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Biomedical subjects

L Valanský

Publications and source records attributed to L Valanský.

18 recordsLinked to original sources
PubMed2006

Sarcomatous dedifferentiated renal cell carcinoma mimicking a severe purulent kidney infection.

Sarcomatous renal cell carcinomas (SRCCs) originate from a dedifferentiation of renal cell carcinoma (RCC). They are characterized by an aggressive course and very poor prognosis. Less known is their ability to imitate inflammatory diseases of the kidney. The aim of the study was to outline the less usual symptoms of SRCCs in a retrospective analysis of 180 patients operated for RCC in 1997-2001. In 11 (6.1%) patients (8 men and 3 women, age 40-76 years, mean age 60 years) SRCC was present. The pTNM classification, results of histological examination, the stage of RCC dedifferentiation and survival after the operation are presented. In almost every patient SRCC was diagnosed at a late stage with combined histological variants of RCC. Survival of the patients after the operation ranged from 1 to 19 (average 8.8) months. In 2 patients an atypical clinical picture imitated abscess of the kidney and calculous pyonephrosis. The authors warn that in spite of the clinical signs of inflammatory disease of the kidneys, a tumorous origin should be excluded. In doubtful cases a quick peroperative biopsy and histology should be performed. Sometimes only a definitive histological examination can reveal the tumorous origin of the disease.

Abscess↗
PubMed2004

Detection of virulence factors in alpha-haemolytic Escherichia coli strains isolated from various clinical materials.

In total, 201 alpha-haemolytic Escherichia coli isolates from various clinical materials (urine samples and vaginal and rectal swabs) were examined by PCR for the presence of genes for the virulence factors alpha-haemolysin (hly), cytotoxic necrotising factor type 1 (cnf1), P-fimbriae (pap), S/F1C-fimbriae (sfa/foc), aerobactin (aer) and afimbrial adhesin (afaI). Among vaginal isolates, 96% were positive for cnf1, compared with 80% of urine strains (p 0.02) and 63% of rectal strains (p 0.0001). Similarly, sfa/foc-specific DNA sequences were found in 97% of vaginal isolates compared with 75% of rectal strains (p 0.004). The afa1 and aer genes were associated more with rectal alpha-haemolytic E. coli strains than with extra-intestinal isolates. The results suggested that CNF1 and/or S/F1C-fimbriae contribute to colonisation and persistence of alpha-haemolytic E. coli strains in the vaginal environment.

Bacterial Toxins↗
PubMed2002

[Long-term results of retropubic vesicopexy in the treatment of urinary stress incontinence in women].

OBJECTIVE: To evaluate long-term results of retropubic vesicopexy (e.g. direct suspension of the anterior and lateral walls of the bladder base) in the treatment of female stress urinary incontinence (SUI) caused by hypermobile urethra. DESIGN: Retrospective clinical study. SETTING: Department of Urology, Faculty of Medicine, University of P. J. Safarik, Kosice, Slovakia. METHODS: From a total of 44 females operated on between 1985-1992, 41 (93%) were available for the study (mean age 50 years, 28 pure SUI, 13 mixed incontinence). 18 (44%) patients had failed previous incontinence surgery. Based on the data collected by a detailed questionnaire as a success cure and/or significant improvement (max. 1 pad/day) of SUI have been considered. RESULTS: With a mean of 103 month follow-up period (48-160 months), 32 (78%) patients reported to have their SUI cured, another 5 (12%) significantly improved. Both persistent (8/13, 62%) and de novo urge incontinence (5/28, 18%) have shown to the main reasons for "partial" satisfaction only with the outcome of surgery. Perioperative bleeding requiring blood transfusion was the only serious complication met with this procedure (2 patients). CONCLUSION: Long-term results of vesicopexy is comparable with the effect of standard retropubic procedures like Burch colposuspension or MMK urethropexy. Technical simplicity, no risk of osteitis pubis as well as persisting micturition problems may be considered the main advantages of the procedure. Because of lower cure rate the procedure is less suitable for SUI type IIB.

Adult↗
PubMed2000

p53 single nucleotide polymorphisms and bladder cancer.

Two p53 germline polymorphisms, a BstUI in exon 4 and a MspI in intron 6 were studied using polymerase chain reaction (PCR) based methods in 50 patients with bladder cancer and 145 healthy controls. Increased frequencies of the BstUI and MspI A2 alleles were found to be associated with statistically non-significant (p = 0.2308 and p = 0.5959) but increased odd ratios for bladder cancer (OR 1.44, 95% CI 0.82-2.27 and OR 1.20, 95% CI 0.61-2.33). Statistically significant difference between patients with bladder cancer and controls was found in the distribution of MspI genotypes. There was a significantly lower proportion of the heterozygous A1A2 genotype in all patients but not in controls (p = 0.0354). The results of this study suggest that BstUI and Msp1 germ line polymorphisms of the tumor suppressor gene p53 marginally modify the risk of bladder cancer.

Deoxyribonuclease HpaII↗
PubMed1999

The role of human glutathione S-transferases M1 and T1 in individual susceptibility to bladder cancer.

Several genes involved in the metabolism of carcinogens have been found to be polymorphic in the human population, and specific alleles are associated with increased risk of cancer at various sites. This study is focused on the polymorphic enzymes glutathione S-transferase M1 (GSTM1) and T1 (GSTT1) that are involved in the detoxification of many xenobiotics involved in the etiology of bladder cancer. To investigate the role of GSTM1 and GSTT1 in bladder carcinogenesis, the polymerase chain reaction was used to determine GSTM1 and GSTT1 genotypes of cancer patients (n = 76) and controls (n = 248). The proportion of putative risk GSTM1 null genotype in the case group was 52.6%, compared to 49.6% in the control group, but the GSTT1 0/0 frequency in the bladder cancer group was significantly higher (P = 0.04) in comparison with the control group (27.6 vs 16.9%). Individuals lacking the GSTT1 gene are at an approximately 1.9-fold higher risk (OR = 1.87, C.I. 95% = 1.03-3.42) of developing bladder cancer in comparison with individuals with at least one active allele in the GSTT1 locus. A significantly higher incidence of GSTM1 deletion genotype (P = 0.02) was found in smokers with bladder cancer compared to the controls (70.6 vs 49.6%). Smokers lacking the GSTM1 gene are at an approximately 2.4-fold higher risk of bladder cancer (OR = 2.44, C.I. 95% = 1.10-5.30). The effect of smoking associated with the GSTT1 0/0 genotype was not found to affect the risk of bladder cancer.

Aged↗
PubMed1998

[Urologic complications of gynecologic surgery and their treatment in our clinical data].

In 19 women (aged 27-66 years, mean 44.6 years) a retrospective analysis of the urological complications suffered during gynecological surgery was performed. 14 (73.6%) patients had ureteral injuries with concomitant bladder lesions in two. In the remaining 4 (21%) bladder injury only was present including a woman with a simultaneous urethral lesion. In the postoperative period 3 ureteric, 5 vesicovaginal, and one vesicouterine fistula developed. Intraoperative diagnosis followed by immediate surgical repair of the ureteric and bladder lesions was performed in 2 (10.5%) patients only. Except one case ureteral injury was unilateral, and predominantly right-sided (10:5). One patient suffered injury of one of the ureters in a complete ureteral duplication. The most frequent side of ureteral injury was at the level of the uterine artery with complete ligature of the ureter in 10 (71.4%), and partial in 4 (28.6%) patients. Percutaneous nephrostomy as a temporary diversion was performed in 8 (57.1%) patients. Definitive treatment involved simple Paquin ureteral reimplantation in 5 patients, Boari's procedure in 3, and psoas hitch technique once. Ureteral lysis only was sufficient in 3 patients. The surgical treatment including repair of vesical fistulas was in all cases successful.

Adult↗
PubMed1998

Genetic polymorphism of glutathione S-transferases M1 and T1 as a risk factor in lung and bladder cancers.

A combined analysis of two polymorphic enzymes, glutathione S-transferase mu (GST M1) and q (GST T1) and their implication as cancer risk factors was performed in a case-control study of lung and bladder cancers. Using a multiplex polymerase chain reaction (PCR) based method, the frequency of the homozygous deleted GSTM1 and GSTT1 genotypes was examined in 117 lung cancer patients, 67 urinary bladder cancer patients, and in a community-based sample of 248 healthy, unrelated individuals. In both cancer groups the frequency of the GSTM1 null genotype was higher in comparison with that of the control group (59% and 59.7% vs. 49.6%), but this increase did not reach statistical significance (p > 0.05). After grouping by the smoking status, among smokers in both cancer groups (62.1% in lung cancer and 71.4% in the bladder cancer group, respectively) there were statistically significantly (p < 0.05) increased frequencies of the GSTM1 deletion genotype as compared to the control group (49.6%). Smokers with absence of the GSTM1 gene were at an approximately 1.7-fold higher risk for lung cancer (odds ratio--OR = 1.67, 95% confidence interval--CI 95% = 1.0-2.7, p = 0.04) and an approximately 2.5-fold higher risk for bladder cancer (OR = 2.54, CI 95% = 1.2-5.5, p = 0.02). As related to GSTT1, our study demonstrated an overall GSTT1 effect on bladder cancer risk. Individuals with absence of the GSTT1 gene were at an approximately 2.5-fold higher risk of developing bladder cancer. In the lung cancer cases, the frequency of the putatively high risk GSTT1 null genotype was not increased as compared with controls. No effect of smoking was found on risk of lung and bladder cancer associated with the GSTT1 0/0 genotype. In combined analysis, the obtained results suggested that individuals who were both GSTM1 null and GSTT1 null may be at increased risk because they lack both enzymes. The findings suggest that the GSTM1 null genotype may be associated with susceptibility to lung and urinary bladder cancer in dependence on the exposure to carcinogens in cigarette smoke and that the GSTT1 null genotype is not a critical factor in mediating the risk of lung cancer, but may be associated with an increased susceptibility to bladder cancer.

Aged↗
PubMed1997

Actinomycosis of the urachus persistens penetrating into the ileum.

A 16-year-old boy is presented with the problem of free micturition, having a palpable, painless tumour spreading from the symphysis to the umbilicus. Cystoscopy revealed an impression in the vertex of the urinary bladder covered by the inflamed mucous membrane with a bulbar oedema. Fistulography showed transitional urachus persistens communicating with the terminal loops of the ileum. During surgery, a solid, fan-like fibrous connective tissue was removed, together with the vertex of the urinary bladder and peritoneum. Adhering loops of the terminal ileum were sharply separated and sutured. Histopathological examination confirmed actinomycosis of the urachus persistens penetrating into the ileum.

Actinomycosis↗
PubMed1996

[Prostate cancer: palpation versus ultrasonography].

The authors compared in a group of 273 symptomatic patients the effectiveness of palpation and transabdominal USG of the prostate and in a group of 162 patients palpation and transrectal USG of the prostate in diagnosing of prostate carcinoma. Histopathological correlation was available in 203 (74.4%) patients, all of them examined by transrectal USG. From the whole group of 273 patients prostate carcinoma was confirmed in 69 (25.3%). Based on USG examination alone prostate cancer was proved by histopathological methods in three (4.3%) patients with a negative finding on palpation. A disappointment of the USG method was that it did not prove possible to diagnose before operation incidental cancer in 14 (20.3%) patients with BPH. USG made it possible to define more accurately the stage of cancer in groups T2 and T3. The effectiveness was assessed as follows: sensitivity, specificity and total accuracy during palpation was 75.4%, 88.8%, 84.2%, in transabdominal USG: 78.3%, 91.8%, 87.2% and in transrectal USG of the prostated 97.7%, 90.7% and the overall accuracy 92.6%. Despite these results for screening of patients with prostate cancer USG of the prostate can be recommended only after palpation and PSA examination.

Adolescent↗
PubMed1994

[Urologic complications in sacrococcygeal agenesis].

In 11 children with partial sacrococcygeal agenesis without concurrent patent cystic myelomeningocele clinical symptoms were analyzed as well as the character of dysfunction of the bladder and therapeutic results. The cause of urinary incontinence, which was a constant symptom, was not diagnosed correctly in six children. Due to impaired innervation, mostly of the supranuclear type, the bladder dysfunction had more frequently the character of impaired evacuation (8 children) always with obstruction of the flow at the level of the external sphincter. Areflexia of the detrusor was found in three children. In this group changes of the upper urinary pathways were found in four children (three times unilateral reflux, twice dilated ureters, twice also pyelonephritis), always in conjunction with a bladder of low compliance. The impaired storage of urine found in three children was due to hyperreflexia of the bladder. After surgery (three children), conservative treatment (8 children) and their combination progression of changes of the upper urinary pathways was arrested and the degree of incontinence improved or was completed relieved during the 18-78-month follow-up of all patients. Extirpation of the associated subcutaneous lipomyelomeningocele and release of the attached spinal cord in three children aged 5, 10 and 12 years did not lead to improvement of the nervous lesion in any of the patients.

Adolescent↗
PubMed1994

[Renal oncocytoma and its morphology, diagnosis and therapy].

Oncocytoma includes 3-5% of all renal tumors. It does not manifest itself by typical symptoms and often is diagnostically confirmed in coincidence with examinations of other diseases. The preoperative diagnosis of oncocytoma is difficult. Oncocytoma must be taken into consideration in cases of bilateral multilocular tumors of the kidney. Neither RTG, USG and CT examinations, nor angiography give the specific picture of oncocytoma. One of the possibilities of diagnosis confirmation is the peroperative biopsy. If the latter confirms the diagnosis, then according to possibilities, operation with maintenance of unimpaired renal parenchyme should be performed. The prognosis of the disease is good and depends on the stage of cellular differentiation of tumor. The study presents observations of 4 patients subdued to surgery at the Urologic Clinic FHwP in Kosice since 1981 to 1990. The patients survive without metastases for 3-4 years.

Adenoma, Oxyphilic↗
PubMed1993

[Correlation of urography, ultrasonography and computer tomography with clinical findings in examinations of the kidneys and retroperitoneum. Possibilities of diagnostic errors].

The authors prospectively and retrospectively mutually compared the diagnostic value of urography, ultrasonography (USG), and computer tomography (CT) in four patients, with the diagnosis misstated prior to operation. The most valuable findings were provided by CT. Mere utilization of these methods does not exclude the possibility of diagnostic misstatements. In three patients the ultimate diagnosis was assessed on the basis of operative revision and in one patient, by means of cytologic examination of the renal punctate. Owing to retrospective evaluation of examinations, diagnostically valuable symptoms which could have lead to the correct diagnosis, were distinguished. Hence, examinations must necessarily be evaluated in complex with the general clinical state. (Fig. 6, Ref. 14.).

Adult↗
PubMed1993

[Renal venous thrombosis in neonates].

The authors present an account on a neonate with dextro-lateral renal venous thrombosis. They focus attention on the diagnostic and therapeutic procedure and compare it with available data from the literature. Contrary to data in the literature, they did not observe in the acute stage of renal venous thrombosis signs of disseminated intravascular coagulation in peripheral blood. It did not prove possible to elucidate the action of any of the factors leading to the development of renal venous thrombosis. After evidence of permanent functional loss of the right kidney nephrectomy was performed. Histopathological examination provided evidence of obliterating thrombosis of the renal veins with partial recanalization and calcifications. The authors emphasize the necessity of early diagnosis of renal venous thrombosis and adequate treatment based on the revealed findings.

Female↗
PubMed1992

[Cystic lesions of the prostate--diagnosis, therapy and clinical significance].

The authors present an account of results of examinations in 162 patients with cancer of the prostate, benign hyperplasia of the prostate, inflammatory diseases of the prostate and patients with a normal finding on palpation of the prostate. The patients were subjected to clinical, laboratory, histopathological and transrectal ultrasonography of the prostate. In one patient a CT examination of the prostate was made. In the group were seven patients with cystic prostate lesions (4.3%). In the group of patients with inflammatory diseases of the prostate they observed cystic changes in five patients (14.2%). The most important group was formed by two patients with abscesses of the prostate and one patient with an ascended utriculus prostaticus. Transrectal ultrasonography of the prostate was the supreme method for the diagnosis of cystic prostate lesions.

Adolescent↗
PubMed1992

[Seminal vesical abscess-diagnosis and therapy].

The authors present case-histories of two patients with abscesses of the seminal vesicles. They emphasize the asset of transrectal ultrasonographic examination for the early diagnosis of an abscess of the seminal vesicles. Antibiotic therapy, puncture of the seminal vesicles and evacuation of pus proved effective therapeutic methods.

Abscess↗