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Biomedical subjects

V Kucera

Publications and source records attributed to V Kucera.

At least 37 records · Page 2Linked to original sources

An immunological study of Lyme disease.

84 patients in the second or third stages of serologically diagnosed Lyme disease suffering from different forms of central as well as peripheral nervous system involvement were tested for the participation of autoimmune mechanisms. Cell hypersensitivity to the encephalitogenic basic protein and to antigens from peripheral myelin was evaluated on an Opton cytopherometer according to the effect of the macrophage slowing factor--liberated during short-term incubation of sensibilized lymphocytes by the respective antigen--on the mobility of tannin-treated sheep red blood cells in an electric field. Judged by the presence of autoimmune reactions. Lyme disease has come to occupy a prominent position compared with previously examined other types of neuroinfections. An explanation can be sought in disordered immunoregulating mechanisms, even though the changes in total and active T lymphocytes were not statistically significant. Data on immunological changes are relevant for the indication of immunomodulating therapy as a suitable complement to antibiotic treatment.

Adolescent↗

[Miniaturized extracorporeal circulation for infants].

By using the smallest commercially available oxygenator and our own modification of an apparatus for extracorporeal circulation we achieved minimal filling. By placing the apparatus close to the operating table the set can be miniaturized and the length of the tubes can be maximally reduced, while a satisfactory overview is ensured. The authors compared a group of 10 children operated by using this miniature apparatus with a control group of 20 children where the standard set up was used. The filling of the apparatus incl. added solutions was significantly smaller in the group with the mini-apparatus--on average 420 ml, as compared with the control group (671 ml). Despite the substantially larger amount of transfused blood in the control group with the greater volume (500 ml/patient), the resulting packed cell volume was the same in both groups. The other common postoperative parameters did not differ significantly in the two groups. The minimal filling of the apparatus for extracorporeal circulation in the described set up makes possible in the majority of children and infants with an elevated packed cell volume perfusion without the use of donor blood which is consistent with contemporary trends.

Extracorporeal Circulation↗

[Possible use of the autotransfusion technic in pediatric heart surgery].

Consequential miniaturization of the apparatus for extracorporeal circulation and its simple connection, by introduction of haemodilution into perfusion technique along with careful surgical technique and the introduction of the principle of autotransfusion made it possible to reduce the consumption of donor blood in our department during the last six years to 25%. Autotransfusion proved to be in children weighing more than 15 kg a safe method. In the first half of 1989 we made 194 operations of the open heart. 167 patients (i.e. 86%) of this number did not require preserved blood in the primary filling of the apparatus for extracorporeal circulation. In a group of 100 patients weighing more than 15 kg in 65% the method of autotransfusion was applied; 55% of the patients did not need donor blood in the course of hospitalization.

Blood Transfusion, Autologous↗

[Immunologic study of Lyme borreliosis].

In 84 patients in the second or third stage of serologically proved Lyme borreliosis suffering from different forms of central and/or peripheral nervous system involvement the participation of autoimmunological mechanisms was investigated. The cellular hypersensitivity to encephalitogenic basic protein and to antigens from peripheral myelin was evaluated on the cytopherometer Opton according to the influence of macrophage slowing factor--liberated during the short-term incubation of the sensibilized lymphocytes with specific antigen--on the mobility of tanned sheep red blood cells in the electrical field. The frequency of positive findings in comparison with the results in other types of neuroinfections, examined previously, put the Lyme borreliosis on the first place. The explanation of this fact may be seen in the immunoregulatory disturbances, even though the changes of the total and active T lymphocytes were not significant. The knowledge of immunological changes is very important for the indication of immunomodulating procedures suitably complementing the treatment by antibiotics.

Adolescent↗

[The effect of heart surgery during extracorporeal circulation and deep hypothermia on glucose metabolism in infants and young children].

Authors examined levels of glucose, insulin, and C-peptide in the plasma of 6 infants and small children with the isolated transposition of the great arteries (3 pts) and ventricular septal defect (3 pts) in the course of open-heart surgery in deep hypothermia. The mean age of the patients was 7.2 months (6 to 15) and weight 5.6 kg (5.2-7.5). Exogenous intake of glucose during the operation was excluded. Methods of anaesthesia, operation technique, and conduction of extracorporeal circulation (ECC) were constant in all patients. Fresh ACD blood diluted with Hartman solution approximately 1:1 was used for the prime of ECC circuit (content 800 ml) to get the hematocrit 0.27 +/- 0.2 after mixing the prime with the patient's blood volume. Glycemia was determined by Beckman ERA 2001 analyzor, and levels of insulin and C-peptide by radioimmunoassay kits MJ-96 (Poland) and Novo (Denmark). Significant hyperglycemia was found in all patients during the period of hypothermia, and was overlasting to the rewarming period until the end of the operation and 1 hour postoperatively. Then level of glycemia was decreasing to the normal values which were found in the last sample (17 hours post-op). The raise of glycemia was not a stimulus to the proportional increase of insulin and C-peptide levels in plasma. It proved transitional suppress of insulin secretion in the beta cells of the pancreas in the cooling period. Levels of insulin and C-peptide significantly and concordantly increased after 20 min. of rewarming (r = 0.83). However, hyperglycemia overlasted during the course of rewarming, too.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗

Erdheim-Chester disease.

A new case of Erdheim-Chester lipoid granulomatosis is described in a 40-year-old man. In this lipid storage disease, characteristic symmetrical osteosclerotic areas are observed mainly in metadiaphyses of long tubular bones. Bone biopsy is mandatory for definite diagnosis, although characteristic radiographic pictures often provide an important clue to the correct diagnosis.

Adult↗