Acta medica (Hradec Kralove). Supplementum最新文献

On the base of long time watching of 16 patients treated by transsphincteric resection of the rectum authors believe that this operation has even nowadays still its justification among operations preserving continention. They have dominant position namely in indications for benign disease, where only a small part of patients require a more extent performance. On the contrary, at rectum carcinoma the operating performance is highly elective.

Health status indicators in 3 groups of workers professionally exposed to fibrous materials and 1 control group have been followed. In spite of the fact that asbestos as a compound of friction elements has been forbidden and replaced by non-asbestos materials, quite important changes in peripheral lymphocytes aberrations we found in persons working with these new materials.

In this paper authors deal with the causes of preparation trauma in stomatology. They have studied effects of high temperature on human cells cultured in vitro. Based both on literature data and on their own experience they summarize basic principles of preparation which prevent preparation trauma. They summarize how to eliminate as much as possible factors that damage hard dental tissues and pulp.

The intravenous line together with port--Implantofix was placed into art. hepatica propria by laparotomic operation in 16 patients with hepatal metastases (with the main diagnosis either colorectal or breast carcinoma). At the same time there were: 1. visually detected hepatal metastases resected in extraanatomical lines in 4 patients 2. non-resectable metastases sclerotised with 96% ethylalcohol in 3 patients All 16 patients underwent locoregional chemotherapy via subcutaneous port. The medium survival length was 9-12 months. 11 patients were lost due to progression of the disease (lung metastases), five patients are still alive.

The authors experience with laparoscopic cholecystectomy in the group of 2200 patients operated on from March 1992 to September 1996 is discussed. The complications rate at the beginning and at the end of the study is expressed. In the last 100 cases there was conversion rate of 1%, no biliary injury was observed and the average postoperative hospital stay was 2.26 days. In the whole group of patients biliary injuries were observed in 0.18%. Lethality was 0.13%. The authors conclude, that laparoscopic cholecystectomy is a save method in the treatment of the gallstone disease, when certain rules are respected.

Based on the complex evaluation of the continence by anorectal manometry, EMG examination of sphincters, transrectal sonography, defecography and Colonic Transit Time examination, the analysis of the group of 15 patients partially incontinent after operation of carcinoma of the lower part of the rectum has been done. In these patients the deep pelvic anastomosis or coloanal anastomosis was performed. In none of the patients any serious organic damage of sphincters was manifested, the causes were dominantly extrasphincteric and functional, solvable well by conservative methods.

Results of the treatment of 225 patients operated between 1991-1995 on the colorectal carcinoma in the II Clinic of Surgery, Medical Academy Wroclaw are evaluated. The analysis of the own material covers the tumor site, age of the patients, histologic grade and clinical stage according to Dukes. The type of surgical procedure--curative or palliative and the evaluation of the survival, death and recurrence rate is presented. Curative procedures were possible only in approximately 60% of cases. The Dukes stage C and D was established in 55.5% of the operated patients. Authors believe that such a significant number of advanced cases was the reason of so poor results. In conclusion they suggest to introduce screening tests for early detection of colorectal carcinoma.

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.

Accurate preoperative examination and early diagnosis of possible recurrence of the disease play an important role in successful therapy of colorectal carcinoma. At present, modifications of classical examination are being applied, too. In this paper the first experience in using the CT pneumocolon for diagnosing the colorectal cancer is presented. The method improves the diagnostic possibilities of the classical CT examination technique. It enables to image the morphology of the tumour in the air insufflated colon lumen, tumour infiltration outside intestinal wall, localization of organs in the presupposed operation field and possible infiltration of lymph-nodes or liver metastases. The examination has proved easy to be performed with minimal patient's discomfort.

The primary hyperparathyreosis needs the interdisciplinary approach. The ideal term for surgical intervention is the period of the latent HPT, that means the time, when the signs of irreversibly damaged organs are not yet present. In the Czech Republic they are approximately 100-300 such cases per year with the primary diagnosed HPT. These patients should be sent to the departments, specialized for this type of surgery.