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Biomedical subjects

J Tichý

Publications and source records attributed to J Tichý.

At least 19 recordsLinked to original sources

[Transient ischemic attacks (TIA) from the viewpoint of the clinical neurologist].

A transient ischaemic attack (TIA) is a cerebrovascular attack the clinical symptomatology of which is restored to normal within 24 hours. Minor haemorrhages, epilepsy, hypoglycaemia, migraine and even peripheral neuropathies can be mistaken for TIA. CT examination indicates in a considerable percentage of examined subjects encephalomalacia. The term TIA should be reserved for ischaemic attacks, where after regression of the clinical symptomatology within 24 hours no structural changes are found.

Humans

[Cerebral ischemic infarct in computer tomography imaging in the diagnosis of transient ischemic attacks].

The term transient ischaemic attack (TIA) does not correspond to findings of new examination methods and is rather a matter of convention. The authors examined 19 patients with the diagnosis of TIA by CT and found in five a cerebral infarction. The dependence of cerebral infarction in TIA on age, sex, risk factors (hypertension, diabetes) and the duration of clinical symptomatology was not significant.

Cerebral Infarction

Experimental devascularization (devitalization) of the rectum and sigmoideum.

In 6 laboratory pigs, devascularization (devitalization) of the rectum and the adjacent part of the sigmoideum was carried out by the vasa rectalia cranialia et media ligatures with simultaneous aboral closure of the rectum at the base of the lesser pelvis and oral closure at the borderline between the rectum and the sigmoideum. The devascularized rectum was not removed but left in situ. Terminal colostomy was established. Laparotomic revision was carried out after 12 weeks, colostomy was removed and continuity of the intestine was reestablished by insertion anastomosis, by suture of the end of the colon to the anal mucosa and skin. In further two pigs, devascularization of the rectosigmoideum was carried out with colostomy and reconstruction was carried out after 12 weeks by procto-sigmoideo-anastomosis. In another 2 animals, devascularization was carried out on the lower part of the sigmoideum and continuity was immediately renewed by end-to-side sigmoideo-sigmo-ideoanastomosis. All revisions indicated that the devascularized necrotic segment shrank to form a minute fibrous tissue residue, anastomosis was patent and continence was retained for colo-proctoanastomosis. The described techniques are technically simple and could be employed as palliative surgical methods for inoperable tumours in the region of the rectum and lower part of the sigmoideum.

Anal Canal

Sternocostal joints, low back pain and lumbar discopathy.

New interrelations between the distensions of the 5th, 6th and 7th ribs and low back pain were studied in two groups of patients: 1) one hundred out-patients with prevalent pseudoradicular symptomatology and 2) fifty patients hospitalised for graphically verified (CT, PMG) lumbar disc herniation and pronounced radicular symptomatology. We have introduced some measurements to document asymmetrical holding of the body and limbs: the distance between the sternoclavicular joint-spina iliaca ant. sup. and the distance between the acromion and spina iliaca post. sup. We found that in the distension (blockade) of the 5th rib, constant spasms are present in m. abdominis obliquus ext., in the most lateral part of the adductors and in the most medial part of the great gluteal muscle. In 6th rib distension, spasms in the external part of the m. rectus abdominis, and in the mediolateral fascicles of thigh adductors and in the external part of m. glutaeus max. could be palpated. In 7th sternocostal distension there are spasms in the most medial parts of m. rectus abdominis, and of thigh adductors and m. glutaeus medius of the same side. After mobilization, statistically significant improvement of body asymmetry (p less than 0.01), improvement of anteflection, bending to the side, Laségue's and Patric's phenomena were found. Surgery was indispensable only in 6% of our patients suffering from severe lumbar disc hernianion (in 3 out of 50). The CT appearance of the prolapse remained unaltered even after clinical remission. There were some changes before and after mobilization in the CT picture of sternocostal joints. The importance of strengthening of the great pectoral muscles--in which preexistent relative weakness was found--is stressed. The beneficial effect of mobilization of the respective sternocostal blockade on the pain syndrome, body asymmetry and mobility is described.

Adolescent

The devitalization of the stomach by a devascularization technique.

Different parts of the stomach in healthy animals (pigs) were devitalized (devascularized) by eliminating the blood supply and left in situ. In model experiments, parts of the stomach were chosen for the devitalization with respect to most frequent location of carcinomas. The operation technique consisted of a complete ligature of perigastric vessels, bling enclosure of the cranial part of the duodenum with two ligatures with a possible application of a seromuscular suture and transverse cutting of the oral part of the stomach and its enclosing by a suture with a partial invagination of the wall. The passage was renewed by a gastroenteroanastomosis, some of the used modifications of the operation technique according to Billroth II (Schlater-Pólya). A method was mostly proposed with an interposition of the jejunal loop, which bridged the site of the devitalized part of the stomach. In 10 to 20 weeks the stomach tissue was stepwise degraded and it was replaced by fibrous tissue. The operation technique is simple; it could be applicable as a palliative or possibly therapeutic intervention in the case of inoperable tumours in human practice.

Animals

A technique of the segmental devitalization of kidneys in experiment.

With the help of partially overlapping parenchymatous sutures, different renal segments were devitalized. After 8 weeks, a fibrous conversion occurred in devitalized part of the kidney. For the orientation during establishing the sutures, a topographic schematic diagram was used, which is simple and quite satisfactory for the use in practice. The study was performed on minipigs (21 x unilaterally, 3 x bilaterally) without any exitus of the experimental animals. A long series of experiments was performed in 37 rats on one kidney and in 40 rats bilaterally. Only in 3 rats the cause of the exitus was obviously in a connection with eliminating more than 70 to 75% of the renal parenchyma from the function. The devitalization technique presents good results in both series of the experiments. Possibilities of its use in the clinical practice in cases, where the resection therapy is being used currently, are discussed.

Animals

Morphology of regressive changes in the kidney following experimental ischaemia.

Total or partial renal ischaemia was studied in rats and pigs in a series of experiments, after total devascularization (ligature of renal vessels and ureter); ligature of isolated renal artery; experimental embolization of renal artery by non-resorbable material; devascularization of a specific renal segment by deep, strangulating sutures. Morphological studies showed that the resulting necrotization is represented most frequently by coagulation necrosis, less frequently by colliquating necrosis. Occlusion of the renal artery by embolization or ligature leads only to partial necrotization or atrophy. Total devascularization of the renal hilus or total devascularization of a specific renal segment by strangulating sutures leads to total destruction of the devascularized (devitalized) tissues. Within 8-12 weeks, the whole organ changes into a small residue of connective tissue. The possibility of the use of the devascularization technique in the treatment of tumours is discussed.

Animals

[Small and large intestine devascularization (devitalization) and potentials in the therapeutic use of this operative method].

The experimental findings with devitalization of various intestinal segments by means of devascularization showed that the isolated segments left in peritoneal cavity (together with their contents) were gradually destroyed and changed into a slight fibrous residue. The retaining of the up to 180 cm long segment did not endanger the life of experimental animals. This experience was used in the surgical treatment of inoperable tumours in left half of large intestine and in rectosigmoideum. The case report of four successful operations is given together with two cases of invagination of the devitalized part into intestinal lumen.

Adenocarcinoma, Scirrhous