Comparison of narrow-band imaging with autofluorescence imaging for endoscopic detection of squamous cell carcinoma of the tonsil.

PURPOSE: Early detection of mucosal neoplastic lesions is crucial for a patient's prognosis. This has led to the development of effective optical endoscopic diagnostic methods such as narrow band imaging (NBI) and autofluorescence (AFI). Independent of each other, both of these methods were proven useful in the detection of mucosal neoplasias. There are limited reported data comparing both methods for oropharyngeal cancer diagnostics. The aim of the study was to compare NBI and AFI endoscopic visualization of signs in identifying tonsillar squamous cell carcinoma (SCC) and assessing its extent and to determine whether the score was related to the evaluator's experience. METHODS: Patients with tonsillar SCC underwent endoscopic pharyngeal examination using NBI and AFI. Fiftyseven video sequences of examinations of lesions proven to be SCC were evaluated by three reviewers. The accuracy of determination of lesion extent and visualization of its endoscopic signs of malignancy were evaluated. RESULTS: Endoscopic visualization of tumour spread was significantly better using AFI than NBI (p = 0.0003). No significant difference was found between NBI and AFI in the visualization of endoscopic malignancy determining signs (p = 0.1405). No significant difference was found among the three reviewers in the visualization of tumour spread and for identifying malignancy-determining signs in NBI endoscopy or AFI endoscopy. CONCLUSIONS: The results show that AFI obtained better results for assessing the extent of tonsillar cancers than NBI. Both methods were proven to be equal in the visualization of endoscopic malignancy-determining signs. Both are useful even for less experienced evaluators.

[Legionellosis and its diagnosis]. / Legionelózy a ich diagnostika.

The diagnosis of legionellosis, especially of its severe, life-threatening form, Legionnaires' disease, is complicated, primarily because of non-typical symptoms of the infection, not always dominating atypical pneumonia, and often a very dramatic septic course of the disease with multiorgan failures. The diagnosis of the acute phase of the disease can be established by the detection of Legionella antigen in urine and by PCR/real-time PCR detection of Legionella DNA in serum and lower respiratory tract and urine samples. Cultivation on specific media remains the gold standard, but this very demanding method is rarely used. Serological testing requires paired samples and thus is relevant to the diagnosis at a later stage of infection, although it is to be noted that about 20% of patients do not produce the antibodies. Great progress has been made in typing methods (RFLP, PFGE, or PCR based and sequence based methods) and rapid identification methods (MALDI-TOF).

Novel approaches to antiviral and anticancer immunotherapy.

In this review we discuss existing as well as new approaches to immunotherapy directed against infected or cancerous cells. These approaches traditionally exploit either natural components of immune system (such as cytokines, chemokines, co-stimulatory molecules and adjuvants), or monoclonal antibodies designed to target foreign agents and/or diseased cells through their molecular markers. Additional strategies in development include therapeutic vaccines, oncolytic viruses and T-cell therapies. In addition, we briefly describe a novel strategy called ReDIT (Re-Directed ImmunoTherapy), based on re-orienting the existing long-lasting immune responses (e.g. induced by measles vaccination or natural infection) towards new target molecules on the surface of infected or malignant cells. This can be principally achieved by using bi-functional protein constructs that contain an antigen carrier component and a re-directing component. The antigen carrier component can consist of the ectodomain of the measles hemagglutinin that can be recognized by antibodies and memory cells generated during previous infection or vaccination. The re-directing component consists of the specific virus- or tumor antigen-binding molecule. The fusion constructs are expected to boost existing anti-measles immunity and re-direct it against a new target, engaging the existing anti-measles immunity as an effector mechanism. Thus, ReDIT is a promising novel approach that may represent a valuable addition to immunotherapy of difficult to treat infections and tumors, as it exploits a mechanism distinct from other available therapies.

[Diagnosing of Acanthamoeba keratitis]. / Diagnostika akantamébovej keratitídy.

Acanthamoeba keratitis is rare corneal disease, its etiology is caused by amoebae of the Acanthamoeba spp. In this paper, the newest findings about the diagnostic and treatment procedures of the disease and epidemiology and preventive issues from the point of public health are presented. The article presents results of the water quality monitoring (according to the Acanthamoeba which is possible to cultivate at 36 degrees C and 44 degrees C) in man-made swimming pools during the period 2004-2008 at the Department of environmental biology of the Regional Public Health Institute in Banská Bystrica, Slovakia, E.U. The examination methods present the techniques of the clinical sampling and taking samples from the environment. The results underline the use of the new effective criteria in controlling of recreational resorts as well as changes of the legal criteria for the water quality used by the public. The results show that the presence of Acanthamoeba spp. in the environment is common, so the water monitoring is perceived as substantial preventive issue to prevent the disease to emerge. The collaboration between the public heath departments and ophthalmologists during the examination of the clinical and environmental samples may help to prevent and diagnose the Acanthamoeba keratitis.