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Biomedical subjects

V Dorazilová

Publications and source records attributed to V Dorazilová.

At least 19 recordsLinked to original sources

Severe late complication of appendicitis. Case report.

BACKGROUND: Diffuse necrotizing soft-tissue infections are severe due to their rapid progression; there is a vital need for settling proper early diagnosis. The task of the clinician is mainly in distinguishing localized infection from the diffuse process. CASE PRESENTATION: In our case report we demonstrate a 32 yr old man with a curious development of severe necrotizing infection of submucosis with gas production as a conclusion of perforation of Schloffer's tumour, which developed after appendectomy carried 20 years ago. CONCLUSIONS: In case of diffuse necrotizing soft-tissue infections only immediate surgical revision can confirm initial stages of severe forms of infection.

Abdominal Abscess↗

[Metastasis as the first sign of thyroid carcinoma].

The authors present on the basis of case report the problematic of thyroid gland cancer where was manifest long-term (3 years) clinical only as the resistance on the right part of the neck in the trigonum submandibular. Histological examination confirmed the metastasis of thyroid gland papillocarcinoma. Total thyroidectomy was performed and the same type of cancer in both lobes was confirmed. The patient has been 2 years after surgery and radiotherapy (radioiodine) without recurrence.

Adult↗

[Tamoxifen or tamoxifen in combination with chemotherapy in adjuvant therapy of breast carcinoma. Results of a multicenter randomized study].

UNLABELLED: Between April 1994 and May 1997 103 breast cancer patients (pts), pT1c-3a, pN0-1, M0, were randomised after surgery to adjuvant tamoxifen (20 mg per day) or to tamoxifen plus CMF (C 500 mg/m2, M 40 mg/m2 and F 600 mg/m2 on days 1st and 8th q 28 day) in 6 cycles. The median age (49-72 years, median 58), tumour size, number of involved lymphnodes (0-3), estrogens receptor status, grade (I-III) and type of operation were well balanced among the 50 pts on tamoxifen and the 53 pts on tamoxifen plus CMF pts, preferably postmenopausal. RESULTS: Grade of toxicity according to WHO criteria was not higher then two in both arms. Toxicity both haematological and non-haematological was higher in the group treated with chemotherapy (0 vs 32 resp. 20%) except weight gain (52% in both group). After median follow-up of 42 mos five recurrences in tamoxifen and seven in tamoxifen plus CMF pts were observed (p = NS). The projected 3-y DFS is 92% for tamoxifen and 88% for tamoxifen plus CMF (p = NS). The 3-y OS is 88% for tamoxifen and 80% for tamoxifen plus CMF pts (p = NS). CONCLUSIONS: Both regimens are equally effective with higher toxicity in the group with combined chemo- and hormonal therapy.

Aged↗

[An unusual case of primary hyperparathyroidism in a woman with Gorlin-Goltz syndrome].

Nevoid basal cell carcinoma syndrome (NBCCS) has been known to coincide with different forms of other neoplasias; however, parathyroid adenoma in this syndrome has not previously been described. The authors report a case of such association in a 50-year old white woman. The adenoma was verified before operation by biochemical, isotopic and cytologic methods and later, after the excision of adenoma, histologically.

Adenoma↗

[Comparison of adjuvant chemotherapy in breast carcinoma with a combination of cyclophosphamide, methotrexate, 5-fluorouracil (CMF) and AC (doxorubicin, cyclophosphamide). Initial results of a national cooperative study].

The aim of this multicentric, prospective randomized trial is to evaluate and to compare, effects and toxicities of two chemotherapeutic combinations (AC and CMF) in adjuvant treatment of breast cancer. Both combinations were given in equitoxic doses and number of cycles was only four. There are 106 women treated for breast cancer T1c-3a, N0-1, M0 in the study. After surgery the patients were randomized, 54 for AC combination and 52 for CMF. We evaluate toxicity of this treatment in all patients in the study. Hematological and nonhematological side effects were comparable in both groups except alopecia (in the group AC was 100%). The study is not finished yet. Preliminary analysis does not show any difference between these two groups.

Antineoplastic Combined Chemotherapy Protocols↗

[An unusual vascular tumor of the pericardium resembling Kaposi's sarcoma].

A peculiar vascular tumor of the pericardial cavity affecting a 21-year-old man is reported. The tumor was formed by spindle cells and narrow vascular channels. It was difficult to decide between primary pericardial Kaposi's sarcoma or angiosarcoma. The patient was HIV negative and no other tumors were revealed in the course of the disease. Immunohistochemical investigations showed positive endothelial markers-FVIII, CD 31, CD 34 in the tumor cells. Due to an inconclusive diagnosis of the tumor six cases of Kaposi's sarcoma and six cases of angiosarcomas were retrieved from our files, the same spectrum of immunohistochemistry as in above case applied, and the results compared. We found no significant differences in the positivity of endothelial markers among these cases and when compared with the case of pericardial tumor. The reactivity of CD 34 was, however, strong in cases of Kaposi's sarcoma whereas in angiosarcomas it yielded a weak and focal reaction only. In spite of the latter finding we feel that in individual cases, like the described tumor of the pericardial cavity, the immunohistochemical investigation cannot discriminate angiosarcoma from Kaposi's sarcoma. The reported tumor of the pericardial cavity was considered an unusual form of a low grade angiosarcoma with immunophenotypic features of Kaposi's sarcoma.

Adult↗

[Secretory meningioma].

Pseudopsammomatous inclusions were found in two cases of secretory meningioma. Their description includes ultrastructural and immunohistochemical features.

Humans↗

[Fabry's disease with isolated disease of the cardiac muscle, manifesting as hypertrophic cardiomyopathy].

A case is presented of Fabry's disease manifesting in an adult (aged 64) as hypertrophic nonobstructive cardiomyopathy caused by massive ceramidtrihexoside storage confined exclusively to the cardiocytes. There was no storage detectable in capillaries or in any other structure of the organs examined (liver, pancreas, brain, aorta, pulmonary artery, coronary arteries, heart valves). The clinical picture was dominated by heart failure slowly progressing during the last fifteen years of the patient's life terminated by pulmonary thromboembolism. There were no clinical signs of ocular, renal or skin affection. Since no unfixed tissues were available for enzyme analysis diagnosis had to be done using formaldehyde fixed tissues. The isolated stored lipid was characterized by TLC and by proton magnetic resonance analysis as globotriaosyl ceramide (Gal alpha 1-4 Gal beta 1-4 Glc beta 1-1' Cer) and was proved to be cleaved by control cell homogenates but left intact by those prepared from Fabry mutant cells (leukocytes, cultured fibroblasts). alpha galactosidase activity in each of his four daughters was in heterozygous range (peripheral leukocytes were used for analysis). The existing variants of cardiological syndromes in Fabry's disease are reviewed together with problems of diagnosis of atypical cases.

Cardiomyopathy, Hypertrophic↗

Cardiocyte storage and hypertrophy as a sole manifestation of Fabry's disease. Report on a case simulating hypertrophic non-obstructive cardiomyopathy.

Fabry's disease was diagnosed in an adult patient as a lipid storage-induced non-obstructive hypertrophic cardiomyopathy. Stable angina pectoris started 15 years before death, was followed by slowly progressive heart failure and repeated pulmonary thromboembolism with death at 63 years. Autopsy disclosed enormous cardiomegaly (1100 g), cardiac storage of ceramide trihexoside (CTH) of the same intensity as in classical cases of generalized Fabry's disease (11 mg lipid/g wet weight) restricted to cardiocytes. Other tissues (liver, kidney, brain, pancreas, pulmonary artery, coronary arteries) were free of storage. Using proton magnetic resonance analysis on formaldehyde-fixed tissue the stored CTH was identified as globotriaosylceramide. It was enzymatically degradable by control cell cultures but left uncleaved by mutant reference Fabry cells. Alpha-galactosidase activities in peripheral leucocytes of all four of the patient's daughters were in the heterozygous range. The diagnostic difficulties in this monosymptomatic novel variant of Fabry's disease are stressed.

Cardiomegaly↗

[Myelodysplastic syndromes].

Myelodysplastic syndromes (MDS) are a group of heterogenous disorders of blood and of the haematopoeitic bone marrow which have been recently in the center of interest of both clinical haematologists and pathologists. The FAB classification is based on cytology; for histological assessment, a special histopathological classification appears to be more appropriate. The main histological findings in MDS and some ultrastructural changes are shown in 138 bone marrow biopsies from 81 patients with MDS. Histological examination brings some findings that cannot be obtained by cytology. Optimal samples well processed can give valuable information without need of special staining methods. The latter can complement the basic information with some additional data or compensate for some technical defects of the slides.

Bone Marrow↗

[Histocytology of lymphatic tissue].

A more detailed analysis of lymphatic tissue showed its sophisticated cytology. About 35 types of cells shared in structure in a confined space. Their most important diagnostic criteria in the light and electron microscopy, histochemistry, and immunohistology were reviewed. Testing group features in advance seemed to be advantageous beginning with lymphocytes, lymphoplasmatic elements, polymorph lymphatic cells, lymphoblasts, histioreticular and vascular cells. A further subgrouping is mostly feasible especially by electron microscopy.

Humans↗