Biomedical subjects

J Molácek

Publications and source records attributed to J Molácek.

11 recordsLinked to original sources

PubMed2006

[Surgical management of major scrotal hernias].

The scope of options for the inguinal hernias management is wide. However, in case of major scrotal hernias, the Lichtenstein hernioplasty, using a mesh, or the Prolen Hernia System (PHS), are the most commonly used methods. Only in cases of generalized malignant disorders and cardiopulmonary insufficiencies, the procedure is contraindicated. Postoperative haematoma, mesh infection, deterioration of the pulmonary functions, resp. deterioration of the cardiac venous return and testicular atrophy are the risks of the procedure. The authors present a case-review of a 48-year old male with bilateral scrotal hernias, operated in two stages according to Lichtenstein.

Genital Diseases, Male↗

PubMed2005

[An inflammatory aneurysm of the abdominal aorta].

Inflammatory aneurysm of the abdominal aorta is a rare disorder, affecting approximately 3-10% of the population with a diagnosis of the abdominal aortic aneurysm. The principal etiological agents of the disorder include bacterial microorganisms, primarily Salmonella, Staphylococcus aureus, and Escherichia coli. However, in many cases the etiology od the disorder remains unclear and, likely, autoimmune and genetic dispositions may play a certain role, as well. The principal diagnostic procedures include ultrasound, CT and MRI examinations. The principal therapeutic procedures include open resection of the inflammatory aneurysm with complete removal of the infectious tissue and its replacement by a prosthesis or a vascular allograft "in situ" or through an extraantomical reconstructive procedure. New procedures also include endovascular therapy which is technically much simpler, less demanding for a patient, however, it may leave a potential infectious focus in the organism with a risk of further septic complications to follow. Therefore, the authors recommend a strictly individual treatment strategy in each patient with this serious disorder. In case of positive cultivation bacteriological findings, extended (a minimum of 6 weeks) antibiotic therapy and regular, long-term patient follow-up with regular visits, are essential.

Aged↗

PubMed2005

[Volvulus of the lienal flexure of the colon].

The authors present the case-report of a 72-year-old man who was admitted to our clinic with acute abdomen symptoms and signs of acute peritonitis. The cause was rather rare diagnosis of left colon flexure volvulus. This find caused extensive gangrene of colon. Solution was subtotal colectomy, the patient is now 4 months after surgery in good shape.

Abdomen, Acute↗

PubMed2004

[Penetrating aortic ulcer with severe gastrointestinal bleeding].

Primary aortointestinal fistula is a rare reason for gastrointestinal bleeding and mainly caused by a communication between the digestive tract and an aortic aneurysm. The penetrating aortic ulcer has been recently recognized as an independent pathological entity. It may penetrate through the aortic wall, leading to fistula into adjacent organs. We report the case of a 78-year-old woman who was admitted to our department with massive gastrointestinal hemorrhage. Endoscopy did not reveal the cause of hemorrhage. The diagnosis was made by computed tomography showing a primary aortoduodenal fistula without aortic aneurysm. The patient was successfully operated on. During urgent operation we found the penetrating atherosclerotic ulcer as the cause of the aortoduodenal communication. Primary aortoenteric fistula has a fatal outcome unless it is diagnosed accurately and urgently treated by surgical intervention. Contrast-enhanced computed tomography is the primary imaging modality to specify the diagnosis.

Aged↗

PubMed2004

[Modified eversion carotid endarterectomy].

The authors describe their own modified eversion technique of the carotid endarterectomy, which they began to carry out in the surgical clinic in Pilsen in 2002. A perfect endarterectomy of the bulbus and of the common carotid is the main advantage of this modified technique, when compared to the classical eversion technique. Later on, the authors learned from the literature that the technique was not entirely new, but a similar technique of the carotid endarterectomy had been used more than 30 years ago, already.

Carotid Stenosis↗

PubMed2004

[Acute resection in unusual cases of symptomatic aneurysms of the abdominal aorta].

On three unusual cases of symptomatic abdominal aortic aneurysms, the authors demonstrate the need for satisfactory erudition of a vascular surgeon, who must manage the above serious conditions. In the first case, the authors deal with a symptomatic aneurysm of the abdominal aorta and a homolateral dystopy of the right kidney co-existence. In the second case, the authors describe a rare, nevertheless a very serious communication between a vein and an adjacent aneurysm. In the third case, the authors prefer the left-sided retroperitoneal approach in the management of the juxtarenal AAA in combination with a "hostile abdomen".

Aged↗

PubMed2004

[Infections of vascular reconstructions in the aortofemoral region].

Infections of vascular reconstructions in the aortofemoral region are among the most feared of conditions in the vascular surgery, having a very poor prognosis. The perioperative mortality reaches over 50% and the extremity loss up to 75%. The authors point out inaccuracies in diagnostics and definitions of the vascular reconstructions infections. On four cases of the vascular reconstructions infections in the aortofemoral region which have been managed in the Surgical Clinic in Plzen in last two years, they demonstrate severity of the above conditions.

Aorta, Abdominal↗

PubMed2003

Can ischemia-reperfusion syndrome in transplanted kidneys procured from non-heart-beating donors be influenced by adding selenium into the reperfusion solution? An experimental study.

Ischemia-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). An animal model of NHBD was used to monitor the influence of the exogenous addition of selenium in the perfusion solution (HTK, Custodiol) on the generation of free oxygen radicals between 0 and 120 minutes after transplantation of the NHBD organ. During this interval, the malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney, significantly decreased. The augmentation of the anti-oxidant capacity of the preservation solution might represent a possible improvement in the function of kidneys transplanted from NHBDs.

Animals↗

PubMed2003

Can the ischemia-reperfusion syndrome in transplanted kidneys procured from non-heart-beating donors be influenced by adding selenium into the reperfusion solution? An experimental study.

The ischemic-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). The animal model of a NHBD was used to monitor the influence of exogenous addition of selenium into the reperfusion solution (HTK, Custodiol) with respect to the formation of free oxygen radicals at 0 to 120 minutes after the NHBD transplantation. This maneuvers produced a statistically significant decrease in malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney. The augmentation of the antioxidative capacity of the preservation solution might be a possible route to improve the function of kidneys transplanted from NHBDs.

Animals↗

PubMed2003

[Rupture of abdominal aortic aneurysm (RAAA)--predictors of the early postoperative mortality].

PURPOSE: To evaluate the main factors of the 30 days mortality rate of patients operated on for abdominal aortic aneurysm rupture (RAAA. PATIENTS AND METHOD: Univariate and multivariate analysis of various factors associated with RAAA was performed in a group of 73 patients operated on for RAAA between 1996-2001. RESULTS: The 30 days mortality rate was 35.6 %. The main factors of mortality were: misdiagnosis, cardio- pulmonary-cerebral resuscitation (CPCR) on admission, configuration of RAAA, number of blood transfusions, hypotension on admission (p < 0.0001) and duration of operation, type of reconstruction and hypertension in anamnesis (p < 0.01). Important factors (p < 0.05) of postoperative mortality were also low haemoglobin level on admission, abdominal aortic aneurysm (AAA) diameter and ischaemic heart disease in anamnesis. The probability of patient's death is the highest (p < 0.003), if factors like CPCR, number of blood transfusions and aneurysm diameter are combined (multivariate analysis, stepwise method). CONCLUSION: The early detection and surgical or endovascular elective treatment of AAA, the regular dispensation of patients with small AAA especially in hypertonics, the correct diagnosis of RAAA without time delay are the best tools for patients survival. The patient's chance for survival increases with highly trained prehospital resuscitation system and experienced team of vascular surgeons and anesthesiologists.

Aged↗

PubMed2003

[Abdominal aneurysm resection in aged patients at the Surgery Clinic in Plzen from 1998 to March 2003].

The authors evaluate resection therapy on aneurysms of abdominal aorta in patients of high age (mean 85 years) at the Clinic of Surgery in Plzen. In the period of 1998-March 2003 the authors performed 13 elective resections on aneurysms of abdominal aorta in patients of high age with zero mortality and 21 acute resections with 38% mortality. In the given period of time, 178 resections of aneurysms of abdominal aorta were made in patients younger than 78 years, 57 being acute interventions. Mortality of elective interventions was 2.9%, in acute interventions being 28%. The present groups indicate that mortality of resection therapy sharply increased in relation to circulation instability of the patients in cases of ruptured aneurysm, but nor in relation to age of the patients.

Aged↗