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Biomedical subjects

J Prásek

Publications and source records attributed to J Prásek.

At least 19 recordsLinked to original sources

[The value of fluorodeoxyglucose positron emission tomography in multiple myeloma].

UNLABELLED: The aim of this study was investigate the appearance of multiple myeloma on flurorine--18 fluorodeoxyglucose positron emission tomography (FDG-PET). Furthermore the accuracy of FDG-PET in detecting myeloma lesions and its influence on patient's management were evaluated. METHODS: Altogether 50 patients, 13 patients with newly diagnosed multiple myeloma with negative radiographs, 4 patients with solitary plasmocytoma, 27 patients in remission with suspected relapse and 6 patients with monoclonal gammopathy of unknown significance (MGUS) with suspicion for multiple myeloma or other malignancy underwent FDG-PET examination. The results of routinely performed radiographs, and MR or CT imaging modalities as well as the clinical course were used for verification of the FDG-PET results. RESULTS: Focally increased tracer uptake was observed in 3 (23 %) of newly diagnosed myeloma patients with negative radiographs and was verified with CT or MR with followed indication for therapy. The FDG-PET was negative in two cases of newly diagnosed multiple myeloma with negative radiographs, no focal infiltration on MR imagination, but with anemia, high monoclonal imunoglobulin and bone marrow infiltration, which was indication for therapy. In all other cases FDG-PET negativity in asymptomatic myeloma had good prognostic significance; these patients are without progression after with a median follow up 14 (7-20) months. Focally increased tracer uptake was found in 5 of the 27 patients in remission. In 4 cases of them it was due to multiple myeloma relapse, in one case due to ovarial carcinoma. Only in 1 patient the PET-FDP failed to recognize extraosseal progression on the scull. 21 patients had true negative FDG-PET imagination, in 1 case disease relapsed 12 months after FDG-PET examination; the other 20 patients are still without progress of this disease with median follow up 15 (7-20) months. FDG-PET was positive in 2 from the 6 patients with MGUS. In one of them carcinoma of thyreoidea was detected, in second the FDG-PET activity was localized in gut, tumor was verified with CT and colonoscopy. CONCLUSION: In conclusion, FDG PET might contribute to initial staging of radiographs negative multiple myeloma and might be useful for follow up of patients in remission, especially in consecratory multiple myeloma, or in patients with large plasmocelular tumor (> 5 cm) after concomitant radiochemotherapy.

Adult↗

[Hereditary pheochromocytoma--a family affected by von Hippel-Lindau disease].

The authors present a case of a 37 year old male (proband) with a 13 year history of progressive sight impairment leading to blindness and a 4 year history of a mild hypertension. He was incidentally found to have large adrenal tumors after an ultrasound kidney examination. The tumors were confirmed with CT scan and magnetic resonance imaging. A bilateral pheochromocytoma was biochemically demonstrated and successfully removed. The eye diagnosis of angiomatosis retinae von Hippel-Lindau was ascertained after a search of the patient files in other medical departments, which led to a family screening. Proband's brother, having hypertension and a history of a cerebellar astrocytoma operation, was also diagnosed with CT scan to have a bilateral pheochromocytoma. Unfortunately, at the same time he was found to have a large irremovable neuroendocrine pancreatic carcinoma, which caused complications and his eventual death. Both proband and his brother were affected by the same CGG(Arg167)->CAG(Gln) mutation in the exon 3 of the VHL gene. Other living and examined family members were not affected, which was confirmed by negative genetic testing. One year after the pheochromocytoma operation, proband was diagnosed to have a retroperitoneal tumor left to the aorta, clinically silent, with slightly and non-constantly elevated urine norepinephrine and normetanephrine. Metaiodobenzylguanidine scintigraphy showed that it was a paraganglioma. The old CT and magnetic resonance picture review demonstrated that the tumor had already been present at the time of the operation. It was surgically removed and histologically verified. It is a pity that proband had not been sent by his ophthalmologist for an endocrine examination when the eye diagnosis was determined. Affection of the family would have been discovered earlier, and proband's brother might have possibly been saved.

Adrenal Gland Neoplasms↗

The influence of moisture wound healing on the incidence of bacterial infection and histological changes in healthy human skin after treatment of interactive dressings.

In this article the authors discuss the problem faced by physicians when trying to use moisture-retentive dressing in pressure sores (decubitus ulcers). First, they report the results of an in vitro study using a new model of experimental wound (radio-isotopic investigation) that assesses the release of Ringer's solution from interactive dressings continually during fourteen hours. Second, they perform an animal experiment that assesses the incidence of wound infection in defects treated conventionally or using interactive dressings. The defects treated with interactive pads had lower incidence of wound infection, and the process of wound healing was rapid. Finally, the authors discuss their experience in four paraplegic patients with decubitus ulcers where they used moisture-retentive dressing on ulcers and on the surrounding intact skin before surgical procedure to detect the possibility of maceration of healthy skin. Histological evaluation was performed in order to find microscopically changes after moisture healing. The changes of healthy skin were not significant after treatment of moisture-retentive dressings.

Aged↗

Cerebral perfusion pressure and spect in patients after craniocerebral injury with transtentorial herniation.

We present a group of 29 consecutive head injured comatose patients with the syndrome of transtentorial herniation. All patients had urgent surgery and then continuous monitoring of ICP, CPP, blood pressure and jugular bulb oximetry was instituted. Two postoperative CT and SPECT examinations were performed in each patient. 15 patients had a normal CPP (> 70 mmHg) throughout the postoperative period, 80% of them had a favourable outcome. On the other hand 14 patients had decreased CPP lasting at least one hour and only 36% of them had a favourable outcome (p < 0.05). Similar relationships were found comparing GOS in patients with normal and increased ICP (> 20 mmHg) and normal and decreased SjO2 (< 55%). All but 3 patients had ischaemia on SPECT. Ischaemia improved on the 2nd SPECT in 11 patients and 10 (91%) of them had a favourable outcome. GOS (mean follow up 9 months) is: 12 patients good, 5 moderately disabled, 2 vegetative, 10 died. We conclude that SPECT is able to disclose even reversible ischaemic changes. In these patients all effort has to be made to keep CPP on normal levels. Improvement in cerebral perfusion is related to a better outcome.

Adolescent↗

Dynamic esophageal scintigraphy in patients with achalasia.

BACKGROUND: Dynamic esophageal scintigraphy has been proven as an efficient technique of diagnosis of esophageal dysmotility. METHODS: The authors monitored the transit velocity, anti-peristalsis and the retention of radioactivity in the esophagus by dynamic esophageal scintigraphy in a group of 50 patients (37 control patients and 13 patients with achalasia). RESULTS: They found a significantly longer period of radioactivity passage via the esophagus compared to the control group (p < 0.001%). CONCLUSIONS: We observed the statistically significant transit prolongation of radioactivity through the esophagus during dynamic esophageal scintigraphy (41.2 seconds) in our group of patients with achalasia compared to the control group (7.9 seconds). Anti-peristalsis and even the radioactivity retention have occurred statistically more frequently compared to the control group.

Journal Article↗

[Helicobacter pylori negative gastroduodenal lesions in subjects treated with NSAID].

The authors examined retrospectively the frequency of NSAID use by patients with gastroduodenal ulcer without HP. The objective was to evaluate whether the use of NSAID is the predominating factor in the development of ulceration in subjects with HP negative ulceration. The group comprised 525 patients with confirmed presence of H, incl. 52 who used NSAID. From the results ensues that the incidence of ulcerous lesions with HP negativity and NSAID medication is significantly higher than in subjects who use NSAID and suffer from a confirmed HP infection.

Adult↗

[Dyspeptic complaints in diabetic patients].

Diabetes is a frequent metabolic disease which affects also the digestive tract. Functional disorders of the latter have a negative impact on the stabilization of diabetes. An important factor as regards motility is the blood sugar level. Subjective complaints of the patients frequently do not correlate with the objectively assessed functional state of the digestive tract. The authors remind of contemporary available diagnostic and therapeutic possibilities.

Diabetes Complications↗

Radionuclide oesophageal transit scintigraphy--a useful method for verification of oesophageal dysmotility by cervical vertebropathy.

We followed up a group of 43 patients suffering from cervical vertebropathy. Dynamic scintigraphy revealed a significant prolongation of oesophageal transit time of 10 ml of labelled liquid (mean transit time, MTT) in comparison with a control group. Patients treated with acupuncture showed a significant reduction in MTT in comparison with patients receiving a placebo needle application. The group of patients treated with manipulative techniques showed in addition to symptom alleviation a significant reduction in MTT. Dynamic scintigraphy facilitates verification of oesophageal dysmotility in patients suffering from vertebropathy and enables the success of therapy to be readily monitored.

Acupuncture Therapy↗

[Traumatic intracranial hemorrhage with a clinical temporal conus syndrome].

The authors investigated a consecutive group of 14 patients treated at the Neurosurgical Clinic on account of traumatic intracranial haemorrhage, admitted with the clinical temporal conus syndrome (GCS 3-5, ipsilateral or bilateral mydriasis, failure of vital functions). All had emergency operations and at the intensive care unit the cerebral perfusion pressure and the saturation in the jugular bulb was monitored continuously. On the first and fifth day after surgery a check-up CT and SPECT examination was made. Only two patients had ischaemia during the first CT check-up, while 11 patients had impaired perfusion on the first SPECT. Improving perfusion on the check-up SPECT was the sign of a favourable prognosis, while ischaemia on the first CT was in both instances fatal. The Glasgow Outcome Score (GOS) six months after the injury was as follows: 9 patients had a good result, 2 patients were moderately disabled 3 patients died. The authors consider the following as basic prerequisites of a favourable outcome: not only early operation but also monitoring and treatment of impaired cerebral perfusion.

Adolescent↗

[Effect of H. pylori eradication regimes on the proliferation index of gastric mucosa].

Eradication regimes with the blocking agent of the proton pump and without it do not influence the activity of cell division after treatment of Helicobacter pylori (H.p.) when using cytoflowmetric evaluation. The non-significant difference in proliferation activity of the gastric mucosa after treatment of H.p. can be also a sign of more rapid repair of the gastric mucosa after elimination of the inflammatory elements.

Cell Division↗

[Effect of octreotide on the clinical course of acute pancreatitis and levels of free oxygen radicals and antioxidants].

Twenty-one patients with a medium severe form of acute pancreatitis were divided into two groups. Eleven were treated with octreotide, 200 micrograms s.c. every 8 hours, combined with standard conservative treatment, 10 patients had the same treatment but without octreotide. In the octreotide-treated group the level of free oxygen radicals and important antioxidants--vitamins A, E and C--was assessed. In the octreotide-treated group the authors found after five days normal levels of originally elevated free oxygen radicals and a significant increase of the vitamin C level. As compared with the control group, in the octreotide group the period of hospitalization was significantly shorter (9.8 +/- 3.2 vs. 13.7 +/- 4.7). The number of complications was not affected.

Acute Disease↗

[Esophageal reflux disease--role of 24-hour pH measurement].

24-hour ph-metry of the oesophagus is a standard examination method in patients with reflux complaints. For objective evaluation of the record the following points are most important: 1. calibration of the instrument, 2. precise placement of the pH-probe, preferably under manometric control, 3. elimination of medication (inhibitors of proton pump, H-2 blockers, antacids, prokinetic preparations), 4. cooperation of the patient. A 24-hour record makes it possible to analyze in detail the type of reflux, and when using available software, also its quantity.

Gastric Acidity Determination↗

[Cisapride (Prepulsid) in the prevention of postoperative gastrointestinal atony].

Administration of cisapride, 3 x 5 mg in a suspension one day before surgery and 30 mg 3 and 8 hours after abdominal surgery with subsequent administration of 2 x 30 mg in suppositories up to the time when oral ingestion is possible, hastens significantly the restoration of GIT motility as compared with placebo. It can be therefore recommended as effective medication in the prevention of complications caused by impaired motility of the digestive tract.

Cisapride↗

[Levels of vitamins A, E and C in serum and gastric juice in relation to gastric mucosa and occurrence of Helicobacter pylori].

Colonization of the gastric mucosa with Helicobacter pylori H.p. reduces the vitamin C concentration of gastric juice. Eradication of H.p. within four weeks after completed treatment does not exert a significant effect on changes in the concentration of vitamins A, E and C in gastric juice or serum. Despite this after eradication a rising trend of vitamin E in gastric juice was recorded. Substitution of vitamin C and E in gastritis associated with colonization with H.p. has a favourable effect and may reduce the risk of malignization.

Ascorbic Acid↗

[Proton pump blockers and their significance in gastroenterology].

Extremely effective drugs used in the therapy of diseases etiologically associated with excessive HCl secretion by the gastric mucosa include proton pump blockers. Their obvious advantage, as compared with commonly used drugs, is that they cause a marked drop of HCl production by the gastric mucosa regardless of the type of stimulus, i.e. whether parietal cell receptors are influenced. Their therapeutic action is extremely effective, while side-effects are minimal. The publication gives the basic indications of administration of proton pump blockers, compares their therapeutic efficiency with H2 blockers and draws attention to possible pitfalls of therapy.

2-Pyridinylmethylsulfinylbenzimidazoles↗