Burk, R. R* Dotaz Zobrazit nápovědu
Checklisten der aktuellen Medizin
2., überarb. und erw. Aufl. xxiii, 616 s. : il. + 18 s. obr. příl.
- MeSH
- oftalmologie MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Ortopedie. Chirurgie. Oftalmologie
- NLK Obory
- oftalmologie
- Publikační typ
- abstrakt z konference MeSH
Mastomys natalensis is a rodent of African origin afflicted with a very high incidence of skin tumors (keratoacanthomas and squamous carcinomas), which are associated with a papillomavirus, M. natalensis papillomavirus (MnPV). We have determined the genomic sequence of MnPV, which has a size of 7687 bp. The genomic organization is similar to that of other papillomaviruses, with open reading frames E6, E7, E1, E2, and E4 in the early and L2 and L1 in the late region. Due to an unusually large hinge region, the transcriptional activator E2 has a size of 542 amino acids rather than 400 to 460 amino acids, as in other papillomaviruses. An open reading frame E5 coding for a small hydrophobic membrane protein is missing, as is the case for some cutaneous human papillomaviruses (HPV). This fact, together with the composition of cis-responsive elements in its long control region and phylogenetic evaluation of segments of its E6, E1, and L1 genes, indicates a relationship of MnPV to the cottontail rabbit papillomavirus and several HPV types found in lesions of cutaneous epithelia, in particular to those that are associated with epidermodysplasia verruciformis. MnPV may be a useful model system for tumorigenesis of cutaneous epithelia in humans.
- MeSH
- genom virový * MeSH
- keratoakantom virologie MeSH
- klonování DNA MeSH
- molekulární sekvence - údaje MeSH
- Muridae * virologie MeSH
- nádory kůže virologie MeSH
- otevřené čtecí rámce MeSH
- Papillomaviridae * genetika klasifikace MeSH
- regulační oblasti nukleových kyselin genetika MeSH
- sekvence aminokyselin MeSH
- sekvence nukleotidů MeSH
- sekvenční analýza DNA MeSH
- sekvenční homologie nukleových kyselin MeSH
- sekvenční seřazení MeSH
- spinocelulární karcinom virologie MeSH
- virové geny * MeSH
- virové proteiny genetika MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- srovnávací studie MeSH
Recurrent respiratory papillomatosis (RRP) is the most common benign tumour of the larynx, affecting both children and adults. We present a series of 25 patients, including 10 cases of juvenile multiple, 8 cases of adult solitary, and 7 cases of adult multiple RRP. Biopsy tissue from each patient was screened by Southern blot hybridization and polymerase chain reaction for the presence of human papillomavirus (HPV) DNA. Sera from patients and age- and sex-matched controls were tested for the presence of HPV-specific antibodies using a synthetic peptide derived from the minor capsid protein (L2) of HPV 6/11. By Southern blot hybridization and/or polymerase chain reaction, biopsies from all patients were positive for HPV 6/11 DNA. There was no difference in antibody response between cases and controls. Female cases and controls had significantly higher antibody titers than male subjects. A correlation was observed between the HPV-specific antibody level and the number of surgery-necessitating recurrences.
- MeSH
- dítě MeSH
- DNA virů analýza MeSH
- dospělí MeSH
- ELISA MeSH
- kapsida * imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- mladiství MeSH
- molekulární sekvence - údaje MeSH
- Papillomaviridae * MeSH
- předškolní dítě MeSH
- protilátky virové * analýza MeSH
- sekvence aminokyselin MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Southernův blotting MeSH
- virové plášťové proteiny * MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Research Support, U.S. Gov't, P.H.S. MeSH
- srovnávací studie MeSH
UNLABELLED: Human papillomavirus type 6 (HPV6) is the major etiological agent of anogenital warts and laryngeal papillomas and has been included in both the quadrivalent and nonavalent prophylactic HPV vaccines. This study investigated the global genomic diversity of HPV6, using 724 isolates and 190 complete genomes from six continents, and the association of HPV6 genomic variants with geographical location, anatomical site of infection/disease, and gender. Initially, a 2,800-bp E5a-E5b-L1-LCR fragment was sequenced from 492/530 (92.8%) HPV6-positive samples collected for this study. Among them, 130 exhibited at least one single nucleotide polymorphism (SNP), indel, or amino acid change in the E5a-E5b-L1-LCR fragment and were sequenced in full. A global alignment and maximum likelihood tree of 190 complete HPV6 genomes (130 fully sequenced in this study and 60 obtained from sequence repositories) revealed two variant lineages, A and B, and five B sublineages: B1, B2, B3, B4, and B5. HPV6 (sub)lineage-specific SNPs and a 960-bp representative region for whole-genome-based phylogenetic clustering within the L2 open reading frame were identified. Multivariate logistic regression analysis revealed that lineage B predominated globally. Sublineage B3 was more common in Africa and North and South America, and lineage A was more common in Asia. Sublineages B1 and B3 were associated with anogenital infections, indicating a potential lesion-specific predilection of some HPV6 sublineages. Females had higher odds for infection with sublineage B3 than males. In conclusion, a global HPV6 phylogenetic analysis revealed the existence of two variant lineages and five sublineages, showing some degree of ethnogeographic, gender, and/or disease predilection in their distribution. IMPORTANCE: This study established the largest database of globally circulating HPV6 genomic variants and contributed a total of 130 new, complete HPV6 genome sequences to available sequence repositories. Two HPV6 variant lineages and five sublineages were identified and showed some degree of association with geographical location, anatomical site of infection/disease, and/or gender. We additionally identified several HPV6 lineage- and sublineage-specific SNPs to facilitate the identification of HPV6 variants and determined a representative region within the L2 gene that is suitable for HPV6 whole-genome-based phylogenetic analysis. This study complements and significantly expands the current knowledge of HPV6 genetic diversity and forms a comprehensive basis for future epidemiological, evolutionary, functional, pathogenicity, vaccination, and molecular assay development studies.
- MeSH
- biologická evoluce MeSH
- buněčný rodokmen MeSH
- fylogeneze MeSH
- genetická variace genetika MeSH
- genom virový genetika MeSH
- genomika metody MeSH
- genotyp MeSH
- infekce papilomavirem komplikace genetika virologie MeSH
- lidé MeSH
- lidský papilomavirus 6 genetika izolace a purifikace MeSH
- nádory anu komplikace genetika virologie MeSH
- nádory děložního čípku komplikace genetika virologie MeSH
- nádory hlavy a krku komplikace genetika virologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
UNLABELLED: Human papillomavirus 11 (HPV11) is an etiological agent of anogenital warts and laryngeal papillomas and is included in the 4-valent and 9-valent prophylactic HPV vaccines. We established the largest collection of globally circulating HPV11 isolates to date and examined the genomic diversity of 433 isolates and 78 complete genomes (CGs) from six continents. The genomic variation within the 2,800-bp E5a-E5b-L1-upstream regulatory region was initially studied in 181/207 (87.4%) HPV11 isolates collected for this study. Of these, the CGs of 30 HPV11 variants containing unique single nucleotide polymorphisms (SNPs), indels (insertions or deletions), or amino acid changes were fully sequenced. A maximum likelihood tree based on the global alignment of 78 HPV11 CGs (30 CGs from our study and 48 CGs from GenBank) revealed two HPV11 lineages (lineages A and B) and four sublineages (sublineages A1, A2, A3, and A4). HPV11 (sub)lineage-specific SNPs within the CG were identified, as well as the 208-bp representative region for CG-based phylogenetic clustering within the partial E2 open reading frame and noncoding region 2. Globally, sublineage A2 was the most prevalent, followed by sublineages A1, A3, and A4 and lineage B. IMPORTANCE: This collaborative international study defined the global heterogeneity of HPV11 and established the largest collection of globally circulating HPV11 genomic variants to date. Thirty novel complete HPV11 genomes were determined and submitted to the available sequence repositories. Global phylogenetic analysis revealed two HPV11 variant lineages and four sublineages. The HPV11 (sub)lineage-specific SNPs and the representative region identified within the partial genomic region E2/noncoding region 2 (NCR2) will enable the simpler identification and comparison of HPV11 variants worldwide. This study provides an important knowledge base for HPV11 for future studies in HPV epidemiology, evolution, pathogenicity, prevention, and molecular assay development.
- MeSH
- fylogeneze MeSH
- genetická variace * MeSH
- genom virový * MeSH
- genomika MeSH
- genotyp MeSH
- infekce papilomavirem virologie MeSH
- jednonukleotidový polymorfismus MeSH
- lidé MeSH
- lidský papilomavirus 11 klasifikace genetika izolace a purifikace MeSH
- molekulární evoluce MeSH
- otevřené čtecí rámce MeSH
- pravděpodobnostní funkce MeSH
- sekvenční seřazení MeSH
- vysoce účinné nukleotidové sekvenování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Neurodegeneration with brain iron accumulation encompasses a heterogeneous group of rare neurodegenerative disorders that are characterized by iron accumulation in the brain. Severe generalized dystonia is frequently a prominent symptom and can be very disabling, causing gait impairment, difficulty with speech and swallowing, pain and respiratory distress. Several case reports and one case series have been published concerning therapeutic outcome of pallidal deep brain stimulation in dystonia caused by neurodegeneration with brain iron degeneration, reporting mostly favourable outcomes. However, with case studies, there may be a reporting bias towards favourable outcome. Thus, we undertook this multi-centre retrospective study to gather worldwide experiences with bilateral pallidal deep brain stimulation in patients with neurodegeneration with brain iron accumulation. A total of 16 centres contributed 23 patients with confirmed neurodegeneration with brain iron accumulation and bilateral pallidal deep brain stimulation. Patient details including gender, age at onset, age at operation, genetic status, magnetic resonance imaging status, history and clinical findings were requested. Data on severity of dystonia (Burke Fahn Marsden Dystonia Rating Scale-Motor Scale, Barry Albright Dystonia Scale), disability (Burke Fahn Marsden Dystonia Rating Scale-Disability Scale), quality of life (subjective global rating from 1 to 10 obtained retrospectively from patient and caregiver) as well as data on supportive therapy, concurrent pharmacotherapy, stimulation settings, adverse events and side effects were collected. Data were collected once preoperatively and at 2-6 and 9-15 months postoperatively. The primary outcome measure was change in severity of dystonia. The mean improvement in severity of dystonia was 28.5% at 2-6 months and 25.7% at 9-15 months. At 9-15 months postoperatively, 66.7% of patients showed an improvement of 20% or more in severity of dystonia, and 31.3% showed an improvement of 20% or more in disability. Global quality of life ratings showed a median improvement of 83.3% at 9-15 months. Severity of dystonia preoperatively and disease duration predicted improvement in severity of dystonia at 2-6 months; this failed to reach significance at 9-15 months. The study confirms that dystonia in neurodegeneration with brain iron accumulation improves with bilateral pallidal deep brain stimulation, although this improvement is not as great as the benefit reported in patients with primary generalized dystonias or some other secondary dystonias. The patients with more severe dystonia seem to benefit more. A well-controlled, multi-centre prospective study is necessary to enable evidence-based therapeutic decisions and better predict therapeutic outcomes.
- MeSH
- dítě MeSH
- dospělí MeSH
- dystonie patofyziologie terapie MeSH
- funkční lateralita MeSH
- globus pallidus patofyziologie MeSH
- hluboká mozková stimulace metody škodlivé účinky MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozek * patofyziologie MeSH
- nemoci mozku patofyziologie terapie MeSH
- neurodegenerativní nemoci patofyziologie terapie MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- železo * metabolismus MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- multicentrická studie MeSH
- práce podpořená grantem MeSH
Feochromocytóm (FEO) a paraganglióm (PGL) sú neuroendokrinné tumory, ktoré vznikajú zo sympatických a parasympatických paraganglií. FEO sa najčastejšie prejavuje trvalou alebo záchvatovitou hypertenziou, bolesťami hlavy, potením, palpitáciami a úzkostnými stavmi. Diagnostika sa zakladá na typickom klinickom obraze a biochemickom potvrdení stanovením plazmatického normetanefrínu a metanefrínu, ktoré majú takmer 100% senzitivitu a sú vyšetrením voľby. Na lokalizáciu nádoru v bruchu a panve je metódou voľby počítačová tomografia (CT) alebo magnetická rezonancia (MRI). Definitívnou a kauzálnou liečbou je chirurgické odstránenie tumoru, a to preferenčne laparoskopicky. Hlavným cieľom predoperačnej liečby je normalizácia krvného tlaku, frekvencie srdca, obnova normovolémie a prevencia katecholamínovej „búrky“ a jej účinkov na kardiovaskulárny systém pri manipulácii s tumorom v priebehu operácie. Autori navrhujú pri hypertenznej kríze iniciálnu liečbu intravenóznym urapidilom, v prípade perzistujúcej tachykardie v kombinácii s perorálnym metoprololom podávaným s časovým posunom po dosiahnutí dostatočnej alfa blokády a/alebo s kalciovým blokátorom amlodipínom. Cieľom práce je upozorniť na úskalia v diagnostike feochromocytómu a ukázať možnosti súčasného predoperačného manažmentu, ktorý by mal zabrániť vážnym poškodeniam detí s FEO. Ošetrujúci lekár by mal rozpoznať a aktívne pátrať po týchto tumoroch, hlavne v kontexte známej genetickej predispozície (von Hippelovom-Lindauovom syndróme, mnohopočetnej endokrinnej neoplázii typu 2, pri neurofibromatóze typu 1 a paragangliómoch). Feochromocytóm nemusí vždy prebiehať pod typickým klinickým obrazom a preto je najdôležitejšou súčasťou jeho diagnostiky myslieť na túto možnosť a pri podozrení ju potvrdiť biochemicky.
Pheochromocytomas and paragangliomas (PHEO/PGL) are neuroendocrine tumors that arise from sympathetic and parasympathetic paraganglia. PHEO presents most frequently by permanent or paroxysmal hypertension, headache, sweating, palpitations and anxiety. Diagnosis is based on typical clinical presentation confirmed by biochemical measurement of plasma metanephrines and normetanephrines with the sensitivity almost up to 100% being the test of choice for the diagnosis of PHEO. The morphological test of choice is either computed tomography or magnetic resonance imaging, which have similar diagnostic sensitivities of the abdomen and pelvis. Definitive and causal treatment is by surgical resection and the procedure of choice for most PHEO is laparoscopic adrenalectomy. Main goal of preoperative management is normalization of blood pressure, heart rate, reinstitution of normovolemia and prevention of catecholamine „storm“ and its effects on cardiovascular system during manipulation with tumor in the course of operation. Authors suggest as initial treatment in hypertensive crisis intravenous urapidil and in case of persisting tachycardia the combination with metoprolol after adequate time delay to achieve satisfactory alpha blockade and/or calcium channel blocker amlodipine. The aim of the report is to draw attention to difficulties in diagnostics of PHEO and to outline current approaches to preoperative management to prevent severe adverse events of children suffering from this tumor. The pediatric provider should be able to recognize and screen for such tumors, particularly in the context of a known genetic predisposition (von Hippel-Lindau syndrome, MEN type 2, neurofibromatosis type 1, and paragangliomas). The clinical presentation of PHEO might be sometime atypical so most important part of correct diagnosis depends on having a clinical suspicion for it and then confirming the diagnosis biochemically.
- Klíčová slova
- hypertenzní krize, urapidil, palpitace,
- MeSH
- adrenalektomie MeSH
- alfa-1-adrenergní receptory - antagonisté terapeutické užití MeSH
- antihypertenziva terapeutické užití MeSH
- bolesti hlavy etiologie MeSH
- dítě MeSH
- feochromocytom * diagnóza chirurgie patofyziologie MeSH
- hypertenze * etiologie farmakoterapie MeSH
- katecholaminy metabolismus MeSH
- lidé MeSH
- metanefrin krev MeSH
- normetanefrin krev MeSH
- piperaziny aplikace a dávkování MeSH
- pocení MeSH
- předoperační péče MeSH
- úzkost etiologie MeSH
- von Hippelova-Lindauova nemoc komplikace MeSH
- Check Tag
- dítě MeSH
- lidé MeSH