Role of the kidney in erythropoiesis. 1957.
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Animals↗
Biomedical subjects
L Plzak
Publications and source records attributed to L Plzak.
Intra-abdominal abscess in the 1980s.
Prompt recognition, early localization, and adequate drainage have contributed to the decreased morbidity and mortality rates associated with intra-abdominal abscess in the last decade. The physical examination, ultrasonography, computed tomography, and radionuclide scans provide information that leads to early detection and localization of abscess in almost all patients. Percutaneous drainage should be the initial procedure unless specific indications for surgery exist.
Abdomen↗
Coronary artery bypass surgery during pregnancy.
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Adult↗
Postoperative monitoring of myocardial oxygen tension: experience in 51 coronary artery bypass patients.
Following a preliminary feasibility report, polarographic monitoring of myocardial tissue O2 tension (Pmo2) in 51 coronary bypass patients has been accomplished. In this context, the influence of rapid atrial pacing (RAP), O2 inhalation, and intra-aortic balloon assistance (IAB) was statistically analyzed using Wilcoxon sign-rank and Student's t-tests. Electrodes were implanted in revascularized and nonrevascularized areas for comparison (24.0 +/- 1.1; and 26.3 +/- 1.8 mmHg Pmo2, p, not significant). Increasing myocardial O2 demand with RAP caused a 6% PmO2 drop (p less than 0.01). A 70% O2 inhalation increased Pmo2 by 30% (p less than 0.01). In 5 cases the benefit of IAB was confirmed by a 41% increase in Pmo2 (p = 0.02). These data support the clinical usefulness of polarographic Pmo2 as a measure of regional myocardial oxygenation. In addition to early recognition of intraoperative or postoperative graft failure previously reported, the efficacy of various therapeutic interventions can be more precisely determined.
Cardiac Pacing, Artificial↗
Monitoring regional myocardial function after myocardial revascularization.
A system using only small platinum electrodes for monitoring intramyocardial polarographic oxygen tension (MP02), electrograms (ECG), and impedance-derived wall motion (WM) was experimentally tested and clinically implemented. In nine open-chest, anesthetized dogs. two platinum electrodes were inserted along the subepicardial direction of the muscle fibers. As verified by cinefluoroscopy, WM corresponded to changes in distance between the platinum electrodes (r = 0.91 +/- 0.02). The system responded to a 10 minute occlusion of the left anterior descending coronary artery (LAD) as follows: Dyskinetic WM appeared in 10 seconds (p less than 0.05); MP02 decreased (26.4 +/- 1.8 to 14.8 +/= 1.9 mm Hg, p less than 0.05) in 1 minute; ST segments increased (4.8 +/- 1.5 to 12.3 +/- 3.1 mV, p less than 0.05) in 3 minutes. On reperfusion, WM, ST segments, and MP02 normalized in 15 seconds, 30 seconds, and 1 minute, respectively. Hence, ischemia affects WM more acutely than either ECG or MP02. In five patients, ischemic changes before coronary bypass were reversed over 5 days: MP02 (17.4 +/-; 1.9 to 19.6 +/-1.7 mm Hg), ST segment (2.2 +/- 6 to 1.0 +/- 0.4 mV), and WM returned to normal. Thus a system has been designed which simultaneously monitors regional WM, MP02, and ECG. The method has proved to be a sensitive and practical approach for assessing perioperative myocardial function.
Animals↗