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Biomedical subjects

K Novák

Publications and source records attributed to K Novák.

At least 19 recordsLinked to original sources

[Inovative techniques in partial laparoscopic resection of the kidney for adenocarcinoma].

Authors present the first case of laparoscopic partial resection of the kidney for RCC using modern technique of tissue sealing with FloSeal, which was used in this indication for the first time in the Czech Republic. The other most useful innovative point was the usage of tail-clipped sutures from resorbable material "Lahodny", which are suitable for suturing in renal parenchyma. Despite the relatively long time of warm ischemia, the function of rest of the kidney is more than satislying.

Adenocarcinoma↗

Visualization of nodulation gene activity on the early stages of Rhizobium leguminosarum bv. viciae symbiosis.

A technique was optimized for the in situ detection of nodulation (nod) gene activity in Rhizobium leguminosarum bv. viciae symbiosis with compatible plant hosts Vicia tetrasperma (L.) SCHREB. and Pisum sativum L. The transcription of nodABC-lacZ fusion was visualized as beta-galactosidase (beta-Gal) activity after reaction with the chromogenic substrate X-Gal and subsequent light microscopy, while the background of the indigenous beta-Gal activity of rhizobia and the host plant was eliminated by glutaraldehyde treatment. V. tetrasperma was suggested as a suitable model plant for pea cross-inoculation group due to its advantages over the common model of V. hirsuta (L.) S.F. GRAY: compactness of the plant, extremely small seeds, fast development and stable nodulation under laboratory conditions. In the roots of both plants, a certain extent of nod gene activity was detectable in all rhizobia colonizing the rhizoplane. In pea 1 d after inoculation (d.a.i.), the maximum was localized in the region of emerging root hairs (RH) later (3 and 6 d.a.i.) shifting upwards from the root tip. Nodulation genes sustained full expression even in the infection threads inside the RH and the root cortex, independently of their association with nodule primordia. Comparison of two pea symbiotic mutant lines, Risnod25 and Risnod27, with the wild type did not reveal any differences in the RH formation, RH curling response and rhizoplane colonization. Both mutants appeared to be blocked at the infection thread initiation stage and in nodule initiation, consistent with the phenotype caused by other mutant alleles in the pea sym8 locus. Judging from the nod gene expression level and pattern in the rhizoplane, flavonoid response upon inoculation is preserved in both pea mutants, being independent of infection thread and nodule initiation.

Bacterial Proteins↗

[Reconstruction surgical procedures for iatrogenic injuries to the ureter. Examples of uncommon, however successful approaches to their management].

The authors present several less usual reconstructions of ureters after the primary iatrogenic lesions. The appropriate ureteric capacity to drain the urine after previous injury is quite demanding and hence before the definitive decision is made the wholesome health status of the patient is to be considered and all possible solutions should be weighted. The efficient primary urinary diversion above the lesion is unavoidable. The genuine reconstruction could be deferred by several weeks or months in the view that in some cases the least invasive (endourologic) methods can completely avoid the need of open surgery in difficult adhesions after previous major surgery.

Abdomen↗

[Role of laparoscopy in uro-oncology].

The article reviews problems of laparoscopic surgery in uro-oncology. Examples supporting and opposing the laparoscopic alternative are given. Original objections against the use of the method for the treatment of malignancies are discussed from the retrospective position. According to the predominant views it looks that laparoscopic treatment by a highly educated team with good technical background, respecting oncologic and functional aspects, does not have worse short-term and long-lasting results. The improving diagnostics and possibility to identify malignancies in early stage of development will enable wider use of the laparoscopic surgery.

Humans↗

[Treatment of the lower pole nephrolithiasis].

BACKGROUND: The purpose of the study was to compare the efficacy of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy for lower pole nephrolithiasis. METHODS AND RESULTS: We retrospectively analyzed results of lower pole nephrolithiasis treatment in 396 patients (221 treated by extracorporeal shock wave lithotripsy and 175 by percutaneuos nephrolithotomy). We evaluated results of the treatment in the 3 months interval after the procedure in groups classified according to the stone size: <10 mm, 10-20 mm, >20 mm. Stone free status was achieved in these groups after 96 (66%), 43 (38 %) and 2 (25%) shock wave lithotripsies and 48 (84%), 75 (76%) and 25 (74%) percutaneous nepholithotomies. The efficacy irrespective of insignificant residual fragments (< 4 mm) was in 176 (66%) lithotripsies and 156 (82%) single percutaneuos nephrolithotomies. CONCLUSIONS: Percutaneous nephrolithotomy is more effective methods in the treatment for lower pole nephrolithiasis than extracorporeal shock wave lithotripsy especially for stone size >10 mm.

Adolescent↗

[Echinococcus cysts (hydatids)].

INTRODUCTION AND MATERIAL: This work is based on rich experience of the first-stated author. During a three-year expertise in Botswana he operated 80 patients with hydatic cysts and he took part in treatment of other patients affected by the Echinococcus granulosus infection. In 59 cases the infectious focus was located in the liver, in 18 cases in the lungs, in 2 cases in the spleen and in one case the foci were multiple peritoneal. METHODOLOGY: During the expertise period, the patients were observed prospectively, throughout the diagnostic decision-making and the treatment. Prior to the surgical procedure, they had been, in a long-run, treated with albendazole. In 18 cases out of the total number of the liver cysts, the experts chose a two-step procedure followed by a secondary plombage of the reduced cavity of the cyst with the omentum. The rest of the cysts were removed. Miniinvasive methods were not applied. However, the authors discuss their risks. RESULTS: None of the patients exited, in 3 cases a peroperational anaphylactic reaction was managed. Throughout the expertise, no cases of the echinococcus dissemination in the operated subjects were recorded. The team even managed to treat the hydatic cysts in patients who were HIV/AIDS positive and who were, originally, in a serious state of immunodeficiency. Five cases are presented in the form of brief case reviews. CONCLUSIONS: Benefits of the long-term preparation with albendazole--plombage operations are beneficial to be conducted in two steps, Betadin is the most suitable lavage solution, miniinvasive surgical procedures (PAIR) may bring on specific complications.

Adult↗

[Mesenteric venous thrombosis--a shift in therapeutic strategy?].

The authors present a group of nine patients suffering from mesenteric venous thrombosis, which were treated in three hospitals with participation of the first author. Basic principles of diagnostic and therapeutic procedure are summarized and a shift in the treatment strategy over the last 10 years is pointed out. The patient after a very radical intestinal resection may expect to survive and entertain an acceptable quality of life, provided the surgery is followed by an extensive team care in the post-operation period, later accompanied by the care of specialists in modern ways of nutrition.

Aged↗

[HIV/AIDS positive patients in surgery. Part I: Epidemiologic situation].

INTRODUCTION AND MATERIAL: The paper is mostly based on materials and experience of the first author, who took part in an expert action, together with an international team of surgeons, treated more than 6000 HIV-positive patients in Botswana and performed more than 3,200 interventions himself. The co-authors corrected the African experience by a brief survey of experience in this country and reviewed the presently valid legislation. METHODS: The first two parts deal with literature knowledge on HIV/AIDS and confront it with the author's experience over three years of his expert stay in a hospital in Gabarone. The first part deal with epidemiological situation in the place of study and the second part analyzes in a general aspect the problems of surgical intervention in HIV-positive patients and the occupational risk. This part also includes a corresponding description of conditions in the Czech Republic including Czech legislation. The third, principal, part of the contribution is a prospective study where the author, under limited local conditions, investigated 3,200 HIV-positive patients undergoing surgery. The relation between HIC and tuberculosis is also analyzed from various other minor aspects and there are mainly the levels of CD4+ T lymphocytes followed from the standpoint of course of therapy and prognosis of the patients. The fourth part of the paper describes briefly twelve cases confirming and illustrating the results. RESULTS: HIC-positive individuals with the CD4 value below 200/mm3 represent the critically endangered patients. The values between 200 and 499 represent a distinct risk, which may be overcome, and values between 500 and 799 represent a minimum risk, whereas the value over 800 is exceptionally favorable. Tuberculosis is a very frequent opportune infection in African conditions (over 53% in the cohort under study), but rather than to influence the prognosis itself it act in relation to the values of CD4+ T lymphocytes. The main risk for surgical patients related to decreased immunity is not due to complications in the wounds and anastomoses, but in severe opportune infections. CONCLUSIONS: This most comprehensive surgical survey on HIV/AIDS, worked out by Czech authors, is very well applicable in conditions of the Czech Republic.

Acquired Immunodeficiency Syndrome↗

[Benefits and risks of urologic laparoscopic surgery in adult patients].

The paper describes the advantages and disadvantages of the laparoscopic operations, the number of which steadily rises in urology. The laparoscopic surgery is considered to be a benefit regarding the short postoperative hospital stay, painless postoperative course, and virtually non-existing postoperative paralytic ileus. As disadvantage are deemed the long learning curve for the operating personal, and high economical costs, which could be cut down only if short off-work period in productive population is included. In the paper, the pathophysiological guidelines are outlined and emphasized during the laparoscopic operation, which the surgical and anesthesiological teams have to have in mind. On the own cohort of patients, the numbers and types of operations are described, which have been done at our department.

Adult↗

Effect of exogenous flavonoids on nodulation of pea (Pisum sativum L.).

Selected flavonoids that are known as inducers and a suppressor of nodulation (nod) genes of the symbiotic bacterium Rhizobium leguminosarum bv. viciae were tested for their effect on symbiosis formation with garden pea as the host. A solid substrate was omitted from the hydroponic growing system in order to prevent losses of flavonoids due to adsorption and degradation. The presumed interaction of the tested flavonoids with nod genes has been verified for the genetic background of strain 128C30. A stimulatory effect of a nod gene inducer naringenin on symbiotic nodule number formed per plant 14 d after inoculation was detected at concentrations of 0.1 and 1 micro g ml(-1) nutrient solution. At 10 micro g ml(-1), the highest concentration tested, naringenin was already inhibitory. By contrast, nodulation was negatively affected by a nod gene suppressor, quercetin, at concentrations above 1 micro g ml(-1), as well as by another tested nod gene inducer, hesperetin. The deleterious effect of hesperetin might be due to its toxicity or to the toxicity of its degradation product(s) as indicated by the inhibition of root growth. Both the stimulatory effect of naringenin and the inhibitory effect of quercetin on nodule number were more pronounced at earlier stages of nodule development as revealed with specific staining of initial nodules. The lessening of the flavonoid impact during nodule development was ascribed to the plant autoregulatory mechanisms. Feedback regulation of nodule metabolism might also be responsible for the fact that the naringenin-conditioned increase in nodule number was not accompanied by any increase in nitrogenase activity. By contrast, the inhibitory action of quercetin and hesperetin on nodule number was associated with decreases in total nitrogenase activity. Naringenin also stimulated root hair curling (RHC) as one of the earliest nodulation responses at concentrations of 1 and 10 microg ml(-1), however, the same effect was exerted by the nod gene suppressor, quercetin, suggesting that feedback regulatory mechanisms control RHC in the range of nodulation-inhibiting high flavonoid concentrations. The comparison of the effect of the tested flavonoids in planta with nod gene activity response showed a two orders of magnitude shift to higher concentrations. This shift is explained by the absorption and degradation of flavonoids by both the symbionts during 3 d intervals between hydroponic solution changes. The losses were 99, 96.4, and 90% of the initial concentration of 10 micro g ml(-1) for naringenin, hesperetin, and quercetin, respectively.

Flavanones↗

[Laparoscopic transperitoneal adrenalectomy in hormonally-active adrenal tumors].

Laparoscopic adrenalectomy is considered the "gold standard" in adrenal surgery for benign functioning (and non-functioning) tumors. Laparoscopy meets criteria of miniinvasive surgery with minimal postoperative pain, short hospital stay and an outstanding cosmetic effect, the radicality of the procedure, open surgery and laparoscopy are equally effective. In cooperation with endocrinological department focused on detection of functioning adrenal tumors, the diagnostic and therapeutic procedure seems to be very efficient, so that the primary goal of rapid cure could be achieved. Patients after laparoscopic adrenalectomy mostly do not need chronic antihypertensive medication and only those after bilateral adrenalectomy (Cushing's disease) require life-long low dose hydrocortisone therapy. In pheochromocytomas, total excision of the tumor is considered to be a life-saving procedure, although up to 20% may recur as hereditary or as a part of von Hippel-Lindau's disease.

Adrenal Cortex Hormones↗