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Biomedical subjects

J Schützner

Publications and source records attributed to J Schützner.

18 recordsLinked to original sources

[Rupture of the trachea and main bronchus after intubation].

The authors present two cases of post-intubation perforation of the trachea and main left bronchus resp. One was diagnosed incidentally during thoracotomy, on the second to third day after attempted intubation during which perforation occurred. The patient's life was threatened by the development of ARDS syndrome. The authors emphasize therefore the necessity of acute tracheobronchoscopy when perforation of the major airways during difficult intubation is suspected. Uncertain suture of the pars membranacea should be covered by the oesophagus.

Bronchi

[The first 300 videothorascopic (VTS) and video-assisted (VATS) operations].

Videothoracoscopic and Videoassisted thoracic surgery makes diagnostic and therapeutic operation in the pleural cavity possible with minimal injury of the thoracic wall. The basic prerequisite is a free pleural cavity and selective pulmonary ventilation. VTS is a great asset in pulmonary biopsy, final treatment of a spontaneous pneumothorax, surgery of the thoracic sympathetic nerve and splanchnic nerves. VATS makes even such operations as lobectomy or pneumonectomy possible. According to the authors experience and views of the European Society of Thoracic Surgeons pulmonary carcinoma should be however operated by classical thoracotomy. The authors discuss the problem of indications and analyze operations implemented at the Third Surgical Clinic in Prague during the last three years.

Contraindications

The results of surgical treatment of non-small cell lung cancer at the Pneumological Clinic in Prague, Czech Republic 1985-1990.

In the Czech Republic, lung cancer is the most frequent malignant tumor in men. In 1990 the incidence was 99.6/100,000 for men and 15.8/100,000 for women. Neither diagnostic nor therapeutic approaches have changed significantly in the last 10 years. Patients undergoing lung resection have a chance of long-term survival. In this retrospective study, the authors analysed the data of 252 patients undergoing the operation for non-small cell lung cancer (NASCL) in the period 1985-1990. Of all patients who in that period had lung cancer diagnosed in our clinic, only 22% were operated on. Lobectomy was the most frequent type of operation (45%), and exploratory thoracotomy was carried out in 13%. The epidermoid type of cancer was the most frequent one (62%). Comparing cTNM with pTNM, concordant results were found in 55% of the series, 39% were clinically underestimated and 6% overestimated. By the time of the evaluation (31 December 1992), 78% of all patients who had undergone surgery during the study period had died. The most frequent cause of death was lung cancer metastasis. In the subseries of patients who died within 1 month after surgery (10% of all patients), the most frequent cause of death was pneumonia. The survival curve shows the best prognosis for patients in the Ist TNM stage, with 40% surviving 5 years. The authors consider the results of this study to favour aggressive surgical treatment of NSCLC patients.

Adenocarcinoma

[Mesotheliomas].

The authors deal with the problem of mesotheliomas, their incidence and types. Most frequent are pleural mesotheliomas, which may be defined/localized/ or diffuse. Localized forms are indicated for surgery and have a favourable prognosis, diffuse forms are highly malignant and are considered a non-resectable malignity. The authors report on their own experience with a group of 47 patients with mesotheliomas. For diagnosis the part played thorocoscopy is significant.

Heart Neoplasms

[Initial experience with videothoracoscopy].

In the course of five months the authors made 32 videothoracoscopies. They consider this surgical operation as a completely new quality in thoracic surgery. The hitherto limited scope of these examinations will, no doubt, expand as a result of the assembled experience.

Humans

[Testing bronchogenic carcinoma cells for sensitivity to cytostatics in vitro and in cell cultures].

The authors submit the first experience assembled in Czechoslovakia with testing of the sensitivity of bronchogenic carcinoma cells to cytostatics by the HTCA method (Human Tumor Clonogenic Assay). Based on work by A. W. Hamburger, S. L. Salmon and others the authors elaborated their own modification of the method of cell cultivation in a double layer of soft agar, which can be used in small laboratories attached to clinical departments. The sensitivity tests were made in eight bronchogenic carcinomas--four adenocarcinomas and four epidermoid carcinomas. For the tests five cytostatics were used: 5-fluorouracil, methotrexate, cis-platinum, vincristine and vinblastine. Because of contamination the results in three tested adenocarcinomas could not be evaluated. The evaluated specimen of adenocarcinoma was sensitive to 5-fluorouracil and methotrexate, but was resistant to the remaining tested cytostatics. In the group of epidermoid carcinomas one specimen was completely resistant and one completely sensitive to all tested cytostatics. In one specimen the test with 5-fluorouracil could not be evaluated, and the specimen was resistant to the remaining cytostatics. The last specimen in this group was resistant to cis-platinum and sensitive to the remaining cytostatics.

Antineoplastic Agents

[Pulmonary sequestration].

In a group of 11 patients with pulmonary sequestration (7 men and 4 women) nine times lower lobectomy was performed and twice segmental resection of the basal segments of the lower lobe. Three times severe haemorrhage from the atherosclerotic degeneratively altered artery supplying the pulmonary sequester was recorded. None of the patients died. No relapse was observed. An essential part of the preoperative examination is angiography of the lungs which reveals reliably an atypical course of the artery for the pulmonary sequester.

Adult

Carcinoembryonic antigen in bronchogenic carcinoma.

The authors determined carcinoembryonic antigen concentration in the sera of patients with bronchogenic carcinoma, some noncancerous lung diseases and in the sera of healthy subjects in order to assess the contribution of this method to the diagnosis of bronchogenic carcinoma with regard to the morphological type. Increased levels of carcinoembryonic antigen in patients with bronchogenic carcinoma were observed in 32% of cases. Among the morphological types of bronchogenic carcinoma statistically significant differences were not found. The comparison of bronchogenic carcinoma regardless of the type with the groups of noncancerous lung diseases and healthy subjects revealed statistically significant differences.

Carcinoembryonic Antigen

[Lung "cysts"].

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Adult

[Mesotheliomas].

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Adult