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Biomedical subjects

J Fanta

Publications and source records attributed to J Fanta.

At least 19 recordsLinked to original sources
PubMed1999

[Percutaneous localization and marking of small solitary pulmonary nodules in CT imaging before video thoracoscopy surgery].

BACKGROUND: The localization of small lung nodules by palpation is not possible when videothoracoscopic surgery is performed. Transparietal fine needle biopsy is frequently not successful in small lung nodules. METHODS AND RESULTS: The authors describe their experiences with percutaneous CT controlled marking of small lung parenchyma around small lung nodules by patent blue and contrast medium mixture. The method was used in 7 patients with nodule size from 7 mm to 25 mm. In all patients the surgeon was able to localize the nodule. Operation followed localization as soon as possible, the interval was from 60 to 120 minutes. Four of 7 nodules were benign, 3 nodules were malignant. CONCLUSIONS: New method of marking of small lung nodules makes a minimal invasive operation possible. The operation stress is lower and the time of hospitalization is shorter.

Coloring Agents↗
PubMed1999

[Myogenic tumors of the digestive tract].

BACKGROUND: Myogenic tumours of the digestive tract are not very frequent. Most often they are found in the stomach, less frequently in the colon and rectum. Many are symptom-free and are an incidental finding on examination or surgery. Treatment is surgical and the type and extent depends on the type, size, site and spread of the tumour. The objective of the submitted paper is to present a group of patients and to confront the findings with those of other authors. METHODS AND RESULTS: In the course of ten years (1992-1996) the authors diagnosed a myogenic tumour of the digestive tract only in 10 patients. Seven patients were males, three females, mean age 64 years (range 46-89 years). The most frequent symptoms were haemorrhage into the GI tract (6x), abdominal pain (4x), palpable resistance in the abdomen (2x), subileus (1x). Most frequently the stomach was affected (7x) and the small intestine (3x). From the histological aspect the tumour was qualified as benign only 3x (site stomach, leiomyoma). Seven times the tumour was malignant (4x stomach: leiomyoblastoma, 3x small intestine: leiomyosarcoma). Five times surgery was curative, 3x palliative, 2x only explorative. At present only three patients with a benign tumour survive. CONCLUSIONS: Myogenic tumours of the GI tract are relatively rare, preoperative diagnosis is an exception. The clinical picture is non-pathognomic. The only effective therapeutic procedure is surgery: survival depends on the type of tumour.

Aged↗
PubMed1999

[Empyema of the thorax].

The authors evaluated the therapeutic procedure and results in patients with empyema of the chest. From December 1996 till June 1998 at the Surgical Clinic of the Third Medical Faculty, Charles University Prague 21 patients with empyema of the chest were hospitalized. The most frequent cause of empyema of the chest was pneumonia in 13 patients (62%). In 16 patients (in 76%) the empyema was classified as the third stage of the disease. Decortication, the most frequent procedure, was performed in 16 patients, incl. three where it was done using videothoracoscopy. Surgical treatment was supplemented by antimicrobial treatment, either monotherapy or a combination of antimicrobial preparations. From the total number one patient died 25 days after thoracotomy and partial decortication with a mesiotheloma of the pleura. The other patients have no signs of relapse of empyema. According to the authors experience the selection of the surgical procedure depends on the stage of the disease. In the authors group decortication by the thoracotomic route was used most frequently.

Adult↗
PubMed1999

[Intrathoracic occurrence of post-transplantation lymphoproliferation].

In the submitted case-history the authors wished to draw attention to serious complications after transplantation. Posttransplantation lymphoproliferation (PTLP) is a rare complication of organ transplantation, its incidence amounts to some 2% of organ recipients, in combined heart-lung transplantations the incidence is as high as 10%. The prerequisite of lymphproliferations is infection with the Epstein-Barr virus. The virus causes transformation of B lymphocytes and subsequent lymphoproliferation. Immunosuppressive preparations, due to their effect on Tlymphocytes promote this transformation. The decisive imaging method in tumoriform occurrence is high resolution computed tomography. Based on CT examination surgical biopsy is performed with subsequent in situ hybridization which confirms unequivocally the diagnosis of posttransplantation lymphoproliferation. Only on the basis of results of in situ hybridization treatment may be started which involves restriction or discontinuation of immunosuppressive treatment and administration of antiviral preparations. Frequently this treatment fails and must be discontinued on account of a rejection reaction of the organism. The prognosis in untreated forms is adverse.

Adult↗
PubMed1998

[Use of collagen with gentamycin in abdominal and thoracic surgery].

Based on an analysis of a group of 16 patients operated at the Surgical Clinic of the Third Medical Faculty, Charles University Prague the indication of collagen with gentamycin was established. Collagen with gentamycin is used locally for prophylaxis and treatment of intraabdominal and intrathoracic infections. In a group of patients it was used for prophylaxis of postoperative infections in elective abdominal operations such as plastic operations of the abdominal wall, anastomoses in the aboral part of the GIT, in operations of fistulae as part of treatment of intraabdominal abscesses and advanced cholecystitis and appendicitis. In thoracic surgery for prophylaxis of postoperative infections in plastic operations of the thoracic wall and also after surgery on account of inflammatory complications (lung abscess, bronchopleural fistula).

Abdomen↗
PubMed1996

[Video-assisted thoracic surgery--lobectomy, pneumonectomy].

Pneumonectomy performed by the V.A.T.S. method-Video Assisted Thoracic Surgery-calls for great skill, concentration and experience of the surgeon and puts greater demands on him than classical surgery. Minithoracotomy (5-10 cm) combined with videothoracoscopy have the joint advantages of miniinvasive operation and safety and radicality of the operation. During surgery lymphadeaectomy can be performed, it is possible to suture injured arteries or veins. Postoperative recovery is markedly better after V.A.T.S. than after conventional surgery. In the group of the first 11 V.A.T.S. lobectomies and one V.A.T.S. pneumonectomy the authors recorded a very low morbidity and zero mortality. The patients usually do not suffer from postoperative pain and rehabilitate well. The easier, less painful postoperative course is associated with earlier discharge, rapid convalescence and early return to work. V.A.T.S. is, no doubt, a benefit for the patient with regard to the postoperative response and course of recovery.

Adult↗
PubMed1995

[Tracheal replacement with a swine prosthesis].

In 12 experimental operations the authors tested the biocompatibility of a xenologous trachea from a pig which was used to replace a 5 cm defect of the trachea in a dog. After special preparation eliminating the antigenicity of the pig trachea the thus prepared graft was sutured into the thoracic portion of the dog trachea. The experiment could not be evaluated in two instances because the dog died on the operating table. In the remaining ten cases it was found that all anastomoses healed perfectly. The fibrous tissues of the tunica propria of the graft was replaced by granulation tissue. Across the anastomoses newly formed capillaries penetrated into the trachea where they caused chondrolysis. This led to a breakdown of the central portion of the prosthesis and stenosis in the airways with terminal respiratory failure. The mucosa of the graft was at some sites covered by metaplastically altered epithelium. Even a reinforcing vascular prosthesis did not prevent the breakdown of the wall of the xenologous graft. An asset for future work is the finding of a well healed suture between the graft and the trachea and evidence that newly formed blood vessels penetrated into the prosthesis.

Animals↗
PubMed1995

[Iatrogenic pneumothorax].

The authors present a group of 22 patients with iatrogenic pneumothorax. They analyze the basic causes of development of iatrogenic pneumothorax, such as cannulation of the subclavicular vein thoracic puncture. They give an account of their experience with the therapeutic procedure which involves the insertion of a classical thoracic drain and several days of active exhausting. In the conclusion they discuss the possibility to use a new method-videothoracoscopy-in some indicated cases.

Adult↗
PubMed1995

[New approaches in the use of antibiotics in the treatment of postoperative intra-abdominal infections].

The authors present the results of a clinical investigation on the therapeutic use of carbapenem, imipenem/cilastatin in 20 patients operated on account of intraabdominal inflammatory affections, hospitalized at the intensive care unit of the Surgical Clinic of the Third Medical Faculty, Charles University, Prague in 1993. Imipenem/cilastatin was administered to patients during surgery--500 mg i.v.--and subsequently after 8--hour intervals for 5-8 days. During comprehensive treatment no superinfection developed and the patients recovered.

Abdomen↗
PubMed1995

[Videothorascopic surgery--initial experience].

Practical experience with the miniinvasive laparoscopic technique in abdominal surgery logically led to extension of this method to thoracic surgery. Video-assisted thoracoscopic operations hold their place in the treatment of spontaneous pneumothorax, pleural syndrome, benign tumours of the thoracic wall etc. A curative solution of malignant diseases by this route is so far controversial and is reserved only for specially defined cases. Experience from the authors' department is based on nine-month use of a thoracoscopic apparatus. The authors operated a total of 21 patients thoracoscopically, incl. pneumothorax 6x, fluidothorax 10x and tumourous disease of the lungs or mediastinum 5x. The use of thoracoscopy is controversial in metastases of the lungs and in thymectomy. With regard to the authors are against thoracoscopic indications in the latter conditions contemporary technical possibilities.

Adult↗
PubMed1994

[Short-term prophylaxis with ceftriaxone in planned intrathoracic operations].

The purpose of the investigation was to evaluate the effect of short-term prophylaxis with a cephalosporin of the IIIrd generation, ceftriaxone, in 20 patients with an elective intrathoracic operation. The investigation comprised patients operated on account of bronchogenic carcinoma, metastases in the lungs, relapsing spontaneous pneumothorax and carcinoma of the distal cesophagus. ceftriaxone - 1 g was administered before the introduction to anaesthesia. The second 1 g dose was administered after 12 hours. In addition to the microbiological examination of the bronchial secretion and evaluation of the minimal inhibitory concentration of ceftriaxone to the isolated bacteria the ceftriaxone serum level was assessed in the patients and its concentration in the pulmonary parenchyma. Postoperative inflammatory complications/pneumonia/ were detected in two patients. With regard to the long serum half-life/longer than surgery/ ceftriaxone is suitable for short-term prophylaxis in thoracic surgery. The serum level and ceftriaxone penetration into the pulmonary parenchyma is higher than the minimal inhibitory concentration in the majority of isolated bacteria.

Bacteria↗
PubMed1994

[A tracheal prosthesis made from P(AEMA)--a further step toward tracheal replacement].

In animal experiments (5 dogs) the authors tested a material for the construction of tracheal prostheses so far not used in other countries. P(AEMA), the polymer 2-acetoxy-ethylmethacrylate is well tolerated, it did not produce a rejection reaction. The inner wall of the prosthesis was throughout the experiment patent, smooth and secretion did not adhere to it. Macroscopic examination did not reveal cumulation of mucus and signs of infection. The self-cleansing capacity was not impaired and the dog was able to expectorate mucus over a 5 cm length of the prosthesis. The solid ends of the prosthesis, however, caused mechanical irritation of the site of anastomosis and after cca 4 weeks of the experiment granulation tissue began to form. The experiments were terminated on account of complete occlusion of the lumen of the airways by granulation tissue 4-6 weeks after operation. The authors' efforts to design a suitable tracheal prosthesis led to a change of strategy of subsequent research. They started experiments with a heterologous portion of the pig trachea devoid of antigenicity; this will be the subject of a subsequent paper.

Animals↗
PubMed1994

[Replacement of the trachea with a prosthesis--an unsolvable problem?].

Reconstruction of the trachea by means of a segmental prosthesis is a complicated problem, which has not been completely resolved so far. The authors present a brief historical review of attempts to bridge the gap by different types of prostheses Evon Neville's silicone prostheses are not well tolerated on a long-term basis and its is thus important to look for other materials for the manufacture of an "ideal" tracheal prosthesis. (ur synthetic prosthesis made from poly/ARMA/is very well tolerated, similarly as silicone prostheses. Despite this the authors produced in 1993 a new type of prosthesis, based on antigenicity-deprived heterologous pig tissue. Trials with this prosthesis will be evaluated in a subsequent paper.

Humans↗
PubMed1991

[Surgical treatment of pulmonary metastases].

During the period from March 31 1987 to April 30 1990 the authors operated 24 patients with pulmonary metastases. They performed 13 operations during which they removed 86 metastases, 54 of which were removed by a Nd:YAG laser, 32 by the classical technique. The results of evaluation of the group support a more active approach of the surgeon to these conditions. As far as the selected surgical technique is concerned, the authors recommend Nd:YAG lasers because of the qualitatively more favourable conditions of the performed operation.

Adolescent↗
PubMed1990

[Removal of pulmonary metastases using the Nd:YAG laser].

The authors submit a case-history on their first successful application of a Nd:YAG laser in pulmonary surgery. They operated a 17-year-old boy with metastases of a synovial sarcoma in both wings of the lungs. First the boy was operated on the left side by the classical technique, half a year later the authors used a Nd:YAG laser on the right side. By means of the laser four metastases were removed. The postoperative course was without complications. One month after operation the patient was discharged from the care of oncologists and was free of complaints. The authors compare the surgical techniques and the postoperative course of the patient. A Nd:YAG laser is a suitable supplement of the equipment of pulmonary surgeons. Since the described case the authors used the laser in same indication in another three patients.

Adolescent↗
PubMed1989

[Removal of a liver tumor using the Nd:YAG laser].

At the Third Surgical Clinic, Charles University Prague a Nd:YAG laser, manufactured locally, MEDICALAS, was used to remove a hepatic tumour with a diameter of 3 cm. The authors used a continuous mode, a wavelength of 1064 nm, a non-contact focusing terminal and output of 100 W. The patient was discharged, healed, on the 11th day after operation. The operation which had no complications was the first of its kind in Czechoslovakia.

Adult↗