BACKGROUND: Percutaneous rhizotomy of the Gasserian ganglion is a well-established intervention for patients suffering from refractory trigeminal pain, not amenable to pharmacological management or microvascular decompression. Traditionally conducted under fluoroscopic guidance using Hartel's technique, this study investigates a modified approach employing low-dose CT guidance to achieve maximal procedural precision and safety with the emphasis on minimizing radiation exposure. METHODS: A retrospective analysis of patients undergoing percutaneous rhizotomy of the Gasserian ganglion at our institution was undertaken. Procedures were divided into fluoroscopy and CT-guided foramen ovale (FO) cannulation cohorts. Radiation doses were assessed, excluding cases with incomplete data. The study included 32 procedures in the fluoroscopy group and 30 in the CT group. RESULTS: In the CT-guided group, the median effective dose was 0.21 mSv. The median number of CT scans per procedure was 4.5, and the median procedure time was 15 min. Successful FO cannulation was achieved in all 30 procedures (100%). In the fluoroscopy group, the median effective dose was 0.022 mSv, and the median procedure time was 15 min. Cannulation of FO was successful in 31 of 32 procedures (96.9%). The only complications in the CT-guided group were three minor cheek hematomas. Immediate pain relief in the CT-guided group was reported in 25 of 30 procedures (83.3%), 22 of 30 (73.3%) provided relief at one month, and 10 of 18 (55.6%) procedures resulting in pain relief at one month continued to provide relief after two years. CONCLUSION: Low-dose CT-guided percutaneous rhizotomy conducted in the radiology suite carries negligible radiation exposure for patients and eliminates it for personnel. This method is fast, simple, precise, and carries a very low risk of complications.

• MeSH
• Radiation Dosage MeSH
• Adult MeSH
• Fluoroscopy methods   MeSH
• Trigeminal Ganglion surgery   diagnostic imaging   MeSH
• Middle Aged MeSH
• Humans MeSH
• Trigeminal Neuralgia * surgery   diagnostic imaging   radiotherapy   MeSH
• Tomography, X-Ray Computed * methods   MeSH
• Radiation Exposure * prevention & control   MeSH
• Retrospective Studies MeSH
• Rhizotomy * methods   MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Stickler syndrome (STL) is an inherited progressive connective tissue collagen disorder. STL is the most common hereditary cause of retinal complications, retinal tears, and the development of retinal detachment (RD) in childhood. The aim of the study was to evaluate the long-term anatomical and functional results of surgical treatment of retinal complications in children and adolescents affected by STL. METHODS: A retrospective, single-center study was performed a cohort of children with STL who underwent retinal surgery between 2004 and 2021. RESULTS: The study group consisted of nine children; the mean age at the time of the retinal tear with/without retinal detachment was 7.2 (2-10) years, and the mean follow-up period was 9.6 (5-16) years. Pathogenic variants COL2A1 (5 children) and COL11A1 (3 children) were confirmed in our cohort. In total, we operated on 13 eyes, 11 eyes with complicated RD and two eyes with multiple retinal defects, but without RD. At the end of the follow-up period, an attached retina was achieved 77% (10 eyes) with or without silicone oil tamponade: cryopexy alone was successful in one eye (10%), scleral buckling (EB) in five eyes (50%), and vitrectomy with silicone oil tamponade combined with EB in four eyes (40%). The mean number of surgeries was 2.3 per eye. The resulting best corrected visual acuity ranged from 0.03 to 0.1 in one eye, from 0.16 to 0.4 in two eyes, and from 0.5 to 1.0 in 7 eyes. CONCLUSION: Repair of retinal tears with/without retinal detachment in patients with Stickler syndrome often requires multiple surgeries with combinations of cryopexy, scleral buckling, and/or vitrectomy with silicone oil tamponade. Treatment of the ocular complications arising from STL requires long-term comprehensive care.

• MeSH
• Scleral Buckling MeSH
• Eye Diseases, Hereditary * surgery   MeSH
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Retinal Detachment * diagnosis   etiology   surgery   MeSH
• Retinal Perforations * surgery   MeSH
• Retina pathology   MeSH
• Retrospective Studies MeSH
• Silicone Oils MeSH
• Vitrectomy methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Publication type
• Journal Article MeSH

PURPOSE: To determine the efficacy of pars plana vitrectomy (PPV) in children with intraocular hemorrhage (IOH) secondary to Abusive head trauma (AHT). METHODS: A long-term retrospective analysis evaluating epidemiology, management, safety, anatomical and functional results of PPV for IOH in children with AHT at tertiary referral center for children in the Czech Republic from 2004 to 2017. RESULTS: 18 children were identified with IOH due to AHT during observation period of 14 years. Overall incidence of IOH related to AHT was 29.6/100 000, in children under 1 year 22.2/100 000, in children 1 to 5 years 7.4/100 000. Mean age at the time of diagnosis was 13.7 (SD±20.53) months, median 5 months. IOH resolved in 56% of children, 64% eyes, spontaneously. 44% children, 36% eyes, underwent PPV. PPV was performed 30.5 (SD±16.98) days after established diagnosis on average. Postoperatively, 80% of eyes had anatomical improvement, 20% eyes had preexisting irreversible changes in the posterior pole. Vision of 50% eyes improved after surgery, vision of 20% eyes remained poor, 30% of eyes was not possible to test due to severe neurological impairment. Mean observational period was 33.4 (SD±38.21) months. Mortality rate of AHT in our group was 17%, all victims were younger 4 months. CONCLUSIONS: PPV is a safe and effective procedure to clear IOH in children with AHT. Ophthalmology outcomes are strongly associated with degree of neurological impairment. Best outcomes were achieved with PPV performed between 2 and 5 weeks after trauma. Opportunity to plan surgery within this time frame indicates a good neurological prospect and prevents deprivation amblyopia.

• MeSH
• Child MeSH
• Craniocerebral Trauma * surgery   MeSH
• Humans MeSH
• Retinal Detachment * surgery   MeSH
• Retrospective Studies MeSH
• Vitrectomy MeSH
• Visual Acuity MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH

OBJECTIVES: The first objective of our study was to determine the radiation exposure received by patients during tin-filtrated ultra-low-dose computed tomography (TFULDCT) of sacroiliac joints and to compare those to conventional X-ray doses. For comparison, we added a cohort examined by low-dose CT (LDCT) without tin filtration. The second objective was to compare the results of TFULDCT and X-ray in the detection of sacroiliitis. METHODS: Our retrospective study covered 45 patients, who were examined for suspected axial spondyloarthritis (AxSpA). The first group underwent TFULDCT as well as conventional radiography (CR); the second group underwent LDCT only without tin filtration. Effective doses of TFULDCT, LDCT and CR were calculated by an experienced medical physicist. TFULDCT and CR were independently evaluated by three investigators, who decided on the presence or absence of rheumatoid inflammatory bone changes. The results were statistically evaluated. RESULTS: In our cohort, the median effective dose for TFULDCT was 0.11 mSv, range (0.06-0.40 mSv), for LDCT 0.5 mSv (0.29-0.89 mSv), and for CR 0.25 mSv (0.06-1.87 mSv). We proved that TFULDCT produces a significantly lower percentage of uncertain results (23.3%; 95% CI: 11.3-41.6%) than CR (66.7%; 95% CI: 48.3-81.1%). CONCLUSIONS: Tin filtration helps to reduce CT radiation exposure to values lower than those resulting from CR. TFULDCT offers better overall diagnostic performance than CR. Our results prove that TFULDCT can replace CR in the diagnosis of sacroiliitis in the radiographical stage of AxSpA.

• MeSH
• Tin * MeSH
• Radiation Dosage MeSH
• Humans MeSH
• Tomography, X-Ray Computed methods   MeSH
• Radiography MeSH
• X-Rays MeSH
• Retrospective Studies MeSH
• Sacroiliitis * diagnostic imaging   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Cíl: Cílem naší práce bylo zjistit, jak sníží cínová filtrace efektivní dávku záření a zda ovlivní kvalitu zobrazení u nízkodávkové výpočetní tomografie (LDCT) sakroiliakálních kloubů (SIK). Hodnocení bylo provedeno u souboru osob s podezřením na ankylozující spondylitidu. Pro srovnání byla vypočtena i efektivní dávka konvenčního RTG snímku. Metodika: Pacienty vyšetřené LDCT SIK na našem pracovišti v letech 2019-2020 jsme rozdělili na dvě skupiny. První skupina byla vyšetřena nízkodávkovým protokolem bez použití cínové filtrace a druhá skupina stejným nízkodávkovým protokolem jen s přidáním cínové filtrace. V případě, že pacient měl v klinickém systému dostupný RTG snímek, byl proveden výpočet jeho efektivní dávky. Výpočet dávek byl proveden radiologickým fyzikem za použití programů ImpactDose 2.3, patient model - real patient data (CT Imaging GmbH, Německo) a PCXMC 2.0 (X-ray, STUK Finsko). Kvalita obrazové dokumentace byla hodnocena nezávisle dvěma radiology. Výsledky: Medián efektivní dávky byl ve skupině vyšetřené s cínovou filtrací 0, 1 mSv (0,05-0,18 mSv), ve skupině bez filtrace 0,5 mSv (0,3-0,9 mSv). Medián efektivní dávky RTG snímků byl v našem souboru 0,25 mSv (0,06-1,16 mSv). V obou skupinách mělo 90 % vyšetření výbornou kvalitu. Závěr: Výsledky prokázaly, že radiační zátěž nemocného při použití cínové filtrace klesá ve srovnání s nízkodávkovým protokolem o 80 %. Ve srovnání s RTG je v našem souboru dávka při použití LDCT s cínovou filtrací nižší o 50 %. Z toho vyplývá, že LDCT s cínovou filtrací lze využívat v diagnostice ankylozující spondylitidy místo RTG snímku či v případě nejasného nálezu nebo nemožnosti provést MR vyšetření.

Objectives: The objective of our study was to determine whether tin filtration reduces the radiation exposure received by patients and whether it affects the quality of imaging in low-dose computed tomography (LDCT) of sacroiliac joints (SIJ). The evaluation was performed on a group of patients with suspected ankylosing spondylitis. For comparison, the effective dose of a conventional X-ray was calculated. Method: Patients examined by LDCT SIJ at our workplace in 2019-2020 were divided into two groups. The first group underwent a low-dose protocol without the use of tin filtration and the second group underwent the same low-dose protocol with tin filtration. When a patient had an X-ray available in the clinical system, its effective dose was calculated. The dose evaluation were performed by a medical physicist using ImpactDose 2.3, patient model - real patient data (CT Imaging GmbH, Germany) and PCXMC 2.0 (X-ray, STUK Finland) programs. The quality of the image documentation was evaluated independently by two radiologists. Results: In our cohort, the median effective dose for LDCT with tin filtration was 0.1 mSv (0.05-0.18 mSv), for LDCT without tin filtration was 0.5 mSv (0.3-0.9 mSv) and for X-ray was 0.25 mSv (0.06-1.16 mSv). In both LDCT groups 90% of image documentation was of an excellent quality. Conclusion: Our results showed that the tin filtration decreases the radiation dose in comparison with the low-dose protocol by 80%. Compared to X-rays, the dose in our LDCT group with tin filtration was 50% lower. It follows that LDCT with tin filtration can be used in the diagnosis of ankylosing spondylitis instead of X-rays or in case of unclear findings or inability to perform MRI examination.

Cíl: Cílem práce je referovat o případu oboustranného poranění očí a oboustranné fraktuře spodiny očnice způsobené vysokotlakým proudem vody z hasičské hadice u šestnáctileté dívky v průběhu soutěže mladých hasičů. Metody: Uvádíme kazuistiku 16leté pacientky, která utrpěla oboustranné zhmoždění, edém a laceraci horních očních víček, laceraci obou bulbárních spojivek, kontuzi obou očních bulbů, levého optického nervu a oboustrannou frakturu spodiny očnice. Výsledky: Vstupní oční vyšetření odhalilo zrakovou ostrost pohyb na pravém a žádné vnímání světla na levém oku. Nitrooční tlak byl velmi nízký na obou očích. Oční pohyblivost byla redukována, zejména na levém oku. Lacerace horních víček a spojivky vyžadovaly chirurgické řešení. Reparace lacerace horního slzného kanálku levého oka nebyla provedena. Paralytická mydriáza a ztráta akomodace obou očí trvá po celou dobu sledování. Chirurgicky byla řešena levostranná zlomenina spodiny očnice, pohyblivost pravého oka se upravila spontánně. Traumatická katarakta se na levém oku vytvořila rok po vlastním úrazu a vyžadovala chirurgické řešení zahrnující implantaci zadněkomorové nitrooční čočky a iridoplastiku. Pravá čočka zůstala čirá. Masivní zjizvení sítnice a cévnatky v dolních partiích obou sítnic spolu s makulou snížilo nejlepší korigovanou zrakovou ostrost pravého oka na 0,15 a levého oka na 0,08. Nitrooční tlak je ve fysiologických mezích bez nutnosti terapie. Sledovací doba je tři roky. Závěr: Tato kazuistika je prvním popsaným případem pacienta s hydraulickým poškozením očí v dětském věku a při sportu.

Purpose: The aim is to present a report of a case of bilateral eye injury with bilateral blowout fracture caused by a high-pressure water jet from a fire hose in a 16-year-old girl during a competition for young firefighters. Methods: We present a case report of a 16-year-old female patient with bilateral extensive eyelid contusion, oedema and lacerations of upper eyelids, lacerations of bulbar conjunctiva, contusion of both eyes, left optic nerve and bilateral blowout fractures of orbits. Results: The initial ocular examination revealed "hand motion" in the right eye and no light perception in the left eye. Intraocular pressure was low in both eyes. Motility of both eyes was reduced, especially in the left eye. Lacerations of the eyelids and conjunctiva required a surgical procedure. No repair of the upper canaliculus of the left eye was attempted. Paralytic mydriasis and loss of lens accommodation in both eyes did not change throughout the follow-up period. A surgical procedure was applied to resolve the left blowout fracture, ocular motility of the right eye improved spontaneously. Traumatic cataract developed in the left eye within 1 year after injury, requiring cataract surgery and posterior capsule lens implantation, the right lens remained clear. Massive scarring of the retina and choroid in the lower parts of the eyes and in the macula reduced best corrected visual acuity in the right eye to 0.15 and in the left eye to 0.08. Intraocular pressure is within normal limits without any glaucoma therapy. The follow up period is three years. Conclusion: This is the first reported case of child with an eye injury caused by a high-pressure water jet during a sports activity.

• Keywords
• traumatická katarakta,
• MeSH
• Cataract Extraction MeSH
• Orbital Fractures etiology   therapy   MeSH
• Fire Extinguishing Systems MeSH
• Hydrostatic Pressure adverse effects   MeSH
• Cataract etiology   MeSH
• Humans MeSH
• Adolescent MeSH
• Eye Injuries * etiology   therapy   MeSH
• Athletic Injuries MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

We report the clinical findings of 26 individuals from 16 unrelated families carrying variants in the COL2A1 or COL11A1 genes. Using Sanger and next-generation sequencing, 11 different COL2A1 variants (seven novel), were identified in 13 families (19 affected individuals), all diagnosed with Stickler syndrome (STL) type 1. In nine families, the COL2A1 disease-causing variant arose de novo. Phenotypically, we observed myopia (95%) and retinal detachment (47%), joint hyperflexibility (92%), midface retrusion (84%), cleft palate (53%), and various degrees of hearing impairment (50%). One patient had a splenic artery aneurysm. One affected individual carrying pathogenic variant in COL2A1 showed no ocular signs including no evidence of membranous vitreous anomaly. In three families (seven affected individuals), three novel COL11A1 variants were found. The propositus with a de novo variant showed an ultrarare Marshall/STL overlap. In the second family, the only common clinical sign was postlingual progressive sensorineural hearing impairment (DFNA37). Affected individuals from the third family had typical STL2 signs. The spectrum of disease phenotypes associated with COL2A1 or COL11A1 variants continues to expand and includes typical STL and various bone dysplasias, but also nonsyndromic hearing impairment, isolated myopia with or without retinal detachment, and STL phenotype without clinically detectable ocular pathology.

• MeSH
• Arthritis genetics   MeSH
• Child MeSH
• Adult MeSH
• Phenotype MeSH
• Infant MeSH
• Collagen Type II genetics   MeSH
• Collagen Type XI genetics   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• DNA Mutational Analysis MeSH
• Connective Tissue Diseases genetics   MeSH
• Retinal Detachment genetics   MeSH
• Hearing Loss, Sensorineural genetics   MeSH
• Child, Preschool MeSH
• Pedigree MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

Cíl: Cílem naší studie bylo zjistit radiační zátěž nízkodávkové výpočetní tomografie s cínovou filtrací (Sn LDCT) sakroiliakálních (SI) kloubů. Získanou efektivní radiační dávku jsme porovnali s dávkou potřebnou pro rentgenové vyšetření SI kloubů a s dávkou při standardním CT vyšetření SI kloubů. Soubor: Retrospektivně jsme hodnotili obrazovou dokumentaci 52 nemocných, kteří podstoupili cílené CT vyšetření SI kloubů v posledních 5 letech. Pro potřebu této studie jsme je rozdělili na skupinu vyšetřenou Sn LDCT a ostatní, kteří byli vyšetřeni standardní dávkou bez cínové filtrace. Třetí skupinu tvoří ti pacienti z výše uvedených, kteří měli k dispozici RTG snímek SI kloubů. Metoda: Výpočet efektivní radiační dávky obdržené při uvedených vyšetřovacích metodách byl proveden s použitím programu ImpactDose 2.3, patient model – real patient data (CT Imaging GmbH, Germany) a PCXMC 2.0 (X-ray, STUK Finland). Výsledky: Efektivní radiační dávka pro jednotlivé metody v pořadí Sn LDCT, RTG, SDCT byly 0,14 mSv (0,06 až 0,40 mSv), 0,29 mSv (0,06–1,15 mSv), 2,07 mSv (0,69 až 5,35 mSv). Všechna vyšetření měla dobrou kvalitu. Závěr: Dávky použité při Sn LDCT byly o polovinu nižší než při RTG vyšetření SI kloubů a desetinné ve srovnání se standardním CT. Z toho vyplývá, že Sn LDCT nezatěžuje pacienta nadměrnou radiací.

Aim: The aim of our study was to evaluate the effective radiation doses that patients received from low-dose computed tomography with tin filtration (Sn LDCT) of sacroiliac (SI) joints. We compared the doses from Sn LDCT with the doses from X-ray of SI joints and with the doses from standard CT examination of SI joints. File: We retrospectively evaluated the imaging documentation of 52 patients who underwent targeted CT examination of SI joints in the last 5 years. For the purpose of this study, we divided them into two groups. The first group was examined by Sn LDCT and the second by a standard dose CT without tin filtration. The third group consisted of those patients (from the above-mentioned ones) who had an X-ray of SI joints. Method: The calculation of the effective radiation dose was performed using ImpactDose 2.3, patient model – real patient data (CT Imaging GmbH, Germany) and PCXMC 2.0 (X-ray, STUK Finland). Results: In our cohort, the effective radiation dose were 0.14 mSv (0.06-0.40 mSv) for the Sn LDCT, 0.29 mSv (0.06–1.15 mSv) for X-ray, 2.07 mSv (0.69-5.35 mSv) for SDCT. All examination methods had good quality. Conclusion: The Sn LDCT effective radiation doses were half that of the X-ray and decimal that of the standard CT. Sn LDCT does not burden the patient with excessive radiation

• Keywords
• nízkodávková výpočetní tomografie, cínová filtrace,
• MeSH
• Early Diagnosis MeSH
• Radiation Dosage MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Tomography, X-Ray Computed * methods   MeSH
• Radiography MeSH
• Sacroiliitis * diagnostic imaging   MeSH
• Aged MeSH
• Spondylarthritis diagnostic imaging   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH

Carbonic anhydrase IX (CAIX) is a transmembrane enzyme that regulates pH in hypoxic tumors and promotes tumor cell survival. Its expression is associated with the occurrence of metastases and poor prognosis. Here, we present nine derivatives of the cobalt bis(dicarbollide)(1-) anion substituted at the boron or carbon sites by alkysulfamide group(s) as highly specific and selective inhibitors of CAIX. Interactions of these compounds with the active site of CAIX were explored on the atomic level using protein crystallography. Two selected derivatives display subnanomolar or picomolar inhibition constants and high selectivity for the tumor-specific CAIX over cytosolic isoform CAII. Both derivatives had a time-dependent effect on the growth of multicellular spheroids of HT-29 and HCT116 colorectal cancer cells, facilitated penetration and/or accumulation of doxorubicin into spheroids, and displayed low toxicity and showed promising pharmacokinetics and a significant inhibitory effect on tumor growth in syngenic breast 4T1 and colorectal HT-29 cancer xenotransplants.

• MeSH
• Amides chemistry   MeSH
• Biological Transport drug effects   MeSH
• Boranes chemistry   pharmacology   MeSH
• Doxorubicin metabolism   MeSH
• Carbonic Anhydrase Inhibitors chemistry   pharmacology   MeSH
• Carbonic Anhydrase IX chemistry   metabolism   MeSH
• Catalytic Domain MeSH
• Humans MeSH
• Models, Molecular MeSH
• Mice MeSH
• Cell Line, Tumor MeSH
• Drug Design MeSH
• Drug Synergism MeSH
• Xenograft Model Antitumor Assays MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Mice MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH