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Biomedical subjects

M Marel

Publications and source records attributed to M Marel.

31 records · Page 2Linked to original sources
PubMed1994

Epidemiological studies on lung cancer in the Bohemia region.

In this epidemiological study, the incidence of lung cancer from 1981 to 1985 was evaluated in one district in the Central Bohemia Region with a population of 44,000. A total of 157 patients were identified as having lung cancer, the male:female ratio was 10:1, and 91% were smokers. Up to 78% of patients were detected because of their complaints, 17% at preventive examination, and 5% at autopsy. The calculated incidence for men was 129/100,000, for women 13/100,000. An average of 42 days elapsed from the time of the initial complaints or the preventive examination to the first visit with a pneumologist. From this visit to the establishment of the diagnosis an average of 28 days elapsed. In 79% of the patients, the diagnosis was confirmed histo- or/and cytologically, but mostly only by cytological examination; 15% of the whole group (23 patients) received surgery, four of whom underwent explorative thoracotomy alone; 18% had radiotherapy only; 12% received radiotherapy in combination with chemotherapy; 9% had chemotherapy alone; and 46% received symptomatic therapy only. In April 1992, the authors reviewed the series of patients and evaluated survival in different subgroups according to method of detection, morphological type, and TNM stage. Of the patients undergoing resection, 37% survived 5 years. In 13 patients, who died after successful resection, the cause of death was analysed. The majority succumbed to progression and dissemination of lung cancer. The authors conclude that prolonged survival could be demonstrated for resected patients, for patients at stages I and II, and for patients with squamous type of cancer.

Adult↗
PubMed1993

[Tumor markers in the diagnosis of lung cancer].

In groups of 50 patients with lung cancer and 19 patients with non-tumourous pulmonary disease the authors evaluated the contribution of examinations using four tumour markers (carcinoembryonic antigen, beta sub-unit of human choriogonadotropin, neuron-specific enolase and alpha-l-fetoprotein) for statistically significant differences were found only in CEA; NSE and HCG levels were higher in patients with tumours, the differences were, however, not statistically higher in patients with non-tumorous diagnoses. The levels of tumour marker rose in relation to TNM stages. When evaluating tumour markers in relation to histological types of lung cancer, the authors found the highest CEA levels in adenocarcinomas, HCG in the non-differentiated type and NSE were highest in small-cell lung cancer. By means of a mathematical model of discrimination analysis the optimal combination of discrimination signs was defined which was age, CEA and HCG. With the help of the elaborated equation it is possible to differentiate on the basis of our results groups of patients with an almost 80% certainty. The authors conclude that tumour markers are not suitable for screening patients with lung cancer; they can be successfully used as auxiliary diagnostic methods at pneumological and oncological in-patient departments.

Biomarkers, Tumor↗
PubMed1993

The incidence of pleural effusion in a well-defined region. Epidemiologic study in central Bohemia.

Pleural effusion may complicate various diseases. To facilitate the differential diagnosis of pleural effusion, the authors conducted an epidemiologic study of incidence and etiology of different types of pleural effusions in a well-defined region in central Bohemia. During a 1-year period, the authors worked with the general practitioners and other physicians from the local hospital to identify patients with pleural effusion either while the patient was alive or at autopsy. During this period, 142 individuals (93 living and 49 at autopsy) with pleural effusion were identified among a population of 44,000 (incidence = 0.32 percent). The most common etiologies of the effusions were congestive heart failure (65, 46 percent), malignant effusions (31, 22 percent), parapneumonic effusions (24, 17 percent), and pulmonary emboli (8, 5.6 percent). Other etiologies for the effusions included pulmonary hemothorax (6), intra-abdominal processes (4), uremia (2), myxedema (1), and rheumatoid pleuritis (1). We conclude that pleural effusions are relatively common and if these figures are extrapolated to the United States and Czechoslovakia respectively, one could expect at least 800,000 cases in the United States and 48,000 in Czechoslovakia annually. Over 90 percent of the pleural effusions will be due to congestive heart failure, malignancy, pneumonia, or pulmonary emboli.

Aged↗
PubMed1992

[Initial experience with the treatment of endobronchial lesions using the Nd:YAG laser].

Endobronchial treatment by means of a laser acquired during the past ten years a firm place in bronchology. In the submitted paper the authors present their initial experience with this treatment in patients of the Pneumological Clinic in Prague-Veleslavín. In the course of 12 months since when there is a Nd:YAG laser, Sharplan Co. at the clinic, 52 patients were treated by this method. Forty of them suffered from lung cancer. Three had other types of tumours. Eight patients suffered from benign cicatricial stenoses and one female patient aspirated a foreign body. A total of 124 bronchoscopies, using a laser, were performed, on average 2.4 per patient. In 75% of patients with lung cancer recanalization was achieved, the trachea was dilated in all patients with cicatricial stenoses, however, only in one quarter of them complete restitution of the lumen was achieved. Hitherto assembled experience confirms the value of laser treatment for improving the life and its prolongation in patients with lung cancer and its importance for treatment of other endotracheobronchial processes. Three serious haemorrhages during operation were recorded, one female patient died. The use of the laser is simple, its operation smooth.

Adult↗
PubMed1991

[Discrimination analysis in the differential analysis of pleural effusions].

The authors applied the mathematical method of discrimination analysis in the differential diagnosis of tumourous and other pleural exudates, as well as for the differentiation of malignant and paramalignant exudates. The basis for the investigation were data obtained during a four-year prospective study of pleural exudates at the Second Clinic of Tuberculosis and Respiratory Diseases in Prague. The analysis was made using a programme elaborated by RNDr. Tomásek, CSc. on a Hewlett-Packard 2100S computer in IHE Prague. After processing of 38 parameters--from 138 patients (without data on the cytology of the exudate, biopsy of the parietal pleura, bronchoscopy and thoracoscopy) the computer selected nine parameters with the greatest discrimination value which made it possible to differentiate tumorous exudates from others in 84%. This concerned the following data: skiagram of chest on admission, CEA in the exudate, temperature, exudate known already before admission to Clinic, LDH in serum on logarithmic scale, general impression of disease during physical examination, red cell sedimentation rate on admission, volume of exudate, alkaline phosphatase in exudate. When it was possible to add to the analyzed parameters also examination of the tissue polypeptide antigen (TPA), the analysis could be performed in 61 subjects. In that case the discriminating capacity rose to 95%. Subsequently we entered in the programme 38 parameters from 88 patients with a tumourous exudate and sought the most suitable ones for differentiation of malignant and paramalignant exudates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Differential diagnosis of pleural effusions. Experience from a clinical study 1986-1990].

In a group of 171 patients with pleural effusions included in a perspective study at the Second Clinic for Tuberculosis and Respiratory Diseases in Prague in 1986-1990, the authors evaluated the asset of examination methods for the diagnosis of different types of effusions. They compared differences between the group of patients with effusions associated with neoplastic diseases (group 1-108 subjects) with a group of patients with other types of effusions (group 2-63 subjects). They compared data in the case-history, physical examination, examination of the effusions and other auxiliary examinations. For significantly different parameters of blood examination (CEA, TPA, IgM, LDH) and the effusions (CEA, IgM, ALP) liminal values, specificity and sensitivity were assessed for differentiation of tumourous and other types of exudates. The authors compared also the required time and method of diagnosis in the two groups of patients. In group 1 cytology of the exudate, biopsy of the pleura and bronchoscopy were most valuable. In patients of group 2 in addition to the cytology of the exudate, biochemistry and bacteriology and auxiliary examinations were most important. The number of necessary diagnostic "steps" for assessment of the aetiology of exudates differed. Fewer steps were necessary for assessment of tumourous exudates. The groups differed as to treatment and survival of the patients.

Adolescent↗
PubMed1991

[Pleural exudates in patients with lung cancer. Comparative study].

A group of 228 patients with cancer of the lungs admitted in the course of 15 months to the Second Clinic for TB and Respiratory Diseases was classified according to the complicating pleural exudate. At the onset or in the course of the disease the exudate developed in 24 patients (11%)--group A, in the remaining 204--group B--there is no information on an exudate. The mean age of the two groups did not differ, smoking habits were similar. Significant differences were recorded as regards the incidence of subjective complaints, in group A the patients complained significantly more frequently of dyspnoea grade III to IV, chest pain, loss of weight and oedema of the neck. As to the number with haemoptysis and exposure to cancerogens the two groups did not differ. As to subsidiary diseases, only CHOPN was more frequent in group B. Differences were recorded also in the ratio of morphological types, in group A the small-cell type was most frequent, in group B the spinocellular type. The two groups differed also as to the incidence of peripheral and central forms, which were significantly more frequent in group A. The TNM stages differed: in group A stage IV predominated, in group B there were 40% of the patients in stage I and II. Significant differences between the groups were found also as to treatment: 17.6% in group B were operated and none in group A. In group A all patients died, in group B to the day of evaluation 25 subjects survive, this difference, is, however, not significant.

Female↗
PubMed1990

[Results of bronchoscopy studies in patients with pleural effusion].

The authors investigated in a group of 141 patients included in a study of pleural exudates at the Second Clinic for TB and Respiratory Diseases, Medical Faculty, Charles University Prague, endoscopic findings in correlation with the basic diagnosis and type of exudate. The group comprised 45 women and 96 men, mean age 52 and 54 years resp. 60.3% of the group suffered from neoplastic disease, most frequently bronchogenic carcinoma which was recorded in 56 of the patients. 114 patients were subjected to bronchoscopy, a tumour was detected by this examination in 33%, inflammatory changes in 19%, stenosis of the segments in 9% and merely dilated carinae in 3% of the subjects with pleural exudates who were subjected to bronchoscopy. The authors verified during bronchoscopy by cytological or histological examination 79% bronchogenic carcinomas, 35% other tumours. Bronchoscopy was the decisive examination; due to it the type of exudate was determined in 17 patients, i. c. 12%. In patients with other than neoplastic disease the endoscopic finding supported the basic diagnosis in 30% of the examined subjects, but did not assess the type of exudate in any of the patients. Bronchoscopy revealed pathological changes in 16 patients (11% of the group) where the skiagram of the chest indicated only changes suggesting a pleural exudate. Fifteen of them suffered from neoplastic disease, one from TB of the intrathoracic nodes. The authors conclude that the importance of bronchoscopic examination in patients with pleural exudates is increasing due to the changed spectrum of basic diagnoses and that it should be made in all patients with an obscure pleural exudate.

Bronchoscopy↗
PubMed1990

[Comparison of the results of transbronchial puncture of the lymph nodes with surgical findings in patients with lung cancer].

Referring to a group of 144 patients with lung cancer planned for lung surgery, the authors compared the results of the needle biopsy of hilar, bifurcation and paratracheal nodes with the pathologist's finding in the resected portions of the lungs. In the hilar region, there were 89.5% findings in agreement with postoperative, 10.5% different findings. These were six patients where falsely negative results were found in 2 patients, falsely positive results in 4 patients. In the bifurcation and paratracheal regions, the cytologist's and pathologist's findings were entirely in agreement. At the same time the authors considered peribronchial needle biopsy for the ability to detect the lymph node. In the group of patients, in whom the nodes had not been reached by the needle, the pathologist described enlarged nodes in 14.7% patients in the hilar region, a 2.9% rate in the region of the bifurcation, and a 12.2% rate in the paratracheal region. In the authors' opinion, the method of peribronchial needle biopsy is sufficiently accurate and very useful for the intrathoracic staging of bronchogenic carcinoma. They see it as an inseparable part of bronchoscopy in patients with lung cancer.

Biopsy, Needle↗
PubMed1990

[Monitoring natural killer cell activity in the blood of patients with malignant pleural effusion after intrapleural administration of Corynebacterium parvum].

In a group of 14 patients with a malignant pleural effusion treated by intrapleural administration of Corynebacterium parvum, in addition to other treatment of the generalized malignant process the activity of Nk cells was investigated before administration, on the 7th and 21st day after instillation of the vaccine. The mean rise of this activity was significant at the 5% level of significance. The activity of Nk cells was equally significantly influenced by age. The survival of patients, although longer in patients who responded positively, was not significantly correlated with the increased activity of Nk cells. Its increase was observed more frequently in the group of patients given the English preparation Coparvax. In the discussion some aspects of the relationship of Nk activity and anti-tumourous immunity are discussed.

Adjuvants, Immunologic↗
PubMed1989

[Comparison of the effectiveness and adverse effects of a Corynebacterium parvum vaccine made in Czechoslovakia with Coparvax, a British preparation made by Wellcome, in the treatment of malignant pleural effusions].

Malignant pleural effusion complicates various malignant diseases, most frequently lung and breast cancer. A group of 20 patients with this complication were treated with the Czechoslovak vaccine Corynebacterium parvum and the English preparation Coparvax, and their effects and side-effects were compared. Within 4 weeks following the application, 7 patients died. In 9 surviving patients, the exudate ceased to be replenished and in 4 persons, after intrapleural application of the preparation, it had to be evacuated one more time, but then its formation ceased. The therapeutical effect of both the Czechoslovak and English preparations was satisfactory. The side-effects of both preparations were comparable except for a significantly higher temperature elicited by the Czechoslovak vaccine. Both preparations Corynebacterium parvum are suitable for palliative treatment of malignant pleural exudates.

Bacterial Vaccines↗
PubMed1989

[Epidemiologic study of pleural effusion in a district].

The pleural exudate complicates many different diseases. With the aim of facilitating differential diagnosis, the authors conducted a prospective epidemiological study of individual types of exudates. In a catchment area of 44,000 inhabitants, the authors, in cooperation with general practitioners and other physicians from the local hospital found clinical and roentgenological signs of effusion in 0.32% of the total population in one-year period. The exudate was diagnosed in 93 living and 49 dead patients, where it was undiagnosed during lifetime. The highest frequency was noted in the cardiac effusion (46%), malignant effusion (22%) and pneumonic exudate (17%). The next most frequent effusions were found in cases of embolism, hemothorax, inductive effusion in abdominal affections, effusion due to uremia, myxedema and rheumatoid exudates. These findings are comparable only with the estimated incidence of pleural effusion made in the USA accompanying the underlying condition and occurring in approximately 0.5% of the population. Accurate data drawn from an epidemiological field study have not been found either in Czechoslovak or world literature.

Aged↗