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Biomedical subjects

V Melichar

Publications and source records attributed to V Melichar.

At least 19 recordsLinked to original sources
PubMed1999

[Central rupture of the liver in multiple injuries].

Authors evaluate clinical material of polytraumatized patients operated on account of liver injury during the last 15 years. The contribution of new imaging techniques is analyzed, especially of spiral computed tomography, for the diagnosis of liver injuries and associated injuries of the abdomen and retroperitoneum. These techniques enable in stabilized patients with the trauma I, II injuries and in some cases of grade III injuries to prefer conservative treatment. During the last 3 years the authors treated 5 polytraumatized patients with central liver rupture. Consistent with experience of major trauma centres in USA and Switzerland, criteria for conservative treatment are outlined, especially in patients of younger age groups.

Humans↗
PubMed1997

[Injury of the extrahepatic bile ducts in multiple injuries].

During the ten-year period between 1982-1991 the authors operated in the Institute 12 casualties after perforation and avulsion of the gallbladder, 8 patients on account of injuries of the hepatocholedochus and 15 patients where after injury posttraumatic acute cholecystitis developed. The authors evaluate critically the asset of new diagnostic preoperative procedures for assessment of early indication of surgery. In the surgical tactics they prefer reconstruction procedures which prevent such serious postoperative complications as relapsing cholangitis or stricture with cholestatic affection of the liver [1,3].

Cholangiography↗
PubMed1996

[Problems with continence in rectal injuries].

Authors analyse the group of 17 patients operated for rectal and anal injury. In this group 7 patients were operated primarily after injury and in 11 patients the secondary reconstruction was performed. Authors called the attention to the high diagnostic difficulty before the planned and indicated secondary reconstruction. Based on assessment of own clinical material and conforming with literature, authors conclude that secondary reconstruction are more difficult, and this difficulty is the higher, the less qualified the primary treatment was performed.

Fecal Incontinence↗
PubMed1991

[Subcapsular hematoma--a grade I liver injury].

The authors give an account of 11 patients hospitalized in 1975-1988 in the Traumatological Research Institute in Brno with a subcapsular haematoma of the liver. In case of suspected liver injury they use nowadays examination by ultrasound. Laparotomy must not be delayed in patients with unstable vital functions only because of various diagnostic examinations. The therapeutic success in liver injuries depends on early operation, correct resuscitation and selection of an optimal surgical procedure which depends above all on the type and grade of severity of the injury.

Adolescent↗
PubMed1991

[Use of the tissue glue, Tissucol, in experimental liver injuries].

The authors investigated in experiments on rabbits the course of recovery of liver injuries after treatment with the fibrin glue Tissucol, as compared with a control group of animals where the injured liver was not treated. Healing was followed-up at several time intervals. Rupture of the liver left to spontaneous healing was at first unsatisfactory from the histological aspect (wide demarcation margin near the necrosis). Subsequently the margin disappeared however. The scar was minimal after two months and were no manifestations of inflamed parenchyma surrounding the scar. When Tissucol was used, as a rule favourable healing was achieved. Scarring was satisfactory although the connective tissue was somewhat wrinkled and the scar was not linear. On the whole the tissue glue Tissucol is favourable in the final stage despite the fact that during healing a granulomatous reaction to the glue developed and the proliferation of the minor biliary pathways persisted also in the final stage of the experiment.

Animals↗
PubMed1990

[Differences in free amino acid serum levels in premature neonates fed Feminar supplemented with whey proteins].

Free amino acids were examined in plasma of premature infants fed adapted dried milk (15 and 22 infants resp.) and breastfed infants (20). The dried milk was Feminar (casein: whey protein 40:60) where the whey (serum) proteins were prepared either by thermal denaturation (F-TD) or by ultrafiltration (F-U). The concentration of different amino acids in infants fed F-TD were closer to those recorded in breastfed infants, as compared with F-U where greater differences (higher values) were recorded.

Amino Acids↗
PubMed1990

Influence of postnatal age on nitrogen metabolism in very low birth weight infants appropriate for gestational age.

In 14 very low birth weight (VLBW) infants appropriate for gestational age the absorption and retention of nitrogen and the energy balance were studied on the 8th day and the 6th week of postnatal age. All infants were fed with a human milk formula composed by fresh mother's milk enriched with 6 g freeze-dried human milk/100 ml. The absorption rates of nitrogen and fat increase significantly with postnatal age but even on the 8th day of life they are on high levels (nitrogen absorption: 86.9 +/- 3.2% of intake; fat absorption: 85.7 +/- 4.3% of intake). Despite the higher nitrogen absorption during the 6th week of life the excretion of total nitrogen is lower in comparison to the 8th day of life. Similarly, the percentages of alpha-amino-nitrogen and of ammonium-nitrogen of the total nitrogen excretion in the urine decrease whereas the percentage of urea-nitrogen increases with postnatal age. The results indicate a postnatal development of both the digestive, as well as the metabolic capacity. The postnatal adaptation of the metabolic capacity to utilize nitrogen seems to be the stronger limiting factor for nutrition than the functional capacity of digestion and absorption. Thus, metabolic monitoring is essential for the individual nutrition of VLBW-infants during the first weeks of postnatal life. Urine analysis data are very sensitive for evaluating the metabolic state of these infants.

Aging↗
PubMed1990

[Personal experience with liver injuries].

The authors give an account of 69 patients hospitalized in 1975-1986 in the Traumatological Research Institute in Brno on account of liver injuries. The mean age of the patients was 38.3 years. The liver injury was very frequently associated with serious craniocerebral injuries, with injuries of the chest and other intraabdominal organs and the total lethality was 62.3%. The most frequent cause were traffic injuries (50 cases). Blunt liver injuries accounted for 92.8% of the cases.

Adolescent↗
PubMed1990

[Treatment of liver rupture in an experiment].

The authors investigated in experiments on rabbits healing of liver incisions under various circumstances: spontaneous healing, liver incisions treated by suture by application of the tissue glue Tissucol, the collagenous haemostatic felt Collastypt combined with one stitch. Healing was followed up after several time intervals. From normal, i.e. the group of spontaneous healing, differed the groups treated by Tissucol and Collastypt where marked encapsulating fibrous tissue reactions round the necroses on the wound margins were found with numerous eosinophils as a transient phenomenon. The final result (with a maximum of cca two months) was adequate in all groups--as a rule a thin fibrous tissue scar with few remnants of atrophic hepatic trabeculae. In the treatment of small injuries it seems best to use the collagenous haemostatic Collastypt. In the treatment of sutures in rare instances a large number of leucocytes was found in the area of the necrosis and stitches, perhaps as result of contamination of the wound or sewing material.

Animals↗
PubMed1989

[Feminar with whey (serum) proteins prepared by thermal denaturation. Nitrogen and lipid balance in neonates with a low birth weight].

For the newborn with low birth weights the Dairy Research Institute and Dairy Industry prepared an adapted dried milk--Feminar where most of the casein was replaced by whey proteins, prepared by thermal denaturation F-BTD. The results of the nitrogen and lipid balance made in low birth weight neonates fed this milk were compared with the results of balances in infants fed commonly prepared Feminar and Feminar where whey proteins were prepared by ultrafiltration F-BU. The balances were made in a total of 23 low birth weight neonates (always four balance days). The nitrogen and lipid retention after F-BTD was higher, and concurrent investigation of metabolites revealed lower blood urea concentration.

Energy Intake↗
PubMed1989

[The compartment syndrome after fractures of the calf].

In the submitted paper the authors summarize views regarding the definition, causes of compartment syndrome, its classification, the diagnostic and therapeutic procedure. In a group of 165 fractures of the leg treated in 1984-1987 in the Traumatological Research Institute in Brno the compartment syndrome was found in 26 patients. The author supplements the problem by case-histories of two patients with compartment syndrome. He discusses the need of early and correct diagnosis, differential diagnosis, therapy, involving in the manifest form of the syndrome decompression by fascitotomy.

Adult↗
PubMed1987

Fatty acid values in the plasma of neonates, umbilical cord and maternal blood.

The proportion of a wide range of fatty acids was studied in the plasma of 15 healthy newborn infants following a physiological pregnancy and delivery. The same measurements were done in seven healthy mothers (immediately after parturition) and the proportion of fatty acids was analysed in mixed umbilical cord blood (n = 7). The fatty acids were identified by gas chromatography as their methyl esters (FAME). In newborn infants the proportion of saturated fatty acids was found to be 42.3%, of monoene fatty acids 31.3% and of polyene fatty acids 25.4%; type n-6 fatty acids formed 13.9% and n-3 11.1%. The proportion of the various fatty acids in healthy maternal plasma was 37.9% (saturated), 34.4% (monoene) and 25.0% (polyene) respectively; type n-6 fatty acids formed 21.6% and type n-3 only 3.6%. The values in mixed cord blood were 44% (saturated FA), 34.8% (monoene FA) and 20% (polyene FA); group n-6 FA accounted for 17.4% and n-3 for only 2.1%. In the above three series we also described the sequence of the fatty acids present in the largest amounts. This is part of an extensive study, in a large series, of the commonest perinatal risks. We particularly draw attention to the high proportion of long-chain fatty acids (C 22 - C 26) in the plasma of healthy newborn infants.

Fatty Acids↗
PubMed1987

The application of redissolved human milk lyophilisate for nutrition of very low birth weight infants.

In the second month of life the nitrogen and fat balances were studied in 21 very low birth weight infants fed with native human milk or redissolved human milk lyophilizate. Caused by fat losses during the lyophilization procedure and decreased fat absorption rate as consequence of heating of the milk before lyophilization, the available energy is significantly lower in infants fed with redissolved human milk lyophilizate than in those fed with native human milk. The reduced energy intake leads to a decreased protein utilization, as well as to a poor weight gain. In addition, hyperaminoacidaemia and hyperaminoaciduria appear in these infants. Thus, supplementation with medium-chain triglycerides must be recommended if redissolved human milk lyophilizate is used for feeding very low birth weight infants.

Body Weight↗
PubMed1986

[Nutrition of very low birth-weight premature infants with enriched breast milk during the adjustment phase].

To enable an enteral nutrition in very low birth weight infants appropriate for gestational age, adapted to the high nutritional requirements, pooled human milk from mothers delivered preterm was enriched with human milk lyophilisate 6 g/100 ml. The concentrations of protein increase from 11.8 +/- 1.2 to 15.8 +/- 2.1 g/l and the non-protein energy substrates raise in the same proportion. Osmolality increases from 291.6 +/- 11.2 to 384.9 +/- 19.6 mosmol/l. The higher protein intake was tolerated without relevant metabolic imbalances. Only small increasing of amino acids concentrations in serum and a higher renal excretion of amino acids could be observed. The nitrogen balance was equalized during the first two days of life and positive from the 3rd day of life. Nitrogen retention was significantly higher in the group fed human milk lyophilisate enriched human milk from the 2nd day of life. Also the postnatal weight losses were significantly lower and the birth weight was reached significantly earlier. Human milk lyophilisate enriched human milk can be recommended for nutrition of very low birth weight infants appropriate for gestational age from the first day of life.

Amino Acids↗
PubMed1986

[Nitrogen and lipid balances in newborn infants with low birth weight fed lyophilized breast milk of various composition].

Nitrogen and fat balance studies were performed in 6 low birth weight infants (average birth weight: 1465 +/- 128 g) who were alternatively fed 3 types of lyophilized human milk during the 5th through 14th week of life. Feeding group I received human milk (protein content 1.32%). Group II was administered concentrated human milk (protein content 1.69%). Group III received human milk fortified with whey from cow's milk (protein content 1.74%). Group II showed the best results with respect to weight gain, nitrogen balance and blood metabolites. The introduction of whey protein in Group III resulted in higher plasma levels of urea (p less than 0.05), threonine (p less than 0.05), valine (p less than 0.025), isoleucine (p less than 0.01), leucine (p less than 0.02) and lysine (p less than 0.001) compared with Group I infants. Accordingly, plasma levels of alpha-amino-nitrogen were elevated in Group III.

Amino Acids↗