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Biomedical subjects

Z Gregor

Publications and source records attributed to Z Gregor.

At least 19 recordsLinked to original sources
PubMed2006

[Rupture of the renal artery aneurysm in a patient with symptoms of a systemic connective tissue disorder--A case review].

The renal arteries aneurysms are relatively rare, however, their rupture has a high mortality rate. The authors present a case-review of a 38-year old female, hospitalized with a pain in the left lumbar region, lasting for 24 hours, which spread into the mesogastrium and the left groin. Upon angiographic examination, the left renal artery aneurysm was detected. Embolization was conducted, aiming to save the kidney, however, it proved unsuccessful and was complicated by a rupture of the aneurysm. Consequently, urgent nephrectomy was completed. Prior to the procedure, massive haemorrhaging from the right groin following angiography, was managed. Relapsing haemorrhaging from the right groin and development of a major retroperitoneal haematoma, complicated the postoperative course and required repetitive postoperative revisions. The accidental finding of a minor aneurysm of the lienal artery, the patient's constitution, her anamnestic data and the complicated course of hospitalization, suggested the systemic connective tissue disorder. Furthermore, the authors discuss contemporary diagnostic and therapeutic approach to the renal arteries aneurysms.

Adult↗
PubMed2005

[Management of infection after aorto-femoral arterial reconstruction].

Arteficial vascular graft infection pertains to the most serious complications in vascular surgery. No satisfactory treatment of implant infection is known yet. The only solution is still explantation of the prosthesis with hard complications for the patient leading in many cases to loss of the limb or even to death of the patient. With the example of two patients the article shows our contemporary approach to solution of vascular prosthetic infection in the aorto-femoral region. The emphasis is put on preserving of the lower extremity vascular supply after removement of the infected reconstruction.

Aged↗
PubMed2004

[The subclavian steal syndrome].

The aim of this work is to summarize the authors' experience gathered during surgical procedures for the subclavian steal syndrome. The authors put forward the method of anaesthesia with patient's vigility and mobility preserved, favouring the arterial transposition procedures against the prostheses implantation methods. The main common feature of the above approaches is to increase the procedure's safety.

Female↗
PubMed2002

[Developments in surgery of the extracranial circulation--findings from a vascular surgery department].

The objective of the paper is to summarize hitherto assembled experience of the department with the application of new approaches to reconstruction operations of the extracranial circulation with emphasis on its most important part, i.e. the carotid circulation. The main feature of this approach is an effort to increase the safety of the operation for the patient at risk which implies among others extension of indications for reconstruction surgery.

Adult↗
PubMed2001

Neovascular age-related macular degeneration: present and future treatment options.

PURPOSE: To review treatment strategies in neovascular age-related macular degeneration (ARMD). METHODS: Medline and Embase search. RESULTS: Age-related macular degeneration (ARMD) is the commonest cause of blindness in the developed world in individuals over 50 years of age. ARMD may lead to loss of vision by atrophy of the retinal pigment epithelium or by the development of choroidal neovascular membranes (CNVM) under the macula, which leak serous fluid and blood and ultimately cause a blinding disciform scar. Treatment options currently being investigated fall into three main approaches: elimination of the CNVM from the subfoveal area (by laser or surgery), modification of the CNVM (by laser, radiotherapy or chemotherapeutic agents) or lastly prevention of the formation of CNVM (by laser prophylaxis, diet or gene targeting). Whilst almost no therapy restores normal visual acuity, any significant visual improvement over the natural history may be regarded as beneficial. CONCLUSIONS: Both the current and immediate future potential therapies for choroidal neovascularisation in ARMD require considerable advances to be made before they will make any impact on blindness caused by ARMD. Of the current treatments none are curative and the treatment benefits are small. There is an urgent need for new therapies.

Aging↗
PubMed2001

Surgery for idiopathic macular holes associated with extensive subretinal fluid.

PURPOSE: To study the baseline characteristics and outcomes of surgery for idiopathic macular holes associated with localized macular detachment. METHODS: In this case-control study, eight consecutive patients with idiopathic macular hole associated with localized macular detachment (cases) and 30 randomly selected patients with idiopathic macular hole not associated with macular detachment underwent macular hole surgery. RESULTS: The mean age (62.1 versus 68.2 years; P = 0.086), mean refractive error (-0.13 versus +0.23 diopters; P = 0.68), average duration of symptoms (5.9 versus 4.6 months; P = 0.47), and macular hole stage (P = 0.43) were similar in the cases and controls. The baseline visual acuity ranged from 20/50-20/80 (1 [13%] versus 1 [3%]) to 20/100-20/200 (2 [25%] versus 24 [80.0%]) to < 20/200 (5 [63%] versus 5 [17%]) (P = 0.10). Single-operation anatomic success was achieved in 2 (25%) cases and 24 (80%) controls (P = 0.007). Visual acuity 3 months after the last macular hole surgery was worse in cases compared to controls: > or = 20/40 in 0 versus 6 (20%), 20/50-20/80 in 1 (13%) versus 13 (43%), 20/100-20/200 in 4 (50%) versus 10 (33%), and < 20/200 in 3 (38%) versus 1 (3%) (P = 0.003). The mean improvement in visual acuity was 0.2 logMAR units in cases versus 0.4 logMAR units in controls (P = 0.054). CONCLUSIONS: Surgical outcomes for idiopathic macular hole associated with a localized macular detachment compare poorly with the outcomes for macular hole not associated with extensive surrounding subretinal fluid.

Adult↗
PubMed2000

Repair of late retinal detachment after successful treatment of retinoblastoma.

PURPOSE: To analyze the results of vitreous surgery for late retinal detachment (RD) after successful treatment of retinoblastoma. METHODS: The records of all patients with retinoblastoma seen at a single ocular oncology service between 1982 and 1998 were reviewed to identify patients treated for late RD. Previous treatments, characteristics of the RD, surgical techniques used, and visual and anatomic results of the surgery were recorded. RESULTS: Of more than 500 charts reviewed, four patients treated for late RD were identified. All four had received previous, whole-eye, external beam radiotherapy and subsequently required cataract surgery. Other previous treatments included radioactive plaque, cryotherapy, xenon photocoagulation, and chemotherapy. At presentation, some patients had shifting subretinal fluid. None had a tear identifiable preoperatively, but two patients had a definite small slit tear at a tumor edge identified at surgery. One patient had a primary scleral buckle that failed. All patients had vitreous surgery with silicone oil. Average postsurgical follow-up was 30 months. Preoperative visual acuity ranged from 20/80 to light perception and improved postoperatively in two patients. The retina remained completely attached in three patients. CONCLUSIONS: Despite shifting subretinal fluid and no identifiable tear, a rhegmatogenous RD should be considered if it occurs late in patients with otherwise stable, treated retinoblastoma. Tumor reactivation must be excluded carefully. Vitreous surgery can be used to repair the RD successfully and improve vision.

Child, Preschool↗
PubMed2000

Ruptured abdominal aortic aneurysm--outcomes in the last ten years.

Ruptured abdominal aortic aneurysm (AAA) remains to be represent a common and highly lethal problem. We reviewed the records of 92 patients (73 men and 19 women) operated on for ruptured infrarenal AAA within the past 10 years (January 1989 to October 1999) in the 2nd Department of Surgery in Brno, Czech Republic. The mean age was 71 years (range 57 to 92 years). Only 10 patients (10.9%) were known to have an AAA before the rupture. Preoperative systolic blood pressure below 90 mmHg was present in 70 patients (76%) and 15 patients (16.3%) experienced cardiac arrest before surgery. The in-hospital mortality rate was 47.8% (44 patients). Among the total of 92 patients, haemoperitoneum was discovered only in 30 patients (32.6%) with the mortality rate of 40% (12 patients). In 62 patients (67.4%) also hemoperitoneum was present, the mortality rate was 51.6% (32 patients) in these patients. Multiorgan failure due to an irreversible hemorrhagic shock was the main cause of death in 23 patients (25%). Further causes were: heart failure--8 patients (8.7%), pulmonary complications--5 patients (5.4%), renal failure--4 patients (4.3%), bleeding--3 patients (3.3%), and sepsis--1 patient (1.1%). The patient's prognosis depends on early diagnostics and on the quality of peroperative and postoperative care. (Tab. 2, Ref. 8.)

Aged↗
PubMed2000

[Ischemic disease of the lower extremity and lumbar sympathectomy].

We consider lumbar sympathectomy (LSE) to be the last attempt to improve the condition of the limb. Though being aware of inconsistent opinions on LSE, we are not opponents of this method, particularly if it is carried out in a selected group of patients, that is in case of: 1) treatment of frostbites, 2) treatment of patients at an early stage of advanced ischemia whose main symptom is moderate night pain at rest, 3) desiccation of chronically moist ulcerations between the toes, 4) treatment of patients with reflex symptomatic dystrophy (causalgia), 5) Buerger's disease.

Female↗
PubMed2000

[Ruptured abdominal aortic aneurysms].

The authors present the results of a retrospective study concerning 96 patients with an abdominal aortic aneurysm rupture who underwent surgery in the 2nd Department of Surgery in Brno in the time period from 1989 to 1999. In 30 cases (31.2%) there was an isolated retroperitoneal rupture, 66 patients (68.8%) also had haemoperitoneum. The mean age of the patients was 74 years and the male/female ratio was 76 (79.2%): 20 (20.8%). Twelve patients (40%) did not survive the retroperitoneal rupture, and 34 patients (51.5%) did not survive the intraabdominal rupture. Total mortality in the study group was 47.9%. The type of the rupture and the size of the haematoma that is in correlation with the time of diagnosis and operation, are among the most decisive prognostic factors. Patients with a small haematoma show higher survival rates. In large retroperitoneal haematomas accompanied by a haemorrhagic shock, the mortality was about 40% in the presented study group, in intraabdominal ruptures the mortality rate increases to values over 50%. The results are in accordance with foreign literature data, and the authors agree with the opinion that haemodynamically unstable patients with suspected abdominal aortic aneurysm rupture should be, after necessary preparations, urgently operated without complementary examinations.

Aged↗
PubMed1998

Surgical removal of non-age-related subfoveal choroidal neovascular membranes.

PURPOSE: To assess anatomical and visual results following the surgical removal of non-age-related subfoveal choroidal neovascular membranes. METHODS: A retrospective study was carried out of 31 consecutive patients undergoing vitrectomy, parafoveal retinotomy and removal of subfoveal choroidal neovascular membranes that were either idiopathic or associated with multifocal choroiditis, high myopia, trauma or angioid streaks. RESULTS: Visual acuity improved or remained the same in 25 eyes (81%) after a mean follow-up of 10.1 months (range 3-37 months). visual acuity improved by more than 2 lines of Snellen acuity in 5 eyes (16%) and decreased by more than 2 lines in 2 eyes (6%). There was no significant association between the final visual outcome and length of symptoms prior to surgery or pre-operative visual acuity. Atrophy of the retinal pigment epithelium and older age were associated with poor outcome. Membranes recurred in 11 eyes (35%), and eyes with subfoveal blood prior to surgery were more likely to have recurrent membranes. CONCLUSIONS: The results of surgical removal of non-age-related subfoveal neovascular membranes have been encouraging, but further studies of long-term outcome and of the natural history of individual conditions are required.

Adolescent↗
PubMed1998

Increased expression of placenta growth factor in proliferative diabetic retinopathy.

Proliferative diabetic retinopathy is thought to be mediated by the hypoxic regulation of angiogenic growth factors, in particular the vascular endothelial growth factor (VEGF) family. The aim of this study was to determine if placental growth factor (PIGF), a recently identified member of the VEGF family, was expressed in diabetic eyes undergoing preretinal neovascularization. Rabbit anti-PIGF antiserum was raised using a 20-amino acid N-terminal sequence to PIGF and did not cross react with VEGF165. Immunohistochemistry was performed on specimens of normal retina (n = 8), diabetic retina in the absence (n = 7) and presence (n = 4) of proliferative retinopathy, scatter laser-treated diabetic retina (n = 7), excised fibrovascular preretinal membranes (n = 12), and nondiabetic fibrocellular epiretinal (n = 7) membranes. PIGF levels were also determined in vitrectomy specimens from patients with either proliferative diabetic retinopathy or macular hole. PIGF immunoreactivity was intensely localized to the endothelial and perivascular regions of newly formed blood vessels of excised fibrovascular preretinal membranes. Intense localization of PIGF protein was also observed in superficial retinal vessels in diabetic retinae adjacent to neovascular preretinal membranes. Localization of PIGF was weak or absent in diabetic retinae that showed no evidence of neovascular proliferation. PIGF protein was also absent in normal retinae, in diabetic retinae that had received extensive treatment with scatter laser photocoagulation, and in nonvascularized epiretinal membranes. PIGF was present in all diabetic vitreous samples (mean 103 pg/ml) but nondetectable in control samples. These results strongly implicate a role for PIGF in the pathogenesis of proliferative diabetic retinopathy.

Adult↗
PubMed1998

[A knit vascular prosthesis of RaK collagen--a clinical evaluation study].

Vascular collagen prosthesis of RaK type (collagen-impregnated knitted prosthesis) made by Výzkumný ústav pletarský (Research Institute of Hosiery) in Brno was introduced into clinical practice in 1990. In comparison with previous type, the collagen-impregnated prosthesis has had a number of advantages and thus it gets into the interests of vascular surgeons. The report presented has given the results of clinical evaluating study carried out at the IInd Clinic of Surgery, Faculty of Medicine, Masaryk University, Brno according to the methods of EN 540 European Norm Proposal for clinical studies. The results obtained from evaluating a set of 107 patients created for this study (besides others, long-term patency of 90.7%, or 0.9% incidence of infection of the vascular prosthesis of Szilagyi III type) have shown that nowadays we have at disposal a very good, reliable and economically acceptable vascular prosthesis of our provenience.

Blood Vessel Prosthesis↗