Injury to the inferior vena cava as a complication of ureteral splint insertion - case report.

The authors describe a rare complication of ureteral stenting is the case study of a patient admitted to the hospital for congestion in the outlet system of both kidneys due to external ureteral compression by tumorous mass in the retroperitoneum. Histology confirmed the B-lymphoma of the retroperitoneum as a cause of the patients problems. The ureteral stent was perforated in the course of inserting the stent into the ureter and the end of the splint was introduced into the inferior vena cava. The patient was asymptomatic, and this complication was detected as late as on day 12 on the follow-up CT scan. Stent extraction was without complications and without bleeding.

[Predictive factors for non-sentinel lymph nodes affection in breast carcinoma--outcomes of a Czech multicenter study of sentinel lymph nodes]. / Prediktivní faktory postizení nonsentinelových uzlin u karcinomu prsu--závery ceské multicentrické studie sentinelových uzlin.

BACKGROUND: The aim of the study was to assess positivity nonsentinel lymph nodes in patients with macro, micro and submicrometastases in sentinel lymph nodes and find predictive factors of positivity nonsentinel lymph nodes. Study was conducted at the Department of Surgery in Pardubice, Pilsen, Ostrava and Zlín. MATERIAL AND METHODS: Sentinel lymph nodes were assessed based on standards of Czech Pathological Society. Detection of sentinel lymph nodes was performed based on radionavigation or combination of radionavigation and blue dye method. RESULTS: In group N1 (macrometastases) there was found positivity of nonsentinel lymph nodes in 50% (45 from 90 patients). In group N1 Mi (micrometastases) there was found positivity of nonsentinel lymph nodes in 26.7% (16 from 60 patients). In group NO I+ (sub-micrometastases) there was found positivity of nonsentinel lymph nodes in 6.7% (1 from 15 patients). Predictive factors were size of metastasis, number of positive sentinel lymph nodes and grading. Size of tumor was not found to be a predictive factor of positivity nonsentinel lymph nodes. DISCUSSION: High positivity of nonsentinel lymph nodes in pacients with macro and micrometastases in sentinel lymph nodes advocates to perform axillary lymph nodes dissection. Due to small number of patients with submicrometastases it is not possible to assess if axillary dissection is necessary or not. Predictive factors of positivity of nonsentinel lymph nodes are size of metastasis in sentinel lymph nodes, number of positive sentinel lymph nodes and grading. Size of tumor was not found to be a predictive factor due to small tumors in the study. In spite of this it is necessary to consider it like a predictive factor of positivity nonsentinel lymph nodes. CONCLUSION: In patients with macro and micrometastases it is necessary to perform axillary dissection. In patients with submicrometastases in sentinel lymph nodes it is necessary to consider predictive factors.

[Problems of suitability laser's excision of pigmented dermal lesions: case report of minimal deviation melanoma]. / Problematika vhodnosti laserového odberu pigmentových kozních lézí: kazuistika minimálne deviovaného melanomu.

The paper describes a case of a 23-year-old woman, in whom an intradermal pigmented nevus was removed by an excision using a CO2 laser. In histological examination a minimal deviation melanoma (MDM) was found, occurring sparsely in the centre of the nevus. A sufficiently wide excision is important not only in terms of the pathologist who assesses the lesion but also, in particular, in terms of the prognosis to the patient. In problematic diagnoses where it is necessary to assess the extent of the lesion as well as its edges and base in particular, the sample taken by laser may be insufficient. The authors report widely used methods of nevus laser surgery and highlight the necessity of a sufficiently radical exstirpation of a nevus.

[The subacute angiohypertrophic myelomalacia Foix-Alajouanine--a rare disease?]. / Subakutní angiohypertrofická myelomalacie Foix-Alajouanine--raritní jednotka?

The subacute angiohypertrophic myelomalacia Foix-Alajouanine was first described by French authors in 1926 and belongs to the wider category of CNS vascular malformations. Both individual casuistics and larger sets of patients with this disease can be found in literature scarcely. We are presenting three necroptic cases of subacute angiohypertrophic myelomalacia (Foix-Alajouanine) that were mistakenly diagnosed clinically, once as metastatic lesion of spinal canal, once as amyotrophic lateral sclerosis, and once as inflammatory lesion of spinal cord. The histologic finding is dominated by myelomalacia of varying extent with varicosely dilated, constricted or even occluded arterialized both extra- and intramedullary veins, sporadically coupled with secondary thrombi. Clinical diagnostics is difficult and requires spinal angiography. According to literature data, it is presumable that this disease is not as rare as it may seem at first sign.

[Quantification of cerebral contusions using the contusion index]. / Kvantifikace pohmozdení mozku pomocí kontuzního indexu.

The submitted results provide evidence that calculation of the contusion index (CI) for objective expression of the extent and depth of cerebral contusion is very suitable for various comparative studies. The authors assessed, using the CI the influence of direction, site of violent action, and age on the extent and depth of cerebral contusion in different types of head injuries. Consistent with the literature, the greatest contusion developed in areas of the frontal and temporal lobes. In case of violence from the back and from the side, in subjects above 50 years of age the CI of contusion par contrecoup was markedly greater than at the site of violence. The highest CI of the whole brain was in case of violence from the side. During falls from major heights or walking during alcohol intoxication the contusion was worse than in casualties during traffic accidents where pedestrians predominated. Fractures of the skull in junior subjects occurred only after an intensity which at the same time led also to the development of more extensive and deeper contusion as compared with older subjects where CI in fractures of the skull and intracranial haemorrhage were markedly smaller.