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Biomedical subjects

J Koudelka

Publications and source records attributed to J Koudelka.

At least 19 recordsLinked to original sources
PubMed1997

[Cysts and pseudocysts of the spleen in children].

A cyst in the upper pole of the spleen was diagnosed in three children. In all the pole of the spleen was resected -in two instances it contained a cyst, in one a pseudocyst. The postoperative course was without complications. All patients had scintigraphic check-up examinations, in all three instances functional lienal tissue was found which did not differ much as to its size from that of a normal spleen. In cysts situated in the splenic pole the authors consider partial resection of the affected portion of the spleen as the optimal surgical method. In cysts of other portions of the spleen it would be better to select a different surgical procedure, e.g. enucleation of the cysts, partial decapsulation of the cyst or percutaneous puncture of the cyst combined, if necessary, with sclerotization.

Adolescent↗
PubMed1996

A simplified procedure for studies of intestinal immunity in rabbits.

As interest in the development of oral vaccines continues to rise, alternative animal models for studies of mucosal immunity are needed. The present study examines a simplified procedure for delivering antigen to rabbit Peyer's patches via an indwelling cannula. The cannula was placed 3-4 cm proximal to the Peyer's patch, and was used to deliver four weekly doses of the potent mucosal immunogen, cholera toxin (CT). Anti-CT specific fecal secretory IgA (S-IgA), serum IgG and serum IgA were found in essentially equal amounts in rabbits with cannulas and in rabbits fitted with Thiry-Vella (T-V) isolated ileal loops. In contrast to animals with T-V loops, the intestinal flora of animals with cannulas contained less bacterial overgrowth with Pseudomonas sp. Further, the villus architecture remained histologically normal in appearance and there were fewer post-surgical complications associated with this technique than with T-V loops. This simplified technique should allow wider use of rabbits in studies of mucosal immunity.

Animals↗
PubMed1996

[Laparoscopy-assisted appendectomy in children].

During a 13-month period (March 1, 1995 March 31, 1996) the authors performed in 70 children a laparoscopically assisted appendectomy. 68 children were operated on account of chronic appendicitis, two on account of acute appendicitis. During the postoperative period early, not very serious, postoperative complications were recorded in 7 children. One girl had on the second day after operation fever and severe abdominal pain, four children developed on the 5th-7th day after surgery abdominal pain, associated in three instances with fever and in two instances with the pathological finding of pericoecal fluid. The complaints receded within 1-2 days in all five patients after conservative treatment. In another two children the wound healed per secundam intentionem. No late complications were recorded.

Adolescent↗
PubMed1995

[Disorders of intestinal rotation and fixation in older children].

The authors discuss five older children where malrotation of the gut was diagnosed. The youngest child was three years old, the oldest 16 years. In three children the malrotation was diagnosed from clinical symptoms and examination by imaging methods, in two it was detected by chance during operation. In the two children where the impaired rotation of the gut was detected on operation, non-rotation was involved. In the remaining three children twice a left side paraduodenal hernia was diagnosed and once an external stenosis of the duodenum by Ladd's bands.

Adolescent↗
PubMed1994

[Diagnosis and therapy of post-traumatic hemobilia].

The submitted case-history deals with a successfully diagnosed and treated case of post-traumatic hemobilia in a 13-year-old girl. Hemobilia was manifested clinically by the typical Sandblom triad of symptoms. It was due to a pseudoaneurysm of the peripheral arteriole of the hepatic artery diagnosed by selective liver angiography. In treatment selective intraarterial embolization of the supplying artery proved useful.

Abdominal Injuries↗
PubMed1994

[Adnexal torsion in childhood].

During the 7-year period (1987-1993) the authors treated nine girls on account of torsion of the adnexa. In six girls torsion of primarily unaltered adnexa occurred, in one girl torsion of an ovary enlarged by a cyst and in two torsion of the ovary affected with a benign tumour, a coetaneous teratoma. In seven instances the organ affected with ischaemic necrosis had to be resected. In two girls detorsion of the ovary was performed, according to a sonographic control examination, however, in one the affected ovary atrophied. In the discussion the authors deal with the diagnosis of torsion of the adnexa and the method of treatment. The authors consider ultrasonic examination of organs of the abdominal cavity and retroperitoneum a very suitable method in all cases of abdominal pain in childhood, as this method can greatly contribute to the diagnosis of acute abdominal and gynaecological attacks. During surgery they recommend to preserve adnexa with a doubtful vitality because there is certain hope that they will be saved. During the postoperative period they recommend the long-term follow up of girls clinically and by ultrasonographic checks. If pathological changes are detected on the preserved adnexa, they recommend early re-operation and elimination of the risk factor (cysts etc.). The operation should be supplemented by prophylactic fixation of the preserved adnexa if this fixation was not done already during the primary operation.

Adnexal Diseases↗
PubMed1994

[Comparison of the results of conservative and surgical therapy of dislocated supracondylar fractures of the humerus in children].

The authors evaluate retrospectively in a group of 121 children with a dislocated supracondylar fracture in 1984-1993 the results of different therapeutic methods. The highest percentage of excellent and satisfactory results was recorded in children treated by closed reposition with percutaneous pinning with Kirschner wires (88%). In open reposition with Kirschner wires 60% of the results were excellent of satisfactory. The lowest percentage of excellent and satisfactory results was recorded when fixation with a plaster bandage was used (48%). The highest percentage of poor results was observed in surgical reposition with internal fixation (37%). The cause of failure in the majority of patients is according to the authors inadequate reposition of fragments. The authors discuss different types of treatment. They recommend non-surgical reposition with percutaneous pinning, even for less dislocated extension supracondylar fractures of the humerus as well as for fractures complicated by vascular injuries.

Adolescent↗
PubMed1994

[A solitary congenital hepatic cyst].

The author discusses a congenital, solitary, multilocular liver cyst in a two-year-old boy. The cyst originated in the margo ventralis of the right liver lobe. Clinically it was manifested by marked enlargement of the abdomen. The diagnosis was established by ultrasonography. The whole cyst was removed surgically.

Child, Preschool↗
PubMed1993

[Conservative therapy of liver injuries in children].

During the 14-year period between 1979 and 1992 the authors treated by conservative methods nine children with liver injuries. They operated on four children. The liver injury did not bleed during operation or haemorrhage was only minimal and probably the patients would have also recovered after conservative treatment. In the discussion the authors mention diagnostic approaches in liver injuries and criteria and methods of conservative treatment. The authors consider conservative treatment of liver injuries in children to be a very suitable method which is associated only with a very small number of complications, and which proves successful in the majority of patients. The prerequisite for its application are high standard of diagnostic visualization methods, monitoring of the child's condition and the possibility of immediate surgery, if conservative treatment fails.

Adolescent↗
PubMed1993

[Splenosis].

Four patients where during childhood splenectomy was performed on account of a traumatic indication were after 9-12 years subjected to sonographic and scintigraphic examination focused on possible evidence of splenosis. In one case asymptomatic splenosis was detected by scintigraphy.

Adolescent↗
PubMed1992

Giant Meckel's diverticulum.

A case of incomplete intestinal obstruction caused by a giant Meckel's diverticulum in a 13-year-old girl is reported. Short resection of the ileum with the diverticulum and end-to-end anastomosis was carried out. The possibilities of diagnosis and treatment as well as the controversial classification of this rare congenital anomaly are discussed.

Adolescent↗
PubMed1992

Endoscopic retrograde cholangiopancreatography in childhood.

ERCP was performed in 19 children and adolescents aged 4 to 16 years. In 13 children the examination was done under general anesthesia, in 6 cases with the usual premedication using dolsin and atropine. Indications for examination were unclear abdominal pain with occasional amylase elevation, in 3 patients status after an abdominal injury. In 16 patients the examination clarified the complaints by detecting organic disease of the gallbladder or the pancreas. ERCP is an important procedure in the event of uncertain diagnosis in children and adolescents and, if the indication is correct, and the technique good, is well tolerated by the patients.

Abdominal Pain↗
PubMed1991

[The significance of endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic injuries in children].

The condition of the main pancreatic duct determines very probably in a decisive way the fate of posttraumatic pancreatic pseudocysts and acute pancreatic injuries. Endoscopic retrograde cholangiopancreatography is the only diagnostic method which makes possible to evaluate the condition of this duct. The authors performed ERCP in three children, in two of them an internal drainage of the pseudocyst was carried out on account of verified ductal rupture. In the third girl, after evidence of an intact main pancreatic duct, conservative therapy was successfully applied. In the discussion the authors summarize data from the literature regarding the use of ERCP in the preoperative diagnosis of posttraumatic pancreatic pseudocysts and acute pancreatic injuries. The authors consider ERCP a method which renders the diagnosis of posttraumatic pancreatic pseudocysts and acute pancreatic injuries more accurate.

Adolescent↗
PubMed1991

[Diagnostic value of the rectal examination and the difference in axillo-rectal temperatures in acute appendicitis in childhood].

The authors deal with the importance of pain in the Douglas space during rectal examination and the contribution of the axillo- rectal difference in temperature in the diagnosis of acute appendicitis in a group of 402 children operated on who had the above preoperative diagnosis. Marked pain in the Douglas space was recorded in 53.6% children and complete absence of pain in 31.2% of the children with acute appendicitis proved at operation. In children where so-called negative laparotomy was performed this ratio was reversed. When evaluating the axillo-rectal difference in temperature the authors reached the paradoxical conclusion that an obviously physiological difference in the axillo-rectal temperature (up to 0.5 degrees C) was slightly more frequent in acute appendicitis than in negative laparotomy. An obviously pathological difference (1 degrees C or more) was three times more frequent in patients with negative laparotomies than in acute appendicitis. Next the authors discuss views reported in the literature where data on the asset of rectal examination in acute appendicitis vary between 2.9-73%. In the conclusion the authors recommend rectal examinations in all children with suspicion of any type of acute abdomen, however, taking into account that pain in the Douglas space will contribute only little to the reduction of the number of negative laparotomies. They consider assessment of the axillo-rectal difference in temperature practically useless.

Acute Disease↗
PubMed1991

[Air gun injuries in children].

The authors describe four cases of air rifle child injuries. One was a potentially lethal injury, a penetrating wound of the transverse colon and injury to the stomach. During urgent laparotomy the perforations of the gastrointestinal tract were sutured. In the remaining three children the injuries were less serious and affected soft tissues. In the discussion the authors summarize data from the literature concerning injuries to the head, neck, chest, abdomen and extremities, incl. lethal injuries. In instances when a penetrating abdominal injury cannot be ruled out, the authors emphasize the necessity of urgent laparotomy and surgical treatment of possible intraabdominal lesions. In injuries to other parts of the body a strictly individual procedure focused on repair of the injury is indicated. The authors also emphasize prevention of these injuries by adherence to safety during shooting and other manipulations with arms an air rifle must not be a toy for children and adolescents unless they are supervised by a responsible adult.

Adolescent↗