Roman Havlik

Publications (10)12.98 Total impact

• Article: Manometric perfusion test in biliary strictures treatment.

  Marie Cerna, Rohit Philip Thomas, Martin Köcher, Jan H Peregrin, Vlastimil Válek, Roman Havlik, Sona Fronkova, Jiri Kozák, Jiri Panek, Jana Zaplatelova, Alena Bilkova
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  ABSTRACT: To assess the biliary manometric perfusion test (BMPT) for evaluating success in treating benign biliary strictures. During 2003 to 2010, 29 patients were subjected to BMPT after percutaneous balloon dilatation treatment. Intrabiliary pressure less than 20cm of water was considered the success threshold. Results of BMPT evaluation were retrospectively compared with a similar group where the standard clinical test was used for evaluating treatment success. The clinical test group included 21 patients treated for biliary strictures from 1994 to 2006. The two groups were statistically similar by age and gender. The BMPT group was tested without complications and pressure inside the biliary tree was less than 20cm of water in 27 of 29 patients. Subsequently, catheters were removed from all 27. Three patients required re-interventions 13 days, 11 months and 32 months later. Kaplan-Meier survival analysis showed that the probability of biliary patency at 3 year was 82.2%. There was no significant difference between groups by this measure (log rank test, p=0.624). The manometric test is an alternative for evaluating success in treating benign biliary strictures. It is simple, less time-consuming, economical, safe, effective and more comfortable for patients than the clinical test.
  Hepato-gastroenterology 12/2011; 59(117):1354-8. · 0.66 Impact Factor
• Source

  Available from: upol.cz

  Article: Is the biliary manometric perfusion test effective in the evaluation of balloon dilatation treatment success of benign biliary strictures?

  Rohit Philip Thomas, Martin Köcher, Marie Cerna, Jiri Kozak, Stanislav Burval, Roman Havlik
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  ABSTRACT: The success of balloon dilatation treatment of benign biliary strictures (BBS) is usually evaluated by 'clinical test'. For objective evaluation of treatment success, measurement of the pressure inside the biliary tree after treatment has been proposed. The aim of this article is to assess the role of biliary manometric perfusion test (BMPT) in the evaluation of treatment success of BBS and to assess the long term biliary patency after evaluation by BMPT. From February 2003 to January 2008, 12 patients (median age 53.5 years) after balloon dilatation treatment were evaluated by BMPT. BMPT was done after a mean of 3 dilatations over a mean period of 6.85 months. An intrabiliary pressure less than 20 cm of water during the test was considered as success threshold. The pressures during BMPT were less than 20 cm of water in 11 out of 12 patients. Subsequently the drain was removed and patients were followed up clinically. Two patients on follow-up required re-intervention 13 days and 11 months later. The remaining 9 patients had no evidence of biliary obstruction at a mean following of 15.3 months. Using the statistical Kaplan-Meier analysis, the probability of biliary patency up to 9 months was 90.9% and at 1, 2 and 3 years was 77%. BMPT is effective in the evaluation of treatment success of BBS. It is simple, cost effective, gives immediate results and helps us to determine the treatment end point.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 06/2009; 153(2):153-6.
• Source

  Available from: upol.cz

  Article: Biliary manometric perfusion test in the evaluation of benign biliary stricture treatment--a case report.

  Rohit Philips Thomas, Martin Köcher, Marie Cerna, Jiri Kozak, Roman Havlik
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  ABSTRACT: Benign biliary strictures treated radiologically by percutaneous dilatation treatment are usually evaluated by 'clinical test'. For objective evaluation of treatment success, measurement of the pressure inside the biliary tree has been proposed. The aim of this article is to report our experience with the measurement of the pressure in the biliary tree after treatment, to present the biliary manometric perfusion test (BMPT) as an alternative method of treatment evaluation and to demonstrate why the perfusion test is a better method of evaluation. A 65 year old lady with post operative biliary stricture and symptoms of jaundice was treated in our Department with percutaneous dilatation treatment and long-term drainage. The perfusion test (BMPT) was adopted for evaluating treatment success after the treatment for 9 months. An intrabiliary pressure less than 20 cms of water during perfusion test was considered success threshold. The test was carried out without any complications and the pressure inside the biliary tree was less than 20 cms of water during the test. Eventually the drain was removed. On follow-up at 6 months the patient developed no recurrence of jaundice and the quality of life improved clinically. Periodic liver function tests during follow-up were normal. The perfusion test (BMPT) is promising efficacious alternative method for the evaluation of radiological treatment of benign biliary strictures. It helps us to decide the end points in treatment and also helps in identifying patients who might later develop strictures.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 01/2009; 152(2):293-7.
• Source

  Available from: Petra Jancova

  Article: JNK inhibitor SP600125 is a partial agonist of human aryl hydrocarbon receptor and induces CYP1A1 and CYP1A2 genes in primary human hepatocytes.

  Zdenek Dvorak, Radim Vrzal, Pavla Henklova, Petra Jancova, Eva Anzenbacherova, Patrick Maurel, Lucie Svecova, Petr Pavek, Jiri Ehrmann, Roman Havlik, Petr Bednar, Karel Lemr, Jitka Ulrichova
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  ABSTRACT: SP600125, a specific inhibitor of c-Jun-N-Terminal kinase (JNK), was reported as a ligand and antagonist of aryl hydrocarbon receptor (AhR) [Joiakim A, Mathieu PA, Palermo C, Gasiewicz TA, Reiners Jr JJ. The Jun N terminal kinase inhibitor SP600125 is a ligand and antagonist of the aryl hydrocarbon receptor. Drug Metab Dispos 2003;31(11):1279-82]. Here we show that SP600125 is not an antagonist but a partial agonist of human AhR. SP600125 significantly induced CYP1A1 and CYP1A2 mRNAs in primary human hepatocytes and CYP1A1 mRNA in human hepatoma cells HepG2. This effect was abolished by resveratrol, an antagonist of AhR. Consistent with the recent report, SP600125 dose-dependently inhibited CYP1A1 and CYP1A2 genes induction by a prototype AhR ligand 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in human hepatocytes. Moreover, SP600125 displayed typical behavior of a partial agonist in HepG2 cells transiently transfected with a reporter plasmid containing two inverted repeats of the dioxin responsive element or with a plasmid containing 5'-flanking region of human CYP1A1 gene. SP600125 transactivated the reporter plasmids with EC(50) of 0.005 and 1.89 microM, respectively. On the other hand, TCDD-dependent transactivation of the reporter plasmids was inhibited by SP600125 with IC(50) values of 1.54 and 2.63 microM, respectively. We also tested, whether the effects of SP600125 are due to metabolism. Using liquid chromatography/mass spectrometry approach, we observed formation of two minor monohydroxylated metabolites of SP600125 in human hepatocytes, human liver microsomes but not in HepG2 cells. These data imply that biotransformation is not responsible for the effects of SP600125 on AhR signaling. In conclusion, we demonstrate that SP600125 is a partial agonist of human AhR, which induces CYP1A genes.
  Biochemical Pharmacology 02/2008; 75(2):580-8. · 4.70 Impact Factor
• Article: Suicide gene therapy in liver tumors.

  Long R Jiao, Roman Havlik, Joanna Nicholls, Steen Lindkaer Jensen, Nagy A Habib
  Methods in molecular medicine 02/2004; 90:433-50.
• Article: Gene therapy for liver metastases.

  Roman Havlik, Long R Jiao, Joanna Nicholls, Steen Lindkaer Jensen, Nagy A Habib
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  ABSTRACT: Although resection is currently the only curative approach for metastatic liver cancer, only a small number of cases are suitable for this procedure. In the past few years, gene therapy has emerged as an appealing treatment option for liver cancer. Phase I and II clinical trials have been conducted in patients with either primary or secondary liver cancer using a variety of genes including tumor-suppressor gene p53, suicide genes, immune genes, and replication-competent oncolytic adenoviruses. The results have shown that, although gene therapy has been well tolerated and toxicity has been low, the clinical benefit has so far been marginal. Gene therapy as a definitive treatment for liver metastases remains limited, at least for the time being, but it may be useful as an adjuvant treatment in combination with radiotherapy, chemotherapy, and/or surgery to achieve disease-free survival.
  Seminars in Oncology 05/2002; 29(2):202-8. · 3.50 Impact Factor
• Article: Clinical trial of E1B-deleted adenovirus (dl1520) gene therapy for hepatocellular carcinoma.

  Nagy Habib, Hosny Salama, Ahmed Abd El Latif Abu Median, Ilia Isac Anis, Rasha Ahmed Abd Al Aziz, Catherine Sarraf, Ragai Mitry, Roman Havlik, Prem Seth, Jack Hartwigsen, Reva Bhushan, Joanna Nicholls, Steen Jensen
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  ABSTRACT: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. The prognosis of HCC is poor and current therapies are largely ineffective. Genetic abnormalities are commonly seen in HCC tumors particularly with inactivation of the p53 tumor suppressor. Gene therapy with E1B-deleted (dl1520) adenovirus could be of therapeutic value as it offers the potential of tumor growth control in patients with p53 mutation. Ten patients with posthepatitis cirrhosis and histologically proven HCC were enrolled into an open label, randomized prospective study. Randomization was to receive either percutaneous ethanol injection (control group) or dl1520. Toxicity and complications in the ethanol group were pain and fever, whereas in the gene therapy group complications were minimal. Grade I-II toxicity fever, stable performance status, and no significant rise in liver enzymes were observed in patients treated with dl1520. Analysis of patients' response to treatment in the gene therapy group showed one patient with a partial response and four patients with progressive disease. In the ethanol-treated group two patients had stable disease and three patients showed disease progression. In conclusion, this study showed that the adenovirus was well tolerated, but did not seem to offer significant tumor control. Although only a small number of patients were treated here it appears that more effective vectors are needed to achieve a useful clinical impact.
  Cancer Gene Therapy 04/2002; 9(3):254-9. · 2.80 Impact Factor
• Chapter: Gene Therapy for Liver Tumours

  Ragai R. Mitry, Marc R. Mansour, Roman Havlik, Nagy A. Habib
  12/2001: pages 193-205;
• Article: Radiofrequency assisted liver resection--a novel technique.

  Long R Jiao, Guiseppe Navarra, Jean-Christophe Weber, Roman Havlik, Joanna P Nicholls, Nagy A Habib
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  ABSTRACT: Surgical resection remains the curative procedure for liver tumors, but even with improvements in method it is still a major operation with significant morbidity and mortality in experts' hands, and a long learning curve for those surgeons who undertake it. Recently radiofrequency ablation has gained some credibility as an alternative method of dealing with liver tumors deemed unresectable. A novel technique of liver resection assisted by the application of radiofrequency is described here. A patient with colorectal liver metastases underwent a segment II/III liver resection with this technique. Following laparotomy, the tumor was identified with intraoperative ultrasound and a 'cooled-tipped' radiofrequency probe was used to ablate liver parenchyma 2cm away from the edge of the tumor. To achieve full thickness of radiofrequency ablation, several insertions were applied. The effect of radiofrequency on liver parenchyma was monitored with an intraoperative ultrasound by micro-bubbles generated by radiofrequency ablation. The length of the resection was 45 min with a blood loss of 30mL. The patient was discharged on the 6th postoperative day without complications. In this report we indicate how the use of radiofrequency ablation can be combined with standard surgical resection of liver cancers to provide a quick, and relatively bloodless operation that is likely to reduce morbidity and mortality and is easy for its practitioners to learn.
  Hepato-gastroenterology 52(66):1685-7. · 0.66 Impact Factor
• Article: Peripheral portosystemic shunt and its selectivity changes measured on duplex ultrasound.

  Vladimir Král, Jiri Klein, Roman Havlik, Jaroslav Vomácka, Petr Utikal, Radek Vrba
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  ABSTRACT: Portosystemic shunts offer a symptomatic treatment for portal hypertension. Their main disadvantage is decreased perfusion of the liver with portal blood. Change of peripheral shunts into total shunts after a period of time is described. This study aims to evaluate long-term hemodynamic changes in peripheral portosystemic shunts. The study was based on 12 patients in whom distal splenorenal shunts 8 patients) and mesocaval shunts (4 patients) were indicated respectively. Duplex sonography was used to measure the blood flow in the portal, splenic and mesenteric veins before shunt surgery and minimally 14 months postoperatively. It was found that the reduction of the portal blood flow was not critical and no centralization of the shunt was observed. Long-term blood flow in the portal vein was not severely reduced after peripheral portosystemic shunt creation, therefore the peripheral portosystemic shunt still has a role in the treatment of some patients with portal hypertension.
  Hepato-gastroenterology 52(61):149-51. · 0.66 Impact Factor