Biomedical subjects
Publications and source records attributed to C Neoral.
Reflux oesophagitis does not represent only an isolated collection of symptoms affecting the patients' quality of life but the risk of serious complications including the benign stenosis and carcinoma of oesophagus, too. Barrett's oesophagus (BO) has the highest risk for development of the neoplasia due to reflux oesophagitis.
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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.
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 evaluated in a group of 25 patients after radical lung resection on account of a non-small cell carcinoma the correlation between tumour grading, invasion into lymphatic and blood vessels, proliferation markers (Ki-67, PCNA), ploidy, cell polymorphism and mitotic cell activity of the lung tumour and the lymphogenic or haematogenic metastatizing proved before or during surgery. From the investigation patients after induction chemotherapy were eliminated. It was of interest that the great majority of investigated parameters was positive or elevated in patients with lymphogenic or haematogenic metastases. Conversely in patients where the majority of these parameters was negative on the day of the operation, no metastases were detected. In the group of patients where the investigated indicators were positive and no metastasis was found, similarly as in both previous sub-groups, the author will continue to follow-up the following: recurrence, median survival and five-year survival. From the assembled parameters a table was prepared stratifying the risk of metastases.
Spontaneous rupture of the oesophagus (Boerhaave's syndrome) is a life threatening disease the successful treatment of which depends on early diagnosis and effective comprehensive treatment. The authors present an account on three patients who were successfully treated on account of spontaneous rupture of the oesophagus.
In 1991-1999 the authors performed at the First Surgical Clinic of the Faculty Hospital in Olomouc extirpation of the oesophagus on account of carcinoma in 133 patients. This number comprised only four patients with a tumour in its early stage. In all these instances an adenocarcinoma in Barrett's oesophagus was involved. The authors emphasize, that the generally poor prognosis of patients with carcinoma of the oesophagus is influenced to a considerably extent by its late diagnosis. The finding of carcinoma of the oesophagus in the early stage of the disease is usually possible only in case of malignization of Barrett's oesophagus. This is the reason why Barrett's oesophagus should be dealt with only in specialized departments concerned with diseases of the oesophagus in general.
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In a group of 20 patients the authors evaluate possibilities of reconstruction of the digestive tract after TGE from the aspect of quality of life. The evaluating criterion are subjective complaints, the necessity to restrict the volume of meals and evaluation of the gastric substitution. The authors did not find a significant difference between reconstructions using a Roux loop and bilateral interposition of a jejunal loop between the oesophagus and duodenum, while the consider the creation of a reservoir very beneficial for the patient.
The authors evaluate the effectiveness of palliative treatment of inoperable oesophageal stenoses by means of self-expandable stents in a group of 102 patients and discuss complications. In all patients after implantation of the stent dysphagia improved by at least two degrees. Eighty nine patients of the group died, the mean period of survival was 107 days. At the time of evaluation 13 patients survive, the mean survival period being 175 days. As to complications the authors recorded incomplete expansion of the stent (n = 1), fissuring of the tumour (n = 1), migration of the stent (n = 8), oesophagorespiratory decubital fistula (n = 4), ingrowth of the tumour into the stent (n = 4), obstruction of the stent by food (n = 7) and arterial haemorrhage (n = 1). The effectiveness of palliative treatment of inoperable oesophageal stenoses by self-expanding stents is high and prompt. The total number of complications is 22%, the mortality after surgery is zero. The majority of complications is easily resolved by methods of interventional radiology.
The authors submit a group of 17 patients with benign hepatic lesions operated during the past five years. Most frequently haemangiomas were encountered, less frequently adenomas and focal nodular hyperplasia. It was revealed that accurate diagnosis is possible even when sonography, CT, MRI and even scintigraph (SPECT) are used only in haemangioms. When indicating surgery the clinical symptomatology, uncertain diagnosis and difficulty and risk of surgery itself must be taken into account.
The increase of organ transposition ill tile reconstruction of digestive tract, particularly transposition of the stomach and colon, is essential ill gullet surgery. The transposition is always accompanied by certain bigger or less degree of ischemia. In this study the authors followed the biochemical markers of tissue ischaemia, capable to lay down both pre- and postoperative vitality of the tucked organ an the anastomosis. Disclosing of the initial and later stadium of intestine ischemia is tile aim. Monitoring of the lactate in the serum is very useful. Its using was proved in the rich experimental group and it was certified in clinical practice.
The possibilities of invasive diagnostic procedures and their place in examination schedule are evaluated in a group of 36 patients. Authors point out the need of close inter-discipline cooperation. They highly appreciate accuracy and reliability of mediastinoscopy and videothoracoscopy, on the other side they show possible complications and contraindications of these procedures.
In a group of 56 patients with inoperable carcinoma of the esophagus treated at the authors' department during the last five years the authors analyse the possibilities of palliative treatment of dysphagia. As a criterion of success they consider life-long restoration of comfortable swallowing achieved during short-term hospitalisation with rapid return of the patient to home care. In the authors' opinion none of the methods is universal. Therefore it is important that a patient with carcinoma of the esophagus should be treated in a department which is familiar with the whole range of the problem.