Comparison of photodynamic therapy with phthalocyanine and photofrin in human colorectal carcinoma.

Photodynamic therapy (PDT) has been developed in recent years as a new modality for the treatment of various neoplastic and non-neoplastic lesions. Although the method of combining light with photosensitizers for treatment has been around for a century, further understanding has been evolved over the past decades. The method is based on the phenomenon involving the combination of photosensitizer and light. Neither drug nor light alone are effective as therapeutic agents. The antitumour effects result from direct cell damage, destruction of tumor vasculature and activation of a nonspecific immune response. The more accepted use of PDT is still restricted for ophthalmology, dermatology and treatment of some stages of esophageal, lung and urinary bladder cancer. In our experiments, the effect of phototherapy with disulfonated hydroxyaluminium phthalocyanine (Al(OH)S2Pc) and photofrin (control group) on the growth of human colorectal carcinoma on nude mice was studied. We chose colorectal carcinoma, because the Czech population has the highest incidence and it is still increasing. We try to offer a new possibility of treatment for patients with this severe disease.

[Complications of the Longo Procedure--rectal occlusion]. / Komplikace operace podle Longa--okluze rekta.

Longo Procedures on hemorrhoids are widely used and standard surgical procedures used in many surgical clinics. Extensive studies, describing benefits and possible complications of the method in a detail, are published in Czech and foreign literature. A wide range of complication rates (5-20%) is reported by individual clinics, however, the rates decrease proportionally to the surgeon's growing experience and mastering of the method. The complications reported are mostly non-serious, bleeding from stapled sutures is one of the commonest ones. However, more serious complications including suture dehiscence or rectovaginal fistules, are less common. Our case-review presents an unusual complication after the procedure, a blind closure of the rectum with a circular PPH stapler. No similar complication has been found in the available literature.

[The malignant melanoma metastasis into the stomach corpus]. / Metastáza maligního melanomu do tela zaludku.

Our case-review studies an unusual case of occult bleeding from the cephalad portion of the digestive tube, caused by a metastasis of the malignant melanoma in the gastric corpus. The worldwide rates of patients with confirmed metastatic affections of the abdominal cavity, reaches only 2%. On the contrary, in 60% patients who died in consequence with malignant melanoma generalization, sections revealed metastases to the gastrointestinal tract. Unspecific symptoms, most frequently general weakness, tiredness, unspecific pains, anaemia and sometimes difficult decision-making, are among the suspected causes of poor diagnostic outcomes. Our case-review and collected literature data have confirmed positive effects of surgery on condition of patients with metastatic affections of the gastrointestinal tract.

[Diverticulosis of the small intestine--the authors study group and a case review]. / Divertikulární onemocnení tenkého streva--vlastní soubor a kazuistika.

Our case review describes an unusual case of an acute GIT haemorrhaging, caused by multiple diverticulosis of the proximal jejunum. The disorder is rare, rarely reported in literature worldwide. The typical course of the disease is asymptomatic, manifesting itself late as acute complications, most commonly urgent abdominal disorders. Chronic symptoms are less frequent, e.g. unspecific abdominal pain or occult haemmorhage. Inspired by literature data, the authors set up their own group of patients, who had been operated by the team for diverticles located in the small intestine, in the last 9 years.

[Use of a tack for hemorrhage in the presacral plexus]. / Pouzití "napínácku" pri krvácení z presakrálních plexu.

In operations where the rectum must be mobilized, frequently haemorrhage from presacral venous plexuses occurs. If the haemorrhage is massive, this is a serious complication, which may threaten the patient's life. In those instances we use a "drawing-pin" to arrest haemorrhage. The possibility to use a "drawing-pin" is not generally known and therefore the authors present their clinical experience with this method.