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Biomedical subjects

M Duda

Publications and source records attributed to M Duda.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Substitution therapy in insufficient external pancreatic secretion].

For assessment and monitoring of adequate enzymatic substitution the authors used repeated examinations of chymotrypsin in the faeces of 19 patients with insufficiency of external secretion (17 patients with chronic pancreatitis and two after duodenopancreatectomy on account of carcinoma of the pancreas). Adequate substitution (chymotrypsin > 6U/g faeces) is individual (1.8-7.2 g pancreatin--Kreon/day). The required dose may be higher in patients with chronic pancreatitis than in conditions following duodenopancreatectomy. When receiving adequate substitution treatment, the patients reported milder complaints, regression of pain and diarrhoea. In two patients with severe signs of malnutrition a satisfactory condition was achieved and their loss of body weight was arrested. The necessary dose of insulin in diabetic patients declined by 4-12 u/day. During treatment no adverse side-effects were found.

Adult↗
PubMed1992

Adequate enzymatic substitution in treating exocrine pancreatic insufficiency.

The chymotrypsin in the stool test was used to monitor adequate enzymatic substitution in treating exocrine pancreatic insufficiency with 18 patients (16 suffering from chronic pancreatitis and 2 having passed duodenopancreatectomy due to pancreatic cancer). This test helps to identify pancreatic insufficiency and can be successfully used in monitoring the adequate amount of pancreatic substitute, which, we have found, differs from patient to patient. The dosage can be higher in cases of chronic pancreatitis than in those required after duodenopancreatectomy.

Adult↗
PubMed1991

[Surgical treatment of patients with paraesophageal and mixed hiatal hernias].

In 1948-1990 the authors operated 112 patients with paraoesophageal and mixed hiatus hernias. 100 patients operated in 1988 were followed up on a long-term basis. Gastroesophageal reflux was recorded before operation in 52%, haemorrhage in 18%, an ulcer in the neck in 7% an incarceration and obstruction in 9%. Before the onset of the seventies hiatorrhaphy and gastropexy were performed. During check-up examinations in these patients relapses were recorded in 47%, reflux in 43%, subjective complaints in 26%. This made the authors change the surgical procedure and in subsequent years they performed hiatorrhaphy, fundoplication, fundophrenopexy and anterior gastropexy. The incidence of relapses of hernia during check-up examinations declined to 21%, of gastroesophageal reflux to 9% and subjective complaints to 10%. The follow-up period varied between 1 and 19 years. The surgical lethality was 2%.

Adult↗
PubMed1991

[Long-term follow-up of patients with diffuse colonic polyps].

During the years from 1968 to 1984, at the First Department of Surgery in Olomouc, 10 patients with diffuse polyposis of the colon were treated. In 5 of them, a familial occurrence of polyposis was dealt with. In three of them, malignity developed. In five unfamilial polyposes, malignity occurred only once. In one patient, the occurrence of malignity was found present immediately with the first manifestation of the disease. In the other patients, it was after an interval of 3 to 17 years after the onset of the disease. Three patients died from generalization of the malignant process. In two of them, carcinoma developed in the remaining part of the colon, once after previous hemicolectomy and once after colectomy. One patient with an advanced disease died one year after proctocolectomy. Two other operated on patients survive after proctocolectomy 12 and 13 years. The other patients who had been operated on before the development of malignity are healthy. The choice of an adequate radicalintervention is of importance. Optimal is the performance of colectomy with ileorectal anastomosis and the regular endoscopic and bioptic follow-up of the stump of the intestine. When proctocolectomy is necessary, it is of advantage to apply Kock's continent ileostomy.

Adult↗
PubMed1991

[Surgical treatment of patients with paraesophageal and mixed hiatal hernias].

During the years from 1948-90, we operated on 112 patients with paraesophageal and mixed hiatal hernias. One hundred patients who had been operated on up to the year 1988 were followed up over a long period. Preoperatively gastroesophageal reflux occurred in 52%, hemorrhage in 18%, riding ulcer in 7%, and incarceration and obstruction in 9%. Up to the beginning of the seventies, hiatoraphy and gastropexy were carried out. In these patients, the checking showed the occurrence of the relapse of hernias in 47%, reflux in 43% and subjective complaints in 26%. This finding induced us to change the surgical procedure and, in the following years, we performed hiatoraphy, fundoplicatio, fundophrenopexy and anterior gastropexy. The checking showed a decrease in the occurrence of the relapse of hernias to 21%, gastroesophageal reflux to 9% and subjective complaints to 10%. The period of the follow-up ranged from 1 to 19 years. The operative letality was 3%.

Adolescent↗
PubMed1991

[Role of manometry in evaluating long-term outcomes of the surgical treatment of functional esophageal diseases].

In the years 1979-1986, 73 patients with esophageal achalasia, 110 patients with the reflux disease of esophagus and paraesophageal herniae, 17 patients with esophageal diverticles and 33 patients with duodenal ulcer were examined. The patients were examined before the intervention and controlled repeatedly after the operation in the intervals up to one month, after 3-12 months and after 2-7 years. The contribution of manometry is considered to be in giving more precision to the diagnosis and, particularly in esophagocardial achalasia, in determining a suitable operation tactics. In the reflux disease of esophagus it can contribute to the decision between a conservative and surgical therapy. The postoperative control examinations help to make an exact evaluation of the results of operation in a complex with other methods of examination.

Adolescent↗
PubMed1991

[Long-term follow-up of patients surgically treated for para-esophageal and mixed hiatal hernias. Experiences with more than 100 surgical patients].

During the years from 1948-1990, we operated on 112 patients with paraesophageal and mixed hiatal hernias. One hundred patients who had been operated up to the year 1988 were followed up over a long period. Preoperatively, gastroesophageal reflux occurred in 52%, hemorrhage in 18%, riding ulcer in 7%, and incarceration and obstruction in 9%. Up to the beginning of the seventies, hiatoraphy and gastropexy were carried out. In these patients, the checking showed the occurrence of the relapse of hernias in 47%, reflux in 43% and subjective complaints in 26%. This finding induced us to change the surgical procedure and, in the following years, we performed hiatorhaphy, fundoplicato, fundophrenopexy and anterior gastropexy. The checking showed a decrease in the occurrence of the relapse of hernias to 21%, gastroesophageal reflux to 9% and subjective complaints to 10%. The period of the follow-up ranged from 1 to 19 years. The operative letality was 3%.

Adolescent↗
PubMed1989

Cerebrospinal fluid cell counts and chemistries in bacterial meningitis.

We evaluated the records of 428 patients with bacterial meningitis to document initial cerebrospinal fluid (CSF) findings and detail their changes during therapy. Compared to patients with an initial polymorphonuclear cell predominance in the CSF, patients with initial CSF lymphocytosis had lower CSF leukocyte counts, milder CSF chemical abnormalities, and a lower frequency of positive CSF Gram stains and cultures. These findings suggest that CSF lymphocytosis may represent an early phase of infection. A low CSF leukocyte count was associated with a poor outcome, presumably reflecting an inadequate host response to infection. The CSF white cell count increased during the first 24 hours of therapy in 45% of cases. Morbidity and case fatality rates were not significantly increased in this group, suggesting that an initial rise in the CSF leukocyte count does not reflect a poor response to therapy.

Acute Disease↗
PubMed1989

[The importance of manometry in the evaluation of long-term results after surgical therapy of functional disorders of the esophagus].

In the years 1979-1986, 73 patients with oesophageal achalasia, 110 patients with the reflux disease of oesophagus and paraoesophageal herniae, 17 patients with oesophageal diverticles and 33 patients with duodenal ulcer were examined. The patients were examined before the intervention and controlled repeatedly after the operation in the intervals up to one month, after 3-12 months and after 2-7 years. There were 446 examinations performed on the whole. The contribution of manometry is considered to be in giving more precision to the diagnosis and, particularly in oesophagocardial achalasia, in determining a suitable operation tactics. In the reflux disease of oesophagus it can contribute to the decision between a conservative and surgical therapy. The postoperation control examinations help to make an exact evaluation of the results of operation in a complex with other methods of examination.

Adolescent↗
PubMed1989

Thyroid surgery in advanced age.

The total of 1,931 patients had been operated on in the Second Department of Surgery, Faculty Hospital and Policlinic, in Olomouc for thyroid disorders. The present paper deals with the operation on the thyroid gland in advanced age. The symptoms of the disease, types of interventions and kinds of complications, factors influenced by age and the secondary diseases are pointed out. In these terms, a group of 69 patients older than 60 and operated on within the period of 1981-1987 are analyzed in detail.

Age Factors↗
PubMed1989

Oesophageal diverticula.

The classification and etiopathogenesis of oesophageal diverticula is discussed, based on the experience with the treatment of 91 (68 Zenker's, 7 parabronchial, and 16 epiphrenic) diverticulectomies performed at the First and Second Departments of Surgery in Olomouc from 1948 to 1987. The tactics and technique of surgical management and its results in the single groups of diseases are analyzed in detail. Parapharyngeal diverticula represent typical true diverticula associated with hypertonia of the upper oesophageal sphincter. No causal relationship could be proved to exist between the origin of this diverticulum and the gastrooesophageal reflux. Thoracic diverticula are probably rather of congenital than traction origin. Epiphrenic diverticula arise most often from hypertonia of the lower oesophageal sphincter. They can also be of congenital origin. Traction etiology could be observed in the presence of a leiomyoma in the diverticulum. The surgical management of Zenker's diverticulum consists in the excision of the diverticulum and cricopharyngeal myotomy. Excision of parabronchial diverticulum is seldom indicated for causing little discomfort, as a rule only when it is very large. Epiphrenic diverticula are usually associated with hypertonia of the lower oesophageal sphincter. In such cases, myotomy after Heller is performed and, as a rule, the diverticulum is excised.

Diverticulum↗
PubMed1989

[Report of experiences in the surgical treatment of functional disorders of the esophagus].

Operations were performed on 1,275 patients for various oesophageal disorders at the First Surgical Department of Olomouc University, between 1948 and 1985. Most of these functional disorders were of benign nature, including simple or complicated reflux disease of the oesophagus, achalasia of the cardia, para-oesophageal and mixed hiatus hernia, and diverticulum. The group of these benign cases included 826 patients. Their lethality amounted to 2.8 percent. Surgical techniques and tactical approaches to various types of functional disorders of the oesophagus are described in some detail. Also reported are lethality, complications, and long-time results.

Czechoslovakia↗