Biomedical subjects
Publications and source records attributed to Z Chudácek.
The authors report their three-year experience with application of thrombolytic treatment in 31 patients with vascular occlusions of the lower extremities. They were successful in two thirds of the patients. The authors analyze the advantages and shortcomings of systemic or selective administration of antithrombotic therapy. Concurrent administration of hyperbaric oxygen is a rational therapy.
Explore the source record for details and available documents.
A significant increase not only in the number of operations for AAA but also in the incidence of autopsy findings of AAA from 1.5 per cent to 4.5 per cent has been observed during the last 20 years. Ultrasound screening of the abdominal aorta in patients examined for other reasons revealed asymptomatic dilatation of the infrarenal aorta to more than 4 cm in 3.8 per cent of men older than 60 years. AAA should be actively searched for at every physical and ultrasound examination of the abdomen in men over 60 years of age.
Rational antithrombotic treatment in vascular occlusions is a marked advance in the therapeutic results, incl. reduced mortality. The prerequisite of success is early adequate thrombolytic or anticoagulant treatment taking into account absolute and relative contraindications. Despite this it is necessary to foresee the risk of haemorrhagic complications and orientate diagnosis with the aspect in mind. As an example three case-histories are presented, their common sign being haemorrhage into the lower extremities during antithrombotic treatment. Attention is drawn to the difficulty of differential diagnosis of venous thrombosis and haemorrhage into muscles or intermuscular spaces where at a given site computer tomography is a great asset. In the treatment in addition to surgical intervention in particular hyperbaric oxygen therapy proves useful.
The author detected a traumatic prolapse of stomach into thorax cavity. The X-ray examination was made only after ultrasonography. Two days after the operation, which confirmed the sonographic finding, symptoms of ileus became evident. The following ultrasonographic finding proved to be very similar to that made before the operation. A relapse of the prolapse was assumed to have occurred, but was not confirmed by a new operation. Since the X-ray examination of the stomach two months after the operation revealed a hiatus hernia, the author is of the opinion that a sliding hernia may have been cause of the erroneous diagnosis of the prolapse relapse.
The authors compared thermographic findings of hands in two groups of apprentices (average age 15 and 16 years) with a group of students (average age 21 years) and a group of young workers (average age 29 years). There was a highly significant difference in the number of cold hands before and after vibration test in the apprentices and adults (29 years). The authors arrive at the conclusion that 1) thermoregulation reaches its final shape only after 20 years of age, 2) in the apprensitive thermographic finding must be verified by regular thermographic control examinations.
Focal fatty liver in 2 females is described. In the first patient with an increasing stenosis of the d. hepaticus com., a transitory focal fatty liver was found. In the second patient a durable focal liver steatosis in a form of a lipom (-30 HU) was covered.
The authors evaluated a group of 78 patients where in addition to radionuclide venography (RNV) also X-ray phlebography was used (RTGF) within a time interval of not more than 72 hours. The results of 102 examinations were compared, 276 areas were correlated at six different sites. Agreement was recorded in 249 instances (90%), a false negative finding in 23 (8%) and a false positive finding in 4 (2%). Sensitivity was low in the area of the calf (55%), high in the femoral area, iliac area and in the area of the inferior vena cava (92-100%). The specificity was in all areas, incl. the calf, relatively high (94-100%). The investigation revealed the disadvantages of RNV--a low reliability in the area of the calf, the impossibility to detect small and parietal thrombi, the inability to assess the "activity and age" of the thrombus, the more difficult interpretation in insufficiency of venous perforators, and advantages of RNV--a great reliability at higher parts of the venous system and after administration of radiopharmaceutical preparations (RF) into peripheral veins, the possibility of simultaneous examination of pulmonary perfusion without further administration of RF, a low failure rate of intravenous administration of RF (less than 2%); RF do not irritate the venous endothelium and therefore thrombosis cannot develop; in case of paravenous escape of RF local inflammations do not develop, the radiation load is low, there is a small probability of allergic reactions, the method is non-invasive, it can be frequently repeated and used for the follow-up of treatment.
In a seven-month boy the authors diagnosed a concretion in the choledochus cyst and cystic dilation of intrahepatic bile ducts by ultrasonography. The finding was verified by surgery.
With conventional radiography and with CT several malformations were detected in a dicephalus masculinus. The most important were: 2 spinal medullas in a common spinal canal (TH1 to L4), hydrocephalus of both lateral ventricles and of the third ventricle, prolaps of the left hepatic lobe into the left thoracic cavity, two aortic arcs, one large internal jugular vein, and twin bases of the vertebrae TH1 to L5. The dicephalus had not only a double head, but also two cervices connected by a falx.
The author investigated the effects of vibration, 125 Hz, on blood supply of hands in 43 healthy students. The temperature of fingers was followed by thermovision camera, the source of vibrations was a specially constructed vibration simulator which enabled to change vibration frequency. Thermographic recordings were made before the vibrations, immediately after the vibrations, 30 and 60 min. after the vibrations, respectively. Maximum temperature changes were always observed 60 min. after the vibrations. The temperature gradient 3-5 degrees C between the back of the palm and the fingers was demonstrated 60 min. after the vibrations in five healthy students (11%), although there was not any temperature gradient before the vibrations there. The negative finding lasted even in repeated examinations, the positive one was sometimes of different nature.
Explore the source record for details and available documents.
In 47 patients with clinically suspected pulmonary emboli CT and scintillation tests were performed. Our result is, that in case of defects in the a. pulmonalis filled with contrast medium and pronounced CT-signs of pulmonary infarction embolization is likely even for a negative or unclear outcome of the scintillation tests.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The authors present a case report on a 60-year-old female patient suffering from benign mediastinal cyst, arterial hypertension and porphyria. CT-guided transparietal fine-needle punction was done simultaneously as a diagnostic and a therapeutic procedure. Partial regression of the cyst was still apparent at the check CT investigation after six months. The examination of the level of immunoglobulins in the fluid obtained during transparietal punction confirms the diagnosis of bronchogenic cyst.
Explore the source record for details and available documents.