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Biomedical subjects

M Lukás

Publications and source records attributed to M Lukás.

31 records · Page 2Linked to original sources
PubMed2000

[Dysphagia after the Rosetti fundoplication for gastroesophageal reflux].

The authors describe as the possible cause of postoperative severe dysphagia after laparoscopic Rosetti's fundoplication low insertion of the cuff drawn behind the oesophagus to the anterior gastric wall. When the stomach is full the cuff is drawn into a spiral and the latter presses against the cardia and twists the cardia and abdominal oesophagus. For the condition unimpaired swallowing of the first mouthfuls is typical followed by severe dysphagia which can lead even to malnutrition. Common examinations may be normal except for the unaccountable dilatation of the oesophagus. An important role in detection of the cause is played by investigation of the passage of the barium suspension during swallowing with the patient in an upright position. The authors recommend insertion of the cuff as high as possible with careful mensuration of the permeability of the abdominal oesophagus during and at the end of surgery and fixation of the cuff to the diaphragm of diaphragmatic cruri.

Adult↗
PubMed1999

[Pathophysiology of development of acute pancreatitis].

Acute pancreatitis is a severe illness with unclear prognosis and mortality rate ranging from 5 to 70%. Dynamic observation of changes in systemic inflammatory response of the body may be helpful in estimating the development of acute pancreatitis as well as giving an idea of therapeutical possibilities. It is obvious, that the intensive therapeutic intervention may reduce the influence of secondary insults (ischemic-reperfusion syndrome, hypoxia, disrupted physiological function of the bowel) on pancreatic tissue. Surgery is limited only for precisely specified indications in the latter stage of acute pancreatitis (secondary inflammation of the necrosis). In this paper we conclude some pathophysiological mechanisms involved in the development of acute pancreatitis.

Acute Disease↗
PubMed1998

[A bizarre inflammatory polyposis of the colon in chronic ulcerative proctocolitis].

A case report of a young patient (born in 1980) with a 2-year history of chronic ulcerative proctocolitis was described. Checking colonoscopy 6 months from the beginning of disease showed multiple and even confluent polypoid lesions in transverse gut starting from hepatic flexure in addition to diffuse inflammatory rectosigmoideal changes. Biopsy found only colic mucosa without any tumorous structures. Five months later the patient's state got worse accompanied instantly by vomiting, weight loss and malabsorption symptoms. A duodenocolic fistula was supposed according to gastroduodenoscopy and biopsy. Because of progressive suffering of the patient colectomy with ileoduodenoanastomosis and ileosigmoidoanastomosis was performed. Polypous lesions were observed from the blind gut up to descendent colon and a transversoduodenal fistula was proved. The removed part of gut was completely changed into a dense network of elongated polypous lesions. In microscopy, bigger polyps showed an inner stromal part often with bands of smooth muscle cells covered by nearly normal gut mucosa. Smaller polyps were formed by hypertrophic gut mucosa only. At the base of polyps, a stagnation of gut contents was found as well as ulcerous defects of various depth. Macroscopy and microscopy of polypoid lesions formed by non-neoplastic gut mucosa were those of so called bizzare ("giant") inflammatory polyposis of the gut. Up to now the patient's clinical picture and local finding in the stump of resected gut have been typical for chronic ulcerous colitis and polypous lesions were not revealed by checking investigations.

Adult↗
PubMed1997

[Hepatobiliary complications of idiopathic intestinal inflammations].

Extraintestinal manifestations and metabolic complications are very frequent in patients with idiopathic inflammations of the gut and are encountered in at least 35% of these patients. In Crohn's disease extraintestinal manifestations are more frequent than in ulcerative colitis, in particular when the large bowel is affected. Metabolic complications are the result of inflammatory changes of the small intestine or develop as a result of the reduced reabsorption surface of the gut. As to the relationship to the activity of the idiopathic inflammation of the gut, extraintestinal manifestations can be differentiated into those which depend on the activity of the basic disease and those which lack this dependence. From the aspect of a long-term prognosis extraintestinal manifestation independent on the activity of the inflammation of the gut are much more serious, because as a rule they have a long-term and usually progressive trend. The most serious extraintestinal complication is primary sclerotizing cholangitis which in the majority of patients leads to destruction of the biliary pathways and the development of biliary cirrhosis. Depending on the predominantly affected site of the biliary system, primary sclerotizing cholangitis is divided into three types. It is encountered much more frequently in ulcerative colitis than in Crohn's disease. Treatment of primary sclerotizing cholangitis is not very effective. At present it appears that the only drug with an effect on the course of the disease is long-term administration of urodesoxycholic acid. For patients with manifestations of hepatic insufficiency the only solution is transplantation of the liver. In all patients where the diagnosis of primary sclerotizing cholangitis was established, at the same time the possibility of inclusion in a transplantation programme should be considered. The relationship between sclerotizing cholangitis and pericholangitis has not been resolved conclusively. At present the majority of authors is inclined to believe that pericholangitis is part of changes associated with sclerotizing cholangitis. Other hepatobiliary complications of idiopathic inflammations of the gut such as cholelithiasis and parenchymatous liver damage, steatosis of the liver and chronic autoimmune hepatitis are not such a serious problem as sclerotizing cholangitis.

Biliary Tract Diseases↗
PubMed1997

[Use of collagen and gentamycin in the treatment of chronic soft tissue lesions].

The authors describe two case-histories where Garamycin-schwamm was used in the treatment of a chronic fistula and cavities in the subphrenium resulting from treatment of a subphrenic abscess, and in the pelvis minor as a result of a fistula which developed after establishment of an ileoanal intestinal pouch. They confirm the experience of authors abroad with the treatment of chronic cavities in soft tissues as a result of operations, which so far had to be treated by other methods.

Adult↗
PubMed1995

[Local production of eicosanoids in patients with ulcerative colitis].

BACKGROUND: Eicosanoids act obviously as mediators of inflammation in ulcerative colitis. The objective of the submitted paper was to assess relations between intraluminal concentrations of prostaglandin E and leukotriene B4 and the activity of ulcerative colitis evaluated according to clinical, endoscopic and histological criteria. METHODS AND RESULTS: In 56 patients with ulcerative colitis the PGE concentration was assessed in the rectal dialysate (3H Prostaglandin E Radioimmunoassay Kit Ca-501, Clinical Assay Cambridge USA). In 35 patients with ulcerative colitis the authors assessed the LTB4 concentration in the rectal dialysate (Leukotriene B4 3H Assay RPN 70, Amersham, G. Britain). The authors proved a statistically significant correlation between the intraluminal PGE concentration and the activity of ulcerative colitis according to clinical criteria (p < 0.1), endoscopic criteria (p < 0.05) and histological criteria (p < 0.01). The intraluminal LTB4 concentration correlated significantly with the activity of ulcerative colitis according to clinical criteria (p < 0.05). When comparing LTB4 values with the activity of the disease according to endoscopic and histological criteria, a tendency of rising LTB4 values with increasing activity of the disease is apparent. However, a significant relationship was not found; this can be explained by the fact that relatively small groups of patients were investigated with a relatively great scatter of LTB4 concentrations. CONCLUSIONS: During the period of active ulcerative colitis the intraluminal PGE concentration rises and correlates with the clinical, endoscopic and histological activity. There is also a rise of the intraluminal LTB4 concentration which correlates with the clinical activity of the disease. A high eicosanoid concentration is found in cases with a severe course and complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[The intestinal pseudo-obstruction syndrome].

Intestinal pseudoobstruction is a syndrome characterized by manifestations and signs of intestinal obstruction without evidence of a lesion obstructing the intestinal lumen. It is divided into primary and secondary forms and into acute and chronic forms. Various diseases, incl. malignant tumours, can be manifested by this syndrome. In its therapy prokinetically acting preparations are used with a favourable effect of colonoscopic decompression.

Humans↗
PubMed1991

[Bronchopulmonary changes in patients with idiopathic intestinal inflammation].

The authors examined a total of 64 patients with idiopathic inflammatory bowel diseases, 33 patients with Crohn's disease and 31 patients with proctocolitis to assess the possible frequency of pulmonary complications. An impaired ventilation was recorded in 33% patients with Crohn's disease and 25% patients who proctocolitis, in both groups an obstructive ventilation disorder predominated. In four patients (12.5%) with Crohn's disease cytological examination of bronchoalveolar lavage revealed alveolitis. The authors draw attention to relatively frequent bronchopulmonary complications of non-specific inflammatory bowel disease which are usually clinically silent.

Adult↗
PubMed1988

Benign hypergammaglobulinemic purpura in a patient with ulcerative colitis and peripheric arthritis.

A 32-year-old patient is described presenting with ulcerative colitis and oligoarthritis who later developed benign hypergammaglobulinemic purpura. This diagnosis was confirmed by clinical investigation, immunological findings as well as by histological and immunofluorescent examination. He was successfully treated with steroids and azathioprin. The relevant literature is reviewed.

Adult↗