Základem terapie karcinomu kolon bez vzdálených metastáz je kompletní chirurgické odstranění nádorové tkáně a adekvátní adjuvantní systémová chemoterapie. U nemocných s metastatickým nádorem je nutné identifikovat ty pacienty, kteří by mohli mít prospěch z metastazektomie. U generalizovaného kolorektálního karcinomu chemoterapie a terapie cílenými léky významně prodlužují dobu do progrese, celkové přežití a zlepšují kvalitu života pacientů., Complete surgical removal of the primary tumour and regional lymph nodes is the most important step in curative treatment of nonmetastatic colorectal cancer. Adjuvant chemotherapy significantly increases the proportion of patients surviving long-term without evidence of disease. Chemotherapy and targeted therapy have become the mainstay of metastatic colorectal cancer treatment. It is critical to identify those patients with metastatic disease who could benefit from metastasectomy., Tomáš Büchler, and Lit.: 45
Karcinom žaludku je ve světě druhou nejčastější příčinou úmrtí na malignitu. V rámci jednotlivých stadií může být prognóza nádoru velmi rozdílná, proto se zájem onkologů upíná k hledání nových prognostických a prediktivních markerů, jako je např. HER-2/neu (HER2). Po jeho stimulaci dochází k nastartování signální dráhy, vedoucí ke zvýšené proliferaci, zablokování apoptózy, ztrátě diferenciace a zvýšení invazivity nádoru. HER2 je negativním prognostickým faktorem, sdruženým s vyšší invazivitou, postižením serózy, metastazováním do uzlin a kratším přežitím, i negativním prediktivním faktorem a cílem pro biologickou léčbu trastuzumabem. Existují dvě metody detekce HER2 – imunohistochemie (IHC) a in situ hybridizace (ISH). Pozitivita HER2 se u karcinomu žaludku pohybuje v rozmezí 6,8–34 % (průměrně 17,6 %) při stanovení IHC, resp. 7,1–42,6 % (průměrně 19,2 %) pomocí ISH. HER2 je častěji přítomen v intestinálním, než v difuzním typu karcinomu. Při stanovení HER2 platí některá specifika – za pozitivní považovány jak buňky s kompletní, tak s pouze bazolaterální expresí proteinu, vzhledem k častěji nehomogenní expresi je dolní hranice v resekátech 10 % pozitivních buněk, ale u endobioptických vzorků je vyžadována přítomnost alespoň jedné skupiny barvících se (2+ nebo 3+) neoplastických buněk., Gastric carcinoma is the second cause of cancer related death worldwide. Prognosis significantly varies among patients within the same stage, therefore oncologists urge for identification of new prognostic and predictive markers, such as HER-2/neu (HER2). Stimulation of HER2 triggers molecular pathway resulting in increased proliferation, blocked apoptosis, loss of differentiation and increased tumor invasion. HER2 is a negative prognostic factor, associated with increased invasiveness, serosal involvement, lymph-node metastases and shorter survival, as well as a negative predictive marker and target for trastuzumab treatment. There are two methods of HER2 detection – immunohistochemistry (IHC) and in situ hybridisation (ISH). Positivity of HER2 in gastric cancer ranges from 6,8 to 34 % (mean 17,6 %) in IHC detection, and 7,1–42,6 % (mean 19,2 %) in ISH detection, respectively. HER2 is more often positive in intestinal than in diffuse type. HER2 detection in gastric carcinoma shows certain specific features – positive cells show either complete or incomplete basolateral (Ushaped) membranous expression. Due to more frequent inhomogenity of tumor population, the threshold has been set at 10 % of positive cells in resection specimens, but even one cohesive cluster of positive (2+ or 3+) neoplastic cells is sufficient in biopsy samples., Aleš Ryška, Tomáš Rozkoš, Jan Laco, and Lit.: 24
The Purpose of the study: define the indications and contraindications to, combined operation in locally invasive tumor of the rectum. The Material and methods of the study: we have analysed results combined operation in cancer of the rectum with germination in genital organs, performed in department of coloproctology in National Oncological Scientific centre during 20052009 years. Under observation were 118 women at age from 21 to 68 years. This before 45 years 26 patients, from 46 to 59 years 54 patients, 60 and above years. The Results and their discussion: Postoperative complications suppurativeinflammatory character appeared beside 36 patients (30,5%), most of all after abdomeno perineal extirpation of rectum (35,5%) and abdominoanal resection of the rectum (33,3%). In lesser extend after front resection of the rectum and after operation Hartman (28,5% and 22,7%). The General lethality has formed 3,4%, have died after combined operation 4 patients from 118 operated patients. The Conclusion: thereby, brought data evident that such important factors, as frequency of the origin relapse (28%), 5year probability of survival (37,1%), under combined interference and operation of the standard volume in the cancer of the rectum practically the same., H. B. Bobokulov, A. M. Hakimov, and Literatura
The Material of the study has formed 78 sick, found on stationary treatment in Republican Scientific Centre Coloproktologii since 1992 on 2010. As it is seen, from table, from 78 sick mans was 58(74,3%), womans 20(25,7%). 19(24,3), sick were at age from 15 before 20 years, 49(60,2%) at age from 21 before 40 years and 13 (16,6%) sick from 41 before 60 years. The Main complaint sick at arrival were a stubborn constipations, which noted beside 70 (89,7%) sick, including absence of the independent chair existed beside 55(70,5%), but beside 54(69,2%) sick were noted periodic stomachache, growing on measure of the absence of the chair. The Ballooned belly existed beside all 78 (100%) sick moreover beside 20(25,6%) of them flatulence was constant. The Sickness and retching existed beside 24(30,7%), weakness, reduction to capacity to work beside 52(66,6%), increasing of the temperature of the body beside 10(12,8%), paradoxical diarrhoeas beside 6(7,6%) sick. Endoskopicheskiy method (rectoromonoscopy, colonoscopy) turned out to be else less informations 51,8% coincidences of the diagnosis. So we biopsy on Svensonu executed beside all sick, entered with suspicion on disease Girshprunga. In our observations from 78 sick beside 42(53,8,1%) were aboveanalni, beside 20(25,6%) sick rectalis, beside 13(16,6%)rectosigmoideys , beside 2(2,5%) leftside and beside 1(1,2%) sick subtotalis form hipoganglios. At biopsies on Svensonu on observations, from 78 sick, beside 44(56,4%) is revealled hipoganglios, but beside 35(44,8%) аganglios rectum. As can be seen from presented tables, from 78 sick beside 68(87,2%) us is executed onemoments radical operation, 10(12,8%) sick is as far as possible made resection hipoor aganglionarnaya of the zone, decompensate part of the large intestine and is formed colostomy. In all events at operations. The Remote results executed radical operation on cause disease Girshprunga traced from 1 before 10 years beside 57(73%) sick. The Results of the surgical treatment were valued on scale Vezika: good, satisfactory and unsatisfactory. In our observations beside 46(80,7%) sick results came in well, beside 10(17,5%) satisfactory and beside 1(1,8%) sick was an unsatisfactory result., Mirzahmedov M. M., Ahmedov M. A., Sapaev D. A., and Literatura
Few studies concerning the importance of wheat allergy affecting the course of atopic eczema in adolescents and adult patients exist. Aim: The evaluation if wheat allergy can deteriorate the course of atopic eczema. Follow-up of patients with confirmed food allergy to wheat. Method: Altogether 179 persons suffering from atopic eczema were included in the study: 51 men and 128 women entered the study with an average age of 26.2 (s.d. 9.5 years) Dermatological and allergological examinations were performed, including skin prick tests, atopy patch tests, and specific serum IgE for wheat, open exposure test and double-blind, placebo-controlled food challenge test with wheat flour. Results: Wheat allergy affecting the coures of atopic eczema was confirmed in eight patients (4.5%) out of 179 patients enrolled in this study by double-blind, placebo controlled food challenge test. The course of atopic eczema showed a positive trend in patients with confirmed food allergy at 3, 6, 9, 12 month follow-up (statistical evaluation with paired t-test) after the elimination of wheat flour. Conclusion: Wheat allergy may play an important role in the worsening of atopic eczema (acting as a triggering exacerbating factor) only in a minority of adolescents and adult patients (4.5% in our study). The diagnostic methods (skin prick test, specific IgE, atopy patch test, history) cannot be used as separated tests for the determination of food allergy to wheat in patients with atopic eczema.Open exposure tests and double-blind, placebo-controlled food challenge should be used for the confirmation of wheat allergy affecting the course of atopic eczema., Jarmila Čelakovská, Květuše Ettlerová, Karel Ettler, Jaroslava Vaněčková, Josef Bukač, and Literatura 34
Importance: Treatment of hepatocellular carcinoma remains a topical issue of Clinical Oncology. More than 80% of cases hepatocellular carcinoma develops in the presence of liver cirrhosis. These patients are doomed, many clinics they held only symptomatic treatment and life expectancy of patients is not more than 6 months. The main reason for the refusal of surgeons and Chemotherapeutists of treatment is associated cirrhosis. Purpose: To improve results of surgical treatment of liver cancer developed on cirrhosis Materials and methods: We analyzed the immediate results of treatment of 12 patients with hepatocellular carcinoma developed on a background of liver cirrhosis. From the large size of the tumor and associated liver cirrhosis, these patients the first stage of oil produced by hepatic artery chemoembolization of the affected lobe of the liver tumor. After 2 3 weeks performed liver resection. Results: After analyzing the results, we concluded: chemoembolization reduces tumor volume and weight, increases the physiological regeneration of hepatocytes unaffected tumor fraction, improves functional performance of the liver and does not affect the frequency and severity of postoperative complications., Juraev M.D., Nematov O.N., Yusupbekov A.A., and Literatura
Pharmaceutical industry - one of the few areas in which innovations affect all of us, because ultimately have a direct impact on the duration and quality of life for us and our loved ones. In the presence of a strong market and a lack of understanding of the need for innovation is necessary, in our opinion, investing in basic research and facilitate the process of innovation in the pharmaceutical industry by the state and society. For the targeted development of pharmaceutical industry seems appropriate to determine at the state level prospects for the domestic pharmaceutical industry and its role in the international market, and develop a drug "doctrine" of Russia. This paper analyzed the problems of the state associated with the pharmaceutical market in the globalization period. Also investigated the theoretical aspects of the modern study of globalization in the light of the analysis for the global pharmaceutical industry and analyzes the major political and economic factors that have the most significant impact on the production of pharmaceuticals., Natalia Klunko, Reta Marynia, and Literatura
Wound healing is a complex physiological process important for tissue homeostasis. An acute injury initiates massive cell migration, proliferation and differentiation, synthesis of extracellular matrix components, scar formation and remodelling. Blood flow and tissue oxygenation are parts of the complex regulation of healing. Higher organisms utilize molecular oxygen as a terminal oxidant. This way of gaining energy for vital processes such as healing leads to the production of a number of oxygen compounds that may have a defensive or informatory role. They may be harmful when present in high concentrations. Both the lack and the excess of reactive oxygen species may influence healing negatively., Jiří Kanta, and Literatura 6
Aim of investigation: to study immediate and remote results of standard and extended lymphodissection in patients with rectal cancer. Material and methods: 132 patients with rectal cancer were performed radical surgery with lymphodissection in D2 and D3 volume according to a height of tumor location. In immediate postoperated period there were noted complications in 4 patients that made up 3,03%. Observation time was 5 years. Tumor recurrence was reported in 5 patients (3,8%). In remote period metastases were revealed in 8 patients (6,6%). 5year total survival rate was 78,5±4,2% at stage II. 5year total survival rate was 56,4±3,7% at stage III. Comparing the results of standard and extended lymphodissection it was noted statistically authentic increase of 5 year survival rate in patients at stage III. Obtained data allow to come to the conclusion about reasonability of performance of different variants of lymphodissection for patients with rectal cancer at stages II and III., Navruzov S. N., Abdujapparov S. B., Akbarov E. T., Navruzov B. S., Islamov H. D., and Literatura
To improve the results of radiotherapy for cervical cancer used local and systemic radiomodification drugs. Materials and methods: 1984 patients with locally advanced cervical cancer (2b 3a stage), which at one stage of complex treatment by a course indoarterial of regional longterm polychemotherapy (EARDPHT) mode: methotrexate 50 mg/m2, the first 12 hours, fluorouracil 1000 mg/m2, over the next 12 hours and cisplatin 100 mg/m2, for 48 hours, 2 stage surgical treatment in the volume expanding hysterectomy 3 type (modification of Wertheim Meigs). Results: The results of treatment of locally cervical cancer using VADRPHT, depending on the unilateral and bilateral tumor invasion in parametrial tissue showed that under unilateral lesion of parametrium results of treatment were higher than for the bilateral involvement of parametrium. Medical pathomorphosis in tumors of different severity was observed in 86.9% of patients, metastasis to regional lymph nodes were detected in 36% of operated patients, and also studied the degree of therapeutic pathomorphosis in lymph nodes. There was revealed that the complete regression of tumors, 5 year survival rate is 98%, whereas in tumor regression of more than 50% of the original volume 78.5%, with stabilization of tumor no more than 58.4%. Conclusion: The study of molecularbiological parameters of the tumor cells show the effectiveness of conducted neoadvent indoarterial chemotherapy and play an important role in further treatment and prediction of disease., Navruzova V. S., Yuldasheva N. Sh., and Literatura