BACKGROUND AND AIM: Minimally invasive endoscopic techniques are the treatment of choice for Zenker's diverticulum (ZD). Our objective was to evaluate the results and efficacy of endoscopic and open approaches, to determine whether postoperative C-reactive protein (CRP) serum levels can be used as a marker to exclude the presence of esophageal leakage, and to identify risk factors for development of postoperative leakage and complications. MATERIALS AND METHODS: Patients who underwent transcervical myotomy and diverticulotomy (TMD) or endoscopic cricopharyngeal myotomy (ECM) with CO2 laser for ZD in years 2008-2021 at our department were included in this retrospective study. RESULTS: Of the 101 patients enrolled, 83 patients underwent ECM and 18 TMD. The procedure time of the endoscopic technique was significantly shorter compared to that of transcervical method (p < 0.001). The median time to oral intake was 6 days for ECM and 10.5 days in the TMD group (p < 0.001). There was a 13% (n = 11) and 16.7% (n = 3) symptomatic recurrence rate and 3.6% (n = 3) and 16.7% (n = 3) major complications rate for ECM and TMD groups, respectively. The incidence of contrast leak (CL) evaluated by postoperative swallow study was 8.9% (9 from 83 patients in the ECM group only). In patients with CL, a significant increase in CRP levels on postoperative day (POD) 2 and 3 was detected when compared to patients without CL. CONCLUSIONS: Endoscopic diverticulotomy with CO2 laser represents a safe and efficient treatment of ZD. Elevation of postoperative CRP serum levels over 123.8 mg/L on POD2 and 98.8 mg/L on POD3 may indicate presence of an esophageal leakage.

• MeSH
• C-reaktivní protein MeSH
• ezofágoskopie metody   MeSH
• lasery plynové * terapeutické užití   MeSH
• lidé MeSH
• oxid uhličitý MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Zenkerův divertikl * chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Vestibular schwannoma is the most common benign neoplasm of the cerebellopontine angle. It arises from Schwann cells of the vestibular nerve. The first symptoms of vestibular schwannoma include hearing loss, tinnitus, and vestibular symptoms. In the event of further growth, cerebellar and brainstem symptoms, along with palsy of the adjacent cranial nerves, may be present. Although hearing impairment is present in 95% of patients diagnosed with vestibular schwannoma, most tumors do not progress in size or have low growth rates. However, the clinical picture has unpredictable dynamics, and there are currently no reliable predictors of the tumor's behavior. The etiology of the hearing loss in patients with vestibular schwannoma is unclear. Given the presence of hearing loss in patients with non-growing tumors, a purely mechanistic approach is insufficient. A possible explanation for this may be that the function of the auditory system may be affected by the paracrine activity of the tumor. Moreover, initiation of the development and growth progression of vestibular schwannomas is not yet clearly understood. Biallelic loss of the NF2 gene does not explain the occurrence in all patients; therefore, detection of gene expression abnormalities in cases of progressive growth is required. As in other areas of cancer research, the tumor microenvironment is coming to the forefront, also in vestibular schwannomas. In the paradigm of the tumor microenvironment, the stroma of the tumor actively influences the tumor's behavior. However, research in the area of vestibular schwannomas is at an early stage. Thus, knowledge of the molecular mechanisms of tumorigenesis and interactions between cells present within the tumor is crucial for the diagnosis, prediction of tumor behavior, and targeted therapeutic interventions. In this review, we provide an overview of the current knowledge in the field of molecular biology and tumor microenvironment of vestibular schwannomas, as well as their relationship to tumor growth and hearing loss.

• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Úvod: Dysfagie má prevalenci v běžné populaci 6–16 %. Na diagnostiku a léčbu se zaměřuje multidisciplinární dysfagiologický tým ve složení klinický logoped, otorinolaryngolog a zdravotní sestra (podle pracoviště může být členem týmu i např. radiolog, nutriční specialista, fyzioterapeut apod.). K objektivnímu vyšetření je jako zlatý standard užíván FEES (Flexible Endoscopic Evaluation of Swallowing) a VFSS (Videofluoroscopic Swallow Study). Cíl práce: Cílem práce je retrospektivně zhodnotit přínos dysfagiologického týmu, který působí na otorinolaryngologickém oddělení Nemocnice České Budějovice, a. s. (NČB), v péči o pacienty po cévní mozkové příhodě (CMP) indikovaných k vyšetření z Komplexního cerebrovaskulárního centra (KCC) v letech 2016–2020. Materiál a metodika: Do retrospektivní studie bylo zařazeno 33 pacientů po CMP s klinickým podezřením na dysfagii, kteří byli doporučeni z KCC do Poradny pro poruchy polykání k objektivnímu vyšetření dysfagie. Výsledky: U 9 pacientů (27,3 %) byla při FEES vyloučena dysfagie, a byl tak umožněn perorální příjem bez omezení. Dysfagie byla při vyšetření potvrzena u 24 pacientů (72,7 %). U 10 pacientů (30,3 %) byla prokázána prodloužená faryngeální fáze polykání bez penetrace nebo aspirace stravy. Tři pacienti (9,1 %) měli při vyšetření penetraci sousta do dýchacích cest, ale nedosahovalo úrovně hlasivek a bylo kompletně vypuzeno (PAS 2). V 11 případech (33,3 %) byla prokázána aspirace, z toho se v devíti případech (27,3 % ze všech pacientů, 81,8 % z pacientů s aspirací) jednalo o tichou aspiraci bez snahy o vypuzení aspirátu z dýchacích cest (PAS 8). Závěr: U 31 pacientů (94,0 %) byl zaznamenán přínos vyšetření dysfagiologickým týmem. V případě 22 pacientů (66,7 %) šlo o úpravu alimentace a rehabilitace polykání při potvrzené dysfagii. U 9 pacientů (27,3 %) došlo ke zrušení restrikcí při falešně pozitivním screeningovém a klinickém vyšetření. Pozitivní efekt dlouhodobé rehabilitace polykání pozorujeme u 61,5 % sledovaných pacientů.

Introduction: The prevalence of dysphagia in the general population is 6–16%. The dysphagia team focuses on diagnosis and treatment of dysphagia. The dysphagia team consists of a clinical speech therapist, an otorhinolaryngologist and nurse (depending on the workplace). Other specialties such as radiologist, nutritionist and physiotherapist can also be a member of the team. FEES (Flexible Endoscopic Evaluation of Swallowing) and VFSS (Videofluoroscopic Swallow Study) are used as the gold standard for objective examination of the dysphagia. Aim of the work: The aim of the work is to evaluate retrospectively the contribution of the dysphagia team working in the department of otorhinolaryngology in Hospital České Budějovice, in the care of patients after stroke disease indicated for examination from the Complex Cerebrovascular Center (CCC) in 2016–2020. Material and methods: The retrospective study included 33 patients after stroke with clinical suspicion of dysphagia, who were referred from the CCC to the Counseling Center for Swallowing Disorders for objective examination of dysphagia. Results: In 9 patients (27.3%), dysphagia was ruled out during FEES, thus enabling oral intake without restrictions. Dysphagia was confirmed in 24 patients (72.7%). Ten patients (30.3%) had a prolonged pharyngeal swallowing phase without food penetration into the airways. Three patients (9.1%) had a bolus penetration into the airways during the examination, but it remained above the vocal cords and it was completely expelled from the airways (PAS 2). In 11 cases (33.3%) aspiration was found, of which nine cases (27.3% of all patients, 81.8% of patients with aspiration) involved silent aspiration without any attempt to expel bolus from the airways (PAS 8). Conclusion: In 31 patients (94.0%) the benefit of examination by the dysphagia team was noted. In the case of 22 patients (66.7%), it was an adjustment of nutrition and swallowing rehabilitation with confirmed dysphagia. Restrictions were lifted in 9 patients (27.3%) with false-positive screening and clinical examination. We observe a positive effect of long-term swallowing rehabilitation in 61.5% of the monitored patients.

• MeSH
• cévní mozková příhoda * komplikace   MeSH
• endoskopie MeSH
• lidé MeSH
• poruchy polykání * diagnóza   terapie   MeSH
• rehabilitace po cévní mozkové příhodě metody   MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH

Importance: Recurrent respiratory papillomatosis (RRP) is a rare benign chronic disease of the larynx etiologically linked with the infection of low-risk human papillomavirus (HPV). Combination of surgical and immunomodulatory therapy has limited success. Possible use of prophylactic HPV vaccine that includes HPV-6 and HPV-11 antigens has been studied. Objective: To evaluate if the HPV vaccination is associated with a lower number of recurrences requiring surgical intervention in patients with new and recurrent RRP. Design, Setting, and Participants: This was a non-placebo-controlled intervention study. Enrollment data were collected from October 2011 to August 2013. The patients were followed up at 1 month, 12 months, and 5 years after the third dose of the vaccine and clinically monitored until December 31, 2018. Data were analyzed from 2019 to 2021. Altogether, 50 adults with active RRP were enrolled and followed up in referral centers. For the final outcome, follow-up data for 42 patients were available. Eight patients who did not fulfill the protocol were excluded. Interventions: All patients received HPV vaccine as an adjuvant treatment and were clinically followed up. When RRP progression or a significant recurrent lesion was detected, surgical removal via direct laryngoscopy was indicated. No adjuvant therapy with antiviral or biological agents was used. Main Outcomes and Measures: This study compared the prevaccination and postvaccination positivity for HPV-specific antibodies. The main outcome was the difference in the frequency of RRP recurrences in the prevaccination and postvaccination period. Results: A total of 50 patients with RRP were enrolled (median [SD] age, 41.5 [12.3] years [range, 21-73 years]; 39 [78%] men and 11 [22%] women). After HPV vaccination, patients with previously no HPV-specific antibodies showed seroconversion, and all patients developed 100-fold higher levels of HPV vaccine type-specific antibodies compared with the prevaccination period. In patients with recurrent RRP, decreased frequency of recurrences requiring surgical treatment was present after vaccination (from 0.85 to 0.36 recurrences/y). No difference in postvaccination recurrences was found between patients with newly diagnosed and recurrent RRP. Conclusions and Relevance: In this nonrandomized clinical trial, the frequency of RRP recurrences was significantly lower after HPV vaccination, and patients with RRP thus had a reduced burden of disease. Because no difference was detected in the frequency of recurrent postvaccination lesions in patients with new and recurrent disease, it appears that both groups showed equal benefit following HPV vaccination. These findings suggest that the earlier that patients with RRP receive HPV vaccine, the sooner they may show reduced burden of disease. Trial Registration: EudraCT Identifier: 2011-002667-14; ClinicalTrials.gov Identifier: NCT01375868.

• MeSH
• Alphapapillomavirus * MeSH
• dospělí MeSH
• infekce dýchací soustavy * prevence a kontrola   MeSH
• infekce papilomavirem * prevence a kontrola   MeSH
• lidé MeSH
• vakcinace MeSH
• vakcíny proti papilomavirům * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH

• MeSH
• diferenciální diagnóza MeSH
• endoskopie mortalita   MeSH
• lidé MeSH
• papilom * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

I přes pokrok v terapii nádorů hlavy a krku se celkové pětileté přežití za posledních několik dekád prakticky nezměnilo, a to zejména kvůli pozdní diagnóze. Vzhledem k tomu, že v minulosti byly slizniční nádory v ORL oblasti zachycovány až ve vyšších stadiích nemoci, byly vyvinuty nové endoskopické optické zobrazovací metody pro lepší a dřívější detekci těchto lézí. Dělíme je na dvě základní skupiny. Horizontální metody zobrazují povrch sliznice (úzkopásmové zobrazení – narrow band imaging, autofluorescence, fotodynamická diagnostika, zvětšovací a kontaktní endoskopie). Vertikální metody umožňují zobrazit různé vrstvy sliznice (optická koherentní tomografie a konfokální laserová endomikroskopie). V zahraničí jsou běžně v současné klinické praxi v různých oborech využívány narrow band imaging a autofluorescence. Do ORL působnosti se stále častěji začleňuje i zvětšovací a kontaktní endoskopie. Autoři předkládají souhrnný přehled o využití narrow band imaging a autofluorescenci při diagnostice karcinomu orofaryngu.

Despite progress in the treatment of head and neck cancer, the five-year overall survival rate is still low because of late dia gnosis. The head and neck mucosal tumours were usually diagnosed in higher stages in past, therefore new endoscopic optical imaging methods were developed for better and earlier detection of these lesions. They are divided in two main groups – horizontal and vertical methods. The horizontal ones show the surface of the mucous membrane (narrow band imaging, autofluorescence, photodynamic diagnosis, magnifying and contact endoscopy). The vertical ones show different layers of the mucosa (optical coherence tomography and confocal endomicroscopy). Narrow band imaging and autofluorescence endoscopy are already used routinely in foreign countries, magnifying and contact endoscopy are getting to practice recently. The authors present a summary of narrow band imaging and autofluorescence endoscopy usage in the diagnostics of oropharyngeal carcinoma.

• MeSH
• diagnostické zobrazování metody   MeSH
• endoskopie metody   MeSH
• lidé MeSH
• nádory orofaryngu * diagnostické zobrazování   diagnóza   MeSH
• optické zobrazování metody   MeSH
• úzkopásmové zobrazení metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives.

• MeSH
• biodiverzita MeSH
• ekologie MeSH
• ekosystém * MeSH
• přístup k informacím * MeSH
• rostliny MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVES: Transoral laser surgery is the optimal surgical treatment modality for the early stages of glottic cancer. To allow for further treatment to be as effective and as minimal as possible, persistent or recurrent tumors should be detected very soon. The main aim is to minimize the risk of necessity of performing a total laryngectomy. Flexible videoendoscopy with narrow band imaging (NBI) was recommended by the European Laryngological Society as a diagnostic method for the follow-up of patients treated for laryngeal cancer. Nevertheless, the efficacy of this technique has not been extensively studied in patients after transoral laser cordectomies for vocal fold cancer. The aim of this study was to evaluate the efficacy of in-office transnasal NBI flexible videoendoscopy in the follow-up of patients after transoral laser cordectomy for glottic cancer. We also focused on describing the specific characteristics of recurrent tumor appearance. MATERIALS AND METHODS: The presented study was conceived as a prospective study. Ninety-four consecutive patients who underwent transoral laser cordectomy for severe dysplasia, Tis, T1, and T2 glottic cancer in the period from June 2010 to August 2015 were enrolled in the study. All patients were postoperatively regularly followed using transnasal videoendoscopic examinations with NBI. Whenever a suspect lesion was identified during in-office examination, its nature was proven histologically. RESULTS: We discovered 23 suspect findings in 21 patients by means of flexible videoendoscopy with NBI. Fifteen (65.2%) of them were histologically confirmed as recurrent tumors, whereas in 8 (34.8%) of them, the recurrent tumor was not proven. In two patients, the recurrent tumor was evident on computed tomography or magnetic resonance imaging, but NBI endoscopy did not reveal relapsing disease. The rest (71 patients) were considered true negative. Of the 15 recurrent tumors detected by NBI-coupled videoendoscopy, 8 (53.3%) were identified as submucosal masses with nonsignificant or no vascular changes, 4 (26.7%) were noted as the progression of leukoplakia without visible vascular changes, only 2 (13.3%) showed typical vascular changes, and, in 1 (6.7%) case, evident, significantly exophytic tumor with pathological vascularization was discovered. The sensitivity, specificity, and positive and negative predictive values of the in-office transnasal videolaryngoscopy with NBI were calculated to be 88%, 92%, 71%, and 97%, respectively. CONCLUSIONS: The results of the study demonstrate that transnasal endoscopy with NBI in an outpatient setting is an excellent method for the follow-up of patients after transoral laser cordectomy for glottic cancer. The method achieves high sensitivity, specificity, and negative predictive value and a slightly low positive predictive value. Nevertheless, we must bear in mind that recurrent tumors after previous endoscopic resection may have a completely different appearance than new tumors originating from previously untreated tissues. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

• MeSH
• dospělí MeSH
• endoskopické operace přirozenými otvory * MeSH
• glottis MeSH
• laryngektomie * MeSH
• laserová terapie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru diagnostické zobrazování   MeSH
• nádory hrtanu diagnostické zobrazování   chirurgie   MeSH
• následné studie MeSH
• prediktivní hodnota testů MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úzkopásmové zobrazení * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Scots pine (Pinus sylvestris L.) is a widespread tolerant forest tree-species; however, its adaptability to environmental change differs among sites with various buffering capacity. In this study, we compared the spatial effects of aridity index (AI) and nitrogen deposition (ND) on biomass density in natural and man-made pine stands of differing soil fertility using geographically weighted multiple lag regression. Soil fertility was defined using soil series as zonal trophic (27.9%), acidic (48.2%), gleyed (15.2%) and as azonal exposed (2.5%), maple (2.4%), ash (0.8%), wet (2.1%) and peat (0.9%) under pine stands in the Czech Republic (Central Europe; 4290.5 km2; 130-1298 m a.s.l.). Annual AI and ND in every pine stand were estimated by intersection between raster and vector from 1 × 1 km grid for years 2000, 2003, 2007 and 2010 of severe non-specific forest damage spread. Biomass density was obtained from a MODIS 250 × 250 m raster using the enhanced vegetation index (EVI) for years 2000-2015, with a decrease in EVI indicating non-specific damage. Environmental change was assessed by comparing predictor values at EVI time t and t+λ. Non-specific damage was registered over 51.9% of total forest area. Less than 8.8% of damaged stands were natural and the rest (91.2%) of damaged stands were man-made. Pure pine stands were more damaged than mixed. The ND effect prevailed up to 2007, while AI dominated later. Temporal increasing ND effect under AI effectiveness led to the most significant pine stand damage in 2008 and 2014. Predictors from 2000 to 2007 afflicted 58.5% of non-specifically damaged stands at R2 0.09-0.76 (median 0.38), but from 2000 to 2010 afflicted 57.1% of the stands at R2 0.16-0.75 (median 0.40). The most damaged stands occurred on acidic sites. Mixed forest and sustainable management on natural sites seem as effective remediation reducing damage by ND.

• MeSH
• borovice lesní * MeSH
• borovice * MeSH
• dusík MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH