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Biomedical subjects

T Hanus

Publications and source records attributed to T Hanus.

At least 19 recordsLinked to original sources
PubMed2005

[Possibilities of the laboratory diagnostic of metabolic skeletal changes].

Skeletal disorders represent ever-rising problem. Such diseases are of the highly heterogenous origin and for their verification the laboratory diagnostic of metabolic skeletal changes cannot be omitted. Increasing knowledge on the physiology and pathophysiology of the bone tissue metabolism and the use of new laboratory methods can improve the diagnosis and treatment of such critical states. The article gives an overview of contemporary possibilities of the laboratory diagnostic of metabolic skeletal changes. The significance, advantages, disadvantages and possible risks in evaluation of individual osteomarkers are presented.

Biomarkers↗
PubMed2005

[Intermittent catheterization of urinary bladder--indications, technique, complications].

The intermittent catheterization technique is considered at present to be one of pillars of the therapy of lower urinary tract dysfunction. The technique gradually became used also in the treatment of some non-neurogenic voiding dysfunctions. There are many ways, how the intermittent catheterization could be performed (methodology, catheter material and type, lubrication type and method, catheterization frequency). Authors provide an overview of present indications to use the treatment; they describe individual techniques and draw attention to the possible complications and their solution. Next they emphasize the necessity of individual approach to intermittent catheterization technique in individual patients in the broader context of general concept of treatment.

Humans↗
PubMed2003

[Renal artery embolism].

Renal artery embolism (RAE) is a rare disease. Urgent treatment is necessary, as ischaemia can cause irreversible kidney damage in 60 to 90 minutes. RAE frequently clinically manifests as a pain similar to renal colic. Source of embolus is predominantly the heart at atrial fibrillation. Laboratory findings are unspecific. Ultrasonography with color Doppler imaging is essential. Kidney perfusion is low and upper urinary tract is undilated. Renal function can be recognized by intravenous urography and at renal scintigraphy. In angiography, renal artery is closed with thromboembolus. With no delay, transcatheter clot aspiration should be performed and fibrinolytic agents (tissue plasminogen activator) should be topically administered. Continual heparinisation and later warfarinisation should follow. In spite of successful revascularisation, parameters of kidney function can almost never reach that prior the RAE and shrinkage of kidney becomes a frequent consequence. Treatment can be successful even in patients with renal occlusion lasting over 90 minutes, since occlusion is often incomplete or significant collateral blood supply exists. In conclusion, renal artery embolism must be considered in cases of flank pain in patients with certain risk actors (especially atrial fibrillation). Ultrasonography with color Doppler imaging and urgent angiography of the renal artery are necessary in these cases. Thromboembolus can be then aspirated, and kidney perfused with fibrinolytic agent.

Embolism↗
PubMed2002

The expression of PAX5, p53 immunohistochemistry and p53 mutation analysis in superficial bladder carcinoma tissue. Correlation with pathological findings and clinical outcome.

OBJECTIVES: The expression pattern of PAX5 in the tissue of superficial bladder transitional cell carcinoma (TCC), its prognostic value and its correlation with p53 immunohistochemistry and p53 mutation analysis were evaluated. METHODS: Study comprised 61 patients with histologically confirmed superficial bladder TCC. Expression level of PAX5 mRNA was investigated using reverse transcriptase-polymerase chain reaction (RT-PCR) and determined semiquantitatively. The presence of p53 mutations was determined by SSCP and confirmed by direct sequencing. The p53 immunohistochemistry was performed with DO1 antibody and semiquantitatively evaluated using HSCORE (HS) method. As the control group for the evaluation of the PAX5 expression served 8 men with benign prostatic hyperplasia. RESULTS: PAX5 expression was found in 50 patients with bladder TCC but in no patient from the control group. Its quantity however correlated neither with the stage nor with the grade of the tumor. P53 mutation was confirmed only in 1 patient with pTaG2 tumor in exon 5 (deletion of proline 128). On the contrary, positive immunohistochemical staining of p53 was detected in most patients. Using the cutoff value of HS 200, 56.9% of patients showed p53 overexpression. Quantity of p53 immunochistochemical positivity did not correlate with the quantity of PAX5 expression. Using the cutoff values of HS 200 for p53 and of 0.2 for PAX5, 7 of 8 patients with future progression had p53 and 4 had PAX5 overexpression respectively. CONCLUSION: The expression of gene PAX5 is a frequent event in superficial TCC of the bladder.

Aged↗
PubMed2000

Causes and treatment of residual urine volume after orthotopic bladder replacement in women.

OBJECTIVES: Intact innervation of the female urethra is conditional for normal urination. In the past, urethrectomy was performed as part of cystectomy. After intense anatomical studies of the female pelvis, urethral-function-sparing cystectomy was developed. METHODS: Our clinical group consists of 41 female patients who were operated from 1993 to 1998 for bladder cancer, utilizing cystectomy with orthotopic bladder replacement. RESULTS: In 28 patients, complete daytime continence was restored and in 13 patients, daytime continence was socially satisfactory (1-2 pads were used due to mild stress incontinence). The drawback of orthotopic replacements in females is the frequent development of serious residual volume, which was seen in one third of the 41 patients. The functional results of orthotopic neobladders and therapy of residual urine volume were documented using urodynamic studies. CONCLUSIONS: Postvoiding residual volume may be caused by isolated dysfunction of the urethra and can be treated with clean intermittent self-catheterization or with alpha-blockers, which improve evacuation of the neobladder.

Adult↗
PubMed1999

[Urinary continence after radical retropubic prostatectomy].

Urinary incontinence following radical retropubic prostatectomy is a serious medical and psychological complication with a major negative impact on quality of life in patients with localized prostate cancer. The overall incidence of this complication is higher than 2% regardless whether the surgery has been done by the retropubic or perineal approach. The correct diagnosis of incontinence is based on urodynamic investigations. Two main causes of incontinence are detrusor hyperactivity and sphincteric insufficiency. The best prevention for postoperative incontinence of urine is meticulous surgery. Treatment options of incontinence are pharmacological or surgical (injections of collagen, autologous fat or implantation of artificial urinary sphincters).

Humans↗
PubMed1999

[Reconstruction of the lower urinary tract in women after cystectomy].

BACKGROUND: The first extirpation of the urinary bladder on account of malignant papilomatosis was carried out by Karel Pawlik in 1889 as the first one in the world. At present cystectomy is indicated usually because of an infiltrating carcinoma of the urinary bladder. The objective of the present paper is, based on anatomical investigations, elaboration of a surgical technique of creating a orthotopic neovesica following cystectomy sparing a functional female urethra. METHODS AND RESULTS: In 1993-1998 32 women were operated within the age bracket of 32-72 years with a confirmed infiltration carcinoma of the urinary bladder. The authors describe in detail their own surgical technique. Day continence was achieved in 20 patients. Twelve patients suffer from stress incontinence. Eight patients have a post-micturition residue of 250-300 ml calling for a combination of medicamentous treatment and autocatheterization. The capacity of the neovesicle is the cause of nycturia: 21 patients must micturate once or twice during the night. Urodynamic studies did not reveal significant differences between patients with chronic post-miction residues and without residues. Also the mean functional length of the urethra was in both groups similar (27 mm in patients with a residue and 26.2 mm in patients without a residue). CONCLUSIONS: The elaborated surgical technique of cystectomy and creation of a neovesica makes a good quality of the patients' life possible.

Adult↗
PubMed1999

[Injuries of the ureter treated at the General Medical School Hospital in Prague during the last 5 years].

Injury of the ureter is the most frequent trauma in urological practice. The most important deal concerning a patient's expectancy is early diagnosis and adequate treatment. During 1994-1998 the authors have treated 65 patients with diagnosis an injury of the ureter. The most frequent cause was the iatrogenic injury. Timing of surgery was 5-6 weeks. A percutaneous nephrostomy was the most frequent method of initial treatment (38 patients). Ureterorhaphy (32 patients), ureterocystoneostomy (12 patients) and Boari's flap operation (5 patients) was the most frequent definitive method of the treatment.

Female↗
PubMed1998

[Small-cell carcinoma of the prostate].

Small cell carcinoma of the prostate (SCCP) is a rare entity. A literature review disclosed less than 150 cases. SCCP has an aggressive course and both local and distant failure is common. The optimal treatment method has not been clearly established. We review our experience with 7 patients paying attention to clinical and pathological details. Three patients had mixed tumors of both SCCP and adenocarcinoma, three had pure adenocarcinomas that occurred as small cell carcinoma and one patient had pure small cell carcinoma. All patients progressed locally and developed distant metastasis. We recommend the use of hormonal manipulation and combination of chemotherapy, as well as surgery and/or radiation therapy of the prostate for local control and we emphasize that histologic entity is important for proper treatment.

Adenocarcinoma↗
PubMed1998

[Treatment of localized carcinoma of the prostate].

Review of the treatment of localized prostate cancer. The major attention is devoted to the surgical treatment. The radical retropubic prostatectomy is used most frequently. Problems of the indication, anatomical foundations and the technique of the surgery are discussed. The radical perineal prostatectomy is used less frequently. The radiation therapy is an alternative to the surgical treatment. The radiation therapy is recommended by urologists in patients, for whom is this treatment considered as more advantageous.

Combined Modality Therapy↗
PubMed1998

Efficacy and acceptability of tadenan (Pygeum africanum extract) in the treatment of benign prostatic hyperplasia (BPH): a multicentre trial in central Europe.

Pygeum africanum extract is available as Tadenan in many countries, including those in central and eastern Europe, for the treatment of mild to moderate BPH. Its efficacy and acceptability have been demonstrated in numerous open and placebo-controlled studies in large populations. The present open three-centre efficacy and safety study was conducted according to common protocol at urology clinics in the Czech and Slovak Republics and in Poland, in order to confirm the therapeutic profile of Pygeum africanum in conditions of daily practice, using International Prostate Symptom Score (IPSS) and flowmetry assessments. Men aged 50-75 years and in compliance with the selection criteria (including IPSS > or = 12, quality of life (QoL) score > or = 3, and maximum urinary flow < or = 15 ml/s) were first examined then recalled after two weeks during which no treatment was provided (washout and check of stability). If still compliant, they were entered at this point into a two-month period of treatment with Pygeum africanum extract 50 mg twice daily. There followed a further one-month period without treatment, the objective being to evaluate the persistence of any effects observed during the previous two months of Pygeum africanum administration. The primary efficacy parameter investigated was IPSS; the other efficacy parameters were QoL, nocturnal frequency, maximum urinary flow, average urinary flow, post-voiding residual volume and prostatic volume, after one and two months of Pygeum africanum treatment and one month after stopping treatment. A total of 85 patients were evenly distributed between the three centres and completed the entire study. At inclusion their mean IPSS was 16.17, QoL was 3.60 and nocturia was 2.6 times per night. The changes in subjective scores, IPSS and QoL after the two-month treatment period were highly statistically significant with mean improvements of 40% and 31%, respectively. Nocturnal frequency was reduced by 32% and the mean reduction was again highly statistically significant. Mean maximum urinary flow, average urinary flow and urine volume were also statistically significantly improved, but the modest improvement in post-voiding volume did not reach statistical significance. The improvements, which exceeded those observed with placebo in earlier studies, were maintained after one month without treatment indicating an interesting persistence of clinically useful activity. Prostatic volume and quality of sexual life remained unchanged throughout. No treatment-related adverse effects were observed. In conclusion, under conditions of daily practice, Pygeum africanum extract induces significant improvement in IPSS and uroflowmetry parameters. These positive effects are accompanied by a very satisfactory safety profile with the overall result of a substantial improvement in QoL.

Aged↗
PubMed1998

[Ureterocystoplasty--ureteral augmentation of the urinary bladder].

The method of choice in the surgical treatment of neurogenic dysfunctions of the lower urinary pathways is to use the ureteral wall for augmentation of the urinary bladder. The advantage of the method is that it rules out risks and complications encountered in techniques using an excluded intestinal or gastric segment (mucus formation, metabolic disorders, malignant transformation, uroinfection, urolithiasis). The author presents the case-history of a 28-year-old man with a neurogenic bladder due to surgery of meningomyelocele during childhood.

Adult↗
PubMed1998

[Kidney sparing surgery].

From 1988 to 1998 107 nephron sparing surgery have been done for localised renal cell tumor. The age was between 21 to 75. Nephron sparing surgery means removal of tumor consumed part of renal tissue with oncology clean border in healthy renal tissue. Elective indication for nephron sparing surgery is renal cell carcinoma on single kidney or on bilateral function disabled kidneys. In the last years indication for nephron sparing surgery have spread also to patients with both kidneys, who have single extrarenal growing renal cell carcinoma to the diameter 4.5 cm. In our group of follow up patients, within the interval 3 to 96 months from operation we have 96.26% survival without evidence of recurrent renal cell carcinoma.

Adult↗
PubMed1997

Female urethra-sparing cystectomy and orthotopic bladder replacement.

OBJECTIVE: Orthotopic bladder replacement after cystoprostatectomy has long become the method of choice in the treatment of infiltrating bladder cancer in males. Very good quality of life in patients thus treated stimulated the work on a similar approach applicable to females. METHODS: Twelve females were treated by urethra-sparing cystectomy. The surgical technique preserves not just the urethra itself but also the pelvic floor and relevant innervation. RESULTS: Diurnal continence was achieved in 11 patients, 1 of whom had a so-called hypercontinence with a residual volume of 300 ml. The remaining patient suffered from stress incontinence. CONCLUSION: The described urethra-sparing radical cystectomy in female patients with a urothelial tumor, with normal pelvic floor and with a low risk of secondary affection of the urethra, permits reconstructing a continent orthotopic neobladder from a detubularized intestinal segment.

Adult↗