[Complications after pulmonary resection]. / Komplikácie po pl'úcnych resekciách.

This retrospective study analyses the postoperative complications of the 587 lung resections performed at our department in the period of 1993--1996. Of 587 resections 435 ones were performed for bronchogenic cancer. The mean age of the patient at the time of operation was 53.3 years ranging from 9 to 79. 30 patients were 70 years old and older. In that group there were 452 men and 135 women. The most frequent resection procedure was lobectomy (61.2%) followed by pneumonectomy (19.8%), wedge resection (11%), bilobectomy (6.1%) and segmentectomy (1.9%). Bronchoplastic procedures made up 6.5% of all procedures. 5 patients died within 30 days of the surgery (mortality 0.85%). 3 of them had undergone pneumonectomy (mortality 2.6%) and 2 of them lobectomy and bilobectomy (mortality 0.5%). Postoperative complications occurred in 89 patients (15.2%). In this group the mortality was significantly higher for the patients after pneumonectomy. The morbidity was significantly higher for patients 70 years or older (23.3%). The morbidity after pneumonectomy (9.5%) was not higher than the morbidity after less extensive resections. We conclude, that low incidence of mortality and major morbidity reflects careful preoperative management, selection of appropriate surgical procedure and anesthestesia and postoperative care.

[Monitoring the important mycotoxin biomarkers (ochratoxin A, aflatoxin M1) in the Czech population]. / Stav sledováni významných biomarkeru mykotoxinu (ochratoxinu A, aflatoxinu M1) u populace v Ceské republice.

BACKGROUND: In among mycotoxins, secondary metabolites of toxinogenic moulds, ochratoxin A and aflatoxins occupy a prominent place. These mycotoxins have been--as etiologic agents-- associated with a wide numbers of acute and chronic human diseases including mycotoxicoses like Balkan endemic nephropathy or liver cancer. While the risk of acute toxic effects of ochratoxin A and aflatoxin B1 is usually considered to be minimal in the Czech Republic, the situation is different as far as the risk of the late toxic effects (particularly carcinogenic), which result from a single or repeated intake of low doses of these mycotoxins from foodstuffs is concerned. METHODS AND RESULTS: The presence of ochratoxin A and aflatoxins in human environment has been monitored within the program "Monitoring the health state of the population". As for ochratoxin A, 2206 samples of blood serum were investigated, 2077 (94 %) of them turned out to be positive (with levels > or = 0.1 microg x l(-1)), the average was 0.28 microg x l(-1), the median was 0.2 microg x (l(-1), and the percentile (90%) was 0.5 microg x l(-1). The ochratoxin A levels ranged from 0.1 to 13.7 microg x l(-1) of sera. The presence of ochratoxin A was also analyzed in 30 samples of human kidneys; 12 samples were positive (with levels > or = 0.1 microg l(-2), the average was 0.07 microg x kg(-1), the median was 0,05 microg x kg(-1). As for aflatoxins, in 1997-1998 the presence of aflatoxin M1 was investigated in 205 samples of human urine; 118 samples (58%) were positive (with levels >125 pg x l(-1) of urine). CONCLUSIONS: When calculated to a concentration of creatinine in urine, the average was 391 pg x g(-1), the median was 127 pg x g(-1), and the percentile (90%) was 585 pg x g(-1). The aflatoxin M1 levels ranged from 19 to 19 219 pg x g(-1) of creatinine.

[Videothorascopic lung biopsy--diagnostic yield of one biopsy sample]. / Videotorakoskopická biopsia plúc--diagnostická výt'aznost' jednej bioptickej vzorky.

OBJECTIVE: The authors evaluate in a retrospective study the diagnostic yield of videothorascopic (VTS) biopsy of the lungs and evaluate the representativeness of one wedge-shaped bioptic specimen of the lungs collected by an endoscopic device according to HRCT, and the macroscopic finding on operation. METHOD: Based on the indication of a pneumologist in 1993-1999 210 patients were subjected to VTS pulmonary biopsy when all non-invasive diagnostic methods had been exhausted. RESULTS: The bioptic specimens gave diagnostic yields in 202 cases (96.2%), the most frequent histological finding included idiopathic pulmonary fibrosis and sarcoidosis. CONCLUSION: From the results ensues that collection of one sufficiently large and aimed bioptic specimen leads to a correct diagnosis in a high percentage of cases.

Use of hemoperfusion in experimental intoxication with nerve agents.

The aim of this study was to evaluate the efficiency of hemoperfusion (HP) through coated resin adsorbent Synachrom E-5 in animal intoxications with organophosphate inhibitors of cholinesterases type of nerve agents. Five anesthetized dogs were intoxicated with 2 to 6 LD50 of VX substance and another 4 with 2 to 3 LD50 sarine. Both nerve agents were given i.m. after starting 5 h HP. The clinical and laboratory tests were monitored during each HP. HP therapy prevented the development of serious signs of intoxication provided that the administered quantity of both sarine and the VX substance was only 2 doses of LD50. Specific antidote therapy was necessary to prevent cardiorespiratory failure in animals intoxicated with a higher dose of poison. The results obtained show that HP through Synachrom E-5 in intoxication with nerve agents sarine and the VX type is only partially successful.

The dialysis of Ochratoxin A (OTA).

Standard dialysis did not result in a decrease of the OTA level in the blood serum of patients regularly treated by dialysis. Therefore, we examined the effect of dialysis on both OTA bound to the blood plasma proteins and free OTA. We carried out an in vivo experiment to determine OTA levels in the serum of patients in the terminal stage of chronic renal insufficiency (CHRI) before and after dialysis and also in the dialysate in which we did not find OTA. OTA bound to blood plasma proteins did not penetrate the dialysis membrane. In contrast, free OTA during an in vitro experiment with the identical dialyzer (as during the in vivo experiment), easily penetrated the same dialysis membrane.