Autoři ve svém příspěvku uvádějí první výsledky šetření, které bylo zaměřeno na zjištění hmotností školních tašek chlapců a dívek 1. a 2. tříd základních škol v olomouckém regionu. Celkem byla zjištěna hmotnost u 502 školních tašek, změřeno 502 dětí (263 dívek a 239 chlapců). Z výsledků měření je zřejmé, že hmotnost tašky se zvyšuje s postupem žáků do vyšší třídy. Největší rozdíl mezi minimální a maximální hodnotou hmotnosti tašky byl zjištěn u 8letých dívek, činil 8,9 kg. Výsledky ukázaly, že procentuální podíl hmotnosti tašky doporučeným 10 % tělesné hmotnosti dítěte odpovídal pouze u 17,5 % dětí. 82,5 % dětí pak nosí aktovky těžké (10–20 %), přičemž 18,3 % dětí nosí aktovky o hmotnosti nad 20 % své tělesné hmotnosti, což už lze považovat za extrémně těžké. Nepřiměřená hmotnost školní tašky pak může ovlivňovat držení těla a výskyt bolesti zad., Effects of the weights of school bags carried by pupils from the first two classes of primary schools in the Olomouc region (502 schoolbags belonging to 263 girls and 239 boys) on the pupils’ posture were examined. The weight of the schoolbags of pupils from the 2nd year class was found to be higher than of pupils in the first year. The greatest difference between minimum and maximum weights (8.9 kilograms) was detected in the schoolbags of 8 year old girls. Only 17.5% of children carried bags that were within the recommended 10% of the child’s body weight. Thus, 82.5% of the children carry heavier bags and 18.3% of these pupils carry extremely heavy bags (over 20% of their body weight).We conclude that the excessive weight of school bags contributes to poor posture and backache amongst these children., Hana Kabátová, Miroslav Kopecký, Dana Strnisková, Jitka Tomanová, and Literatura 5
Objective: The study aimed to evaluate plasma adiponectin (ADP), adipocyte fatty acid binding protein (A-FABP) and fibroblast growth factor 21 (FGF 21) levels as potential predictors of severity of acute pancreatitis (AP) in day 4 after admission. Simultaneously, the classical proinflammatory makers were analysed as well. Settings: Department of Clinical Biochemistry and 2nd Department of Internal Medicine, Faculty Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic; Hospital Písek, Karla Čapka 589, 397 23 Písek, Czech Republic. Study design: The study was conducted in subjects with acute pancreatitis (n = 84, 37 females, 47 males). The analyses were performed in the groups according to the mild/severe classification of AP, and partly in the computed-tomography severity index (CTSI) score subgroups. Results: From adipokines, only FGF 21 tended to be higher in the severe AP subgroup in day 4. The multiple regression analysis revealed a positive association of A-FABP with procalcitonin (PCT), whilst FGF 21 was associated positively with ADP and negatively with C-reactive protein (CRP) in patients with the severe AP. The receiver-operator characteristics (ROC) analysis confirmed that not adipokines, but only CRP and interleukin 6 (IL-6) were suitable as potential predictors of the disease severity. The cut-off values were established for both parameters: 100 mg/L for CRP and 37 ng/L for IL-6, with negative predictive values (NPV) 96 % and 92 %, and positive predictive values (PPV) 39 % and 29 %, respectively. Conclusion: The role of ADP, A-FABP and FGF 21 has been limited in a prediction of the disease severity in day 4 after admission, while CRP and IL-6 might be useful to exclude a severe AP., Cíle studie: Studie byla zaměřena na vyhodnocení sérových hladin adiponektinu (ADP), adipocytárního proteinu vázajícího mastné kyseliny (A-FABP) a fibroblastového růstového faktoru 21 jako potenciálních prediktorů závažnosti akutní pankreatitidy (AP) 4. den po přijetí. Současně byly stanoveny vybrané klasické prozánětlivé markery. Název a sídlo pracoviště: Oddělení klinické biochemie a II. interní klinika Fakultní nemocnice Olomouc, I. P. Pavlova 6, 775 20 Olomouc; Nemocnice Písek, Karla Čapka 589, 397 23 Písek. Materiál a metody: Studie byla provedena u pacientů s akutní pankreatitidou (n = 84, 37 žen, 47 mužů). Laboratorní markery byly měřeny v podskupinách podle klasifikace lehká/ těžká AP, a částečně také v podskupinách vytvořených na základě CTSI (computed-tomography severity index) skóre. Výsledky: Ze sledovaných adipokinů měl u pacientů s těžkou AP pouze FGF 21 tendenci k vyšším hladinám v den 4 po přijetí. Za pomoci mnohočetné regresní analýzy byla zjištěna pozitivní asociace A-FABP s prokalcitoninem (PCT), zatímco FGF 21 asocioval u těžké AP pozitivně s ADP a negativně s C-reaktivním proteinem (CRP). ROC (receiver-operator characteristics) analýza potvrdila, že pouze CRP a interleukin 6 (IL-6) jsou využitelné jako potenciální prediktory závažnosti onemocnění. Pro oba parametry byly stanoveny cut-off hodnoty: 100 mg/l pro CRP a 37 ng/l pro IL-6, s negativními prediktivními hodnotami (NPV) 96 % a 92 %, a s pozitivními prediktivními hodnotami (PPV) 39 % a 29 %. Závěr: Ve studii jsme zjistili, že hladiny ADP, A-FABP a FGF 21 nejsou vhodnými parametry pro predikci tíže AP 4. den po přijetí. Naopak stanovení CRP a IL-6 v tento den by mohlo být vhodné zejména pro vyloučení těžké akutní pankreatitidy., Novotny D., Malina P., Krumpholcova P., Tozzi I., Prochazka V., and Literatura
Úvod: Posouzení významu PET/CT pro iniciální staging karcinomu jícnu s důrazem na metastatické postižení uzlin a průkaz vzdálených metastáz. Dále bylo cílem práce ověření významu PET/CT vyšetření při hodnocení efektu neoadjuvantní léčby. Metody: V prospektivní studii byl sledován soubor 354 nemocných s karcinomem jícnu, kteří byli vyšetřeni na I. chirurgické klinice LF UP a FN Olomouc v letech 2006–2012. Vstupní PET/CT vyšetření bylo provedeno u 349 nemocných. Analyzovali jsme přínos vyšetření ke stanovení stagingu onemocnění a v závislosti na něm jsme stanovovali strategii léčby. Na základě vstupního PET/CT byl u 102 nemocných zjištěn různý stupeň generalizace a byli indikovaní k paliativní či symptomatické terapii. U 247 pacientů bylo zjištěno omezení nádoru na jícen ev. regionální uzliny. Po posouzení celkového stavu a dle přání pacienta byla dále u 188 nemocných indikovaná neoadjuvantní radiochemoterapie (RCHT), léčbu nedokončilo 32 nemocných. U 156 pak bylo v průměrném odstupu 8,4 týdnů od ukončené neoadjuvantní terapie provedeno kontrolní vyšetření PET/CT. Na základě tohoto vyšetření bylo kompletní vymizení známek nádoru (complete response- CR) zjištěno u 38 vyšetřených (24,4 %), regrese u 89 (57,0 %), stacionární nález u 10 (6,4 %) a progrese u 19 (12,2 %). K chirurgické léčbě bylo indikováno 97 pacientů, z toho resekci jícnu bylo možné provést u 85 a u 12 byl výkon pouze paliativní resp. šlo o exploraci. Výsledky: Vstupní PET/CT vyšetření u 349 pacientů u naprosté většiny správně posoudilo rozsah onemocnění v souhlase s histologicky ověřenou diagnózou. Falešně negativní výsledek byl jen u 5 nemocných (1,43 %). Při hodnocení efektu neoadjuvantní léčby byli pacienti rozděleni do skupin dle nálezu při kontrolním PET/CT po neoadjuvanci a bylo vyhodnocováno jejich přežívání. Byl zjištěn signifikantní rozdíl (p=0,0004) v přežívání mezi skupinami s rozdílnou reakcí na neadjuvantní léčbu (CR (n=38), regrese (n=89), stacionární nález (n=10), progrese (n=19)) bez ohledu na další léčbu po neoadjuvanci, ve prospěch pacientů s lepší reakcí na neadjuvantní léčbu. Signifikantní rozdíl v přežívání byl zaznamenán i mezi skupinou pacientů po neoadjuvanci radikálně operovaných (n=85) a neoperovaných (n=59) ve prospěch operovaných (p=0,003). Nejdelšího průměrného přežívání 38,6 měsíců (medián 29,0 měsíců) bylo dosaženo ve skupině operovaných po neoadjuvanci, kde kontrolní PET/CT ukázalo CR. Nebyl však prokázán signifikantní rozdíl (p=0,587) ve výsledcích mezi skupinami operovaných s rozdílnou reakcí na neadjuvantní léčbu (regrese, stacionární nález). Počet případů v jednotlivých hodnocených skupinách není zatím natolik velký, abychom získané výsledky mohli považovat za jednoznačně průkazné a ve sledování a zařazování dalších nemocných do studie budeme dále pokračovat. Závěr: V práci je dokumentován význam a přínos PET/CT v iniciálním stagingu karcinomu jícnu, zejména v průkazu metastatického onemocnění, a to jak v postižení uzlin, tak v odhalení vzdálených metastáz. PET/CT má velký význam pro stanovení léčebné strategie. Dále byl ověřen význam PET/CT vyšetření při hodnocení efektu neadjuvantní léčby., Introduction: To evaluate the significance of PET/CT for the initial staging of esophageal cancer with emphasis on metastatic lymph node affection and detection of distant metastases. Furthermore, the aim of the work was to analyze the significance of PET/CT examination when evaluating the effect of neoadjuvant therapy. Methods: A set of 354 patients with esophageal cancer treated at the 1st Department of Surgery, University Hospital Olomouc and Medical Faculty at Palacky University in Olomouc between the years 2006−2012 were analyzed in a prospective study. The initial PET/CT examination was performed in 349 patients. We analyzed the benefit of this examination in regard to disease staging and based on the result, therapeutic strategy was determined. The initial PET/CT showed varying degrees of disease generalization in 102 patients, these patients were indicated for palliative or symptomatic therapy. In 247 patients, the disease was limited only to the esophagus and /or regional lymph nodes. After considering the patient’s overall condition and taking into account the wishes of the patient, 188 patients were indicated for neoadjuvant chemoradiotherapy (CRT); 32 patients did not complete this treatment. In 156 patients a follow-up PET/CT scan was performed after an average of 8.4 weeks following completion of neoadjuvant therapy. Based on this examination, a complete response- CR, was observed in 38 patients (24.4%), regression of the tumor in 89 (57.0%), stationary findings were seen in 10 (6.4%), and progression in 19 (12.2%). Ninety-seven patients were indicated for surgical resection; however, esophagectomy was only possible in 85 patients, in the remaining 12 patients only an explorative laparotomy was performed due to disease progression. Results: The initial PET/CT examination performed in 349 patients correctly described the extent of the disease in accordance with the histologically confirmed diagnosis in virtually all patients. A false positive result was seen in only 5 patients (1.43%). When evaluating the effect of neoadjuvant therapy, the patients were divided into groups based on the findings of the follow-up PET/CT after neoadjuvant therapy and their overall survival was evaluated. A significant difference (p=0.0004) in survival was observed between the groups based on the different reactions to neoadjuvant therapy (CR (n=38), regression (n=89), stationary findings (n=10), progression (n=19)) without taking into account the following treatment the patient received after neoadjuvant therapy. Patients who had a better response to neoadjuvant therapy had better survival results. There was also a significant difference in survival between the group of patients who completed neoadjuvant therapy and underwent radical surgical resection (n=85) versus those patients who completed neoadjuvant therapy but did not undergo subsequent surgery (n=59). The operated group had a significantly higher overall survival (p=0.003). The longest mean survival, 38.6 months (median 29.0 months), was achieved by the group of patients who completed neoadjuvant therapy, showed a complete response on the follow-up PET/CT, and underwent surgical resection. However, a significant difference was not observed (p=0.587) between the groups who underwent surgical resection and whose follow-up PET/CT results differed (regression or stationary findings). To date, the number of cases in the individual groups is not great enough to consider the obtained results conclusive, and we will continue to include more patients into the study and continue with the analysis. Conclusion: The work documents the significance and benefit of PET/CT in the initial staging of esophageal cancer, especially in detecting metastatic disease- positive lymph nodes as well as distant metastases. PET/CT has great importance in determining therapeutic strategy. Furthermore, the significance of PET/CT in evaluating the effect of neoadjuvant therapy was also studied., and K. Vomáčková, Č. Neoral, R. Aujeský, R. Vrba, M. Stašek, M. Mysliveček, R. Formánek
INTRODUCTION: The male:female ratio at birth (male births divided by total live births - M/T) has been shown to increase in response to ionizing radiation due to gender-biased fetal loss, with excess female loss. M/T rose sharply in 1987 in central-eastern European countries following the Chernobyl accident in 1986. This study analyses M/T and births for the former Soviet Republics and for the countries most contaminated by the event. METHODS: Annual birth data was obtained from the World Health Organisation. The countries with the highest exposure levels (by 137Cs) were identified from an official publication of the International Atomic Energy Agency. All of the former Soviet states were also analysed and the periods before and after 1986 were compared. RESULTS: Except for the Baltic States, all regions in the former USSR showed a significant rise in M/T from 1986. There were significant rises in M/T in the three most exposed (Belarus, Ukraine and the Russian Federation). The birth deficit in the post-Soviet states for the ten years following Chernobyl was estimated at 2,072,666, of which 1,087,924 are accounted by Belarus and Ukraine alone. DISCUSSION: Chernobyl has resulted in the loss of millions of births, a process that has involved female even more than male fetuses. This is another and oft neglected consequence of widespread population radiation contamination. and V. Grech
The Purpose of the study: define the indications and contraindications to, combined operation in locally invasive tumor of the rectum. The Material and methods of the study: we have analysed results combined operation in cancer of the rectum with germination in genital organs, performed in department of coloproctology in National Oncological Scientific centre during 20052009 years. Under observation were 118 women at age from 21 to 68 years. This before 45 years 26 patients, from 46 to 59 years 54 patients, 60 and above years. The Results and their discussion: Postoperative complications suppurativeinflammatory character appeared beside 36 patients (30,5%), most of all after abdomeno perineal extirpation of rectum (35,5%) and abdominoanal resection of the rectum (33,3%). In lesser extend after front resection of the rectum and after operation Hartman (28,5% and 22,7%). The General lethality has formed 3,4%, have died after combined operation 4 patients from 118 operated patients. The Conclusion: thereby, brought data evident that such important factors, as frequency of the origin relapse (28%), 5year probability of survival (37,1%), under combined interference and operation of the standard volume in the cancer of the rectum practically the same., H. B. Bobokulov, A. M. Hakimov, and Literatura
The condition of the protective barrier of the stomach in patients with duodenal ulcer associated and non-associated with H. pylori infection has been studied. The state of gastric mucosal barrier was studied in 72 patients with peptic ulcer disease association with H. pylori and 26 patients without H. pylori by determining the content of insoluble glycoproteins and its fractions in the basal portion of the gastric juice. In a comparative perspective the state of these indicators were studied depending on the association with H. pylori and the severity of the disease. In patients with H. pylori, damages of protective mucus barrier are characterized by the significant shortage of fucose, which is considered to be the main component of the insoluble glycoproteins. In patients without H. pylori, status of mucosal barrier is characterized by uniform and less significant reduction in the content of fractions of insoluble glycoproteins. In this patients the reduction of insoluble glycoproteins is not dependent on the frequency of exacerbation. The content of fucose in the mucous gel of gastric juice is a diagnostic criterion for determining the frequency of recurrence of the disease in patients with H. pylori infection., Abdujalol Vahabovich Yakubov, Nargiza Ihsanovna Pulatova, and Literatura
The Material of the study has formed 78 sick, found on stationary treatment in Republican Scientific Centre Coloproktologii since 1992 on 2010. As it is seen, from table, from 78 sick mans was 58(74,3%), womans 20(25,7%). 19(24,3), sick were at age from 15 before 20 years, 49(60,2%) at age from 21 before 40 years and 13 (16,6%) sick from 41 before 60 years. The Main complaint sick at arrival were a stubborn constipations, which noted beside 70 (89,7%) sick, including absence of the independent chair existed beside 55(70,5%), but beside 54(69,2%) sick were noted periodic stomachache, growing on measure of the absence of the chair. The Ballooned belly existed beside all 78 (100%) sick moreover beside 20(25,6%) of them flatulence was constant. The Sickness and retching existed beside 24(30,7%), weakness, reduction to capacity to work beside 52(66,6%), increasing of the temperature of the body beside 10(12,8%), paradoxical diarrhoeas beside 6(7,6%) sick. Endoskopicheskiy method (rectoromonoscopy, colonoscopy) turned out to be else less informations 51,8% coincidences of the diagnosis. So we biopsy on Svensonu executed beside all sick, entered with suspicion on disease Girshprunga. In our observations from 78 sick beside 42(53,8,1%) were aboveanalni, beside 20(25,6%) sick rectalis, beside 13(16,6%)rectosigmoideys , beside 2(2,5%) leftside and beside 1(1,2%) sick subtotalis form hipoganglios. At biopsies on Svensonu on observations, from 78 sick, beside 44(56,4%) is revealled hipoganglios, but beside 35(44,8%) аganglios rectum. As can be seen from presented tables, from 78 sick beside 68(87,2%) us is executed onemoments radical operation, 10(12,8%) sick is as far as possible made resection hipoor aganglionarnaya of the zone, decompensate part of the large intestine and is formed colostomy. In all events at operations. The Remote results executed radical operation on cause disease Girshprunga traced from 1 before 10 years beside 57(73%) sick. The Results of the surgical treatment were valued on scale Vezika: good, satisfactory and unsatisfactory. In our observations beside 46(80,7%) sick results came in well, beside 10(17,5%) satisfactory and beside 1(1,8%) sick was an unsatisfactory result., Mirzahmedov M. M., Ahmedov M. A., Sapaev D. A., and Literatura
AIMS: Authors studied potential side effects of fetal calf serum (FCS) in cultivation media on human dental pulp stem cells (DPSC) during long-term cultivation. METHODS: Two lines of DPSC obtained healthy donors (male 22 years, female 23 years) were used. Both lines were cultivated under standard cultivation conditions in four different media containing 10% or 2% FCS and substituted with growth factors. During long-term cultivation proliferation ability, karyotype and phenotype of DPSC were measured. RESULTS: Both lines of DPSC cultivated in a media containing 2% FCS and ITS supplement showed the highest number of population doublings. On the other hand the proliferation rate of DPSC cultivated in a media with 2% FCS without ITS supplement was slowest. Proliferation rate of DPSC cultivated in 10% FCS media with or without FGF-2 was comparable. DPSC cultivated in a media with 10% FCS showed a significantly higher amount of chromosomal aberrations. These chromosomal aberrations do not seem to be clonal but surprisingly we found large amounts of tetraploid cells in the 9th passage in both media containing 10% FCS. CONCLUSIONS: Our study proved that cultivation of DPSC in media containing higher concentration of FCS has critical side effects on cell chromosomal stability. and J. Suchánek, TS. Kleplová, M. Kapitán, T. Soukup
Few studies concerning the importance of wheat allergy affecting the course of atopic eczema in adolescents and adult patients exist. Aim: The evaluation if wheat allergy can deteriorate the course of atopic eczema. Follow-up of patients with confirmed food allergy to wheat. Method: Altogether 179 persons suffering from atopic eczema were included in the study: 51 men and 128 women entered the study with an average age of 26.2 (s.d. 9.5 years) Dermatological and allergological examinations were performed, including skin prick tests, atopy patch tests, and specific serum IgE for wheat, open exposure test and double-blind, placebo-controlled food challenge test with wheat flour. Results: Wheat allergy affecting the coures of atopic eczema was confirmed in eight patients (4.5%) out of 179 patients enrolled in this study by double-blind, placebo controlled food challenge test. The course of atopic eczema showed a positive trend in patients with confirmed food allergy at 3, 6, 9, 12 month follow-up (statistical evaluation with paired t-test) after the elimination of wheat flour. Conclusion: Wheat allergy may play an important role in the worsening of atopic eczema (acting as a triggering exacerbating factor) only in a minority of adolescents and adult patients (4.5% in our study). The diagnostic methods (skin prick test, specific IgE, atopy patch test, history) cannot be used as separated tests for the determination of food allergy to wheat in patients with atopic eczema.Open exposure tests and double-blind, placebo-controlled food challenge should be used for the confirmation of wheat allergy affecting the course of atopic eczema., Jarmila Čelakovská, Květuše Ettlerová, Karel Ettler, Jaroslava Vaněčková, Josef Bukač, and Literatura 34