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Biomedical subjects

M Konecný

Publications and source records attributed to M Konecný.

At least 19 recordsLinked to original sources
PubMed2004

[Atypical portocaval anastomosis for hemorrhage in portal hypertension].

The success of endoscopy in treating esophageal varices and the later introduction of liver transplantation into the algorithm of therapy for liver failure shifted surgery of portal hypertension out of sight of hepatologists and surgeons. This decline from surgical treatment was further confirmed by introduction of TIPS into clinical practice. It is completely out of question that only liver transplantation is the causal solution of decompensated liver disease and a series of reliable and less invasive methods may be selected for acute treatment of bleeding from varices. However, even at the present time the portal-systemic shunt may be used in its own indication in repeatedly bleeding patients with a good liver capacity, where it can play a role by bridging the time to liver transplantation in a way similar to TIPS or even to provide a final solution, which makes it possible to live the life expectancy in adequate comfort without the risk of bleeding complications. However, it is not always possible to place a surgical shunt on some of the main branches of the portal vein. In such cases, devascularization is often successfully applied. Atypical shunts represent an exceptional alternative, because side feeder veins of the portal vein are rarely of sufficient caliber for placing a hemodynamically significant shunt. The authors describe two cases, in which stubborn anemia-causing bleeding events in portal hypertension were treated with left-side epiploic-renal shunt or anastomosis between the mesenteric and left-side iliac vein.

Aged↗
PubMed2002

[Mini-invasive treatment of purulent spondylitis associated with a psoas abscess in a child (case report)].

The authors describe a case of a 12 years old boy who suffered from pain in the lumbar region, limitation of dynamics in lumbosacral spine with a gradual deterioration of the condition. The patient was afebrile. The pain was getting worse and the classic radiographs did not show at the beginning any pathological changes. Suspected were mainly the discogenic syndrome, functional vertebrogenous syndrome but also development of a tumour in the region of spine. CT scan revealed structural changes in the region of L3 vertebra and less in the L4 region. At the same time it showed a soft mass pushing the psoas muscle to the left which was described as paravertebral abscess and the structural changes as a suspect L3, L4 spondylitis. The condition of the patient was associated with a high risk of endocarditis as in the childhood he underwent the Senning operation for coarctation of great vessels. Therefore it was necessary to determine etiological agent as quickly as possible. After a mini-invasive surgery with a probational biopsy and subsequent drainage the spondylytis was confirmed also histologically and a coagulation-negative Staphylococcus aureus was cultivated as an etiological agent. At the same time tumour development was eliminated. After 15 weeks the antibiotic therapy was changed as after the removal of drains the microbe was already resistant to the administered antibiotics and therefore the antibiotics were changed with regard to sensitivity and minimum inhibition concentrations. Within 15 weeks after a local drainage by antibiotics and the total antibiotic therapy also inflammation markers gradually decreased and the patient is for a long period without complaints with full range of motion in the lumbosacral spine. In the conclusion the authors emphasize the accurate timing algorithm of the diagnosis in children which may initiate an early and successful treatment.

Child↗
PubMed2001

[Long-term follow-up of patients with extensive ulcerous colitis with emphasis on the occurrence of dysplastic changes and colorectal carcinoma].

The chronic course of idiopathic intestinal inflammations is characterized also by a relatively high incidence of complications, local ones affecting the entire large intestine, as well as extraintestinal ones in remote organs. In the submitted paper the authors present the results of a six-year follow-up focused on the incidence of dysplastic changes of the intestinal mucosa and colorectal carcinoma in 46 patients from a group of 220 patients followed up on a long-term basis at the Second Medical Clinic of the Faculty Hospital and Medical Faculty Olomouc because of the extensive type of ulcerative colitis. The incidence of these complications is not high in our group and is only slightly higher than in the general population. As it is however a very serious disease and so far an optimal algorithm for its follow up has not been elaborated, we feel it is useful to investigate this high risk group of patients after 6-24-month intervals according to the confirmed grade of dysplasia of the intestinal mucosa.

Adult↗
PubMed2000

Radiotherapy of early stages Hodgkin's disease. 10 years experience of the Masaryk Memorial Cancer Institute.

Radiotherapy and chemotherapy, alone or in combination, are curative treatment methods in early stages of Hodgkin's disease (HD). The choice of treatment depends on the stage of the disease, histological type and localization of the tumor, as well as on other prognostic factors. A retrospective study was conducted including 145 patients with clinical Stages I and II of HD according to Ann Arbor classification, all treated in the Masaryk Memorial Cancer Institute in Brno during the years 1985 through 1994. 80 patients were males (55%) and 65 patients females (45%). The age of the patients ranged from 11 to 77 years, with an average of 34.8 years. 41 patients were diagnosed with Stage IA tumor, 1 patient with Stage IB, 75 patients with Stage IIA and 28 with Stage IIB disease. The histological types of the disease were lymphocyte predominant in 23 patients, nodular sclerosis in 49 patients, mixed cellularity in 65 cases and lymphocyte depletion in 8 cases. 91 patients were treated with radiotherapy alone. In this group 14 patients relapsed within the radiation field (15%) and 25 outside the radiation field (28%). 39 patients were treated with combination of radiotherapy and chemotherapy. In this group relapse occurred within the radiation field in 3 patients (8%) and outside the radiation field in 7 patients (18%). 15 patients were given chemotherapy alone, 7 patients from this group experienced a relapse. The five-year survival was 81% in patients with Stages IA and IIA disease, 65% in Stages IB and IIB disease. The five-year survival in the patients who relapsed was 56%. Radiotherapy remains the curative method of choice in highly selected group of patients with early stages of Hodgkin's disease. The results of radiotherapy alone are unsatisfactory in unselected clinical Stage I--II patients because of the presence of patients with adverse prognostic factors, particularly B symptomatology, mixed cellularity/lymphocyte depletion histology, higher age. These patients are candidates for combined treatment. Modern equipment and meticulous treatment are conditions crucial for the outcome of curative radiotherapy in patients with Hodgkin's disease. Combination chemotherapy is very effective in the treatment of relapse following the primary radiotherapy.

Adolescent↗
PubMed2000

[Surgical treatment of spontaneous esophageal perforation--Boerhaave syndrome].

Spontaneous rupture of the oesophagus (Boerhaave's syndrome) is a life threatening disease the successful treatment of which depends on early diagnosis and effective comprehensive treatment. The authors present an account on three patients who were successfully treated on account of spontaneous rupture of the oesophagus.

Esophageal Diseases↗
PubMed1998

[Initial experience with treatment of choledocholithiasis using shock waves].

From March 1996 till August 1997 at the First Surgical Clinic in Olomouc 18 patients with concrements in the biliary pathways were treated by shock waves. All patients were older than 68 years; residual choledocholithiasis was involved which could not be eliminated during ERCP because of the size of the size of the stone. In 125 instances treatment was successfully terminated, i.e. by crushing the stones and their elimination. Only in three patients it was necessary to resolve the situation by surgery. The authors confirmed that it is possible to treat by this method patients with choledocholithiasis and avoid the risk of surgery in particular in older patients.

Aged↗
PubMed1998

[Surgical treatment of a complication of Crohn's disease of the duodenum].

In 1995-1997 at the First Surgical Clinic, Medical Faculty, Palacký University and Faculty Hospital Olomouc three patients were treated on account of obstruction of the pyloroduodenal region caused by Crohn's disease. The condition was treated by anastomosis, possibly with vagotomy, depending on the site of stenosis. Clinical, laboratory and endoscopic control examinations after a 6-month to 3-year interval revealed good results of this approach.

Adolescent↗
PubMed1997

[Radical surgery of stage II primary nonresectable colonic tumors].

The authors present an account on six patients with a primarily non-resectable tumour of the colon where radical resections were made in the second stage. Based on their experience they recommend an active approach to patients with primarily non-resectable tumours of the colon who have no signs of dissemination of the tumour. In these patients they recommend not only dispensarisation but also adjuvant chemotherapy and radiotherapy. In case of regressing tumourous infiltration they recommend resection of the tumour in the second or if necessary third stage.

Aged↗
PubMed1997

[Surgical possibilities in the treatment of ulcerative colitis].

During the five-year period between 1992-1996 at the First Surgical Clinic of the Medical Faculty, Palacký University and Faculty Hospital in Olomouc 22 patients were operated on account of ulcerative colitis. Twelve patients were subjected to primary operations on account of acute complications of the disease, ten patients are in the group of elective operations. As the incidence of ulcerative colitis in our population is not high there is little experience with treatment of this disease and ulcerative colitis is still a problem for gastroenterologists as well as surgeons. The authors draw attention to two factors which have an impact on surgical treatment of ulcerative colitis: 1. optimal time for indication of surgical treatment calls for treatment of patients in a specialized gastroenterological department, 2. Surgical treatment calls for a specialised team linked with the gastroenterological department concerned with treatment of ulcerative colitis.

Adult↗
PubMed1997

[Less common metastases of colorectal adenocarcinoma].

The authors present an account on four patients, treated because of colorectal carcinoma who had solitary secondaries of a colorectal tumour at less common sites. Twice a secondary in the urinary bladder wall was found once in the right cerebral hemisphere and once in the humerus.

Adenocarcinoma↗
PubMed1996

The level of neopterin in blood serum as one of the possible prognostic markers of Crohn's disease activity.

Neopterine is considered to be one of the markers of immunity system activity. An increased level of this pteridine derivate is determined in blood or urine in infections, transplant rejections, and in other conditions accompanied by changes in the immunity system. Monitoring its level in various body liquids can be important when assessing the immunity system condition, nevertheless, its non-specificity causes difficulties when interpreting the results. Up to now, very few papers have been published dealing with the determination of neopterine levels in patients with IBD. We studied a group of 25 patients who are monitored in a longterm manner at our clinic suffering from Crohn's disease. During 1993 and 1994, we were determining their levels of neopterine in blood together with other parameters. It was a group of patients chosen at random in different stages of disease, and we were interested in the correlation of the height of neopterine level with the activity of Crohn's disease. We proved statistically unimportant correlation between the height of neopterine level in blood serum and Crohn's disease activity. The question is discussed whether the examination of this marker be useful when monitoring Crohn's disease activities.

Biomarkers↗
PubMed1996

C-ANCA and p-ANCA in patients with Crohn's disease.

In 32 patients suffering from various stages of activity of Crohn's disease, c-ANCA and p-ANCA in serum were examined. Altogether, 54 blood samples were examined. In 21 patients of 32, i.e. 65.6%, at least in one examination of c-ANCA in serum the value was higher than 9 units (positive finding). In 10 patients of 32, i.e. 32.2%, at least in one examination of p-ANCA in serum the value was higher than 9 units (positive finding). In the case of high activity of Crohn's disease, c-ANCA in serum were higher than 9 units (positive finding) in 69.6% examinations, in case of low activity, values of c-ANCA in serum were higher than 9 units (positive finding) only in 9.5% examinations. p-ANCA in serum were, when the activity was high, positive in 46.1% examinations, while when the activity of Crohn's disease was low, p-ANCA were positive in 9.5%. The question of specificity of findings is discussed.

Adolescent↗
PubMed1989

Variations in dose distributions by the use of independent asymmetric jaws. A new technique for irradiation of localized carcinoma of the prostate.

The use of independent jaws set asymmetrically in the moving field technique with bilateral arcs allows the entirely new dose distributions be obtained. The basic principle of this technique is that, with the use of moving field technique with bilateral arcs, the independent jaw more proximate to the central ray (axis) of beam must always be on the side of the critical organ. In this area the characteristic deformation of isodoses and the formation of very steep dose slope occur. We consider as optimum technique for the target irradiation of the prostatic carcinoma the moving field technique with bilateral 105 degrees arcs with 20 MeV X-ray beam of linear accelerator and with independent jaws set asymmetrically, when the independent jaw more proximate to the central ray is always + 1.5 cm from the central ray of the beam.

Carcinoma↗
PubMed1989

[Radiotherapy of carcinoma of the prostate--5 years' experience].

Forty three patients were treated for cancer of prostate by irradiation at the Radiotherapeutic Ward of the Research Institute of Clinical and Experimental Oncology in the years 1976 to 1981. The five-year period of survival in patients with a localized tumorous disease was 45%. The authors analyzed causes of unsuccessful therapy and evaluated complications of the therapy, the latter being mostly early postirradiation reactions. Possibilities of improving the results of treatment in optimizing the radiotherapy of the localized prostate cancer are outlined.

Carcinoma↗
PubMed1988

Optimization of radiation therapy in prostatic cancer.

The results of a study on the optimization of external irradiation of prostatic cancer are discussed. The study was performed with the aid of an automatic water phantom, an automatic densitometer, and a computerized treatment planning system using an anthropometric phantom Alderson. The following parameters were studied: Dose gradient, the size of areas of selected isodoses, and the shape of the 90% isodose. At present, we consider that the twosector biaxial arc technique characterized by an arc angle of 120 degrees, a distance of the arc axes of 3 cm, employing a 20 MeV X-ray of a linear accelerator is the optimal technique for target irradiation of carcinomas of the prostate.

Humans↗