[Effect of vitamin d receptor polymorphisms on the development and progression of malignant melanoma]. / Prehlad vplyvu polymorfizmov receptora vitamínu D na vznik a progresiu malígneho melanómu.

BACKGROUND: Malignant melanoma is one of the most aggressive cutaneous tumors in men and women. The risk of developing a malignant melanoma depends on several external factors along with deregulation of mutual interaction of genotype and phenotype. Nowadays, growing attention is focused on the study of the interactions of the active form of vitamin D3 with its receptor and inhibitory effect of vitamin D3 receptor polymorphisms on multiple signaling pathways involved in proliferative and metastatic processes. OBJECTIVES: This review article addresses the relationship between factors involved in the development of malignant melanoma through Hedgehog signaling pathway (HH). It summarizes current knowledge of malignant melanoma in regard to the role of the active form of vitamin D3 binding to vitamin D3 receptor (VDR), as well as it describes the influence of polymorphisms of VDR on the inhibition of HH. Understanding of these mechanisms and critical assessment of available data is beneficial to both primary and secondary prevention of malignant melanoma particularly by means of chemo -preventive substances.

[Chronic wound as a precancerosis (Ulcus marjolini--Marjolin's ulcer)--a case review]. / Chronická rana ako prekanceróza (Marjolinov ulkus).

Marjolin's ulcer is defined as a tumor arising from a chronic wound, scar or chronic inflammation. Commonly, it is histologically diagnosed as a squamous cell carcinoma or a basocellular carcinoma. Its management includes its excisioning including a sufficient circumferential rim and histological examination of the sentinel lymphnode. The authors present a case review of a 51-year-old male with a history of a sacral decubitus, treated for over 40 years. The patient was hospitalized to cover the defect with a skin flap. During the hospitalization, histological examinations of his inguinal lymphnodes and subsequent wound granulations were performed with an identical finding of a squamous cell carcinoma. Based on the findings, the Marjolin's ulcer was diagnosed. The patient underwent the first series of chemotherapy. However, the patient's condition deteriotated. He exited 24 days following establishment of the diagnosis. The aim of this study is to highlight one of the most dangerous complications of chronic wounds. Marjolin's ulcer is a diagnosis, which must be considered in any chronic wound of any etiology, persisting for over 3 months.

Hyperbaric oxygenotherapy as a possible means of preventing ischemic changes in skin grafts used for soft tissue defect closure.

The Center of Hyperbaric Oxygenotherapy was established in September 2001 and started to provide hyperbaric treatment services for patients suffering from chronic, non-healing soft tissue defects in close cooperation with the Department of Plastic, Reconstructive and Aesthetic surgery, the Septic Department of the Traumatology Clinic and Vascular Surgery Department at the University Hospital of L. Pasteur, and the Medical Faculty of the University of P. J. Safárik. We usually deal with elderly patients suffering from various accompanying diseases such as diabetes mellitus, atherosclerosis, microangiopathy, blood clotting disturbances, nutritional deficits, etc. Hyperbaric oxygenotherapy can be of a great use in enhancing the survival of the skin grafts used for soft tissue defect closure. It can lower the percentage of graft failures by about 50% by enhancing the fibroblast proliferation and collagen synthesis supporting the required amount of oxygen in tissues (2). Hyperbaric oxygenotherapy is a form of treatment using increased levels of physically dissolved oxygen in blood plasma. This form of transported oxygen, compared with oxygen chemically bounded to hemoglobin, is able to enter tissues with minimal or almost no blood flow. A skin graft is a typical tissue with reduced nutritional and oxygen support, and in patients with a concomitant disease it can be very vulnerable. Ischemia and infection very often cause graft failure and recurrent operations (3). The patient is repeatedly invited for hospitalization and multiple operations, which enormously increases economical expenses and lowers the patient's trust in hospital staff. Adding hyperbaric oxygenotherapy into the treatment algorithm of indicated patients may be of considerable benefit to them and also to the whole society.

[Surgical treatment of hand syndactyly in Apert syndrome]. / Chirurgické riesenie syndaktýlií rúk u Apertovho syndrómu.

Authors describe 6 cases (3 women, 3 men) affected by Apert syndrome (acrocephalosyndactyly). Clinical material has been documented since 1953. They concentrate on the description of individual clinical cases on the basis of objective and radiograph examination of patients. They describe surgical procedure of syndactyly between the thumb and 2nd-5th digits on both hands. Prior to 1998 they started with separation of digits at the age of 3-5 years. After 1998 they began with it as early as at the age of 3-6 months. For the reconstruction of lateral aspects of separated digits and for the creation of inter-digital space they use "zig-zag" incision and for covering the resulting skin defects they use skin transplants. During separation of 2nd-4th digits they extirpate all phalanges of 3rd digit and they leave metacarpal III in situ by which they create a three-digit hand with a relatively good functional result.

[Dermatolipectomy of the abdominal wall]. / Dermatolipektómia brusnej steny.

The authors describe clinical cases of dermatolipectmy of the abdominal wall performed during the last 15 years: a group of six female patients with excess skin after rapid and excessive reduction of adipose tissue, a second group of 42 patients with cumulation of subcutaneous fat in the region of the hypogastrium with formation of massive skinfolds, the so-called clinical picture of "venter pendulus". The third group of 122 patients with excessive adipose tissue and skin combined with diastasis of the rectus abdominis muscles or even prolapse of the abdominal organs. Transverse puboinguinal dermatolipectomy was performed. In 56 patients, high transverse resection is not used by the authors. Vertical lipectomy in the median line was performed in three patients and combined transverse-vertical lipectomy in 104 patients. From the total number of 170, operations satisfactory from the aspect of the surgeon and in particular the patient, were achieved in 122 (71.7%) cases, good results in 43 (25.4%) and satisfactory results in 5 (2.9%).