Search PubMed⌕ Search

Biomedical subjects

Z Chudácek

Publications and source records attributed to Z Chudácek.

At least 19 recordsLinked to original sources
PubMed2003

[Urologic complications in pelvic injuries].

OBJECTIVE: Urological complications of pelvic fractures include in particular rupture of the urinary bladder (RUB), injury of the posterior urethra (IPU) and erectile dysfunction (ED). The authors present their own group of patients and in particular the diagnostic and therapeutic algorithm in IPU. MATERIAL AND METHODS: In the Plzen Faculty Hospital in 1/1998 to 8/2002 a total of 19 patients were treated with serious urological complications of pelvic fractures--9x RUB, 11x IPU (once with RUB). RUB was in one instance intraperitoneal, in the remainder extraperitoneal. RESULTS: IPU was without dislocation 6x, with dislocation 5x. Primary "realignment" of the urethra was made in 6 patients (in dislocations and in concurrent rupture of the bladder). In the remaining 5 an epicystostomy was established. In 4 after an interval of 3 months a posterior resection urethroplasty was made because of a distraction defect. One patient with a distraction defect was referred to the urological department of the catchment area and in another patient after-treatment is planned. Severe ED developed in 6 IPU of 10, always in dislocations of the urethra. In one patient we lack information on erections. CONCLUSION: When IPU is suspected (urethrorhagia), dislocation of the prostate on examination p.r.) ascendent urethrography and IVU are essential. Do not catheterize before completed examination. Then needle epicystostomy is performed, in major dislocations of the urinary bladder or in associated injuries primary "realignment" of the urethra open on a catheter or endoscopically. In distraction defects after 12 weeks a posterior resection plastic operation follows.

Adult↗
PubMed2002

[An AV aneurysm of a branch of the pulmonary artery associated with a pulmonary tumorlet].

The authors present a rare case of a relatively large A-V aneurysm of the branch of the pulmonary artery in the right upper pulmonary lobe. Successful and technically easy surgical treatment was preceded by a serious dilemma whether to select in a high risk patient another (less invasive) therapeutic method or even conservative treatment. The surgical finding and smooth postoperative course confirmed that the indication of surgery was correct. As a further pathological finding in the resected portion a pulmonary tumourlet was detected. The combination of the two rare findings is an extreme rarity.

Arteriovenous Fistula↗
PubMed1999

[Severe injury of the tracheal bifurcation].

The authors demonstrate a rare case of serious rupture in the area of the tracheal bifurcation with incomplete rupture of both bronchi which occurred after a severe multiple injury. The authors describe the difficult surgical solution, using temporary selective intubation of both main bronchi across the surgical field. The imperfect success of jet ventilation is ascribed to severe pulmonary contusion and major haemorrhage from the trachea which increased the risk of barotrauma. The authors emphasize the importance of peroperative and postoperative bronchoscopy.

Female↗
PubMed1998

Gastric lipoma presenting as upper gastrointestinal obstruction.

A 61-year-old man presented with an upper gastrointestinal obstruction caused by a submucosal gastric lipoma in the prepyloric area. The diagnosis was made coincidentally during his admission for another disease. Gastric resection was performed because of a large lipoma combined with florid gastric ulcers. The frequency of gastric lipoma, its differential diagnosis, means of diagnosis, and treatment are discussed.

Diagnosis, Differential↗
PubMed1997

[Histologic findings in kidney tumors].

The authors present a group of 304 adult patients (with the exception of one child with a Wilms tumour) from 1988-95 with the diagnosis of a primary renal tumour treated by surgery and subsequently subjected to histological examination. The tumours were in 83.9% clear renal cell tumours (Grawitz carcinoma), 4.3% were papillary carcinomas, 3.3% renal cortical adenomas, 3.9% oncocytomas and 2.0% non-differentiated carcinomas, 0.7% angiomyolipomas, 0.7% chromophobe cell renal carcinomas, 0.7% secondaries (carcinoma of the breast and testis), 0.7% multilocular cysts, one case each (0.3%) Wilms tumour, malignant lymphoma, necrotic histologically not classifiable tumour. The authors give a more detailed account of multilocular cystic RCC (which accounts for 5.9% Grawitz tumours), papillary tumours, chromophobe cell renal carcinoma, oncoytoma and angiomyolipoma. The authors correlate briefly the histological findings with preoperative graphic examinations. They are very sceptical as regards assessment of the histological type of tumour from preoperative graphic examination (with the exception of angiomyolipoma). Finally the authors suggest classification of renal expansions from the urologists aspect-in the first place from preoperative graphic examinations for non-neoplastic lesions (in particular cysts and hypertrophy of the columna Bertini), parenchymatous tumours and tumours of the renal pelvis and secondly (mainly in parenchymatous tumours) histological classification is taken into account.

Adult↗
PubMed1995

[Surgical problems in acute acalculous cholecystitis].

The authors report on the prevalence of acute cholecystitis in the absence of calculi with special attention paid to the development of this disease as a complication of prolonged parenteral nutrition. In 1990-1993 at the Surgical Clinic in Plzen 125 cases of acute cholecystitis were operated, incl. 14 acalculous ones (11.2%). These 14 patients comprised 5 (28.6%) who were on parenteral nutrition for a prolonged period. The authors analyze the causes of the development of acute acalculous cholecystitis. They deal with the problem of diagnosis where in severe postoperative and posttraumatic cases ultrasonography proved useful.

Acute Disease↗
PubMed1993

[Treatment of acetabular fractures].

The authors present an account of 85 patients with fractures of the acetabulum treated at the Orthopaedic Clinic, Faculty Hospital Plzen in 1985-1991. The fractures are classified according to Lettournel-Judet. The authors investigated associated injuries which prolong the interval between injury and operation as well as the correlation between the mechanism of injury and the patient's age and the incidence of injuries in different months of the year. For indication for operation the quality of reposition evaluated by computed tomography is essential. The authors analyze the length of the interval between injury and operation, administration of antibiotics and anticoagulants. As to early complications, they pay attention in particular to bronchopneumonia, infection and thromboembolic disease. The paper deals also with the most serious late complication--avascular necrosis--and the authors discuss the causes of its development as well as possibilities to influence it. The paper presents also results evaluating patients as regards their return to work, subjective evaluation of gait, pain of the joints and satisfaction with treatment. The case-history is followed by discussion concerned with the importance of computed tomography, the surgical approach, importance of treatment of the sacroiliac complex, the development of heterotopic and ectopic ossifications and the essential time of relief of the operated joint. In the conclusion the authors summarize the basic principles of fractures of the acetabulum.

Acetabulum↗
PubMed1992

[Drug therapy in vascular occlusions of the lower extremities].

The authors report their three-year experience with application of thrombolytic treatment in 31 patients with vascular occlusions of the lower extremities. They were successful in two thirds of the patients. The authors analyze the advantages and shortcomings of systemic or selective administration of antithrombotic therapy. Concurrent administration of hyperbaric oxygen is a rational therapy.

Adult↗
PubMed1991

[Incidence of aneurysms of the abdominal aorta in the Czechoslovak population and possibilities of its detection].

A significant increase not only in the number of operations for AAA but also in the incidence of autopsy findings of AAA from 1.5 per cent to 4.5 per cent has been observed during the last 20 years. Ultrasound screening of the abdominal aorta in patients examined for other reasons revealed asymptomatic dilatation of the infrarenal aorta to more than 4 cm in 3.8 per cent of men older than 60 years. AAA should be actively searched for at every physical and ultrasound examination of the abdomen in men over 60 years of age.

Aged↗
PubMed1991

[Pseudophlebothromobsis].

Rational antithrombotic treatment in vascular occlusions is a marked advance in the therapeutic results, incl. reduced mortality. The prerequisite of success is early adequate thrombolytic or anticoagulant treatment taking into account absolute and relative contraindications. Despite this it is necessary to foresee the risk of haemorrhagic complications and orientate diagnosis with the aspect in mind. As an example three case-histories are presented, their common sign being haemorrhage into the lower extremities during antithrombotic treatment. Attention is drawn to the difficulty of differential diagnosis of venous thrombosis and haemorrhage into muscles or intermuscular spaces where at a given site computer tomography is a great asset. In the treatment in addition to surgical intervention in particular hyperbaric oxygen therapy proves useful.

Aged↗
PubMed1990

[The reliability of ultrasonic diagnosis in diaphragmatic rupture].

The author detected a traumatic prolapse of stomach into thorax cavity. The X-ray examination was made only after ultrasonography. Two days after the operation, which confirmed the sonographic finding, symptoms of ileus became evident. The following ultrasonographic finding proved to be very similar to that made before the operation. A relapse of the prolapse was assumed to have occurred, but was not confirmed by a new operation. Since the X-ray examination of the stomach two months after the operation revealed a hiatus hernia, the author is of the opinion that a sliding hernia may have been cause of the erroneous diagnosis of the prolapse relapse.

Adult↗
PubMed1990

[Thermography findings in the hands in relation to the age of the examined individual].

The authors compared thermographic findings of hands in two groups of apprentices (average age 15 and 16 years) with a group of students (average age 21 years) and a group of young workers (average age 29 years). There was a highly significant difference in the number of cold hands before and after vibration test in the apprentices and adults (29 years). The authors arrive at the conclusion that 1) thermoregulation reaches its final shape only after 20 years of age, 2) in the apprensitive thermographic finding must be verified by regular thermographic control examinations.

Adolescent↗
PubMed1990

[Focal steatosis].

Focal fatty liver in 2 females is described. In the first patient with an increasing stenosis of the d. hepaticus com., a transitory focal fatty liver was found. In the second patient a durable focal liver steatosis in a form of a lipom (-30 HU) was covered.

Adenocarcinoma↗
PubMed1989

[Comparison of radionuclide venography with roentgen phlebography].

The authors evaluated a group of 78 patients where in addition to radionuclide venography (RNV) also X-ray phlebography was used (RTGF) within a time interval of not more than 72 hours. The results of 102 examinations were compared, 276 areas were correlated at six different sites. Agreement was recorded in 249 instances (90%), a false negative finding in 23 (8%) and a false positive finding in 4 (2%). Sensitivity was low in the area of the calf (55%), high in the femoral area, iliac area and in the area of the inferior vena cava (92-100%). The specificity was in all areas, incl. the calf, relatively high (94-100%). The investigation revealed the disadvantages of RNV--a low reliability in the area of the calf, the impossibility to detect small and parietal thrombi, the inability to assess the "activity and age" of the thrombus, the more difficult interpretation in insufficiency of venous perforators, and advantages of RNV--a great reliability at higher parts of the venous system and after administration of radiopharmaceutical preparations (RF) into peripheral veins, the possibility of simultaneous examination of pulmonary perfusion without further administration of RF, a low failure rate of intravenous administration of RF (less than 2%); RF do not irritate the venous endothelium and therefore thrombosis cannot develop; in case of paravenous escape of RF local inflammations do not develop, the radiation load is low, there is a small probability of allergic reactions, the method is non-invasive, it can be frequently repeated and used for the follow-up of treatment.

Female↗
PubMed1989

[Radiodiagnostic methods in the postmortem study of a dicephalus masculinus].

With conventional radiography and with CT several malformations were detected in a dicephalus masculinus. The most important were: 2 spinal medullas in a common spinal canal (TH1 to L4), hydrocephalus of both lateral ventricles and of the third ventricle, prolaps of the left hepatic lobe into the left thoracic cavity, two aortic arcs, one large internal jugular vein, and twin bases of the vertebrae TH1 to L5. The dicephalus had not only a double head, but also two cervices connected by a falx.

Abnormalities, Severe Teratoid↗