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Biomedical subjects

J Morávek

Publications and source records attributed to J Morávek.

At least 19 recordsLinked to original sources
PubMed2001

[Treatment of hypospadias in childhood].

The aim of the paper is to compare different techniques of correction of hypospadias with the author's own group of patients and to compare the results with those achieved at other departments. Between 1992-1999 at the Department of Paediatric Surgery, Teaching Hospital Motol 348 operations were made in 219 boys. A plastic operation with a distal shift of the urethra a and conization of the glans in 112 patients predominated. Other methods included in 39 patients the creation of a ventral circumference of the urethra from the inner laver of the prepuce while preserving the urethral plate ("onlay island flap") and a parameatally everted flap according to Mathieu in 11 patients. A plastic operation by complete tubulization of the inner laver of the prepuce was used in 19 patients, in 2 boys the method of Duplay-Byars tubulization of the urethral plate. In one patient the urethra was replaced by a free flap as described by Nove Josserand. Another 129 operations included formerly used and now abandoned two-stage operations to straighten the penis, operations to reconstruct the prepuce and operations on account of complications. The latter comprised 16.4% fistulae, 9.58% dehiscences and 1.36% strictures.

Child↗
PubMed2000

[Extracorporeal membrane oxygenation in the treatment of severe pulmonary hypertension in a neonate after surgery for laparoschisis].

The authors describe the case of newborn with laparoschisis in whom severe idiopathic pulmonary hypertension during postoperative period developed and initiation of extracorporeal membrane oxygenation (ECMO) to maintain circulatory stability and adequate oxygenation was necessary. ECMO was performed for 75 hours with maximum extracorporeal support up to 50% of cardiac output (Biomedicus pump BP 50, Jostra oxygenator M8). Patient was successfully weaned and switched to conventional ventilation and nitric oxide inhalation with consequent extubation. No bleeding complications were observed during ECMO in connection with surgical repair of laparoschisis.

Extracorporeal Membrane Oxygenation↗
PubMed2000

[Abdominal lymphangiomas in childhood].

The authors evaluate their experience with the diagnosis and treatment of abdominal lymphangiomas during the period of 1995-1999. During the above period 6 girls and 4 boys with abdominal lymphangiomas were operated. The mean age at the time of operation was 5 years and 8 months. Ultrasonographic examination was made in all 10 patients, CT examination in 8. The surgical finding was lymphangioma of the mesenterium 4x, of the omentum 2x, of the adrenals 2x of the retroperitoneum 1x and intestinal lymphangiomatosis 1x. Macroscopically complete extirpation of the lymphangioma was possible in 9 patients and called for resection of the gut 3x and for adrenalectomy 2x. In one patient subtotal extirpation was performed. Postoperative follow-up did not reveal a relapse in any of the children. Abdominal cystic lymphangiomas are rare benign malformations of the lymphatic system. For preoperative differential diagnosis in typical cases USG is sufficient. The therapeutic method is complete surgical extirpation which is associated with a low incidence of relapses.

Abdomen↗
PubMed2000

[Ileus and intestinal perforation in premature infants--current trends in diagnosis and treatment].

OBJECTIVE OF STUDY: a) assessment of the relationship between ileus of premature infants and the development of intestinal perforation in premature infants, b) suggestions of an optimal therapeutic procedure. In the study children (n = 50) are included a) with intestinal perforation in conjunction with impaired excretion of meconium (n = 22), b) with an ileus state based on obstruction of the ileum by a viscous meconium treated either surgically or conservatively (n = 28). Surgical treatment involved: a) establishment of a double ileostomy (n = 28), b) insertion of a T drain into the terminal ileum (n = 8), c) removal of meconium from the gut and its primary closure (n = 2). Conservative treatment in 11 children involved irrigography with an liquid contrast substance under X-ray control. The group of children with perforation was compared with the group of children without perforation, risk factors were evaluated by statistical methods. The necessity of ventilation (P = 0.051) and gestation age (P = 0.006) proved to be statistically significant risk factors for the development of perforation. Survival was not influenced by perforation. All 11 children treated conservatively survived, of 39 operated children 26 survived (66.7%). An early start of conservative treatment of ileus of premature infants reduces markedly the risk of intestinal perforation and can thus influence the survival of low birth weight neonates.

Female↗
PubMed1999

Penetration of antibiotics into the pancreas in rats: an effect of acute necrotizing pancreatitis.

BACKGROUND: Penetration of antibiotics into the pancreas is considered to be an important criterion in determining the most appropriate antibiotic treatment during severe acute pancreatitis. Our study investigated pancreatic penetration of five antibiotics in rats with and without acute necrotizing pancreatitis (ANP) (non-pancreatitis rats (NR), pancreatitis rats (AP)). METHODS: ANP was induced by intraductal bile acid injection, and 3 h later the antibiotic was administered. In both NR and AP the antibiotic concentrations were evaluated in blood and pancreatic tissue 90 min after antibiotic administration. RESULTS: The tissue/serum (T/S) ratios for NR were 16% with amikacin, 24% with amoxycillin/clavulanic acid, 27% with piperacillin, 59% with ofloxacin, and 108% with cefoperazone. The ratios for AP were 7%, 23%, 26%, 52%, and 70%, respectively. T/S ratios were similar for NR and AP except for amikacin, for which the T/S ratio was lower in AP than in NR (P = 0.02). Pancreatic tissue concentrations of antibiotics with high penetration rates (cefoperazone and ofloxacin) were sufficient to inhibit most of the pathogens expected during acute pancreatitis. The concentrations of the other antibiotics were less than the minimal inhibitory concentrations (MIC) for common potential pathogens in pancreatic infection. CONCLUSIONS: Cefoperazone and ofloxacin showed the best pancreatic penetration of the five antibiotics tested. The high concentrations of these antibiotics in the pancreatic tissue would have enabled efficient antibacterial activity against most of the potential pathogens causing pancreatic infection. An early stage of acute necrotizing pancreatitis did not have a major effect on the pancreatic concentrations of the antibiotics.

Amikacin↗
PubMed1990

[Abnormal placement of the testes].

The authors defined a uniform classification of abnormal positions of the testes. They recommend also a uniform therapeutic procedure: after the first year of life treatment with human chorionic gonadotropin in one or two curves, if orchiopexy fails.

Cryptorchidism↗
PubMed1990

Changes of lithium elimination in acute polyuric renal failure caused by cisplatin and mercuric chloride.

Changes in lithium elimination were studied under the condition of experimentally induced polyuric acute renal failure by cisplatin (6 mg/kg body wt) or HgCl2 (3 mg/kg body wt). The histologically proven lesions of tubuli were associated with the decrease of plasma clearance of lithium (C(Li)) and polyfructosan-S (CP(FS). The decrease of these clearance values was not proportional and the ratio C(Li)/CP(FS) (indicating renal fractional excretion of Li+) increased significantly (p less than 0.01). The increase of C(Li)/CP(FS) was related to the increase of renal fractional sodium excretion (FENa) (p less than 0.01). The results suggest that the impairment of tubular cells by cisplatin or HgCl2 caused the decrease of tubular reabsorption of Li+ and Na+. From the pharmacokinetic point of view, these experiments suggest that changes in tubular transport of drugs should be taken into account in their dosing adjustment in patients with acute polyuric tubular lesion.

Acute Kidney Injury↗
PubMed1990

Pharmacokinetics of roxithromycin in kidney grafted patients under cyclosporin A or azathioprine immunosuppression and in healthy volunteers.

The pharmacokinetics of roxithromycin was studied in 9 kidney grafted patients under cyclosporin A immunosuppression, in 10 transplanted patients with azathioprine, and in 6 healthy volunteers. The biological half-life (beta-phase) of roxithromycin in cyclosporin patients was 34.4 (+/- 12.25) h (mean +/- SD), in azathioprine patients 23.4 (+/- 8.18) h and in healthy volunteers 17.0 (+/- 3.8) h. The total elimination constant (k10) was 0.046 (+/- 0.014), 0.068 (+/- 0.019) and 0.084 (+/- 0.036) h, respectively. The total clearance was 0.79 (+/- 0.21), 1.45 (+/- 0.66) and 1.84 (+/- 0.56) l/h, respectively. The areas under the serum level curves were 407.6 (+/- 118.3), 251.0 (+/- 106.6) and 180.7 (+/- 73.2) mg.h/l, respectively. The differences in these parameters between healthy volunteers and cyclosporin patients were statistically significant, as well as those between cyclosporin and azathioprine patients. The differences between healthy volunteers and azathioprine patients were not statistically significant. The results cannot be interpreted unambiguously as an interaction between roxithromycin and cyclosporin; the effect of cyclosporin on the function of eliminating organs which causes the slowed-down elimination of roxithromycin could be taken into account.

Adult↗
PubMed1989

[Why is peroperative antibiotic prophylaxis of infectious complications most effective?].

The concentrations of oxacillin, azlocillin, temocillin, amoxycillin, cefoperazone, cefazoline, netilmicin, clindamicin, ofloxacine in serum and coagulum take a parallel course but their content in the coagulum is ten times lower than in serum--with the exception of doxycycline which reached a 40% value of the serum level in the coagulum. From this ensues that most effective are those antibiotics which can be administered in large doses and which have a long half-life. Unfavourable are antibiotics with a narrow therapeutic range and those with a short half-life. Preoperative application of such doses which create sufficiently high and prolonged levels is the optimal method of antibiotic prophylaxis of infectious complications during surgical operations.

Anti-Bacterial Agents↗
PubMed1989

Cefoperazone pharmacokinetics in patients with liver cirrhosis: a predictive value of the ujoviridin test.

Pharmacokinetics of cefoperazone was studied in 10 healthy volunteers and in 11 patients with liver cirrhosis. In the same persons, we also examined the clearance of ujoviridin--a preparation of indocyanine green. Within 12 h, 31.8 (+/- 7.6)% of the 2 g dose of cefoperazone was eliminated in the urine of healthy persons and 74.3 (+/- 7.9)% (mean +/- SD) was eliminated in the urine of cirrhotics. The biological half-life (beta-phase) of cefoperazone in healthy volunteers and in cirrhotics was 1.77 (+/- 0.25) and 4.29 (+/- 1.16) h, total clearance 1.009 (+/- 0.187) and 0.583 (+/- 0.169) ml/s and hepatic clearance 0.694 (+/- 0.174) and 0.152 (+/- 0.079) ml/s, respectively. The differences are statistically significant (p less than 0.001). We also found good correlation between total clearance of cefoperazone and clearance of ujoviridin (r = 0.842) and even better between hepatic clearance of cefoperazone and ujoviridin clearance (r = 0.957), both statistically significant. The findings suggest that the dosage of cefoperazone should be reduced in patients with liver cirrhosis and that the ujoviridin clearance test is a good indicator of impaired cefoperazone elimination.

Adult↗
PubMed1987

Preclinical modeling of changes in drug kinetics caused by acute renal failure in rats.

The rates of total and extrarenal elimination of amikacin, cefoperazone, ceftriaxone, gentamicin, mesocain, theophylline, tobramycin, and polyfructosane-S were determined in rats with intact kidneys and in those after bilateral nephrectomy. While the values of the elimination constants of the tested drugs were markedly higher in the rats than in man, the ratio of nonrenal and total elimination constants, expressing the fraction of drugs eliminated extrarenally, is close to the value found in man. These findings suggest that the model might be useful in preclinical drug testing and can help in the prediction of changes in the kinetics of drugs caused by renal failure.

Acute Kidney Injury↗
PubMed1986

Changes of pharmacokinetic in rats after bilateral nephrectomy--a model for prediction of pharmacokinetic changes in patients with chronic renal insufficiency.

Elimination of gentamicin, tobramycin, amikacin, cefoperazone, ceftriaxon and lithium was investigated in healthy and bilaterally nephrectomized rats. This model of renal failure was used to determine the nonrenal elimination constantsebz, diesambino calculation of the ratio of the nonrenal and total elimination constant Qo. The values of Qo of the investigated drugs in the used model were very close to those given in the literature for men. These results suggest that the described model can be helpful in predicting the percentage of drug excreted renally and nonrenally, and the delay in drug excretion in renal insufficiency.

Animals↗
PubMed1986

Pharmacokinetics of cefoperazone in healthy volunteers.

Pharmacokinetics of cefoperazone was studied in 10 healthy volunteers following 15 min intravenous infusion of 2 g. Cefoperazone levels in the blood serum and in the urine were determined microbiologically. At the end of the infusion, mean serum concentrations of the antibiotic were 340.4 (+/- 81.5) mg/l, at the 4th hour after the infusion 38.4 (+/- 10.3) mg/l, and 12 hours after the infusion all subjects had detectable concentrations with the mean value 2.2 (+/- 0.7) mg/l. Within 12 hours, 33.3 (+/- 6.1) % of the total dose of cefoperazone had been eliminated in the urine. The fitting of the individual serum concentration curves and the determination of pharmacokinetic constants were done according to a two-compartment model with the aid of nonlinear least-squares regression analysis on a programmable calculator TI 59. The mean value of the biological half-life (beta phase) of cefoperazone was 1.77 (+/- 0.25) h, mean serum clearance was 61.7 (+/- 12.1) ml/min and the mean distribution volume (Vd area) was 9.44 (+/- 2.2) 1. Our data are in agreement with those previously reported in the literature. The only exception is the distribution volume, which we found to be smaller.

Adolescent↗
PubMed1986

Pharmacokinetics of temocillin after intravenous and intramuscular administration.

Pharmacokinetics of temocillin (BRL 17421) was studied in a crossover study in 10 male healthy volunteers after administration 1 g of temocillin intravenously or intramuscularly. The mean serum levels of temocillin at the 5th min after i.v. administration were 131.57 mg/ml, at 1 h 71.27 mg/l and at 12.12 mg/l. The values of the pharmacokinetic parameters were as follows: AUC 509.2 mg X h X l-1, t1/2 4.2 h-1, Vd ss 11.57 l, Vd area 12.28 l, CL 2049 ml X h-1. The urinary excretion by 12 h was 70.58% of the administered dose of temocillin. The mean serum levels of temocillin after i. m. administration were at 2 h 46.65 mg/l and at 12 h 15.89 mg/l, the corresponding pharmacokinetic parameters were: AUC 501.38 mg X h X l-1, t1/2 4.3 h-1, Vd 12.69 l. The urinary excretion by 12 h was 57% of the administered dose of temocillin. It follows from the study that pharmacokinetic parameters of temocillin after both ways of temocillin administration are very closed and that the dose 1 g of temocillin is sufficient to create effective serum levels for the majority of sensitive gramnegative organismus.

Adult↗
PubMed1986

Comparison of serum and coagulum antibiotic levels with respect to protected blood coagulum.

Serum and coagulum antibiotic levels have a parallel course. Coagulum antibiotic concentrations are more than ten times lower than serum concentrations. Therefore the optimal dosage of perioperative infusion should be high enough to establish steady state by means of sufficiently high serum levels. Antibiotics capable of attaining high serum levels and having a long half-life are best suited for the formation of effective antibiotic concentrations in blood coagulum. This is particularly true for cephalosporins and penicillins. Aminoglycoside antibiotics are not recommended for the formation of protected coagulum. "Ceftriaxon in the treatment of Severe bacterial infections".

Animals↗