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Biomedical subjects

P Kozler

Publications and source records attributed to P Kozler.

18 recordsLinked to original sources
PubMed2006

Molecular cytogenetic stratification of recurrent oligodendrogliomas: utility of interphase fluorescence in situ hybridization (I-FISH).

In oligodendroglial brain tumours, losses of chromosomal material of the short arm of chromosome 1 and long arm of chromosome 19 have been shown to predict responsiveness to chemotherapy and prolonged patients' survival. Therefore, the correct diagnosis of these genetic alterations in tumours of oligodendroglial origin is particularly important. To detect deletions of 1p36 and/or 19q13.3 in oligodendroglial cells we used dual-colour I-FISH with locus-specific DNA probes. I-FISH was performed on isolated whole cell nuclei, prepared from fresh non-fixed tumour tissue samples resuspended in media and processed using a standard cytogenetic procedure, thus bypassing the problem of nuclear truncation. We examined 16 patients with histologically proved oligodendrogliomas (5x oligodendroglioma, 9x anaplastic oligodendroglioma, 2x anaplastic oligoastrocytoma). The results of molecular cytogenetic analyses were correlated with morphological and clinical findings. Molecular cytogenetic analyses were successful in 15 patients and, due to a non-adequate tissue specimen, were uninformative in one patient only. Combined deletions 1p36/19q13 were proved in 13 patients. However, in six of them additional genetic alterations typical for high-grade astrocytoma were found, which could have negative influence on the prognosis. One patient had isolated deletion of 1p36 and another had a normal genetic pattern without any chromosomal alterations. In summary, I-FISH on isolated cell nuclei is a powerful tool for detecting chromosomal aberrations in tumour cells. A systematic molecular cytogenetic analysis may advance diagnosis, prognostic stratification, and targeted treatment of patients with brain tumours.

Adult↗
PubMed2005

[Intracranial meningiomas--criteria for selection of the optimum therapeutic modality].

The authors present their own proposal for a standard diagnostic procedure algorithm in intracranial meningiomas, which they used in their prospective, non-randomized longitudinal study in a group of 30 subjects within a year. The following four criteria were assessed in each patient: age, physical condition according the ASA classification, location of the meningioma on the MRI (superficial, the scull base) and the growth invasivity using selective DSA (ACI+ACE) and MRI (the vascularization type, the oedema index and the change in the oedema signal intensity in 3.5 hours). The criteria helped to establish the optimum therapeutic procedure for each patient: embolisation without a follow-up surgery (2 subjects), observation (2 subjects), pre-operative embolisation (5 subjects) and surgery without preceeding embolisation (21 subjects). This study did not assess the intracranial meningiomas treatment outcome. It highlights significance of the diagnostic procedures standardization in order to establish their optimum therapeutic modality.

Adult↗
PubMed2004

Effects of intracarotid injection of methylprednisolone on cellular oedema after osmotic opening of the blood-brain barrier in rats.

In our work we studied methylprednisolone (MP) for its effects on the permeability of cytoplasmatic membranes of neuronal populations in the rat. We used a standard model of cellular oedema induced by water intoxication, applying MP selectively into the internal carotid (ICA) after opening the blood-brain-barrier (BBB) with mannitol. The results were assessed under fluorescence microscopy in keeping with the Intracellular Distribution Index of Evans Blue (IDI) in the neocortical field (Cortex) and in hippocampal areas CA1, CA3 and GD. Evans blue (EB) was applied similarly as MP Three different experiments were carried out. In experiment 1--EB alone and no MP was applied. In experiment 2--5.4 mg/kg MP and EB were applied. In experiment 3--54 mg/kg MP and EB were applied. In experiment 1 the IDI values were high (>1), indicating the presence of large quantities of EB in the cells. In experiments 2 and 3 the IDI values were low (<1), indicating more EB outside than inside cells. IDI differences between experiments 2 and 1 and experiments 3 and 1 were statistically significant (p<0.05). This morphological evidence sufficiently proved the possibility to restore the cell membrane integrity by means of MP administration.

Animals↗
PubMed2003

Altered blood-brain barrier permeability and its effect on the distribution of Evans blue and sodium fluorescein in the rat brain applied by intracarotid injection.

The aim was to study the blood-brain permeability according to the distribution in the rat brain of Evans blue (EB) and sodium fluorescein (NaFl) administered by an intracarotid injection. Eighteen animals were divided into six groups according to the state of the blood-brain barrier (BBB) at the moment when the dyes were being applied. In the first two groups, the BBB was intact, in groups 3 and 4 the barrier had been opened osmotically prior to the application of the dyes, and in groups 5 and 6 a cellular edema was induced by hyperhydration before administration of the dyes. The intracellular and extracellular distribution of the dyes was studied by fluorescence microscopy. The histological picture thus represented the morphological correlate of the way BBB permeability had been changed before the application of the dyes.

Animals↗
PubMed2003

Evans blue distribution in the rate brain after intracarotid injection with the blood-brain barrier intact and open to osmosis.

Evans blue was applied to 12 rats by way of intracarotid injection into the common carotid artery or internal carotid artery both with the blood-brain barrier intact and after its mannitol-induced osmotic opening. For each type of application, a histological picture of Evans blue propagation through the brain was obtained by means of fluorescence microscopy. An assessment was made of the overall intensity of staining, and the ratio was established of the intra:extra-cellular Evans blue distribution in the cortex and hippocampus of both hemispheres. The histological picture obtained on injecting Evans blue into the internal carotic artery two minutes after the blood-brain barrier opening with mannitol can be seen as morphological evidence of the fact that the substance thus applied does have an effect on cell homeostasis since the intracellular share of Evans blue distribution is considerable.

Animals↗
PubMed2002

[Pathophysiology and clinical aspects of brain edema].

Brain oedema is defined as an abnormal accumulation of fluid in the brain tissue accompanied by an increased volume of the brain. It results in the intracranial hypertension directly endangering the patient's life. No causal treatment of the brain oedema is known at present. The brain oedema is not a disease, but it is a symptom of various clinical states. That is why experimental studies of its pathophysiology become the centre of attention. Though the classification of brain oedema according to the pathogenesis is still used (the vasogenic type--resulting from the increased permeability of blood-brain barrier; the cytotoxic type--caused by the cell metabolism impairment), recent papers has shown a definite retraction from such categorisation. It has been shown that neither type of brain oedema comes alone, but both can occur simultaneously during the development of the pathological state of the brain. The most important appears to be the primary insult. It affects the state of blood-brain barrier and brings about the vasogenic extracellular oedema or it can influence the cell metabolism with subsequent cytotoxic, cellular oedema. Categorisation of oedema into extracellular and cellular reflects more precisely the impairment of the homeostasis of the internal environment of the brain. Contemporary view on the classification and pathophysiological mechanisms of the brain oedema is discussed in our review.

Brain Edema↗
PubMed2000

[Brain injuries].

The author presents an account of contemporary knowledge on the classification of brain injuries and different types of these injuries which comprise a wide range from minor injuries of the head with impairment of memory to severe lethal injuries. The author emphasizes the differentiation of two basic types of injuries--primary and secondary, because this differentiation is important for the prognosis of the casualty as well as for the therapeutic strategy. He emphasize also the fact that the target group in brain injuries are patients with secondary damage which is caused as a rule by a sequelae of intracranial hypertension.

Brain Injuries↗
PubMed1998

[Intracranial hypertension].

Intracranial hypertension is a serious consequence of the impaired intracranial volume homeostasis. It can be encountered in practically all fields of clinical praxis. The article reviews bibliographic data of the mechanisms of the intracranial hypertension development: Intracranial expansion, Brain edema, Hemodynamic brain edema, Liquor accumulation--hydrocephalus. A pathophysiological approach to the hypotheses of edema and brain swelling is stressed. Outlines of the modern diagnostics and therapy of the intracranial hypertension are presented.

Humans↗
PubMed1996

[Nucleotomy--a new method in the treatment of lumboischiadic syndrome].

BACKGROUND: Degenerative changes in the lumbosacral portion of the spine are frequently associated with the lumboischiadic syndrome (LI syndrome). Its treatment is traditionally conservative or surgical. In the seventies and eighties to these two procedures percutaneous punctures were added. The objective of the authors is to present their own experience with a new puncture method of LI syndrome--APLD (automated percutaneous lumbar discectomy). METHODS AND RESULTS: The number of operated patients in 1991-1994 comprised 45 patients, 19 men and 28 women, mean age 40.7 years (18-64 years). APLD was performed 47 times (four times at the level of L3/4, 30 times at the level of L4/5 and 13 times at the level of L5/S1; in two subjects the operation was repeated because the first operation was not effective. APLD is a miniinvasive method made under local anaesthesia with skiascopic control, using special instruments of Surgical Dynamics, USA. Patients with the LI syndrome are selected for treatment according to strict clinical and radiological criteria, the effectiveness of treatment depends on the selection of patients. In the published group treatment was successful in 83% (17% not improved, 38% improved, 45% cured) which is consistent with the experience of others, in particular authors abroad. Only in one instance a minor peroperative complication occurred; the authors did not record any postoperative complications. CONCLUSIONS: APLD is an effective and safe method of invasive treatment of prolapse of lumbar intervertebral discs in an indicated group of patients. It does not replace surgical treatment but reduces the period of conservative treatment. If this treatment is not successful after 4-6 weeks, APLD should be the method of choice. Therefore doctors who are the first to treat these patients should become familiar with the clinical indications.

Adolescent↗
PubMed1996

[Treatment of craniocerebral injuries in other than neurosurgery departments].

The author presents his practical experience with the present state of organisation and tactics as regards treatment of craniocerebral injuries from the aspect of a neurosurgeon who worked for eight years as head of the neurosurgical department of a regional hospital. He emphasizes two factors which influence most the prognosis of casualties apart from the factor of the primary brain injury. The first factor is time, the second one is the principle od adequate treatment of the cerebral injury by the neurosurgeon in a large hospital with permanently available CT diagnosis and the possibility of team work. In the conclusion the author mentions some possibilities how to improve the perspectives of casualties.

Brain Injuries↗
PubMed1995

[Teamwork in saving the life and lower extremities of a child].

The authors describe the case of a successfully cured severe multiple injury in a seven-year-old boy, who after falling from his bicycle under a lorry suffered a brain injury, injury of the small intestine and of the neurovascular bundle in the retroperitoneal and inguinal area. The author emphasizes that in multiple injuries the life can be saved and best possible function recovered only by a correct algorithm of different surgical procedures in therapeutic care focused first on saving the patient's life and subsequently on restoration of all important functions and application of the maximum of contemporary therapeutic possibilities. The authors describe the life saving revision of the abdominal cavity and arrest of massive haemorrhage, the urgent reconstruction of blood vessels of the left inguinal area made within six hours after the accident and the delayed reconstruction of the femoral nerve made within four months after the injury. The resultant condition is evaluated after a six-year period. The general condition of the injured boy is normal, the functional condition of the left lower extremity can be evaluated clinically and on the basis of EMG as excellent.

Accidents, Traffic↗
PubMed1990

[Prevention of pulmonary embolism after brain surgery with the use of local heparinization].

The authors describe briefly anticoagulation treatment of thrombosis of the lower extremity by heparin which developed on the third day after operation of a glioblastoma of the temporal lobe. An adequate therapeutic dose of heparin administered by infusion into the affected lower extremity was neutralized by an infusion of protamine into the upper extremity. Haematological examination revealed normal clotting in the systemic circulation. The method of local heparinization improved the clinical symptoms, pulmonary embolism did not develop and was there was no hemorrhage complication in the surgical field.

Brain↗