Zlatým standardem léčby karcinomu endometria je chirurgická léčba. Adjuvantní radioterapie ve formě brachyterapie či zevní radioterapie je indikována u středně a vysoce rizikového karcinomu, kde snižuje zejména výskyt lokoregionální recidivy. U vysoce rizikového karcinomu jsou však pacientky ohroženy i generalizací onemocnění, což je důvodem pro zvažování zařazení adjuvantní chemoterapie do léčebného schématu. Chemoterapie může být použita současně s radioterapií jako konkomitantní chemoradioterapie nebo sekvenčně po skončení radioterapie. Článek popisuje výsledky prací, které použily adjuvantní chemoterapii. Výsledky nejsou zatím zcela jednoznačné, na závěry velkých studií stále čekáme. Přesto u vysoce rizikového karcinomu endometria již dnes v klinické praxi zvažujeme použití chemoterapie., Surgical treatment is the gold standard for treating endometrial carcinoma. Adjuvant radiotherapy in the form of brachytherapy or external radiotherapy is indicated in moderate and high-risk carcinoma where it particularly reduces the rate of locoregional recurrence. In high-risk carcinoma, however, patients are also at risk of disease generalization, which is the reason for considering the inclusion of adjuvant chemotherapy in the treatment regimen. Chemotherapy can be used concomitantly with radiotherapy as concomitant chemoradiotherapy or sequentially after radiotherapy termination. The article describes the results of papers that have utilized adjuvant chemotherapy. The results have not been entirely unequivocal so far, and the conclusions of large studies are yet to be published. Still, in high-risk endometrial carcinoma, the use of chemotherapy is currently taken into consideration in the clinical practice., Renata Soumarová, Markéta Těžká, Dana Vráblová, Lenka Teglová, Pavel Bartoš, Martin Trhlík, Robert Bučko, and Literatura
Článek popisuje terapeutické spektrum možností a jeho specifika u gastrointestinálního stromálního tumoru (GIST) se zaměřením na adjuvantní léčbu. V jeho úvodní části se věnuje obecným poznatkům o GIST – epidemiologii, histopatologii či symptomatologii. Vzhledem k faktu, že GIST patří mezi radiorezistentní a chemorezistentní tumory, účinnost imatinib mesylátu (Glivec®), selektivního inhibitoru tyrozinkinázových domén receptorů c-kit, PDGFRA-alfa a bcr-abl, znamenala výrazný průlom v terapii tohoto nádoru. V další části proto článek shrnuje současné poznatky o indikacích imatinibu a popisuje determinaci rizika rekurence – pro GIST dlouho nebyla vytvořena TNM klasifikace, míra rizika recidivy byla tedy stanovována na základě několika kritérií, jako je velikost tumoru, počet mitóz na 50 patologických polí při histologickém vyšetření nádoru, lokalizace a ruptura tumoru, z nichž také nová TNM klasifikace vychází. Současně článek přináší přehled zásadních klinických studií pro adjuvantní podávání imatinibu a zmiňuje se i o možnostech terapie pro pacienty s metastatickým či pokročilým onemocněním, resp. o další linii biologické léčby, sunitinibu (Sutent®)., The paper describes the spectrum of therapeutic options and its specific features in gastrointestinal stromal tumour (GIST) with a focus on adjuvant therapy. The introduction deals with general information related to GIST, i. e. epidemiology, histopathology and symptomatology. Given the fact that GIST is among radioresistant and chemoresistant tumours, the efficacy of imatinib mesylate (Glivec®), a selective tyrosine kinase inhibitor of c-kit, PDGFRA-alpha and bcr-abl, has been a significant breakthrough in the treatment of this tumour. Therefore, the paper also summarizes the current knowledge of the indications for imatinib treatment and describes the assessment of the risk of recurrence – there had been no TNM classification for GIST for a long time; therefore, the risk of recurrence was established based on several criteria, including the tumour size, the number of mitoses per 50 high-power fields on the histological examination of the tumour, and the tumour site and rupture, criteria which are also used in the new TNM classification. Additionally, the paper presents an overview of clinical trials essential for adjuvant imatinib treatment and deals with the treatment options for patients with metastatic or advanced disease as well as with another line of biological therapy, sunitinib (Sutent®)., Michaela Zezulová, Bohuslav Melichar, and Lit.: 13
We investigated the effects of telmisartan, the blocker of angiotensin II receptor 1, on the regulation of systolic blood pressure (SBP) and oxidative stress through endothelial nitric oxide (NO) release in spontaneously hypertensive rats (SHRs). SHRs randomly received placebo, oral feeding of telmisartan (5 mg/kg or 10 mg/kg) every day and Wistar-Kyoto rats (WKYs) served as normotensive control. The SBP of rat was measured before and weekly thereafter. After a total of 8-week treatment, rats were killed for experimental measurements. Parameters that subject to measurements in isolated aorta endothelial cells include: NO concentration, protein expression levels of angiotensin II receptor 1, nitrotyrosine, 8-isoprostane, SOD, PI3K, Akt, AMPK and eNOS. In addition, L-NMMA, a general inhibitor of nitric oxide synthase, was also applied to test the inhibition of NO concentration. We found that SBPs were significantly lower in telmisartan therapy group than in placebo treated hypertensive rats and WKYs (p<0.05). The NO concentration was significantly higher in telmisartan-treated group with increased activity of the PI3K/Akt pathway and activated eNOS signaling. Blockade of Akt activity reversed such effects. Activation of AMPK also contributed to the phosphorylation of eNOS. L-NMMA treatment reduced less NO concentration in SHR rats than the telmisartan co-treated groups. Oxidative stress in SHRs was also attenuated by telmisartan administration, shown by reduced formation of nitrotyrosine, 8-isoprostane, and recovered SOD protein level. Telmisartan enhanced NO release by activating the PI3K/Akt system, AMPK phosphorylation and eNOS expression, which attenuated the blood pressure and oxidative stress in SHRs., L. Xu, Y. Liu., and Obsahuje seznam literatury
Let y be observation vector in the usual linear model with expectation Aβ and covariance matrix known up to a multiplicative scalar, possibly singular. A linear statistic aTy is called invariant estimator for a parametric function ϕ=cTβ if its MSE depends on β only through ϕ. It is shown that aTy is admissible invariant for ϕ, if and only if, it is a BLUE of ϕ, in the case when ϕ is estimable with zero variance, and it is of the form kϕˆ, where k∈⟨0,1⟩ and ϕˆ is an arbitrary BLUE, otherwise. This result is used in the one- and two-way ANOVA models. Our paper is self-contained and accessible, also for non-specialists.