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Biomedical subjects

J Michek

Publications and source records attributed to J Michek.

At least 19 recordsLinked to original sources
PubMed1996

[Stress ulcers in patients with polytrauma].

Authors treat in their institution yearly 100-120 patients with polytrauma. In the Endoscopic Centre of the hospital approx. 20 gastroduodenal ulcers are diagnosed yearly in patients with supposed stress etiology. Authors analyze the pathophysiology of origin of stress ulcer, clinical symptoms and acute diagnostics. They evaluate results of early surgical treatment. Authors place the great importance on explicit treatment methods for prevention of stress ulcer origin.

Humans↗
PubMed1996

[Early treatment of the unstable thorax in polytrauma].

Thoracic trauma represents 12.8% of all trauma patients treated in author's evaluated the contribution of new diagnostic methods, in particular CT and sonography, to determinate the indication of conservative therapy or early surgical treatment. From 1992 in the framework of the grant project the early surgical treatment of instable thorax was performed in 29 patients with polytrauma or severe associated thoracoabdominal trauma. Authors determined indications for thorax stabilisation after serious consideration, and stated contemporary contraindications of this treatment. They evaluated the therapeutic contribution of these methods and prepared in cooperation with the company Medin Nové Mĕsto the set of osteosynthetic material with accessories for treatment of instable thorax.

Flail Chest↗
PubMed1996

[Pitfalls of deep pelvic anastomoses in rectal carcinoma].

Authors analyse a group of patients operated for colorectal carcinoma in their hospital during ten-years period 1982-1991. 421 patients were operated for ca recti, in more as 65% of cases the sphincter saving operation was preferred. The used method was elaborated by Hojo and Kaso from Japan. The contraindication of sphincter, and insufficiency of sphincter, objectively rectomanometrically detectable. The resection of urinary bladder was contemporary performed in 15 patients, the hysterectomy with adnexotomy in 8 patients, the vaginal resection in 5 cases and the resection of small intestine in 8 cases. The resection of os sacrum to S 3 was performed in 3 patients. The radical resection with establishment of the deep pelvic anastomosis is burdened by certain number of early and delayed complications, too. Authors analyse its causes, possible corrections, but also its prevention.

Anastomosis, Surgical↗
PubMed1996

[Injuries of organs in the abdominal and retroperitoneal cavities].

In the Traumatological Hospital Brno approx. 100 polytraumatised patients yearly are admitted with involvement of 2, 3 or 4 systems. During the period of years 1982-1991 authors operated 308 injured patients with increasing haemoperitoneum, 254 patients with profuse bleeding into retroperitoneum, 77 patients with traumatic perforative peritonitis and 61 patients with severe thoracoabdominal trauma. Mortality in this group was 26%. Authors evaluate the contribution of new diagnostic methods for the indication of early surgical treatment, and results of operations, complications and problems.

Abdominal Injuries↗
PubMed1996

[Associated injuries of the pelvis].

In last three years 27 injured patients were operated in Traumatological hospital Brno for associated pelvic trauma. This trauma was associated with injury of urinary tract in 8 patients, with traumatic lesion in area of the colon in 6 cases and with injured big vessels of the retroperitoneum in 8 patients. The urgent operation was performed in 44%. Authors put stress in diagnostic analysis and early indication of surgical operation on careful anamnestic clinical examination, they utilize the contribution of the sonographic and CT examination with contrast, in indicated cases the selective angiography and retrograde urethrocystography, too. Authors prefer early reconstructional operations.

Abdomen↗
PubMed1994

[Serum levels of cytokines as a measure of response to stress after various types of elective gallbladder surgery].

The authors investigated the cytokine levels in patients after laparoscopic cholecystectomy (LCHE), conventional open cholecystectomy (OCHE) and complicated open cholecystectomy (KOMPL) in order to assess whether there is a relationship between cytokine levels and the general reaction of the organism, the type and extent of the operation. They did not find an increase of IL-1 or IL-2 levels in any of the patient groups. The IL-6 concentration was slightly raised only in three patients of the OCHE group three hours after surgery and this rise persisted for 24 hours. In the KOMPL group there was a more marked rise of IL-6 in 9 patients within 3 hours after surgery, persisting in 6 patients for 24 hours and in 2 patients for 48 hours. The TNF values were similar; in group OCHE they were slightly elevated in 2 patients 24 hours after operation. In the KOMPL group these values were elevated in 5 patients for 3 hours after surgery and this increase persisted in 2 for 24 hours after surgery. Based on the investigation of cytokine levels, which is a recent indicator for evaluating the reaction of the organism to stress, conclude that laparoscopic cholecystectomy is a minimal stress for the patient and is associated with a zero defence reaction of the organism, if evaluated according to serum cytokine concentrations.

Adult↗
PubMed1992

Surgical treatment of the atonic bladder ("vesical cap").

As demonstrated in animal experiments and in five patients with atonic bladders, "vesical cap" surgery causally solves detrusor impairment by functionally reinforcing it with a vital muscle layer from an ileal seromuscular flap. All other genuine components of the bladder are kept intact, which is very beneficial for bladder function.

Animals↗
PubMed1991

[Treatment of injuries of the cervical spine].

Injuries of the cervical spine are re-evaluated at present. New surgical procedures and research on the stability, when these procedures are used, caused that surgical treatment is used more frequently. Attention is draw to provisions in the field as well as in hospitals, on the diagnostic approach and classification of these injuries, on the procedure of conservative surgical treatment. The domain of conservative treatment are injuries of the upper cervical spine (C1 and C2); injuries of the lower cervical spine are frequently unstable, and therefore frequently indicated for operation. Attention is drawn to modern views on surgical treatment of comminuted fractures of the atlas and the dens axis. The authors analyzed their own material from 1986 to April 30, 1989 and in case-histories of three patients they draw attention to their therapeutic method. The authors demonstrate their own modified plates for the anterior stabilization of the cervical spine and their modification of the Halo device "Halo Vest". They discuss biomechanical properties of posterior and anterior stabilization methods.

Adult↗
PubMed1990

[Recurrent peptic ulcer--surgical complications].

Recurrent ulcer is serious complication of surgical treatment. Resection, reconstructive operations under conditions of severe adhesions, inflammatory infiltrates and abscesses are exacting and often connected with complication. In the period of 1978-1987 the authors carried out 64 reoperations for recurrent peptic ulcer, incl. 39 cases, whom they had to operate urgently. 19 patients were reoperated on account of penetration and peroperation of the ulcer, 11 because of massive haemorrhage, and 9 patients because of gastrocolic fistulae. In reoperations, subtotal resection of the stomach with vagotomy was carried out in 66%. In 4 patients reoperated repeatedly, Zollinger-Ellison's syndrome was found and resection of the pancreas was performed simultaneously. The mortality rate in the group, including patients reoperated urgently, was 21.9% (i.e. 14). The authors emphasize that the main aim of reoperation must be long-term therapeutic results without recurrences of ulcers and without serious functional disturbances.

Adult↗
PubMed1990

[Uretero-enteral anastomosis of dilated ureters in ileocecal replacement of the urinary bladder].

In very dilated efferent urinary pathways with an impaired peristaltic activity of the ureter the authors selected for ureteroenteral anastomosis in ileocoecal replacement of the urinary bladder anastomosis with the ileum, leading into the ileocoecal reservoir via the invaginated trans-Bauhin's ileal valve. This valve was ensured against devagination by a transparietal suture after longitudinal intraluminal discision of the outer leaf the invaginate. By adjusting the discision of the outer leaf of the invaginate the authors obtained the selected pressure resistance of the valve which was desirable from the clinical aspect. This technique was described in two patients who were followed up for 6 and months and in a patient with convercion of Bricker's conduit into an ileocoecal prosthesis.

Anastomosis, Surgical↗
PubMed1990

[Personal experience with liver injuries].

The authors give an account of 69 patients hospitalized in 1975-1986 in the Traumatological Research Institute in Brno on account of liver injuries. The mean age of the patients was 38.3 years. The liver injury was very frequently associated with serious craniocerebral injuries, with injuries of the chest and other intraabdominal organs and the total lethality was 62.3%. The most frequent cause were traffic injuries (50 cases). Blunt liver injuries accounted for 92.8% of the cases.

Adolescent↗
PubMed1990

[Treatment of liver rupture in an experiment].

The authors investigated in experiments on rabbits healing of liver incisions under various circumstances: spontaneous healing, liver incisions treated by suture by application of the tissue glue Tissucol, the collagenous haemostatic felt Collastypt combined with one stitch. Healing was followed up after several time intervals. From normal, i.e. the group of spontaneous healing, differed the groups treated by Tissucol and Collastypt where marked encapsulating fibrous tissue reactions round the necroses on the wound margins were found with numerous eosinophils as a transient phenomenon. The final result (with a maximum of cca two months) was adequate in all groups--as a rule a thin fibrous tissue scar with few remnants of atrophic hepatic trabeculae. In the treatment of small injuries it seems best to use the collagenous haemostatic Collastypt. In the treatment of sutures in rare instances a large number of leucocytes was found in the area of the necrosis and stitches, perhaps as result of contamination of the wound or sewing material.

Animals↗
PubMed1990

[Necrotizing pancreatitis and its complications managed by surgery].

The authors have summed up their 10-years experiences (1978-1987) with the therapy of acute necrotizing pancreatitis and of some serious surgical complications. While in 252 patients operated early for biliary pancreatitis mortality rate did not exceed 8.7% in 65 patients operated for necrotizing abscessing pancreatitis and its complication it was as many as 63%. The stress has been laid both on early operations of biliary tract diseases and the prevention of developing severe forms of pancreatitis. Even in the cases of advanced necrotizing pancreatitis, priority has been given to radical necrectomy as early as in the second week of the disease duration supplemented with lavage and profuse drainage. The maintenance of therapeutical laparostomy is suitable.

Humans↗
PubMed1990

[Primary sclerosing cholangitis].

Authors report about 3 cases of primary sclerosing cholangitis type I of the total 3,043 patients operated for benign disease of biliary ducts in the course of 10 year's period (1978-1987). Diagnosis was determined not only on the base of clinical symptoms but mainly on the base of ERCP, PTC and histological examination. Two cases of obstructive icterus were treated by hepato-jejuno-anastomosis after Rouxe and one patient by high-hilar anastomosis with jejunum and diahepatal drainage left for 3 months. During the postoperative period patients were treated with hepatoprotectives and corticosteroids.

Cholangitis, Sclerosing↗
PubMed1990

[Reoperation in colorectal surgery].

Because of unsatisfactory results of surgical therapy in rectal carcinoma the authors have re-evaluated their attitudes and elaborated resection methods of the rectum with retaining the system of sphincters trough atypical approaches: abdominotransvaginal in female and anterior abdominoperineal in male patients. They have also worked out the methods of coloanal anastomosis with passing through by trans-sphincter approach from posterior colpotomy or transperineally. These new access ways have been used in reconstructive operations after rectal resections performed previously according to Hartmann with terminal sigmoideostomy. Physiological passage through the rectum was restored till 3 weeks. 55 patients underwent the reoperation, 47 of them with excellent and good results (i.e. 85.5%) and the patients have returned to the normal social and working process.

Colorectal Neoplasms↗
PubMed1989

Ileocoecal augmentation and orthotopic bladder replacement in the management of urinary bladder injury following multiple trauma.

The authors offer their experience with the use of the ileocoecal segment for orthotopic bladder replacement (in 7 patients) or augmentation (in 2 patients) in contracted bladders after multilpe trauma. The group of patients was followed up for 6-35 months. In no case did replacement result in adverse metabolic changes, and it was invariably instrumental in normalization of the upper urinary tract, if dilated. By virtue of its hypotonic nature, replacement was not associated with incontinence, with urge incontinence persisting only in patients undergoing augmentation, probably in view of the remaining spacious lower urinary bladder segment with inadequate neurogenic signalization. As both intervention provided patients with a sufficiently long intermicturition intervals thus giving them relative comfort, the response by patients was most favourable.

Cecum↗
PubMed1989

[A modified Goodwin ureterosigmoidostomy and our experience].

On the collection of 35 people with ureterosigmoidostomy analyse the authors advantages and disadvantages of these operation. Suitable indicated operation can give to the patients good hygienical amenities, continention of stool and urinae give him full sociability. Nondesirable consequences of connection between urinary and intestinal tract can be influated by optimal medication. The authors detaily described operation technique with their modification and indication.

Adult↗