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P Zivný

Publications and source records attributed to P Zivný.

15 recordsLinked to original sources

Comparison of different protocols for 13C-urea breath test for the diagnosis of Helicobacter pylori infection in healthy volunteers.

OBJECTIVE: The (13)C-urea breath test ((13)C-UBT) is the most accurate non-invasive method for diagnosis of Helicobacter pylori infection. However, several methodological issues have not been resolved yet. The aim of this study was to test different protocols of (13)C-UBT to find the optimal test drink and sampling interval. MATERIAL AND METHODS: (13)C-UBT was performed at 3-day intervals in 27 healthy volunteers using citric acid (test A), orange juice (B) and still water (C) as test drinks. Breath samples were collected from time 5 to 60 min. A total number of 2106 breath samples were analysed by isotope ratio mass spectrometry (cut-off value 3.5). RESULTS: Differences in delta values were greater than would be expected by chance (A versus B and A versus C at times 20, 25, 30, 35 and 40 min, p<0.05, Dunnett's method). There were no grey zone- or false-negative results among H. pylori-positive persons in test A at any time, but some were found in tests B and C. Optimal intervals for breath sampling are at times 20 or 25 min after (13)C-urea ingestion. CONCLUSIONS: Citric acid solution as a test drink and 20- or 25-min breath sampling intervals are optimal for the (13)C-UBT in healthy volunteers.

Adult↗

[Examination of gastric emptying rate by means of 13C-octanoic acid breath test. Methods of the test for adults and results of the investigation of healthy volunteers].

BACKGROUND: 13C-octanoic acid breath test (13C-OABT) is a simple, safe and non-invasive technique for measuring gastric emptying. However, the method has not been standardized yet. Aim of the study was to work up, introduce and evaluate our own method of the 13C-OABT for adults. METHODS AND RESULTS: Ten healthy volunteers entered the study (5 men, 5 women, mean age 32 years, 50 % Helicobacter pylori positive). Standard test meals (with 100 mg 13C-sodium octanoate) were used three times within 3 weeks. The same solid meal (1,178 kJ) for Tests 1 and 2 contained scrambled egg (+ 3 g oil), white bread (40 g), butter (10 g) and distilled water (200 ml). Semi-solid meal (1,020 kJ) for Test 3 contained milk pudding (200 g) and distilled water (200 ml). Duplicate breath samples were obtained before and every 15 minutes after eating the test meal during 255 minutes. Altogether 1,080 breath samples were analysed twice (isotope ratio mass spectrometry, AP2003 Analytical Precision, UK). To assess the half-life of elimination (t1/2 E), we modelled the process of elimination with the incomplete gamma-function, which has a convenient form for the empiric plotting of breath test data. Mean t1/2E was 136+/-10 minutes (Test 1), 134+/-14 (Test 2) and 123+/-16 minutes (Test 3). Clinical reproducibility of 13C-OABT in particular persons was 98.2% (18 breath samples series), 90.8 % (15 samples) and 87.1% (9 breath samples series). There was a significant correlation between Test 1 and Test 2 results (r=0.887, p<0.0001). Mean difference of duplicate breath sample analysis was 1.460 % (in 540 pairs), mean baseline one-day analysis difference was 0.0982 (99.9274% accuracy). In healthy volunteers, normal range of t1/2E is 110-160 minutes for solids and 91-155 minutes for semisolid test meal. Using our own computed mean time of intermediate metabolism of 13C-octanoic acid (76.5+/-7.5 minutes), gastric emptying half-time is 33.5-83.5 minutes for solids and 14.5-78.5 minutes for semisolid test meal in healthy volunteers. CONCLUSIONS: The 13C-OABT is accurate non-invasive method for gastric emptying measurement.

Adult↗

Changes in metabolism and blood flow in peripheral tissue (skeletal muscle) during cardiac surgery with cardiopulmonary bypass: the biochemical microdialysis study.

The aim of this study was to monitor the metabolism and blood flow in the interstitium of the skeletal muscle during cardiac surgery with cardiopulmonary bypass (CPB) and in the early postoperative period by means of microdialysis and to compare metabolic changes during CPB at normothermia (NT) and hypothermia (HT). Surgical revascularization using CPB was performed in 50 patients, 25 patients (group HT) were operated using hypothermic CPB, 25 (group NT) using normothermic CPB. Interstitial microdialysis was performed by two CMA 60 probes (CMA Microdialysis AB, Solna, Sweden) inserted into the patient's deltoid muscle. Constituents analysed in the obtained dialysates, collected at intervals, were glucose, urea, glycerol and lactate. Tissue blood flow was monitored by dynamic microdialysis with gentamicin as a marker. In both groups, NT versus HT, similar dynamics of concentrations were found. Low initial concentrations were followed by gradual increases during CPB and in the following phase of the operation. Concentrations were higher in the NT group. Immediately after the operation, the decrease in values continued, with a gradual increase in the succeeding postoperative period in both groups. Similar dynamic changes in the lactate concentration were found in both groups. The gentamicin concentrations were lower in the NT group (versus the HT group). The results showed dynamic changes in the interstitial concentrations of glucose, urea, glycerol and lactate, which depend on the phase of the surgery in the CPB and early postoperative phase in the both groups of patients. Higher tissue perfusion of the skeletal muscle was noted in those patients operated on in normothermia. The dynamics of the concentration changes of these substances in the interstitium of the skeletal muscle has been proven to be caused by both the metabolic activity of the tissue and by the blood flow through the interstitium of the muscle.

Aged↗

[Surgical stress and biochemical indicators].

AIMS: An investigation of some relationships of routinely and rarely used biochemical markers to surgical (operating) trauma. PATIENTS AND METHODS: A group of 37 patients was divided to two subgroups according type of disease with need a resection of large bowel for malignant or benign malady. Large bowel adenocarcinoma was dominated in a subgroup of malignancies (23 patients, mean BMI 25.59, mean age 63.65 years) and Crohn's disease and complicated diverticullary disease were the reasons to operate in the second subgroup of benignities (14 patients, mean BMI 21.21, mean age 39.5 year). Blood samples were taken before an operation, postoperatively (immediately) and at 6:00 a.m. the 1st, 3rd and 5th postoperative day. The routine methods (albumin, CRP, cholinesterase, haptoglobin, cholesterol), special methods (SOD, glutathion) and ELISA methods (leptin, IL-2r, IL-8, TNF)were used for evaluation markers. The results were estimated by statistic methods Sigma-Stat, One Way ANOVA and linear regression test. RESULTS: The mean serum concentrations of albumin, leptin, cholesterol shifted down very clearly compared to preoperative values. The mean serum concentrations shifted up the 3rd day postoperatively to 722% in benignities and to 1814% in malignancies respectively. The values of cholinesterase, glutation, SOD, and haptoglobin didn't show any more serious dynamics perioperatively. The serum leptin concentrations correlated with BMI but other markers serum concentrations didn't correlate with BMI or with age. CONCLUSIONS: The serum leptin, albumin, haptoglobin, CRP concentrations demonstrated serious dynamics perioperatively. These concentrations are stabilized and they reach preoperative levels the 5th postoperative day. Each-other markers correlation is minimal.

Adult↗

[Interstitial microdialysis study of changes in metabolism and blood flow in skeletal muscles during cardiac surgery with normothermic and hypothermic extracorporeal circulation].

AIM: Hypoperfusion of peripheral tissues and splanchnic organs during cardiac surgery in extracorporeal circulation may lead to the origin of serious complications. The aim of the study was to monitor metabolism and blood pressure in interstital peripheral tissue, skeletal muscle, during the operation on the patient with extracorporeal circulation (ECC) in an early post-operation period by means of microdialysis. METHODS: The interstitial microdialysis is a minimally invasive method for the biochemical monitoring of metabolic changes and blood pressure in extracellular space of tissue. The substances in interstitium pass across a semipermeable membrane of the inserted microdialysis probe and may be analyzed. Microdialysis in this study was performed by means of two microdialysis probes CMA (CMA Microdialysis AB, Sweden) inserted into the deltoid muscle of the surgically treated patient. The probes were perfused by the Ringer solution at the rate of 0.3 ml/hour. The dialysates were sampled in the following intervals: beginning of the operation, beginning of ECC, end of ECC, end of the operation, two hours during the post-operation period. Standard biochemical methods were to evaluate, in the dialysates, glucose, urea, glycerol and lactate. The blood flow in the interstitium was monitored by means of dynamic microdialysis of gentamycine as a marker. Microdialysis was performed in 40 patients with ischemic heart disease, operated on in the extracorporeal circulation. In 20 patients the ECC was performed in normothermia (NT), while in the other 20 patients it was made in hypothermia (HT). RESULTS: In both groups, NT versus HT, a similar dynamism of interstitial concentration of the observed substances in relation to the operation phase and in early post-operation period. Low initial concentrations were gradually increasing during the extracorporeal circulation and increased further after the end of extracorporeal circulation and also in the subsequent phase of the operation. The concentration values of the analytes under observation were higher in the groups operated on under normothermia, apparently due to normal cellular activity during normothermia (versus values in hypothermia). Immediately after the operation the observed values decreased in the both groups and subsequently gradually increased in the post-operation period in the both groups. The trend of dynamic changes of the observed analytes, selected as compounds indicating metabolic activity of skeletal muscles during hypothermia documents a lower metabolic activity of the cells during hypothermia and its marked increase (against NT) in the phase of subsequent normalization of the tissue temperature. Analysis of the concentrations of lactate, as a compounds mapping anaerobic metabolism of skeletal muscle, revealed similar dynamic changes in the both groups (NT vs. HT). There were no significant differences, related to the phase of the operation or the phase of immediate post-operation course when the both groups were compared. The analysis of gentamycine concentrations as a flow marker revealed lower gentamycine concentrations in dialysate during the operation, ECC and the early post-operation course in the group operated on in normotheramia (vs. HT), indicating a higher tissue flow in skeletal muscle against the group of patients operated on under hypothermia. CONCLUSION: The results of the microdialysis study demonstrated dynamic changes in interstitial concentrations of the observed compounds (glucose, urea, glycerol and lactate) related to the phase of operation on the heart in extracorporeal circulation and in early post-operation period. A higher perfusion of skeletal muscle was documented in patients operated on under normothermia. It became obvious that the dynamism in the changes of the compounds observed in the interstitium of skeletal muscle was determined by metabolic activity of the tissue as well as by blood flow in the muscle interstitium.

Aged↗

[Serum leptin levels in the perioperative period in surgery patients].

AIM: To assess dynamics of serum leptin concentrations (as a possible marker of stress) at some surgical patients during short perioperative period. PATIENTS AND METHODS: The serum leptin concentrations were estimated in group of patients with trauma or large bowel diseases in stress of both own disease and next elective or urgent surgery. The subgroups of patients were: a) monotrauma (13), b) polytrauma (10), c) malignant (20) or d) inflammatory disease (13) of large bowel. The serum leptin concentrations were evaluated preoperatively and during 16 hours postoperatively-immediately after surgery, after 8 and 16 hours after operation. The serum IL-6 concentrations were estimated immediately and 48 hours postoperatively. RESULTS: The serum leptin concentrations showed a time depending dynamic phase: they decreased postoperatively and increased during the first 16 hours postoperatively. It was more expressed in the malignant bowel disease subgroup. A correlation between age and serum leptin concentrations was not found in any subgroup. We found correlation between serum leptin concentrations preoperatively and postoperatively. CONCLUSIONS: The serum leptin concentrations demonstrated some dynamics in short perioperative periods. It was very considerably in patients with large bowel malignancy. Any significant difference in serum IL-6 concentrations was not discovered preoperatively and postoperatively in all subgroups.

Humans↗

[Diagnosis of Helicobacter pylori with the 13C-labeled urea breath test: study methodology].

Helicobacter pylori is one of the most common causes of chronic bacterial infection in humans, and it is associated with many diseases of the upper gastrointestinal tract. The 13C urea breath test (13C-UBT) is a simple, non-invasive and global test for Helicobacter pylori detection. The test reflects the hydrolysis of 13C-labelled urea by Helicobacter pylori urease. The 13C-UBT is the gold standard test for Helicobacter pylori infection. Since the original description (in 1987) several modifications of 13C-UBT have been published to simplify and optimise the test. However, neither Standardised European Protocol nor Standard US Protocol were accepted. This paper gives the methodology of the 13C-UBT based on eur own study and on the review of the literature.

Breath Tests↗

[Thyrotoxicosis due to long-term therapy with interferon alpha in the patient with mixed chronic active hepatitis B and C].

The authors describe a case report of 48-year-old woman treated with Interferon alpha for the chronic active hepatitis B and C. During this therapy thyrotoxicosis occurred. It disappeared after the withdrawal of Interferon alpha and administration of strumigens. Immediately after stopping of the administration of Interferon alpha and three month later antibodies against the thyroid epithelium were found.

Antiviral Agents↗

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↗

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↗