Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Bratisl Lek Listy [journal]
- The proteome differences - new trend of placenta examination. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2013; 114(11):669.
- Alterations in paraoxonase-1 activity. [JOURNAL ARTICLE]
- Bratisl Lek Listy 2013; 114(11):668.
- The recurrent primary retroperitoneal liposarcoma. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):662-7.
Aim:Describe a patient with multiple recurrences of the primary recurrent liposarcoma.Clinical case: A 60-years-old man complained of weight loss (BMI 18.4) with a palpable huge retroperitoneal tumour, which displaced left kidney, and was confirmed on USG and CT. Laboratory examination showed anaemia and pathological blood tests. Chest X-ray initially showed a negative finding. A complete transperitonealy surgical extirpation of the tumour with left side nephrectomy was performed on June 28, 2007. The tumour mass weight was 1900 g. It was lying on the posterior face of the kidney in diameters 170x120x120 mm, completely capsulated by thin grey-pink capsula with peripheral fat tissue on the section grey-pink, lobulary shaped, in ¾ parts with central necrotic changes. Histopathologically was confirmed the primary dedifferentiated (non-lipogenous) liposarcoma low grade of malignancy. Nephrectomy specimen was confirmed as age related finding. There was no evidence of positives surgical margins. Despite oncological and surgical treatment, followed repeated recurrence with eight transperitoneal surgeries in the retroperitoneum and abdomen with extirpation of the metastases, left side hemicolectomy, splenectomy and repeated extirpation tumour metastases from abdomen and radix mesenterii. Last tumour weighed 2900 grams. Patient died on January 9, 2011, after the eight surgeries on multiorgans failure due to hemorrhagic shock and persistent atrial fibrilaton by cardiopulmonary insufficiency. As a speciality, he was treated without transfusion because as Jehovah´s witness he refused blood derivates.
Conclusion:Despite complex surgical and oncological treatment, the prognosis in patient with recurrent liposarcoma was fatal (Tab. 1, Fig. 5, Ref. 50). Keywords: primary retroperitoneal liposarcoma, recurrence, surgery, chemotherapy.
- Surgical treatment of nervus pudendus. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):657-61.
An objective of our work was to clarify variations in pudendal nerve formation, as well as their possible impact on the clinical picture.Bilateral pudendal nerve course and formation was studied on 20 adult cadavers. Anterior approach was used in 15 of them, both posterior and anterior approaches were used in five of them. The prefixed type plexus formation was observed in eight cases (40 %). In these cases S1, S2 roots contributed to the formation of the pudendal nerve. In the postfixed type particularly the S3 root was dominant in two cases (66.7 %), and less the S4 root in one case (23.3 %) from three cases. Mostly the S2 root participated in its formation in 17 cases (85 %). The pudendal nerve branches run below the sacrospinous ligament on the level of the sacrospinous and sacrotuberous ligaments. The changes of the nerve and the branching therof were most evident from the anterior access below the sacrospinous ligament and in front of the sacrotuberous ligament. The inferior rectal nerve penetrating the sacrospinous ligament was seen in one case, it has risen from the pudendal nerve before entering the pudendal canal in four cases. The dorsal nerve of the penis has risen from the S1 root in two cases (10 %). We observed its branching before entering the pudendal canal in 15 cases (75 %). It has divided in the pudendal canal in other cases. This description may be useful particularly for the pudendal nerve block and the nerve saving surgeries directed on the relevant region (Fig. 8, Ref. 24). Keywords: pudendal nerve, sacral plexus, sacrospinous ligament, sacrotuberous ligament.
- Primary obstructed megaureter (POM) in children. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):650-6.
The aim of this study was to analyze the results of surgical and conservative treatment of non-refluxing POM. In the period 2000-2009, 45 children (52 ureters) were treated, the average age was 5.8 months (±10.33), 24 children (26 ureters) by surgery (I) and 21 children (26 ureters) by conservative means (II). The average follow-up period was 73.8 (±32.91) and 30.85 months (±23.1) resp. Urine examination, USG, DTPA99mTc, biochemical testing, micturating cystouretography in all patients were performed. Significant difference was present in the occurrence of hydronephrosis of 0th, 3rd and 4th grade, p10 mm, p<0.01; and in the occurrence of normal and prolonged time T ½, p<0.01. The health condition was adjusted in 13 (54.20 %), improved on DTPA99mTc in 5 (20.85 %), non-improved in 3 (12.50 %), deteriorated in 1 (4.15 %) and unknown in 2 (8.3 %) patients. In the IInd group a significant difference was in case of occurrence of hydronephrosis of 0th, 2nd and 3rd grade, (p<0.01, or p=0.037 and p=0.011) and in occurrence of normal ureter, with ureter 0-5 mm and dilated ureter 5-10 mm, p<0.01. The condition at the end of the follow-up period was assessed DTPA99mTc as adjusted in 11 (52.39 %) patients, improved in 6 (28.57 %), unimproved in 3 (14.28 %) and no patient was assessed as having deteriorated and unknown in 1 (4.76 %).
Conclusion:In patients with an impaired separate kidney function, early surgical treatment helps to minimize damage to the kidney function and prevents future complications (Tab. 6, Fig. 3, Ref. 32). Keywords: primary obstructed megaureter, cystouretography, hydronephrosis, kidney function, normal ureter.
- A comparison of Ki 67 proliferative index in primary tumor and axillary metastatic lymph nodes with length of survival in patients with breast cancer. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):645-9.
Objective:The aim of the present study was to investigate the possibility to predict the histopathological features of breast and metastatic lymph nodes and survey and prognosis of patients and likelihood of being a predictive factor for treatment by using Ki67 immunohistochemical stain. Materials and methods: 95 patients who were admitted to Uludag University Medical Faculty, Department of General Surgery with a diagnosis of stage II-III breast cancer between dates May 1997 and December 2002 were retrospectively evaluated with respect to breast cancer related prognostic factors treatments and last-control related data. Ki67 immunohistochemical staining was performed to appropriate specimens using Streptavidin-biotin technique. Ki67 was reported as the proliferation index, and the number of stained nuclei were stated to be / 1000.
Results:In the evaluation of the lymph node by univariate analysis, we ascertained that duration of survival is shorter above the 227 cut-off value for Ki67 proliferative index. Length of survival of patients with tumor Ki67 proliferative index below 141 and with no distant metastasis was established to be better. Ki67 proliferative index in the lymph node was detected to increase more with increasing histological and nuclear grade, estrogen and progesterone receptor negativity and at stage III.
Conclusion:Since numerous factors are effective on breast cancer, each patient and tumor behaves differently. A lot of prognostic factors are taken into account while treatment choice is determined. We may have information on the biological behavior of the tumor in patients who underwent sentinel lymph node biopsy or axillary dissection in staining with Ki67 pattern (Tab. 5, Fig. 3, Ref. 13). Keywords: breast cancer, prognostic factor, Ki67.
- Complete scrotal urinary bladder hernia with both ureters and small intestine presenting as dysuria, bilateral ureterohydronephrosis, and acute renal insufficiency. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):642-4.
We report a case of a complete scrotal bladder hernia with both ureters presenting as dysuria, bilateral ureterohydronephrosis, and acute renal insufficiency. A 37-year-old man with a recurrent large scrotal mass after two surgeries, suffering with small urinary symptoms as a dysuria and nocturia, was examined before the third surgery on an outpatient basis. Urological examination revealed a negative urine, bilateral large ureterohydronephrosis on USG, and serum creatinine 231-250 µmol/l. CT displayed the urinary bladder completely herniated into the scrotum with distal parts of both ureters and small intestine, and bilateral large ureterohydronephrosis. After admission to urological department on retrograde cystography a completely herniation of the urinary bladder with residual urine more than 250 ml was confirmed. A permanent catheter was indwelled. The hernia was explored with urinary bladder repositioning. Because bilateral ureteral obstruction on USG did not retreat, a bilateral percutaneous nephrostomy was done. The patient´s serum creatinine markedly improved, also hernia and ureterohydronephrosis was repaired with normally moisten without residual urine (Fig. 2, Ref. 26) Keywords: scrotal hernia, urinary bladder, ureterohydronephrosis, acute renal insufficiency.
- Normalization of blood lactate as early end-point of polytrauma treatment. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):637-41.
Background:The main aim of the early treatment of polytrauma is recovery of patient's physiological functions. The early achievement of therapeutic goals, mainly adequate tissue perfusion and repayment of oxygen debt, are postulated. The aim of the study was to confirm whether blood lactate level as a quantifier of oxygen deficit, as well as normalization of blood lactate level within the first 24 hours, have an impact on the mortality and morbidity of seriously injured patients.
Methods:Sixty-nine mechanically ventilated patients with a severe trauma and organ dysfunction defined according to SOFA score and ISS >17, age >15 years, were enrolled into this retrospective study. 8 patients died within first 24 hours, 8 patients did not reach serum lactate level above 2 mmol/l on admission to hospital. The hypothesis that normalization of serum lactate level within 24 hours is related to lower mortality and morbidity, was assessed. Reduced mortality and morbidity were represented by lower severity of multi-organ dysfunction, the highest SOFA score during hospitalization, lower incidence of sepsis, number of days in ICU and artificial ventilation.
Results:The association between severity of multi-organ failure (p=0.0006), mortality (p=0.0022) and repayment of oxygen debt was confirmed. Hypothesis of sepsis incidence was not confirmed (p=0.34). The association between number of days on artificial ventilation and number of days in ICU to repayment of oxygen debt was not confirmed either. Multivariate significant factors were age, GCS, ISS and SOFA score on patient's admission.
Conclusion:The patients, who repaid oxygen debt within first 24 hours, have lower morbidity and mortality (Tab. 6, Ref. 19). Full Text in PDF www.elis.sk. Keywords: polytrauma, lactate, MOF, SOFA score.
- Flow-mediated vasodilatation in the patients with anorexia nervosa. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):634-6.
Objective:To compare flow-mediated vasodilatation in patients with anorexia nervosa and healthy subjects.
Background:Endothelial dysfunction is present in the patients with anorexia nervosa. However, flow-mediated vasodilatation in the patients with anorexia nervosa in comparison with control subjects has not been yet evaluated.
Methods:Flow-mediated vasodilatation in the brachial artery was examined in 30 patients with anorexia nervosa admitted to metabolic care unit for realimentation and compared to 30 control subjects.
Results:The average age of the patients with mental anorexia was 25.0±5.2 compared to 25.5±4.5 years of the healthy control subjects (NS). BMI was in 14.0±1.7 kg/m2 in patients with anorexia nervosa comparing to 20.4±1.0 kg/m2 in the healthy control subjects (p<0.001). The baseline mean diameter of the right brachial artery was 0.33±0.06 cm in the anorexia nervosa patients and 0.35±0.05 cm in the control subjects (NS). The absolute increase of brachial artery size after reactive hyperemia was 0.029±0.006 cm (9%) in the anorexia nervosa patients and 0.039±0.006 cm (11 %) in the control subjects (p=0.002). After realimentation, the baseline mean diameter of the right brachial artery was comparable to the result before nutrition intervention - 0.34±0.05 cm but brachial artery increase due to reactive hyperemia was 0.036±0.05 cm (10.5 %). It was for 19 % higher compared to the first examination (p<0.001).
Conclusion:Flow-mediated vasodilatation is decreased in the patients with anorexia nervosa in comparison with the healthy control subjects and improves after realimentation (Tab. 1, Ref. 20). Keywords: anorexia nervosa, flow-mediated vasodilatation, realimentation.
- Blood pressure impact on left ventricular geometry in chronic haemodialysis patients. [Journal Article]
- Bratisl Lek Listy 2013; 114(11):629-33.