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J Martínek

Publications and source records attributed to J Martínek.

At least 19 recordsLinked to original sources
PubMed2006

[Autoimmune ovarian failure in adolescent girls].

BACKGROUND: The aim of the study was to map the incidence of antiovarian antibodies (AOA) in adolescent girls with ovarian cycle irregularities in comparison with girls with the regular cycle. The relation between the AOA positivity and structural changes in the bioptic samples of ovaria was examined. MATERIAL AND RESULTS: The studied cohort included 39 girls with primary amenorrhea (N = 18) and oligo/secondary amenorrhea (N = 21). All patients were tested for the presence of antiovarian antibodies (AOA) in the serum and levels of FSH and LH. The examination was done at the beginning of the study and after six months of therapy, in most of the cases by the hormone substitution treatment. In indicated cases the laparoscopic ovarian biopsy was done. A patients with serious failure of ovarian cycle the positivity of antibodies against various components of ovaria was found. Significantly higher levels of FSH was also found, LH levels were not higher. In our patients the depletion and alteration of the follicular apparatus in the cortex of ovaria belonged to the common findings. The control examination after the six month of hormonal substitution brought about lower levels of AOA, in some patients AOA fully disappeared. CONCLUSIONS: Incidence mapping of antiovarian antibodies in patients with ovarian cycle irregularities correlate with findings of elevated atresia. Ovarian cycle irregularities can later or earlier turn into the extinction of the follicular apparatus and fibrotization of the ovarian cortex.

Adolescent↗
PubMed2006

[Atypically localised hepatic haemangioma as a cause of dyspeptic syndrome].

INTRODUCTION: Haemangioma is a benign mesenchymal tumor growing from the endothehum of blood vessels. Most hepatic haemangiomas are asymptomatic while symptomatic haemangioma are usually manifested by non-specific pain dyspeptic syndrome, quite rarely also by hemorrhage, or icterus Symptomatic haemangiomas or large haemangiomas with fast growth, are indicated for surgical treatment. CASE REPORT: The authors present a 50-year-old patient with chronic dyspeptic condition and pressure pain in the epigastria. USG, CT, MR, CT angiography and EUS have all shown two lesiones (haemangioma of the left hepatic lobe, a tumor in the left subphrenic area of uncertain origin). We proposed an operational solution, and, surprisingly, the finding was a single haemangioma (2 parts-- intra- and extraparenchymatous--connected by a vascular bridge). We then performed left lobectomy. DISCUSSION: In the diagnosis of haemangioma, MR is a method of choice with high specificity and sensitivity. Why did not it yield the correct diagnosis? The structure, the signal and the type of postcontrast enhancement of the second lesion corresponded to a haemangioma, but the extraparenchymatous location and also the considerable remoteness from the liver invalidated this possibility before operation. Regarding to the differential diagnostics of the lesiones in the subphrenic area, which according to the imaging techniques are not related to the hepatic parenchyma, it is advisable to consider the possibility of the incidence of pedunculated hepatic haemangioma.

Dyspepsia↗
PubMed2003

Treatment of patients with achalasia with botulinum toxin: a multicenter prospective cohort study.

Botulinum toxin (BT) injection is an alternative treatment of achalasia. The aim of the study was to examine outcomes of patients treated with BT in the Czech Republic. Since 1997, 49 patients with achalasia have been treated with BT. We prospectively evaluated the effect of BT injection on 41 patients during a median follow-up of 24 months (range 9-62). Esophageal manometry was performed before and at 3-5 months after the injection. In 16 patients, BT was injected from the antegrade angle only (subgroup A), in 15 patients, BT was injected from both retrograde and antegrade angles (subgroup B) and, in 10 patients, BT injection was combined with subsequent balloon dilatation (subgroup C). Immediate clinical response was achieved in 93% of patients. Clinical remission was sustained beyond 3 months in 83% of patients (responders). Fourteen responders (41%) did not experience a relapse during the median of 22 months. Twenty responders (59%) experienced symptomatic relapse approximately 8 months after the injection. Ten relapsers underwent BT reinjection, five (50%) of them were asymptomatic for another 14 months. The remaining five (50%) patients reported a second relapse approximately 6 months after the reinjection. Median duration of the symptom-free period was 11.5 months after the first BT injection, and 10.5 months after the second (P = 0.21). We did not find any significant predictor of a favorable outcome; responders tended to be older and to have a lower basal lower-esophageal-sphincter pressure. Patients in subgroup C were more likely to be in remission at 1 and 2 years as compared with patients in subgroup A. BT injection is an effective treatment of achalasia in the short term. However, almost 70% of patients experience a relapse within 2 years. BT injection should therefore be reserved for patients at risk for more invasive procedures or for patients who prefer this treatment.

Adolescent↗
PubMed2003

A modified method of botulinum toxin injection in patients with achalasia: a pilot trial.

BACKGROUND AND AIMS: Injection of botulinum toxin (BT) from direct vision into the lower esophageal sphincter (LES) lowers its basal tone and improves symptomatology in most of the patients with achalasia. We hypothesized that the effect could be improved by better degree of LES infiltration by toxin administered from both prograde and retrograde views. The aim of the study was to investigate the feasibility, safety and efficacy of this modified method of intrasphincteric BT injection in patients with achalasia. PATIENTS AND METHOD: Sixteen patients with achalasia were treated with BT injection. Hundred units of BT (Botox) were diluted with 4 ml of normal saline. Aliquots of 0.5 ml were injected into four quadrants of the LES from retrovision and then into each quadrant from direct vision. The patients were followed up for a median of 25.5 months (range 19-31). RESULTS: No serious adverse events were noted. All patients responded well to the injection within one week and 3 patients (18.7 %) experienced an early relapse. The remaining 13 patients were classified as responders. After a single BT injection, 11 responders reported a relapse and 2 patients remained asymptomatic. The median symptom-free interval was 17 months (8-28). Five patients with a relapse underwent BT reinjection. Three of them remained asymptomatic and two experienced the second relapse. After BT reinjection, the median symptom-free interval was 16 months (10-19). All other patients with a relapse and without BT reinjection were treated with either balloon dilatation or surgery and are currently asymptomatic. CONCLUSION: Combining injection of BT into the LES from both direct vision and retrovision was feasible, safe and produced a rapid response which was sustained for more than 1 year in the majority of patients. This method of BT administration might be superior to the traditional injection from direct view only, and a randomized and prospective study comparing those techniques of administration should be performed.

Adult↗
PubMed2003

[The role apoptosis in the extent of endometriosis and its clinical symptomatology].

OBJECTIVE: To evaluate the presence and intensity of apoptosis in lesions of peritoneal endometriosis. To consider the role of different intensity of apoptosis in the progression of the disease and in the manifestation of clinical symptoms. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynecology and Department of Histology and Embryology, 1st Medical Faculty, Charles University and General Faculty Hospital, Prague. METHODS: Lesions of peritoneal endometriosis were excised at laparoscopy in women with 1st to 3rd stage of the disease. Specimens were fixed in the Karnowski solution. The presence of apoptosis was assessed immunohistochemically. RESULTS: Biopsies of peritoneal endometriosis were consecutively taken in 48 women. Altogether, 29 patients were symptomatic, and 19 did not complain of any symptoms. The average duration of symptoms was 16.6 months. The presence of apoptosis was detected in 11 out of 35 evaluated specimens. In comparing the groups with and without apoptosis, no differences were found in the stage of the disease, in the proportion of asymptomatic patients, and in the manifestation of different subjective complaints. CONCLUSIONS: The study confirmed a frequent presence of apoptosis in biopsies of peritoneal endometriosis. However, there were no relationships found between the presence of apoptosis and the stage of the disease or manifestation or character of subjective complaints.

Adult↗
PubMed2001

Cisapride does not improve precolonoscopy bowel preparation with either sodium phosphate or polyethylene glycol electrolyte lavage.

BACKGROUND: Oral sodium phosphate solution (NAP) and polyethylene glycol-electrolyte lavage (PEG-EL) are used for precolonoscopy bowel preparation. The benefit of adding cisapride to PEG-EL is controversial, and its influence on the effectiveness of NAP has not been investigated. The primary aim of this study was to determine whether cisapride improves the effectiveness and/or tolerableness of bowel preparation with either NAP or PEG-EL. METHODS: In 187 patients undergoing colonoscopy, a randomized, double-blind, placebo-controlled trial with a Latin square design was conducted to compare 4 different bowel preparations: NAP plus either cisapride (10 mg; 2 doses) or placebo, or PEG-EL plus either cisapride (10 mg; 1 dose) or placebo. Quality of the bowel preparation was graded by the endoscopist according to the amount of stool present in the colon (excellent, satisfactory, unsatisfactory). To assess tolerability, patients rated 8 symptoms, the taste of the lavage solution, and the ease of preparation on a 5-point scale (1: easy; 5: distressing). RESULTS: Endoscopists scored the bowel preparation as either excellent or satisfactory as follows: NAP: cisapride 50% versus placebo 61% (p = 0.3); PEG-EL: cisapride 80% versus placebo 78% (p = 1.0). Cisapride did not improve tolerability or the frequency of adverse symptoms associated with either solution. The ease of bowel preparation was significantly better in the NAP group versus PEG-EL group (mean score 1.8 versus 2.8; p < 0.0001). CONCLUSIONS: Cisapride does not improve the quality of bowel preparation with either NAP or PEG-EL. NAP is better tolerated by patients than PEG-EL; however, PEG-EL results in better bowel preparation.

Administration, Oral↗
PubMed2000

Review article: the clinical influence of Helicobacter pylori in effective acid suppression-implications for the treatment of gastro-oesophageal reflux disease.

The relationship between gastro-oesophageal reflux disease (GERD) and Helicobacter pylori is unclear. Recent data indicate that H. pylori probably exerts a protective effect against GERD. In recent years, the interaction between H. pylori, proton pump inhibitors and GERD has been widely studied. Currently available proton pump inhibitors produce significantly higher intragastric pH in H. pylori-positive patients than in those who are H. pylori negative, and this phenomenon may be clinically relevant. The mechanisms responsible for this difference in efficacy are not fully understood, although there are two major theories. Ammonia, produced by H. pylori, is able to neutralize gastric acid, and thus apparently increase the effect of acid suppressive agents (the 'ammonia theory'). The other theory is that decrease in acid output is due to the development of corpus gastritis during treatment with a proton pump inhibitor (the 'gastritis theory'). Treatment strategies to overcome this lowered sensitivity to acid suppression are to increase the frequency/dose of a proton pump inhibitor or to add an H2-receptor antagonist in the evening-but both have pharmaco-economic implications. An agent that could provide adequate pH control regardless of H. pylori status would be highly beneficial in the treatment of GERD, and may also lower treatment costs.

Drug Administration Schedule↗
PubMed2000

Autoimmune antiovarian antibodies and their impact on the success of an IVF/ET program.

In previous papers, we referred to studies of the influence of antiovarian autoantibodies on menstrual cycle disorders in adolescent girls. We examined autoantibodies against ooplasma, zona pellucida, membrana granulosa, theca folliculi interna, and lutein cells. In infertile women in the IVF/ET program, we studied the positivity of antiovarian antibodies and cytokines, namely, TNF-alpha and IL-1 beta, in follicular fluid correlated with the following subgroups, characterized by the outcome of in vitro fertilization, as follows: G, pregnant; F, fertilized; N, nonfertilized; and O, no oocyte gained. The presence of autoantibodies corresponds to the success or failure of the IVF/ET program. Our results support the hypothesis that antiovarian autoantibodies play an important role in both the endocrine and the reproductive function of the human ovary and that it can influence them negatively.

Adult↗
PubMed2000

Evaluation of calcium channel blockers as potential hepatoprotective agents in oxidative stress injury of perfused hepatocytes.

The aim of this study was to investigate the effects of calcium channel blockers on tertbutyl hydroperoxide (TBH) induced liver injury using isolated perfused rat hepatocytes. Rat hepatocytes were immobilized in agarose threads and perfused with Williams E medium. Hepatocyte injury was induced by the addition of tertbutyl hydroperoxide (1 mM) to the perfusion medium 30 min after the addition of either verapamil or diltiazim. Hepatocyte injury was observed by monitoring the functional and metabolic competence of hepatocytes or by ultrastructural morphological examination of hepatocytes. Verapamil (0.5 mM) reduced lactate dehydrogenase leakage in TBH-injured hepatocytes as compared to the controls (154+/-11% vs. 247+/-30%). Lipid peroxides production was reduced after verapamil pretreatment as compared to the controls and oxygen consumption was increased by pretreatment of hepatocytes with verapamil. Verapamil pretreatment increased the protein synthesis activity at both levels of granular endoplasmic reticulum and free polysomes in cytoplasm and decreased ATPase activity. Diltiazem was qualitatively effective as verapamil. It is concluded that in hepatocyte oxidative injury, calcium channel blockers exhibited hepatoprotective properties. The hepatoprotective effect of calcium channel blockers was accompanied by a decrease in ATPase activity, which may implicate a normalization of Ca2+i after TBH intoxication.

Adenosine Triphosphatases↗
PubMed1999

Premenarchal and postmenarchal girls with insulin-dependent diabetes mellitus: ovarian and other organ-specific autoantibodies, menstrual cycle.

STUDY OBJECTIVE: To estimate various organ-specific autoantibodies and detect other endocrine autoimmune disorders and menstrual cycle characteristics in girls with Type 1 insulin dependent diabetes mellitus (IDDM). DESIGN: Prospective cohort study from 1993 to 1998, duration 4.5 years. SETTING: Diabetes & Endocrine Clinic of the University Hospital, Motol, Prague. PATIENTS: 53 IDDM girls (group A--43 postmenarchal, group B--10 premenarchal), 15.5 +/- 2.5 (8-19) years old, 6.2 +/- 4.3 years after IDDM onset. MAIN OUTCOME MEASURES: Ovarian autoantibodies directed to ooplasm, zona pellucida, membrana granulosa, theca folliculi interna, and lutein cells, insulin autoantibodies, thyroid peroxidase and thyroglobulin autoantibodies. Menstrual cycle character, endocrine glands disturbance. Diabetes control, body mass index, duration of IDDM. RESULTS: Ovarian autoantibodies in at least one of the followed structures were found in 67.9% of the IDDM girls. In the control group of 21 healthy girls of corresponding age, the positive findings in lutein cells were found in only 4.8% of the girls (P < 0.01 versus IDDM girls). The lutein cells commonly associated with theca folliculi interna cells were the most frequent immunopositive structures in diabetic girls (P < 0.05 versus another positive ovarian autoimmune structure). Autoantibodies directed to ovarian steroid producing cells were frequent in IDDM patients with both irregular and normal menstrual cycles. Irregular menstrual cycles were diagnosed in 27.9% of IDDM girls, polymenorrhea in half of them, and oligomenorrhea in the remainder. Diabetes control in our patients (glycosylated hemoglobin HbA1c in postmenarchal girls 10.1 +/- 2.0%) did not differ between those with regular and those with irregular menstrual cycles. Over a follow-up period one-third of the girls with oligomenorrhea and a long-term noncompliance (HbA1c 13.5%) developed secondary amenorrhea. Insulin autoantibodies were found in 67.8%, thyroid peroxidase autoantibodies in 12.5%, and thyroglobulin autoantibodies in 10.4% of the IDDM girls. Autoimmune thyroiditis was diagnosed in 5 IDDM patients (9.4%); hypothyroidism developed in 3 of them. Menstrual cycle was irregular in 4 of the 5 girls with autoimmune thyroiditis (polymenorrhea in 1, oligomenorrhea in another 3 girls). CONCLUSIONS: An increased incidence of various circulating autoantibodies may be markedly demonstrated in IDDM girls. Their reproductive function might have an important relationship to an evidence of ovarian autoantibodies. Menstrual cycle disturbances could be linked to the poor diabetes control, to the presence of ovarian and other autoantibodies, and also to other autoimmune disease.

Adolescent↗
PubMed1999

Effects of pumaprazole (BY841), a novel reversible proton pump antagonist, and of omeprazole, on intragastric acidity before and after cure of Helicobacter pylori infection.

BACKGROUND: Omeprazole produces a higher intragastric pH in the presence of Helicobacter pylori infection than after cure. AIM: To investigate whether this effect also occurs with pumaprazole (BY841), a reversible proton pump antagonist which, in contrast to omeprazole, does not require activation in the acid compartment of the parietal cell. METHODS: In a randomized, crossover, double-blind study, 24-h intragastric pH was measured in 13 H. pylori-positive subjects before and after a 1-week course of omeprazole (20 mg o.d.) or of pumaprazole (100 mg b.d.). The studies were repeated after the infection was cured. RESULTS: In the absence of drug administration, the median 24-h pH values before cure (median 2.0, 90% CI: 1.2-3.2) did not differ from those after cure (median 1.5, 90% CI: 1.3-2.2; P = 0.115). The 24-h pH values were higher before cure of the infection than after during both pumaprazole (6.0, 4.8-6.7 vs. 4.3, 2.6-5.7; P = 0.002) and omeprazole (5.8, 4.0-6.2 vs. 3.6, 2.8-5; P = 0.004). Both before and after cure, there were no significant differences between the two drugs with respect to acid inhibition over the 24-h period. The median decrease in acid inhibition after cure of the infection (calculated as the difference in H+ activity in mmol/L) during pumaprazole (median 0.05, 90% CI: 6 x 10-4- 2.3) was no different from that during omeprazole (median 0.2, 90% CI: 3 x 10-3-1.5; P = 0.6). CONCLUSIONS: Both before and after cure of H. pylori infection, pumaprazole raised the intragastric pH over a 24-h period to a similar degree as omeprazole. H. pylori infection similarly augments the pH-increasing effect of both drugs. This effect is related to H. pylori infection and not to an increased activation of acid inhibitory agents in the parietal cell compartment.

Adult↗
PubMed1999

Penetration of antibiotics into the pancreas in rats: an effect of acute necrotizing pancreatitis.

BACKGROUND: Penetration of antibiotics into the pancreas is considered to be an important criterion in determining the most appropriate antibiotic treatment during severe acute pancreatitis. Our study investigated pancreatic penetration of five antibiotics in rats with and without acute necrotizing pancreatitis (ANP) (non-pancreatitis rats (NR), pancreatitis rats (AP)). METHODS: ANP was induced by intraductal bile acid injection, and 3 h later the antibiotic was administered. In both NR and AP the antibiotic concentrations were evaluated in blood and pancreatic tissue 90 min after antibiotic administration. RESULTS: The tissue/serum (T/S) ratios for NR were 16% with amikacin, 24% with amoxycillin/clavulanic acid, 27% with piperacillin, 59% with ofloxacin, and 108% with cefoperazone. The ratios for AP were 7%, 23%, 26%, 52%, and 70%, respectively. T/S ratios were similar for NR and AP except for amikacin, for which the T/S ratio was lower in AP than in NR (P = 0.02). Pancreatic tissue concentrations of antibiotics with high penetration rates (cefoperazone and ofloxacin) were sufficient to inhibit most of the pathogens expected during acute pancreatitis. The concentrations of the other antibiotics were less than the minimal inhibitory concentrations (MIC) for common potential pathogens in pancreatic infection. CONCLUSIONS: Cefoperazone and ofloxacin showed the best pancreatic penetration of the five antibiotics tested. The high concentrations of these antibiotics in the pancreatic tissue would have enabled efficient antibacterial activity against most of the potential pathogens causing pancreatic infection. An early stage of acute necrotizing pancreatitis did not have a major effect on the pancreatic concentrations of the antibiotics.

Amikacin↗
PubMed1999

Total and local changes in the arthritis adjuvans.

Arthritis adjuvans was studied in the murine model. An effect of different treatment (methotrexate, tauredon, collagen hydrolysate) was estimated in the course of developing disease (day 3, 5, 11 and 21). Repeated evaluation of body weight and peripheral blood leukograms as a total response of organism was performed. Oedema of paw periarticular and tail regions, light- and electron-microscopical screening and immunohistochemical investigation of prevalence of interleukin-1-beta (IL-1beta) and tumour necrosis factor (TNF-alpha) were estimated. The most pronounced benefit effect of methotrexate at stabilization of the monocytes blood level, synovial membrane cell invasion and TNF-alpha immunopositivity was ascertained.

Animals↗
PubMed1997

[Gastroenterology. II: Acid research and ulcer therapy].

Three discoveries of the last thirty years have revolutionized acid research and ulcer therapy: H2-receptors and their competitive inhibition, the acid pump and its blockade and, finally, Helicobacter pylori and its central role in ulcer disease. Today the problem of ulcer treatment is more or less solved by the correct use of antibiotics, while the cure of reflux disease is still problematic: pump blockers accelerate the healing of mucosal breaks and prevent, when given at long term, recurrences but they cannot change the natural history of reflux disease. These facts form the basis for future research.

Animals↗
PubMed1996

Circulating ovarian autoantibodies and FSH and LH levels in adolescent girls with primary menstrual cycle disorders.

Seventy three adolescent patients with primary menstrual disturbances were studied by immunofluorescent methods for prevalence of ovarian autoantibodies (O-Ab), the enzyme immunoassay (EIA) method for examination of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) hormonal levels was used. Clinically healthy girls (40) served as controls. Patients were divided into a group of 13 girls with primary amenorrhea (PA) and a group of 60 girls with oligo and/or secondary amenorrhea (OSA). In the PA group 38.5% positivity linked to ooplasm (OO), zona pellucida (ZP), and membrana granulosa cells (MG), as well as 46.2% to theca folliculi interna (TI) and 53.8% to lutein cells (LC), was detected. Statistically significant differences (p < .05) of LH levels between OO immunopositive and negative girls (19.0 and 9.4 mU/ml) were found, while FSH values were not different. In the OSA group a 16.7% positivity linked to OO, 23.3% to ZP and MG, 38.3% to TI, and 58.3% to LC were detected. Significant linkage between MG immunopositive and negative girls and FSH:LH ratio values were estimated. FSH values were significantly different (p < .05) for PA and OSA groups (23.7 and 6.7 IU/l) which corresponded particularly with higher findings of Ab in germ line-cells (OO-, ZP-, and MG-Ab). A striking correlation between evidence of O-Ab and menstrual cycle irregularities was found. It could support a possible coincidence of autoimmune mechanism in these dysfunctions. Localization of O-Ab-binding was verified at the electron microscopic level.

Amenorrhea↗
PubMed1994

Preparation of functionally active immobilized and perfused mammalian cells: an example of the hepatocyte bioreactor.

In the present study, a method has been employed for hepatocyte immobilization in agarose threads which allows for cell perfusion. The rat hepatocytes are isolated from the liver. A 1.8% low-gelling agarose solution is prepared in warm Krebs-Henseleit solution. The agarose solution is mixed 1:1 with the hepatocytes and the cells are immobilized in agarose threads by extruding the agarose-cell mixture through cooled Chemfluor teflon (TFE) tubing. Light and electron microscopy studies indicated the integrity of the hepatocytes in the gel matrix. This system allows for liver cell perfusion and viability studies to be carried out non-invasively on the cells and provides data that are comparable to those obtained with a perfused isolated liver. Immobilized hepatocytes are an in vitro system worthy of further evaluation which may be useful in the studies of liver cell metabolism and the response of the liver to foreign chemicals.

Animals↗
PubMed1994

Adrenergic lipolysis in immobilized and perfused adipocytes.

The method of cellular immobilization and perfusion was applied to adipocytes. The lipolytic effect of isoprenaline, whose action is produced as a result of receptor-drug interaction, was followed. An agarose solution kept at at 37 degrees C was mixed 1:1 with the cell suspension. Thereafter, adipocytes were immobilized in the agarose threads. The lipolytic effect of 0.1 ml of isoprenaline (1 x 10(-4) mol/l), that was rapidly introduced to the cell perfusion inlet in a non-recirculating system, was monitored by assessing glycerol production. The immobilized and perfused adipocytes exhibited significant lipolytic activity. After reaching the maximum effect, 0.1 ml of propranolol (1 x 10(-3) mol/l) that was applied to the bioreactor inlet, abolished the isoprenaline effect. The present data demonstrate the potential applicability of immobilized perfused adipocytes for various kinds of studies.

Adipocytes↗