Sbornik lekarsky最新文献

{"title":"[Laparoscopic fundoplication in the treatment of Barrett esophagus].","authors":"Z Krska,&nbsp;P Urbánek,&nbsp;T Krechler,&nbsp;M Pesková,&nbsp;J Sváb,&nbsp;R Demes,&nbsp;J Petrtýl,&nbsp;K Lukás,&nbsp;M Lukás,&nbsp;R Brůha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>Barrett's esophagus (BE) the serious complication of gastroesophageal reflux disease (GERD) is discussed. BE has been defined as the complete intestinal metaplasia of distal esophagus. The most serious complication of BE is esophageal adenocarcinoma. We present our results with the group of patients with GERD from the years 1998-2000. We prospectively followed 67 patients with GERD (group A) and 8 patients with GERD/BE (group B). All patients underwent laparoscopic fundoplication. The average length of the Barrett's segment was 4.3 cm. Average time of the surgery was 75 min. Nissen fundoplication was used in seven cases in group B, in one case we used Rossetti laparoscopic fundoplication. The postoperative endoscopic controls were performed at two months after surgery and then every one-year.</p><p><strong>Results: </strong>In one case we observed the complete reepithelization with the mixed spinocelullar and columnar components. We didn't observe any one case of histological deterioration. There was on any difference between two groups regarding the subjective complains. Six patients form group B reported complete disappearing of pyrosis. Two patients reported significant improvement, with very rare pyrosis or dysphagia. Our experience (together with the literature) proved the surgical antireflux therapy is very safe, very effective and with very long lasting effect. The effectivity of surgical therapy is increased by the laparoscopy. Described laparoscopic approaches can lead to the reepithelization of Barrett's metaplasia or, at least, they can diminish the symptoms without any long-term medication. Surveillance endoscopy and biopsy are strictly recommended in all patients with BE and also in the patients with BE after antireflux surgery. The intervals depend on the grade of dysplasia in metaplastic epithelium.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 2","pages":"181-7"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cognitive-behavioral therapy in obesity and activities of the STOB (Stop to Obesity) society].","authors":"I Málková","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>STOB Society (STop to OBesity) was founded in the Czech Republic in 1991. It joins together psychologists, medical doctors, instructors of appropriate physical exercises and other professionals whose aim is to help obese people in the struggle with their excess weight. Activities of STOB Society are based on the method of cognitive behavioural psychotherapy, it proceeds from the assumption that inappropriate habits are learnt and so with a help of various techniques they can be also unlearnt. The aim is to induce desirable changes in behaviour, that is in eating and physical activity habits, and at the same time to get rid of the emotions and thoughts that lead to an inappropriate behaviour. The basis of cognitive-behavioural therapy is described. STOB Society popularizes appropriate and healthy way of weight reduction through articles in newspapers and journals, through programmes in radio and television and through brochure, audio and wide tapes, calendar etc. STOB Society organizes national campaigns in which it prompts thousands of obese people in the Czech Republic to appropriate eating and physical activity habits. It organizes \"Weight reduction courses\" in 70 towns in the Czech Republic.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 4","pages":"559-63"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-pump coronary artery bypass grafting. The 1st Medical Faculty of Charles University study.","authors":"M Semrád,&nbsp;P Bodlák,&nbsp;M Stríteský,&nbsp;J Kristof,&nbsp;J Lindner,&nbsp;T Urban,&nbsp;V Vondrácek,&nbsp;I Vanĕk","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the surgical technique, anaesthesiological management, immediate and mid-term results, graft patency and effectiveness of less invasive coronary artery bypass grafting through a median sternotomy.</p><p><strong>Methods: </strong>From January 1998 through December 1999, 144 patients had coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) done by one surgeon through a median sternotomy. The cohort of 107 men and 37 women averaged 60.8 years, mean ejection fraction (EF) was 51.8%. An average of 2.7 (range 1 to 5) grafts/patients was achieved. Results are compared with a CPB subgroup of patients operated on through a median sternotomy in the same time (N = 234). In a random subgroup of 100 patients (50 per group) an angiographic control of graft patency was done.</p><p><strong>Results: </strong>A non-CPB group showed less postoperative acute myocardial infarction (0.7% vs. 3.8%, p < 0.05) and atrial fibrillation (14.6% vs. 26%, p < 0.05), lower incidence of renal (2.8% vs. 5.1%, p < 0.05) and respiratory complications (2.0% vs. 3.8%, NS). We observed lower operative mortality (0.7% vs. 3.4%, p < 0.05), as well as the occurrence of low cardiac output syndrome (0.7% vs. 5.6%, p < 0.05) in the off-pump group. The follow-up is 36 +/- 12 months and the number of patients with recurrent angina, late AMI and late death is acceptable. We did not find an inordinate number of vein grafts occlusions (0.7% vs. 1.8%, NS) and stenoses (6.6% vs. 6.7%, NS) at anastomotic sites. None of the arterial grafts in both groups were occluded.</p><p><strong>Conclusions: </strong>There was little known about the efficacy of the less invasive coronary artery bypass grafting at the beginning of our study. Starting with pioneering the operative technique, we have discovered and proposed three types of a heart verticalization and a reusable stabilizing device. We detected lower incidence of postoperative complications and decreased operative mortality in a non-CPB group. Angiographic assessment displayed an excellent run-off in both groups of patients. Off-pump coronary bypass grafting is associated with sufficient short-term graft patency and mid-term clinical outcomes.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 3","pages":"297-304"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Dilatation of the popliteal artery in hyperemia and intimal-medial thickness of the carotid artery in hyperlipoproteinemia, ischemic heart disease and in healthy individuals].","authors":"J Spácil,&nbsp;R Ceska,&nbsp;T Haas","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Non-invasive measurement of the intima-media thickness (IMT) of the carotid artery and flow-mediated dilatation (FMD) of the brachial artery are increasingly used as surrogate markers of vascular disease. Using ultrasound, we measured the diameter of the popliteal artery at rest and during reactive hyperaemia after release of 5-minute arterial occlusion. We also measured IMT of the common carotid artery. In 29 control subjects (average age 35 years) we demonstrated an increase in the diameter by 6.0 +/- 3.3% (p < 0.05), in 29 asymptomatic patients with hyperlipidemia (without therapy, average age 46 years) only by 0.9 +/- 3.0% and in patients with coronary heart disease (average age 50 years) only by 0.2 +/- 2.7%. The difference between patients and control subjects was highly significant (p < 0.001). IMT was 0.58 +/- 0.10 mm, 0.78 +/- 0.17 mm and 1.03 +/- 0.25 mm respectively (p < 0.001). We conclude that in patients FMD of the popliteal artery is smaller and IMT of the common carotid artery is thicker than in controls.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 3","pages":"305-11"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Apoptosis and its importance in the development and therapy of tumors (review)].","authors":"Z Kleibl,&nbsp;M Raisová,&nbsp;J Novotný,&nbsp;P Pohlreich,&nbsp;B Matous","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This review focuses on apoptosis and its regulation as a tool of principal control mechanism of tissue homeostasis. Defects in regulation of apoptosis contribute to a various pathological processes, including tumor development, chronic inflammatory diseases, immunological disorders and many others. Apoptosis influences sensitivity to radiotherapy and chemotherapy of tumours. Microscopically the apoptosis is characterized by morphological changes, which result in the formation of apoptotic bodies. Apoptosis is an active process, which require synthesis and activation of a set of the specific cellular proteins. Among them, the key role belongs to the family of cystein proteases--caspases activated either through the death receptors or via activation steps starting with the release of a mitochondrial cytochrome c. Activation of caspases promotes the activation of downstream effectors leading to the cleavage of target cellular proteins and genomic DNA. The members of Bcl-2 family and p53 are- the others important proteins influencing the regulation of apoptosis. Enhancing of our knowledge about apoptosis and its mechanisms highly improves the rationale for diagnostics and therapy in oncology.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22126788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical treatment of sleep apnea syndrome in otorhinolaryngology].","authors":"P Rambousek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sleep apnea syndrome must be exactly confirmed by the standard set or collection of examinations from rhonchopathy. The diagnosis is distinguished and identify by ENT examination, nocturnal recording by polyMESAM or by complete polysomnography. Then is performed neurological and maxillomandibular examination, X-rays pictures (cephalometric data), and CT of pharynx. Part of patient is indicated to undergo surgery. In region of velopharyngeal space we performed classical uvulopalatopharyngoplasty (UPPP), described first time by Fujita 1981 in Detroit [4]. It means, that we take out both tonsils and then remove part of soft palate to enlarging the velopharyngeal space. The findings of retrobasilingual obstruction and obesity are negative predictors for success of UPPP. Narrowing of posterior airway space is indication for the alternative therapy called maxillomandibular advancement. We prefer the surgery by classical method without laser. Adenotomy is performed in children population since residuum of adenoids, and sometimes tonsillectomy should be added for good postoperative results. Part of patient should undergo septoplasty due to local findings of obstruction or another anatomical abnormalities on the level of nasal cavity or nasopharynx. This surgery is very important for this reason of treatment by CPAP.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 1","pages":"91-7"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22127340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ventilatory support in neurologic diseases].","authors":"J Fiksa,&nbsp;J Bauer,&nbsp;K Sonka,&nbsp;J Böhm,&nbsp;P Vymĕtalová","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many neurological diseases cause permanent ventilatory insufficiency. In the ambulatory care we consider regular observation of these patients as a very important. The detection of the early clinical symptoms initialises early ventilatory support. We prefer non-invasive mechanical ventilatory methods to invasive ones. Invasive home care ventilation is very difficult and needs adequate social, medical and economical conditions. We present one case.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 1","pages":"99-105"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22127341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender, obesity and health.","authors":"Berit Lilienthal Heitmann","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 4","pages":"465-70"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22333591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Results of rectal resection procedures at the First Surgical Clinic of the First Medical Faculty of Charles University].","authors":"J Cermák,&nbsp;R Gürlich,&nbsp;J Hubík,&nbsp;O Paul,&nbsp;D Schmidt,&nbsp;J Sváb,&nbsp;M Pesková","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Conventional surgical techniques play an important role in rectal cancer. Dehiscence of the anastomosis after low anterior resection of the rectum is a serious complication. The incidence of dehiscences can be reduced when known principles of preoperative care are respected but in particular by correct surgical technique. In 92 patients operated for rectal cancer at First Surgical Clinic of Charles University we had six patients (6.5%) with dehiscences of anastomosis. The serious character of this surgical complication can be reduced by a primary derivative stomy. Authors recommend implementing a preventive ileostomy in low resection of the rectum in high-risk patients.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 2","pages":"189-92"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevention of thromboembolism in surgery of fractures of the upper end of the femur].","authors":"K Kudrna,&nbsp;Z Krska,&nbsp;J Kvasnicka,&nbsp;J Bríza,&nbsp;S Trca","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Morbidity and mortality after hip fractures is often a result of deep vein thrombosis and pulmonary embolism. Therefore, prophylaxis for venous thrombosis is recommended in patients undergoing osteosynthesis of upper end of lower extremity or arthroplasty of the hip. Study compared efficacy of UFH and LMWH in prevention of thromboembolic disease. The most important part of the study is the prospective trial, which describe group of 81 patients, undergoing operation for hip fracture. These patients suffered fracture of the neck of femur (35) or intertrochanteric fracture (46). For prevention of DVT was used UFH or LMWH. The evaluation was exercised by laboratory tests, Doppler test and by phlebography in cases, where was suspicion of phlebothrombosis. All patients were controlled for two months after operation. Died eleven patients; in every case was PE or cause of death or main complication. Nine of dead was operated for pertrochanteric fracture, another two for fracture of the neck. Prevention drug was UFH in nine dead patients; eight of them suffered pertrochanteric fracture. The most often death sated in fourth and fifth weeks after operation. It means, that the risk of PE continue for a several weeks. It appears, that the prevention use of UFH is not sufficient.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 2","pages":"203-12"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}