Biomedical subjects
Publications and source records attributed to J Samohýl.
Monitoring method for patients who undertook the reconstructive operation of flexor tendons of the hand is described. Pre-operative condition, operation finding, surgery execution, post-operative condition, rehabilitation as well as the situation during the graduated checks up after 6 and 9 months; 2, 6 and 10 years were noted down into standard forms.
Flap prefabrication was studied on the rat thigh by implanting femoral vessels into the flap's subcutaneous tissue. The aim of the experiment was to determine optimal prefabrication time, and to monitor, using contrast staining, the dynamics and morphology of the neovascularization process. The minimal time for successful prefabrication was 14 days in our experimental model. The potential of physiological and pharmacological regulation of the process of capillary neoformation is discussed. A successful attempt at free transfer of a prefabricated flap to the contralateral thigh and at femoral vessel anastomosis by microsurgery was also made as part of the experiment.
Development of a poorly differentiated eccrine carcinoma was observed in a 6-year-old woman. She had been operated on many times during 20 years for some tens of classical as well as less usual forms of eccrine spiradenomas, e.g. giant vascular spiradenomas. They were mostly localized in the skin of back, thorax and neck. The patient died of an extensive skin involvement and spine and liver secondaries 12 months after occurrence of the carcinoma. The structure of carcinoma was trabecular and partly papillary, tumour cells had bulky nuclei and striking nucleoli. There was a juxtaposition of spiradenomas with carcinoma and direct transformation of spiradenoma into carcinoma was observed. Immunohistological positivity of carcinoma concerned S-100 protein, slightly CEA, focally cytokeratin 7 and 18; cytokeratin 14 was negative. Ultrastructure of tumour cells showed irregular intercellular lumina with some microvilli, but structures characteristical for eccrine glandular of ductal differentiation were lacking.
The authors submit a brief report on replantation activities during the past five years and discuss the problem of indications and terminology of traumatic amputations. The paper contains instruction regarding communication by telephone between the attending surgeon and a specialized microsurgical department. There are also instruction how to handle the amputated portion of the limb and how to transport the patient and the amputated portion of the limb. The authors discusses traditional procedures in replantation surgery on the basis of his own experience with 292 replantations or revascularizations.
The authors follow up spastic reactions in free flap transplantations. In experiments on rats groin flaps were transplanted and during their preparation models of four types of spasms were made--segmental spasms of the afferent artery of the flap, spasms of the whole artery, spasms in the flap and tissue shock of the flap. The authors discuss possibilities of influencing and preventing spasms under experimental conditions and in clinical practice.
In free transfers of groin flaps in neurotized rats, spasms of the pedicle and of the vessels of the flap itself were observed. These spasms were in many cases the cause of complications. Four kinds of spasms were distinguished: 1. Segmental spasm--practically always on the inferior epigastric artery, characterized by short sections of spasm of the artery, alternating with sections of normal dilatation. 2. Spasm of the whole artery. 3. Spasm in the flap itself--characterized by normal dilatation of the artery stem of the flap and by slowing or stopping of blood circulation through the flap. 4. Tissue shock of the flap characterized by spasm of the pedicle in the flap also. The present work further shows a method of assessing the amount of blood circulation through the flap and the results of local medication influencing spasm, including 1% Mesocain, 0.5% Marcain and Solutio Vischnjevskij.
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The problems of substituting larger areas of the bladder wall are not definitely solved. Experiments on implantation of auto-allografts resulted in complications, which prevented correct epithelization of the interior surface, due to ischemia. In successful experiments on 34 rabbits, the authors obtained sufficient blood supply of the implantate and re-epithelization of the graft's interior surface in a two-stage operation.
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