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
We investigate the Bergman kernel function for the intersection of two complex ellipsoids {(z,w1,w2) 2 Cn+2 : |z1|2+. . .+|zn|2+|w1|q
<1, |z1|2+. . .+|zn|2+|w2|r < 1}. We also compute the kernel function for {(z1,w1,w2) 2 C3 : |z1|2/n + |w1|q < 1, |z1|2/n + |w2|r < 1} and show deflation type identity between these two domains. Moreover in the case that q = r = 2 we express the Bergman kernel in terms of the Jacobi polynomials. The explicit formulas of the Bergman kernel function for these domains enables us to investigate whether the Bergman kernel has zeros or not. This kind of problem is called a Lu Qi-Keng problem., Tomasz Beberok., and Seznam literatury
HD 94033 was discovered by Przybylski in 1975 as an dwarf cepheid with a pulsation period of 86 min. From 1981 to 1984, we have observed it many times, and found its (0-C) values of the time of maxima exhibiting regular variation with a long period of about 9 years. The new observation until 1987 still fits this variation very well. We believe it is due to the light-time effect in a binary system, Then we discuss some physical nature about the dwarf cepheid and δ Scuti stars.
Although the fluid therapy plays a fundamental role in the
management of polytrauma patients (PP), a tool which could
determine it appropriately is still lacking. The aim of this study
was to evaluate the application of a bioimpedance spectroscopy
(BIS) for body fluids volume and distribution monitoring in these
patients. This prospective, observational study was performed on
25 severe PP and 25 healthy subjects. The body fluids
composition was repeatedly assessed using BIS between days 3
to 11 of intensive care unit stay while the impact of fluid intake
and balance was evaluated. Fluid intake correlated significantly
with fluid excess (FE) in edemas, and their values were
significantly higher in comparison with the control group. FE was
strongly associated with cumulative fluid balance (p<0.0001,
r=0.719). Furthermore, this parameter was associated with the
entire duration of mechanical ventilation (p=0.001, r=0.791)
independently of injury severity score. In conclusion, BIS
measured FE could be useful in PP who already achieved
negative fluid balance in prevention the risk of repeated
hypovolemia through inappropriate fluid restriction. What is
more, measured FE has a certain prognostic value. Further
studies are required to confirm BIS as a potential instrument for
the improvement of PP outcome.
The aphids Schizaphis graminum (Rondani) (greenbug) and Diuraphis noxia (Mordvilko) (Russian wheat aphid, RWA) were collected from several localities in Argentina and Southern Chile. Clones were established from aphids collected at each location. The host preferences were studied in free choice tests. Biotypes were characterized on the basis of aphid antibiosis and host plant tolerance. The production of sexuals was assessed under natural conditions, from March to November in 1997-2001, at La Plata (34°55' S, 57°57' W). The greenbug distribution ranged from 24°40' to 43°28' S, and was bounded between isothermals 18-20°C and 8-10°C, and isohyets 400-600 mm and greater than 1200 mm. The aphids at all localities were collected from a wide range of cultivated and wild hosts. The biotypes in ten out of thirty-four populations were identified. One population was obligatorily parthenogenetic, the remainder cyclically parthenogenetic. No correlation was found between the region they came from and the period required for the induction of sexuals. RWA was found between 26°50' and 43°28' S, bounded by the isothermals 20-22°C and 8-10°C, and isohyets 400-600 mm and 2000 mm. In Chile, this aphid was only found in Osorno County, which lies on isothermal 8-10°C and is bounded by the isohyets 1000 mm and 2000 mm. Only a few RWA genotypes (clones) produced sexuals irrespective of the host they were collected from, period of the year, region, current host, or the day length and average temperature of the rearing conditions. For the first time, RWA was found infesting cultivated as well as wild oats in South America. At low latitudes, populations of both aphid species were found only infesting wild Sorghum halepensis (L).
If our mental attitudes were reasons, we could bootstrap anything into rationality simply by acquiring these mental attitudes. This, it has been argued, shows that mental attitudes cannot be reasons. In this paper, I focus on John Broome’s development of the bootstrapping objection. I distinguish various versions of this objection and I argue that the bootstrapping objection to mind-based accounts of reasons fails in all its versions., Kdyby naše duševní postoje byly důvody, mohli bychom se dostat do racionality jednoduše tím, že bychom získali tyto mentální postoje. To, jak bylo argumentováno, ukazuje, že duševní postoje nemohou být důvody. V tomto příspěvku se zaměřuji na vývoj námitek bootstrappingu Johna Broomeho. Rozlišuji různé verze této námitky a argumentuji tím, že námitka bootstrappingu proti účtům založeným na myslích selhává ve všech jejích verzích., and Christian Piller
The main purpose of this paper is to prove the boundedness of the multidimensional Hardy type operator in weighted Lebesgue spaces with a variable exponent. As an application we prove the boundedness of certain sublinear operators on the weighted variable Lebesgue space.
The boundednees of multilinear commutators of Calderón-Zygmund singular integrals on Lebesgue spaces with variable exponent is obtained. The multilinear commutators of generalized Hardy-Littlewood maximal operator are also considered.