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INTRODUCTION: Biliary tract malignancies belong to very aggressive malignancies of the gastrointestinal tract. The only radical treatment is surgical resection which is possible only in a limited number of cases due to late diagnosis. The aim of this report was to present the experience of our own department with the diagnosis and treatment of these tumours. METHODS: In the years 2005-2021 radical (R0) resection was performed in 27 (28.4%) patients, the same number were managed only symptomatically and in 41 (43.2%) patients we used biliary stenting and external-internal drainage as the definitive procedure. Adjuvant oncological treatment was indicated in 16 (59.3%) of the radically operated and 49 (72.1%) of the non-operated patients. RESULTS: Median overall survival and median progression-free survival in the operated patients were 19.9 months and 15.7 months, respectively. Overall survival in the operated patients was significantly better (p.
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Neoplasias dos Ductos Biliares , Ductos Biliares Extra-Hepáticos , Humanos , Ductos Biliares Extra-Hepáticos/cirurgia , Neoplasias dos Ductos Biliares/cirurgia , Drenagem , StentsRESUMO
INTRODUCTION: Differentiated thyroid cancer (DTC) has a good prognosis and low mortality despite its growing incidence, which is particularly the case of microcarcinomas (T1a - up to 10 mm). METHODS: Retrospective analysis of overall survival of patients in the group of thyroid gland surgeries for differentiated forms of microcarcinoma in the period of 2006-2015 up to the present. An overview of contemporary therapeutic methods is included. RESULTS: Thyroid cancer was detected in 144 cases out of the total of 1820 patients with thyreopathy undergoing surgery (8%); DTC microcarcinoma was detected in 65 cases (45.1%) of all carcinomas. The papillary form was diagnosed in 59 cases (51.8% of all papillary cases), and the follicular form was found in 6 cases (37.5% of all follicular cases). Two cases of Hürthle cells cancer were found, both in a stage higher than T1. Overall 10-year survival of carcinomas >T1 was 86%, reaching 90% in the microcarcinoma group (Gehan Wilcoxon test: p=0.10675). CONCLUSION: Differentiated microcarcinoma shows a very good overall survival. Provided that other criteria are satisfied, particularly unifocal occurrence without spreading through the gland casing and without any suspicion of nodal involvement, hemithyroidectomy is considered to be a sufficient procedure or the method of choice, respectively.
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Carcinoma Papilar , Neoplasias da Glândula Tireoide , Carcinoma Papilar/cirurgia , Humanos , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/cirurgia , TireoidectomiaRESUMO
INTRODUCTION: Future liver remnant volume (FLRV) is a crucial factor impacting resectability of colorectal liver metastases (CLM). In case of low FLRV, augmentation can be done by performing portal vein embolization (PVE). However, there is a risk of progression of CLM between PVE and resection. Intraportal application of autologous hematopoietic stem cells (HSC) is a possibility to accelerate the growth of FLRV. The effect of thus applied SC on CLM progression still remains unclear, though. METHODS: 63 patients underwent PVE between 2003 and 2015. In 20 patients a product with HSC was applied intraportally on the first day after PVE (PVE HSC group). HSC were gained from peripheral blood (10 patients) or bone marrow (10 patients). FLRV and volume of liver metastases (VLM) were evaluated by CT volumetry. The gained data were statistically evaluated in relation to the disease free interval (DFI), overall survival (OS), achievement of CLM resectability and progression of extrahepatic metastases. We compared the PVE HSC group with the group of patient undergoing simple PVE. RESULTS: No significant difference in FLRV and VLM growth was observed between the study groups. The percentage of exploratory laparotomies was smaller in the group with PVE and HSC application. Patients with simple PVE had a significantly higher incidence of extrahepatic metastases during follow up. We did not observe any significant differences in DFI and OS between the groups. CONCLUSION: HSC application did not accelerate CLM growth in comparison with PVE alone. PVE and HSC application had a higher percentage of patients undergoing liver resection and a lower incidence of extrahepatic metastases.
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Neoplasias Colorretais , Embolização Terapêutica , Neoplasias Hepáticas , Células-Tronco , Neoplasias Colorretais/patologia , Hepatectomia , Humanos , Neoplasias Hepáticas/secundário , Veia PortaRESUMO
Pemetrexed is an intravenously administered antifolate cytostatic agent targeting several folate-dependent enzymatic pathways, widely used in the treatment of patients with advanced non-small cell lung cancer (NSCLC). It has been previously demonstrated that the superiority of pemetrexed is limited to patients with non-squamous histology. Aside from the non-squamous histology, there is still no available molecular biomarker predicting treatment efficacy of pemetrexed-based chemotherapy. The aim of our retrospective study was to evaluate the association of baseline serum levels of C-reactive protein (CRP) with outcomes in a large cohort of patients with non-squamous NSCLC treated with pemetrexed. Clinical data of 325 patients were analysed. Serum samples were collected within one week before the initiation of treatment. The median progression-free (PFS) and overall survival (OS) for patients with high CRP was 2.1 and 9.5 compared to 4.2 and 20.5 months for those with normal CRP (p=0.002 and p<0.001, respectively). The multivariable Cox proportional hazards model revealed that serum CRP (HR=1.46, p=0.002) was significantly associated with PFS and also with OS (HR=1.95, p<0.001). In conclusion, the study results suggest that pretreatment serum CRP is associated with poor outcome of non-squamous NSCLC patients treated with pemetrexed.
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Proteína C-Reativa/análise , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Pemetrexede/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/sangue , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Intervalo Livre de Doença , Humanos , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/tratamento farmacológico , Prognóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
INTRODUCTION: Even though thyroid carcinoma has, in general, a good prognosis and low mortality rate, its incidence, especially the incidence of early forms of the disease has been growing. METHOD: Retrospective analysis of the file of surgeries of documented thyroid carcinoma within the years of 2006-2015. RESULTS: Thyroid carcinoma was recorded in 145 of 1820 patients operated for thyreopathy (8%); microcarcinoma (<10mm) was recorded in 64 cases (44.1%). The carcinoma was mostly detected accidentally during total thyroidectomy, which was in 70 cases (48.3%). The carcinoma was expected in 35 cases (24.1%) on the basis of prior puncture and total thyroidectomy was carried out straight away. Perioperative histology after hemithyroidectomy was requested in 31 cases (21.4%), and it was found positive only in 13 cases; thyroidectomy was finished in the second period in the other cases. Due to advanced carcinoma, tumour exploration/debulking was performed in 3 cases (2.1%) - for anaplastic carcinoma in all these cases. A permanent unilateral lesion - n. laryngeus recurrens - occurred in 3 cases (2.1%); a permanent bilateral lesion was recorded twice (1.4%).The most frequently manifested carcinoma was the papillary carcinoma in 114 patients (78.6%; 83 women/31 men; age of 1284 years; mean age of 50.6), the second most frequent carcinoma was the follicular carcinoma in 16 patients (11.0%; 15/1; 1969; 55.3), followed by the medullary carcinoma in 10 patients (6.9%; 6/4; 2576; 58.1). Anaplastic carcinoma was detected only in 4 cases (2.8%; 2/2; 6487; 75.5), and lymphoma of the thyroid gland occurred twice as well as Hürtle cell carcinoma. CONCLUSION: Thyroid carcinoma is mostly found accidentally during surgery in the early phase of the disease. This proves the high quality of endocrinology care and the correctness of the tendency to indicate early surgical treatment of thyroidal pathology.Key words: thyroid carcinoma - thyroidectomy complications.
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Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Adenocarcinoma Folicular/patologia , Adenocarcinoma Folicular/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos do Nervo Laríngeo Recorrente/etiologia , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/efeitos adversos , Adulto JovemRESUMO
INTRODUCTION: Radiofrequency ablation (RFA) is a well-established method for palliative therapy of unresectable liver tumors. We use an open or percutaneous approach for the treatment of colorectal liver metastases (CLM). METHOD: Clinical data of patients undergoing percutaneous or open RFA for CLM between January 2001 and January 2015 were included in the retrospective study. We evaluated clinical factors for overall survival (OS), no evidence of disease (NED) and non-ablation in relation to tumor sizes and numbers, type of approach and type of used probes. RESULTS: 147 patients underwent RFA for CLM in this time period. Mean age was 65 years. 168 RFAs were performed in total. OS was influenced by a high number of censors. OS for the first and third years was 93.6% and 61% with no statistical differences between the percutaneous and open approach. NED was significantly shorter in patients with the percutaneous approach. NED was not influenced neither by size nor number of the lesions. A higher risk of non-ablation was observed as statistically significant in patients with percutaneous RFA. A higher, although not statistically significant, risk of non-ablation was also observed for larger metastases. Patients with percutaneous RFA showed a shorter stay in the hospital and fewer complications. CONCLUSION: RFA is an alternative approach to the treatment of unresectable CLM. In our study the open approach was associated with a lower risk of non-ablation. Percutaneous RFA showed a lower risk of complications and a shorter stay in the hospital. KEY WORDS: radiofrequency ablation percutaneous RFA colorectal liver metastases CLM palliative therapy.
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Ablação por Cateter/métodos , Neoplasias Colorretais/patologia , Neoplasias Hepáticas/cirurgia , Idoso , Feminino , Hospitais de Ensino , Humanos , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Nowadays, when climate change is becoming more and more evident, drought stress plays a very important role, including in agriculture. The increasing number of years with extreme temperatures in the Czech Republic has a negative impact on agricultural production, among other things. Therefore, ways are being sought to reduce these negative impacts. One of them may be the use of compochar (a mixture of compost and biochar) to improve water retention in the soil. The effect of compochar addition on soil properties and crop yield was tested under conditions simulating severe drought stress (greenhouse experiments) compared to normal conditions (field experiments). The aim was to find the most suitable ratio of compochar addition that would reduce the negative effects of drought stress on the yield and quality of peas and beans. Tested soil was only able to retain water between 0.03 and 0.18 cm3/cm3, while the compochar itself retained between 0.12 and 0.32 cm3 cm-3. Three substrate variants were tested by varying the amount of compochar (10, 30 and 50 % v/v) in the soil, and all three substrates showed a similar water content between 0.03 and 0.21 cm3 cm-3 depending on the planted crop and week of cultivation. No apparent stress was observed in crops planted in 100 % compochar. Nevertheless, in general, the trend of chlorophyll a/b ratio increased with increasing amounts of compochar in the soil, indicating stress. Yield increased by approximately 50 % for both test crops when 30 % compochar was used as substrate. The flavonoid content in beans was between 410 and 500 µg CE g-1 DW and in peas was approximately 300 µg CE g-1 DW. The results showed that the utilization of compochar had no effect on either total phenol content, flavonoid content or antioxidant capacity. The combination of compochar with soil (30 %) was found to positively affect the (i) soil moisture, (ii) crop yield, and (iii) nutritional properties of peas and beans and (iv) the ability of plants to withstand drought stress.
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Fabaceae , Solo , Solo/química , Secas , Clorofila A , Verduras , Produtos Agrícolas , Pisum sativum , Água , FlavonoidesRESUMO
BACKGROUND: It has been previously published that the frontal branch of the middle meningeal artery (MMA) is usually embedded in a bony canal (BC). Although the incidence of the BC was over 70%, this structure is currently omitted both in anatomical nomenclature and in most of the literature. We found the same gap pertaining to the grooves for the MMA on the skull base. The aims of our study were to assess the incidence and morphometry of the MMA BC and grooves on the skull base. MATERIALS AND METHODS: Computed tomography (CT) scans of 378 patients, 172 skull bases as well as 120 sphenoidal bones and 168 temporal bones, and 12 histological specimens from 3 men and 3 women and 3 different regions of the MMA course were assessed. RESULTS: Based on CT scans, the incidence of the BC was 85.44% and was significantly higher in females than in males. Most of the canals and grooves were bilateral. The mean canal length was 17.67 mm, the mean transverse diameter 1.33 mm, and the mean distance from the superior orbital fissure (dFOS) was 26.7 mm. In the skull bases, the BC incidence was 70.07%, the mean canal length 10.74 mm, and the mean dFOS was 19.16 mm. The groove for the MMA on the temporal and sphenoidal bones was present in 99.42% and 95.35%, respectively. Histological specimens confirmed the presence of the MMA and accompanying vein/s. CONCLUSIONS: Based on our results, we suggest the addition of the BC and grooves for the middle meningeal vessels to the upcoming version of the Terminologia Anatomica.
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Artérias Meníngeas , Neurocirurgia , Feminino , Humanos , Masculino , Artérias Meníngeas/diagnóstico por imagem , Órbita , Osso Esfenoide/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
In mice, the antigen-specific serum antibody response following exposure to bites of Triatoma infestans nymphs and adults was determined using enzyme-linked immunosorbent assay (ELISA). The second and the third exposure to T. infestans bites resulted in higher antibody levels than during the primary exposure. Antigen-specific antibody development was faster in mice exposed to bites of nymphs than in mice exposed to adults; however, a higher antibody level was found in mice bitten by adult bugs. Protein components of T. infestans saliva were characterised using electrophoretic and blotting techniques. The immunoblotting patterns were similar in mice exposed to insect bites of various developmental stages. Antigen-specific serum antibodies reacted only with high molecular mass components (two double bands of 100 and 120 kDa, and the 80 kDa antigen). The 80 kDa component was glycosylated. Affinity to lectin derived from Pisum sativum revealed the presence of a bi- or triantennary complex type of glycan. There were similar glycan structures in the main glycoprotein components of T. infestans saliva at 18-35 kDa; however, the components did not react with antibodies of mice exposed to insect bites.
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Antígenos/análise , Mordeduras e Picadas de Insetos/imunologia , Triatoma/imunologia , Animais , Formação de Anticorpos , Antígenos/química , Antígenos/imunologia , Eletroforese em Gel de Poliacrilamida , Ensaio de Imunoadsorção Enzimática , Feminino , Immunoblotting , Masculino , Camundongos , Ninfa/imunologia , Glândulas Salivares/imunologia , Fatores de TempoRESUMO
This article gives basic overview of the USS protocol as a communication interface to drive Siemens frequency inverters. It presents our implementation of this protocol into LabVIEW, as there was permanent demand from the community of the users to have native LabVIEW implementation of the USS protocol. It also states encountered problems and their solutions.
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Equipamentos e Provisões , Software , EletricidadeAssuntos
Intoxicação/terapia , Ressuscitação , Tchecoslováquia , Departamentos Hospitalares , Humanos , SuicídioRESUMO
The authors measured the venous pressure in the iliofemoral segment in 12 patients in good general conditions, with a normal patency of the inferior caval vein, profound pelvic veins, and lower limb veins. Examination was performed with Claudy manometer. The resting venous pressure in the external iliac vein was 40--75 mm H2O = 3--5.5 mmHg. During Valsalva's manoeuvre the patients achieved an overpressure 250--1 100 mm H2O = 18--81 mmHg for 20 s. After induction of general anaesthesia and intubation, the anaesthesiologist produced an overpressure of 50 cm H2O in the patient's respiratory circuit for 20 s, but the venous pressure rose only to 90--175 mm H2O = 7-- mmHg. This rise is lesser with a high statistical significance than the overpressure produced in the Valsalva's manoeuvre. In the light of these results the authors discuss the tactics of venous thrombectomy. As a safe prevention of peroperative uplmonary embolism they regard either Valsalva's manoeuvre, carried out under local anaesthesia, or a tourniquet fixation of the clot head during the surgical intervention under general anaesthesia. The anaesthesiologist cannot prevent embolism by restriction of the venous return by producing an overpressure in the respiratory circuit of a patient under general anaesthesia.
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Anestesia Geral , Anestesia Local , Veia Femoral/cirurgia , Veia Ilíaca/fisiopatologia , Trombose/cirurgia , Pressão Venosa , Adulto , Idoso , Anestesia Endotraqueal , Determinação da Pressão Arterial/métodos , Humanos , Veia Ilíaca/cirurgia , Cuidados Intraoperatórios , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Embolia Pulmonar/prevenção & controle , Trombose/fisiopatologia , Manobra de ValsalvaRESUMO
Leptin values were investigated during four week treatment of obese children by weight reducing diet and dosed physical activity, controlled by sport-testers. Leptin values correlated significantly with BMI and HDL-cholesterol at the beginning of spa treatment and at the end of treatment. Values of leptin at the beginning of treatment correlated with fasting insulinaemia. There were no changes in leptin values during oral glucose tolerance test. Significant decrease of BMI, total cholesterol, LDL-cholesterol, triglycerides, systolic BP and leptin values appeared after four week treatment. Leptin values did not correlate with total or LDL-cholesterol at the beginning or at the end of the treatment and leptin values were not predictive for development of atherosclerosis.