Acta medica (Hradec Kralove). Supplementum最新文献

In this report there is described the case of 48-years-old women with nonpenetration chest trauma with respiratory insufficiency. The surgical strategy consisted of two-stage repair of surgical stabilization of the chest wall.

We retrospectively reviewed the incidence of bronchopleural fistula after pneumonectomy. The records of 844 consecutive patients who underwent pneumonectomy within a period between the January 1962 and December 2000 either for the lung cancer or for benign diseases have been assessed. There were 12 cases of bronchopleural fistula representing an incidence of 1.42 %. All operations were performed using an uniform hand suture technique. Eight fistulas developed in patients who underwent pneumonectomy for lung cancer while four occurred in patients with benign diseases. Bronchial dehiscence was confirmed by bronchography or bronchoscopy in each patient. Resuturing of the stump and single completed muscle flap closure was performed in five patients. In three patients with very small fistulas we used the drainage of the pleural cavity and antibiotics only. Three other patients were treated by thoracoplasty. In one patient bronchoscopy closure by tissue adhesive and bone graft was done. The treatment was successful in nine patients from our set while the other three developed fatal complications.

Intrathoracic and intravascular migratory foreign bodies are a small but distinctive subgroup of injuries. The intravascular embolus can be treated like arterial or venous emboli of any other sort and removed as indicated. Wandering foreign bodies in the body cavities should be removed when they need to be, just like bodies imbedded in the body in a fixed position. Authors report an unusual case of migratory foreign body as a complication of osteosynthesis.

Approximately 50 percent of the world's population has been infected by Helicobacter pylori (Hp) infection. In this paper, a literature review is given on pathogenic features, immunology of acute and chronic infection and host - bacterium interaction.

The study exploits knowledge-oriented and context-based modification of well-known algorithms of (fuzzy) clustering. The role of fuzzy sets is inherently inclined towards coping with linguistic domain knowledge also. We try hard to obtain from rich diverse data and knowledge new information about enviroment that is being explored.

The neurotoxic lesion of the rat brain, induced by stereotaxic infusion of the ibotenic (IA) or kainic (KA) acids, is a commonly used model of Huntington's disease (HD) in animal studies. Neurodegenerative process in HD develops for 10-20 years. However, the majority of studies related to the animal models of HD deal with only the several weeks surviving animals. For that reason, a detailed description of the development of histopathological changes in the striatum in the rat brain is presented in this study. Intrastriatal instillation of both, the IA or the KA causes the partial necrosis of the striatum, accompanied by a rarefaction of the neuropil. Owing to a rather low number of subsequently in situ proliferating glial cells, predominantly astrocytes, the whole process results in a shrinkage of the striatum compensated by an enlargement of the lateral brain ventricles. Although, the fully developed IA lesion is envisaged at 1 week and KA lesion at 3-4 weeks after the injection of neurotoxic acids, the degenerative process within the striatum develops in a rather long time -- at least 6 months. The only morphological observation that doesn't correlate to the findings from the HD patients, is the needle-track area, which is repaired by a conspicuous glial or glial-fibrotic scar. There is no substantial difference in the histopathological characteristics of both the neurotoxic acids used in our studies. However, if the IA must be applied into 3-4 sites in each hemisphere in comparison with only one injection of the KA, the use of KA is, from the morphological point of view, more suitable in relation to the number of artificial needle-track areas.

The paper presents a protocol for the evaluation of energy metabolism in hepatocytes with the aid of high-resolution oxygraphy in permeabilized cells. Optimal conditions are suggested for the isolation of hepatocytes from the hepatic tissue of the rat and the proper technique for control of their structural integrity. Our work describes in detail the experimental schemes for oxygraphic evaluation of the individual enzyme complexes of the respiratory chain (Complex I, II, IV) and methods for the assessment of the mitochondrial function of phosphorylation using the respiratory control index and oligomycin inhibitory effect on ADP-activated respiration. On the example of oxidative damage of hepatocytes by tert-butylhydroperoxide, we demonstrate the utility of oxygraphy in the diagnostics of pathologic conditions caused by disturbances in energy metabolism of the cell.

Endovascular surgery has dramatically changed the possibilities for treatment of occlusive arterial diseases. The first reports on balloon dilatation of internal carotid artery stenosis appeared 20 years ago. Between January 1997 and June 2002 37 patients were treated at our institution and 41 carotid angioplasties were performed. The first group includes the patients who were not indicated for conventional surgical treatment (vertebral artery 6 patients, intracranial stenosis of internal carotid artery 2 patients and one patient with stenosis of midle part of basilar artery). The second group were the patients with extracranial internal carotid stenosis combined with contralateral carotid occlusion (13 patients). The third group were the patients with restenosis following surgical carotid endarterectomy (11 patients). One patient had fibromuscular dysplastic stenosis. Seven patients were contraindicated for conventional surgical endarterectomy either for cardiopulmonary or other reasons. The result of the treatment by angioplasty was excellent because only three patients had restenosis (7,5%). Mortality rate in our set was 0. Nowadays it is too early to say if outcomes and safety of carotid angioplasty are comparable with surgical endarterectomy. For this reason it is necessary to have many randomized studies.

Work deals with the evaluation of a questionnaire given to 110 young clinicians at the teaching hospital of School of Medicine in Hradec Králové asking questions concerning their opinion of the pregraduate teaching of anatomy; 97 of them answered. This yielded a response rate 96%. The results were analysed by customary statistical formulas. Some selected data: 93% respondents consider anatomy as essential, 92% believe that dissection should be part of anatomy curriculum, 60% consider the idea of creation of an anatomy core as correct. Twenty four percent of respondents prefer oral form of the examination alone, 47% assume that there should be oral and practical form of the anatomy examination. Sixty one percent reject the suggestion of an unified examination identical in all medical schools in the country. Respondents would shorten teaching of central nervous system mostly: almost not the gastrointestinal.