Biomedical subjects

O Topolcan

Publications and source records attributed to O Topolcan.

At least 19 recordsLinked to original sources

PubMed2006

[A partial relaps of a colorectal carcinoma metastatic process following liver surgery--a multifactorical study].

In the period of November 1999 - June 2003 78 patients with colorectal liver metastases (CLM) were operated at Department of Surgery, University Hospital in Pilsen. In multifactorial analysis there were evaluated these clinical parametres: age of patient, sex, localisation of primary tumor, Dukes classification, grading, staging and histology of primary tumor, histologicaly free resection margin, chemotherapy or actinotherapy after colorectal operation, type of liver resection, complications after liver surgery, radicality of liver surgery, lateralisation of liver metastatic process, number of metastases, blood transfusions, repeated liver surgery, volume of metastases. Kaplan-Meier method was used for evaluation of survival rate and disease free interval (DFI). Statistical analysis of studied clinical parametres was performed by Log-rank test and Wilcoxon test. The medium DFI after liver surgery was 16 months for all the patients (range 0-55 months), the medium DFI for patients after radical surgery was 18 months. The medium survival time after liver surgery for all the patients was 30 months (range 1-57 months), for patients after radical surgery it was 32 months, and for patients after palliative surgery the medium disease free interval was 29 months (range 5-30 months). The 4-year survival rate after the liver surgery was for all the patients 37%. The factors statistically significant for a disease free interval after liver surgery were bilaterality of metastatic process, the microscopically free resection line, radical surgical treatment versus RFA and unilaterality of metastatic process. The authors proved followed factors as statistically significant for survival rate: grading of colorectal cancer and age of patients. The prediction of early recurrence enables us to choose adequate surgical therapy or its extension by oncological therapy. More thorough follow up of patients with tendency to early recurrence of CLM helps to early diagnosis of relaps and it increases the posssibility of repeated liver surgery.

Carcinoma↗

PubMed2006

[Prognostic factors of early recurrence of colorectal liver metastases and their usage in clinical praxis].

Liver surgery for colorectal liver metastases (CLM) is very often followed by recurrence. The prediction of early relapse of CLM is important for successful treatment, long disease free period and for long survival of patients, because it could help us to choose adequate surgical and oncological treatment. The authors present contemporary overview of the prognostic factors of early CLM recurrence and their possible use in prognostic scoring systems. These could be very helpful in clinical practice.

Colorectal Neoplasms↗

PubMed2006

[A recommended procedure in laboratory-based diagnostics of thyroid function--yes or not?].

The author discusses the current status of laboratory-based thyroid diagnostics in the Czech Republic, and compares it with the procedure recommended by the National Academy of Clinical Biochemistry (NACB), USA. Based on an analysis of the current situation, the author recommends the introduction of a Czech version of the above-mentioned recommended procedure.

Autoantibodies↗

PubMed2005

[Serum tumor markers at exocrine adenocarcinoma of pancreas].

Pancreatic cancer represents a group of cancers with the worst prognosis. There exists only one method of successful therapy--radical surgery, i.e. the complete resection of the tumor. However, only 5% of cases are diagnosed in the early stage. More than 60% are recognised in the period of advanced disease. For those patients only palliative treatment can be used. Only early diagnosis can ensure better therapy results. Possibility of early diagnosis based on imaging and endoscope methods is at present very limited due to the anatomical location of pancreas. Serum tumor markers assessment might represent one of the possibilities of early detection of the pancreatic cancer. Review summarizes current knowledge on the use of tumor markers for diagnosis, prognosis and therapy monitoring of pancreatic exocrine adenocarcinomas with respect to the clinical use at the daily routine practice.

Adenocarcinoma↗

PubMed2005

[Epidemiological study of hypothyroidism as cardiovascular risk in population].

BACKGROUND: Prevalence of hypothyroidism (HT) markedly differs among various populations. We aimed to establish the prevalence of HT in the Czech population and to assess its association with conventional cardiovascular risk factors. METHODS AND RESULTS: 1240 subjects (629 m, 611 f; mean age 52.3); a random, population-based sample were evaluated. Cut-off points for thyroid parameters were defined as follows: thyreostimulating hormone (TSH) 0.58-3.65 mU/I, free thyroxine (fT4) 9-22 pmol/l and thyroid peroxidase antibodies (TPOAb) < or = 14 IU/A. The overall prevalence of HT was 6.8% in males and 13.8% in females (p < 0.0001); subclinical HT (high TSH, normal fT4) was found in 3.0% and 8.0%, overt-untreated (high TSH, low fT4) in 3.2% and 3.0% and overt-treated HT in 0.6% and 2.8% of males and females, respectively. Moreover, in euthyroid subjects, 4.6% of males and 9.3% of females showed positive TPO-Ab (p < 0.0001). The adjusted relative risk of hypothyroidism was significantly increased in males with manifest vascular disease (odds ratio 3.48 (1.56-7.74)]), in females aged > or = 55 years (2.08 (1.29-3.36)) or hypertension (1.80 (1.03-3.13)), and moreover, in males and females with positive TPOAb (5.81 (2.57-13.13) and 5.92 (3.38-10.36), resp.) CONCLUSIONS: Hypothyroidism was found in Czech population highly prevalent and it can contribute to the coronary risk, produced by conventional factors.

Adult↗

PubMed2004

[Clinical importance of determination of tumor markers during follow-up in breast carcinoma].

BACKGROUND: Paper deals with detection of the early disease progression in breast cancer patients during follow up using tumor markers. METHODS AND RESULTS: The basic group of 1184 patients with breast carcinoma in follow up after primary therapy were examined from 1996 to 2002. Sera were tested using commercial kits CA 15-3 (MEIA, Abbot), CEA (IRMA, Immunotech), TPA (IRMA, Byk Sangtec), TPS (IRMA, Beki). Results were compared with the retrospectively confirmed clinical status of individual patients. The authors calculated optimal cut offs and sensitivities and their combinations for particular tumor markers at 95% level of specificity. Best sensitivities for the detection of distant metastases into bone, liver, lung and brain was achieved by CA 15-3 (53-68%). As an optimal combination of tumor markers seems to be the tricombination CA 15-3, CEA and TPA. All the tumor markers have insufficient sensitivity for the metastatic process into the lymphnodes. CONCLUSIONS: As optimal combination of tumor markers during the follow up seem to be tricombination CA 15-3, CEA and TPA, but also the clinical relevance and cost effectiveness of these assessments have to be considered. For the tumor disease follow up only CA 15-3 has sufficient sensitivities (at 95% specificities) for the early diagnosis of the metastatic process.

Aged↗

PubMed2004

[Is liver resection or radiofrequency ablation indicated in breast carcinoma metastases?].

AIM: Until recently, metastasizing of the breast carcinoma to the liver has been considered the sign of the disease process generalization with a poor therapeutic prognosis. Therefore, the aim of this work was to assess any positive effects of liver resections in cases of patients with metastases with respect to the patients' survival rate and the relapse rate of the disorder. METHODOLOGY: From January 2000 until September 2003, 13 women aged 55.8 years on average (39-71 years of age) underwent surgery in the Surgical clinic of the Faculty Hospital in Plzen for liver metastases of the breast carcinoma. The average period of time from the date of the primary surgery for the breast carcinoma till the breast carcinoma liver metastasis appeared, was 4.3 years (3 months to 9 years). The breast carcinoma liver metastases were solitary in 11 cases and in two cases the metastases were multiple. The authors conducted four right-sided hepatectomies, three segmentectomies, two left-sided lobectomies, three radiofrequence ablations (RFA), one combined surgery--the liver resection and RFA, in total. In seven cases, the histological examination proved a ductal carcinoma and in six cases a lobular carcinoma. Following the surgery, all female patients underwent curative chemotherapy. None of the patients died earlier than 30 days after the surgery. In case of one patient during the complicated hepatectomy, the ductus hepaticus communis was iatrogenically injured, and the situation was solved using hepaticojejunoanastomosis according to Roux. The data were statistically evaluated according to the Kaplan-Meier long-term survival rate and the mestases relapse rate curve. A twelve-month and a thirty-month survival rate were 100%, and 66.7%, respectively. A probability of the relapse anywhere in the body is rated 0% and 71.5%, respectively for the same periods of time following the liver surgery for the breast carcinoma. CONCLUSION: Based on the authors' own findings and in conjunction with the current literature data, it is clearly evident that surgical therapy (liver resection, eventually RFA) followed by adjacent chemotherapy is the therapeutic method of choice in cases of patients suffering from the breast carcinoma liver metastases. The above method represents the only chance for a considerable extension of a quality life for women suffering from the breast carcinoma liver metastases.

Adult↗

PubMed2004

[Gastrointestinal tract cancer and diabetes mellitus].

Risk of development of some gastrointestinal tract cancers (colorectal cancer, pancreas cancer and liver cancer) is higher in type II diabetics. Another important risk factor is obesity (for gall bladder cancer in women and in men also for stomach and esophageal cancer). Pathogenetic factors have been explored especially in colorectal cancer (diet, hyperinsulinaemia, metabolic receptors activation, absence of physical activity). Our Czech study also proved up to 4 times increased risk of colorectal cancer in diabetics and, in accordance with literature, probable influence of persistent diabetes on tumour development. Type II diabetes mellitus should be considered as a risk factor especially for colorectal cancer, liver cancer, and pancreas cancer. In type I diabetics no risk of gastrointestinal tract cancers was proved.

Colorectal Neoplasms↗

PubMed2004

[Clinical relevance of tumor markers in epithelial ovarian cancer].

AIM OF STUDY: The authors present the view of possible usage of tumour markers in epithelial ovarian cancer, and they aim at their use in routine clinic practice. TYPE OF STUDY: Review article. SETTING: Oncology and Radio-Therapeutic Department, Faculty Hospital, Pilsen. SUBJECT AND METHODS OF THE STUDY: Summary of data published in Czech and foreign professional literature. CONCLUSION: In case of epithelium tumours of ovaries, CA 125 is the tumour marker of the first choice. For the reason of low sensitivity, it is not possible to use the tumor markers for screening and primary diagnostics. Regarding prognoses, high pre-operational levels of CA 125 are considered unfavourable. At the same time the study demonstrates that CA 125 levels monitoring in the course of chemotherapy appears to be one of the most significant indicators of chemotherapy effects and, therefore, also of prognoses. Regular CA 125 monitoring in the course of follow up can contribute to early detection of tumour disease relapses. The optimal time interval for monitoring seems to be three months for the period of the first two years, and then six-month interval. Other tumour markers used in routine clinic practice are mainly CA 19-9 and CA 72-4, particularly in case of mucinoid epithelium tumours. However, these markers are of subsidiary importance only.

Biomarkers, Tumor↗

PubMed2004

[The role of procalcitonin in the patient assessment after surgical procedures].

In the group of 450 patients operated in the Cardiosurgical Department of the Faculty Hospital in Plzen during the period from III/2003 till XI/2003, 1451 samples were collected to examine the following-procalcitonin levels (PCT), white blood cell counts (Leu) and C-reactive protein levels (CRP). The findings were assessed with respect to the respective patient's clinical status, and any correlation between procedures with extracorporeal circulation (MO), signs of inflammation, septic and non-septic serious complications and between the above mentioned markers levels, was searched. It was detected, that the PCT levels correlated well with the clinical signs of inflammation and sepsis, as well as with the non-inflammatory complications. The CRP and Leu changes were not statistically significant and their levels are commonly increased by the surgical procedure itself.

Biomarkers↗

PubMed2004

[Metabolic syndrome and latent depression in the population sample].

BACKGROUND: The aim of study was to reveal the relationship between metabolic syndrome and depression in a population sample, based on clinical and metabolic parameters. METHODS AND RESULTS: We tried to estimate depression (or other psychopathologies) prevalence in a randomly chosen population sample of the Pilsen city, using special questionnaires. Further, we estimated metabolic syndrome of insulin resistance risk factors and we looked for the relationship between these two disorders. Mental state of object was classified according to the questionnaires results, currently evaluated by the psychiatrist. Metabolic syndrome of insulin resistance was diagnosed as a presence of 3 of the 5 following factors: Triglycerides > or = 1.7 mmol/l, HDL cholesterol < 1.0 mmol/l in males or < 1.3 mmol/l in females, blood pressure > or = 130/85 mmHg (and/or antihypertensive medication), fasting plasma glucose > or = 6.1 mmol/l, waist circumference >102 cm in males or > 88 cm in females. Depressive syndrome diagnosed by Zungs scale is present in 31% of the Pilsen population, in 38% females and 31% males (n = 340). In the group of depressive objects, characteristics of metabolic syndrome of insulin resistance were two times higher than in the control group. Differences in resting heart rate, triglycerides level and fasting C-peptid were significantly higher in the depressive subjects. After the corrections considering age, sex and treatment adjustment, the waist to hip ratio was in the depressive subjects statistically higher as well as the 24 hour excretion of urine cortisone. In persons with metabolic syndrome of insulin resistance the prevalence of depression and anxiety was significantly higher. CONCLUSIONS: Our results show a possible relationship between depressive disorder and risk factors of the syndrome of insulin resistance. The question remains if the depression treatment can correct some of the metabolic syndrome risk factors.

Depression↗

PubMed2003

Clinical utility of biochemical markers in colorectal cancer: European Group on Tumour Markers (EGTM) guidelines.

In recent years, numerous serum and cell/tissue-based markers have been described for colorectal cancer (CRC). The aim of this article was to provide guidelines for the routine clinical use of some of these markers. Lack of sensitivity and specificity preclude the use of any available serum markers such as carcinoembryonic antigen (CEA), CA 19-9, CA 242, CA 72-4, tissue polypeptide antigen (TPA) or tissue polypeptide-specific antigen (TPS) for the early detection of CRC. However, preoperative measurement of CEA is desirable as this may give independent prognostic information, help with surgical management and provide a baseline level for subsequent determinations. For patients with stage 2 (Dukes' B) and 3 (Dukes' C) disease who may be candidates for liver resection, CEA levels should be measured every 2-3 months for at least 3 years after diagnosis. For monitoring treatment of advanced disease, CEA should also be tested every 2-3 months. Insufficient evidence is presently available to recommend the routine use of other serum markers for monitoring purposes. Similarly, the new cell and tissue-based markers (e.g, ras, P53) cannot yet be recommended for routine clinical use.

Antigens, Tumor-Associated, Carbohydrate↗

PubMed2003

Immunohistochemical detection of dipeptidyl peptidase IV (CD 26) in thyroid neoplasia using biotinylated tyramine amplification.

Differential diagnosis between malignant and benign thyroid tumors derived from follicular cells can pose certain difficulties in routine surgical pathology. The aim of the study was to evaluate dipeptidyl peptidase IV (DPP IV/CD 26) in differential diagnostics of thyroid lesions. DPP IV/CD 26 was evaluated in thyroid glands of 309 patients (261 females and 48 males, age range of patients 15-80 years). DPP IV/CD 26 was assessed in paraffin-embedded thyroid specimens immunohistochemically using commercially available antibody (Serotec) and biotinylated tyramine amplification kit (DAKO). Well-differentiated carcinoma revealed DPP IV/CD 26 positivity in 33 out of 42 cases (79%). Neither medullary nor insular carcinoma was DPPIV/CD 26 positive (only one case of each tested). DPPIV/CD 26 expression in isolated cells was seen in 18/261 (7%) benign disorders. The sensitivity of the method was 68%, the specificity was 94%, and the diagnostic accuracy was 91%, respectively, using 5% threshold of positive follicular cells. DPP IV/CD 26 can be assessed immunohistochemically using biotinylated tyramine amplification kit. DPP IV/CD 26 could be an adjunct in the thyroid gland differential diagnosis. However, DPP IV/CD 26 positivity is limited to the group of well-differentiated carcinomas, particularly papillary carcinoma. Furthermore, it is of limited value for follicular and oncocytic tumors.

Adolescent↗

PubMed2002

Effect of acrylate chemistry on human health.

OBJECTIVES: The prospective cohort study of 1992-1999 describes the effect of occupational exposure to chemical substances in the production of acrylic acid, acrylic acid esters and acrylate dispersions at the various workplaces of one chemical plant. METHODS: Exposure to selected chemicals (acrylonitrile, n-butanol, butyl acrylate, ethyl acrylate, methyl acrylate, methyl methacrylate, toluene, and styrene) was determined by personal passive dosimetry (GC/MS method). The annual examinations included general health, by guided interview, a general medical examination, hematological and biochemical examinations, examination of the parameters of serum immunity and selected tumor markers, and spirometry. The authors also repeatedly performed cytogenetic analysis of human peripheral lymphocytes. RESULTS: The authors followed a group of 120 employees (60 exposed, 60 controls), mean age 40+/-8 years in both groups, with average period of exposure to chemicals (exposed group) 13+/-5 years. The measured concentrations of chemicals in the working atmosphere were generally low; maximum allowable concentrations (MAC) values or suggested limits of certain chemicals were occasionally exceeded (most frequently for butyl acrylate). The results of the examination of the workers over the 8 years have not revealed any marked differences between the exposed and control groups that could be attributable solely to the acrylate exposure. CONCLUSIONS: Exposure to chemical substances at the workplace was relatively low, the limits being exceeded only sporadically (each such case was investigated at the workplace), and the level of exposure continues to decrease gradually over the years. Considering the fact that the exposed individuals are expected to work for 23 additional years on average, we feel that long-term monitoring of selected health-related parameters, not including tumor markers, appears desirable. The examination of tumor markers has not contributed to the problem evaluation for a number of false-positive results.

Acrylates↗

PubMed2002

[Biological activity in colorectal carcinoma].

The trend of current research is not only to obtain a complete characterisation of the cause of inception of tumor proliferation, but in particular to characterize in detail multi-degree cascades of the metastatic process. Precise description of the effector genes and their protein products which influence individual processes of the metastatic cascade, is of great significance not only for the early diagnosis of the possible tumor invasion into its immediate environment and the creation of distant metastases, but particularly for the development of new therapeutic procedures which will help to change from empirical to causal treatment. In practice this means a shift from those therapeutic procedures which lead only to simple blocking of cell division or cell growth, to addressing the individual stages of tumor development (correction of genetic defects in tumor cells, inhibition of the metastatic cascade, inhibition of angiogenesis and apoptosis, etc.). The article characterizes the biological activity of tumors in connection with the metastatic process in colorectal carcinoma.

Carcinoma↗

PubMed2002

[Effect of a dialysis solution with icodextrin on ultrafiltration and selected metabolic parameters in patients treated with peritoneal dialysis].

BACKGROUND: To date, peritoneal dialysis has been performed almost exclusively using dialysis solutions containing glucose as the osmotic agent. Use of these solutions is fraught with problems regarding adequate fluid removal from the body and is also associated with undesirable metabolic effects; hence the search for alternative osmotic agents. A dialysis solution with the glucose polymer icodextrin generates ultrafiltration on the principle of colloidal osmosis. The aim of the study was to establish the effect of icodextrin-base dialysis solution on the magnitude of ultrafiltration and evaluate selected metabolic parameters of patients treated by ambulatory peritoneal dialysis. METHODS AND RESULTS: A total of 9 patients whose glucose-based solution was replaced by an icodextrin-based solution during the night-time exchange were evaluated. A control group of 9 patients used glucose-solution during all exchanges. Night-time bag ultrafiltration, blood pressure, and the serum levels of lipids, insulin, leptin, maltose, and amylase were determined before icodextrin administration (time 0), at one-month intervals (time 1, 2, 3), and one month after study completion (time 4). In icodextrin-treated patients, ultrafiltration rose from 246.5 +/- 60.5 ml (mean +/- SEM) at time 0 to 593.1 +/- 87.4 ml; p < 0.01, at time 1, to 547 +/- 67 ml; p < 0.05, at time 2, and to 586.7 +/- 58.8 ml; p < 0.01, at time 3, the icodextrin administration led to a rise in maltose from 0.02 +/- 0.01 g/l at time 0 to 0.1 +/- 0.1 g/l; p < 0.01, at time 1, to 1.0 +/- 0.09 g/l; p < 0.01, at time 2, and to 1.1 +/- 0.09 g/l; p < 0.01, at time 3, with a fall to zero values at time 4 (NS). Icodextrin administration was followed by a decrease in leptinemia from 34.6 +/- 17.2 ng/ml at time 0 to 21.7 +/- 8.9 ng/ml; p < 0.05, at time 1, to 21.4 +/- 9.5 ng/ml; p < 0.05, at time 2, and to 15.9 +/- 24.1 ng/ml; p < 0.05 at time 4. Insulin and lipid levels were not affected. There was no change in the above parameters in the control group. Icodextrin-treated patients reduced their antihypertensive medication, but not statistically significantly. CONCLUSION: Icodextrin administration significantly increase ultrafiltration thus providing for effective control of hydration status without the need for high-level glucose-based dialysis solutions. The use of a glucose polymer-based dialysis solution is associated with a significant yet reversible rise in serum maltose. The decrease in leptin may signal a reduction in body weight after replacing glucose in dialysis solutions with icodextrin, or enhanced rates of leptin elimination as a result of ultrafiltration-induced convective transport.

Adult↗

PubMed2002

[Prevalence of thyroid gland disorders in pregnant women in the West Bohemia Region during their 2nd trimester of pregnancy in the year 2000--pilot study].

The diagnostics and the treatment of the disorders of the thyroid gland in pregnancy belong to the most important topics for most endocrinologists in the whole world. Untreated or mistreated thyroid gland disorders may influence the course of pregnancy and development of the foetus and child. Autoimmune thyroiditis, hyperthyroidism and hypothyroidism represent the most common thyreopaties in pregnancy and that is why the aim of the study was to establish their prevalence in population of pregnant women of the West Bohemia region. In our study we assessed serum levels of thyrotropin (TSH), free tyroxin (fT4) and antithyroid peroxidase antibodies (antiTPO) in 650 pregnant women. Sera were acquired during routine blood sampling for Down syndrome screening in the 2nd trimester of pregnancy. In our group we found the prevalence of 1.5% of hypothyroidism and 9.4% of autoimmune thyroiditis and we revealed no case of thyrotoxicosis, only subnormal TSH in 2.3%.

Adult↗

PubMed2002

[Thyroid disease in pregnant women and its development after childbirth].

OBJECTIVE: To assess the incidence of post-partum thyropathies in women with positive antibodies against thyroid peroxidase in the second trimester of pregnancy. MATERIAL AND METHODS: Based on a cross-sectional study of the prevalence of abnormal laboratory parameters of thyroid function in a group of 650 pregnant women in the second trimester of pregnancy the authors invited for subsequent clinical examination and repeated controls women with elevated antibodies against thyroid peroxidase (antiTPO) above 60 mU/l (1). The group comprised 75 pregnant women, incl. 44 (58.7%) who attended the examination. After delivery the authors examined the serum levels of TSH, fT4, antiTPO, if necessary fT3 and TRAK. RESULTS: 18, i.e. 58.1% women developed post-partum thyroiditis, incl. 10, i.e. 55.6% who developed hypothyroidism and 8, i.e. 44.4% who developed hyperthyroidism. CONCLUSION: Based on the presented study the authors recommend in pregnant women in the first trimester of pregnancy to introduce assessment of thyrotropin (TSH) and free thyroxin (fT$) and antibodies against thyroid peroxidase (antiTPO)[to detect neuropsychic sequelae on the infant after delivery. The investigation of serum levels of antiTPO antibodies will make it possible to select a group of women in risk of by the development of post-partum thyropathies which must be followed up.

Adult↗