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Biomedical subjects

R Jelinek

Publications and source records attributed to R Jelinek.

At least 37 records · Page 2Linked to original sources
PubMed1988

Factors affecting mortality in transduodenal sphincteroplasty.

An analysis of 1,200 consecutive transduodenal sphincterotomies performed between 1967 and 1985 is presented herein. The over-all mortality rate was 3.75 per cent. Since 1980, however, the mortality rate has decreased to 2.1 per cent. The mortality rate was influenced by the age of the patient at the time of the operation (p less than 0.005). Furthermore, the mortality rate increased from decade to decade (less than 30 years, zero per cent; greater than 70 years, 6 per cent). The operative mortality rate was also influenced by general risk factors--hypertony (mortality rate of 5.8 per cent, not significant), diabetes (mortality rate of 6.5 per cent, p congruent to 0.05), renal failure (15.5 per cent, p less than 0.005), jaundice (bilirubin level in survivors, 78.3 micromoles per liter and in those who died, 120.4 micromoles per liter, p less than 0.005) and vital indication (mortality rate of 15 per cent, p less than 0.01). Although the indication for sphincterotomy had a small influence on the mortality (papilla stenosis without bile duct stones, 1.7 per cent; papilla stenosis with common duct stones, 3.6 per cent, and impacted stones in the papilla, 5.0 per cent), these small differences are not significant. A significant influence, however, was due to complicating intraoperative findings, such as bilioenteral fistulas (a mortality rate of 10.8 per cent, p less than 0.0005). The fact that the mortality rate increased in patients with T-tube insertion shows that operative problems and complications influence the mortality rate for sphincterotomy. From these results, we concluded that, in the aforementioned risk groups, a preoperative endoscopic sphincterotomy should be strongly considered, as the risk from the surgical procedure is diminished by the endoscopic relief of the obstruction of the biliary tract.

Adult↗
PubMed1987

[Eosinophilic gastroenteritis].

Eosinophilic gastroenteritis represents a very rare inflammatory disease of the stomach and bowel. Aetiologically an allergic diathesis must be assumed, but it is only very seldom that a particular allergen can be identified as being responsible for any case. Characterized by peripheral blood eosinophilia and eosinophilic infiltration of various parts of the gastro-intestinal tract, together with disturbed gastro-intestinal function, complications can arise in this disease requiring surgical intervention. In general, however, conservative therapy is adequate. The clinical features are discussed on the basis of an own case report.

Duodenum↗
PubMed1984

[Changes in the value of papilla excision in papilla cancer. A retrospective study].

A retrospective analysis of 56 patients with a carcinoma of Vater's ampulla in the years 1956-1983 demonstrated a steadily increasing resection index of duodenopancreatectomy from 34% (1961-1965) to 86% (1981-1983), although the rate of mortality was 0% since 1975. The reason for the increasing resection index was the treatment of all patients since 1975 by only one team of operators and the improvement of peri- and postoperative medicine treatment. Thus it was possible to perform a duodenopancreatectomy without operative mortality even in patients in the 8th decade of life. Therefore an indication for a local excision of the ampulla no longer seems to be justified.

Adult↗
PubMed1983

[Primary gallbladder cancer].

118 surgically-treated patients with gall bladder carcinoma and 407 autopsies recording this diagnosis were reviewed and analysed with a view to investigating the reasons for the bad prognosis of this disease. An early tumour stage was seen in only 5.9% of the surgical patients. A possible reason for the bad results even at an early tumour stage is undertreatment by simple cholecystectomy. In advanced stages of gall bladder carcinoma palliative operations have a better prognosis than diagnostic laparotomies. Prevention of gall bladder carcinoma through prophylactic cholecystectomy in the case of documented lithiasis failed to prevent gall bladder carcinoma in our group of patients because only 9% of the patients with gall bladder carcinoma had been diagnosed as having lithiasis in time to consider cholecystectomy as a preventive measure.

Cholelithiasis↗
PubMed1983

Comparative study of the effects of ceftazidime compared with tobramycin plus cefamandole in the treatment of gall bladder empyema.

Fifty patients with empyema of the gall bladder took part in a prospective comparative study. One treatment group received ceftazidime 2 g bd, while the other received combined therapy with cefamandole 2 g tds and tobramycin 80 mg bd. The intraoperative administration of the antibiotic was started immediately after a sample had been obtained for culture, by puncture of the gall bladder. Results with ceftazidime monotherapy in severe infections were superior to the combined therapy. No septic complications of wound healing were observed.

Adult↗
PubMed1983

Origin of hydrocortisone induced orofacial clefts in the chick embryo.

The growth and fusion of facial processes were studied in White Leghorn chicken embryos treated with hydrocortisone. This treatment results in complete bilateral cleft beak in 80-100% of cases. The frontonasal complex of the experimental embryos exhibited marked hypoplasia prior to cleft manifestation. During the critical period for cleft beak formation, the maximum mitotic activity was concentrated in the medial nasal processes, which thus became vulnerable to the mitosis inhibiting effect of corticoids. Primary hypoplasia of the facial processes was documented as a causative factor of corticoid-induced cleft beak which is analogous to mammalian cleft lip/palate.

Animals↗
PubMed1983

[Incidence of fatal, biliary pancreatitis--an analysis of 19167 autopsy protocols].

19 167 autopsy records are analysed to the frequency and to risk-groups for a lethal biliary pancreatitis. In cholecystolithiasis biliary pancreatitis was the far most stone caused lethal complication, in choledocholithiasis the 4. An increased incidence of the lethal biliary pancreatitis was found in younger individuals, in male individuals and in choledocholithiasis.

Adolescent↗
PubMed1982

[Factors influencing the survival time of patients subjected to "radical" surgery for cancer of the papilla of Vater (author's transl)].

17 patients who were treated by partial pancreato-duodenectomy for cancer of the ampulla of Vater were reviewed to see if intermittent jaundice, the staging of the carcinoma, the grading of the carcinoma and the presence of regional lymph node metastases had any influence on the survival time. There were markedly longer survival times for patients with intermittent jaundice, high grading, low staging and absence of regional lymph node involvement.

Adult↗
PubMed1982

Use of chick embryo in screening for embryotoxicity.

In vitro systems afford a unique opportunity for investigating the direct interaction of substances with developing morphogenetic systems (MGSs), since maternal influences are excluded. As a carrier of a complete set of MGSs, the chick embryo in ovo manifests an advantage over those in vitro systems that employ isolated embryos or embryonic tissues that have only limited survival. Under controlled experimental conditions including standardization of subjects, administration technique and mode of evaluation according to the basic principles of teratology, the chick embryo test was demonstrated to be reliable and to afford quantifiable endpoints for evaluation (e.g., specific embryotoxicity effect level, positive dose response, and a stage response and effect). Individual compounds, mixtures of compounds, and even poorly identified extracts can easily be tested. The chick embryo possesses its own basic enzyme-catalyzed drug-transformation capacity and, moreover, it can be used for screening specific human metabolites. Comparative studies have indicated a high predictive value of the chick embryo system relative to other in vitro systems as well as to whole-animal testing.

Animals↗
PubMed1982

[Carcinoma of the gallbladder unexpectedly diagnosed after cholecystectomy for lithiasis (author's transl)].

Patients with clinically apparent carcinoma of the gallbladder seldom survive 5 years. This is only seen in about 20% of the patients whose gallbladder carcinoma is unexpectedly first discovered by the pathologist after a routine cholecystectomy for lithiasis. The prognosis of this seldom seen early stage of carcinoma of the gallbladder, which is applicable to only 10-23% of all gallbladder carcinomas, is strongly dependent on the penetration of the tumor in the wall of the gallbladder. Of the patients with a carcinoma infiltrating only the mucosa of the gallbladder, 60% can be cured for 5 years by a simple cholecystectomy, whereas for more advanced cancers this procedure seem to be inadequate. In these stages a relaparotomy should be considered with an addition wedge resection of the liver and a regional lymphadenectomy.

Aged↗
PubMed1981

[Quality of life after duodenopancreatectomy in patients with carcinoma of Vater's ampulla (author's transl)].

Partial duodenopancreatectomy, which leads to poor long-term results in the treatment of cancer of the head of the pancreas, achieves 5 years survival rates of 30% in cancer of Vater's ampulla. A report is given on 3 patients, who could be cured of a cancer of Vater's ampulla by this procedure for more than 10 or 15 years respectively. The quality of life of these patients is satisfactory. As a late consequence diabetes mellitus occurred in 2 patients.

Adenocarcinoma↗
PubMed1981

[Posttraumatic recurrent luxation of knee joint (author's transl)].

A posttraumatic, recurrent luxation of the knee joint is presented. The cause for the first luxation was a severe trauma. As the treatment of the ligament and capsule ruptures of the first luxation was inadequate, the effect was a completely unstable knee joint. By hyperextension trauma or hyperextension following weakness of the muscles of the thigh recurrent luxations of the knee were caused. The importance of a sufficient treatment of ligament and capsule damage following a knee luxation is emphasized.

Female↗
PubMed1980

[Isolated Crohn's disease of the appendix].

A case of isolated Crohn's disease involving the appendix and, indeed, presenting as acute appendicitis is described and related to 12 analogous cases reported in the literature. Crohn's disease of the appendix is exclusively diagnosed by histopathological evidence. According to published data isolated Crohn's disease of the appendix would not seem to predispose towards the formation of fistulae after appendectomy. Subsequent evidence of Crohn's disease in other sites is similar in frequency to cases with primary Crohn's disease in other parts of the intestinal tract.

Adult↗
PubMed1979

[Results of partial duodenopancreatectomies (author's transl)].

The results of 36 partial duodenopancreatectomies (1956-1976) are reported. The operative mortality was 25%, during the last 5 years 12.5%. The lowest operative mortality and the best prognosis was found in carcinomas of Vater's ampulla, with 14.2% mortality and 50% 5 years survival time, followed by carcinomas of the distal bile duct. The most infavorable result was found in the carcinomas of the head of the pancreas with an operative mortality of 36% and the shortest survival times.

Adult↗
PubMed1979

[Carcinoma of papilla of Vater and its surgical treatment (author's transl)].

Partial pancreato-duodenectomy is in our opinion the method of choice. Mortality rate 15%; 5-years survival rate 31.5%. The results obtained by resection of Vater's papilla are less favourable: the mean survival time comes only up to less than 50%. Palliative procedures should only be practiced in cases of incurability.

Aged↗