Hubert Poláček

Comenius University in Bratislava, Presburg, Bratislavský, Slovakia

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Publications (16)15.75 Total impact

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    ABSTRACT: Introduction: There still is some debate about the relationship between handedness and speech in healthy subjects. We used focal transcranial magnetic stimulation (TMS) as a non-invasive method to determine hemispheric dominance and compared our results with several neuropsychological tests. Methods: 91 healthy subjects (age 26 ± 4.6) underwent neuropsychological testing for handedness, TMS mapping of cortical representation of abductor pollicis brevis (APB), repetitive TMS (rTMS) to determine language lateralization with Number-counting paradigm - rTMS(1), and Verb-generation paradigm - rTMS(2). Results: There was a significant correlation between cortical asymmetry of the left/right APB and all the used neuropsychological tests of handedness (p < 0.001). Laterality of speech arrest using rTMS(1) correlated with the majority of tests for handedness. When rTMS(2) was used, there was significantly longer reaction time in 29/42 subjects but we found correlation with only one of the tests. Conclusion: Handedness is associated with asymmetry in cortical motor representation. Right-cerebral dominance for language in healthy right-handers is not as rare as it was supposed (9.5%). Stronger left-handedness is associated with higher probability of language dominance in the right hemisphere (9.5-33%). When using rTMS, we found that: a) speech production can be influenced by 2 different areas in the gyrus frontalis inferior, b) pars triangularis is involved in verb production only in some subjects, c) motor threshold is significantly higher for cognitive processes than for motor functions. TMS with focal magnetic coil can be used as an objective method for mapping cortical motor asymmetry of handedness and language functions.
    No preview · Article · Jan 2013 · Ceska a Slovenska Neurologie a Neurochirurgie
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    ABSTRACT: Internal carotid artery (ICA) lesions in the parapharyngeal space (a dissection and a pseudoaneurysm) may present as isolated lower cranial nerves (IX, X, XI, and XII) palsy (Collet-Sicard syndrome). Some arteriopathies such as fibromuscular dysplasia and tortuosity make a vessel predisposed to dissection. Extreme vessel tortuosity makes the treatment by a stent graft impossible. Two Silk stents were used in a 46 year-old man with left lower cranial nerves (IX-XII) palsy for the treatment of left ICA spontaneous dissection with pseudoaneurysm. A follow-up angiogram 5 months later confirmed pseudoaneurysm thrombosis and patency of the left ICA. The patient recovered completely from the deficits.
    No preview · Article · Oct 2012 · CardioVascular and Interventional Radiology
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    ABSTRACT: Endovascular treatment for a wide-neck anterior communicating artery (AcomA) aneurysm remains technically challenging. Stent-assisted embolization has been proposed as an alternative of treatment of complex aneurysms. The X-configuration double-stent-assisted technique was used to achieve successful coiling of wide-neck AcomA aneurysm. Implanted stent can alter intra-arterial flow. Follow-up angiograms 4 months later showed flow changes due to used X-technique of stents implantation and filling of the anterior cerebral artery from the opposite internal carotid artery.
    Full-text · Article · Mar 2011 · CardioVascular and Interventional Radiology
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    ABSTRACT: Treatment results of non-varicose bleeding from upper gastrointestinal tract are changing by improved endoscopic methods and introduction of new drugs in treatment. Objective of this work was to compare the results in treatment of patients with non-varicose bleeding from upper gastrointestinal tract in two different 5-years periods. We hospitalised 229 patients with non-varicose bleeding from upper gastrointestinal tract at the Department of Surgery in Faculty Hospital of Martin in the period 1992-1996. (161 men and 68 women, average age 56.7, patients up to 60 were 42.4%). 203 patients were hospitalised in the years 2003-2008 (146 men and 57 women, average age 61.5, patients up to 60 were 54%). We compared both groups by retrospective analysis and we evaluated differences by using statistical methods (nonparametric test of independence of the qualitative data). There was only minimal difference in primary conservative and endoscopic haemostasis in both groups. Relaps of bleeding was the same in both groups. Definitive conservative and endoscopic haemostasis was higher by 3.2% in the period 2003-2008 and number of urgent operations decreased by 5.1%. Differences in total mortality were minimal between both groups but postoperative mortality was higher by 5.9% in the years 2003-2008. Number of urgent operations decreased due to improved results in definitive conservative and endoscopic haemostasis in the treatment of non-varicose bleeding from upper gastroinestinal tract. There was no significant change in the relaps of bleeding. There were only minimal changes in total mortality between both groups, but postoperative mortality increased in the second period (Tab. 8, Ref. 35).
    No preview · Article · Jan 2011 · Bratislavske lekarske listy
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    ABSTRACT: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder primarily affecting upper and lower motor neurons. Due to relative fast progression of the disease, early diagnosis is essential. Proton magnetic resonance spectroscopy ((1)H-MRS) is used for objectivization of upper motor neuron (UMN) lesions. The aim of this study was to assess the use of (1)H-MRS in the early stages of ALS. Eleven patients with clinically definite (n=2), probable (n=7), and probable laboratory-supported (n=2) diagnosis of ALS with disease duration of less than 14 months were studied. Control group consists of 11 sex- and age-matched healthy subjects. All subjects underwent assessment of functional disability using revised ALS Functional Rating Scale (ALSFRS-R) and single-voxel (1)H-MRS examination of both precentral gyri, pons, medulla oblongata, and occipital lobe. Spectra were evaluated with LCModel software. The mean disease duration was 6.5 ± 3.5 months. The median ALSFRS-R was 42. Significant decrease between patient and control groups was found in the NAA/Cre ratio in the left and right precentral gyri (p=0.008, p=0.040). Other metabolite ratios in other areas did not show significant differences. Total ALSFRS-R score weakly positively correlated with NAA/Cre ratio in the left precentral gyrus (p=0.047). (1)H-MRS is sensitive to detect metabolic changes caused by neurodegeneration processes during ALS and can be used for detection of UMN dysfunction. These MRS changes in the early stages of ALS are most prominent in motor cortex.
    No preview · Article · Apr 2010 · Neuroradiology
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    ABSTRACT: We report the case of a 4-year-old boy suffering from a cerebral form of toxocariasis. High serum titres of anti-Toxocara antibodies indicated that the primary infection was induced by a high number of Toxocara eggs and that the larvae did not penetrate to cerebrospinal fluid due to the hematoencephalic barrier. MRI of the patient’s brain showed multiple focal lesions spread diffusely in almost all parts of the brain, predominantly paraventricularly. These might be eosinophil-rich granulomatous infiltrates enclosing larvae. Extensive morphological changes were the cause of serious neurological symptoms, most of them being reversible after follow-up therapy. Radiology proved to be useful diagnostic method, but the specific serological assessment had a key role for the final diagnosis. In conclusion, diagnosis of this patient was intracranial primary Toxocara infection with central quadruparesis and parainfective myocarditis.
    Preview · Article · Dec 2009 · Helminthologia
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    ABSTRACT: Cystic form in the spleen was diagnosed accidentally in a 44 years old patient during ultrasonography of the abdomen. It reached 6.0 cms in diameter. The mass was localised superficially, closely beneath the capsule of the spleen. The diagnose was confirmed serologically. Because of the localisation and the size of the cyst, the surgical approach - splenectomy - was indicated and performed.
    No preview · Article · Oct 2009 · Klinicka mikrobiologie a infekcni lekarstvi
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    Kamil Zelenák · Dusan Mistuna · Jaroslav Lúcan · Hubert Polácek
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    ABSTRACT: Esophageal stent fractures occur quite rarely. A 61-year-old male patient was previously treated for rupture of benign stenosis, occurring after dilatation, by implanting an esophageal stent. However, a year after implantation, the patient suffered from dysphagia caused by the broken esophageal stent. He was treated with the interventional radiology technique, whereby a second implantation of the esophageal stent was carried out quite successfully. © Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2009.
    Full-text · Article · Aug 2009 · CardioVascular and Interventional Radiology
  • L Laca · J Urdzik · Fani M Dobrota · H Polácek
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    ABSTRACT: Evaluation of the functional reserve before resectional performance and sufficient rest of liver parenchyma function is essential for the surgeon. From these factors, the decision based on operability, the maximum extent of liver parenchyma resection and the severity of post-operative course. In the period from December 2003 to December 2008, at the Dept of Transplant and Vascular surgery, JLF UK Martin, have been performed 161 resections of the liver in 144 patients, of which 91 large resections performances in the liver (hemihepatektomies or greater performance). Six patients have undergone repeated resection (4.1%), in 11 patients was performed Radio Frequency Ablation due to relaps of the disease (6.1%), and 3 patients were performed two steps resection. Of 91 major resection performance in the liver was 62 (68%) performed by anatomical boundaries of individual segments, in remaining 29 (32%) resections was reflected more to the localization of tumor itself as anatomical subdivision called combined anatomical and non-antomical resection. Radical resection R0 has been achieved in 76% of malignant tumors. In the post-operative course in 17% experienced complications, most often to the hematoma and biloma in place of the resection area, pleural effusion and 8 patients had postoperative liver dysfunction. Of this group, 5 patients had made volumetric examinations, and in all was the volume of residual liver parenchyma < 30% of the total volume of functional liver. Mortality within 30 days of the performance was 1.1%. The survival of patients was affected mainly by extent of resection, histological type of tumor, radicality of resection and necessity of the complex surgical procedures. Based on our evaluation of the results of a group of patients was arranged scheme measures for planning resectional procedures of the liver in our department. These include the adjustment of laboratory parameters, management of jaundice, preference of anatomical resections and volumetric examinations in patients with an estimated loss of more than 60-70% functional parenchyma of liver.
    No preview · Article · Apr 2009 · Rozhledy v chirurgii: měsíčník Československé chirurgické společnosti
  • L Laca · J Urdzik · F M Dobrota · H Polácek
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    ABSTRACT: Evaluation of the functional reserve before resectional performance and sufficient rest of liver parenchyma function is essential for the surgeon. From these factors, the decision based on operability, the maximum extent of liver parenchyma resection and the severity of post-operative course. In the period from December 2003 to December 2008, at the Dept of Transplant and Vascular surgery, JLF UK Martin, have been performed 161 resections of the liver in 144 patients, of which 91 large resections performances in the liver (hemihepatektomies or greater performance). Six patients have undergone repeated resection (4.1%), in 11 patients was performed Radio Frequency Ablation due to relaps of the disease (6.1%), and 3 patients were performed two steps resection. Of 91 major resection performance in the liver was 62 (68%) performed by anatomical boundaries of individual segments, in remaining 29 (32%) resections was reflected more to the localization of tumor itself as anatomical subdivision called combined anatomical and non-antomical resection. Radical resection R0 has been achieved in 76% of malignant tumors. In the post-operative course in 17% experienced complications, most often to the hematoma and biloma in place of the resection area, pleural effusion and 8 patients had postoperative liver dysfunction. Of this group, 5 patients had made volumetric examinations, and in all was the volume of residual liver parenchyma < 30% of the total volume of functional liver. Mortality within 30 days of the performance was 1.1%. The survival of patients was affected mainly by extent of resection, histological type of tumor, radicality of resection and necessity of the complex surgical procedures. Based on our evaluation of the results of a group of patients was arranged scheme measures for planning resectional procedures of the liver in our department. These include the adjustment of laboratory parameters, management of jaundice, preference of anatomical resections and volumetric examinations in patients with an estimated loss of more than 60-70% functional parenchyma of liver.
    No preview · Article · Jan 2009
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    ABSTRACT: Electrolytic production of aluminium in former Czechoslovakia started in the year 1953 in the Žiar valley in the central Slovakia. However, till 1995 the hygienic conditions for health protection were not met in the factory. It underwent a reconstruction afterwards. The authors demonstrate cases of occupational skeletal fluorosis (currently rare in Europe) in 14 metallurgists which were all disclosed in foundry workers in Žiar nad Hronom as to the year 2005. The occupational disease was diagnosed after 17.7 ± 7.67 years (x±SD) of exposure in the foundry. The authors describe the clinical conditions, haematological and biochemical tests (decreased level of ionising calcium was found in serum). The content of fluorides in urine was increased (254.4±130.95 µmol/l). The average age of patients at the time of recognition of the professional etiology of the disease was 57.93±7.95 years. Eight patients were older than 60 years. Skeletal abnormalities were evaluated by using X-ray skiagraphy, estimating the Stage I–III of the skeletal fluorosis. Typically an increase of bone density was found, the compact part of long bones was coarsed, there were calcifications of the interosseous membrane between radius and ulna and some ossifications of the sacrospinal and sacrotuberous ligaments. Twelve patients suffered sensorimotor polyneuropathy of extremities, chronic bronchitis was found in 6 patients (two of them were smokers). The last occupational case was registered in the year 2001. The authors assume that aluminium production with modern technology of better safety and protection of health of workers is the key which will make the skeletal fluorosis the history in the Czech and Slovak Republic.
    Full-text · Article · Sep 2008 · Interdisciplinary toxicology

  • No preview · Article · Jul 2008 · Transplantation
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    ABSTRACT: Fifty spontaneously breathing pentobarbital-anesthetized cats were used to determine the incidence rate and parameters of short reflex expirations induced by mechanical stimulation of the tracheal mucosa (ERt). The mechanical stimuli evoked coughs; in addition, 67.6% of the stimulation trials began with ERt. The expiration reflex mechanically induced from the glottis (ERg) was also analyzed (99.5% incidence, p < 0.001 compared to the incidence of ERt). We found that the amplitudes of abdominal, laryngeal abductor posterior cricoarytenoid, and laryngeal adductor thyroarytenoid electromyograms (EMG) were significantly enhanced in ERg relative to ERt. Peak intrathoracic pressure (esophageal or intra-pleural pressure) was higher during ERg than ERt. The interval between the peak in EMG activity of the posterior cricoarytenoid muscle and that of the EMG of abdominal muscles was lower in ERt compared to ERg. The duration of thyroarytenoid EMG activity associated with ERt was shorter than that in ERg. All other temporal features of the pattern of abdominal, posterior cricoarytenoid, and thyroarytenoid muscles EMGs were equivalent in ERt and ERg. In an additional 8 cats, the effect of codeine administered via the vertebral artery was tested. Codeine, in a dose (0.03 mg/kg) that markedly suppressed cough did not significantly alter either the incidence rate or magnitudes of ERt. In the anesthetized cat the ERt induced by mechanical stimulation of the trachea was similar to the ERg from the glottis. These two reflex responses differ substantially only in the frequency of occurrence in response to mechanical stimulus and in the intensity of motor output.
    Full-text · Article · Apr 2008 · Cough
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    ABSTRACT: Authors present findings on 14 cases of professional bone fluorosis in metallurgists who have worked at the electrolytic production of aluminium in the plant built in the Žiar basin in Slovakia for 17.71 ± 7.67 years (x- ± SD). The plant, which started the production in 1953, has not fulfilled hygienic conditions for health protection. Fluoride concentrations in the working environment were tested irregularly and varied from 1.25 to 1.7 mg . m-3, being even 5 mg . m-3 in some samples, fluoride concentrations in urine were 20.2-491.1 μmol. l -3 before the work shift in the morning. The average age at diagnosing fluorosis in the stage I and higher was 57.93 ± 7.95 years. All cases were reported as occupational diseases after taking professional history and clinical examination, necessary hematological and biochemical laboratory tests (the decreased level of ionized calcium in serum was found), including evaluation of the fluoride content in urine which was 236.06 ± 121.6 μmol. l-1 and exceeded the limit for nonexposed population 3.8 times. X-rays of long bones, LS backbone and pelvis were evaluated in collaboration with specialists in radiodiagnostics and an orthopedist. Eight cases of bone fluorosis were reported in men 60 years old and older ones. First cases were reported in 1965. There were 9 cases of fluorosis in the stage I, 3 cases of fluorosis in the stage II, 2 cases were classified as the stage II-III. The typical X-ray findings were increased bone density, a compact part of long bones was roughen on the expenses of a core cavity, ossification of membrana interossea between radius and ulna, between tibia and fibula, exostoses of muscle attachments at foramen obturatorium, ossifications of the ligamentum sacrotuberale, ossifications at spina iliaca anterior; pseudoperiostosis at lower edge of ribs was found only in one patient. The overal fatigue was found in the half of the group, sensomotor polyneuropathy of extremities in two thirds of the group, chronic bronchitis in six metallurgists, including two smokers, dyspepsia in three cases. Five men complained about milder backache and difficulties at walking, three men reported arthralgia of big joints, the rheumatic origin was excluded. Neither bone fluorosis nor some osteoarthrotic changes did not result in significant reduction of motility. In the time of reporting occupational diseases, six metallurgists were already pensioners, four ones were excluded from the risk, four ones younger than 48-53 years with the stage I fluorosis worked on even after reporting an occupational disease as metallurgists. Eleven diseases were reported until 1991. The plant was undergoing the reconstruction, substantially in 1995. Last three cases of fluorosis in the stage I has occured in 2000-2001. Patients were followed on at the clinic of occupational diseases, fluoride values in urine were low in all cases after the exposure was cut for a half year. Only in two cases of fluorosis of the stage I, a certain decline of a bone density was found on the X-ray after two years, however, it was not possible to exclude the process of demineralization related to the age and decline of physical activity. The disease was evaluated by a low financial compensation of the lower the social application according to the legislation in the Slovak Republic implemented in 2003 which was due to mild late clinical symptoms which occured at the time the metallurgists were already pensioners. Currently, the occurrence of bone fluorosis from professional exposure is an exemption in the European region. The authors presume that the new production of aluminium from 1995 and preventive projects will ensure that the occurrence of bone fluorosis will be the history in Slovakia.
    No preview · Article · Jan 2007
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    ABSTRACT: Alveolar echinococcosis (AE), caused by proliferating metacestodes of the parasitic fox tapeworm Echinococcus multilocularis, is a life-threatening disease in humans. In this study we report four human cases of AE in Slovak Republic with regard to various clinical manifestations and susceptibility to chemotherapy with albendazole or mebendazole. Patients were monitored serologically by ELISA test and Western Blots within 2–5 years after initiation of chemotherapy/surgery. Using computerized tomography (CT) we compared morphological changes of the parasitic lesions in the liver during the course of treatment. The parasitic lesions in the CT were manifested as nodular hyperplasia with hyper or hypodense zones and calcified foci within the lesion. In other cases the lesion was visualised as a hypodense poorly-delineated septated focus without calcifications. In the last case, the diagnosis of AE was confirmed only at surgery. Calcified foci found inside the main parasitic lesions were the only abnormality that was detected in two cases and were absent in other two cases. The levels of specific anti-parasitic antibodies followed the pathomorphological changes in the livers. Total IgG levels to Em2+ and EmP antigen declined gradually during the follow-up (1–5 years) and disappeared only in the patient receiving radical surgery (cured). In comparison with total IgG, concentration of the IgG4 antibody subclass seemed to correlate more adequately with the outcome of therapy as their levels decreased in improved/stabilised patients, but were elevated in “aggravated” patients. We showed that, in patients with AE in Slovakia, radical surgery of parasitic foci proved to be the most successful treatment and, in inoperable cases, albendazole and mebendazole were differently effective. Moreover. IgG4 levels rather than total IgG to protoscoleces antigens proved to be more sensitive serological marker of the progress of therapy.
    Full-text · Article · Dec 2006 · Helminthologia
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    ABSTRACT: The paper presents three case reports of toxocarosis in children - two siblings and their cousin - with probable common source of infection. Toxocariasis was diagnosed by serology based on the finding of eosinophilia (70%) during examination for anemia in one child and by a purposeful preventive screening (depistage) examination in the two other children. Two siblings displayed numerous hypoechogenic foci of the size up to 1 cm in ultrasonographic examination while the echogenicity of the liver was diffusely increased. Laboratory examination revealed elevation of aspartate aminotransferase in two of them. All three children were treated with mebendazol under the control of blood picture, hepatic tests, USG and antibodies against the toxocariasis antigen.
    No preview · Article · Jan 2004