Biomedical subjects
Publications and source records attributed to J Mergancová.
The authors present three case-reviews of rare metastatic affections of the female mammary gland by the following disorders--a malignant lymphoma, a Grawitz carcinoma of the kidney and by a malignant melanoma. Histological examinations of the tumors and restrospective examinations of the respective patients anamneses resulted in the primary focus determination in two cases.
Incidence rates of solid tumors increase with age in our population. Epithelial tumors are the most frequent tumors of the old age. On the contrary, extraperitoneal mesenchymal tumors are rare. Surgical treatment remains the most important and the most effective therapeutic modality to manage solid tumors. The risk level of the surgical treatment in the elderly is influenced by many factors, which may often be substancially reduced. Therefore, the elderly should not be excluded from curative surgical procedures on their calendary age basis.
Authors present their experience with the intraoperative enteroscopy method--an invasive technique of small bowel examination. It is performed under narcosis at an operating theatre (i.e. in co-operation with surgeon and anaesthesiologist). The endoscopy-performing physician becomes one of the members of the operating team. The advantage of the method is the possibility to examine of the whole small intestine and to solve immediately the pathological findings by endoscopic or surgical intervention. The examination is invasive and the correct indication is mandatory. Authors report their results of 18 intraoperative panendoscopies of small intestine.
BACKGROUND: Incorporation of doxorubicin hydrochloride into pegylated liposomes (PLD) may decrease chemotherapy side effects and increase the activity. Hyperthermia could further potentiate its effectiveness. CASE REPORT: A patient with skin metastases of breast carcinoma was treated with intravenous infusion of PLD (Caelyx) in combination with ultrasound hyperthermia. Each cycle consisted of infusion of 40 mg PLD absolute dose, followed by 2 fractions of hyperthermia 41-43 degrees C for 45 min 1 and 48 h after infusion. A complete remission was observed after the combination treatment with no significant toxicity. CONCLUSION: Present observations suggest that the combination of PLD with hyperthermia of skin metastases of breast carcinoma may be an active and well tolerated treatment.
The authors present information of a group of 63 patients (60 women and 3 men) treated in 1976-1998 where supernumerous aberrant or accessory mammary gland tissue was found. The diagnosis in the majority of the patients was based on histological examination. The tissue of an aberrant mammary gland is subject to the same physiological influences as the mamma proper and can be affected by the same pathological processes--benign and malignant. This is the reason why the authors recommend early extirpation.
The immune system of the patients with colorectal cancer is activated. Urinary neopterin is an index of this systemic immune activation, reflecting the circulating activity of interferon-gamma. We have measured urinary neopterin excretion in 34 patients with colorectal cancer. This excretion was significantly higher in our patients compared to reference group (325 +/- 267 vs 169 +/- 62 mumol/mol creatinine, neopterin concentrations were considerably higher in Dukes' stage D disease compared with Dukes' stage B and C disease/561 +/- 372 vs 188 +/- 47 and 250 +/- 142 mu/mol creatinine. Increased neopterin detected the presence of metastatic disease with 90% sensitivity and 87.5% specificity. Authors conclude that urinary neopterin measurement may be useful in the staging of colorectal cancer.
Urinary zinc excretion is known to be increased in cancer patients, but the pathogenesis of this phenomenon remains uncertain. Both skeletal muscle catabolism and renal tubular cell dysfunction have been proposed to explain this observation. We have investigated urinary zinc and N-acetyl-beta-D-glucosaminidase (NAG), an indicator of renal tubular cell dysfunction, as well as serum neopterin, an index of systemic immune activation, in 22 patients with cancer and seven controls. Both serum neopterin and urinary zinc were significantly elevated in cancer patients (15.8 +/- 12.7 versus 7.3 +/- 2.3 nmol l-1 and 1.77 +/- 0.80 versus 1.21 +/- 0.41 mmol mol-1 creatinine, P < 0.02 and P < 0.05, respectively), while NAG was similar in cancer patients and the controls (13.58 +/- 13.80 versus 13.68 +/- 12.19 mu kat mol-1 creatinine). A significant correlation was observed between serum neopterin and urine zinc (rs = 0.5119, P < 0.02), serum neopterin and urine NAG (rs = 0.6761, P < 0.002), and urinary zinc and NAG (rs = 0.6348, P < 0.002). In conclusion, the present data indicate a link between urinary zinc excretion and immune activation as well as renal tubular cell dysfunction. In addition, renal tubular cell dysfunction appears to be linked to immune activation.
Although an increase in renal zinc excretion in cancer patients is well documented, the mechanisms involved are still disputed. As recent studies have raised the question of the role of renal tubular cell dysfunction in the elevation of urinary zinc output, we have examined urinary zinc excretion and the excretion of N-acetyl-beta-D-glucosaminidase (NAG), an indicator of tubular cell dysfunction, in 30 patients with cancer, 28 healthy controls and 20 patients with benign non-inflammatory disorders. As expected, urinary zinc excretion was significantly higher in the cancer patients compared with controls and patients with benign disorders (2.64 +/- 3.05 vs. 0.86 +/- 0.36 and 0.89 +/- 0.29 mmol mol creatinine-1, p < 0.001). NAG activity was also elevated (18.9 +/- 20.1 vs. 4.32 +/- 3.33 and 9.99 +/- 9.72 mukat mol creatinine-1, p < 0.001 and p < 0.05, respectively). A significant correlation between urine zinc and NAG was observed in all three groups (rho = 0.73, p < 0.001, rho = 0.55, p < 0.01 and rho = 0.45, p < 0.05, respectively). In conclusion, our data provide additional support for the role of renal tubular cell dysfunction in hyperzincuria in cancer. Urinary zinc measurement may represent an alternative approach to detecting renal tubular dysfunction in human pathology.
Although several studies have described an increase in urinary zinc output in cancer patients, little attention has been paid to the excretion of copper. In this study, we investigated urinary excretion of zinc and copper, and serum levels of alpha-1 acid glycoprotein, an acute phase protein, in 22 patients with colorectal cancer. Urinary excretion of copper and zinc were significantly increased compared to the reference group (77 +/- 72 vs. 32 +/- 14 mumol/mol creatinine, P < 0.05, and 1.50 +/- 0.62 vs. 0.70 +/- 0.41, P < 0.002, respectively). In addition, a negative correlation was observed between urinary copper and serum alpha-1 acid glycoprotein (rs = -0.5256, P < 0.02). In conclusion, urinary excretion of copper, as well as that of zinc, appears to be elevated in colorectal cancer. The finding of a negative correlation between urinary copper and alpha-1 acid glycoprotein supports the postulated role of the latter in regulating renal glomerular permselectivity.
Human liver tissue obtained at autopsy was extracted with hot 0.1 M NaOH. Determination of amino acids desmosine and isodesmosine was used to quantify elastin in the insoluble residue. Hydroxyproline content was used as an index of collagen content in the liver. Hydroxyproline content was twofold in fibrotic liver and threefold in cirrhotic liver when compared to normal liver, while the sum of desmosine and isodesmosine increased threefold and sixfold, respectively. Elastin content is low in normal liver when compared to collagen but appears to grow much faster in diseased liver.
In the course of 15 years in the author's department some 15,000 cannulas were inserted into the subclavian or femoral vein. This number included cca 2300 cannulas inserted to dialyzed patients. 213 patients (inl. 28 dialyzed) died with the inserted cannula. In these patients the incidence of complications was evaluated. A parietal thrombosis was the most frequent complication and was recorded in 119 cases, i.e. in 56% (in non-dialyzed in 57% and in dialyzed in 50%). In two non-dialyzed patients it was the cause of embolization into the lungs. In the incidence of complications there is no significant difference in dialyzed and non-dialyzed patients. For completeness the authors present a preliminary calculation per approximate number of inserted cannulas during this period. From the total number of 15,000 inserted cannulas fatal complications occurred in 0.06% (in dialyzed in 0.13% and non-dialyzed in 0.047%).
The case of a strange type of generalized xanthogranulomatosis, ending by a lethal kidney complication, is described in a woman aged 68. The clinical symptoms of the patient were not characteristic and did not lead to the actual diagnosis. The process was located along the basal brain arteries, it adhered to the adventitia of the descending thoracic aorta and of the coronary arteries. An identical xanthogranulomatous infiltrate was found in the peripelvic adipose tissue of both kidneys, where it led to stenosis of the proximal ends of both ureters; to a lesser extent such infiltrates appeared also in the periportal areas of the liver and in the bone marrow. Histological findings grant the possibility of the Erdheim-Chester disease. Differential diagnosis is subjected to discussion.
A case of conjoined twins diagnosed prenatally by ultrasound is presented. The pathologist's report, the ultrasonographic differential diagnosis, management of delivery and a summary of the literature are included.
A case is described of 68 years old woman suffering from a peculiar xanthogranulomatous process terminated with fatal renal complication. The clinical symptomatology was not characteristic and did not lead to diagnosis during the life. The process was localized around the cerebral basilar arteries, and was also in close connection with the adventitia of the thoracic aorta and of coronary arteries. Identical xanthogranulomatous infiltrate was found in the peripelvic fat of both kidneys where it led to stenosis of proximal parts of both ureters; less extensive infiltrates were present periportally in the liver and in the bone marrow. Histological findings are suggestive of the diagnosis of Erdheim-Chester disease. The differential diagnosis of the process is discussed.
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