Biomedical subjects
Publications and source records attributed to Z Novák.
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.
Biopsies of orbital tumours are made as a rule by the classical surgical approach. In a 82-year-old risk patient the authors chose, however, the stereotactic method of collection of pathological tissue from the orbit and this non-traditional procedure, using special instruments, proved unpretentious and successful.
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.
The aim of the study was to evaluate the possibility of detecting thyroid cancer recurrences without the need for withdrawal of thyroid suppressive treatment. Upper-body or whole-body scintigraphy was performed in a group of 200 patients evaluated for differentiated thyroid cancers in 1993 and 1994 using technetium-99m sestamibi. Scans were performed 20-30min following i.v. administration of 500MBq of 99mTc-methoxyisobutylisonitrile (MIBI). Bone and lung metastases were detected with very high sensitivity and specificity, with a very high predictive value of negative results and a somewhat lower predictive value of positive results. The sensitivity and specificity of findings in the neck were lower but the predictive value of negative results was high. Whole-body scans with 99mTc-MIBI are a useful tool in the follow-up of patients with differentiated thyroid cancer, for the detection of distant metastatic lesions.
From a group of 134 patients with complete documentation before goitrectomy the authors selected 10 histologically defined cases of (A) simple colloid nodular goitre, (B) toxic parenchymatous goitre type GB and (C) autoimmune thyroiditis. Marked hormonal suppression was achieved in group B by thyrostatic therapy, as compared with A and C, the autoantibody titres (TGAb and TMAb) differentiated the groups. The authors examined the interleukin 6 concentrations and those of its soluble receptor (IL-6, IL-6R), of the tumour necrotizing factor alpha (TNF-alpha) interferon gamma (IFN-gamma) and of adhesion molecules ICAM-1 and VCAM-1. Plasma values were, except for not very significant differences, similar in all groups and ruled out a marked effect on tissue levels. The most remarkable finding in the homogenate of a peroperative excision were low IL-6, IL-6R and adhesion molecule values in group A, as compared with B and C and the absence of differences in TNF-alpha values between groups and in particular markedly higher IFN-gamma values in group B which supports theories on the etiopathogenetic role of this cytokine in GB disease. The pilot study is part of the preparation of in situ hybridization of mRNA for diagnostically usable cytokines.
In earlier studies of authors on acute and intermittent human pancreatitis it appeared that oxygen radicals may have important role in inflammations of pancreas. Therefore, detailed and systematic studies have been started in order to understand the rheological characteristics of human red blood cells (RBCs), antioxidant enzymes and other antioxidant parameters in clinically serious acute pancreatitis. Measurements of antioxidant system of blood, plasma and haemolysates have indicated prooxidant preponderance, and have apparently well reflected the "oxidative stress" conditions of the organism.
99Tcm-tetrofosmin imaging was performed in 23 thyroid cancer patients and compared with whole-body 131I scans, neck ultrasonography and plasma thyroglobulin levels. Of 22 patients with differentiated thyroid cancer, 8 showed identical images on 131I scan and tetrofosmin; 1 patient with medullary cancer had identical images with 99Tcm-DMSA and 99Tcm-tetrofosmin, the findings being confirmed by sonography. The potential usefulness of 99Tcm-tetrofosmin imaging in the follow-up of thyroid cancers is discussed.
A description is given of the bioactive glass-ceramic material, BAS-O, and of clinical tests of this material in stomatology. Granules of BAS-O bioactive glass-ceramic were used for implantation into cyst cavities in jaw bones. Radiological examination was carried out after 3, 6 and 12 months. A total of 37 radiographs of 23 patients were recorded and evaluated. Symptoms of ossification were found in 28 cases (75.7%), while five radiographs (13.5%) did not show visible bone apposition and loss of the BAS-O granules from the operation site was found in four cases (10.8%). The authors have demonstrated the excellent healing properties and tolerance for the BAS-O material, and no significant changes were observed in biochemical and haematological examinations.
The elevated antibody level against receptors for TSH assessed by the commercial set TRAK (Henning Berlin) supports the diagnosis of endocrine orbitopathy (EO) which is important in more complicated cases with unilateral EO or EO in euthyroid or hypothyroid patients. During treatment of EO by elimination of the thyroid with radioiodine 131I (with or without previous thyroidectomy) a decline of originally high TRAK values to normal suggests successful elimination. Persistence of high TRAK values is associated with a poorer therapeutic effect of elimination and reasons for this should be sought. In four of 26 such patients the authors found radioiodine accumulation in the residual thyroid tissue, in 8 patients they found a non-accumulating residue by means of sonography. In 14 patients within two years after administration of the radioiodine elimination dose a residue of the thyroid gland was not found by scintigraphy nor by sonography. Improvement of the therapeutic effect occurred in one of these subjects with a drop of the TRAK value after the 30th month following elimination, in another female patient after a high diagnostic radioiodine dose. Improvement of the protrusion after radioiodine treatment with or without previous incomplete thyroidectomy and was recorded in 33 subjects where a drop of the originally high level of TRAK antibodies occurred was significantly greater than in subjects where the TRAK values did not decline.
In 1991-1992 in the Czech Republic an epidemiological survey was conducted focused on prevention of iodine deficiency and the incidence of some thyropathies. The authors examined samples of the Prague and Vsetín population selected at random. The clinical examination comprised also somatometric assessment. In a group of 1,100 subjects from Prague and Vsetín anthropometry of basic somatometric characteristics was performed (height, body weight, BMI and four skinfolds). From comparison of the two groups ensues that the Vsetín population is shorter, as compared with the Prague population, the BMI values are significantly higher and so is the percentage of subcutaneous body fat.
The bioactive glass-ceramic material BAS-0 and results of clinical testing of this material in stomatology are described. The granules of bioactive glass-ceramic BAS-0 were chosen for implantation into cyst cavities in jaw-bones. Radiological evaluations were carried out after 3, 6 and 12 months. Altogether 37 radiographs of 23 patients were evaluated. The symptoms of ossification were proved in 28 cases (75.7%), 5 radiographs (13.5%) were without visible apposition of the bone and in 4 cases the loss of the BAS-0 granules from operation wound was observed (10.8%). The authors proved very good healing properties and tolerance of BAS-0 material, no significant changes in biochemical and haematology examinations were observed.
Despite the knowledge of immunological mechanisms of Graves-Basedow's disease the pathogenesis of endocrine orbitopathy remains obscure. Apart from the most frequent association with GB disease it may occur also in patients with primary hypothyroidism, Hashimoto's thyroiditis or in rare instances in euthyroid patients not suffering from thyroid disease. Endocrine orbitopathy is a typical example of a disease with a multidisciplinary approach to its diagnosis and treatment. In the submitted paper the authors demonstrate the collaboration of four clinics of the Faculty Hospital when dealing with this problem. Complete or almost complete removal of the thyroid gland leads within 1-4 years to regression of the protrusion of the bulbus by 1 mm. In combination with decompression of the orbit by a modification of Ogura's and Walsh's method improvement of visual acuity by 50% was achieved and the mean value of the exophthalmus diminished by 3.5 mm.
Changes of the locomotor apparatus in prolonged uraemia with regular dialyzation treatment determine the quality of life with all its consequences for the patient. The greatest impact on osteodystrophic disease (the most typical finding on the skeleton) is exerted by the length of dialyzation treatment. Of 216 patients having regular dialyzation treatment in 1979 to 1992 the authors observed osteodystrophic disease in 25, i.e. 11.6%. As to other most frequently observed changes they recorded osteoporosis in 12.9%, only very rarely osteomalacia and even osteopetrosis (1.8%). Carpal tunnel syndrome was recorded in 17.4% as a symptom of so-called dialyzation amyloidosis and in one man they observed the development of typical rheumatoid arthritis shortly after the onset of haemodialyzation. This is a rare observation not described in the literature so far. Crystalline arthropathy, incl. typical attacks of gout, were recorded only in 11 patients (5%). Changes on the locomotor apparatus in conjunction with irreversible renal failure with regular dialyzation treatment were recorded in 45%. It is important to differentiate findings which are not associated with uraemia and haemodialysis. This applies in particular to osteoarthritis deformans of the joints and spine. In major uraemic changes participates in particular secondary hyperparathyroidism. These changes comprise in particular osteolysis or even spontaneous absorption, erosive changes and destructive spondylopathy. Contemporary findings on the locomotor apparatus are so varied that they must be classified.(ABSTRACT TRUNCATED AT 250 WORDS)
Explore the source record for details and available documents.
In order to assess the contribution of individual steroidogenic organs to over-all steroid biosynthesis, the basal plasma levels of six hormonal steroids, reflecting the function of gonads and adrenals, as well as both gonadotropins and prolactin, have been determined in 63 oligo- and/or asthenozoospermic men with palpable varicocele, confirmed in each case by sonography. The values obtained were compared with the results of a group of age-matched normospermic men without endocrine disorders. Insignificantly lower levels of testosterone accompanied by significantly lower levels of dihydrotestosterone, slightly decreased LH but increased FSH undistinguishable concentrations of cortisol in patients with varicocele were in agreement with previous findings. Higher levels of an exclusively adrenal androgen 11 beta-hydroxyandrostenedione in men with varicocele indicate increased activity of the adrenal cortex. Significantly higher basal levels of 17 alpha-hydroxyprogesterone in the patient group (p < 0.001), so far not unequivocally proved, evidence for suggested decreased enzyme activity of C17-20 lyase in the testis in at least some of men with varicocele.
Based on clinical experience on the rising incidence of some thyropathies in our population, the authors examined a random sample of the Prague population. They assessed and evaluated iodinuria, the sonographic finding of the thyroid gland, the palpation finding of the thyroid and a clinical examination which comprised a detailed case-history (a questionnaire checked during the examination) and a clinical and anthropometric examination. The results indicate that iodinuria (which reflects the iodine intake) reaches the recommended optimum (above 150 micrograms iodine/l) only in 11.4% of boys, 14% men, 6.3% girls and 5.4% women. A quite inadequate intake (less than 50 g iodine/l) was recorded in 13.2% boys, 15.2% men, 17% girls and 33.1% women. When evaluating the thyroid volume, an enlarged volume is found in 20.4-58.3% and on evaluation by palpation pathological changes are found in a considerable proportion of the examined population. The findings suggest that the iodine supply of the Prague population is inadequate and the incidence of abnormal findings on the thyroid gland is high. It will be necessary to verify these findings in other random population samples from other localities. If the adverse position will be confirmed, this will call for an urgent solution, i.e. a better iodine supply of the population.
Surgical removal of the thyroid gland in Graves-Basedow's disease has, beyond doubt, also a major effect on endocrine orbitopathy. After total or near-total removal of the thyroid gland after three months a slighter deterioration or even ameloriation of ocular protrusion is found, contrary to the effect of subtotal thyroidectomy. There exists a significant correlation between the volume of the residual gland evaluated according to 24 h-uptake of 131I, and between the regression of the protrusion (r = 0.385, p < 0.01). Total or near-total thyroidectomy alone even in the absence of other therapeutic methods leads after 1 to 4 years to an average regression of the protrusion by 1 mm which matches the results of prednisone treatment, if the latter is used as the sole treatment. Orbital decompression by the modified method of Ogura and Walsh led in patients treated concurrently with prednisone and thyroidectomy to improvement of the visual acuity on average by 50% (from the range of 0.008 to 0.33 to values from 0.4 to 1.0) and to regression of the protrusion on average by 3.3 mm. When determining the time of operation of the oculomotor muscles, in addition to the unchanged ocular finding also the echographic picture in sectorial visualization proves useful.
Antioxidant nomination covers a substance group of great variety, therefore, the determination of action mechanism of new antioxidants requires a complicated test system. The present work demonstrates this labour and time consuming procedure conducted on human red blood cells (RBCs) exposing them to "stress effect" with diluted hydrogen peroxide. It was studied how did these oxidative stress conditions affect the filtration parameters, lipid peroxidation, reduced glutathione content and superoxide dismutase activity of RBCs. It was attempted to reverse or influence the significant changes caused by "oxidative stress" with known antioxidants (vitamin E and uric acid).