Sbornik vedeckych praci Lekarske fakulty Karlovy univerzity v Hradci Kralove. Supplementum最新文献

Liver regeneration means the ability of the liver to restore the initial cellular mass after damage of various etiology. The primary mechanism of liver regeneration is not clearly defined yet. According to the recent knowledge the liver regeneration is directed by co-acting of many factors and events, among which the metabolic changes in regenerating liver tissue play important role. The aim of this study is to summarize the most important metabolic changes in the early steps of liver regeneration. The study presents the changes, which are taking place in the liver and in the other tissues and organs during liver regeneration, particularly after partial hepatectomy, but also in other types of liver damage. In the beginning the short overview of genetic changes, which enable the development of metabolic changes, is presented. After that the attention is drawn to the carbohydrate, lipid and protein metabolism. In the part, discussing the lipids, the results of experiments, in which the authors followed the influencing of liver regeneration in the rat after partial hepatectomy by means of parenteral and enteral application of various types of lipids and lipids combined with carnitine, is presented. In the next part the study discusses the metabolism of protein kinases and/or ions and trace elements. The energy metabolism as the necessary part of metabolic events is mentioned after that. In the last part the study draws attention to enzymatic retrodifferentiation in regenerating liver.

The aneurysms of the vein of Galen may be defined as a midline arteriovenous fistula with aneurysmal dilatation of the median venous sac. From the literature and author's experiences a survey of embryology, pathophysiology as well as contemporary state of diagnosis and therapy of vein of Galen malformation is presented.

The efficacy of cholinesterase reactivators tetroxime, HI-6 and obidoxime in combination with atropine against highly toxic organophosphate soman as well as organophosphorus insecticide fosdrin was evaluated in male mice using median lethal dose (LD50) for 48 hours. Oxime HI-6 appears to be considerably more effective than tetroxime as well as obidoxime for the treatment of acute poisonings by soman or fosdrin, although the difference in effect is not significant in the case of poisoning by fosdrin. These findings suggest that HI-6 has definite advantage over obidoxime as well as tetroxime in the treatment of poisoning with not only highly toxic organophosphates but also organophoshorus insecticides.

Evaluation of biological properties of filling materials used as an alternative to amalgams shows that none of the tested materials possess the required biological properties. It is therefore necessary to search for new and better filling materials.

Ruptured cerebral aneurysm is the most common cause of non-traumatic subarachnoid hemorrhage. Subsequent to this catastrophe, patients have usually evidence of severe headache with sudden onset, signs of meningeal irritation, and depression of consciousness. Difficulties in diagnosis arise when the clinical picture is not classical. Cerebral vasospasm following aneurysmal subarachnoid hemorrhage is the leading cause of death and disability after aneurysm rupture. In the presence of a typical history and a normal CT scan, lumbar puncture should be performed with spectrophotometry analysis of the supernatant. After subarachnoid hemorrhage has been confirmed, four-vessel angiography should be performed as soon as possible. The surgical treatment of subarachnoid hemorrhage caused by ruptured aneurysm is the method of choice.

At the Department of Urology in Hradec Králové five patients were treated in 1991 to 1993 with bleeding to the adrenal glands. We present our reports of these patients and stress the difficulty of preoperative diagnosis.

A literature review is given on effectivity and safety of total parenteral and enteral nutrition in gastroenterological diseases and associated disorders. There is a well-known close association between malnutrition and morbidity. Administration of total parenteral and/or enteral nutrition is often life-saving regimen and omission of this therapy could be considered as a seviour vitium artis in such a condition. However, there are some diseases with a lack of proved effectiveness of nutritional support. It is necessary for patients' safety to be stressed that it is necessary to give parenteral and enteral nutrition only in indicated cases (being aware of risk, cost and possible benefit). This regimen can be administrated only by well-trained skilled staff (nutrition teams if possible) with regular controls and patient monitoring.

Between 1972 to 1994 there were admitted 105 patients with blunt trauma of the kidney, 89 men and 16 women with median age 32 years. In 53 patients the left kidney was affected and in 52 of them the right side was injured. According to the grade of trauma we evaluated in 77 patients a contusion (73.3%), by 16 patients a laceration (15.2%), in 11 patients a rupture of the kidney with fragmentation of the parenchyma and in one the renal artery was injured. The mechanism leading to the blunt trauma of the kidney was following: traffic accident in 52 patients (49.5%), during sport in 20 patients (19.5%). 16 patients were injured in own home (9.5%) and 7 patients in work (6.7%). In 28 patients the trauma of the kidney was serious, by 5 of them we have done nephrectomy (17.8%), in two suture of the parenchyma (7.1%) and in further two patients heminephrectomy. After considering clinical status, grade of hypovolemic shock and finding on CT scan we prefer lately conservative steps in the treatment serious trauma of the kidney.

The authors describe in following paper their own group of patients with asymptomatic but hemodynamically significant carotid disease operated under cardiopulmonary bypass on. Current studies recommend the "alpha-stat" regime as the optimal strategy of CPB conduction to ensure intraoperative cerebral protection. This study was done to verify this idea. 284 consecutive patients admitted for elective coronary surgery underwent a non-invasive Doppler scanning of extracranial carotid arteries. Twenty seven patients (10%) had significant carotid disease. All patients underwent coronary surgery as the first procedure. There was no cerebral complication in this group of patients and neurological status of these patients postoperatively was the same as it was preoperatively. This study shows that CPB in patients with hemodynamically significant carotid disease can be achieved without impairment of central nervous system with "alpha-stat" regime of perfusion.