Biomedical subjects

M Duda

Publications and source records attributed to M Duda.

At least 19 recordsLinked to original sources

PubMed2007

Immunohistochemical localization of androgen receptor in two subpopulations of porcine granulosa cells in vitro.

In the ovarian follicles of mammals, androgens are utilized as substrates for estrogen synthesis or can act via androgen receptor (AR). Within the ovary, granulosa cells generally display the strongest immunoreactivity for AR protein. Therefore, the aim of the present study was to analyse possible changes in the intensity of AR staining in cultured mural and antral granulosa cells isolated from follicles at various stages of development. Porcine ovaries were obtained at a local slaughterhouse and the follicles were classified as small, medium and large dependently on their diameter. Isolated granulosa cells were separated into two populations, mural and antral, and then the cells were cultured during 48 h. After this time the cells were fixed and immunostained to visualize the AR. Androgen receptor immunostaining was detected in both, antral and mural granulosa cell cultures isolated from follicles at all stages of the development. In the mural granulosa cultures the immunostaining was comparatively weaker than that in the antral granulosa cells originating from all types of follicles. Our results provide immunohistochemical evidence that antral granulosa layer is the main site of AR immunoexpression.

Abattoirs↗

PubMed2006

Ischemic preconditioning prevents endothelial dysfunction, P-selectin expression, and neutrophil adhesion by preventing endothelin and O2- generation in the post-ischemic guinea-pig heart.

Evidence indicates that ischemia/reperfusion (IR) results in endothelial dysfunction and neutrophil adhesion in the post-ischemic myocardium and that ischemic preconditioning (IPC), superoxide dismutase (SOD), and anti-endothelin-1 (ET-1) interventions prevent these effects. We tested the hypothesis that ET-1-induced superoxide (O(2)(-)) generation mediates endothelial injury and neutrophil accumulation in the IR heart, that IPC protects the endothelium and prevents the adhesion by attenuating post-ischemic ET-1, and thus O(2)(-), generation, and that the mitochondrial ATP-dependent potassium channel (mK(ATP)) triggers the IPC-induced protection. Langendorff-perfused guinea-pig hearts were subjected either to 30 min ischemia/35 min reperfusion (IR) or were preconditioned prior to IR with three cycles of either 5 min ischemia/5 min reperfusion or 5 min infusion/5 min wash-out of mK(ATP) opener diazoxide (0.5 microM). Neutrophils were infused to the hearts at 15-25 min of the reperfusion. Coronary flow responses to acetylcholine (ACh) and nitroprusside (SNP) served as measures of endothelium-dependent and -independent vascular function, respectively. Myocardial outflow of ET-1 and O(2)(-), P-selectin expression, neutrophil adhesion and functional recoveries were followed during reperfusion. IR augmented ET-1 and O(2)(-) outflow, P-selectin expression, and neutrophil adhesion, and impaired ACh response. These effects were attenuated or prevented by IPC and diazoxide, and 5-hydroxydecanoate (a selective mK(ATP) blocker) abolished the effects of IPC and diazoxide. SOD (150 U/ml) and tezosentan (5 nM, a mixed ET-1-receptor antagonist) mimicked the effects of IPC, although they had no effect on the ET-1 generation. The preventive effect of IPC, SOD and tezosentan on P-selectin expression preceded their effect on neutrophil adhesion. These data suggest that in guinea-pig heart: (i) ET-1-induced O(2)(-) generation mediates the post-ischemic endothelial dysfunction, P-selectin expression and neutrophil adhesion; (ii) IPC and diazoxide afford protection by attenuating the ET-1, and thus O(2)(-) generation; (iii) the mK(ATP) opening triggers the IPC protection; (iv) endothelial injury promotes post-ischemic neutrophil adhesion, but not vice versa.

Animals↗

PubMed2005

[The intraabdominally located mesh in the laparotomy management of major hernias].

AIM: Major hernias in sutures following abdominal surgical procedures make the patients' quality of life significantly worse. Our aim is to prove that, even now, the surgical management of such hernias has its cons and in most cases requires a plastic mesh application. PATIENT SUBJECTS AND RESULTS: The authors operated 82 patients with hernias via the middle laparotomy. The patients had been primarily operated for their colorectal disorders. The incidence rate of the major hernias in sutures was 5.25% (82/1564). The defects of the abdominal wall were corrected using a prolene mesh placed intraperitoneally. Although in 11 patients the authors report postoperative complications in the sutures (1x absces, 6x seroma, a 4x infiltration), the long-term results of the above technique remain very positive. 2 patients had a relaps of the hernia and clinical manifestations of adhesions following the procedure were reported in 7 patients. CONCLUSION: The technique of the intraabdominally located mesh in the major postoperative hernias management enables tension-free procedures of the major defects of the abdominal wall to be conducted with very good long-term results.

Hernia, Ventral↗

PubMed2004

[Total stripping of the greater saphenous vein--an obsolete method?].

The authors discuss the surgical treatment of primary varices. The analysis is based on pathophysiological principles in the development of venous insufficiency. The attention is paid to reflux in key positions, presumably sapheno-femoral and sapheno-popliteal junctions, respectively. Dilated perforators with a reflux are considered to ensue from these refluxes. These principles enable to draw conclusions on an adequate therapeutic procedure, a limited stripping of saphena veins. A total stripping is indicated only exceptionally, when the whole stem is affected.

Humans↗

PubMed2004

Nitric oxide synthase inhibition and elevated endothelin increase oxygen consumption but do not affect glucose and palmitate oxidation in the isolated rat heart.

Evidence indicates that nitric oxide (NO) suppresses myocardial oxygen consumption (MVO(2)) and regulates myocardial substrate oxidation, however data from in vivo and isolated heart preparations are conflicting. In addition, cardiac endothelin (ET-1) release has been shown to increase with inhibition of NO synthase (NOS), however the effects of ET-1 on myocardial energetics is not clear. We employed the isolated rat heart model to assess the role of NO and ET-1 on myocardial function and metabolism. Oxidation of glucose and FFA was measured using [U-(14)C]glucose and [9,10-(3)H]palmitate. NOS inhibition with N(G)-methyl-L-arginine acetate salt (L-NMMA, 50 microM), resulted in an increase in MVO(2) at a given rate of myocardial external workload, and no change in myocardial glucose or FFA oxidation. ET-1 (25 pM), which caused coronary vasoconstriction similar to that produced by L-NMMA, also increased MVO(2) without an effect on cardiac workload, or substrate oxidation, suggesting a role for ET-I in the regulation of myocardial energetics. We assessed also the effect of ET(A)/ET(B) receptor blockade (tezosentan; 5 nM) on MVO(2) and glucose and FFA oxidation and observed no effect, suggesting that basal ET-1 production does not play a role in regulating MVO2 or substrate selection. In conclusion, inhibition of NOS or the addition of ET-1 resulted in an increase in MVO2, but did not affect glucose or FFA oxidation.

Animals↗

PubMed2004

Complex therapy of advanced colorectal carcinoma.

The present paper reports on a complex therapy of 18 patients with primary unresectable advanced carcinoma of the rectum and rectosigmoid. The results of surgery following complete chemoradiotherapy are evaluated. Radical surgery was successful in 15/18 patients. The authors describe a high incidence of postoperative complications and point out a high erudition of an oncosurgeon necessary for such intervention as well as for the indication of a patient to this extensive operation. (Tab. 2, Ref. 18.)

Carcinoma↗

PubMed2004

Esophageal dysfunction in a female patient with diabetes mellitus and achalasia.

BACKGROUND: Achalasia is an infrequent disorder of esophageal motility. Diabetes mellitus is an endocrine metabolic disease, the complication of which can afflict the motor activity of gastroenteral tract. The combination of these diseases in one patient is also very rare. In this study we introduce one patient suffering from this scarce coincidence of diseases. CASE HISTORY: A 54-year-old diabetic patient who lost weight of 26 kg in one month with repeated hypoglycaemic collapse states and regurgitation of poorly digested food and saliva with maintained appetite and thirst. The diagnosis of esophageal achalasia II was proved. A standard surgical performance was chosen, namely the laparoscopic myotomy. The extent of myotomy was verified by preoperative manometry. Approximately 1 month after the surgery, intermittent mild dysphagia especially after the consumption of solid food and some sorts of fruit appeared. The suspicion of stricture in the site of myotomy led us to the performance of endoscopic and radiologic examinations. The balloon calibration of cardia did not reveal any residual muscular fibres. The supplementation of a prokinetic drug of itoprid three times a day resulted in a significant improvement of difficulties. CONCLUSION: Despite the sufficient extent of surgical treatment in a patient suffering from these two diseases, the resulting effect was not fully satisfactory. It is apparent that despite the correctly indicated and performed operation in patients suffering from a metabolic disease, the complications of which afflict the motility of upper digestive tract, the ideal response to treatment cannot be expected. The supplemented prokinetic therapy is inevitable, and informing the patient on the expected result and particular residual disorders can save both the patient and surgeon from disappointment. (Fig. 3, Ref. 8.).

Deglutition Disorders↗

PubMed2004

Endothelial protection from reperfusion injury by ischemic preconditioning and diazoxide involves a SOD-like anti-O2- mechanism.

Cardiac ischemia/reperfusion leads to coronary endothelial dysfunction, mediated by superoxide anion (O2-), but not hydroxyl radical (*OH). Ischemic preconditioning and mitochondrial ATP-dependent potassium channel opener (diazoxide) protect endothelium in the mechanism involving attenuation of O2- burst at reperfusion. We hypothesize that the endothelial protection involves upregulation of myocardial anty-O2- defense. Langendorff-perfused guinea-pig hearts were subjected to global ischemia/reperfusion (IR) or were preconditioned prior to IR with three cycles of ischemia/reperfusion (IPC) or infusion/washout of 0.5 microM diazoxide. Coronary flow responses to acetylcholine were measures of endothelium-dependent vascular function. Myocardial outflow of O2- and of *OH during reperfusion and myocardial activities of superoxide dismutase (SOD) and catalase were measured. IR impaired acetylcholine response and augmented cardiac O2- and *OH outflow. IPC, diazoxide, and SOD (150 IU/ml) attenuated O2- outflow, increased *OH outflow and protected endothelium. There were no differences in Cu/Zn-SOD, Mn-SOD and catalase activities between sham-perfused and IR hearts and only catalase activity was increased in the IPC hearts. We speculate that: (i) IPC and diazoxide endothelial protection involves activation of some SOD-like anti-O2- mechanism resulting in attenuation of O2- burst and increase in *OH burst, (ii) improved SOD activity might have not been detected because it was confined to a small, although functionally important, enzyme fraction, like that bound to the endothelial glycocalyx.

Animals↗

PubMed2004

[Recurrence of varices in lower extremities].

Authors have done a retrospective analysis of 94 lower extremities in 88 patients examined from 1996 to 2002 for recurrence of varices in lower extremities. The goal was to find out the most frequent causes of recurrence of varices in lower extremities in patients with history of varices surgery referred to venous guidance clinic because of another onset of varices in lower extreminites or clinical signs of chronic venous insufficiency. Reflux was proved in 78 lower extremities from the total number of 94 (83%) in our sample. Isolated reflux was discovered in 59 extremities in saphenofemoral junction (39 extremities), in saphenopopliteal junction (14 extreminies), and in perforators (6 extremities). Combined reflux detected simultaneously in two or three places (SFJ, SPJ, perforators) was found in 19 extremities. In 11 cases the reflux was proved in two places and in 8 cases even in 3 places simultaneously. The main cause of recurrence of varices in lower extremities in our sample was reflux especially in saphenofemoral junction and saphenopopliteal junction. Reflux in perforators was usually accompanied with saphenofemoral and/or saphenopopliteal junctions incompetence. Isolated reflux in perforators was found very rarely (6.4%). The cause of varices recurrence was not disclosed in 17% of cases.

Female↗

PubMed2004

Oncologic markers in patients with colorectal cancer after a complex therapy.

The authors present a prospective study on a value of oncologic markers CEA and CA 19-9 in patients after curative therapy for colorectal adenocarcinoma. During a five-year follow-up in 320 patients, a significant elevation of CEA or CA 19-9 was documented in 71 patients (22.8 %), and resulted in tumour detection in 39/71 patients (55 %). Although the levels were defined as false positive in 32 patients (45 %), the importance of CEA and CA 19-9 monitoring is documented by elevated levels of oncomakers in 39/55 patients (71%) with metastases or local-regional recurrence of colorectal adenocarcinoma. (Tab. 3, Ref: 21.)

CA-19-9 Antigen↗

PubMed2004

[Surgical treatment of the colorectal carcinoma synchronous with liver metastases].

The authors present their results of the surgical treatment of the synchrone liver metastases in the second stage and following three courses of chemotherapy. Although the trial group is small, counting 25 patients operated between April 2002 and October 2003 (i.e. 18 months), the procedure's clinical benefits may be deducted, based on the immediate postoperative results.

Adenocarcinoma↗

PubMed2004

[Surgery of the low extremity varices as a part of a same-day surgery programme].

INTRODUCTION: One-day surgical methods lower the procedures costs as well the need for urgent beds in surgical clinics. The varix operation seem to be the optimal diagnosis suitable for the one-day surgical procedure. AIM: The aim of this work is to assess a feasibility of the one-day surgery for the low extremities varix operations. METHODOLOGY: During the period starting in January until December 2003, 98 extremities were operated for varices. The surgical procedure was the same for the hospitalized as well as for the patients assigned to the one-day surgery programme. Each patient was examined with the duplex ultrasound prior to the surgery, after the surgery a compressive bandage was indicated. RESULTS: We operated 98 extremities in 96 patients suffering from varices during the period from January 2003 to December 2003. The trial group consisted of 67 females and 29 males aged 21-79 years of age (the average of 45.3 years). According to the CEAP classification, 57 extremities (58.2%) were assigned to the C2 category, 30 extremities (30.6%) to the C3 category, 6 extremities (6%) to the C4 category, 4 extremities (4%) to the C5 category and one extremity (1%) to the C6 category. 14 extremities in the group were operated due to the disease relapse. 62 patients (i.e. 65%) were released for the home-care on the day of the operation, 27 patients (28%) were released the following day. One patient was hospitalized for two days, three patients for three days, one patient for four days and two patients for five days. 91 out of the total 98 extremities (i.e. 93%) underwent the one-day surgery. CONCLUSION: Although some patients require hospitalization, the varix surgery is safe and suitable for the one-day surgery. A thorough preoperative examination as well each patient's cooperation are both very important.

Adult↗

PubMed2003

[Endoscopic subfascial dissection of perforators (ESDP) vs open ligation of perforators].

OBJECTIVE: Comparison of two surgical procedures in discontinuation of the venae perforantes. METHOD: The authors evaluated perspectively a group of 78 patients subjected to 82 operations with severing of the venae perforantes on the lower extremities. They defined the indications for both surgical procedures. RESULTS: The open procedure (Cockett's segmental operation) was indicated in 10 extremities, ESDP in 72. The endoscopic operation lasted on average 59 minutes, the open one 50 minutes. The hospitalization period in the endoscopic variant was shorter (6.1 days vs. 8.5 days after the open operation). preoperative complications such as haemorrhage from the severed perforator occurred in ESDP. In Cockett's operation there were no preoperative complications, but there were two cases of healing per secundam during the postoperative period. Healing of crural ulcers within 12 weeks was recorded in both types of operations. The open procedure is indicated where there are major nodes on the leg and there are no extensive trophic changes, in particular in patients in stages C3 and C4. ESDP is indicated in patients in advanced stages of CVI, i.e. C5 and C6 according to CEAP. CONCLUSIONS: Every method has its indications whereby a higher incidence of complications may be foreseen after the open operation as compared with the endoscopic one.

Adult↗

PubMed2003

[Severing perforators in advanced stages of chronic venous insufficiency].

OBJECTIVE: To evaluate the importance of anastomozing veins in the development of chronic venous insufficiency (CVI). METHOD: Perspective analysis of a group of 82 extremities where the perforators were severed by the endoscopic or open method. RESULTS: Surgery of the perforators was associated with a decline of the total number of perforators detectable on DUS, with a marked reduction of extremities with insufficient perforators and improved total CEAP score. In 98% extremities at the same time surgery of the epifascial venous system was performed. CONCLUSIONS: The role of perforators in the development of CVI is not unequivocal and its assessment is more difficult due to concurrent operations of the epifascial system. Dissection of the perforators is indicated in cca one tenth of patients with CVI.

Adult↗

PubMed2003

[Peroperative diagnostic methods during esophageal achalasia surgery. Initial experience].

AIM OF THE STUDY: The authors present their first experience with the application of esophageal manometry during the operation on achalasia of esophagus. The completeness of performed myotomy is evaluated on the basis of decreased pressure in the region of lower esophageal sphincter (LES). METHODS: Stationary pull-through four-channel manometry was performed twice during the operation: before the application of capnoperitoneum to localize LES with evaluation of its length and tonus and after the myotomy was performed after capnoperitoneum was abolished to verify sufficient extent of myotomy. The subsequent endoscopic control was used to exclude damage of esophagus mucous membrane. RESULTS: In the period of one year during 2002/2003 the authors operated on four patients with achalasia, when manometry was used for peroperative localization of LES and evaluation of the extent of myotomy. The peroperation manometry demonstrated decreased tonus of LES (the mean 42.06 mmHg before myotomia and the mean 20.03 mmHg after myotomia) and in one case the finding resulted in necessary extension of myotomia. CONCLUSIONS: Based on our preliminary experience with peroperation manometry in operations on achalasia of esophagus it may be stated that it is a useful method for objectivization of the completeness of myotomy, which does not significantly prolong the period of operation. It contrast, it makes it possible to respond to lasting hypertonic area in LES subjected to myotomy, which may be the cause of lasting complaints of patients after the operation.

Esophageal Achalasia↗

PubMed2003

[Complications after laparoscopic surgery of inguinal hernias].

AIMS: The authors describe the occurrence of complications in laparoscopic approach to treat inguinal hernias in patients operated on at 2nd Surgical Clinic in Olomouc from May 1991 to the end of the year 2002. METHODS: The occurrence of preoperation and postoperation complications and relapses in inguinal hernias treated with laparoscopy in the period of May 1991 to the end of 2002. The TAPP method was used for operation on 98% of inguinal hernias, the IPOM method for 0.9% of inguinal hernias, TEP method in 0.4% and a simple suture in operation on 0.7% of inguinal hernias. RESULTS: Five hundred and thirty four (56% of all surgically treated inguinal hernias) were treated with laparoscopy in adult patients in the period of May 1991 to the end of 2002. Eight preoperation and postoperation complications (1.4%) were encountered. These included two cases of hematoma in the wound after port (0.3%), one hematoma of scrotum (0.2%), two artificial perforations of intestine (0.3%), one case of neuralgia of n. genitofemoralis, one artificial perforation of urinary bladder (0.2%), and one postoperation hydrocele (0.2%). There were 14 relapses (2.6%) in the 534 inguinal hernias operated on with laparoscopy. CONCLUSION: Based on our experience in the solution of inguinal hernias with laparoscopy the method of transabdominally-preperitoneally localized grid (TAPP). In this method we have used three-point fixation--by a screw to pected ossis pubis and the upper margins of the grip with two transparietal stitches fixed permanently in subcutaneous tissue.

Adult↗

PubMed2003

[CHS 100P surgical mesh in inguinal hernioplasty in adults using the Lichtenstein tension-free method].

AIMS: The authors present their initial experience with surgical grid CHS 100 P with strengthened middle strip for the intestinal hernioplasty by the method without tension according to Lichtenstein. METHODS: In the inguinal hernioplasty by anterior transinguinal way in adult patients the authors use prolene grid and a surgical grid CHS 100 P with strengthened middle strip having been developed in collaboration with the Research Knitting Institute in Brno. RESULTS: From November 2001 to May 2003 56 adult patients were operated on inguinal hernia by the tensionless plasty according to Lichtenstein using a surgical grid CHS 100 P. No preoperation of postoperation complication or relapse were encountered. The patients were subject to load in the first postoperation day. CONCLUSION: Based on our first experience with flexible surgical grid with strengthened middle band CHS 100 P used for tensionless inguinal hernioplasty in adult patients according to Lichtenstein it may be concluded that the grid is well tolerated by the patients. Flexibility of the grid makes it possible to fully load inguinal area during the first postoperation day.

Hernia, Inguinal↗

PubMed2002

[Use of ultrasonography in surgery].

OBJECTIVE: To draw attention to the perspectives of application of ultrasonography in surgery. METHOD: Based on their own experience and data in the literature the authors draw attention to contemporary possibilities to use ultrasound in surgery. This concerns in particular the following areas: abdominal sonography, injuries, examination of small areas, peroperative sonography, laparoscopic sonography, intraluminal sonography, Dopplerometric examination of the vessels, use during transplantations and in neurosurgery. RESULTS AND CONCLUSIONS: While urologists use sonographic examinations commonly, only a small percentage of surgeons are familiar with this method. The authors explain the necessity of greater involvement of surgeons in this area which is consistent with the development of surgery and trends abroad.

Endosonography↗