Achalasia of the esophagus is combination of dysfunction of the lower esophageal sphincter and disorder of the peristaltic movement of the esophageal body. Both components influence one another in a negative way, but the first usually prevails. That is why satisfactory and long-term results can be obtained in most of patients with non-advanced achalasia by Heller's myotomy. In a small group of patients with disease of megaesophagus-type (disorder of the motility of the esophageal body prevails) and in patients in which their disease reach for various reasons the stage of advanced (decompensated) achalasia, the resection-surgery is etiopatogeneticly justified. At the Ist and IInd surgical clinic in Olomouc 331 patients with achalasia have been operated so far. 29 patients treated by resection of a shorter or longer portion of the aboral esophagus, in 2 patients the whole thoracic esophagus was extirpated without thoracotomy. Resection was in principle indicated as secondary treatment. To substitute the esophagus the stomach in various operative modifications was used in two thirds of the patients, in the remaining patients interposition by a segment of the small or large intestine was carried out.
- MeSH
- Esophageal Achalasia classification diagnostic imaging surgery MeSH
- Humans MeSH
- Follow-Up Studies MeSH
- Radiography MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Cílem bylo analyzovat příčiny smrti a pitevní nálezy na srdci u zemřelých s implantabilními kardiostimulátory a implantabilními kardiovertery-defibrilátory (PM a ICD), se kterými se setkávají jak soudní lékař tak patolog. Klinické a sekční nálezy byly analyzovány u 83 zemřelých s PM a 14-ti s ICD. V souboru byla většina mužů. Ve skupině s PM 49 mužů a 34 žen, s ICD 11 mužů a 3 ženy. Muži byli mladší v obou skupinách (76?10 vs. 82?6 roků s PM, 64?9 vs. 68?10 roků s ICD). Zemřelí s ICD byli mladší než s PM (65?9 vs. 78?9 roků). Interval od primoimplantace přístroje do smrti byl u PM 4.0?3.0 roky, u ICD 2.8?2.5 roku. Základní příčina smrti byla kardiovaskulární u 86,7% zemřelých s PM a 71.4% s ICD, což je více než v běžné české (51,1%) a evropské (35,5%) populaci. Ischemická choroba srdeční byla přítomna u 97,6% pacientů s PM a 85,7% s ICD a její závažné důsledky (jizvy, chronická aneurysmata, stenty) byly nalezeny častěji u zemřelých s ICD. Dilatační kardiomyopatie byla potvrzena u 4,8% zemřelých s PM a 28,6% s ICD. Sklerotické (28,9%) a revmatické (7,2%) změny chlopní byly přítomny jen u v průměru starších zemřelých s PM. Bezprostřední příčina smrti byla kardiální (srdeční selhání, infarkt myokardu) u 51,8% zemřelých s PM a 64,2% s ICD. Nekardiální příčiny (embolie, bronchopneumonie, sepse) byly rovněž časté, což může spoluvysvětlovat relativně krátký interval primoimplantace přístroje - úmrtí.
83 pacemaker (PM)/14 implantable cardioverter-defibrillator (ICD) autopsied patients, predominantly males, deceased 4.0?3.0/2.8?2.5 years after implantation in hospital. Coronary artery disease was most frequent. Its consequences were more severe in ICD patients. Sclerotic and rheumatic heart changes were present in older PM patients group only. The immediate cause of death was mostly of cardiac etiology. Relatively short implant-death interval should be explained by rather great part of non-cardiac causes of death in hospitalised patients.
- MeSH
- Defibrillators, Implantable * MeSH
- Adult MeSH
- Hospitalization MeSH
- Pacemaker, Artificial * MeSH
- Cardiovascular Diseases complications MeSH
- Middle Aged MeSH
- Humans MeSH
- Treatment Failure MeSH
- Autopsy MeSH
- Cause of Death * MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Heart * physiopathology MeSH
- Heart Failure mortality MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Keywords
- reptilázový čas, aktivovaný parciální tromboplastinový čas,
- MeSH
- Batroxobin MeSH
- Heparin adverse effects therapeutic use MeSH
- Humans MeSH
- Monitoring, Physiologic MeSH
- Thrombin Time utilization MeSH
- Thrombophilia prevention & control MeSH
- Blood Coagulation Tests utilization MeSH
- Check Tag
- Humans MeSH
The aim of this study was to investigate the structure and function of fibrinogen obtained from a patient with normal coagulation times and idiopathic thrombophilia. This was done by SDS-PAGE and DNA sequence analyses, scanning electron microscopy, fibrinopeptide release, fibrin polymerisation initiated by thrombin and reptilase, fibrinolysis, and platelet aggregometry. A novel heterozygous point mutation in the fibrinogen Aα chain, Phe98 to Ile, was found and designated as fibrinogen Vizovice. The mutation, which is located in the RGDF sequence (Aα 95-98) of the fibrinogen coiled-coil region, significantly affected fibrin clot morphology. Namely, the clot formed by fibrinogen Vizovice contained thinner and curled fibrin fibers with reduced length. Lysis of the clots prepared from Vizovice plasma and isolated fibrinogen were found to be impaired. The lysis rate of Vizovice clots was almost four times slower than the lysis rate of control clots. In the presence of platelets agonists the mutant fibrinogen caused increased platelet aggregation. The data obtained show that natural mutation of Phe98 to Ile in the fibrinogen Aα chain influences lateral aggregation of fibrin protofibrils, fibrinolysis, and platelet aggregation. They also suggest that delayed fibrinolysis, together with the abnormal fibrin network morphology and increased platelet aggregation, may be the direct cause of thrombotic complications in the patient associated with pregnancy loss.
- MeSH
- Platelet Aggregation MeSH
- Batroxobin metabolism MeSH
- Point Mutation MeSH
- Time Factors MeSH
- Adult MeSH
- Fibrin metabolism MeSH
- Fibrinogen genetics metabolism MeSH
- Fibrinolysis MeSH
- Blood Coagulation MeSH
- Heterozygote MeSH
- Protein Conformation MeSH
- Humans MeSH
- Abortion, Spontaneous blood MeSH
- Pregnancy MeSH
- Thrombin metabolism MeSH
- Thrombophilia blood genetics MeSH
- Blood Coagulation Tests MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
1 grafický list ; 31 cm
Grafický list s portrétem německého chemika Lorenze Crella (1744-1816).
- Conspectus
- Chemie. Mineralogické vědy
- NML Fields
- chemie, klinická chemie
- NML Publication type
- grafické listy
... 9.1.3 Endoprotetika 165 -- 9.2 Postižení PIP kloubů 172 -- 9.2.1 Deformita knoflíkové dírky (Boutoniere def ... ... .) 173 -- 9.2.2 Deformita labutího krku (Swan-neck def.) 177 literatura 185 -- 10. ... ... Popelka 188 -- 10.1 Deformita knoflíkové dírky (Boutoniere def.) 188 -- 10.2 Deformita labutího krku ... ... (Swan-neck def.) 189 literatura 193 -- 11. ...
1. vyd. 198 s. : il. ; 24 cm
