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Biomedical subjects

V Treska

Publications and source records attributed to V Treska.

At least 19 recordsLinked to original sources
PubMed2003

Can ischemia-reperfusion syndrome in transplanted kidneys procured from non-heart-beating donors be influenced by adding selenium into the reperfusion solution? An experimental study.

Ischemia-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). An animal model of NHBD was used to monitor the influence of the exogenous addition of selenium in the perfusion solution (HTK, Custodiol) on the generation of free oxygen radicals between 0 and 120 minutes after transplantation of the NHBD organ. During this interval, the malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney, significantly decreased. The augmentation of the anti-oxidant capacity of the preservation solution might represent a possible improvement in the function of kidneys transplanted from NHBDs.

Animals↗
PubMed2003

Can the ischemia-reperfusion syndrome in transplanted kidneys procured from non-heart-beating donors be influenced by adding selenium into the reperfusion solution? An experimental study.

The ischemic-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). The animal model of a NHBD was used to monitor the influence of exogenous addition of selenium into the reperfusion solution (HTK, Custodiol) with respect to the formation of free oxygen radicals at 0 to 120 minutes after the NHBD transplantation. This maneuvers produced a statistically significant decrease in malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney. The augmentation of the antioxidative capacity of the preservation solution might be a possible route to improve the function of kidneys transplanted from NHBDs.

Animals↗
PubMed2003

[Rupture of abdominal aortic aneurysm (RAAA)--predictors of the early postoperative mortality].

PURPOSE: To evaluate the main factors of the 30 days mortality rate of patients operated on for abdominal aortic aneurysm rupture (RAAA. PATIENTS AND METHOD: Univariate and multivariate analysis of various factors associated with RAAA was performed in a group of 73 patients operated on for RAAA between 1996-2001. RESULTS: The 30 days mortality rate was 35.6 %. The main factors of mortality were: misdiagnosis, cardio- pulmonary-cerebral resuscitation (CPCR) on admission, configuration of RAAA, number of blood transfusions, hypotension on admission (p < 0.0001) and duration of operation, type of reconstruction and hypertension in anamnesis (p < 0.01). Important factors (p < 0.05) of postoperative mortality were also low haemoglobin level on admission, abdominal aortic aneurysm (AAA) diameter and ischaemic heart disease in anamnesis. The probability of patient's death is the highest (p < 0.003), if factors like CPCR, number of blood transfusions and aneurysm diameter are combined (multivariate analysis, stepwise method). CONCLUSION: The early detection and surgical or endovascular elective treatment of AAA, the regular dispensation of patients with small AAA especially in hypertonics, the correct diagnosis of RAAA without time delay are the best tools for patients survival. The patient's chance for survival increases with highly trained prehospital resuscitation system and experienced team of vascular surgeons and anesthesiologists.

Aged↗
PubMed2003

[Cystic abdominal lymphangioma in adults].

Cystic abdominal lymphangioma is a rare tumor in adult age. It occurs usually in children and is localised mostly in the head and neck. Only 2-8 % of lymphangiomas are localised intraabdominally. We present a case of a 20-year-old man who complained about acute abdominal pain after physical activity. Diagnosis of intraabdominal multilocular cyst was done by ultrasound, computed tomography and coeliacography. The definitive diagnosis of lymphangioma of the hepatoduodenal ligament was established by laparotomy and histologic examination of the specimen. Cystic abdominal lymphangioma is a rare disease in adults with difficult preoperative diagnosis. The surgical extirpation often completed with resection of involved organ is the method of choice in the treatment of this rare disease.

Abdomen↗
PubMed2003

[The Einstein sign].

Untreated rupture of an aneurysm of the abdominal aorta is fatal in almost 100% of the patients. In the majority of cases the assessment of a correct, early diagnosis is simple (hypotension, backache, abdominal pain, pulsating resistance in the abdomen) and makes a prompt surgical or endovascular operation possible. In some instances however rupture of aneurysms of the abdominal aorta simulates other clinical conditions (acute cholecystitis, acute diverculitis of the sigmoid) which may delay the correct diagnosis and reduce the patient's chance of survival. The author describes, based on historical documents, the treacherous course of the disease in the scientific genius Albert Einstein where rupture of an aneurysm simulated acute cholecystitis, and in the world literature this symptomatology was subsequently described as Einstein's sign.

Acute Disease↗
PubMed2003

[A technique of liver resection].

In comparison with other types of therapy, surgical treatment offers the best chance of long-term survival to the patient with a malignant liver disease. It is the only radical therapy of patients with primary or secondary tumors of the liver. Liver surgery has been the subject of great development over the last years. The technique of liver resection entertained principal changes reflecting various technical advancements. The author deals in greater detail with the present terminology of liver resections. The second part of the contribution deals with the proper technique of the operations on the liver with the application of per-operation ultrasonography, ultrasound dissector, radiofrequency ablation, harmonic scalpel, argon coagulation and the spray pump (Tissomat) for the application of fibrin glue. The correct surgical technique, together with the application of technical background, makes a series of large liver resections possible without necessity of blood transfusions. Liver surgery belongs to highly specialized interventions, which should be performed only in centers dealing with full-extent liver surgery.

Hepatectomy↗
PubMed2003

[Abdominal aneurysm resection in aged patients at the Surgery Clinic in Plzen from 1998 to March 2003].

The authors evaluate resection therapy on aneurysms of abdominal aorta in patients of high age (mean 85 years) at the Clinic of Surgery in Plzen. In the period of 1998-March 2003 the authors performed 13 elective resections on aneurysms of abdominal aorta in patients of high age with zero mortality and 21 acute resections with 38% mortality. In the given period of time, 178 resections of aneurysms of abdominal aorta were made in patients younger than 78 years, 57 being acute interventions. Mortality of elective interventions was 2.9%, in acute interventions being 28%. The present groups indicate that mortality of resection therapy sharply increased in relation to circulation instability of the patients in cases of ruptured aneurysm, but nor in relation to age of the patients.

Aged↗
PubMed2002

[Present possibilities in vascular surgery].

Contemporary vascular surgery relies on the progress in imaging techniques and on modern materials for vascular substitutes. The collaboration with radiodiagnosticians enabled the treatment of arterial thromboses by means of fibrinolysis. Radiodiagnostics plays an important role also in the field of endovascular operations, namely percutanous transluminal angioplasty, insertion of stents, and recently in the abdominal aorta aneurysms treatment by means of stents. Long-lasting effects of such operations, namely those in the aorta, have not been fully established and the classical reconstructive surgery has not lost its importance.

Angioplasty, Balloon↗
PubMed2002

[Extraanatomic bypass surgery for peripheral arterial vascular disease--is it still justified?].

OBJECTIVE: Our results of extraanatomic bypass surgery in the last 5 years should be analysed in a retrospective study. PATIENTS AND METHODS: 66 extraanatomic reconstructions were performed in 65 patients (52 male, 13 female). Femoro-femoral bypasses (78.8 %) were mainly included in this study, followed by axillo-femoral (bifemoral) and obturator bypasses. The procedures could be divided in 45 (68.2 %) primary and 21 (31.8 %) recurrent operations. 57.6 % of the patients revealed a critical lower limb ischemia. RESULTS: The bypass patency rates were 97 % after one year and 81.1 % after 3 years. 24.2 % of the patients showed immediate postoperative complications, 12.1 % of them major complications (surgical and nonsurgical). No patient died postoperatively or in the first year after operation. The 3-year mortality rate ranged to 10.8 %. Major amputations had to be carried out in 4 patients (6.1 %) during the first year and in one patient later on, so that the total amputation rate amounted to 7.6 %. CONCLUSIONS: Our results prove extraanatomic reconstructions to be a valuable surgical tool in lower limb ischemia with good long-term success. Extraanatomic bypasses are technically simple procedures in the majority of cases and take good care of the patient with low morbidity and mortality.

Adult↗
PubMed2002

[Treatment of diabetic neuropathic defect at the surgery department and at the center for diabetic foot care].

UNLABELLED: The aim of the study was to evaluate the treatment of neuropathic diabetic ulcer at the surgery department and the treatment at the diabetic foot centre at dismissal time and 3 months after the dismissal. METHODS: For assessment of treatment success parameters of glucose control were used (average of daily blood glucose values, glycosylated haemoglobin--HbA1C and glycosylated protein), healing of ulcers (Wagner classification), hospitalisation time and number of amputations. 22 diabetic patients at the centre and 17 patients at the surgical department were observed in this investigation. There was no difference between the groups as for the age, glucose control (HbA1C), and severity of diabetic ulcers (Wagner 3-4). Local and antibiotic therapies were the same ones. Results as median and difference 75th and 25th percentile were evaluated by Wilcoxon test for paired data within the groups and by Man-Whitney test between both of the groups. RESULTS: In the both group the diabetic control and ulcer healing were significantly improved during hospitalisation period, 3 months after discharge deteriorate diabetic control and ulcer healing stagnated, however, only in the group treated at the surgical department. The hospitalisation time was significantly longer in the surgical group in comparison with the centre group [median 52 days (35)] vs. [median 31 days (38)], p < 0.01. Amount of transmetatarsal and higher amputations was lower at the foot centre in comparison with the surgical group (1 vs. 7). Statistical evaluation was not used for low amount of amputations. CONCLUSION: Team approach at the centre of diabetic foot is effective in the treatment of diabetic foot ulcers, significantly shortened the hospital stay, probably decrease amount of amputations. Three months after discharge the diabetic control and ulcer healing were significantly better in patients treated at the diabetic foot centre.

Aged↗
PubMed2002

[Injuries of extremity blood vessels, personal experience and results].

The authors evaluated the results achieved in 47 patients with injuries of the acral vesels where they performed a total of 50 vascular operations during the five-year period from 1998-2001. 21.3% injuries were part of multiple injuries. The mean period of hospitalization was 14.7 days. The 30-day mortality was 6.4% and the morbidity 12.8%. The upper extremity was saved in all instances (100%), the lower extremity in 77.3% of the injured. The reason for high amputations of the lower extremity were most frequently injuries of the popliteal artery associated with skeletal injury and extensive contusion of the soft tissues of the extremity. The authors discuss the optimal diagnostic and therapeutic procedures in injuries of the acral vessels. They emphasize a multidisciplinary approach without delay with early, frequently during the primary operation indicated fasciotomy, to prevent the development of compartment syndrome. The order of operations in concurrent injuries of the acral skeleton depends on the stage of ischaemia, type of injury and solution of the skeletal fractures. This type of injury frequently calls for repeated redressing in the operation theatre with repeated necrectomies of soft tissues to prevent infection which may prove fatal for the extremity. Injuries of the acral vessels should be nowadays treated in specialized departments with a 24-hour diagnostic and therapeutic traumatological service which comprises a highly specialized team of vascular surgeons.

Adolescent↗
PubMed2002

[Initial experience with transplantation of a kidney from a non-beating heart donor (NHBD)].

The authors present their initial experience with transplantations of the kidneys from a donor with a non-beating heart (NHBD). This programme was developed because of the permanently declining number of cadaverous kidney donors with a beating heart. Since January 2002 the authors collected a total of three kidneys from NHBD 3 kidneys of which were used for transplantation. The first two started to function immediately, the third one restored its function three weeks after transplantation. The viability and suitability of use of kidneys from NHBD is evaluated with regard to vascular resistance and flow of the perfusion fluid through the kidneys when using a perfusion pump and by means of totalglutathione-S-transferase (tGST) assessed at intervals in the perfusion fluid. The values of the above parameters are limiting between the 6th and 8th hour after the onset of instrumental perfusion of the collected kidneys when the perfusion values should be within the range of 30-50 ml/min/100 g and the vascular resistance should be < 0.7 mmHg and tGST < 100 U/l. For immunosuppression the authors use during the fist days after transplantation basiliximab, rapamycin and corticoids, later in case of satisfactory function of the graft they add cyclosporin A. The initial results of renal transplantation from NHBD are promising and the programme will be developed further.

Cadaver↗
PubMed2002

[Liver resection technique using the harmonic scalpel].

The authors present their one-year experience with the use of a harmonious scalpel (HS) in resections of the liver on account of malignant and benign disease. The advantages of HS is safe coagulation and section of the vessels and bile ducts at the site of dissection of the liver parenchyma, without unnecessary coagulation "sideways", and in particular the use of HS significantly reduces the need of blood transfusions during resection. In some instances transfusions are not necessary at all. A certain disadvantage of HS in liver resections is restriction of coagulation of vessels under 2-3 mm in diameter and a longer time of operation which is however compensated by minimal blood losses. In the conclusion the authors recommend HS as the technique of choice in resection of the liver.

Hepatectomy↗
PubMed2002

[Initial experience with radiofrequency ablation in non-resectable secondary liver tumors].

The authors evaluate their initial experience with a newly introduced ablation method--radiofrequency ablation (RFA) in non-resectable liver metastases. Within an 11-month interval (February-December 2001) the authors made a total of 20 RFA. A total of 37 hepatic secondaries were destroyed. There was only one complication--suppuration in the surgical wound. The success rate of the method was 90%.

Adult↗
PubMed2001

[Stromal tumor of the small intestine--a cause of massive gastrointestinal hemorrhage].

A 41-year-old man attended our clinic with massive gastrointestinal bleeding due to a tumor of the small intestine. The tumor was not diagnosed until during acute laparotomy. The histological examination revealed a gastrointestinal stromal tumor with uncertain biological behaviour. The authors discuss the rare gastrointestinal stromal tumors, where preoperative diagnosis is difficult and in symptomatic forms urgent laparotomy is usually the only diagnostic method. The differential diagnosis between leiomyoma, schwannoma, mesenterial fibromatosis or intraabdominal solitary fibrous tumor as well as metastatic melanoma is not simple and immunohistochemistry plays a leading role. Prediction of biological behaviour of these tumors is also problematic and depends on the histological picture, site, size and mitotic activity.

Gastrointestinal Hemorrhage↗