Lymphomas and acute abdomen - a set of case reports.

Surgical treatment of gastrointestinal solid tumors is the basic method with a curative potential. However, the first-line treatment modalities in lymphomas are systemic oncology therapy (chemotherapy, immunotherapy and hematopoietic stem cell transplantation), radiotherapy or their combination. Surgery in lymphomas is predominantly associated with acute disease and dominantly, surgery is still used mainly in diagnosing lymphomas. Acute abdomen associated with lymphoma can be divided into 3 groups: bleeding, obstruction and perforation of GIT due to lymphoma. All these conditions might be caused by both gastrointestinal (extranodal) lymphomas or advanced nodal lymphomas that directly infiltrate or compress gastrointestinal tract (GIT) as well. Perforation is also often associated with the effect of systemic chemotherapy administration. When treating acute abdomen conditions caused by lymphomas, multidisciplinary cooperation with all participating experts is necessary. From the surgical point of view, minimizing the risk of postoperative complications is crucial to ensure the possibility of early systemic oncological treatment administration.

[Confocal Laser Endomicroscopy in the Diagnostics of Malignancy of the Gastrointestinal Tract]. / Konfokální laserová mikroskopie v diagnostice onkologických onemocnení gastrointestinálního traktu.

In confocal laser endomicroscopy (CLE), a type of optical microscope that uses a laser beam as its light source and processes the acquired image by processor unit is used. Although the principle behind the device has been known since 1957, its use in clinical practice has only recently been enabled by technical developments, and it is therefore a relatively new modality in differential diagnosis. CLE enables real-time microscopic imaging of the tissue under investigation and in fact non-invasive in vivo biopsy. First experiences with CLE have primarily been obtained in the field of endoscopy, in particular in the pathology of the esophagus, stomach, bile duct, pancreas, and colon. Further to its use in endoscopy, CLE was recently developed for perioperative use, with the most experience gained in neurological, breast, and prostate surgery. Numerous prospective randomized trials have confirmed the benefits of CLE in tumor screening, differential diagnosis of tumors or inflammatory diseases, earlier diagnostics of diseases, and reducing the number of required endoscopic examinations. In addition, CLE is associated with minimal side effects. A known possible side effect is allergy to the fluorescein used to stain tissues during the examination. Extending of endoscopic examination or surgery is minimal in the hands of trained personnel. Current limiting factors of CLE include insufficient clinical experience, the price of the CLE device and probes, and the subjectivity inherent in the evaluation of microscopic images by the endoscopist or surgeon. This article summarizes published studies of CLE in the diagnostics of oncological diseases of the gastrointestinal tract.Key words: confocal microscopy - gastrointestinal tract - neoplasms The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 9. 2. 2017Accepted: 26. 2. 2017.

Comparison of cervical anastomotic leak and stenosis after oesophagectomy for carcinoma according to the interval of the stomach ischaemic conditioning.

Background Stomach preparation by ischaemic conditioning prior to oesophageal resection represents a potential method of reducing the risk of anastomotic complications. This study compares the results of the anastomotic complications of cervical anastomosis after oesophagectomy with a short interval after ischaemic conditioning (group S) and a long interval (group L). Methods Subjects undergoing oesophagectomy for carcinoma after ischaemic conditioning were divided into two groups. Group S had a median interval between ischaemic conditioning and resection of 20 days, while for group L the median interval was 49 days. Anastomotic leak and anastomotic stenosis in relation to the interval between ischaemic conditioning and actual resection were followed. Results After ischaemic conditioning, 33 subjects in total underwent surgery for carcinoma; 19 subjects in group S and 14 subjects in group L. Anastomotic leak incidence was comparable in both groups. Anastomotic stenosis occurred in 21% of cases in group S and 7% of cases in group L (not statistically significant). Conclusions A long interval between ischaemic conditioning and oesophagectomy does not adversely affect the postoperative complications. A lower incidence of anastomosis stenoses was found in subjects with a longer interval, however, given the size of our sample, the statistical significance was not demonstrated. Both groups seem comparable in surgical procedure course and postoperative complications.

Distribution of ozone and other air pollutants in forests of the Carpathian Mountains in central Europe.

Ozone (O3) concentrations were monitored during the 1997-1999 growing seasons in 32 forest sites of the Carpathian Mountains. At all sites (elevation between 450 and 1320 m) concentrations of O3, nitrogen dioxide (NO2), and sulfur dioxide (SO2) were measured with passive samplers. In addition, in two western Carpathian locations, Vychodna and Gubalówka, ozone was continuously monitored with ultraviolet (UV) absorption monitors. Highest average hourly O3 concentrations in the Vychodna and Gubalówka sites reached 160 and 200 microg/m3 (82 and 102 ppb), respectively (except for the AOT40 values, ozone concentrations are presented as microg/m3; and at 25 degrees C and 760 mm Hg, 1 microg O3/m3 = 0.51 ppb O3). These sites showed drastically different patterns of diurnal 03 distribution, one with clearly defined peaks in the afternoon and lowest values in the morning, the other with flat patterns during the entire 24-h period. On two elevational transects, no effect of elevation on O3 levels was seen on the first one, while on the other a significant increase of O3 levels with elevation occurred. Concentrations of O3 determined with passive samplers were significantly different between individual monitoring years, monitoring periods, and geographic location of the monitoring sites. Results of passive sampler monitoring showed that high O3 concentrations could be expected in many parts of the Carpathian range, especially in its western part, but also in the eastern and southern ranges. More than four-fold denser network of monitoring sites is required for reliable estimates of O3 distribution in forests over the entire Carpathian range (140 points). Potential phytotoxic effects of O3 on forest trees and understory vegetation are expected on almost the entire territory of the Carpathian Mountains. This assumption is based on estimates of the AOT40 indices for forest trees and natural vegetation. Concentrations of NO2 and SO2 in the entire Carpathian range were typical for this part of Europe and below the expected levels of phytotoxicity.

Isolation of Neisseria gonorrheae and concomitant bacterial microflora from urine obtained by suprapubic bladder puncture in women with gonococcal urethritis.

The authors examined 38 non-pregnant women with gonococcal urethritis. Thirty-three (86.8%) of them suffered also from endocervical gonorrhea. Neisseria gonorrheae (N. go) was isolated from the midstream of urine in a quantity of 1 x 10(2) to 9 x 10(8) in 1 ml of urine with an average of 5.08 x 10(4) N. go per 1 ml of urine and S. E. M. +/- 3.85 x 10(4) N. go per 1 ml of urine. On the basis of suprapubic puncture ascendent propagation of bacteria to the bladder was observed by cultivation in 13 (34.2%) patients, with isolation of N. go in 5 cases.

[Quantification of Neisseria gonorrhoeae from the cervicovaginal area in nonpregnant women infected with gonorrhoea]. / Kvantifikácia Neisseria gonorrhoeae z cervikovaginálnej oblasti negravidných zien infikovaných kvapavkou.

The authors studied quantification of Neisseria gonorrhoeae from the cervicovaginal area of 53 nonpregnant women with gonorrhoea. The variability of the amount of gonococci in cervicovaginal secretion was rather high from 1.0.10(1) to 1.1.10(8) cfu N. gonorrhoeae in 1 ml. Maximum values of N. gonorrhoeae have been found intra menses (from 1.0.10(2) to 3.0.10(8) cfu N. gonorrhoeae in 1 ml). These findings allow the authors to make some, already more or less known, conclusions usable in clinical practice.

[Naftifin--laboratory and clinical experience with a new antimycotic from the allylamine group]. / Naftifin--laboratorní a klinické zkusenosti s novým antimykotikem ze skupiny alylaminu.

The authors evaluated the effectiveness of naftifin on a broad spectrum of 42 types of agents causing mycoses. Using the microdilution method, the authors assessed minimal inhibiting concentrations (MIC) of this antimycotic agent in 107 clinical isolates. Naftifin displayed a selective antifungal activity: excellent sensitivity was found in dermatophytes (MIC 90% = 0.39 mg.l-1), Aspergillae were medium sensitive (MIC = 0.09-12.5 mg.l-1). The majority of yeasts and filamentous fungi from the group of Zygomycetes was resistant to naftifin. The therapeutic results in 57 subjects with dermatomycoses corresponded to the results of in vitro tests of the antimycotic agent. Most successful as treatment of dermatophytoses at extra-intertriginous sites and treatment of pityriasis versicolor; manifestation of candidoses were not affected. The commercial preparation used--Fetimin cream--is considered by the authors a suitable alternative of hitherto used local antimycotics, in particular preparations from the azole series.

[Isolation of a rare serovar of Plesiomonas shigelloides]. / Izolácia vzácneho sérovaru Plesiomonas shigelloides.

The authors describe the isolation of a rare serovar Plesiomonas shigelloides from a patient with diarrhoea. The isolated strain belongs according to a combined Japanese-Czechoslovak antigenic scheme to serovar 024 H"o". The interesting finding draws attention to the possibility of routine departments to contribute to investigations of the incidence, importance and antigenic structure of this bacterial species.

Isolation of Neisseria gonorrhoeae from urine obtained by suprapubic puncture of bladders of men with gonococcal urethritis.

The authors examined three urine specimens from each of 24 men with acute gonococcal urethritis. Gonococcal concentrations in urine were 7 X 10(3)/ml to 9 X 10(8)/ml in first samples, 1 X 10(2)/ml to 5 X 10(6)/ml in midstream samples, and, in the terminal samples from only 22 men, 8 X 10(4)/ml. A further 17 men with symptomless gonococcal urethritis were examined. Seven of them yielded 1 X 10(2)/ml to 2.5 X 10(5)/ml in first samples and 5 X 10(5)/ml in midstream samples, and only two yielded 5 X 10(1)/ml in final samples. All 24 men with acute gonococcal urethritis, and seven of the men with symptomless gonococcal urethritis who had yielded N gonorrhoeae in midstream urine samples, were examined by suprapubic puncture before morning voiding. Four of the 24 men with acute gonococcal urethritis were found to have infection that had ascended into the bladder.

Morphological changes of Neisseria gonorrhoeae in amniotic fluid of pregnant women in their midtrimester.

Ten selected samples of amniotic fluid obtained through transabdominal amniocentesis from 10 pregnant women in their 17th-19th weeks of pregnancy were investigated for the survival of Neisseria gonorrhoeae in amniotic fluid. In 8 cases an antibacterial effect was observed with morphological changes comparable to the effect of benzylpenicillin. When N. gonorrhoeae was inoculated in amniotic fluid at 10(5)-10(7) cells/ml, it survived as an average 2 h longer than after inoculation of 10(2)-10(4) cells/ml. Electron microscopic pictures of gonococci taken after 2.6 and 24 h incubation in amniotic fluid correlated with the growth curves. Electron microscopically there were marked morphologic changes of N. gonorrhoeae, viz. vacuolar degeneration of their cytoplasm with a damage to the bacterial wall up to its complete destruction and lysis of the cell.