage of the urinary bladder. Primary correction of the fistula was successful in 34 (94.4%) patients. In two patients further surgical treatment was necessary. With regard to their favourable experience the authors recommend a transvaginal approach which is in their opinion suited for the majority of non- complicated vesicovaginal fistulae. In corrections of extensive fistulae after radiotherapy a combined transvesical and transperitoneal approach with fixation of the omentum in the space between the vagina and urinary bladder proved useful.

Adult↗
PubMed1991

A new approach in radionuclide imaging to ureteric peristalsis using 99Tcm-MAG 3 and condensed images.

A new method for the evaluation of ureteric peristalsis is described. Standard, dynamic renal scintigraphy was carried out using 99Tcm-MAG 3 in 59 patients. Time-activity curves and condensed images over the ureter area were created simultaneously. A six-grade scale (O-V) was chosen for the classification of ureteral function. The results obtained were compared with parameters of renographic curves and other clinical findings. In a group of 13 patients, two different renal radiopharmaceuticals were used: 131I-OIH and 99Tcm-DTPA. The results show that the new method is suitable for the assessment of ureteral disorders, and has some advantages compared with previously described methods. 99Tcm-MAG 3, with a better target-to-background ratio compared to 131I-OIH and 99Tcm-DTPA, is the most suitable radiopharmaceutical for this purpose.

Adult↗
PubMed1990

Surgical management of vesicoureteral reflux by modified Gil-Vernet method.

Modified antireflux Gil-Vernet technique was used in the surgical management of primary vesicoureteral reflux grades II and III in 62 patients (60 children, 2 adults). Reflux has been eliminated in 90.3% of the patients. In patients with persisting reflux it was of lower grade than before surgery and showed a tendency to spontaneous disappearance when treated conservatively. Taking into consideration also the late results of elimination of the reflux, the success rate is comparable to that in other antireflux methods. In none of our patients has obstruction or other more serious complication occurred. Advantages of this technique are stressed, first of all its simplicity, preservation of musculature of terminal ureters, possibility of management of both ureters and absence of complications, mostly of obstructive character.

Adult↗
PubMed1990

Isolation of Neisseria gonorrheae and concomitant bacterial microflora from urine obtained by suprapubic bladder puncture in women with gonococcal urethritis.

The authors examined 38 non-pregnant women with gonococcal urethritis. Thirty-three (86.8%) of them suffered also from endocervical gonorrhea. Neisseria gonorrheae (N. go) was isolated from the midstream of urine in a quantity of 1 x 10(2) to 9 x 10(8) in 1 ml of urine with an average of 5.08 x 10(4) N. go per 1 ml of urine and S. E. M. +/- 3.85 x 10(4) N. go per 1 ml of urine. On the basis of suprapubic puncture ascendent propagation of bacteria to the bladder was observed by cultivation in 13 (34.2%) patients, with isolation of N. go in 5 cases.

Bacteria↗
PubMed1990

[Clinical evaluation of a new radiopharmaceutical agent 99mTc-mercaptoacetyltriglycine (MAG3)].

In the present clinically oriented study the authors checked the properties of 99mTc-mercaptoacetyltriglycine (MAG3), the new radiopharmaceutical for dynamic scintigraphy of the kidneys, in a group of 30 patients. They positively value particularly the high quality of visualization of the parenchyma and the urinary tract, the pharmacokinetic properties similar to those of 131I-orthoiodhippurate and the capability of representation of the kidneys with their markedly decreased function. They examined the take-up of the pharmaceutical in the liver, which is slightly more marked with the worsening tubular function and partly depends also on the length of the time interval between the preparation and administration of MAG3. No significant changes were found in the clinical and principal laboratory parameters after its administration. In conclusion, the authors point out to advantageous properties of the novel radiopharmaceutical for clinical use in our conditions.

Adolescent↗
PubMed1990

[The significance of a new radiopharmaceutic agent, 99mTc-mercaptoacetyltriglycine (MAG 3), in the diagnosis of diseases of the kidneys and urinary tract in children].

Using the method of dynamic scintigraphy of the kidneys by means of a new radiopharmaceutical preparation, 99mTc--mercaptoacetyltriglicide [MAG 3], the authors examined 35 children with various urological and nephrological diseases. In indicated cases the examination was supplemented by administration of a diuretic, further projections or indirect mictional cystography. The authors assessed normal parameters of functional curves and their normal extent in a group of 18 healthy kidneys. They did not find a significant difference, as compared with results obtained by means of 131I-OIH. The assessed values of global clearance attained 66% of the 131I-OIH clearance values. In 60% of the patients the visualization of the parenchyma and in 80% the visualization of the efferent urinary pathways was better than when 99mTc-DTPA was used. In all instances the scintigrams were better than when 131I-OIH was used. The new radiopharmaceutical preparation combines the advantages of technetium-labelled preparations and the favourable pharmacokinetic properties of hippuran. It is suitable for quantification of tubular secretion. It is superior to hitherto used substances as regard the quality of visualization and in particular the lower radiation load. Therefore it is particularly suited for paediatric practice.

Adolescent↗
PubMed1989

[Dynamic scintigraphy of the kidneys using a diuretic].

The authors describe the application of the method of dynamic scintigraphy of the kidneys, using a diuretic, in patients with signs of stasis in the upper urinary pathways, based on findings of excretory urography and standard radioisotope examination of the kidneys. They obtained three groups of results: 1. Obstruction during the standard radioisotope examination of the kidneys became normal after administration of the diuretic. 2. The obstruction receded during the standard radioisotope examination of the kidneys as a result of the diuretic, but only insignificantly. 3. There were signs of obstruction on standard radioisotope examination of the kidneys and they persisted also after administration of the diuretic. These results of dynamic scintigraphy of the kidneys using a diuretic make it possible to differentiate more readily dilatation of the upper urinary pathways in the absence of an obstruction from dilatation due to a significant obstruction, which is important when deciding on further diagnostic and therapeutic procedures in clinical urological practice.

Adolescent↗