Prophylactic surgical mesh placement as a prevention of parastomal hernia in open radical cystectomy with ileal conduit diversion - pilot study.

INTRODUCTION: This study examines the efficacy of prophylactic mesh implantation during open radical cystectomy with ileal conduit diversion in preventing parastomal hernias (PH). Despite PH being a common complication, prophylactic methods have been underexplored. METHODS: A pilot, single-center, prospective cohort study was conducted involving five patients undergoing surgery with mesh implantation. Demographic and clinical characteristics were monitored, including the incidence of PH, operation time, blood loss, and hospitalization duration. RESULTS: During the mean follow-up period of 9.1±3.2 months post-operation, no occurrences of PH were observed in the patient group. Despite the risks associated with implanting foreign material in an area of surgery involving open small intestine, no infectious complications were noted. CONCLUSION: Prophylactic mesh implantation in radical cystectomy with ileal conduit diversion appears to be an effective preventive measure against PH. Further extensive studies are required to definitively confirm the efficacy and safety of mesh use in this context.

High-Dose Rate Brachyther-apy in the Treatment of Early Stages of Penile Carcinoma.

BACKGROUND: Interstitial low dose rate brachyther-apy is established organ spar-ing treatment of T1- T2 penile carcinoma. Experience with high-dose rate brachyther-apy is limited in this indication. MATERIALS AND METHODS: Twenty-six patients with early penile carcinoma were treated by high-dose rate brachyther-apy at dose 18 × 3 Gy per fraction twice daily between 2002- 2018 at the Department of Oncology and Radiother-apy, University Hospital in Hradec Kralove. Breast interstitial brachyther-apy template was used for fixation and precise geometry reconstruction of stainless hollow needles. RESULTS: Median follow up was 85 months (range 7- 200 months). Acute reaction usually consisted of grade 2 mucositis that dissolved dur-ing 8 weeks after the treatment. Local recurrence occurred in 6 patients, 5 of them were successfully treated with partial amputation. One patient had a nodal recurrence successfully salvaged by lymphadenectomy. One patient developed necrosis of the glans requir-ing partial amputation. Currently, there are 24 patients alive without signs of dis-ease. One patient died of cardiac comorbidity, one died of duplicate lung cancer. Nineteen patients have a preserved penis (73%), 18 of them sexually active before treatment report satisfactory intercourse. CONCLUSION: Hyperfractionated interstitial high-dose rate brachyther-apy with 18 × 3 Gy per fraction twice daily is a promis-ing method in selected patients with penile carcinoma and deserves further evaluation in a larger prospective study. Key words penile neoplasms -  conservative treatment -  brachyther-apy This work was supported by programm Progres Q40. 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: 8. 1. 2019 Accepted: 15. 1. 2019.

[Opposite trends in the incidence of gonorrhea and syphilis in the East Bohemian Region - 30 years of surveillance]. / Protikladný vývoj trendu incidence kapavky a syfilis ve východoceském regionu - 30 let surveillance.

The epidemiology of selected sexually transmitted diseases in the Czech Republic has been carefully evaluated for many years. Data from 1981-2011 for eastern Bohemia shows a sharp decrease in the incidence of gonorrhea in 1993-1994 and a very low incidence thereafter with a slightly higher prevalence in males. However, syphilis and genitourinary infections with Chlamydia trachomatis show entirely opposite trends. Also, for the similar number of diagnostic tests performed, Chlamydia had a 10 fold higher rate of positive results. This underscores the changing epidemiology of sexually transmitted infections (STI) and necessity for adapting the reporting algorithms accordingly.

[Biochemic evidence of the presence of urine in a drain following surgery]. / Biochemický prukaz prítomnosti moci v drénu po chirurgickém výkonu.

OBJECTIVE: Evaluation of the laboratory investigations of the postoperative wound drains liquids containing urine and establishing the borderline levels for confirmation of the urine presence. PATIENTS GROUP AND THE METHODS: Biochemical analysis of the drain liquids, urine and blood serum from the 34 patients with confirmed urine leak out of the urinary tract. The urea, creatinine, natrium, potassium and chloride levels were measured in all samples. RESULTS: The mean natrium, potassium, chlorides, urea and creatinine mean levels were 93.8 mmol/l, 15.9 mmol/l, 77.0 mmol/l, 73.3.

[Changes in target volumes definition by using MRI for prostate bed radiotherapy planning--preliminary results]. / Zmeny cílových objemu pri pouzití magnetické rezonance pro plánování radioterapie luzka prostaty--predbezné výsledky.

BACKGROUNDS: Magnetic resonance imaging (MRI) is used quite routinely in radiotherapy treatment planning in the primary radiotherapy of prostate cancer as it provides more contrast imaging of soft tissues in the small pelvis than planning CT, thanks to which it allows more exact delineation of target volumes and thus the saving of organs at risk We tried to verify whether it is possible to use MRI by analogy in the planning of prostate bed radiotherapy. PATIENTS AND METHODS: Twentyone patients indicated for prostate bed radiotherapy were considered in this study. Here we present the preliminary results of 10 of them. Four patients were indicated for adjuvant, 6 for salvage radiotherapy. All the patients underwent, besides standard planning CT, MRI in the same position. Target volumes and organs at risk were delineated into CT,T1 and T2 MRI images - clinical target volume (CTV), planning target volume (PTV), urinary bladder and rectum. Based on the merging of images, the volumes delineated in MRI were copied into planning CT, where the evaluation was done. We evaluated the volumes of each structure, agreement in contouring with the help of the rate of union and intersection of the volumes and with Cohen's kappa, and 3D differences between volumes of CTV on CT, T1 and T2 MRI. RESULTS: Statistically, volumes of CTV and PTV are not significantly different. The volume of the rectum is significantly smaller on T1 and also T2 MRI images. The index of agreement (union/intersection) is statistically significantly different from 1 for CTV and PTV as well. Cohen's kappa indicates moderate agreement for CTV CT and T1, T1 and T2 MRI, fair agreement for CTV CT and T2 MRI, and substantial agreement for PTV. In the superior and superolateral direction, the CTV volume on MRI in the central plane is smaller on T1 and T2 images. In the area of seminal vesicles (SV) the cranial border is similar on CT and MRI. In the superoposterior direction, the volume of CTV is smaller on CT than on T1 and T2 MRI, which means, that seminal vesicles are delineated larger in the posterior direction on MRI (about 0.24cm on T1; by about 0.20cm on T2 images). In the posterior direction, there are no differences in CTV on CT and T1 while on T2 the CTV is larger (a difference of 0.29 cm). In the posterolateral direction, CTV is smaller on T1 MRI than on CT on both sides, on the right as well as on the left. CONCLUSION: Preliminary results suggest that clinical target volume defined with the help of MRI is shifted compared with CTV defined on planning CT. The agreement of CTV delineation by one radiation oncologist is moderate to fair and is similar to interobserver variability in the contouring of the prostate bed in the planning CT. MRI provides more contrast imaging of the anterior rectal wall, where we have confirmed the most differences in contouring. Moreover, it provides better imaging of local recurrences and seminal vesicles, where the most differences in our group of patients were seen in comparison with planning CT.

[Antibiotic prophylaxis in urology]. / Antibiotická profylaxe v urologii.

Antibiotic prophylaxis is an important measure aimed at reduction of infectious complications after urologic procedures. The goal of this prospective study is assessment of the efficacy, safety and cost of short-time antibiotic prophylaxis before planned urologic surgery. Uncomplicated cystoscopy, urodynamic examination and ESWL were performed without antibiotic prophylaxis. Oral quinolones were effective in prostate biopsy. In open, laparoscopic or endoscopic surgery intravenous prophylaxis by cephalosporins had excellent efficacy. All types of prophylaxes were very safe and without adverse effects, and could be applied at low economic cost.

[Peroperative diagnostics of acute bowel ischemia using ultraviolet light and fluorescein dye]. / Peroperacní diagnostika ischemie streva za pouzití fluoresceinu a ultrafialového svetla.

Acute bowel ischemia continues to have a high mortality rate. The main factor related to this poor outcome is considered to be the delay in diagnosis. The ability to detect ischemia early and to assess the extent of bowel involvement, are the most important aspects of successful treatment. The combination of ultraviolet (UV) light and fluorescein dye would be considered a simple, reliable and technically easy procedure for diagnosis of intestinal ischemia. The method can be used both for laparotomy when the source of UV light is a Wood's lamp as well for laparoscopy when the optical filters are placed to the light source of laparoscopic set to produce UV light. Present clinical experience shows that the method is precise, objective and accessible and that it gives a greater amount of independence to the surgeon allowing him to make the diagnosis of intestinal ischemia without having to rely on the assistance of other specialists.

Two-Functional Direct Current Sputtered Silver-Containing Titanium Dioxide Thin Films.

The article reports on structure, mechanical, optical, photocatalytic and biocidal properties of Ti-Ag-O films. The Ti-Ag-O films were reactively sputter-deposited from a composed Ti/Ag target at different partial pressures of oxygen pO(2) on unheated glass substrate held on floating potential U(fl). It was found that addition of ~2 at.% of Ag into TiO(2) film has no negative influence on UV-induced hydrophilicity of TiO(2) film. Thick (~1,500 nm) TiO(2)/Ag films containing (200) anatase phase exhibit the best hydrophilicity with water droplet contact angle (WDCA) lower than 10° after UV irradiation for 20 min. Thick (~1,500 nm) TiO(2)/Ag films exhibited a better UV-induced hydrophilicity compared to that of thinner (~700 nm) TiO2/Ag films. Further it was found that hydrophilic TiO(2)/Ag films exhibit a strong biocidal effect under both the visible light and the UV irradiation with 100% killing efficiency of Escherichia coli ATCC 10536 after UV irradiation for 20 min. Reported results show that single layer of TiO(2) with Ag distributed in its whole volume exhibits, after UV irradiation, simultaneously two functions: (1) excellent hydrophilicity with WDCA < 10° and (2) strong power to kill E. coli even under visible light due to direct toxicity of Ag.

[Apoptosis of urothelial carcinoma cells]. / Apoptóza u bunek uroteliálního karcinomu.

BACKGROUND: Programmed cells death, apoptosis, is a physiological, genetically controlled mechanism. It represents the fate of the majority of cells formed during the somatic development and during the next life of most of the creatures. In the article, data from the study of urothelial carcinoma cells are presented and compared with histochemical analysis. METHODS AND RESULTS: During 1999 to 2002 native urine samples of 36 of patients with the verified urothelial carcinoma were studied. Nine patients had tumors of grade II, 27 patients had tumors of grade III. Urine samples were analysed by flow cytometry and the data obtained were compared with tumor gradients. In our cohort the zero apoptotic activity was found in 32 patients (88.9%). In four patients with preserved apoptosis the tumors were of grade III. CONCLUSIONS: Lack of apoptosis of the tumor cells was the dominant sign in our sample. The premise of existing apoptosis in tumors of the lower grade contrary to the higher one was not confirmed when apoptosis was found in four tumors of the grade III. When the tumor grading was compared, apoptosis was less active in the group of tumors with the highest histopathologic grading. Values expressing the direct relation between apoptosis and the histopathologic grading were obtained.

[Results of treatment of ureterolithiasis with shock-wave extracorporeal lithotripsy]. / Výsledky lécby ureterolitiázy extrakorporální litotrypsí rázovou vlnou.

At the Urological Clinic, Faculty Hospital Hradec Králové the authors performed extracorporeal lithotripsy in ureterolithiasis in 172 patients, mean age 46.5 years. The patients were divided into two groups. The first group was formed by 114 patients (66.3%) with subrenal ureterolithiasis, the second group by 58 patients (33.7%) with iuxtavesical ureterolithiasis. In 56 patients (32.6%) derivation of urine had to be made by means of a stent or nephrostomic puncture drainage because of an obstruction by a concrement. The general success rate of the method was 96.4% in the subrenal localization and 81% in iuxtavesical ureterolithiasis. In 15 patients an alternate solution had to be sought (URS or extraction of the concrement by a Dormi basket, Zeiss loop).

[Immunologic profile of patients with a transplanted kidney in the postoperative period]. / Imunologický profil pacienta s transplantovanou ledvinou v pooperacním období.

In our study we follow up a response of specific and a part of nonspecific cellular immunity in recipient organism with renal transplantation of cadaveric kidney to a standard immunosuppressive treatment used in the Department of Urology in Faculty hospital in Hradec Králové.