Angiosarcoma is a soft tissue tumour with a dismal prognosis. We present a 74 year old male presenting with a non healing ulcer on the scalp. On histopathology a diagnosis of angiosarcoma was made. An early diagnosis and tumour size play a pivotal role in the survival of the patient., Deepal J Deshpande, Chitra S Nayak, Sunil N Mishra, and Literatura 6
Introduction: Obstruction of the appendiceal lumen is the primary cause of appendicitis. The most common causes of luminal obstruction are fecaliths and lymphoid follicle hyperplasia. Additionally, bacterial infections or enteric and systemic viral diseases can cause a reaction of the lymphoid follicle. Case presentation: An 11-year-old boy with active phase of chickenpox presented on our Pediatric surgery emergency department under the impression of acute appendicitis. An appendectomy was performed on the same day. An inflamed and edematous retrocecal appendix was removed during surgery. Histological investigation of the appendix revealed transmural acute inflammation, with diffuse proliferation of inflammatory cells, with characteristic intranuclear inclusion surrounded by a clear halo. The PCR analysis of peripheral blood and appendix tissue specimen revealed positive VZV DNA. Conclusion: We have shown that varicella-zoster virus infection of the appendix is associated with acute appendicitis and possibly also with severity of the disease., Zenon Pogorelić, Mihovil Biočić, Ivo Jurić, Klaudio Pjer Milunović, Ivana Mrklić, and Literatura 11
Cíl: Průzkumné šetření zjišťovalo schopnosti spolupráce nemocných při léčbě Warfarinem a dodrţování léčebného reţimu v průběhu dlouhodobé antikoagulační terapie Warfarinem. Konkrétně byla mapována a vyhodnocena úroveň edukace sestrou, informovanost a adherence k léčbě u pacientů léčených Warfarinem. Metodika: Průzkumný soubor tvořilo 108 pacientů evidovaných v ambulantním léčení interní a kardiologické ambulance při interním oddělení Nemocnice ve Frýdku-Místku. Průzkumné šetření probíhalo v prosinci roku 2010 a lednu roku 2011. Pro sběr dat byla vyuţita metoda dotazníkového šetření. Výsledky: Výsledky průzkumného šetření ukazují, ţe naprostá většina pacientů léčených Warfarinem se aktivně podílí na léčebném procesu. Nemocným se od zdravotníků dostává poučení o léčbě, sestry se na edukaci podílejí v 75 %. Většina dotázaných dochází na pravidelné kontroly a zná zpaměti uţívanou dávku léku. Čtvrtina nemocných však není schopna uvést krvácení jako hlavní riziko léčby. Převáţná většina respondentů si je vědoma skutečnosti, ţe účinek léčby můţe být ovlivněn sloţením přijímané potravy, méně neţ polovina respondentů zná interakci Warfarinu s jinými léky či doplňky stravy. Nemocní mají na zřeteli, ţe je nutno informovat kaţdého lékaře o této léčbě, jen polovina respondentů však informuje i lékárníka. Závěr: Adherence k léčbě ze strany pacienta je základem úspěšné a bezpečné terapie Warfarinem. Cílem všech zdravotníků by měla být snaha o kvalitní a efektivní komunikaci s nemocnými, snaha o dosaţení co nejvyšší úrovně spolupráce, ochoty a schopnosti pacientů řídit se pokyny zdravotníků. Tím se výrazně zvýší úspěšnost léčby a eliminuje se riziko moţných komplikací léčby., Aim: Exploratory investigation ascertained capabilities of cooperation of patients when treated with warfarin and adherence to treatment regimen during long term anticoagulant therapy by warfarin. Specifically was mapped and assessed the level of education by nurse, foreknowledge and adherence to treatment in patients treated with warfarin. Methods: The exploratory set consisted of 108 patients, who were registered in ambulant treatment of internal and cardiac ambulance at internal department of Hospital in Frydek-Mistek. Exploratory investigation took place in December 2010 and January 2011. For data collection was used method of questionnaire survey. Results: The results of questionnaire survey show, that absolute majority of patients treated with warfarin is actively participating in the treatment process. The patients receive from the health care providers education about the treatment, nurses are participating in education in 75%. Majority of respondents have regular check ups and knows by heart the dose of the drug. A quarter of patients is not able to state bleeding as the main risk of treatment. The vast majority of respondents are aware of the fact, that the treatment effect may be influenced by the composition of the diet, less than half of the respondents know the warfarin interactions with other medication or supplements. Patients have in mind that every doctor should be informed about this treatment, only half of the respondents, however, informs as well the pharmacist. Conclusion: Adherence to treatment by the patient is the foundation of a successful and safe warfarin therapy. The goal of all health professionals should be to aim for quality and effective communication with patients, effort to achieve the highest level of cooperation, willingness and ability of patients to follow medical instructions. This greatly increases the effectiveness of treatment and eliminates the risk of potential complications of treatment., Michaela Teperová, Lucie Sikorová, and Literatura 8
Plicní aspergilóza patří mezi zánětlivá onemocnění způsobená houbami rodu Aspergillus. V závislosti na stavu imunitního systému a plicního parenchymu nemocného existují invazivní, semi-invazivní a neinvazivní formy onemocnění. V diagnostice tohoto onemocnění hrají hlavní úlohu prostý rentgenový snímek hrudníku a HRCT plic. Prezentujeme kazuistiku pacienta s nově diagnostikovaným high-grade gliomem mozku, u kterého se v důsledku antiedematózní terapie kortikoidy rozvinula invazivní plicní aspergilóza včetně mimoplicní disseminace., Pulmonary aspergillosis belongs to inflammatory diseases caused by Aspergillus spp. Invasive, semi-invasive and non-invasive forms of the disease exist depending on the level of immunity and possible impairment of pulmonary parenchyma. Chest X ray and lung HRCT play the key role in the diagnostics of this disease. We present a patient with newly discovered high grade glioma of the brain, who had contracted invasive pulmonary aspergillosis due to antiedematous corticotheraphy., Lukáš Hrdina, Eva Čecháková, Filip Čtvrtlík, Stanislav Buřval, Barbora Remeníková, and Literatura 6
Brachial Plexus is formed by the union of the anterior rami of cervical 5, 6, 7, 8 and thoracic 1 nerves. These nerves unite and divide to form the key nerves innervating the upper limb. Variations in the course of these nerves are clinically important to anesthetists, neurologists and orthopedicians. We report bilateral variations in the arterial and neural structures in the upper limb of a 65 year old cadaver. The muscles of the arm on one side were innervated by the median nerve with absence ofmusculocutaneous. While on the other side the musculocutaneous nerve contributed to the formation of the median nerve. There was a presence of high bifurcation of brachial artery on both sides. Knowledge of such variations in the innervations of muscles and the arterial supply of the limbs are important to remember before performing any reconstructive procedures or interventions on the limb. and V. Tomar, S. Wadhwa
Unilateral otosclerosis combined with avascular necrosis of stapes crura is a rare entity. It should be considered in a case of high grade otosclerosis. Symptoms are the same as in patients who suffer from common otosclerosis. Patients complain on progressive hearing loss and tinnitus. The diagnosis is made clinically by conventional audiologic evaluation and radiologically by x-ray mastoid Schuller's view and CT scan. HRCT scan makes visible all parts of ossicular chain and gives surgeon some information about ossicular chain damage. Surgery with stapedotomy and stapes prosthesis implantation in a case of otosclerosis with avascular necrosis of stapes crura can be success therapy to improve patient's hearing and M. Erdoglija, J. Sotirovic, V. Jacimovic, B. Vukomanovic
Chemodektom, paragangliom glomus caroticum neboli tumor karotického glomu se vyskytuje v populaci s incidencí 1 : 30 000. Tumor je makroskopicky, mikroskopicky i biologicky velmi podobný adrenálnímu feochromocytomu. Významným znakem těchto tumorů je jejich bohatá vaskularizace. Patří mezi nejvíce prokrvené tumory vůbec. Histologicky se popisuje alveolární uspořádání nádorových buněk, na rozdíl od feochromocytomu, ostře od sebe ohraničených jemnými pruhy vaziva se širokými kapilárami a buňkami podobnými buňkám Schwannovým. Cytoplazma nádorových buněk hlavních je slabě eozinofilní a jemně granulovaná. Jádra buněk mohou být pleomorfní a hyperchromní, ale nutno konstatovat, že jaderná atypie není jednoznačnou známkou malignity. Biologicky se jedná o tumory převážně benigní. Klinicky se jedná o pomalu rostoucí, nebolestivý, tuhý a kulovitý útvar za úhlem dolní čelisti. Přestože chemodektom je všeobecně považován za radiosenzitivní, hlavní terapeutický postup je chirurgická exstirpace tumoru., Chemodectoma, paraganglioma of glomus caroticum or carotid glomus tumor occurs in the population with an incidence of 1:30 000. The tumor is macroscopically, microscopically and biologically very similar adrenal pheochromocytoma. An important feature of these tumors is their rich vascularization. Among the most blood supply tumors at all. Histologically, alveolar described arrangement of tumor cells, in contrast to pheochromocytoma, sharply demarcated from each other soft tissue with broad stripes capillaries and cells like Schwann cells. The cytoplasm of tumor cells is a major weakly eosinophilic and finely granular. Nuclei of cells may be pleomorphic and hyperchromic, but must be stated that nuclear atypia is not unequivocal sign of malignancy. Biologically they are mostly benign tumors. Clinically, it is a slow-growing, painless, firm and globular in shape for the angle of the mandible. Although chemodectomas were found is generally considered to be radiosensitive, the main therapeutic approach is surgical extirpation of the tumor., Alžběta Poprachová, Monika Váchalová, Radka Filipčíková, Martin Dobiáš, Zdeňka Blažková, Milada Dušková, Petr Utíkal, Marcela Bezdičková, and Literatura
Seminal vesicle secretion is important for increasing the stability of sperm chromatin, inhibition of the immune activity in the female reproductive tract and so on. Metronidazole (MTZ), a drug used for treatment of infections caused by anaerobic bacteria and protozoa, may have negative effects on the genital gland including the seminal vesicles. Curcumin exhibits antioxidant as well as anti-inflammatory properties. The present study aims to evaluate the negative effects of MTZ on the seminal vesicle structure and ameliorative effects of curcumin using stereological methods. Thirty balb/c mice were divided into six groups. The control group was received distilled water. The second and the third received higher doses of MTZ (500 mg/kg body weight/day) and MTZ (500 mg/kg/day) + 100 mg/kg/day curcumin, respectively. The fourth and the fifth were treated with lower doses of MTZ (165 mg/kg body weight/day) and MTZ (165 mg/kg body weight/day) + curcumin (100 mg/kg body weight/day), respectively. The sixth group received 100 mg/kg body weight/day curcumin. All the administrations were done by oral gavages for 14 days. After 30 days, seminal vesicles were removed. Stereological study of the seminal vesicle structure revealed a significant reduction in gland and vesicular fluid volume in MTZ-treated (higher or lower doses) animals. Curcumin protected the reduction of both parameters in therapeutic-dose treated animals. Metronidazole treatment does not induce structural changes in the seminal gland; however, it can have a significant impact on its secretion ability. Importantly, these deteriorations might be preventable by curcumin co-treatment., Ali Noorafshan, Saied Karbalay‑Doust, and Literatura 30