• MeSH
• lidé MeSH
• pánev * anatomie a histologie   krevní zásobení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Těla zemřelých jsou od pradávna nedílnou součástí výuky anatomie, potažmo studia medicíny. Bez nich by nemohly být realizovány kvalitní výuka anatomie a klinické anatomie ani mnoho výzkumných projektů. V současnosti se v evropských zemích používají k anatomické pitvě pouze těla dárců. V poslední době jsme zaznamenali vzrůstající trend potřeb těl nejen pro výuku mediků, ale také z hlediska klinické anatomie a popromočního vzdělávání. Také vyvstala otázka vhodnosti použití COVID-19 pozitivních dárců nebo legislativní možnosti získání těl při nedostatku dárců v dárcovském programu. Naše sdělení řeší aktuální otázky dárcovství těla pro výukové a výzkumné účely a jejich využití v Česku.

Since time immemorial, bodies of deceased have been an integral part of teaching anatomy, and therefore the study of medicine. Without them, the teaching of anatomy, clinical anatomy and many research projects could not be realized. Nowadays, the European countries allow to use exclusively bodies of the deceased donors. Recently, we have registered a growing trend in the needs of the bodies not only for the purposes of medical education, but also for those of clinical anatomy. The question also arose of the suitability of using COVID-19 positive donors or the legislative possibility of obtaining bodies in the absence of donors in the donor program. Our communication addresses current issues of body donation for teaching and research purposes and their use in the Czech Republic.

• MeSH
• dárci tkání zákonodárství a právo   MeSH
• informovaný souhlas pacienta zákonodárství a právo   MeSH
• lidé MeSH
• studium lékařství MeSH
• získávání tkání a orgánů * zákonodárství a právo   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• anatomie MeSH
• dějiny lékařství MeSH
• filozofie MeSH
• humanismus MeSH
• Publikační typ
• biografie MeSH

• O autorovi
• Pirogov, Nikolaj Ivanovič, 1810-1881 Autorita

• MeSH
• anatomie dějiny   MeSH
• chirurgie dějiny   MeSH
• dějiny 19. století MeSH
• krymská válka MeSH
• vojenské ošetřovatelství MeSH
• Check Tag
• dějiny 19. století MeSH
• Publikační typ
• biografie MeSH
• historické články MeSH
• Geografické názvy
• Rusko (před 1917) MeSH

• O autorovi
• Pirogov, Nikolaj Ivanovič, 1810-1881 Autorita

• Publikační typ
• abstrakt z konference MeSH

PURPOSE OF THE STUDY: The study was designed to investigate whether anatomical variations of the anterior and posterior divisions of the internal iliac artery and their branches are associated with different risks of bleeding resulting from injury to the posterior pelvic segment. MATERIAL AND METHODS: The study was carried out on 19 cadavers. The dissected area included the internal iliac artery from the common iliac artery bifurcation to the origins of the superior gluteal artery, the inferior gluteal artery and the internal pudendal artery. Using an electronic slide rule, distances between the bifurcation and the origin of each branch from either the anterior or the posterior division were measured. The diameter of each vessel was also determined. Findings of the study were compared with variations described in the literature. The degree of risk for bleeding related to different anatomical variations of the internal iliac artery and its branches was evaluated based on the proximity to the bone. RESULTS: There are six anatomical variations of internal iliac artery branches. Four of them were found: type A1 was recorded in 10 specimens, type A2 in six, type B1 in two and type C in one specimen. Types B2 and D were not seen. DISCUSSION: The type B2 and C anatomical variations were considered to carry higher risks of bleeding due to injury to the posterior pelvic segment. These variations are characterized by vessels larger in diameter and a longer course of the posterior division along the posterior part of the greater sciatic notch (area often involved in unstable pelvic ring fractures). On the other hand, the type C variation showed a longer internal iliac artery separated from the bone with a thick layer of soft tissue, which suggested lower risk than was attributed to the dominant type A1 variation. It was not possible to evaluate type B2 variation because it is very rare and was not found in study material. In type A2 and B1 variations, the branches were separated from bony structures similarly to the dominant type A1 variation. CONCLUSIONS: The cadaver study designed to assess the risk of bleeding associated with different morphological variations of the branching pattern of the internal iliac artery did not identify any anatomical arrangement that might carry a higher risk of injury to the vessels by free bone fragments of the posterior segment in unstable pelvic fractures. It can be concluded that less common branching patterns of the internal iliac artery are not associated with higher risk of bleeding than the dominant type A1 variation.

• MeSH
• arteria iliaca anatomie a histologie   zranění   MeSH
• fraktury kostí komplikace   MeSH
• hodnocení rizik metody   MeSH
• krvácení etiologie   MeSH
• lidé MeSH
• mrtvola MeSH
• pánevní kosti zranění   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• dítě MeSH
• energetický metabolismus fyziologie   genetika   imunologie   MeSH
• energetický příjem fyziologie   genetika   imunologie   MeSH
• fyziologie výživy dětí fyziologie   genetika   MeSH
• fyziologie výživy kojenců fyziologie   genetika   MeSH
• genomový imprinting * fyziologie   genetika   imunologie   MeSH
• homeostáza * fyziologie   genetika   imunologie   MeSH
• kojenec MeSH
• lidé MeSH
• mateřské mléko metabolismus   MeSH
• mikrobiota fyziologie   genetika   imunologie   MeSH
• mladiství MeSH
• nadváha dietoterapie   prevence a kontrola   MeSH
• obezita dětí a dospívajících * diagnóza   dietoterapie   epidemiologie   MeSH
• předškolní dítě MeSH
• primární prevence metody   trendy   výchova   MeSH
• statistika jako téma MeSH
• vývoj plodu fyziologie   genetika   imunologie   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE OF THE STUDY The aim of the study was to assess treatment outcomes in patients undergoing K-wire transfixation of unstable ankle fractures and compare the results with those of patients in whom it was possible to perform primary one-stage osteosynthesis. MATERIAL AND METHODS Between 2009 and 2012, a total of 358 patients (191 women and 167 men) had surgery for unstable ankle fracture. At 1-year follow-up, their subjective feelings, objective findings and ankle radiographs were evaluated. The fractures were categorised according to the Weber classification. A patient group treated by one-stage osteosynthesis, a group with definitive transfixation and a group of patients in whom temporary transfixation was converted to definitive osteosynthesis were assessed and compared. RESULTS The group treated by one-stage osteosynthesis included 278 patients with an average age of 47 years; the group of 20 patients with definitive transfixation had an average age of 67 years, and the group of 60 patients who had temporary transfixation with subsequent conversion to internal osteosynthesis were 55 years on average. In the group with one-stage osteosynthesis, 223 (80%) ankle fractures on post-injury radiographs were associated with minor joint dislocations and 55 (20%) with major dislocations. On the other hand, the radiographs of the patients treated by temporary transfixation and delayed open reduction with internal fixation showed major dislocations in 38 (63%) and minor dislocations in the rest of the patients (37%); the difference between the two groups was statistically significant (p<0.001). Posterior malleolar fractures were most frequent in the group with temporary transfixation (60%) and least frequent in the group with primary osteosynthesis (44%); also this difference was statistically significant (p=0.032). At one-year follow-up, in the group with one-stage osteosynthesis, 220 patients (79%) had no radiographic signs of posttraumatic ankle osteoarthritis while, in the group with temporary transfixation, no radiographic evidence of ankle osteoarthritis was recorded in 25 (42%) patients. While tibiofibular synostosis was recorded in only few patients (9%) of the group with one-stage osteosynthesis, it showed a high occurrence in the group with temporary transfixation (35%). The patients with one-stage osteosynthesis (188/68%) had a higher proportion of excellent outcomes measured on the Olerund-Molander ankle scoring scale than the other two groups (temporary transfixation, 47%; definitive transfixation,10%); in both cases the difference was significant (p < 0.001 and p = 0.003, respectively). DISCUSSION In this study the morphological and clinical aspects of surgically treated ankle fractures were assessed. The patients with one-stage osteosynthesis were compared with those treated by temporary or definitive transfixation. The majority of patients undergoing temporary transfixation had a fractured posterior margin of the tibia and major ankle joint dislocation, which suggested serious injuries to bone and ligament structures. Generally, the use of only two K-wires inserted through the calcaneus and talus into the distal tibia is recommended. Patients with K-wire transfixation usually require a longer hospital stay because of the serious nature of their injuries. CONCLUSIONS The therapy of choice for unstable ankle fractures is one-stage osteosynthesis. Temporary transfixation is an effective method of primary management when an unstable fracture cannot be treated by definitive osteosynthesis at the early stage due to local or general health conditions of the patient. The temporary transfixation provides good alignment of the ankle joint necessary for successful healing of soft tissues. A higher occurrence of post-traumatic ankle osteoarthritis, ossification and distal tibiotalar synostosis found in the patients treated by temporary transfixation is more related to serious types of ankle fractures the patient had suffered than to the method itself. Key words: unstable ankle fracture, soft tissue condition, indications for transfixation, treatment outcome.

• MeSH
• časové faktory MeSH
• fraktury kotníku radiografie   chirurgie   MeSH
• kostní dráty * MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• počítačová rentgenová tomografie MeSH
• retrospektivní studie MeSH
• tříštivé fraktury radiografie   chirurgie   MeSH
• vnitřní fixace fraktury metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• Klíčová slova
• Anatomický ústav 3. LF UK, Ústav histologie a embryologie 3. LF UK,
• MeSH
• anatomie * dějiny   metody   trendy   MeSH
• antropologie * metody   trendy   výchova   MeSH
• dějiny lékařství MeSH
• embryologie * dějiny   organizace a řízení   trendy   MeSH
• histologie dějiny   organizace a řízení   trendy   MeSH
• kardiovaskulární systém anatomie a histologie   patofyziologie   patologie   MeSH
• lidé MeSH
• mozek anatomie a histologie   patofyziologie   patologie   MeSH
• výchova a vzdělávání MeSH
• významné osobnosti MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• historické články MeSH

• Klíčová slova
• Popis Jeseniovy pražské pitvy,
• MeSH
• anatomie * dějiny   MeSH
• dějiny 17. století MeSH
• dějiny lékařství MeSH
• lidé MeSH
• pitva * dějiny   MeSH
• významné osobnosti MeSH
• Check Tag
• dějiny 17. století MeSH
• lidé MeSH
• Publikační typ
• historické články MeSH

• O autorovi
• Jessenius, Jan, 1566-1621 Autorita