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Biomedical subjects

J Michek

Publications and source records attributed to J Michek.

At least 19 recordsLinked to original sources
PubMed1999

[Central rupture of the liver in multiple injuries].

Authors evaluate clinical material of polytraumatized patients operated on account of liver injury during the last 15 years. The contribution of new imaging techniques is analyzed, especially of spiral computed tomography, for the diagnosis of liver injuries and associated injuries of the abdomen and retroperitoneum. These techniques enable in stabilized patients with the trauma I, II injuries and in some cases of grade III injuries to prefer conservative treatment. During the last 3 years the authors treated 5 polytraumatized patients with central liver rupture. Consistent with experience of major trauma centres in USA and Switzerland, criteria for conservative treatment are outlined, especially in patients of younger age groups.

Humans↗
PubMed1999

[Our concept of defecography. Methods and reproducibility of results].

Defecography is used in the Czech Republic only exceptionally. Since 1988 the authors made 402 defecographic examinations. They submit a detailed description of hitherto assembled experience and their own modification of the examination. As contrast material they use at present Micropaque susp. thickened by means of wheat bran. They administer it by means of a modified press for dough preparation. The X-rays are taken on a modified ordinary stool made from soft timber. For screening of uncovered places in the visual field they use individually placed copper plates 2 mm thick. For better evaluation of the X-rays the authors place during examination an X-ray contrasting net behind the patient. Pictures are taken at rest, during contraction, during modified Valsalva's manoeuvre and during all stages of defecation. The authors mention the most interesting pathological pictures they encountered so far--internal prolapse, levator hernia, rectocele, sphincter defect, various forms of prolapses and dyskineses of the pelvic floor. In the authors opinion the basic quantifiable parameters are the magnitude of the anorectal angles. They used the assessment method described by Mahieu, as well as the mediorectal angle which in their opinion is a reflection of the patient's somatotype and levator function. More than the absolute values of the angles they emphasize the difference of the two angles and change of the latter during contraction and defecation. In their opinion enlargement of the difference during contraction and diminution to values close to zero is normal. Converse values are according to the authors evidence of dyssynergy of the pelvic floor. Independent assessment of the angles and magnitude of the lift of the pelvic floor by three subjects are subjected to statistical analysis. They provide evidence of complete reproducibility of results of anorectal angles according to the authors' definition. The results of assessment can be used to investigate relations with parameters of anorectal manometry (AM) or transrectal sonographyy (TRS) in subsequent investigations.

Contrast Media↗
PubMed1999

[Loss injuries of the biliary tract in laparoscopic cholecystectomy-- possibilities of reconstruction].

Authors analyze occurrence of injuries of external biliary tract relating to the increasing number of laparoscopic cholecystectomies, especially of loss injuries, very demanding for its reconstruction. The early diagnosis of these injuries is emphasized and the necessity of their surgical revision as soon as possible, best still during the primary intervention. Authors present the own reconstruction method by high intrahepatic anastomoses in loss injuries of the common hepaticus and its branches.

Biliary Tract Surgical Procedures↗
PubMed1997

[Problems with continence after deep pelvic anastomoses in rectal carcinoma].

Based on the complex evaluation of the continence by anorectal manometry, EMG examination of sphincters, transrectal sonography, defecography and Colonic Transit Time examination, the analysis of the group of 15 patients partially incontinent after operation of carcinoma of the lower part of the rectum has been done. In these patients the deep pelvic anastomosis or coloanal anastomosis was performed. In none of the patients any serious organic damage of sphincters was manifested, the causes were dominantly extrasphincteric and functional, solvable well by conservative methods.

Anastomosis, Surgical↗
PubMed1997

[Injury of the extrahepatic bile ducts in multiple injuries].

During the ten-year period between 1982-1991 the authors operated in the Institute 12 casualties after perforation and avulsion of the gallbladder, 8 patients on account of injuries of the hepatocholedochus and 15 patients where after injury posttraumatic acute cholecystitis developed. The authors evaluate critically the asset of new diagnostic preoperative procedures for assessment of early indication of surgery. In the surgical tactics they prefer reconstruction procedures which prevent such serious postoperative complications as relapsing cholangitis or stricture with cholestatic affection of the liver [1,3].

Cholangiography↗
PubMed1997

[Acute surgical diseases in spinal injuries with spinal cord lesions].

Authors analyse the group of 22 operated patients admitted to the Spinal Centre of the Traumatological Hospital Brno for instable spinal fracture with the transversal lesion of the spinal cord, in whom the acutely affected abdomen and acute surgical disease manifested. The anamnestic and clinic examination of the abdomen is not reliable in patients with the transversal lesion of spinal cord for valid laws of the spinal cord. Authors evaluate the contribution of new diagnostic imaging techniques and endoscopic methods to determinate the early indication for surgical treatment.

Abdomen↗
PubMed1996

[Stress ulcers in patients with polytrauma].

Authors treat in their institution yearly 100-120 patients with polytrauma. In the Endoscopic Centre of the hospital approx. 20 gastroduodenal ulcers are diagnosed yearly in patients with supposed stress etiology. Authors analyze the pathophysiology of origin of stress ulcer, clinical symptoms and acute diagnostics. They evaluate results of early surgical treatment. Authors place the great importance on explicit treatment methods for prevention of stress ulcer origin.

Humans↗
PubMed1996

[Early treatment of the unstable thorax in polytrauma].

Thoracic trauma represents 12.8% of all trauma patients treated in author's evaluated the contribution of new diagnostic methods, in particular CT and sonography, to determinate the indication of conservative therapy or early surgical treatment. From 1992 in the framework of the grant project the early surgical treatment of instable thorax was performed in 29 patients with polytrauma or severe associated thoracoabdominal trauma. Authors determined indications for thorax stabilisation after serious consideration, and stated contemporary contraindications of this treatment. They evaluated the therapeutic contribution of these methods and prepared in cooperation with the company Medin Nové Mĕsto the set of osteosynthetic material with accessories for treatment of instable thorax.

Flail Chest↗
PubMed1996

[Pitfalls of deep pelvic anastomoses in rectal carcinoma].

Authors analyse a group of patients operated for colorectal carcinoma in their hospital during ten-years period 1982-1991. 421 patients were operated for ca recti, in more as 65% of cases the sphincter saving operation was preferred. The used method was elaborated by Hojo and Kaso from Japan. The contraindication of sphincter, and insufficiency of sphincter, objectively rectomanometrically detectable. The resection of urinary bladder was contemporary performed in 15 patients, the hysterectomy with adnexotomy in 8 patients, the vaginal resection in 5 cases and the resection of small intestine in 8 cases. The resection of os sacrum to S 3 was performed in 3 patients. The radical resection with establishment of the deep pelvic anastomosis is burdened by certain number of early and delayed complications, too. Authors analyse its causes, possible corrections, but also its prevention.

Anastomosis, Surgical↗
PubMed1996

[Injuries of organs in the abdominal and retroperitoneal cavities].

In the Traumatological Hospital Brno approx. 100 polytraumatised patients yearly are admitted with involvement of 2, 3 or 4 systems. During the period of years 1982-1991 authors operated 308 injured patients with increasing haemoperitoneum, 254 patients with profuse bleeding into retroperitoneum, 77 patients with traumatic perforative peritonitis and 61 patients with severe thoracoabdominal trauma. Mortality in this group was 26%. Authors evaluate the contribution of new diagnostic methods for the indication of early surgical treatment, and results of operations, complications and problems.

Abdominal Injuries↗
PubMed1996

[Associated injuries of the pelvis].

In last three years 27 injured patients were operated in Traumatological hospital Brno for associated pelvic trauma. This trauma was associated with injury of urinary tract in 8 patients, with traumatic lesion in area of the colon in 6 cases and with injured big vessels of the retroperitoneum in 8 patients. The urgent operation was performed in 44%. Authors put stress in diagnostic analysis and early indication of surgical operation on careful anamnestic clinical examination, they utilize the contribution of the sonographic and CT examination with contrast, in indicated cases the selective angiography and retrograde urethrocystography, too. Authors prefer early reconstructional operations.

Abdomen↗
PubMed1996

[Problems with continence in rectal injuries].

Authors analyse the group of 17 patients operated for rectal and anal injury. In this group 7 patients were operated primarily after injury and in 11 patients the secondary reconstruction was performed. Authors called the attention to the high diagnostic difficulty before the planned and indicated secondary reconstruction. Based on assessment of own clinical material and conforming with literature, authors conclude that secondary reconstruction are more difficult, and this difficulty is the higher, the less qualified the primary treatment was performed.

Fecal Incontinence↗
PubMed1994

[Serum levels of cytokines as a measure of response to stress after various types of elective gallbladder surgery].

The authors investigated the cytokine levels in patients after laparoscopic cholecystectomy (LCHE), conventional open cholecystectomy (OCHE) and complicated open cholecystectomy (KOMPL) in order to assess whether there is a relationship between cytokine levels and the general reaction of the organism, the type and extent of the operation. They did not find an increase of IL-1 or IL-2 levels in any of the patient groups. The IL-6 concentration was slightly raised only in three patients of the OCHE group three hours after surgery and this rise persisted for 24 hours. In the KOMPL group there was a more marked rise of IL-6 in 9 patients within 3 hours after surgery, persisting in 6 patients for 24 hours and in 2 patients for 48 hours. The TNF values were similar; in group OCHE they were slightly elevated in 2 patients 24 hours after operation. In the KOMPL group these values were elevated in 5 patients for 3 hours after surgery and this increase persisted in 2 for 24 hours after surgery. Based on the investigation of cytokine levels, which is a recent indicator for evaluating the reaction of the organism to stress, conclude that laparoscopic cholecystectomy is a minimal stress for the patient and is associated with a zero defence reaction of the organism, if evaluated according to serum cytokine concentrations.

Adult↗
PubMed1992

Surgical treatment of the atonic bladder ("vesical cap").

As demonstrated in animal experiments and in five patients with atonic bladders, "vesical cap" surgery causally solves detrusor impairment by functionally reinforcing it with a vital muscle layer from an ileal seromuscular flap. All other genuine components of the bladder are kept intact, which is very beneficial for bladder function.

Animals↗
PubMed1991

[Treatment of injuries of the cervical spine].

Injuries of the cervical spine are re-evaluated at present. New surgical procedures and research on the stability, when these procedures are used, caused that surgical treatment is used more frequently. Attention is draw to provisions in the field as well as in hospitals, on the diagnostic approach and classification of these injuries, on the procedure of conservative surgical treatment. The domain of conservative treatment are injuries of the upper cervical spine (C1 and C2); injuries of the lower cervical spine are frequently unstable, and therefore frequently indicated for operation. Attention is drawn to modern views on surgical treatment of comminuted fractures of the atlas and the dens axis. The authors analyzed their own material from 1986 to April 30, 1989 and in case-histories of three patients they draw attention to their therapeutic method. The authors demonstrate their own modified plates for the anterior stabilization of the cervical spine and their modification of the Halo device "Halo Vest". They discuss biomechanical properties of posterior and anterior stabilization methods.

Adult↗
PubMed1990

[Recurrent peptic ulcer--surgical complications].

Recurrent ulcer is serious complication of surgical treatment. Resection, reconstructive operations under conditions of severe adhesions, inflammatory infiltrates and abscesses are exacting and often connected with complication. In the period of 1978-1987 the authors carried out 64 reoperations for recurrent peptic ulcer, incl. 39 cases, whom they had to operate urgently. 19 patients were reoperated on account of penetration and peroperation of the ulcer, 11 because of massive haemorrhage, and 9 patients because of gastrocolic fistulae. In reoperations, subtotal resection of the stomach with vagotomy was carried out in 66%. In 4 patients reoperated repeatedly, Zollinger-Ellison's syndrome was found and resection of the pancreas was performed simultaneously. The mortality rate in the group, including patients reoperated urgently, was 21.9% (i.e. 14). The authors emphasize that the main aim of reoperation must be long-term therapeutic results without recurrences of ulcers and without serious functional disturbances.

Adult↗
PubMed1990

[Uretero-enteral anastomosis of dilated ureters in ileocecal replacement of the urinary bladder].

In very dilated efferent urinary pathways with an impaired peristaltic activity of the ureter the authors selected for ureteroenteral anastomosis in ileocoecal replacement of the urinary bladder anastomosis with the ileum, leading into the ileocoecal reservoir via the invaginated trans-Bauhin's ileal valve. This valve was ensured against devagination by a transparietal suture after longitudinal intraluminal discision of the outer leaf the invaginate. By adjusting the discision of the outer leaf of the invaginate the authors obtained the selected pressure resistance of the valve which was desirable from the clinical aspect. This technique was described in two patients who were followed up for 6 and months and in a patient with convercion of Bricker's conduit into an ileocoecal prosthesis.

Anastomosis, Surgical↗