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Biomedical subjects

J Malina

Publications and source records attributed to J Malina.

At least 19 recordsLinked to original sources
PubMed2005

["Mixed" and "miscellaneous" vulvovaginitis: diagnostics and therapy of vaginal administration of nystatin and nifuratel].

AIM OF THE STUDY: The evaluation of combined and miscellaneous vulvovaginal infections incidence and their treatment with combined vaginal products containing nifuratel and nystatin. DESIGN: Prospective study. SETTING: Gynecologic outpatient department LEVRET, Prague; Laboratories of Microbiology AescuLab, Prague. METHODS: 70 consecutive patients were examined with complaint of vaginal fluor and/or pruritus. We established macroscopic features of fluor, pH, amine test and mounts stained with Giemsa and Gram. We qualified the cases with more diagnostic criteria (mycosis, lactobacillosis, anaerobic vaginosis, aerobic vaginitis) as combined infection, those with no diagnostic criteria as miscellaneous. We treated all patients with vaginal tablets nystatin + nifuratel (Macmiror complex). We prescribed clotrimazol cream, if pruritus was present. We evaluated withdrawals of symptoms and relapses during 3 months after treatment. RESULTS: Combined infection was found in 21 patients from 70 (30%). The most frequent combination was that of mycosis and aerobic vaginitis (13/70, 18.6%) or mycosis and anaerobic vaginosis (4/70, 5.7%); 11 patients fulfilled criteria of no diagnosis. We concluded them as "miscelaneous". The treatment was successful in all cases, 10 women relapsed in 3 months. CONCLUSIONS: Combined vaginal infection findings are present very often (30%), likewise miscellaneous ones (15%) occur. The treatment of these women in successful with vaginal tablets with nystatin + nifuratel.

Administration, Intravaginal↗
PubMed2003

[Treatment of aerobic vaginitis and clinically uncertain causes of vulvovaginal discomfort].

OBJECTIVE: The treatment of clinically uncertain conditions of vaginal discomforts with a mixed preparation of nifuratel + nystatin (Macmiror complex) and the relation of uncertain conditions to aerobic vaginitis. DESIGN: A prospective study. SETTING: Gynecology-Obstetrics Outpatient Department LEVRET Ltd., AescuLab Ltd., Laboratory of Microbiology, Prague. METHODS: 50 women with vaginal discomfort, causes of which had not been clarified by gynecological examination, determination of pH and the amine test, were examined by vaginal smears using microscopy. The results were evaluated in relation to aerobic vaginitis in a pure form or in combination with other nosological units. The authors also evaluated results of therapy by oral nifuratel (Macmiror tbl) 3 x 200 mg daily and a vaginal combined preparation containing nifuratel 500 mg + nystatin 200 kIU (Macmiror complex 500 glo vag) for the period of 7 days. RESULTS: In 50 women candida was demonstrated 24 times, presence of key cells 11 times, lactobacillus nine times with more than 50 in the field, six women were affected by aerobic vaginitis. In all these cases the pH was 4.8 or higher, leukocytes were significantly represented in all cases (> 15 in the field), as well as gram-negative bacteria and/or cocci (> 30 in the field), indicating a combined picture of mycosis, anaerobic vaginosis or lactobacillosis with aerobic vaginitis. The therapy was successful in all cases, the relapse of complaints during one month occurred in three cases. CONCLUSIONS: Aerobic vaginitis in a pure form or with anaerobic vaginosis, mycosis or lactobacillosis is frequently concealed under clinically uncertain pictures of vulvo-vaginal discomfort. The therapy by a combination of nifurated 3 x 200 mg orally together with the combined vaginal preparation nifuratel 500 mg + nystatin 200 kIU for the period of 7 days exerts high effect and a low number of relapses.

Female↗
PubMed2001

Increased incidence of small and well-differentiated breast tumours in post-menopausal women following hormone-replacement therapy.

Exposure to hormone-replacement therapy (HRT) has consistently been associated with an increased incidence of breast cancer, particularly of small tumours. Other tumour characteristics in relation to HRT have received less scientific attention. Our aim in this population-based prospective cohort study was to assess whether HRT is associated with an increased incidence of breast-cancer subgroups defined in terms of stage, type (according to the WHO system), Nottingham grade and the Nottingham Prognostic Index (NPI). Evaluation was based on a cohort of 5,865 post-menopausal women followed for an average of 9.8 years. Twenty percent of women reported current use of HRT at the time of the baseline interview. Record linkage with the Swedish Cancer Registry and local clinical registries identified 141 incident invasive breast-cancer cases. All tumours were reclassified by 1 pathologist. The incidence of breast cancer in HRT users was 377/10(5) and in non-users 221/10(5) person-years [relative risk (RR) = 1.72, 95% confidence interval (CI) 1.17-2.52]. This risk remained statistically significant after adjustment for established risk factors in a Cox proportional hazards analysis (RR = 1.66, 95% CI 1.12-2.45). Among HRT users, there was over-representation of cases with stage I tumours (adjusted RR = 2.33, 95% CI 1.44-3.76), of lobular carcinomas (RR = 4.38, 95% CI 1.60-12.0) and of tubular tumours (RR = 4.81, 95% CI 1.37-16.8). Nottingham grade I/II carcinomas (RR = 2.02, 95% CI 1.29-3.16) and cases with NPI < or = 3.4 (RR = 2.29, 95% CI 1.41-3.72) were similarly over-represented among HRT users. Incidence of breast cancer was increased in post-menopausal women who used HRT at baseline. Among HRT users, there was over-representation of tumours that, with regard to stage, type and grade, are associated with a favourable prognosis.

Age Factors↗
PubMed2001

Smoking associated with hormone receptor negative breast cancer.

Women who smoke have less favourable prognosis following breast-cancer diagnosis. Some studies suggest that this is due to a more advanced stage at diagnosis, on average. Our present aim was to assess whether smoking is associated with other prognostic markers as well, e.g., hormone receptor status, histopathology and tumour differentiation. The evaluation was based on 268 incident cases in a cohort of 10,902 women (35% smokers) followed for an average of 12.4 years. An immunohistochemical method on recuts of tumour tissue was used to assess hormone receptor status. One pathologist classified all tumours according to the WHO system, Nottingham grade and Nottingham Prognostic Index. The relative risk (RR) of oestrogen receptor-negative tumours was, for current smokers, 2.21 [95% confidence interval (CI) 1.23-3.96] and, for ex-smokers, 2.67 (95% CI 1.41-5.06) compared to never-smokers. Ex-smokers had an increased risk of progesterone receptor-negative tumours (RR = 1.61, 95% CI 1.07-2.41), but there were no other significant associations between smoking habits and oestrogen receptor-positive or progesterone receptor-positive or -negative tumours. The incidence of Nottingham grade III tumours was higher in ex-smokers than in never-smokers (RR = 2.03, 95% CI 1.17-3.54). In terms of histopathological type or Nottingham Prognostic Index, there were no significant differences between smoking groups. We conclude that smoking is associated with an increased occurrence of hormone receptor-negative tumours.

Age Factors↗
PubMed2001

Biophysical analysis of natural, double-helical DNA modified by anticancer heterocyclic complexes of ruthenium(III) in cell-free media.

Modifications of natural DNA by three anticancer heterocyclic ruthenium(III) compounds were studied by methods of molecular biophysics. These methods included DNA binding studies using atomic absorption spectrophotometry, inhibition of restriction endonucleases, mapping of DNA adducts by transcription assay, interstrand cross-linking employing gel electrophoresis under denaturing conditions, DNA unwinding studied by gel electrophoresis, circular dichroism analysis of the B-->Z transition in DNA, and DNA melting curves measured by absorption spectrophotometry. The results indicate that the complexes HIm[trans-Cl4Im2RuIII], HInd[trans-Cl4Ind2RuIII], and Na[trans-Cl4Im(Me2SO)RuIII] (Im and Ind stand for imidazole and indazole, respectively) coordinate irreversibly to DNA. Their DNA binding mode is, however, different from that of cisplatin. Interestingly, Na[trans-Cl4Im(Me2SO)RuIII] binds to DNA considerably faster than the other two ruthenium compounds and cisplatin. In addition, when Na[trans-Cl4Im(Me2SO)RuIII] binds to DNA it exhibits an enhanced base sequence specificity in comparison with the other two ruthenium complexes. Na[trans-Cl4Im(Me2SO)RuIII] also forms bifunctional intrastrand adducts on double-helical DNA which are capable of terminating RNA synthesis in vitro, while the capability of the other two ruthenium compounds to form such adducts is markedly lower. This observation has been interpreted to mean that the bifunctional adducts of HInd[trans-Cl4Ind2RuIII] and Na[trans-Cl4Im2RuIII] formed on rigid double-helical DNA are sterically more crowded by their octahedral geometry than those of Na[trans-Cl4Im(Me2SO)RuIII]. In addition, the adducts of all three ruthenium compounds affect the conformation of DNA, Na[trans-Cl4Im(Me2SO)RuIII] being most effective. It has been suggested that the altered DNA binding mode of ruthenium compounds in comparison with cisplatin might be an important factor responsible for the altered cytostatic activity of this class of ruthenium compounds in tumor cells.

Antineoplastic Agents↗
PubMed2001

Breast cancer incidence in ex-smokers in relation to body mass index, weight gain and blood lipid levels.

According to several studies breast cancer is more common among former smokers. This study explores whether this association has any relationship with anthropometric measurements or blood lipid levels. The 2082 ex-smokers (mean age 49.9 years) in the Malmö Preventive Cohort were followed for an average of 13.3 years using official cancer registries. This yielded 93 incident breast cancer cases. Oestrogen receptor (ER) status was assessed by an immunological method. Incidence of breast cancer covaried with height, body mass index, weight gain and cholesterol levels. None of these associations reached statistical significance. Incidence of breast cancer increased over quartiles of serum triglycerides, Ptrend: 0.02, relative risk (RR) for triglycerides as a continuous variable: 1.46 (1.21-1.77). Nineteen tumours were ER negative; this subgroup was similarly related to high triglycerides, 1.76 (1.40-2.21). All results were similar when BMI and cholesterol levels were entered into the model. It is concluded that breast cancer incidence covaries with triglyceride levels in ex-smokers.

Adult↗
PubMed2001

[Unusual treatment of late complications of acute pancreatitis].

AIM OF THE STUDY: To present the case of 28 years old man operated on acutely for gastric bleeding. Pancreatic pseudocyst and portal hypertension was diagnosed intraoperatively. METHODS: For this reason the Jurasz procedure (pseudocystogastrostomy) was performed. In emergency reoperation for recurrent bleeding total gastrectomy had to be performed. The situation was solved by creating the oesophago-jejunostomy and pseudocystojejunostomy on the Roux-Y limb as a single anastomosis. RESULTS: Postoperative course was uneventful. After 5 years time the patient was readmitted for secondary malabsorbtive syndrome. The conservative treatment was used successfully. CONCLUSION: Unusual solving of above mentioned complication was successful in this case. The follow up and substitutive treatment is necessary following the total gastrectomy.

Acute Disease↗
PubMed2000

DNA interactions of antitumor cisplatin analogs containing enantiomeric amine ligands.

Modifications of natural DNA and synthetic oligodeoxyribonucleotide duplexes in a cell-free medium by analogs of antitumor cisplatin containing enantiomeric amine ligands, such as cis-[PtCl(2)(RR-DAB)] and cis-[PtCl(2)(SS-DAB)] (DAB = 2,3-diaminobutane), were studied by various methods of molecular biophysics and biophysical chemistry. These methods include DNA binding studies by pulse polarography and atomic absorption spectrophotometry, mapping of DNA adducts using transcription assay, interstrand cross-linking assay using gel electrophoresis under denaturing conditions, differential scanning calorimetry, chemical probing, and bending and unwinding studies of the duplexes containing single, site-specific cross-link. The major differences resulting from the modification of DNA by the two enantiomers are the thermodynamical destabilization and conformational distortions induced in DNA by the 1,2-d(GpG) intrastrand cross-link. It has been suggested that these differences are associated with a different biological activity of the two enantiomers observed previously. In addition, the results of the present work are also consistent with the view that formation of hydrogen bonds between the carbonyl oxygen of the guanine residues and the "quasi equatorial" hydrogen of the cis amine in the 1, 2-d(GpG) intrastrand cross-link plays an important role in determining the character of the distortion induced in DNA by this lesion.

Amines↗
PubMed2000

Breast cancer incidence in relation to smoking cessation.

High plasma levels of oestrogens are associated with increased breast cancer risk. If smoking, as has been suggested, have both a tumour initiating mutagenic effect and a protective anti-oestrogenic effect, one would assume that smokers who give up smoking have the highest incidence of breast cancer. This was evaluated in the follow-up of a cohort of 10,902 women of whom 4,359 were premenopausal. Record-linkage with official cancer registries yielded 416 incident cases during an average follow-up of 13.6 years. The adjusted relative risk in all ex-smokers was 1.31 (1.02-1.69), as compared to never smokers, and in premenopausal ex-smokers it was 1.57 (1.07-2.30). Breast cancer incidence in premenopausal ex-smokers was inversely related to time since cessation, (p for trend = 0.01), and was highest among the women who had given-up smoking less than 12 months before screening: 2.76 (1.55-4.91). There was no significant association between current smoking and breast cancer risk. We conclude that incidence of breast cancer in premenopausal women who have given up smoking is higher than it is in smokers and never smokers. To what extent this may be related to endocrine effects associated with smoking cessation remains to be evaluated.

Adult↗
PubMed2000

Endovascular healing is inadequate for fixation of Dacron stent-grafts in human aortoiliac vessels.

BACKGROUND: migration and kinking of stent-grafts can occur late after endovascular aneurysm repair. It is unknown if endovascular grafts incorporate enough to be permanently anchored. In this report, healing of aortic stent-grafts was assessed in humans. PATIENTS AND METHODS: we retrieved 23 Dacron stent-grafts from patients treated for an aortic aneurysm since 1993. Twelve stent-grafts were explanted at late conversion to open repair and 11 at autopsy. The deaths were unrelated to graft fixation. The median age of the patients was 74 years (IQR 55-84 years) and the grafts were explanted 9 months (1-31 months) after insertion. Microscopic slides were prepared by conventional techniques or by cutting and grinding arterial specimens embedded in plastic with the stent-grafts in situ. RESULTS: the stent-grafts detached readily from the native arteries at surgery or autopsy, except when the stents had hooks or barbs which engaged the vessel wall. A space filled with poorly organised blood components persisted between the graft and the aortic wall 2.5 years after implantation. No firm incorporation of the grafts was observed proximally in the aneurysm neck or distally in the iliac segment. A friable neo-intimal layer covered parts of the luminal aspect of the grafts. CONCLUSIONS: endovascular healing provides poor fixation of Dacron stent-grafts in humans. At present, fixation relies on the mechanical properties of the stent-grafts.

Aged↗
PubMed2000

The impact of stent design on proximal stent-graft fixation in the abdominal aorta: an experimental study.

OBJECTIVE: to study the proximal fixation of different aortic stent grafts in comparison to a hand-sewn anastomosis. DESIGN: experimental study. MATERIAL: the infrarenal aorta of 16 human cadavers were exposed, left in situ and transected 3 cm above the aortic bifurcation to mimic an infrarenal aortic neck. Stent grafts were deployed through a sheath 5 cm into the aorta. Ancure, Talent, Vanguard, Zenith and a Palmaz based stent graft were assessed. In addition a polyester graft was anastomosed to the aorta by running sutures. Distal force was applied to the grafts in increments of 0.5 Newton until the stent grafts were completely dislodged from the aorta. The displacement force (DF) was thereby determined. RESULTS: a force of 150 N (140-160) applied to the hand-sewn graft resulted in tearing of the aorta, without breakage of the sutures. The median displacement force was for Talent 4.5 N (1.3-5.5), Vanguard 9.0 N (3. 5-12), Ancure 12.5 N (12-14), Zenith 24 N (23-26.5) and Palmaz 25 N (17-25). Ballooning the stent after deployment improved fixation in some cases. CONCLUSIONS: a sutured anastomosis fixates a graft better than any stent design tested. Hooks and barbs improve the fixation of self-expandable stents. Balloon dilatation of the proximal stent after deployment might increase fixation further. Balloon expandable stents seem to provide good fixation without the use of hooks and barbs.

Aged↗
PubMed2000

Survival of women with breast cancer in relation to smoking.

OBJECTIVE: To compare survival of patients with breast cancer who had never smoked, were smokers, and who were ex-smokers. DESIGN: Observational study. SETTING: City of Malmö, Sweden. PATIENTS: 792 patients with breast cancer diagnosed between 1977-1986 in the Malmö mammographic screening trial. INTERVENTIONS: Follow-up of breast cancer cases through record-linkage with the Swedish Cause of Death Registry. MAIN OUTCOME MEASURES: Death from breast cancer. Relative risk (RR) with 95% confidence interval (CI) of death from breast cancer was calculated for different smoking groups using Cox's proportional hazards analysis. RESULTS: During a mean follow-up of 12.1 years, 145 patients died of breast cancer. Breast cancer mortality was 1347/10(5) person-years in those who had never smoked, 1941/10(5) in smokers, and 1493/10(5) in ex-smokers. The crude RR for smokers and ex-smokers, compared with those who had never smoked were 1.44 (1.01 to 2.06) and 1.13 (0.66 to 1.94), respectively. The RR associated with smoking remained significant after adjustment for age and stage at diagnosis, 2.14 (1.47 to 3.10), and other potential confounders. CONCLUSIONS: Survival after breast cancer was, as expected, strongly related to stage at diagnosis. However, stage by stage there was considerable variation between individual patients. We conclude that differences with regard to exposure to smoking contribute to this heterogeneity.

Adenocarcinoma↗
PubMed2000

Intestinal colonization leading to fecal urobilinoid excretion may play a role in the pathogenesis of neonatal jaundice.

BACKGROUND: Neonatal hyperbilirubinemia remains of concern because of the potential danger for the central nervous system. Because urobilinogen is a nontoxic derivative of bilirubin, the current study was conducted to examine the fecal excretion of urobilinoids and bilirubin in healthy newborns and infants, as well as their intestinal bacteria capable of reducing bilirubin, to assess a possible relation to serum bilirubin levels during the first weeks of life. METHODS: Bilirubin pigments, urobilinoids, and porphyrins were measured in stools of infants during the first week (group A, n = 60) and between the second week and the first 6 months of life (group B, n = 64). Microbiologic analysis of stools was performed in selected cases and bilirubin-converting activity of isolated bacteria was determined in vitro. RESULTS: Urobilinoids were detectable in stools of 57% of the neonates at day 5, but not before. However, fecal urobilinoid production on that day was only a fraction of that observed in adults (0.07 vs. 0.7-3.6 mg/kg per day), whereas at week 6 it increased significantly to an average of 0.9 mg/kg per day. Microbiologic analysis of neonatal stools revealed two novel bacterial strains of Clostridium perfringens and Clostridium difficile capable of reducing bilirubin to urobilinoids. CONCLUSIONS: Urobilinoids can be detected in stools of 57% of newborns at day 5 after delivery. However, the urobilinoid production during the first week of life is quantitatively insufficient to contribute significantly to the removal of bilirubin. Enhancement of the microbial conversion of bilirubin could decrease the intestinal concentration of bilirubin and may decrease the degree or enhance the removal of neonatal hyperbilirubinemia.

Bacteria↗
PubMed2000

Intra-urban differences in breast cancer mortality: a study from the city of Malmö in Sweden.

STUDY OBJECTIVE: To assess whether in an urban population stage at breast cancer diagnosis is related to area of living and to what extent intra-urban differences in breast cancer mortality are related to incidence respectively stage at diagnosis. DESIGN: National registries were used to identify cases. Mortality in 17 residential areas was studied in relation to incidence and stage distribution using linear regression analysis. Areas with high and low breast cancer mortality, incidence and proportion of stage II+ tumours at diagnosis were also compared in terms of their sociodemographic profile. SETTING: City of Malmö in southern Sweden. PATIENTS: The 1675 incident breast cancer cases and 448 deaths that occurred in women above 45 years of age in Malmö 1986-96. MAIN RESULTS: Average annual age standardised breast cancer mortality ranged between residential areas, from 35/10(5) to 107/10(5), p = 0.04. Mortality of breast cancer was not correlated to incidence, r = 0.22, p = 0.39. The ratio of stage II+/0-I cancer incidence varied between areas from 0.45 to 1.99 and was significantly correlated to breast cancer mortality, r = 0.53, p = 0.03. Areas with high proportion of stage II+ cancers and high mortality/incidence ratio were characterised by a high proportion of residentials receiving income support, being foreigners and current smokers. CONCLUSIONS: Within this urban population there were marked differences in breast cancer mortality between residential areas. Stage at diagnosis, but not incidence, contributed to the pattern of mortality. Areas with high proportion of stage II+ tumours differed unfavourably in several sociodemographic aspects from the city average.

Aged↗
PubMed1999

[Laparoscopic appendectomy in acute appendicitis].

Laparoscopic appendectomy has not yet become a stable part of surgical armamentary as has laparoscopic cholecystectomy. The authors on the basis of their own experience show its benefit for the surgeon and for the patient. The conversion rate (7.7%) in the study group is comparable with literature data. The indication for operation was always periappendical mass, in combination with retroceocal position of the appendix. Minimum complication rate in the study group (one case of subfebrile fever in 5 days), very good overview in operation field with the possibility to treat also another pathologic findings concern the authors together with short hospital stay a clear advantages of laparoscopic appendectomy. On the basis of this experience their advocate the routine use of this operation. (Ref. 19.)

Acute Disease↗