المؤلفون: R. Novotny, J. Chlupac, T. Marada, V. Borovicka, V. Vik, L. Voska, L. Janousek, Jiri Fronek

المصدر: Journal of Medical Case Reports, Vol 12, Iss 1, Pp 1-6 (2018)

مصطلحات موضوعية: Renal cell carcinoma, Thrombus, Inferior vena cava, Thrombectomy, Nephrectomy, Transperitoneal, Medicine

الوصف: Abstract Background Advanced renal cell carcinoma in some cases causes malignant intravascular thrombus with the potential for growth into the inferior vena cava or even the right atrium. Renal cell carcinoma is accompanied by malignant intravascular thrombus in up to 10% of cases. We present an overview of three patients diagnosed as having renal cell carcinoma with malignant intravascular thrombus requiring radical nephrectomy combined with inferior vena cava thrombectomy. Case presentation Three patients diagnosed as having renal cell carcinoma were indicated for renal cell carcinoma combined with inferior vena cava thrombectomy between 2014 and 2017 at our department: a 69-year-old white Caucasian woman, a 74-year-old white Caucasian woman, and a 58-year-old white Caucasian woman. According to the Novick classification of inferior vena cava tumor thrombus, there was one infrahepatic (level II) and two supradiaphragmatic (level IV) malignant intravascular thrombi. The average age of these patients was 67 years (range 58–74 years). All patients underwent radical nephrectomy combined with inferior vena cava thrombectomy through transabdominal approach. In patients with level IV malignant intravascular thrombus, transesophageal echocardiogram was used to guide the placement of the inferior vena cava cross-clamp above the diaphragm. In one patient the pericardium was opened to place a cross-clamp above a tumor just below the right atrium. There were no postoperative mortalities to date with an average follow-up of 23 months (range 2–48 months). To date, no patient has demonstrated recurrent inferior vena cava malignant intravascular thrombus requiring secondary inferior vena cava thrombectomy or any other treatment. A comparison of estimated blood loss and transfusion rate was not significantly different in all three cases. Conclusion Despite the technical complexity of the procedure, caval thrombectomy combined with radical nephrectomy currently represents the only radical treatment for renal cell carcinoma accompanied by malignant intravascular thrombus with good mid-term oncological outcomes.

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s13256-018-1845-2Test; https://doaj.org/toc/1752-1947Test

الوصول الحر: https://doaj.org/article/fba27bed7f114fed8edf261719424baaTest

المؤلفون: L Voska, P Zdrahal, L Sedlackova, P Stadler, M Prucha, P Sedivy, P Prokopova

المصدر: Clinical and Experimental Immunology

مصطلحات موضوعية: 0301 basic medicine, Male, Pathology, medicine.medical_specialty, Immunology, Plasma Cells, IgG4‐related disease, Pathogenesis, Inflammation/Inflammatory disease, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, Hypergammaglobulinemia, parasitic diseases, medicine, Immunology and Allergy, Humans, skin and connective tissue diseases, Aorta, Aged, Retrospective Studies, IgG4, biology, integumentary system, business.industry, fungi, Original Articles, Middle Aged, medicine.disease, Abdominal aortic aneurysm, 030104 developmental biology, Immunoglobulin G, biology.protein, histopathology, IgG4-related disease, Histopathology, Original Article, Female, diagnostic value, Immunoglobulin G4-Related Disease, Antibody, Vasculitis, business, aortic abdominal aneurysm, 030215 immunology, Aortic Aneurysm, Abdominal

الوصف: Summary The objectives of this study were to evaluate patients with aortic abdominal aneurysm (AAA) with regard to immunoglobulin (Ig)G4-related disease (IgG4-RD). IgG4-RD represents a recently defined condition comprised of a collection of disorders characterized by IgG4 hypergammaglobulinemia, the presence of IgG4-positive plasma cells in organs affected with fibrotic or sclerotizing changes and typical histopathological features. It was identified as a possible cause of vasculitis in large vessels. Studies have been published on a possible association between inflammatory aortic or cardiovascular disease and IgG4-RD. We examined 114 patients with AAA requiring surgery in order to identify findings which are characteristic of IgG4-RD. Aneurysm samples from seven patients showed histopathological features consistent with IgG4-RD and the presence of IgG4+ plasma cells. Only two of these seven patients showed elevated IgG4 serum levels higher 1·35 g/l. In five of the patients, the concentration of serum IgG4 was lower than 1·20 g/l, with the number of IgG4+ plasma cells being higher than 50/high-power field. These findings were consistent with AAA being a heterogeneous group of inflammatory diseases with different pathogenesis.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a13d6ee468bcce8a10fb43eb473f64c0Test
http://europepmc.org/articles/PMC6693967Test

المؤلفون: Robert Novotny, V. Vik, Vladimír Borovička, Jiri Fronek, Jaroslav Chlupac, L. Voska, Libor Janousek, Tomas Marada

المصدر: Journal of Medical Case Reports, Vol 12, Iss 1, Pp 1-6 (2018)
Journal of Medical Case Reports

مصطلحات موضوعية: medicine.medical_specialty, medicine.medical_treatment, 030232 urology & nephrology, lcsh:Medicine, Vena Cava, Inferior, Case Report, Transesophageal echocardiogram, Inferior vena cava, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, Blood loss, Renal cell carcinoma, Abdomen, Humans, Medicine, Pericardium, cardiovascular diseases, Thrombus, Carcinoma, Renal Cell, Aged, Thrombectomy, Venous Thrombosis, medicine.diagnostic_test, business.industry, lcsh:R, Transperitoneal, General Medicine, Middle Aged, medicine.disease, Kidney Neoplasms, Diaphragm (structural system), Treatment Outcome, medicine.anatomical_structure, medicine.vein, 030220 oncology & carcinogenesis, cardiovascular system, Female, Radiology, business, Echocardiography, Transesophageal

الوصف: Background Advanced renal cell carcinoma in some cases causes malignant intravascular thrombus with the potential for growth into the inferior vena cava or even the right atrium. Renal cell carcinoma is accompanied by malignant intravascular thrombus in up to 10% of cases. We present an overview of three patients diagnosed as having renal cell carcinoma with malignant intravascular thrombus requiring radical nephrectomy combined with inferior vena cava thrombectomy. Case presentation Three patients diagnosed as having renal cell carcinoma were indicated for renal cell carcinoma combined with inferior vena cava thrombectomy between 2014 and 2017 at our department: a 69-year-old white Caucasian woman, a 74-year-old white Caucasian woman, and a 58-year-old white Caucasian woman. According to the Novick classification of inferior vena cava tumor thrombus, there was one infrahepatic (level II) and two supradiaphragmatic (level IV) malignant intravascular thrombi. The average age of these patients was 67 years (range 58–74 years). All patients underwent radical nephrectomy combined with inferior vena cava thrombectomy through transabdominal approach. In patients with level IV malignant intravascular thrombus, transesophageal echocardiogram was used to guide the placement of the inferior vena cava cross-clamp above the diaphragm. In one patient the pericardium was opened to place a cross-clamp above a tumor just below the right atrium. There were no postoperative mortalities to date with an average follow-up of 23 months (range 2–48 months). To date, no patient has demonstrated recurrent inferior vena cava malignant intravascular thrombus requiring secondary inferior vena cava thrombectomy or any other treatment. A comparison of estimated blood loss and transfusion rate was not significantly different in all three cases. Conclusion Despite the technical complexity of the procedure, caval thrombectomy combined with radical nephrectomy currently represents the only radical treatment for renal cell carcinoma accompanied by malignant intravascular thrombus with good mid-term oncological outcomes.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::23cde5d1213c2613d5e5e54173f095d4Test
http://link.springer.com/article/10.1186/s13256-018-1845-2Test

المؤلفون: K. Lipar, Nurcan Üçeyler, Jelena Skibova, Frantisek Saudek, P Boucek, A. Lodererova, L Voska, Vondrová H, Claudia Sommer, T. Havrdova

المصدر: American Journal of Transplantation. 16:2196-2201

مصطلحات موضوعية: Graft Rejection, Male, medicine.medical_specialty, Diabetic neuropathy, medicine.medical_treatment, Urology, 030209 endocrinology & metabolism, Nerve fiber, Pancreas transplantation, Kidney Function Tests, 03 medical and health sciences, Vibration perception, Nerve Fibers, Postoperative Complications, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Immunology and Allergy, Diabetic Nephropathies, Pharmacology (medical), Kidney transplantation, Skin, Transplantation, Type 1 diabetes, business.industry, Insulin, Graft Survival, Middle Aged, Prognosis, medicine.disease, Kidney Transplantation, 3. Good health, Diabetes Mellitus, Type 1, Peripheral neuropathy, medicine.anatomical_structure, Endocrinology, Female, Pancreas Transplantation, business, 030217 neurology & neurosurgery, Follow-Up Studies, Glomerular Filtration Rate

الوصف: Whether nerve fiber loss, a prominent feature of advanced diabetic neuropathy, can be reversed by reestablishment of normal glucose control remains questionable. We present 8-year follow-up data on epidermal nerve fiber (ENF) density and neurological function in patients with type 1 diabetes after simultaneous pancreas and kidney transplantation (SPK) with long-term normoglycemia. Distal thigh skin biopsies with ENF counts, vibration perception thresholds (VPTs), autonomic function testing (AFT) and electrophysiological examinations were performed at time of SPK and 2.5 and 8 years after SPK in 12 patients with type 1 diabetes. In comparison to controls, baseline ENF density, VPT and AFT results of patients indicated severe neuropathy. At follow-up, all SPK recipients were insulin independent with excellent glycemic control and kidney graft function; however, the severe ENF depletion present at baseline had not improved, with total ENF absence in 11 patients at 8-year follow-up. Similarly, no amelioration occurred in the VPT and AFT results. Numerical improvement was seen in some electrophysiological parameters; however, statistical significance was achieved only in median motor nerve conduction velocity. ENF loss and functional deficits in advanced diabetic peripheral neuropathy are rarely reversible, even by long-term normoglycemia, which underscores the importance of neuropathy prevention by early optimal glycemic control.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8b2b969ccd32b00580279f07325cdcd5Test
https://doi.org/10.1111/ajt.13715Test

المؤلفون: L. Voska, Přemysl Falt, Julius Spicak, R Andelova, Petr Fojtík, Tomas Hucl, Jan Martinek, O Urban, Pavel Drastich

المصدر: ESGE Days 2018 accepted abstracts.

مصطلحات موضوعية: medicine.medical_specialty, business.industry, medicine, Full thickness resection, business, Surgery

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::6be7488bf572380755c210f018a4febfTest
https://doi.org/10.1055/s-0038-1637336Test

المؤلفون: Terezie Havrdová, Monika Cahova, Claudia Sommer, K. Zacharovova, L Voska, Věra Lánská, Frantisek Saudek, Helena Daňková, Nurcan Üçeyler

المصدر: Journal of Diabetes Research, Vol 2018 (2018)
Journal of Diabetes Research

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Diabetic neuropathy, Article Subject, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Neural Conduction, 030209 endocrinology & metabolism, Pancreas transplantation, lcsh:Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, Vibration perception, Nerve Fibers, 0302 clinical medicine, Endocrinology, Diabetic Neuropathies, Neurotrophic factors, Internal medicine, medicine, Glial cell line-derived neurotrophic factor, Humans, Nerve Growth Factors, ddc:610, Skin, lcsh:RC648-665, biology, business.industry, Middle Aged, medicine.disease, Kidney Transplantation, Nerve Regeneration, Nerve growth factor, Peripheral neuropathy, biology.protein, Female, Pancreas Transplantation, business, 030217 neurology & neurosurgery, Research Article, Neurotrophin

الوصف: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes with potential severe consequences. Its pathogenesis involves hyperglycemia-linked mechanisms, which may include changes in the expression of neurotrophic growth factors. We analyzed the expression of 29 factors potentially related to nerve degeneration and regeneration in skin biopsies from 13 type 1 diabetic pancreas and kidney recipients with severe DPN including severe depletion of intraepidermal nerve fibers (IENF) in lower limb skin biopsies (group Tx1 1st examination). The investigation was repeated after a median 28-month period of normoglycemia achieved by pancreas transplantation (group Tx1 2nd examination). The same tests were performed in 13 stable normoglycemic pancreas and kidney recipients 6–12 years posttransplantation (group Tx2), in 12 matched healthy controls (group HC), and in 12 type 1 diabetic subjects without severe DPN (group DM). Compared to DM and HC groups, we found a significantly higher (p < 0.05–0.001) expression of NGF (nerve growth factor), NGFR (NGF receptor), NTRK1 (neurotrophic receptor tyrosine kinase 1), GDNF (glial cell-derived neurotrophic factor), GFRA1 (GDNF family receptor alpha 1), and GFAP (glial fibrillary acidic protein) in both transplant groups (Tx1 and Tx2). Enhanced expression of these factors was not normalized following the median 28-month period of normoglycemia (Tx1 2nd examination) and negatively correlated with IENF density and with electrophysiological indices of DPN (vibration perception threshold, electromyography, and autonomic tests). In contrast to our expectation, the expression of most of 29 selected factors related to neural regeneration was comparable in subjects with severe peripheral nerve fiber depletion and healthy controls and the expression of six factors was significantly upregulated. These findings may be important for better understanding the pathophysiology of nerve regeneration and for the development of intervention strategies.

وصف الملف: application/pdf; text/xhtml

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9cb9ac46f6edc45caf7ce7524e18fbb7Test
https://opus.bibliothek.uni-wuerzburg.de/files/22746/preserved_expression.pdfTest

المؤلفون: M Benes, V. Lanska, Julius Spicak, M. Vasicek, Jan Martinek, Tomas Hucl, V. Nosek, L. Voska, P. Brandtl

المصدر: Endoscopy. 40:711-716

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Comorbidity, Adenocarcinoma, Risk Assessment, Gastroenterology, Helicobacter Infections, Cohort Studies, Barrett Esophagus, Internal medicine, medicine, Humans, Prospective Studies, Esophagus, Low Grade Intraepithelial Neoplasia, Aged, Aged, 80 and over, Intraepithelial neoplasia, Helicobacter pylori, Esophageal disease, business.industry, Incidence, Intestinal metaplasia, Endoscopy, Middle Aged, medicine.disease, digestive system diseases, Hernia, Hiatal, medicine.anatomical_structure, Barrett's esophagus, High Grade Intraepithelial Neoplasia, Female, business, Carcinoma in Situ

الوصف: BACKGROUND AND STUDY AIMS: Barrett’s esophagus is a premalignant condition. The risk of developing high grade intraepithelial neoplasia (HGIN) or adenocarcinoma is currently a matter of debate. Due to several shortcomings, previous studies have probably overestimated the risk. The main aim of our study was to investigate the incidence of HGD and adenocarcinoma in a cohort of patients with Barrett’s esophagus. PATIENTS AND METHODS: In a prospective, cohort study, all patients had intestinal metaplasia and macroscopic evidence of short- or long-segment (< 3 cm or ≥ 3cm) Barrett’s esophagus. All patients underwent a standard protocol including regular endoscopies with biopsies and were treated with a proton pump inhibitor or antireflux surgery. RESULTS: A total of 135 patients underwent 623 endoscopies during 700 patient-years (mean follow-up 5.2 ± 2.3 years). Simultaneous HGIN and adenocarcinoma were detected in two patients with long-segment Barrett’s esophagus (1.5 %; 2 and 6 years after the index endoscopy). Low grade intraepithelial neoplasia (LGIN) was detected in 25 patients (18.5 %); in 11 of these patients (44 %), LGIN was not confirmed in later biopsies. Our study shows an incidence of HGIN/adenocarcinoma of 1/350 patient-years. Endoscopic regression of Barrett’s esophagus was seen in 20.7 % of patients. CONCLUSION: The incidence of HGIN/adenocarcinoma is low in patients with adequately treated Barrett’s esophagus. The annual risk of developing HGIN/adenocarcinoma is 0.21 % (1.6 % in long-segment Barrett’s esophagus).

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::76493e81ceec28ff3a0b6c4d82a28b4bTest
https://doi.org/10.1055/s-2008-1077502Test

المؤلفون: N. Pilecká, Jan Kučera, V. Foltýnová, L. Voska, M. Rakovič, C. Povýšil

المصدر: Journal of Radioanalytical and Nuclear Chemistry Letters. 201:477-480

مصطلحات موضوعية: Bone mineral, Health, Toxicology and Mutagenesis, Sodium, Radiochemistry, Public Health, Environmental and Occupational Health, chemistry.chemical_element, Soft tissue, Yellow marrow, Pollution, Analytical Chemistry, Crystallography, Undecalcified bone, Nuclear Energy and Engineering, chemistry, Compact bone, Red Marrow, Radiology, Nuclear Medicine and imaging, Neutron activation analysis, Spectroscopy

الوصف: Sodium was determined by the use of instrumental neutron activation analysis in sections of compact bone, red marrow and yellow marrow to check possible effects of shoft tissues in the bone when determining the Na/Ca ratio in sections of the undecalcified bone tissue. The results indicated that this ratio actually reflects the sodium content in the bone mineral, the contribution from the soft tissues being two orders of magnitude lower.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::624162c7fd1b87eab83580a24a3ca6ccTest
https://doi.org/10.1007/bf02162725Test

المؤلفون: M. Rodova, Antonij Slavcev, Ivan Málek, T. Gazdic, L. Voska, Jan Pirk, Věra Lánská

المصدر: The Journal of Heart and Lung Transplantation. 35:S203

مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Heart transplantation, Transplantation, biology, business.industry, medicine.medical_treatment, Human leukocyte antigen, Predictive value, Immunology, biology.protein, Medicine, Surgery, Antibody, Cardiology and Cardiovascular Medicine, business

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::460b19f9eb585e3e9f3a87ad91fa09f0Test
https://doi.org/10.1016/j.healun.2016.01.569Test

المؤلفون: T Jedináková, R. Koznarova, Milos Adamec, L Voska, P Boucek, Frantisek Saudek

المصدر: Transplantation Proceedings. 33:2304-2306

مصطلحات موضوعية: Adult, Graft Rejection, Male, medicine.medical_specialty, Time Factors, Urinary system, Urology, Azathioprine, Disease-Free Survival, medicine, Humans, Diabetic Nephropathies, Lymphocyte Count, Adverse effect, Kidney transplantation, Antilymphocyte Serum, Retrospective Studies, Transplantation, Kidney, Platelet Count, business.industry, Graft Survival, medicine.disease, Kidney Transplantation, Tacrolimus, Surgery, Histocompatibility, Survival Rate, Diabetes Mellitus, Type 1, surgical procedures, operative, medicine.anatomical_structure, Injections, Intravenous, Kidney Failure, Chronic, Female, Pancreas Transplantation, business, medicine.drug

الوصف: IN PANCREAS and kidney transplantation, intensive induction therapy is mandatory because of the difficulty in performing rejection diagnosis; the frequent low histocompatibility between the donor and recipient; and, when combined with kidney transplantation, large transplanted tissue mass. According to the International Pancreas Transplant Registry, polyclonal or monoclonal antibody induction therapy has therefore been used in 75% of simultaneous transplants performed in the USA from 1994 to 1998. Antibody therapy, however, can cause considerable side effects, is expensive, and may prolong hospitalization. The introduction of new and more potent immunosuppressive drugs such as tacrolimus and mycophenolate mofetil (MMF) has brought about the question of whether antibody therapy is still necessary. Certain compromise could represent acceptable short-term, yet intensive anti–T-lymphocyte therapy initiated just before graft exposure to the allogeneic milieu. In kidney transplantation, triple-drug therapy, together with intraoperative T-cell depletion, has proven to be superior to triple-drug therapy without T-cell depletion in terms of long-term patient and graft survival and, in combination with tacrolimus and MMF, was shown to be equivalent to 10-day ATG therapy with azathioprine and cyclosporine in combined pancreas and kidney transplantation. The aim of the present study was to evaluate the incidence of rejection and adverse events as well as the possibility of early withdrawal of steroids in a series of consecutive pancreas and kidney transplantations (n 5 24).

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::49c2ddb9ef3b97dd687feedf57f72df6Test
https://doi.org/10.1016/s0041-1345Test(01)02000-0