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Z Voboril

Publications and source records attributed to Z Voboril.

At least 19 recordsLinked to original sources
PubMed2002

[Infectious aneurysm of the abdominal aorta caused by Salmonella: diagnosis, endovascular therapy].

The authors present a case of an infected abdominal aortic aneurysms by means of a minimally invasive endovascular method using a stent graft. This patient had already been treated by TIPS (transjugular intrahepatic portosystemic shunt) for repeated varicose bleeding due to liver cirrhosis. Standard surgical therapy of infected abdominal aneurysms and about advantages and possibilities of endovascular treatment with stent grafts are discussed. Regular follow-up of the patient and long-term antibiotics therapy are important for accurate assessment of an implanted stent graft into the infected abdominal aorta. Endovascular stent graft combined with antibiotic therapy may be an alternative to conventional open surgery in managing infected infrarenal abdominal aneurysms.

Aneurysm, Infected↗
PubMed2002

Hepatocellular carcinoma presenting with bone metastasis.

Bone metastasis is an unusual complication of hepatocellular carcinoma. We report here 2 cases of patients with bone metastases of hepatocellular carcinoma at presentation. Patient No. 1 with liver cirrhosis and hepatocellular carcinoma was admitted with a bone metastasis in the rib. The patient was treated with hepatic arterial chemotherapy and rib resection. Patient No.2 was known to have an asymptomatic liver mass of uncertain histology for a year when he presented with back pain. Because of signs of spinal compression, laminectomy was performed, and the diagnosis of metastatic hepatocellular carcinoma was established. The presence of bone metastases in hepatocellular carcinoma at presentation is extremely rare. More frequently, bone lesions are observed after successful treatment of the primary liver tumor. Both surgery and radiotherapy are used as palliative treatment in bone metastases of hepatocellular carcinoma. The treatment of hepatocellular carcinoma presenting with bone metastasis by bone resection and intraarterial chemotherapy seems to be of limited impact on patient survival because of dissemination of micrometastases in other organs and the frequent presence of other comorbid conditions. However, effective palliation using this multimodality approach is feasible. Hepatocellular carcinoma should be considered in the differential diagnosis of bone metastases.

Aged↗
PubMed2001

Immunoscintigraphy and intra-operative radioimmunodetection in the treatment of colorectal carcinoma.

PURPOSE: Intra-operative radioimmunodetection of malignant involved lymph nodes follows the pre-operative immunoscintigraphy in the treatment of patients with colorectal carcinoma. The aims of this clinical study were to determine the sensitivity of the method, to compare the results in study when using Oncoscint and CEA-Scan and to evaluate the importance of the method of surgery and postoperative adjuvant therapy. PATIENTS AND METHODS: 121 patients with colorectal tumours (106 primary and 15 recurrent) were operated on using radioimmunoguided surgery (RIGS). The study compared results of pre-operative immunoscintigraphy, intra-operative radioimmunodetection and postoperative histological examination. Histological investigation used classical H&E staining. In histologically negative and RIGS positive cases the immunohistochemical investigation was supplemented. Two radiopharmaceuticals were used Oncoscint CR 103 (MAb B72.3, Satumomab Pendetide), labelled with 111In in 56 patients and CEA-Scan (IMMU 4-Fab' fragments MAb against CEA, Arcitumomab), labelled with 99mTc in 65 patients. RESULTS: The relationship between RIGS positive results and histological examination was statistically assessed after 38 operations and the most acceptable RIGS evaluating index was determined. All subsequent results were evaluated by this index. Immunoscintigraphy of tumour was positive in 112 cases (92.6%). Fifty-five RIGS positive cases of malignant infiltrated lymph nodes were confirmed by 43 histologically positive examinations (78%). In this group 9 cases were discovered only by immunohistochemistry. Sixty-six remaining RIGS negative results were confirmed in 62 (94%) cases by negative histology. CONCLUSIONS: Both immunoscintigraphy and RIGS enable one to make a more accurate diagnosis. While treating the primary disease the use of RIGS may help in assessment of necessary extent of operation performance and in staging of the disease by revealing occult lymph nodes involved. Pre-operative immunoscintigraphy seems to be a useful diagnostic method for detection of tumour recurrence. When comparing two radiopharmaceuticals used, CEA-Scan seems to be more suitable for diagnostic studies, but using the Oncoscint for tumour recurrence detection had some specific benefit, too.

Journal Article↗
PubMed2000

[Subadventitial rupture of the internal carotid artery].

The author describes the case of a 21-year-old patient who contracted an injury of the internal carotid by collision with the tip of a metal rod. The injury led to the development of a sub-adventitial rupture of the carotid artery and its subsequent thrombosis. The patient was admitted to the Clinic 12 hours after he lost consciousness. CT examination of the brain did not reveal malacia. The patient was operated--resection of the injured portion of the carotid artery was performed, carotid thrombectomy and reconstruction of the artery. After surgery the patient improved rapidly and gradually his condition returned to normal.

Adult↗
PubMed2000

[The spiral Z-stent with a knit dacron coating in endoluminal therapy of aneurysms of the abdominal aorta].

The authors present their own experience with construction, experimental testing and clinical application of endoluminal grafts. In the first part of the project, a new selfexpandable stentgraft was constructed on the basis of spiral Z stent. Spiral Z stent was covered by ultrathin polyester sleeve. Next, stentgraft was tested on animal model of abdominal aortic aneurysm. On the basis of experimental results endoluminal grafting of AAA was started in Czech Republic.

Aged↗
PubMed1999

[Aberrant mammae, personal experience].

The authors present information of a group of 63 patients (60 women and 3 men) treated in 1976-1998 where supernumerous aberrant or accessory mammary gland tissue was found. The diagnosis in the majority of the patients was based on histological examination. The tissue of an aberrant mammary gland is subject to the same physiological influences as the mamma proper and can be affected by the same pathological processes--benign and malignant. This is the reason why the authors recommend early extirpation.

Adolescent↗
PubMed1999

Inguinal hernioplasty according to Lotheissen and McVay.

Inguinal hernioplasty represents one of the most frequently performed operation in surgery. In the article the author describes the technique of inguinal hernioplasty according to Lotheissen and McVay. He has an excellent experience when using this procedure. This communication tried to focus the attention of surgical community on this method.

Hernia, Inguinal↗
PubMed1998

Dissection of the infrarenal aorta treated by stent graft placement.

Aortic dissection is primarily localized in the thoracic aorta. Dissection of the abdominal aorta is exceedingly rare, especially in the absence of a blunt abdominal trauma. Two cases of a primarily infrarenal aortic dissection were diagnosed by US, CT and angiography. The patients were treated by stent graft placement. The stent grafts were introduced via a femoral arteriotomy through the introducer sheath and were placed so that they occluded entry and reentry of aortic dissection. The stent graft placement caused total obliteration of a false channel of the dissection immediately after endoprosthesis deployment. The patients were followed-up by CT and angiography at 16 and 3 months after surgery without complication.

Aged↗
PubMed1997

Juxtarenal aortic aneurysm associated with a horseshoe kidney. Transfemoral endoluminal repair.

Horseshoe kidney complicates aortic aneurysm surgery in 1 of 200 cases. A patient with asymptomatic juxtarenal aortic aneurysm associated with a horseshoe kidney was successfully treated by stent graft placement. The kidney was supplied by 4 renal arteries. The proximal uncovered part of the stent graft was anchored across the origin of 1 renal artery. Another renal artery, arising from the aneurysmal sac, was occluded by the covered part of the stent graft. A kidney infarction developed postoperatively, which did not affect renal function or blood pressure. The patient was discharged from the hospital in good condition. Follow-up computed tomography and angiography confirmed a satisfactory result of the endovascular treatment.

Aged↗
PubMed1997

Juxtarenal aortic aneurysm: endoluminal transfemoral repair?

Endoluminal transfemoral repair of an abdominal aortic aneurysm by a stent graft placement requires a segment of the nondilated infrarenal aorta of at least 15 mm long for safe stent graft attachment. The possibility of endoluminal treatment of a juxtarenal abdominal aortic aneurysm with partially covered spiral Z stent was assessed in experiment and in three clinical cases. In the experiment, the noncovered spiral Z stent was placed into the abdominal aorta, across the origins of renal arteries and mesenteric arteries, in six dogs. In the clinical cases, a partially covered stent graft was attached in 3 patients with the juxtarenal abdominal aortic aneurysm (of the group of 12 patients with abdominal aortic aneurysm). The stent grafts were attached with proximal uncovered parts across the origins of the renal arteries. In experiment, the renal artery occlusions or stenoses were not observed 36 months after stent placement, and in clinic, 3 patients with the juxtarenal aortic aneurysm were successfully treated by stent graft placement. There were no signs of flow impairment into the renal arteries 14 months after stent graft implantation. This approach can possibly expand the indications for endoluminal grafting in the treatment of juxtarenal aortic aneurysms in patients who are at high risk for surgery.

Aged↗
PubMed1997

[Activation of the immune system in colorectal carcinoma and its assessment].

The immune system of the patients with colorectal cancer is activated. Urinary neopterin is an index of this systemic immune activation, reflecting the circulating activity of interferon-gamma. We have measured urinary neopterin excretion in 34 patients with colorectal cancer. This excretion was significantly higher in our patients compared to reference group (325 +/- 267 vs 169 +/- 62 mumol/mol creatinine, neopterin concentrations were considerably higher in Dukes' stage D disease compared with Dukes' stage B and C disease/561 +/- 372 vs 188 +/- 47 and 250 +/- 142 mu/mol creatinine. Increased neopterin detected the presence of metastatic disease with 90% sensitivity and 87.5% specificity. Authors conclude that urinary neopterin measurement may be useful in the staging of colorectal cancer.

Biomarkers, Tumor↗
PubMed1996

[Polyester-covered spiral Z stent. Initial clinical experience with endovascular treatment of aortic aneurysms].

The authors present their initial clinical experience with endovascular treatment of an aneurysm of the abdominal aorta using of a polyester covered spiral Z stent. Since May 1995 they treated by the endoluminal route 13 patients with aneurysms of the abdominal aorta and 1 patient with thoracic aneurysm. In patients with a subrenal aneurysm (n = 10) the stent graft was anchored below renal arteries origins. In patients with a juxtarenal aneurysm (n = 3) the stent graft was anchored across the renal arteries origins. All patients were followed up by angiography, computed tomography and ultrasonography. In one patient with a subrenal aneurysm dislocation of the stent graft during implantation occurred. In the remaining patients it proved possible to exclude the aneurysm successfully. One patient with an juxtarenal aneurysm died 6 days after surgery. The cause of death was not associated with the aneurysm or surgery. In patients with juxtarenal aneurysms the authors did not observe changes of renal functions or occlusion of the renal artery in the course of 12 months.

Aged↗
PubMed1995

Increased urinary zinc excretion in cancer patients is linked to immune activation and renal tubular cell dysfunction.

Urinary zinc excretion is known to be increased in cancer patients, but the pathogenesis of this phenomenon remains uncertain. Both skeletal muscle catabolism and renal tubular cell dysfunction have been proposed to explain this observation. We have investigated urinary zinc and N-acetyl-beta-D-glucosaminidase (NAG), an indicator of renal tubular cell dysfunction, as well as serum neopterin, an index of systemic immune activation, in 22 patients with cancer and seven controls. Both serum neopterin and urinary zinc were significantly elevated in cancer patients (15.8 +/- 12.7 versus 7.3 +/- 2.3 nmol l-1 and 1.77 +/- 0.80 versus 1.21 +/- 0.41 mmol mol-1 creatinine, P < 0.02 and P < 0.05, respectively), while NAG was similar in cancer patients and the controls (13.58 +/- 13.80 versus 13.68 +/- 12.19 mu kat mol-1 creatinine). A significant correlation was observed between serum neopterin and urine zinc (rs = 0.5119, P < 0.02), serum neopterin and urine NAG (rs = 0.6761, P < 0.002), and urinary zinc and NAG (rs = 0.6348, P < 0.002). In conclusion, the present data indicate a link between urinary zinc excretion and immune activation as well as renal tubular cell dysfunction. In addition, renal tubular cell dysfunction appears to be linked to immune activation.

Acetylglucosaminidase↗
PubMed1995

Association between renal tubular cell dysfunction and increased urinary zinc excretion in cancer patients.

Although an increase in renal zinc excretion in cancer patients is well documented, the mechanisms involved are still disputed. As recent studies have raised the question of the role of renal tubular cell dysfunction in the elevation of urinary zinc output, we have examined urinary zinc excretion and the excretion of N-acetyl-beta-D-glucosaminidase (NAG), an indicator of tubular cell dysfunction, in 30 patients with cancer, 28 healthy controls and 20 patients with benign non-inflammatory disorders. As expected, urinary zinc excretion was significantly higher in the cancer patients compared with controls and patients with benign disorders (2.64 +/- 3.05 vs. 0.86 +/- 0.36 and 0.89 +/- 0.29 mmol mol creatinine-1, p < 0.001). NAG activity was also elevated (18.9 +/- 20.1 vs. 4.32 +/- 3.33 and 9.99 +/- 9.72 mukat mol creatinine-1, p < 0.001 and p < 0.05, respectively). A significant correlation between urine zinc and NAG was observed in all three groups (rho = 0.73, p < 0.001, rho = 0.55, p < 0.01 and rho = 0.45, p < 0.05, respectively). In conclusion, our data provide additional support for the role of renal tubular cell dysfunction in hyperzincuria in cancer. Urinary zinc measurement may represent an alternative approach to detecting renal tubular dysfunction in human pathology.

Acetylglucosaminidase↗
PubMed1995

[Endoluminal grafts in the therapy of aneurysms of the abdominal aorta. Experimental results].

In 1991 a new method of treatment of aneurysms of the abdominal aorta was published. The method is based on bridging the sac of the aneurysm by an endoluminal graft. The graft is a stent provided with a special vascular prosthesis. The endoprosthesis is inserted by means of a catheter from arteriotomy of the common femoral artery. The objective of the submitted work was to test the possibility to use a polyester covered spiral Z stent in the treatment of aneurysms of the abdominal aorta. For experiments six dogs were used weighing 12-18 kg. In the experimental animals an artificial aneurysm of the abdominal aorta was induced. Then the authors interposed surgically into the subrenal section of the abdominal aorta a special polyester knitted prosthesis imitating the shape of the aneurysm. Two weeks after surgery angiography of the abdominal aorta was performed. After angiography the authors introduced from arteriotomy of the superficial femoral artery an endoluminal graft into the artificial aneurysm. The graft bridged the aneurysm on the inside and this led to thrombosis of the sac of the aneurysm. The state of the graft and aneurysm was checked sonographically and angiographically. The graft was successfully used in all experimental animals. Angiographic check-up examinations revealed that application of the graft led to immediate exclusion of the sac of the aneurysm. In two experimental animals the graft was inserted in an excessively cranial position. It did not bridge the aneurysm throughout its length. Reflux of blood in the distal part persisted and filled the residual cavity of the sac of the aneurysm.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Urinary zinc excretion and acute phase response in cancer patients.

We investigated urinary zinc and serum levels of C-reactive protein, alpha-1 acid glycoprotein, haptoglobin, transferrin and prealbumin in 55 patients with solid tumors and 20 controls. Urinary zinc, serum C-reactive protein, alpha-1 acid glycoprotein and haptoglobin were significantly higher, and serum prealbumin was significantly lower in cancer patients. A significant positive correlation between urinary zinc and C-reactive protein, alpha-1 acid glycoprotein and haptoglobin, as well as a negative correlation with transferrin and prealbumin were observed. Hyperzincuria in cancer patients appears to be linked to the acute phase response. Our data provide further evidence implicating systemic inflammatory response in increased urinary zinc excretion.

Acute-Phase Reaction↗
PubMed1994

Increased urinary zinc and copper excretion in colorectal cancer.

Although several studies have described an increase in urinary zinc output in cancer patients, little attention has been paid to the excretion of copper. In this study, we investigated urinary excretion of zinc and copper, and serum levels of alpha-1 acid glycoprotein, an acute phase protein, in 22 patients with colorectal cancer. Urinary excretion of copper and zinc were significantly increased compared to the reference group (77 +/- 72 vs. 32 +/- 14 mumol/mol creatinine, P < 0.05, and 1.50 +/- 0.62 vs. 0.70 +/- 0.41, P < 0.002, respectively). In addition, a negative correlation was observed between urinary copper and serum alpha-1 acid glycoprotein (rs = -0.5256, P < 0.02). In conclusion, urinary excretion of copper, as well as that of zinc, appears to be elevated in colorectal cancer. The finding of a negative correlation between urinary copper and alpha-1 acid glycoprotein supports the postulated role of the latter in regulating renal glomerular permselectivity.

Adult↗