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Biomedical subjects

J Simek

Publications and source records attributed to J Simek.

At least 55 records · Page 3Linked to original sources

[Localized benign pleural mesothelioma].

The authors describe a case of benign mesothelioma of the pleura. This is a not very frequently encountered condition which as a rule is diagnosed only on the basis of histological examination of a preparation taken during operation. The surgical operation is most frequently indicated on account of the diagnosis of a lung tumour. If this diagnosis is taken into consideration and the patient's diagnosis is made in time and the patient is operated, the subsequent prognosis is very favourable.

Humans↗

[Injuries of the diaphragm].

The authors submit a group of 11 patients treated in 1977-1988 on account of traumatic injury of the diaphragm. The group comprised 9 adults and two children. The authors analyzed the causes of injury, the condition of the patients on admission to hospital, the interval between admission and surgical treatment of the diaphragm, the diagnostic approach, the surgical approach and its results.

Adolescent↗

[Pleural mesothelioma in data from the Surgical Clinic in Hradec Králové 1971-1987].

The authors describe a group of 12 patients operated at the Surgical Clinic in Hradec Králové in 1971-1987 with the diagnosis of a pleural mesothelioma. This tumour was found most frequently in the 6th decade. A slight predominance of women was found. Risk factors which might be associated with the development of a mesothelioma were found only in one patient. This disease is often recorded in a too advanced stage as it is manifested by a late, poor and non-specific symptomatology. In the authors' group of patients operated on account of mesothelioma the tumour was removed in six patients. Only those survive where the mesothelioma had a benign localization 2 patients). The fate of one patient could not be traced. All patients with the histological classification of malignancy in the diffuse or localized form died (9 patients), even when the tumour was surgically removed (3 patients). This fact indicates the great aggressivity of malignant mesotheliomas.

Adult↗

[Results of surgical treatment of aortic coarctation].

The authors summarize the results of surgical treatment of coarctation of the aorta in 98 patients. Te group comprised 70 children aged 3 to 15 years and 28 adults. The most frequently used technique was resection of the coarctation with a direct end-to-end anastomosis. It was used in a total of 83 patients. Three patients died, i. e. 3.1%. Of 32 patients who were invited for a check-up examination 16 came. Three of them had undergone a plastic operation with a dacron patch. All were subjected to angiographic examination in a lateral projection by injection of the contrast substance into the aortal arch and pressure readings were taken in the aorta above and below the site of anastomosis. Residual gradients were found in three patients (10, 12, 20 torr). Hypertension persists in 6 patients. In four patients slight stenosis of the aorta was found without a gradient, in one patient a small pseudoaneurysm. None of the findings called for further surgical intervention.

Adolescent↗

[An unusual complication of myxoma of the left atrium].

The authors give an account of a 59-year-old female patient with a myxoma of the left atrium which was complicated by repeated multiple embolizations into the systemic circulation. The cause of death after a successful operation was haemorrhage into the abdominal cavity from a ruptured spleen, as a result of a new lienal infarction after embolization of a portion of the myxoma into the lienal artery, 24 before the operation. The authors emphasize the necessity of immediate removal of an intracardiac formation as soon as it is detected.

Female↗

[Aortic stenoses and pulmonary hypertension].

Authors have been catheterized a total of 36 patients with isolated aortal stenosis. In 14 from them (38%), the mean pression value in pulmonar artery was ranged as over 25 torrs (3.33 kPa). It was proved on the statistical evaluation of hemodynamic data that the pulmonar hypertension is correlated with the pression on the end of diastola of the left ventricle (correlation coefficient r = 0.89), being irrelated of the extent of aortal gradient, bed surface, heart index, age, pulmonar vascular resistence and functional classification. The pression value in pulmonar artery is correlated negatively with the ejection fraction of left ventricle (r = -0.76). Pulmonar hypertension in isolated aortal stenoses is inflicted with functional disorder of left ventricle. The significance of pression value in pulmonar artery is discussed from the scope of indicatory strategy as to provide an urgent surgery, i.e. the exchange of the aortal valve.

Aortic Valve Stenosis↗

[Serum levels of oxacillin and cephalothin in patients with extracorporeal circulation during surgery].

The authors investigated the oxacillin and cephalotine serum levels in patients operated under conditions of extracorporeal circulation. They found that the time for which the patients are adequately protected against staphylococcal infection is in oxacillin cca 180 mins. and in cephalotine 150 mins. after administration of the first dose of antibiotic. They recommend to administer a second dose of the antibiotic along with protamine sulphate after removal of the aortal cannula to obtain a maximum concentration of the antibiotic in the newly formed blood clots. If the surgical operation lasts longer, they recommend to administer the antibiotic in the given time interval regardless of the operation and to administer a third dose when removing the cannula. The authors investigated a total of 30 patients. In one case they encountered an early and in another case a urinary infection.

Adolescent↗

Effect of parenteral administration of carnitine on liver regeneration in partially hepatectomized rats.

Male Wistar rats were subjected to 65-70% hepatectomy and either immediately or 18 h after surgery were given a 6-hour infusion containing 3 ml of either Ringer solution or aqua pro injectione alone or with L-carnitine in doses 8 mg (12.4 mumol), 40 mg (62 mumol) and 200 mg (310.2 mumol)/kg b.w. The rats were killed 6, 18, 24 and 30 h after surgery. The changes in the DNA specific activity and in the mitotic activity demonstrate that L-carnitine has a stimulating, dose-dependent effect on liver regeneration. This effect acts both during early post-hepatectomy, the prereplicative period and in the subsequent replicative period.

Animals↗

[Bacteriological findings in bronchial secretions of the lower respiratory tract in resected lungs].

The authors investigated during operation the bacteriological findings in the bronchial secretion of the respiratory pathways of resected lungs. Of 100 patients whom they included in the group they detected a positive finding in 42. Wound in 27 patients. Twenty of them had a positive bacteriological finding in the lower respiratory pathways. The authors discuss the problem of prophylactic use of antibiotics in pulmonary surgery. Based on data in the literature and their own observations, the authors recommend preventive administration of antibiotics in pulmonary surgery.

Adolescent↗

[General problems of psychological treatment of psychosomatic disorders].

The author summarizes the principles ensuing from the multifactorial theory on the pathogenesis of disease for clinical work with psychosomatic patients; he describes problems which must be resolved when attempting psychological treatment of these patients and explains general principles of therapeutic strategies in psychosomatic medicine.

Humans↗

[The psychologist in a somatic department].

A psychologist in a somatic department cannot replace the psychiatrist consultant and cannot take the responsibility for the further fate of any patient; he can, however, be useful in many other ways. The psychologist should be indispensible in the diagnostic process, similarly as the X-ray department or laboratory, he should be also consulted when the therapeutic strategy is elaborated. The psychologist can directly interfere with treatment, if he knows the necessary psychotherapeutic technique; the psychologist can effectively help the patients with adaptation to the disease and hospital environment, he can accompany the patient in more complicated situations which arise in conjunction with his disease and act as a mediator between the patient and health personnel. The psychologist should be invited to resolve more complicated problems in the department, such as conflicts, informing the patient on a malignant process, etc. The limiting factor as regards the use of the psychologist in a somatic department is the interest of clinical doctors in psychological problems of their patients and in aspects of the work contributed by the psychologist.

Humans↗

[Metabolic changes in liver tissue damage and the effect of nutrition on liver regeneration].

The present work reviews basic changes occurring in metabolism of carbohydrates, lipids and amino acids of an organism with liver injury and after resection of 70% of liver tissue. On the background of mentioned changes, the effect of individual energetic substrates and amino acids on the course of liver regeneration is discussed. Literature data and our proper results allow us to preclude that administration of only carbohydrates is impeding liver recovery. According to our observation, the liver regeneration after partial hepatectomy as well as the restoration of toxically damaged liver tissue may be favorably enhanced by infusion of lipid emulsion (Intralipid). The infusion of balanced amino acid solution (8% Nutramin) rather depresses the development of liver regeneration. Parenteral administration of amino acid solution enriched with branched chain amino acids (valine, leucine, isoleucine) has a favorable effect on the onset of liver regeneration after partial hepatectomy compared with glucose and of commercial amino acid solution (8% Nutramin). Probable mechanisms of inhibitory effect of glucose and favorable action of lipid emulsion infusions as well as branched chain amino acids on the initiation of liver regeneration are discussed.

Amino Acids↗

Effect of the parenteral administration of amino acid solutions in different phases after partial hepatectomy on the initiation and development of liver regeneration in rats.

Amino acid solutions enriched with branched-chain amino acids or pure branched-chain amino acid solutions were administered parenterally to female laboratory rats (pre-operative weight 230 +/- 30 g) which had been subjected to 65-70% partial hepatectomy (PH), and specific liver DNA activity, the hepatocyte mitotic index and other indicators of the initiation of liver regeneration were studied. Both solutions were infused in an hourly dose of 3.3 ml/kg body weight, during the following postoperative intervals: 1-6, 7-12, 1-12, 1-18 and 1-24 hours. The control rats continued to be fed on the standard laboratory diet after the operation. The results show that the infusion of an amino acid solution enriched with branched-chain amino acids had an inhibitory effect on the onset of DNA synthesis in the liver 18 hours after partial hepatectomy whatever the administration interval. The situation in the case of pure branched-chain amino acid solutions was the same. Twenty-four hours after PH, neither type of solution, irrespective of the infusion interval, was followed by an increase in DNA synthesis compared with the controls fed on the standard laboratory diet. Neither the hepatocyte mitotic index, nor the total liver DNA concentration, showed any changes indicative of stimulation of the initiation of liver regeneration. An infusion stress effect, evaluated from the decrease in the weight of the thymus, was found chiefly in the case of infusions lasting 12 h or longer.

Amino Acids↗

Effect of the parenteral administration of energy substrates in different postoperation phases on the initiation and development of liver regeneration in rats subjected to partial hepatectomy.

DNA specific activity in the liver, the total DNA content of the liver and the mitotic index of the hepatocytes were studied after the infusion of glucose or lipid emulsions in female laboratory rats with a mean pre-operation weight of 250 +/- 30 g after partial (65-70%) hepatectomy (PH). The infusions were administered in the early prereplication phase (the 1st to 6th hour after the operation), in the late prereplication phase (the 7th to 12th hour after the operation), or continuously from the 1st to the 12th, or the 1st to the 24th, hour after partial hepatectomy. The effect of these parenterally administered energy substrates on the initiation of liver regeneration was evaluated 18 and 24 hours after partial hepatectomy. The results indicate that the infusion of glucose, in any interval after the operation, inhibited the initial phases of liver DNA synthesis (18 h after PH), but not its further development (24 h after PH). Neither the mitotic index of the hepatocytes, nor the total DNA content of the liver differed from the control groups in the case of rats given a glucose infusion. In the experimental groups given lipid emulsions, inhibition of liver DNA synthesis was recorded 18 h after PH only when the infusions were given from the 1st to the 12th or the 1st to the 18th hour after PH. The total DNA content of the liver 18 h after PH was raised in all the experimental groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Effect of saline solutions administered parenterally in different postoperation phases on the regeneration of rat liver after partial hepatectomy.

Two series of experiments were carried out on female laboratory rats with a mean pre-operation weight of 250 +/- 30 g, fed up to the time of the experiment on a standard laboratory diet with water ad libitum. In the first series the rats were subjected to 65-70% partial hepatectomy (PH) or to laparotomy (LAP) and their serum Na+, K+, Cl- and total calcium concentrations were determined 6, 12, 18 and 24 h after the operation. At given postoperation intervals the serum Na+, Cl- and total calcium concentrations in hepatectomized animals were lower than in the intact controls, while the K+ concentration was higher. In the second series of experiments, the rats were given infusions of physiological saline or Ringer solution at different intervals (1-6, 7-12, 1-12 and 1-24 h) after PH. Specific DNA activity in the liver, the hepatocyte mitotic index, the total DNA content of the liver and other indicators show that physiological saline infusions had an inhibitory, or at most a neutral effect on the initiation of liver regeneration, while the effect of the infusion of Ringer solution on the initiation of liver regeneration, in most of the given intervals, was indifferent. The regeneration response depends on the post-PH phase in which the solution is infused.

Animals↗

Course of liver regeneration after partial hepatectomy in rats treated with dialysates obtained 17 hours after partial hepatectomy.

Various theories have been put forward to explain the regenerative capacity of liver tissue induce by partial hepatectomy (PH). One of them presumes the existence of humoral factors stimulating proliferation of the liver tissue. We evaluated the course of liver regeneration after 65-70% PH as influenced by dialysates (DIA) of the organs of a rat killed 17 h after PH. In addition to kidney DIA, we were particularly interested in the effect of liver and spleen DIA. The experiments were carried out on rats weighting 310-370 g. Kidney, liver or spleen dialysate was administered subcutaneously and the rats were killed 12 or 24 h later by exsanguination from the abdominal aorta. In further rats, PH was performed 24 h after administering DIA and the rat were killed 18, 24, 30, 48 and 72 h after the operation. The initiation of liver regeneration was stimulated by all the given DIA, but especially by liver DIA. The faster onset of liver regeneration 18 h after PH in rats given spleen DIA is interesting. DIA did not greatly affect the hepatocytes of intact liver, but accelerated the initiation of liver regeneration after PH by synchronizing the cell cycle of proliferating hepatocytes. DIA obtained 17 h after PH contained substances which primarily stimulated liver DNA synthesis. From the changes in inhibition of the migration of spleen macrophages in the medium containing liver antigens, and from the circulating immunocomplex values, we conclude that DIA activation of the immune system, a well as the hepatic stimulator substance contained in the DIA, participates in acceleration of the liver regeneration process.

Animals↗

Course of liver regeneration after partial hepatectomy in rats treated with dialysates of intact organs.

A number of growth phenomena observed in vitro have shown that cells, at high densities, produce and release substances which, when they have reached a given concentration, arrest further growth. In vivo, these possibilities can be studied on the model of rapid regeneration of the rat liver after 65-70% partial hepatectomy (PH). We evaluated the course of liver regeneration after PH in animals treated with dialysates (DIA) of intact rat tissues. In addition to kidney and lymph node DIA, we were particularly interested in the effect of liver and spleen DIA. The experiments were carried out on male rats weighing 210-240 g. The relevant DIA was administered 24 h prior to PH; the controls were given physiological saline. The animals were killed just before PH and 24, 48, 30 and 72 h and 14 days after. DIA obtained from intact liver tissue inhibited the regeneration process induced by PH and its effect persisted 48 h after PH. Compared with the controls and with the rats given kidney DIA, DNA synthesis in the liver 24 h after PH was reduced to 77%. After spleen DIA, several (still hypothetical) factors probably acted together synergically (factors belonging to the immune system--RES--and spleen-produced factors capable of promoting proliferation of the hepatocytes--the "portal blood factor"). We arrived at this conclusion from an evaluation of liver DNA synthesis 24 h after 24h after PH, when synthesis was altogether markedly raised, but attained far higher values after the administration of spleen DIA.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗