Biomedical subjects

V Treska

Publications and source records attributed to V Treska.

At least 37 records · Page 2Linked to original sources

PubMed2004

[Radiofrequency coagulation for splenic resection--a case report].

Radiofrequency ablation is used in our Department of Surgery in cases of unresectable liver tumors. The case of a 22-year old male, who underwent nonanatomical resection of the spleen for trauma, is briefly reported. Splenic resection with the use of the radiofrequency needle could be performed safely and easily without complications. We use radiofrequency coagulation routinely in cases of blunt trauma of the spleen and liver.

Abdominal Injuries↗

PubMed2004

[Penetrating aortic ulcer with severe gastrointestinal bleeding].

Primary aortointestinal fistula is a rare reason for gastrointestinal bleeding and mainly caused by a communication between the digestive tract and an aortic aneurysm. The penetrating aortic ulcer has been recently recognized as an independent pathological entity. It may penetrate through the aortic wall, leading to fistula into adjacent organs. We report the case of a 78-year-old woman who was admitted to our department with massive gastrointestinal hemorrhage. Endoscopy did not reveal the cause of hemorrhage. The diagnosis was made by computed tomography showing a primary aortoduodenal fistula without aortic aneurysm. The patient was successfully operated on. During urgent operation we found the penetrating atherosclerotic ulcer as the cause of the aortoduodenal communication. Primary aortoenteric fistula has a fatal outcome unless it is diagnosed accurately and urgently treated by surgical intervention. Contrast-enhanced computed tomography is the primary imaging modality to specify the diagnosis.

Aged↗

PubMed2004

[Clinical importance of determination of tumor markers during follow-up in breast carcinoma].

BACKGROUND: Paper deals with detection of the early disease progression in breast cancer patients during follow up using tumor markers. METHODS AND RESULTS: The basic group of 1184 patients with breast carcinoma in follow up after primary therapy were examined from 1996 to 2002. Sera were tested using commercial kits CA 15-3 (MEIA, Abbot), CEA (IRMA, Immunotech), TPA (IRMA, Byk Sangtec), TPS (IRMA, Beki). Results were compared with the retrospectively confirmed clinical status of individual patients. The authors calculated optimal cut offs and sensitivities and their combinations for particular tumor markers at 95% level of specificity. Best sensitivities for the detection of distant metastases into bone, liver, lung and brain was achieved by CA 15-3 (53-68%). As an optimal combination of tumor markers seems to be the tricombination CA 15-3, CEA and TPA. All the tumor markers have insufficient sensitivity for the metastatic process into the lymphnodes. CONCLUSIONS: As optimal combination of tumor markers during the follow up seem to be tricombination CA 15-3, CEA and TPA, but also the clinical relevance and cost effectiveness of these assessments have to be considered. For the tumor disease follow up only CA 15-3 has sufficient sensitivities (at 95% specificities) for the early diagnosis of the metastatic process.

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PubMed2004

[Splenic peliosis associated with adrenal adenoma].

PURPOSE: Peliosis of the spleen is very rare disease diagnosed mainly histologically. The ethiopathogenesis is still unknown and various factors can play the important role (steroids, chemotherapy, chronic infection, hematology disease etc.). Authors present the case of peliosis of the spleen which was combined with suprarenal adenoma. METHOD: The splenectomy for the large spleen with suspicion from lymphoma was done in hypertonic patient with normocytic normochromic anaemia. During operation the left suprarenal adenoma was revealed and epinephrectomy was performed. The diagnosis of peliosis of spleen was done by histological examination. The hypothesis of the connection between hormonal activity of the suprarenal adenoma and development of the peliosis was expressed. Unfortunately the suprarenal adenoma was not diagnosed before operation and so plasma hormone levels were not evaluated. RESULTS: The postoperative course of patient was without complications and patient was discharged 8th postoperative day. One year after operation the patient is in the good health condition. The hypertension is corrigated on the lower dosage of antihypertensive medicaments. CONCLUSIONS: It is probable, that the suprarenal adenoma could play the important role in the ethiopathogenesis of peliosis of the spleen in our case.

Adenoma↗

PubMed2004

[Is liver resection or radiofrequency ablation indicated in breast carcinoma metastases?].

AIM: Until recently, metastasizing of the breast carcinoma to the liver has been considered the sign of the disease process generalization with a poor therapeutic prognosis. Therefore, the aim of this work was to assess any positive effects of liver resections in cases of patients with metastases with respect to the patients' survival rate and the relapse rate of the disorder. METHODOLOGY: From January 2000 until September 2003, 13 women aged 55.8 years on average (39-71 years of age) underwent surgery in the Surgical clinic of the Faculty Hospital in Plzen for liver metastases of the breast carcinoma. The average period of time from the date of the primary surgery for the breast carcinoma till the breast carcinoma liver metastasis appeared, was 4.3 years (3 months to 9 years). The breast carcinoma liver metastases were solitary in 11 cases and in two cases the metastases were multiple. The authors conducted four right-sided hepatectomies, three segmentectomies, two left-sided lobectomies, three radiofrequence ablations (RFA), one combined surgery--the liver resection and RFA, in total. In seven cases, the histological examination proved a ductal carcinoma and in six cases a lobular carcinoma. Following the surgery, all female patients underwent curative chemotherapy. None of the patients died earlier than 30 days after the surgery. In case of one patient during the complicated hepatectomy, the ductus hepaticus communis was iatrogenically injured, and the situation was solved using hepaticojejunoanastomosis according to Roux. The data were statistically evaluated according to the Kaplan-Meier long-term survival rate and the mestases relapse rate curve. A twelve-month and a thirty-month survival rate were 100%, and 66.7%, respectively. A probability of the relapse anywhere in the body is rated 0% and 71.5%, respectively for the same periods of time following the liver surgery for the breast carcinoma. CONCLUSION: Based on the authors' own findings and in conjunction with the current literature data, it is clearly evident that surgical therapy (liver resection, eventually RFA) followed by adjacent chemotherapy is the therapeutic method of choice in cases of patients suffering from the breast carcinoma liver metastases. The above method represents the only chance for a considerable extension of a quality life for women suffering from the breast carcinoma liver metastases.

Adult↗

PubMed2004

[Mesenteric fibromatosis. Case report].

The authors describe a case of a young patient, who underwent a by-pass surgery for ileus of the small intestinal loops due to a wide-spread tumor of the mesentery, conducted in a different hospital. The patient was then re-operated in the Faculty hospital in Plzen, the tumor was successfully removed en-block and the pathologist came to a conclusion and diagnosed mesenterial fibromatosis. The case is being discussed from the point of view of the rarely occurring intraabdominal fibromatosis.

Fibroma↗

PubMed2004

[Modified eversion carotid endarterectomy].

The authors describe their own modified eversion technique of the carotid endarterectomy, which they began to carry out in the surgical clinic in Pilsen in 2002. A perfect endarterectomy of the bulbus and of the common carotid is the main advantage of this modified technique, when compared to the classical eversion technique. Later on, the authors learned from the literature that the technique was not entirely new, but a similar technique of the carotid endarterectomy had been used more than 30 years ago, already.

Carotid Stenosis↗

PubMed2004

[Various types of pelvic lymphadenectomy--surgical options--comparison of their significance].

Based on recent literature data, the authors summarize contemporary trends in the surgical therapy for carcinomas in the pelvic region, in particular a significance of the pelvic lymphadenectomy, which has become a standard part of the treatment of the above mentioned disorders. Furthermore, they bring forward new trends in research on lymphatic mapping and the sentinel lymphonode detection.

Humans↗

PubMed2004

[Acute resection in unusual cases of symptomatic aneurysms of the abdominal aorta].

On three unusual cases of symptomatic abdominal aortic aneurysms, the authors demonstrate the need for satisfactory erudition of a vascular surgeon, who must manage the above serious conditions. In the first case, the authors deal with a symptomatic aneurysm of the abdominal aorta and a homolateral dystopy of the right kidney co-existence. In the second case, the authors describe a rare, nevertheless a very serious communication between a vein and an adjacent aneurysm. In the third case, the authors prefer the left-sided retroperitoneal approach in the management of the juxtarenal AAA in combination with a "hostile abdomen".

Aged↗

PubMed2004

[Radiofrequence ablation in contemporary surgery--our experience].

Radio-frequency ablation (RFA) is one of the methods used in multimodale treatment of liver tumors. The opportunities for the use of RFA are more wide recently. Authors present their own experience with RFA in the treatment of liver tumors and also its use in the treatment of parenchymatous abdominal organs injury. They compare the different operative approaches for RFA with concentration to their advantages.

Aged↗

PubMed2004

[Infections of vascular reconstructions in the aortofemoral region].

Infections of vascular reconstructions in the aortofemoral region are among the most feared of conditions in the vascular surgery, having a very poor prognosis. The perioperative mortality reaches over 50% and the extremity loss up to 75%. The authors point out inaccuracies in diagnostics and definitions of the vascular reconstructions infections. On four cases of the vascular reconstructions infections in the aortofemoral region which have been managed in the Surgical Clinic in Plzen in last two years, they demonstrate severity of the above conditions.

Aorta, Abdominal↗

PubMed2003

Can ischemia-reperfusion syndrome in transplanted kidneys procured from non-heart-beating donors be influenced by adding selenium into the reperfusion solution? An experimental study.

Ischemia-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). An animal model of NHBD was used to monitor the influence of the exogenous addition of selenium in the perfusion solution (HTK, Custodiol) on the generation of free oxygen radicals between 0 and 120 minutes after transplantation of the NHBD organ. During this interval, the malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney, significantly decreased. The augmentation of the anti-oxidant capacity of the preservation solution might represent a possible improvement in the function of kidneys transplanted from NHBDs.

Animals↗

PubMed2003

Can the ischemia-reperfusion syndrome in transplanted kidneys procured from non-heart-beating donors be influenced by adding selenium into the reperfusion solution? An experimental study.

The ischemic-reperfusion syndrome significantly influences the function of a kidney transplanted from a non-heart-beating donor (NHBD). The animal model of a NHBD was used to monitor the influence of exogenous addition of selenium into the reperfusion solution (HTK, Custodiol) with respect to the formation of free oxygen radicals at 0 to 120 minutes after the NHBD transplantation. This maneuvers produced a statistically significant decrease in malondialdehyde concentration, an indicator of free oxygen radicals in the venous blood of the transplanted kidney. The augmentation of the antioxidative capacity of the preservation solution might be a possible route to improve the function of kidneys transplanted from NHBDs.

Animals↗

PubMed2003

[Rupture of abdominal aortic aneurysm (RAAA)--predictors of the early postoperative mortality].

PURPOSE: To evaluate the main factors of the 30 days mortality rate of patients operated on for abdominal aortic aneurysm rupture (RAAA. PATIENTS AND METHOD: Univariate and multivariate analysis of various factors associated with RAAA was performed in a group of 73 patients operated on for RAAA between 1996-2001. RESULTS: The 30 days mortality rate was 35.6 %. The main factors of mortality were: misdiagnosis, cardio- pulmonary-cerebral resuscitation (CPCR) on admission, configuration of RAAA, number of blood transfusions, hypotension on admission (p < 0.0001) and duration of operation, type of reconstruction and hypertension in anamnesis (p < 0.01). Important factors (p < 0.05) of postoperative mortality were also low haemoglobin level on admission, abdominal aortic aneurysm (AAA) diameter and ischaemic heart disease in anamnesis. The probability of patient's death is the highest (p < 0.003), if factors like CPCR, number of blood transfusions and aneurysm diameter are combined (multivariate analysis, stepwise method). CONCLUSION: The early detection and surgical or endovascular elective treatment of AAA, the regular dispensation of patients with small AAA especially in hypertonics, the correct diagnosis of RAAA without time delay are the best tools for patients survival. The patient's chance for survival increases with highly trained prehospital resuscitation system and experienced team of vascular surgeons and anesthesiologists.

Aged↗

PubMed2003

[Cystic abdominal lymphangioma in adults].

Cystic abdominal lymphangioma is a rare tumor in adult age. It occurs usually in children and is localised mostly in the head and neck. Only 2-8 % of lymphangiomas are localised intraabdominally. We present a case of a 20-year-old man who complained about acute abdominal pain after physical activity. Diagnosis of intraabdominal multilocular cyst was done by ultrasound, computed tomography and coeliacography. The definitive diagnosis of lymphangioma of the hepatoduodenal ligament was established by laparotomy and histologic examination of the specimen. Cystic abdominal lymphangioma is a rare disease in adults with difficult preoperative diagnosis. The surgical extirpation often completed with resection of involved organ is the method of choice in the treatment of this rare disease.

Abdomen↗

PubMed2003

[The Einstein sign].

Untreated rupture of an aneurysm of the abdominal aorta is fatal in almost 100% of the patients. In the majority of cases the assessment of a correct, early diagnosis is simple (hypotension, backache, abdominal pain, pulsating resistance in the abdomen) and makes a prompt surgical or endovascular operation possible. In some instances however rupture of aneurysms of the abdominal aorta simulates other clinical conditions (acute cholecystitis, acute diverculitis of the sigmoid) which may delay the correct diagnosis and reduce the patient's chance of survival. The author describes, based on historical documents, the treacherous course of the disease in the scientific genius Albert Einstein where rupture of an aneurysm simulated acute cholecystitis, and in the world literature this symptomatology was subsequently described as Einstein's sign.

Acute Disease↗

PubMed2003

[A technique of liver resection].

In comparison with other types of therapy, surgical treatment offers the best chance of long-term survival to the patient with a malignant liver disease. It is the only radical therapy of patients with primary or secondary tumors of the liver. Liver surgery has been the subject of great development over the last years. The technique of liver resection entertained principal changes reflecting various technical advancements. The author deals in greater detail with the present terminology of liver resections. The second part of the contribution deals with the proper technique of the operations on the liver with the application of per-operation ultrasonography, ultrasound dissector, radiofrequency ablation, harmonic scalpel, argon coagulation and the spray pump (Tissomat) for the application of fibrin glue. The correct surgical technique, together with the application of technical background, makes a series of large liver resections possible without necessity of blood transfusions. Liver surgery belongs to highly specialized interventions, which should be performed only in centers dealing with full-extent liver surgery.

Hepatectomy↗

PubMed2003

[Abdominal aneurysm resection in aged patients at the Surgery Clinic in Plzen from 1998 to March 2003].

The authors evaluate resection therapy on aneurysms of abdominal aorta in patients of high age (mean 85 years) at the Clinic of Surgery in Plzen. In the period of 1998-March 2003 the authors performed 13 elective resections on aneurysms of abdominal aorta in patients of high age with zero mortality and 21 acute resections with 38% mortality. In the given period of time, 178 resections of aneurysms of abdominal aorta were made in patients younger than 78 years, 57 being acute interventions. Mortality of elective interventions was 2.9%, in acute interventions being 28%. The present groups indicate that mortality of resection therapy sharply increased in relation to circulation instability of the patients in cases of ruptured aneurysm, but nor in relation to age of the patients.

Aged↗