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Biomedical subjects

V Smrcka

Publications and source records attributed to V Smrcka.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Cerebral blood flow measurement].

A cerebral blood flow measurement is an important part of studying various brain pathologies, particularly brain ischemia. The methods of measurement are still improving, although the physical substance of many of them, like Fick's or Doppler's principles, outlasts further. A change in quality in last several years came with the use of isotopes and a computer technique. New options in imaging of circulatory changes with the help of magnetic resonance technology seem to be particularly perspective. If there were no economical obstacles, this method, which is able to disclose non-invasively a brain perfusion disorder in the very beginning, would be certainly immediately applied in the broad clinical practice.

Blood Flow Velocity↗
PubMed1999

[Anatomic and functional basis for the effect of systemic hypertension on focal cerebral ischemia].

Contemporary vascular neurosurgery cannot sometimes avoid electively used focal brain ischemia. In aneurysm surgery, for example, it is sometimes necessary to close temporarily the parent vessel for a safer dissection of the aneurysm sac. Also carotid endarterectomy cannot be done without a temporary closure of the artery. One of possible neuroprotective methods to be used during this controlled focal ischemia is a systemic hypertension. The knowledge of anatomical and functional capabilities of the brain circulation is crucial for understanding the advantages but also the limits of this neuroprotective method.

Adult↗
PubMed1999

[Traumatic intracranial hemorrhage with a clinical temporal conus syndrome].

The authors investigated a consecutive group of 14 patients treated at the Neurosurgical Clinic on account of traumatic intracranial haemorrhage, admitted with the clinical temporal conus syndrome (GCS 3-5, ipsilateral or bilateral mydriasis, failure of vital functions). All had emergency operations and at the intensive care unit the cerebral perfusion pressure and the saturation in the jugular bulb was monitored continuously. On the first and fifth day after surgery a check-up CT and SPECT examination was made. Only two patients had ischaemia during the first CT check-up, while 11 patients had impaired perfusion on the first SPECT. Improving perfusion on the check-up SPECT was the sign of a favourable prognosis, while ischaemia on the first CT was in both instances fatal. The Glasgow Outcome Score (GOS) six months after the injury was as follows: 9 patients had a good result, 2 patients were moderately disabled 3 patients died. The authors consider the following as basic prerequisites of a favourable outcome: not only early operation but also monitoring and treatment of impaired cerebral perfusion.

Adolescent↗
PubMed1999

Precision grip with congenital hypoplasty or hypofunction of the thumb.

We tested the grip in four patients with congenital defects of the hand and either a hypoplastic thumb or a thumb with impaired inervation. Small objects were taken by a scissors grip between the fingers. In a hand with radial duction in the manus vara congenita, during strengthening of the wrist, the grip from the ulnar side between the fourth and fifth fingers was changed to the radial side between the second and third fingers. Large objects were gripped by all the three-phalanx fingers into the palm in a horizontal position. In case 4 with hypoplasia of the thumb grade IIIC by the classification of Blauth and Buck-Gramcko, we describe a transposition of the index finger to the site of the thumb and the hypoplastic thumb to the site of the index finger. It is obvious that the precision grip is affected by the thumb length and strengthening of the ulnar side of the wrist. We assume that the scissors grip is the earliest precision grip in the evolution of the primate hand.

Child↗
PubMed1998

Treatment of a maxillary defect following resection of carcinoma.

A group of 37 oncological patients with tumours of the head and neck where extensive resection of the face, maxilla or mandible or calva was necessary, comprised five patients with a typical defect after resection of part of the maxilla including half of the palate and exenteration of the orbit. This extensive defect causes discomfort to the patient and his environment--functional i.e. impaired speech, and cosmetic. A satisfactory solution during reconstruction of the maxilla without the need of skeletal reconstruction is microsurgical transplantation of a narrow flap of the latissimus dorsi, usually with two cutaneous islands--one to close the palate and the other to close the orbit and face.

Aged↗
PubMed1998

Reconstruction of paralyzed biceps brachii muscle by transposition of pedicled latissimus dorsi muscle: report of two cases.

The biceps brachii muscle was reconstructed in two patients with inveterate injuries of the brachial plexus. The latissimus dorsi muscle was transferred on the thoracodorsal neurovascular bundle into the regio brachii anterior and sutured to the long head of the m. biceps brachii. The distal part of the latissimus dorsi muscle was sutured above the tuberositas radii along with the insertion tendon of the biceps brachii muscle. Both patients achieved very satisfactory restoration of flexion in the elbow joint 12 and 16 months after surgery.

Adult↗
PubMed1998

Inveterate lesions of the collateral ligaments of the thumb joints.

Inveterate lesions 2-18 months following injury to the collateral ligaments of the metacarpophalangeal (MP) joint of the thumb and pollicised proximal interphalangeal (PIP) joint were replaced by a tendinous transplant from the palmaris longus muscle. The group comprised three patients, 34-46 years old, with a post-traumatic injury of the ulnar collateral ligament of the MP joint of the thumb and a seven-year-old child with an congenital defect of the radial collateral ligament. Lateral 30-degree instability indicates injury of the collateral ligament. On examination the range of instability in the investigated group was between 45 and 90 degrees. The authors recommend comparison with the contralateral thumb.

Adult↗
PubMed1998

[Minimally invasive treatment of traumatic cerebral hematoma. Further experience with stereotaxic evacuation].

The authors summarise their experience with 16 post-traumatic cerebral haematomas which they evacuated using stereotactic technique. Based on the achieved results they reached the conclusion that stereotactically aimed treatment of haematomas is an advance, for the patient's benefit. The evacuation cannula is safely inserted to its target from a transcutaneous drill hole of the skull and thus the patient is spared the surgical trauma associated with craniotomy and further brain damage. If necessary, the focus of haemorrhage can be reached again by puncture via the channel in the bone which navigates the cannula. Surgery under local anaesthesia is rapid and the results of promising. Extension of the new method depends, however, on the availability of simple stereotactic equipment which starts to play a part in the surgery of traumatic haematomas.

Adult↗
PubMed1998

Congenital contracture of the superficial flexor of the hand.

The authors describe a case of an inborn contracture of the superficial flexors of the three-phalangeal fingers in a 15-year-old girl and treatment of the condition. For clinical purposes a classification on congenital deformities in the proximal part of the flexor complex was proposed in which the described case is included. The classification was derived from the ontogenetic development of flexor tendons. There are three types of deformities: S1--the muscular belly of the superficial flexor of the fingers is only in the palm; S2--the muscle is attached to the area between the wrist and medial epicondyle; S3--the palmaris longus of the fingers is on the medial epicondyle, however the m. palmaris longus is lacking; Pl-1 the superficial flexor exists only in the form of a proximal muscular belly of varying length; Pl-2--the palmaris longus is on the wrist and the insertion tendon may be thinner than on the contralateral side. The described contracture deformity was classified as type S2.

Adolescent↗
PubMed1998

Environmental pollution and the occurrence of congenital defects in a 15-year period in a south Moravian district.

We have made a simple 15-year retrospective epidemiological study of a part of South Moravia, district Breclav, on the basis of genetic documentation of 245 congenital defects and 28 spontaneous abortions. The whole area was worked up by computer-geographical methods, and the occurrence of congenital defects was compared both in areas of severe chronic air pollution and in less contamined areas. There were three municipal areas, Mikulov, Breclav-Postorná, Velké Bilovice and their surroundings, in which an increased number of congenital defects was recorded. In the municipal area of Breclav-Postorná there was also a greater occurrence of organic solvents and phosphoric acid and a significantly higher occurrence of spontaneous abortions and at the same time a higher occurrence of heart defects.

Abortion, Spontaneous↗
PubMed1997

Circular stereotactic callosotomy: a preliminary report. Technical note.

The authors propose a new method for performing stereotactic callosotomy, which they have named circular callosotomy. The operating device is the original Riechert-Mundinger's string electrode, which can be protruded through a side window and by rotating the probe it is possible to cut the commisural pathways to the extent required. The anatomical results of the operation can be checked using MRI scanning.

Corpus Callosum↗
PubMed1997

[Present possibilities for dura mater substitutes].

Since 1995, we have been using the Neuro-Patch--a fibrillar microporous polyesterurethane produced by B. Braun Surgical GmbH Melsungen. We have compared the Neuro-Path with the until very recently used autologous and homologous tissues from June 1995 to December 1996. According to the results of study, Neuro-Path appears to be the most suitable replacement material for duraplasty for both practical (no inflamation, CSF fistula appeared) and ethical reasons.

Adolescent↗
PubMed1997

[Surgical findings in stereotaxic therapy of spontaneous cerebral hemorrhage].

Observation of stereotactic evacuation of haematomas in the deep structures of the brain in 41 patients and in the white matter of the cerebral lobes in 33 patients revealed that in the surgical technique and results no substantial difference can be found. The tactics of the intervention in deep hypertensive haemorrhages call however for greater care to avoid a new haematoma and also a greater effort to crush possible blood clots.

Adult↗
PubMed1996

Microsurgical reconstruction of a stiff jointless thumb after an avulsion injury.

We demonstrate three types of reconstruction of a stiff jointless thumb after an avulsion injury. In the first type, the skeleton of the thumb was harvested from the iliac crest or from a rib, the cutaneous cover was formed from a forearm flap on the a. radialis. In the second type, the preserved skeleton of the thumb from crushed tissues was transferred to the forearm and from there subsequently used for reconstruction together with the forearm flap. These two types of reconstruction were carried out if the amputation line reached the metacarpophalangeal (MP) joint of the thumb. In an amputation proximally from the MP joint, the skeleton of the thumb was reconstructed with a graft from the fibula on a vascular pedicle. The fibula with the vascular pedicle was transferred to the forearm and sutured in an Y-shape suture to the a. radialis. The tissue block of the forearm flap together with the fibula were subsequently transferred for the reconstruction of the thumb. The fundamental prerequisite for the reconstruction of a stiff jointless thumb were freely mobile three-phalangeal digits which could form a functional unit with the stiff thumb. The reconstructions were performed in 7 patients. The advantages and disadvantages of these particular operation schemes are discussed postoperatively after 2 years.

Amputation, Traumatic↗
PubMed1996

[Stereotaxic therapy of post-traumatic cerebral hemorrhage].

The authors present five case-histories pertaining to stereotactic evacuation of lobar traumatic cerebral haematomas and indicate new ways of their treatment. It ensure already from initial observations of the authors that stereotactic operation of these haemorrhages is justified and useful in haematomas affecting several cerebral lobes simultaneously or in case of symmetrical haematomas.

Adult↗
PubMed1995

Replantation by arterialization of the venous system of amputated parts.

Only in four cases out of 800 replantations and revascularizations as the last resort it was necessary to anastomose an artery of the stump to a vein of the amputated part. Three of these cases were very distal finger amputations in zone II and III and one was an auricle amputation with so severely damaged arteries of the amputated part that it was not possible to perform their anastomosis. All of these four clinical cases were successful and they confirm the possibility of arterialization of the venous system which was proved in experiments with rabbit auricle replantation by Mundy and Pajn (1994) and by Farrior and Baker (1988).

Adolescent↗