Biomedical subjects
Publications and source records attributed to Z Pelák.
The authors describe the case history of a female patient indicated for laparoscopic cholecystectomy. In the patient with progressing muscular dystrophy and thickening of the peritoneum it did not prove possible to establish a capnoperitoneum at the onset of the operation.
The authors investigated the frequency of squamous intraepithelial lesions (SIL) in young women, in particular university students with special attention to morphological signs of the presence of human papilloma virus (HPV) in SIL low grade-SIL, LG-HPV. As compared with data in the world literature, they revealed a significantly lower rate of SIL LG, HPV-2.81% as compared with 5.5% reported in WHO studies of young women. The authors analyzed the biological behaviour of SIL, LG-HPV. As compared with data in the literature on known values of spontaneous regression which are 50-62% in the course of three years, they demonstrated during a time interval from 3 months to 2 years spontaneous regression in 39.1%. Further possibilities of regression in a longer time interval are expected in the group of clinically latent cytologically persistent LG lesions (18.1%) and in the group of patients which after termination of their studies were lost from the records (24.3%). During the investigated time interval no case of progression to a higher grade lesion was recorded. The authors reflect on diagnostic and therapeutic procedures with regard to the application of results of HPV typing.
In 20 patients treated on account of advanced cholecystitis, inflammations of the biliary pathways and liver a cephalosporin of the third generation, cefoperazone, was administered within the framework of antimicrobial treatment after surgery or after endoscopic intervention. In the laboratory investigation of the study in isolated bacteria minimal inhibitory concentrations and serum, biliary and tissue levels of cefoperazone were assessed. The minimal inhibitory concentrations in the assessed bacteria were several times lower than the levels assessed in serum, bile and the wall of the gallbladder. The infection was eradicated in 20 patients. Seventeen patients were cured (85%).
The authors present a group of 22 patients with iatrogenic pneumothorax. They analyze the basic causes of development of iatrogenic pneumothorax, such as cannulation of the subclavicular vein thoracic puncture. They give an account of their experience with the therapeutic procedure which involves the insertion of a classical thoracic drain and several days of active exhausting. In the conclusion they discuss the possibility to use a new method-videothoracoscopy-in some indicated cases.
The authors present the results of a clinical investigation on the therapeutic use of carbapenem, imipenem/cilastatin in 20 patients operated on account of intraabdominal inflammatory affections, hospitalized at the intensive care unit of the Surgical Clinic of the Third Medical Faculty, Charles University, Prague in 1993. Imipenem/cilastatin was administered to patients during surgery--500 mg i.v.--and subsequently after 8--hour intervals for 5-8 days. During comprehensive treatment no superinfection developed and the patients recovered.
The authors give an account of their experience with the treatment of punctures and gunshot injuries of the chest and abdomen in 43 patients hospitalized at the Surgical Clinic of the Third Medical Faculty, Charles University Prague 10 between 1989 and 1992. Injuries of the chest were recorded 15 times, abdominal injuries in 25 patients and concurrent injuries of the chest and abdomen in three patients. To ensure treatment of penetrating injuries the authors present an algorithm which comprises differentiated care as well as some non-interventional diagnostic methods (ultrasonography, computed tomography). Based on analysis of their own results and data in the literature, the authors recommend in casualties with penetrating chest injuries and abdominal injuries early indicated surgical revision which alone ensures adequate treatment with minimal diagnostic errors. They also draw attention to the necessity to ensure effective first aid and rapid transport of casualties to prevent the development of irreversible changes as a result of haemorrhage, as observed in a single patient who died after a piercing heart injury.
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The authors tested the possibility of assessment of fertile and infertile days during the menstrual cycle by investigating the crystallization of saliva by means of a minimicroscope PC 2000 IMPCON. They followed up for five months a total of 58 women where they assessed by a combination of at least three classical examination methods ovulatory and anovulatory cycles. They monitored a total of 120 cycles and examined 1649 specimens of saliva. Some women had to be eliminated on account of virosis during a flu epidemic (a total of 11 cycles). During the periovulatory period the authors recorded in ovulatory cycles the foreseen crystalline structures in saliva in 78.57%. In anovulatory cycles agreement between the expected character of the saliva specimen and anovulation was found in 84% of the examined cycles. In addition to structures suggesting fertile or infertile days, the authors identified also intermediary types. In the discussion the authors analyze various aspects as regards evaluation of the correlation between salivary and serum levels of gonadotropins and ovarian steroids. They evaluate physical and chemical changes of saliva and vaginal secretion and discuss the problem of crystallization of the saliva during the menstrual cycle. Based on their findings, when testing the minimicroscope PC 2000, they supplement the list of factors with influence the results of examinations. They consider PC 2000 a suitable modern equipment which extends the range of contraceptives and at the same time helps to assess the optimal time for conception in planned pregnancies.
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