INTRODUCTION: It is hypothesized that systemically administered antibiotics penetrate wound sites more effectively during negative pressure wound therapy (NPWT). However, there is a lack of clinical data from patients who receive NPWT for deep sternal wound infection (DSWI) after open-heart surgery. Here, we evaluated vancomycin penetration into exudate in this patient group. PATIENTS AND METHODS: For this prospective observational study, we enrolled 10 consecutive patients treated with NPWT for post-sternotomy DSWI. On the first sampling day, serum and exudate samples were synchronously collected at 0 (pre-dose), 0.5, 1, 2, 3 and 6 h after vancomycin administration. On the following three consecutive days, additional samples were collected, only before vancomycin administration. RESULTS: The ratio of average vancomycin concentration in wound exudate to in serum was higher for free (unbound) (1.51 ± 0.53) than for total (bound + unbound) (0.91 ± 0.29) concentration (p = 0.049). The percentage of free vancomycin was higher in wound exudate than serum (0.79 ± 0.19 vs. 0.46 ± 0.16; p = 0.04). Good vancomycin wound penetration was maintained on the following three days (vancomycin trough exudate-to-serum concentration ratio > 1). The total hospital stay was significantly longer in patients with DSWI (46 ± 11.6 days) versus without DSWI (14 ± 11.7 days) (p < 0.001). There was no in-hospital or 90-day mortality. Two patients experienced late DSWI recurrence. All-cause mortality was 4.8% during a median follow-up of 2.5 years. CONCLUSION: Vancomycin effectively penetrates wound exudate in patients receiving NPWT for DSWI after open-heart surgery.The protocol for this study was registered at ClinicalTrials.gov on July 16, 2024 (NCT06506032).

• MeSH
• antibakteriální látky * farmakokinetika   aplikace a dávkování   MeSH
• exsudáty a transsudáty metabolismus   mikrobiologie   MeSH
• infekce chirurgické rány * MeSH
• kardiochirurgické výkony * škodlivé účinky   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prospektivní studie MeSH
• senioři MeSH
• sternotomie * škodlivé účinky   MeSH
• sternum chirurgie   MeSH
• terapie ran pomocí řízeného podtlaku * metody   MeSH
• vankomycin * aplikace a dávkování   farmakokinetika   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

OBJECTIVE: Oral squamous cell carcinoma (OSCC) originates from the mucosal lining of the oral cavity. Almost half of newly diagnosed cases are classified as advanced stage IV disease, which makes resection difficult. In this study, we investigated the pathological features and mutation profiles of tumor margins in OSCC. METHODS: We performed hierarchical clustering of principal components to identify distinct patterns of tumor growth and their association with patient prognosis. We also used next-generation sequencing to analyze somatic mutations in tumor and marginal tissue samples. RESULTS: Our analyses uncovered that the grade of worst pattern of invasion (WPOI) is strongly associated with depth of invasion and patient survival in multivariable analysis. Mutations were primarily detected in the DNA isolated from tumors, but several mutations were also identified in marginal tissue. In total, we uncovered 29 mutated genes, mainly tumor suppressor genes involved in DNA repair including BRCA genes; however none of these mutations significantly correlated with a higher chance of relapse in our medium-size cohort. Some resection margins that appeared histologically normal harbored tumorigenic mutations in TP53 and CDKN2A genes. CONCLUSION: Even histologically normal margins may contain molecular alterations that are not detectable by conventional histopathological methods, but NCCN classification system still outperforms other methods in the prediction of the probability of disease relapse.

• Publikační typ
• časopisecké články MeSH

Lung malignancies have a substantial impact on cancer incidence and mortality worldwide. Even though many factors involved in the development of the disease are known, many questions remain unanswered. Previous studies suggest that the intestinal microbiota may have a role in developing malignant diseases. According to some findings, the microbiota has proven to be a key modulator of carcinogenic processes and the immune response against cancer cells, potentially influencing the effectiveness of immunotherapy. In our study, we characterized culturable microorganisms associated with non-small cell lung cancer (NSCLC) that can be recovered from rectal swabs and mouthwash. In addition, we also explored differences in the culturable microbiota with two main types of NSCLC - adenocarcinoma (ADC) and squamous cell carcinoma (SCC). With 141 patients included in the study (86 ADC and 55 SCC cases), a significant difference was observed between the two types in seven bacterial species (Collinsella, Corynebacterium, Klebsiella, Lactobacillus, Neisseria, Rothia, and Streptococcus), including the site of origin. The relationship between microbial dysbiosis and lung cancer is poorly understood; future research could shed light on the links between gut microbiota and lung cancer development.

• MeSH
• adenokarcinom * MeSH
• lidé MeSH
• mikrobiota * MeSH
• nádory plic * mikrobiologie   patologie   MeSH
• nemalobuněčný karcinom plic * mikrobiologie   patologie   MeSH
• spinocelulární karcinom * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: The incidence of advanced oral cavity and oropharyngeal cancers is generally high. Treatment outcomes for patients, especially those unfit for comprehensive cancer treatment, are unsatisfactory. Therefore, the search for factors to predict response to treatment and increase overall survival is underway. OBJECTIVE: This study aimed to analyze the presence of 32 HPV genotypes in tumor samples of 34 patients and the effect of HPV status and RAD51 on overall survival. METHOD: Tumor samples of 34 patients with locally advanced oropharyngeal or oral cavity cancer treated with accelerated radiotherapy in monotherapy were analyzed using reverse hybridization and immunohistochemistry for the presence of HPV and RAD51. Its effect on overall survival was examined. RESULTS: Only two types of HPV were identified-HPV 16 (dominant) and HPV 66 (two samples). The HPV positivity was associated with a borderline insignificant improvement in 2-year (p = 0.083), 5-year (p = 0.159), and overall survival (p = 0.083). Similarly, the RAD51 overexpression was associated with borderline insignificant improvement in 2-year (p = 0.083) and 5-year (p = 0.159) survival. CONCLUSION: We found no statistically significant differences but detected trends toward improvement in the survival of HPV-positive and RAD51 overexpressing patients unfit for surgical treatment or chemotherapy treated with hyperfractionated radiotherapy. The trends, however, indicate that in a larger group of patients, the effects of these two parameters would likely be statistically significant.

• MeSH
• infekce papilomavirem * komplikace   MeSH
• lidé MeSH
• nádory orofaryngu * MeSH
• prognóza MeSH
• rekombinasa Rad51 MeSH
• spinocelulární karcinom * patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: The study aimed to evaluate audiological benefits, quality of hearing and safety of two Bonebridge generation: BCI601 and BCI602 (MED-EL, Innsbruck, Austria) in children. METHODS: Twelve children were implanted: five BCI601 and seven BCI602 comprising of ten conductive hearing loss, and two single sided deaf SSD subjects. Audiological outcomes tested were sound field audiometry, functional gain, speech recognition threshold (SRT50), speech recognition in noise (SPRINT) and localisation abilities. Subjective measures were Speech, Spatial and Qualities of Hearing Scale (SSQ12). RESULTS: The mean FG with the BCI601 was 25.0 dB and with the BCI602 28.0 dB. The benefit in SRT50 was 23.2 dB and 33.8 dB, respectively. The mean benefit in SPRINT was 15% and 6.7% and the localisation ability improved from 33.3° to 16° and from 26.2° to 17.6°, respectively. The two SSD subjects reported a FG of 17 dB, a benefit in SRT50 of 22.5 and a benefit in SPRINT of 20%. Subjective outcomes improved significantly and even exceeded the values of their age-and sex matched normal hearing peers. One revision was reported: a retroauricular emphysema above the implant occurred 12 months post-OP, it was resolved operatively with the implant still being functional. CONCLUSION: The pediatric cohort reports significant audiological benefit, even exceeding that of the age- and sex matched control. The combination of the high safety and audiological benefit makes the Bonebridge a comfortable and effective option in hearing rehabilitation in children.

• MeSH
• dítě MeSH
• kostní vedení zvuku MeSH
• lidé MeSH
• percepce řeči * MeSH
• převodní nedoslýchavost chirurgie   MeSH
• sluch MeSH
• sluchové pomůcky * MeSH
• sluchové testy MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

AIMS: Limited contemporary data are available on the clinical and echocardiographic outcomes after surgery for cardiac papillary fibroelastoma (CPF). The aim of this study was to review the clinical manifestations, pathological characteristics, surgical management, and prognoses of patients with histologically verified CPF, who underwent surgery at our cardiac surgery center from 2008 to 2018. METHODS AND RESULTS: Twelve patients of median age 62 years (28 to 77 years) were treated. Embolic stroke or transient ischemic attack (five patients, 42%) were the only CPF clinical manifestations. Eleven (92%) tumors were localized on the valves, with the aortic valve being the most common tumor site (seven patients; 58%). Multiple factor analysis revealed no independent predictor of CPF-related embolization. Simple shave tumor excision was sufficient in most patients (10 patients, 83%). No operative or tumor-related late mortality during the median follow-up period of 4.7 years (1.1 to 10.2 years) was recorded. Asymptomatic metachronous valve tumor recurrence (in a location different from that of the original tumor) was revealed in two patients (17%) by transesophageal echocardiography (TEE), not detected by transthoracic echocardiography (TTE). One of these two patients underwent repeated surgery for CPF but later suffered a recurrent embolic stroke, due to another tumor recurrence. CONCLUSION: CPF can be safely and effectively treated surgically. TEE is superior to the TTE option in CPF post-operative recurrence detection. There is a clear need for a prospective study to determine criteria for embolization risk stratification and optimum management in patients with CPF.

• MeSH
• dospělí MeSH
• echokardiografie transezofageální MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití MeSH
• následné studie MeSH
• papilární fibroelastom srdce diagnóza   mortalita   chirurgie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

This study aims to investigate the changes in atmospheric deposition trends in Bulgaria, studied using the moss biomonitoring technique since 1995. For the first time, a paired (site-wise) comparison was performed after a critical review of the sampling networks and adjusting for location, the distance between the sampling points, and moss species. Data from the 2005/2006 and 2015/2016 moss surveys were chosen as instrumental neutron activation analysis was employed in both to determine the content of 34 elements (Al, As, Ba, Br, Са, Ce, Cl, Со, Cr, Cs, Fe, Hf, I, K, La, Mn, Na, Nd, Ni, Rb, Sb, Sc, Se, Sr, Ta, Tb, Th, Ti, Tm, U, V, W, Yb, Zn). In addition, Cd, Cu, and Pb were determined using complementary analytical methods: inductively coupled plasma atomic emission spectroscopy in 2015/2016 and atomic absorption spectroscopy in 2005/2006. For the subset of 57 routinely sampled locations in Bulgaria, hierarchical clustering on principal components and multiple factor analysis (MFA) were applied to assess the spatial trends in the 10 years elapsed between the surveys, as well as to characterise the origin of the determined elements. Elevation and distance between the sampling points were used as additional variables in the multiple factor analysis plane to ascertain their effect on the overall variance in the datasets. Distribution maps were constructed to illustrate the deposition patterns for the pollutant Pb. The results were consistent with decreased industrial output in the country, increased coal combustion and transport pollution, and construction of roads.

• MeSH
• Bryophyta * MeSH
• látky znečišťující vzduch analýza   MeSH
• monitorování životního prostředí MeSH
• průzkumy a dotazníky MeSH
• stopové prvky analýza   MeSH
• těžké kovy analýza   MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Bulharsko MeSH

A passive biomonitoring survey using terrestrial mosses was performed in a heavily polluted industrial region on the border between Czechia and Poland in a regular grid of 41 sampling points. The concentrations of 38 elements were determined in the moss samples, using Neutron Activation Analysis (NAA). Simultaneously, air pollution modelling was performed using the Czech reference methodology Symos'97 for the year of the sampling (2015) and 3 years prior (2012) in order to compare the results of both the approaches and evaluate the credibility of the moss biomonitoring method. The NAA results were transformed according to the principles of compositional data analysis and assessed using hierarchical clustering on principal components. The resulting clusters were compared with the results of air pollution modelling using one-way analysis of variance. The association of determined clusters with the pollution from industrial sources was confirmed only for the results of the 2012 modelling. This validates the complementarity of the air pollution modelling and the moss biomonitoring, ascertains the moss biomonitoring as a valid method for long-term pollution assessment and confirms one of the fundamentals of moss biomonitoring, the reflection of the atmospheric conditions prevailing in the period before the sampling.

• MeSH
• biologický monitoring MeSH
• Bryophyta * MeSH
• látky znečišťující vzduch analýza   MeSH
• mechy * MeSH
• monitorování životního prostředí MeSH
• těžké kovy analýza   MeSH
• znečištění ovzduší analýza   MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Polsko MeSH

Mucosal surfaces are the first mechanical barrier preventing the entry of foreign particles into the organism. The study addresses the detection and analysis of metal-based solid particles in cytological mucus samples from the surface of human hypertrophic tissue in the inferior nasal turbinates in patients diagnosed with chronic rhinitis. Solid particles were characterized by scanning electron microscopy and Raman microspectroscopy; all the biological samples were also subjected to vibration magnetometry. Since the upper airways are the first part of the respiratory tract, which is exposed to inhaled particles, it can be assumed that inhaled particles may be partially deposited in this region. Scanning electron microscopy revealed the presence of metal-based solid particles/clusters in the majority of the analysed cytological mucus samples and also in hypertrophic tissues; in all groups, the particles were of submicron size. Raman microspectroscopy detected the presence of particles/clusters based on amorphous carbon, graphite, calcium carbonate, anatase and barite only in the hypertrophic tissue. The obtained results show that the composition of some of the solid particles (i.e. Ba, Zn, Fe and Ti) detected in the mucus from the surface of the hypertrophic tissues resembled the particles found in the hypertrophic tissue itself. It can be assumed that after the capture of the inhaled particles by the mucus, they penetrate into the deeper layers of tissue.

• MeSH
• hlen MeSH
• kovy MeSH
• lidé MeSH
• mikroskopie elektronová rastrovací MeSH
• nosní skořepy * MeSH
• rinitida * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Úvod: Funkční endoskopická endonazální chirurgie (FESS) je rinochirurgická metoda využívající poznatky z oblasti patofyziologie vedlejších nosních dutin a mukociliárního transportu. Jako každý chirurgický výkon přináší riziko komplikací, zde vymezené především úzkým anatomickým vztahem dutin k okolním strukturám. Cíl: Cílem práce bylo zhodnotit míru rizika vzniku perioperačních komplikací na ORL pracovišti Nemocnice České Budějovice, a.s., jejich četnost v závislosti na operační diagnóze a porovnání počtu komplikací se soubory z jiných pracovišť. Metodika: V práci byla provedena retrospektivní analýza údajů o pacientech, kteří podstoupili funkční endoskopickou endonazální operaci na našem oddělení v letech 2000-2017. Byla sledována operační diagnóza, vzniklé komplikace a jejich závažnost. Výsledky: Na našem pracovišti byl v letech 2000-2017 proveden FESS u 1633 pacientů. Celkem se v souboru vyskytlo 25 perioperačních komplikací, z toho 18 komplikací malých (1,1 %) a 7 komplikací velkých (0,43 %). 394 pacientů bylo operováno pro chronickou rinosinusitidu bez nosní polypózy a komplikace v tomto souboru se vyskytly u 1,52 % případů. U pacientů s chronickou rinosinusitidou s nosní polypózou (1138 pacientů) se komplikace vyskytovaly v 1,67 % případů. Nebyl zjištěn signifikantní rozdíl v rizikovosti výkonu u těchto dvou skupin. U 101 pacientů s cystou maxilární dutiny nenastala žádná perioperační komplikace. Nejčastěji zaznamenanou komplikací bylo poranění lamina papyracea v 0,98 %, dále pak likvorea v 0,37 %, krvácení vedoucí k předčasnému ukončení výkonu v 0,12 % a retrobulbární hematom v 0,06 % případů. Závěr: FESS je metoda s nízkým rizikem vzniku komplikací. Porovnáním s počty komplikací z jiných pracovišť naše pracoviště nevybočuje.

Introduction: Functional Endoscopic Endonasal Surgery (FESS) is a rhinosurgical method utilizing the knowledge of the pathophysiology of sinuses and mucociliary transport. As with any surgical procedure, there is a risk of complications, defined here primarily by the narrow anatomical relationship of the cavities to the surrounding structures. Aims: The aim of the study was to evaluate the risk of perioperative complications at the ENT department of the Hospital České Budějovice, a.s., their frequency depending on the surgical diagnosis and to compare the number of complications with the numbers from other institutions. Methods: A retrospective analysis of data on patients who underwent functional endoscopic endonasal surgery in our department between 2000 and 2017 was performed. Operational diagnosis, complications and their severity were monitored. Results: FESS was performed in 1633 patients at our department in 2000 - 2017. There were 25 perioperative complications in total, of which 18 were small (1.1%) and 7 were large (0.43%). 394 patients were operated for chronic rhinosinusitis without nasal polyposis and complications in this group occurred in 1.52% of cases. In patients with chronic rhinosinusitis with nasal polyposis (1138 patients), complications occurred in 1.67% of cases. There was no significant difference in performance risk for these two groups. No perioperative complications occurred in 101 patients with maxillary sinus cyst. The most frequently reported complication was lamina papyracea injury in 0.98%, followed by liquorrhea in 0.37%, bleeding leading to premature discontinuation in 0.12% and retrobulbar hematoma in 0.06% of cases. Conclusion: FESS is a method with low risk of complications. By comparison with the number of complications from other insitutions, our ENT department does not deviate.

• Klíčová slova
• endoskopická endonazální resekce, rinosinusitida,
• MeSH
• endoskopie metody   MeSH
• lidé MeSH
• otorinolaryngologické chirurgické výkony * MeSH
• paranazální dutiny chirurgie   MeSH
• peroperační komplikace MeSH
• retrospektivní studie MeSH
• rinitida chirurgie   MeSH
• sinusitida chirurgie   MeSH
• Check Tag
• lidé MeSH