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M Duda

Publications and source records attributed to M Duda.

At least 19 recordsLinked to original sources
PubMed2003

[Endoscopic subfascial dissection of perforators (ESDP) vs open ligation of perforators].

OBJECTIVE: Comparison of two surgical procedures in discontinuation of the venae perforantes. METHOD: The authors evaluated perspectively a group of 78 patients subjected to 82 operations with severing of the venae perforantes on the lower extremities. They defined the indications for both surgical procedures. RESULTS: The open procedure (Cockett's segmental operation) was indicated in 10 extremities, ESDP in 72. The endoscopic operation lasted on average 59 minutes, the open one 50 minutes. The hospitalization period in the endoscopic variant was shorter (6.1 days vs. 8.5 days after the open operation). preoperative complications such as haemorrhage from the severed perforator occurred in ESDP. In Cockett's operation there were no preoperative complications, but there were two cases of healing per secundam during the postoperative period. Healing of crural ulcers within 12 weeks was recorded in both types of operations. The open procedure is indicated where there are major nodes on the leg and there are no extensive trophic changes, in particular in patients in stages C3 and C4. ESDP is indicated in patients in advanced stages of CVI, i.e. C5 and C6 according to CEAP. CONCLUSIONS: Every method has its indications whereby a higher incidence of complications may be foreseen after the open operation as compared with the endoscopic one.

Adult↗
PubMed2003

[Severing perforators in advanced stages of chronic venous insufficiency].

OBJECTIVE: To evaluate the importance of anastomozing veins in the development of chronic venous insufficiency (CVI). METHOD: Perspective analysis of a group of 82 extremities where the perforators were severed by the endoscopic or open method. RESULTS: Surgery of the perforators was associated with a decline of the total number of perforators detectable on DUS, with a marked reduction of extremities with insufficient perforators and improved total CEAP score. In 98% extremities at the same time surgery of the epifascial venous system was performed. CONCLUSIONS: The role of perforators in the development of CVI is not unequivocal and its assessment is more difficult due to concurrent operations of the epifascial system. Dissection of the perforators is indicated in cca one tenth of patients with CVI.

Adult↗
PubMed2003

[Peroperative diagnostic methods during esophageal achalasia surgery. Initial experience].

AIM OF THE STUDY: The authors present their first experience with the application of esophageal manometry during the operation on achalasia of esophagus. The completeness of performed myotomy is evaluated on the basis of decreased pressure in the region of lower esophageal sphincter (LES). METHODS: Stationary pull-through four-channel manometry was performed twice during the operation: before the application of capnoperitoneum to localize LES with evaluation of its length and tonus and after the myotomy was performed after capnoperitoneum was abolished to verify sufficient extent of myotomy. The subsequent endoscopic control was used to exclude damage of esophagus mucous membrane. RESULTS: In the period of one year during 2002/2003 the authors operated on four patients with achalasia, when manometry was used for peroperative localization of LES and evaluation of the extent of myotomy. The peroperation manometry demonstrated decreased tonus of LES (the mean 42.06 mmHg before myotomia and the mean 20.03 mmHg after myotomia) and in one case the finding resulted in necessary extension of myotomia. CONCLUSIONS: Based on our preliminary experience with peroperation manometry in operations on achalasia of esophagus it may be stated that it is a useful method for objectivization of the completeness of myotomy, which does not significantly prolong the period of operation. It contrast, it makes it possible to respond to lasting hypertonic area in LES subjected to myotomy, which may be the cause of lasting complaints of patients after the operation.

Esophageal Achalasia↗
PubMed2003

[Complications after laparoscopic surgery of inguinal hernias].

AIMS: The authors describe the occurrence of complications in laparoscopic approach to treat inguinal hernias in patients operated on at 2nd Surgical Clinic in Olomouc from May 1991 to the end of the year 2002. METHODS: The occurrence of preoperation and postoperation complications and relapses in inguinal hernias treated with laparoscopy in the period of May 1991 to the end of 2002. The TAPP method was used for operation on 98% of inguinal hernias, the IPOM method for 0.9% of inguinal hernias, TEP method in 0.4% and a simple suture in operation on 0.7% of inguinal hernias. RESULTS: Five hundred and thirty four (56% of all surgically treated inguinal hernias) were treated with laparoscopy in adult patients in the period of May 1991 to the end of 2002. Eight preoperation and postoperation complications (1.4%) were encountered. These included two cases of hematoma in the wound after port (0.3%), one hematoma of scrotum (0.2%), two artificial perforations of intestine (0.3%), one case of neuralgia of n. genitofemoralis, one artificial perforation of urinary bladder (0.2%), and one postoperation hydrocele (0.2%). There were 14 relapses (2.6%) in the 534 inguinal hernias operated on with laparoscopy. CONCLUSION: Based on our experience in the solution of inguinal hernias with laparoscopy the method of transabdominally-preperitoneally localized grid (TAPP). In this method we have used three-point fixation--by a screw to pected ossis pubis and the upper margins of the grip with two transparietal stitches fixed permanently in subcutaneous tissue.

Adult↗
PubMed2003

[CHS 100P surgical mesh in inguinal hernioplasty in adults using the Lichtenstein tension-free method].

AIMS: The authors present their initial experience with surgical grid CHS 100 P with strengthened middle strip for the intestinal hernioplasty by the method without tension according to Lichtenstein. METHODS: In the inguinal hernioplasty by anterior transinguinal way in adult patients the authors use prolene grid and a surgical grid CHS 100 P with strengthened middle strip having been developed in collaboration with the Research Knitting Institute in Brno. RESULTS: From November 2001 to May 2003 56 adult patients were operated on inguinal hernia by the tensionless plasty according to Lichtenstein using a surgical grid CHS 100 P. No preoperation of postoperation complication or relapse were encountered. The patients were subject to load in the first postoperation day. CONCLUSION: Based on our first experience with flexible surgical grid with strengthened middle band CHS 100 P used for tensionless inguinal hernioplasty in adult patients according to Lichtenstein it may be concluded that the grid is well tolerated by the patients. Flexibility of the grid makes it possible to fully load inguinal area during the first postoperation day.

Hernia, Inguinal↗
PubMed2002

[Use of ultrasonography in surgery].

OBJECTIVE: To draw attention to the perspectives of application of ultrasonography in surgery. METHOD: Based on their own experience and data in the literature the authors draw attention to contemporary possibilities to use ultrasound in surgery. This concerns in particular the following areas: abdominal sonography, injuries, examination of small areas, peroperative sonography, laparoscopic sonography, intraluminal sonography, Dopplerometric examination of the vessels, use during transplantations and in neurosurgery. RESULTS AND CONCLUSIONS: While urologists use sonographic examinations commonly, only a small percentage of surgeons are familiar with this method. The authors explain the necessity of greater involvement of surgeons in this area which is consistent with the development of surgery and trends abroad.

Endosonography↗
PubMed2002

[Manometry in esophageal achalasia].

OBJECTIVE: Manometric findings in achalasia are pathognomic already in early clinical stages of the disease. The authors evaluate the importance of manometry in the diagnosis and therapy, in particular in early stages of the disease. METHOD: During manometry we obtain data on the function of the lower oesophageal sphincter and the body of the oesophagus. Impaired relaxation of the sphincter is evaluated, as well as increased tonus of the sphincter and tertiary contraction of the body of the oesophagus. In patients with achalasia we implement laparoscopically extramucous myotomy. RESULTS: In 1997 we started a prospective manometric study of dysphagic complaints. We examined 304 patients on account of different diseases of the oesophagus incl. 16(5.2%) where we proved or confirmed achalasia in stage I, II or III according to the radiological classification. These patients were indicated for laparoscopic myotomy. In one instance we had to convert the operation to an open one. In two instances we added partial fundoplasty according to Thal on account of perforation of the oesophageal mucosa. Four patients were subjected after a 5-12-month interval to remyotomy. Twice because of the development of a fibrous stricture at the site of myotomy and twice for an obviously inadequate original myotomy. The history of dysphagia in patients with primary operations was on average 37.3 months. CONCLUSIONS: Manometric examination of patients with functional dysphagia makes it possible to detect achalasia in early stages and to indicate in time surgical treatment. In case of a relapse or persistence of complaints manometry makes it possible to express objectively the cause which is most frequently an atonic oesophagus with inadequate evacuating capacity, stricture at the site of myotomy or inadequate myotomy.

Adult↗
PubMed2002

Limited versus total stripping of vena saphena magna.

BACKGROUND: There are two different ways to operate on patients with varicose veins. OBJECTIVES: Prospective evaluation of two groups of patients operated on in two different ways to find out more convenient procedure for varicose veins surgery. METHODS: The results of 577 patients operated on for lower limbs varicose veins were evaluated. The patients were divided into two groups. The first group comprised of 125 patients in whom limited stripping of vena saphena magna was performed. The second group comprised of 397 patients in whom total stripping of vena saphena magna was applied. In the remaining 55 patients an operation other than VSM was performed in the venous system of lower limbs. During the follow-up three months after the operation the main attention was paid to a possible neurological disturbance. RESULTS: Much better results were observed in the group of patients treated with the method of limited stripping. Neurological disturbances occurred in two patients only (i.e. 1.6%). Within the other group disturbances were encountered in 28 patients (i.e. 7%). CONCLUSIONS: Limited stripping of vena saphena magna results in lower number of neurological disturbances. (Tab. 1, Ref. 10.).

Adult↗
PubMed2001

Primary malignant melanoma of the esophagus treated by endoscopic ablation and interferon therapy.

Primary malignant melanoma of the esophagus is a rare illness accounting for 0.1-0.2% of malignant diseases of the esophagus; however, the incidence of the disease appears to be rising. The average survival time is between 10 and 15 months. The authors describe the 25 month follow up of a patient with primary malignant melanoma of the esophagus which was treated with endoscopic ablation followed by interferon therapy. No other focus was found and the patient is undergoing regular endoscopic check-ups, currently without any problems.

Biopsy, Needle↗
PubMed2001

The expression of androgen receptor, cytochrome P450 aromatase and FSH receptor mRNA in the porcine ovary.

The aim of this study was to visualize the expression of androgen receptor, cytochrome P450 aromatase and FSH receptor mRNAs in various structures of porcine ovary. Porcine ovaries were frozen in liquid nitrogen, and 8 microm sections were prepared for in situ hybridization. In the small, medium and large antral follicles as well as in early, midluteal and regressing corpora lutea, mRNAs for androgen receptor, P450 aromatase and FSH receptor were detected. In small antral follicles high levels of mRNAs for androgen and FSH receptors were observed, mainly in the granulosa layer, while mRNA expression for P450 aromatase was negligible. As follicles grew, amount of mRNAs for androgen receptor and FSH receptor decreased, and that for P450 aromatase increased. Small amounts of androgen receptor mRNA were also present in corpora lutea at all examined stages. P450 aromatase mRNA was not detected in early and midluteal corpora lutea. However, regressing corpus luteum showed a weak expression of aromatase mRNA.

Animals↗
PubMed2001

Estrogen receptor alpha and beta expression in the porcine ovary.

In order to investigate the expression of estrogen receptor alpha (ERalpha) and estrogen receptor beta (ERbeta) in the porcine ovary, in situ hybridization was applied. Specific ovine ERalpha and bovine ERbeta cDNA probes were labeled with [-32S]dCTP. In the porcine ovary, positive signals for ERbeta were found in both granulosa and theca cells of all types of antral follicles as well as in the corpora lutea at all stages of regression. ERalpha mRNA was limited exclusively to the granulosa cells of preovulatory follicles and was present in a few cells of early corpora lutea. Thus, we showed differential expression of ERalpha and ERbeta at the mRNA level. Large antral follicles and early corpora lutea are the site, where both forms of estrogen receptor are expressed.

Animals↗
PubMed2000

[Quo vadis laparoscopic appendectomy?].

The authors evaluated a group of 282 patients subjected between January 1993 and December 1998 to appendectomy, either by the open or laparoscopic route. They compared the period of work incapacity in the two groups to confirm or rule out the fact that after laparoscopic appendectomy the return to work is faster. The results are more favourable in the group of patients operated by the mini-invasive procedure, but even then the period of work incapacity is twice as long, as compared with other countries.

Adult↗
PubMed2000

The role of a surgeon in a palliative treatment of tumours.

The aim of the presented study is to determine a surgeon's part in diagnostics, therapy and dispensary treatment of patients suffering from tumour disease. We carried out an analysis of our own clinical experience and stated the surgeon's participation in the individual stages of diagnostics and treatment of oncological patients with the emphasis on the share in the palliative treatment.

General Surgery↗
PubMed1999

Determination of norgestimate and its metabolites in human serum using high-performance liquid chromatography with tandem mass spectrometric detection.

A rapid and reliable analytical method is described for the simultaneous determination of a synthetic progestin norgestimate (NGM), and its metabolites, 17-deacetylnorgestimate (17-DA-NGM), 3-ketonorgestimate (3-keto-NGM) and norgestrel (NGL) in human serum using reversed phase high-performance liquid chromatography (HPLC) with tandem mass spectrometric (MS-MS) detection. The assay was linear over the concentration ranges of 0.1-5.0 ng/ml for 17-DA-NGM and NGL and 0.5-5.0 ng/ml for NGM and 3-keto-NGM. The inter-assay reproducibility was consistently less than 10%. The overall recovery of the analytes ranged from 72 to 92%. Serum profiles following oral administration of norgestimate to female volunteers are presented.

Chromatography, High Pressure Liquid↗
PubMed1999

Flow cytometric cell cycle analysis of two subpopulations of porcine granulosa cells.

Two types of granulosa cells from 120 individual follicles (forty follicles in particular stages of development) were analysed by DNA flow cytometry to determine the percentage of cells with degraded DNA (apoptosis) and the cell cycle analysis. The distribution of cells in the cell cycle (G1, S, G2/M) was studied to show relation to location within a follicle and follicular development. Isolated granulosa cells were scraped from the vesicle walls with rounded-tip ophthalmological tweezers and separated into weakly-associated (AGc) and tightly-bound (MGc) according to Ford (1991) and Duda (1997). Granulosa cells after fixation in 70% ethanol and staining with propidium iodide (PI) were analysed. At least 20,000 events were collected in each specimen. The S-phase fraction (SPF) and apoptosis were calculated using the ModFit LT programme for the cell cycle analysis (Verity Software House Inc., USA). In AGc a population with degraded DNA was found, containing less fluorescence than the G1/G0 peak as shown in the DNA histograms. The percentage of apoptotic AGc ranged from 39.29 in small, to 58.9 in medium and was significantly higher than in large follicles (26.13%; p < 0.05). The percentage of apoptotic MGc was significantly lower than in the AGc (p < 0.05) and was equal to 3.78 in small, 0.10 in medium and 0.08% in large follicles. There are no significant statistical differences between the mean percentage of SPF in MGc of small and medium follicles (4.94, 7.25%). However, SPF was significantly lower in large follicles (1.31%). The number of SPF in AGc decreased during follicular development (35.92, 26.98, and 19.62%). Our data indicate lack of apoptotic cell death in MGc which seem to be more differentiated, and lose their mitotic potential. In AGc however, which are undifferentiated and undergo numerous mitosis, apoptosis was observed.

Animals↗