Karcinom prostaty jako jeden z nejčastějších zhoubných nádorů a příčina smrti u mužů představuje vysoce závažný medicínský, ale i společenský a ekonomický problém. Diagnostika a následná léčba – jak kurativní, tak především léčba pokročilých stadií, včetně jejich komplikací – je proces, který je velmi náročný. Jednak pro pacienty, protože zejména časná detekce karcinomu prostaty se týká obrovské cílové skupiny mužů, jednak pro zdravotnictví, protože stále rostoucí incidence a prevalence karcinomu prostaty klade na systém nesmírné nároky organizační, personální a v neposlední řadě i ekonomické. Není možno říci, jaká je optimální léčba, protože onemocnění představuje velmi heterogenní skupinu, ale je třeba se pokusit odpovědět na otázku, jaká je optimální léčba u konkrétního pacienta a zda vzhledem ke stadiu onemocnění je ta která léčebná modalita možná a hlavně smysluplná. Autor se zaměřil na karcinom prostaty vyšších stadií a rizikových skupin a hodnotí možnosti provedení a výsledky jednotlivých léčebných modalit – radikální operace a radioterapie., Prostate cancer – one of the most common malignant tumours and cause of death in men – represents very significant medical but also social and economic problem. Diagnostics and ensuing treatment (both curative treatment and treatment of advanced stages, including associated complications) is a very complex process, not only for patients (because early detection of prostate cancer affects large numbers of men) but also for healthcare systems, because continuously increasing incidence and prevalence have significant organizational, HR and last but not at least economic demands. Owing to the heterogeneous nature of prostate cancer the optimal therapy is not clear. But we can try to determine the best treatment in an individual patient and assess if it is feasible and justified considering the individual prostate cancer stage. The author focuses on higher stage prostate cancer and higher risk groups and evaluates the feasibility and results of individual treatment options – radical surgery and radiotherapy., and Vít V., Čermák A., Pacík D.
Karcinom prostaty je jedním z nejčastějších nádorových onemocněním mužů. S rostoucím počtem diagnostikovaných karcinomů prostaty roste i počet nutných operací. Radikální prostatektomie u lokalizovaného karcinomu prostaty je metodou volby. Je to jediný léčebný postup, jehož přínos byl potvrzen randomizovanou prospektivní studií. Pokud je provedena zkušeným operatérem, má excelentní onkologické i funkční výsledky a minimum komplikací. V současné době nelze jasně upřednostnit jeden operační přístup před jiným. Role radikální prostatektomie a pánevní lymfadenektomie u pokročilých onemocnění se stále hledá., Prostate cancer is one of the most common malignancies in men. The number of surgeries required increases with the increasing numbers of prostate cancers diagnosed. Radical prostatectomy is the method of choice for localized prostate cancer. It is the only therapeutic approach the benefit of which was confirmed in a randomized prospective trial. When performed by an experienced surgeon, it results in excellent oncological as well as functional outcomes and minimal complications. Currently, there is no clear evidence of the superiority of one surgical approach over another. The role of radical prostatectomy and pelvic lymphadenectomy in advanced disease is yet to be determined., Michal Grepl, and Lit.: 42
A radio antipodal coloring of a connected graph G with diameter d is an assignment of positive integers to the vertices of G, with x ∈ V (G) assigned c(x), such that d(u, v) + |c(u) − c(v)| ≥ d for every two distinct vertices u, v of G, where d(u, v) is the distance between u and v in G. The radio antipodal coloring number ac(c) of a radio antipodal coloring c of G is the maximum color assigned to a vertex of G. The radio antipodal chromatic number ac(G) of G is min{ac(c)} over all radio antipodal colorings c of G. Radio antipodal chromatic numbers of paths are discussed and upper and lower bounds are presented. Furthermore, upper and lower bounds for radio antipodal chromatic numbers of graphs are given in terms of their diameter and other invariants.
In this paper we describe the influence of NU7026, a specific inhibitor of DNA -dependent protein kinase, phosphoinositide 3-kinase, and AT M-kinase on molecular and cellular mechanisms triggered by ionising irradiation in human T-lymphocyte leukaemic MOLT -4 cells. We studied the effect of this inhibitor (10 μM) combined with gammaradiation (1 Gy) leading to DNA damage response and induction of apoptosis. We used methods for apoptosis assessment (cell viability count and flow-cytometric analysis) and cell cycle analysis (DNA content measurement) and we detected expression and post-translational modifications (Western blotting) of proteins involved in DNA repair signalling pathways. Pre-treatment with NU7026 resulted into decreased activation of checkpoint kinase-2 (Thr68), p53 (Ser15 and Ser392), and histone H2A.X (Ser139) 2 hours after irradiation. Subsequently, combination of radiation and inhibitor led to decreased amount of cells in G2-phase arrest and into increased apoptosis after 72 hours. Our results indicate that in leukaemic cells the pre-incubation with inhibitor NU7026 followed by low doses of ionising radiation results in radio-sensitising of MOLT -4 cells via diminished DNA repair and delayed but pronounced apoptosis. This novel approach might offer new strategies in combined treatment of leukaemia diseases., Aleš Tichý, Eva Novotná, Kamila Ďurišová, Barbora Šalovská, Radka Sedlaříková, Jaroslav Pejchal, Lenka Zárybnická, Jiřina Vávrová, Zuzana Šinkorová, Martina Řezáčová, and Literatura 42
Idiopatická plicní fibróza je onemocnění, jehož incidence a prevalence stoupá. Zobrazovací metody tvoří nedílnou součást v diagnostice tohoto fibrotizujícího plicního postižení. Stěžejní ze zobrazovacích metod je výpočetní tomografie s vysokým rozlišením. Radiologickým obrazem idiopatické plicní fibrózy je běžná intersticiální pneumonic Výpočetní tomografie s vysokým rozlišením umožňuje určit, zda jsou vyjádřeny změny typické běžné intersticiální pneumonie, možné běžné intersticiální pneumonie či změny neodpovídají běžné intersticiální pneumonii. Snaha o objektivizaci změn na výpočetní tomografii s vysokým rozlišením vedla k vytvoření jednotného skórovacího systému, který bude jednoduchý a reprodukovatelný. Klíčová slova: běžná intersticiální pneumonie, idiopatická plicní fibróza, skórování, voština, Incidence and prevalence of idiopathic pulmonary fibrosis are increasing. The integral part of diagnostics of idiopathic pulmonary fibrosis is high resolution computed tomography. Radiological image of idiopathic pulmonary fibrosis is usual interstitical pneumonia. On high resolution computed tomography are changes of typical usual interstitial pneumonia, possible usual interstitial pneumonia or signs which are not typical for usual interstitial pneumonia. There was made uniform scoring system which is quite simple and reproducible. Key words: honeycombing, idiopathic interstitial pneumonia, scoring system, usual interstitial pneumonia, Kočová E., Eliáš P., and Literatura
Beside heart failure and metabolic syndrome, atrial fibrillation is termed the cardiovascular epidemic of the 21st century. Its increased morbidity and mortality is alarming. The present, most effective therapy of atrial fibrillation is catheter ablation. Successful ablation of atrial fibrillation prevents the occurrence and progression of electrical, structural and mechanic myocardium remodelling, improves function of the left ventricle, and prevents the risk of thrombembolism. Onset of sinus rhythm activates the reversal remodelling leading to wall reconstruction and atrium reduction. The paper reviews the technique and presents own experience with catheter ablation., R. Lábrová, J. Špinar, N. Honzíková., and Obsahuje bibliografii a bibliografické odkazy
The aim of this study was to assess the effects of radiofrequency electromagnetic field (RF EMF) on heart rate variability (HRV) in rabbits with intensity slightly exceeding the limits for occupations. Totally 21 New Zealand white rabbits divided into two groups were used in this double-blind study. The first group of animals without general anesthesia was subjected to HRV examination under exposure to a device generated RF EMF source (frequency 1788 MHz, intensity 160 V/m, lasting 150 min.). The second group (premedications + α chloralose mg/kg) underwent the same protocol under the exposure to the real RF EMF signal from the base stations of mobile providers (frequency range 1805 - 1870 MHz - corresponding to the downlink signal of Slovak mobile providers, 160 V/m, 150 min., respectively). Individual 5-min records were used to analyze the HRV parameters: heart rate and root Mean Square of the Successive Differences (rMSSD) for time domain analysis and spectral powers in the low (LF-VFS) and high frequency (HF-VFS) bands for frequency domain analysis. Our study revealed the increased in HRV parameters (HF-HRV, rMSSD) associated with lower heart rate indicating increased cardiac vagal control under the exposure to RF EMF in experimental methods., Jakub Misek, Marcel Veterník, Ingrid Tonhajzerova, Viera Jakusova, Ladislav Janousek, Jan Jakus., and Obsahuje bibliografii
This work discusses the clinical performance of chromogranin A, free metanephrine and normetanephrine determination in plasma using a radioimmunoanalytical methods for the diagnosis of pheochromocytoma and paraganglioma. Blood samples were collected from 55 patients (46 pheochromocytomas, 9 paragangliomas). A sampling of biological materials was performed preoperatively and about one week, six months and one year after adrenal gland surgery. The comparative group without a diagnosis of pheochromocytoma/paraganglioma consisted of 36 pheochromocytoma/paraganglioma patients more than 4 months after adrenal gland surgery, and of 87 patients, 16 of them with multiple endocrine neoplasia, 9 with medullary and 5 with parafolicullar carcinoma of the thyroid gland. The rest were patients with various adrenal gland disorders. Chromogranin A, metanephrine and normetanephrine were determined in the EDTA-plasma using a radioimmunoassay kits Cisbio Bioassays, France and IBL International GmbH, Germany. Clinical sensitivity was 96 % for the combination of metanephrine and normetanephrine, and 93 % for chromogranin A. Clinical specificity was 100 % for the combination metanephrine and normetanephrine, and 96 % for chromogranin A. Falsely elevated levels of chromogranin A were observed in 1 patient with chronic renal insufficiency and 9 analyses were influenced by the administration of proton pump inhibitors. These results were excluded of CGA specificity. Both the combination of plasma free metanephrine, normetanephrine and chromogranin A as determined by radioimmunoassays, which are simple without the necessity of special laboratory material, are effective markers of pheochromocytoma or paraganglioma. Chromogranin A exerts association to malignity and all markers are associated with tumor mass., R. Bílek, T. Zelinka, P. Vlček, J. Dušková, D. Michalský, K. Novák, E. Václavíková, J. Widimský Jr., and Obsahuje bibliografii
The clinical outcome of 153 Graves' disease patients treated with a wide dose range of radioactive iodine-131 (RAI) was analyzed retrospectively. Six to nine months after the first dose of RAI 60 patients (39%) were hypothyroid (or rather thyroxine-substituted) and 26 (17%) were euthyroid, while 67 patients (44%) did not respond properly: in 32 (21%) their antithyroid drug (ATD) dose could be reduced but not withdrawn (partial response) and 35 (23%) remained hyperthyroid or the same dose of ATD was necessary (no response). The outcome did not correspond significantly to the administered activity of RAI (medians 259, 259, 222, and 259 MBq for hypothyroid, euthyroid, partial, and no response subgroups, respectively), or the activity retained in the gland at 24 h (medians 127, 105, 143, and 152 MBq). The effect was, however, clearly, and in a stepwise pattern, dependent on initial thyroid volume (17, 26, 33 and 35 ml, P < 0.001) or activity per gram tissue retained at 24 h (6.02, 4.95, 4.75, and 4.44 MBq/g, P = 0.002). Also, higher residual level of thyrotoxicosis at the time of RAI treatment was connected with worse outcome. The dose-dependency of outcome was further analyzed. When our sample was divided into tertiles, according to the adjusted dose, the same modest success rates (47%) were seen in the lower and middle tertiles. However, doses higher than 5.88 MBq/g (the upper tertile) resulted in success rate of 75%. Finer division into decils has shown a threshold-like increase in cure rate between the 7th and the 8th decil. In the first 7 decils (doses ≤ 6 MBq/g) the complete response rate was 45 to 50%, in the 8th decil (6.0 to 7.8~MBq/g) it rose to 80% and was not further increased with increasing dose. Direct comparison of higher (> 6 MBq/g, cure rate 80%) and lower (≤ 6 MBq/g, cure rate 46%) doses gave highly significant difference (P < 0.001). With our dosing range we found a dose-dependent clinical outcome that suggests an optimum delivered dose near 6.5 MBq/g, resulting in successful treatment of ca 80% patients. and J. Čepková, J. Horáček, J. Vižďa, J. Doležal
Lumbální spinální stenóza je klinicko‑radiologický syndrom, nejnovější definice zohledňují klinickou manifestaci i anatomické změny (zúžení páteřního kanálu). Za nejvhodnější neinvazivní vyšetření k potvrzení anatomického zúžení páteřního kanálu nebo přítomnosti komprese nervových kořenů u pacientů s klinickým podezřením na lumbální spinální stenózu je považována magnetická rezonance bederní páteře. K přesnějšímu hodnocení radiologického nálezu byla definována řada kvantitativních parametrů popisujících rozměry páteřního kanálu, nicméně korelace těchto parametrů s klinickým obrazem není uspokojivá. Perspektivním postupem ke zvýšení výtěžnosti radiologického vyšetření se jeví zohlednění dynamického aspektu lumbální spinální stenózy a důraz na tíži komprese nervových a cévních struktur v páteřním kanálu s využitím morfologického popisu durálního vaku a jeho obsahu., Lumbar spinal stenosis is a clinical-radiological syndrome; a recent definition covers both the clinical manifestation and the anatomic abnormality (narrowing of the spinal canal). Magnetic resonance imaging is suggested as the most appropriate non-invasive test to confirm the presence of anatomic narrowing of the spinal canal or the presence of nerve root impingement in patients with clinical suspicion of lumbar spinal stenosis. Many numerical parameters describing the dimensions of spinal canal have been defined for more precise assessment of radiological images; correlation between these radiological parameters and clinical symptoms, however, is unsatisfactory. To improve the usefulness of radiological imaging in patients with lumbar spinal stenosis, it seems to be meaningful to take into account the dynamic aspect of lumbar spinal stenosis and to assess neural and vascular tissue impingement based on morphology of the dural sac and its content. Key words: lumbar spinal stenosis – magnetic resonance imaging – computed tomography –perimyelography – plain radiography – neurogenic claudication The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers., and B. Adamová, M. Mechl, T. Andrašinová, J. Bednařík