Rutinní testování prostatického specifického antigenu v některých částech světa vedlo k významné migraci stadia karcinomu prostaty v době diagnózy, což má často za následek zbytečnou diagnostiku (over-diagnosis) a zbytečnou léčbu (over-treatment) onemocnění. Při volbě radikálních definitivních možností léčby jako radikální prostatektomie a radioterapie jsou potom pacienti vystaveni nežádoucím účinkům souvisejícím s léčbou. Koncepce „aktivního sledování s indikací odložené intervence v případě potřeby“ získala popularitu jako možné řešení zbytečné léčby onemocnění, přestože tento přístup má svá omezení. Pro léčbu některých typů lokalizovaného karcinomu prostaty se tak nabízí jako vhodná alternativa fokální terapie. Pokrok v zobrazovacích technologiích a skutečnost, že jsme schopni bezpečně a účinně aplikovat energii potřebnou pro ablaci ložiska lokalizovaného karcinomu prostaty, umožnily rychlejší přijetí této formy léčby. Ačkoli v současné době nejsou k dispozici žádné údaje první úrovně, probíhá několik studií, které se pokoušejí definovat roli fokální terapie. Kryoterapie a fokusovaný ultrazvuk o vysoké intenzitě jsou zavedené modality užívané pro ablaci celé prostatické žlázy. V našem článku hodnotíme různé techniky fokální léčby lokalizovaného karcinomu prostaty a indikace pro tuto léčbu spolu s prvními publikovanými výsledky. Klíčová slova: karcinom prostaty fokální terapie kryoablace fokusovaný ultrazvuk o vysoké intenzitě intersticiální laserová terapie fotodynamická terapie ireverzibilní elektroporace a fokální brachyterapie, The ubiquity of prostate specific antigen testing in certain parts of the world has led to significant stage migration of prostate cancer at presentation, apparently resulting in over-diagnosis and over-treatment. With radical definitive therapies such as radical prostatectomy and radiotherapy, patients have to endure treatment-related adverse effects. “Active surveillance with delayed intervention if necessary”, has gained popularity as a possible solution for the over-treatment problem, although this approach also has inherent limitations. Focal therapy is emerging as a viable management option for certain localized prostate cancers. Advancement in imaging technology coupled with the ability to safely and effectively deliver energy to ablate foci of localized prostate cancer has accelerated acceptance of this form of management. Level one evidence is still lacking, although a number of trials are now underway to define the role of focal therapy. Cryotherapy and high intensity focused ultrasound have an established track record as energy sources for whole gland prostate ablation. In this article we review the indications and technique of focal treatment for localized prostate cancer, as well as early published results using these two technologies. Key Words: prostate cancer focal therapy cryoablation high intensity focused ultrasound interstitial laser photodynamic therapy irreversible electroporation and focal brachytherapy, and Siddiqui K. M., Billia M., Izawa J., Chin J. L.
From 1994-1997 the food of Coccinella septempunctata L. was investigated on the basis of gut dissections of adults and larvae collected in the field. Additionally, the gut contents of adults fed under laboratory conditions were investigated. The likelihood of recovering different prey types during gut dissection was variable, which will be illustrated by presenting some common prey fragments. The food eaten by adult C. septempunctata throughout a year was studied at a locality in Berlin-Staaken. Ladybirds were collected from March 1994 until November 1997 in different crops and habitats on roughly a monthly basis. Aphid feeding was detectable from April until October. In May and June they were the most frequent food type. Fungal spores, in most cases the conidia of Alternaria spp., became most frequent in July. Additionally non-aphid arthropods were frequently preyed upon in July. A very common non-aphid prey item were thrips. Pollen was important in May and September. Comparing the food components of newly emerged adults with those of overwintered adults some remarkable differences were detected. In newly emerged adults non-aphid arthropods and fungal spores were much more frequent than in overwintered adults whereas aphids were less frequently found. The diet of adults and larvae was also investigated in June and July in cereal fields at two other localities, Northern Flaeming and Magdeburger Boerde. No difference in adult diet was found between the three localities. The composition of the larval diet was relatively similar to that of the adults., Holger Triltsch, and Lit