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Endoscopy 01/2005; 36(12):1133. · 5.21 Impact Factor
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European Journal of Clinical Microbiology 06/2003; 22(5):327-8. · 2.86 Impact Factor
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ABSTRACT: A 28-year-old female patient was operated on account of symptomatic hepatocellular adenomas of the liver. Tumours with a diameter of 10 x 11 cm in the left lobe and 9 x 7 cm in the right lober were extirpated. In the adenomas non-ferric pigment resembling the pigment in Dubin-Johnson's syndrome was detected. The patient did not use contraceptives and was treated for more than 10 years for epilepsy. The size, pigmentation, frequency of adenomas and absence of contraceptives in the case-history made the authors consider another aetiology of these adenomas. The authors discuss the possible development of adenomas of the liver as a result of long-term use of phenobarbital. As a basis they use experimental observations where this drug acts as a strong promotor of DNA synthesis and leads to the development of multiple adenomas and carcinomas in the liver of rats and mice.
Rozhledy v chirurgii: měsíčník Československé chirurgické společnosti 05/2003; 82(4):192-5.
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J Nozicka
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ABSTRACT: An interventional radiological procedure TIPS (transjugular portosystemic shunt) assists in the decrease of portal hypertension. Portal blood is conducted via the hepatic vein into the lower vena cava. Blood drainage is performed via non-vascular formation, i.e. by the channel created within the liver parenchyma (shunt). Histological changes (maturation) within the wall of an artificially formed blood conducting channel were studied on the base of examination of the set of 38 autopsy cases with the placed TIPS (25 males and 13 females, ages ranging from 22-81 years). Maturation course can be divided into three periods. The first stage is characterised by the presence of alternative changes mainly within the liver parenchyma surrounding the shunt. Reparative changes pass through the second stage with the predominance of liver cell debris removal and organisation of fibrin remnants. Consolidation changes dominate the third stage with the development of so-called neointima and giant-cell reaction around the stent struts. In three cases of the acute period of stent placement a new, so far not described specific phenomenon of compressive fusiform hepatocellular remodellation was found within the nodules of hepatocytes exposed to the pressure of resilient stent struts. Neointima is a non-thrombogenous structure participating on the shunt patency. It is possible to judge approximately the time of stent placement according to the histologically estimated level of shunt wall maturation. TIPS is a long-lasting supplement conduit between the portal and systemic blood circulation. Contrary to the easily reconstructable formal pathogenesis of histological changes, the problems of causal pathogenesis of the neointima challenge mainly the interest of laboratories involved in basic science.
Ceskoslovenska patologie 11/2002; 38(4):155-62.
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ABSTRACT: To study the correlation between the degree of histopathological changes in the liver and selected biochemical tests after bile duct ligation (BDL) in male and female Wistar rats. Rats were divided into 4 groups. Laparotomized male rats (M-LAP), male rats with BDL (M-BDL), laparotomized female rats (F-LAP) and female rats with BDL (F-BDL). Liver bioptic samples were taken 7 and 14 days after operations and were cultivated 24 hours under standard conditions. TNF-alpha and IL-6 (pg/ml) concentrations were estimated in cell culture supernatants. Rats were sacrificed 14 days after operations, histological evaluation of liver tissue was performed, and serum activity of alanine-transaminase (ALT) and gamma-glutamyl transferase (GMT) (microkat/l) and estradiol concentration (EST) (pmol/1) were estimated. Results are presented as median (cytokines, estradiol) or mean +/- SEM. IL-6 concentration in cell culture supernatants was 7 days after the operation 1495 pg/ml in M-BDL and 1050 pg /ml in F-BDL, but were not detected in M-LAP and F-LAP. TNF-alpha concentration in supernatants was detected in all groups and was not significantly higher in male rats in comparison with female rats. M-BDL group had higher activity of ALT (1.5+/-0.1) and GMT (1.24+/-0.38) in comparison with F-BDL (ALT - 1.24+/-0.38, GMT - 0.98+/-0.38). Estradiol concentrations were detected in BDL groups, male rats 175 pmol/l and female rats 543 pmol/l. Although ALT and GMT activities and TNF-alpha and IL-6 concentrations were higher in male rats histopathological findings have shown slightly more advanced fibrotic and inflammatory changes in female rats.
Advances in clinical pathology: the official journal of Adriatic Society of Pathology 11/2001; 5(4):147-53.
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ABSTRACT: The objective of the work was to find an optimal preservation medium for short-term preservation of venous grafts which could be subsequently used to line metal stents. The external jugular vein of dogs (n = 15) was removed surgically, divided into portions and immersed into preservation media. For hypothermic preservation (+4 degrees C) solutions of Optisol (Chiron, USA), University of Wisconsin (Baxter, USA), Eurocollins (Fresenius, GFR) and saline (Bieffe Medital, Italy) were used. For normothermic preservation (+37 degrees C) in an atmosphere with 5% CO2 Dulbecc's medium for tissue cultures (Sigma, USA) was used. During hypothermic preservation the specimens were kept for 24 hours, 3 and 7 days, during normothermic preservation in Dulbecc s medium also for 24 hours, 3 and 7 days. The specimens were evaluated by light microscopy and raster electron microscopy. The results revealed that minimal changes on the endothelia of venous grafts occurred during normothermic preservation in Dulbecc's medium where after 7 days the endothelium did not become detached and the vitality of cells did not change. During hypothermic preservation the solution of Wisconsin University proved most suitable. By addition of 5% human albumin to this solution it proved possible moreover to reduce pyknosis of the endothelial cell nuclei. The specimens kept in saline displayed deformities of the nuclei, oedema and loss of endothelia incl. incipient oedema of the cellular wall already after 24 hours of hypothermic preservation. The authors consider the use of this solution unsuitable for preservation.
Rozhledy v chirurgii: měsíčník Československé chirurgické společnosti 07/2000; 79(6):244-9.
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A Ferko,
J Páral,
J Raupach,
V Chovanec,
A Krajina,
P Mericka,
D Pavcnik,
B Uchida,
D Slizová,
O Krs, J Nozicka
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ABSTRACT: To evaluate expandable stents healed into vein wall as autologous vein stent-grafts for endoluminal grafting.
Balloon expandable stents were placed into external jugular veins of eight dogs. Stent and vein patency was followed by ultrasonography. Five weeks after stent placement, jugular veins with endothelialized stent were harvested. The autologous vein stent-grafts were divided into two groups. In group A, autologous vein stent-grafts (n = 3) were placed immediately into Baker solution for microscopic examination. In group B, autologous vein stent-grafts (n = 3) underwent mechanical manipulation; they were compressed, mounted on angioplasty balloon, pushed through a 9-F sheath and dilated. The autologous vein stent-graft endothelialization and changes after mechanical manipulation were evaluated by light and electron microscopy.
Stent placement was successful in seven dogs. One stent migrated into the pulmonary artery. One well placed stent was damaged by compression dressing and thrombosed. At 5 weeks, gross and microscopic examinations revealed the autologous vein stent-grafts were fully covered by a 0.115- +/- 0.036-mm-thick neointimal layer. Small wall thrombus was observed in one autologous vein stent-graft. Repeated manipulations did not result in any intimal damage or stent loosening in the autologous vein stent-grafts.
Expandable stents healed into a vein have potential to be used as autologous vein stent-grafts for endoluminal grafting without risk of disruption during percutaneous transcatheter introduction.
Journal of Vascular and Interventional Radiology 02/2000; 11(1):111-4. · 2.08 Impact Factor
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J Nozicka
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ABSTRACT: Systemic embolisation of mucous substance occurs as a rare complication of mucinous carcinomas. A case of primary carcinoma of stomach is described with embolisation of mucus into cerebral, renal, pulmonary and myocardial vessels. Vascular blockade by mucus caused multiple partly haemorrhagic microinfarctions of the brain tissue. Beyond this, investigated tumour samples did not show any signs of angioinvasion and the production of mucus was far from massive.
Ceskoslovenska patologie 02/1999; 35(1):24-6.
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A Krajina,
P Hůlek,
P Eliás,
A Michl,
J Zizka, J Nozicka,
T Vanásek,
M Lojík,
I Niangová,
M Volfová,
O Pozler,
J Erben,
Z Papík,
J Bures
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ABSTRACT: A transjugular intrahepatic portosystemic shunt (TIPS) is the creation of a percutaneous portosystemic anastomosis which is used as an alternative method of surgical portosystemic shunts and endoscopic treatment in the therapy of complications of portal hypertension. The objective of the present work was to summarize experience with TIPS in 100 patients.
In 1992-1995 the authors treated 100 patients with symptomatic portal hypertension by TIPS. To create the shunt in 84% patients a spiral Z stent was used, in the remainder a Wallstent. In 86% patients the indication for TIPS was haemorrhage associated with portal hypertension and in 14% refractory ascites. TIPS was implemented in 98% patients. The pressure in the portal vela was not reduced on average to 58% of the original value. Haemorrhage was not stopped in one of 7 patients. Haemorrhage from varices reappeared in 7% patients indicated on account of repeated haemorrhage and was always associated with the finding of chronic stenosis of the shunt. The mortality in conjunction with the procedure was 4%, the mortality within 30 days after operation was 8%. Uncontrollable encephalopathy developed in 3% of the patients. Primary patency of the shunt created by the spiral Z stent was 85% after 6 months, after 12 months 72% and thus does not differ from primary patency when Wallstents are used, as reported in the literature.
TIPS is an effective method to reduce the pressure in the portal vein in portal hypertension. The main limiting factor of the method is stenosis of the shunt due to hyperplasia of the neointima. Stenoses of the shunt can be effectively dilated by percutaneous balloon angioplasty.
Casopís lékar̆ů c̆eských 10/1996; 135(18):584-8.
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ABSTRACT: Three cases of intraperitoneal bleeding from extrahepatic portal vein laceration were observed in a series of 104 patients with TIPS. In one patient, bleeding continued after Wallstent placement and the patient died during an emergency laparotomy. Bleeding was stopped in the other two patients by using a stent graft rather than a regular stent. One shunt remained patent and outflow stenosis developed in 3 months. The other shunt thrombosed in 5 months. Both shunts were fully reopened.
Hepato-gastroenterology 44(15):667-70. · 0.66 Impact Factor
