PURPOSE: Discrepancy between the morphology of the acetabular margin and the design of hemispheric acetabular cups used in total hip arthroplasty may produce postoperative hip pain due to an iliopsoas impingement at the iliopsoas notch. This study aimed to determine the anatomical features of the iliopsoas notch in the Central European sample, and to test whether the morphology of the proximal femur affects the size of the iliopsoas notch. METHODS: The sample was composed of 40 matched pairs of dry hip bones and corresponding femora. The depth and length of the iliopsoas notch were measured and correlated with the available demographic data. The anthropometric parameters of the proximal femur were calculated using image-analysis software, and their association with the measurements of the iliopsoas notch was tested. RESULTS: The iliopsoas notch was present in all specimens and featured four morphological configurations: curved (61.3%), angular (16.2%), irregular (16.2%), and straight (6.3%). Its size was found to be larger in males (P = 0.014 for depth, P < 0.001 for length). No significant difference existed between the sides. The height and age of the specimens did not correlate with the size of the iliopsoas notch. Furthermore, neither the femoral neck version, the lesser trochanteric version, nor the angle between the neck of the femur and the lesser trochanter influenced the dimensions of the iliopsoas notch. CONCLUSION: The iliopsoas notch is a consistent landmark of the acetabulum, although its anatomical appearance is widely variable. The iliopsoas notch arrangement cannot be predicted perioperatively based on the morphology of the proximal femur. The various shapes and sex-related differences detected in this study could be used for designing new hip implants or could be utilized during cup positioning in total hip arthroplasty.

• MeSH
• Acetabulum * anatomy & histology   MeSH
• Lower Extremity MeSH
• Femur surgery   MeSH
• Muscle, Skeletal surgery   MeSH
• Humans MeSH
• Arthroplasty, Replacement, Hip * adverse effects   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH

Recent MRI studies have shown that abnormal functional connections in schizophrenia coexist with subtle changes in the structure of axons in the brain. However, there is a discrepancy in the literature concerning the relationship between white matter abnormalities and the occurrence of negative psychopathological symptoms. In the present study, we investigate the relationship between the altered white matter structure and specific psychopathology symptoms, i.e., subscales of Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptoms Scale (BNSS) in a sample of schizophrenia outpatients. For investigation on white matter abnormalities in schizophrenia, the diffusion tensor imaging analysis of between-group differences in main diffusion parameters by tract-based spatial statistics was conducted on schizophrenia outpatients and healthy controls. Hence, the correlation of PANSS and BNSS psychopathology subscales in the clinical group with fractional anisotropy was analyzed in the 17 selected cortical regions of interest. Presented between-group results revealed widespread loss of white matter integrity located across the brain in schizophrenia outpatients. Results on the white matter relationship with psychopathology revealed the negative correlation between fractional anisotropy in the left orbital prefrontal cortex, right Heschl's gyrus, bilateral precuneus and posterior cingulate cortex and the severity of asociality, as assessed with the BNSS. In conclusion, the presented study confirms the previous evidence on the widespread white matter abnormalities in schizophrenia outpatients and indicates the existence of the subtle but specific association between fractional anisotropy in the fronto-temporo-parietal regions with the asociality.Recent MRI studies have shown that abnormal functional connections in schizophrenia coexist with subtle changes in the structure of axons in the brain. However, there is a discrepancy in the literature concerning the relationship between white matter abnormalities and the occurrence of negative psychopathological symptoms. In the present study, we investigate the relationship between the altered white matter structure and specific psychopathology symptoms, i.e., subscales of Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptoms Scale (BNSS) in a sample of schizophrenia outpatients. For investigation on white matter abnormalities in schizophrenia, the diffusion tensor imaging analysis of between-group differences in main diffusion parameters by tract-based spatial statistics was conducted on schizophrenia outpatients and healthy controls. Hence, the correlation of PANSS and BNSS psychopathology subscales in the clinical group with fractional anisotropy was analyzed in the 17 selected cortical regions of interest. Presented between-group results revealed widespread loss of white matter integrity located across the brain in schizophrenia outpatients. Results on the white matter relationship with psychopathology revealed the negative correlation between fractional anisotropy in the left orbital prefrontal cortex, right Heschl’s gyrus, bilateral precuneus and posterior cingulate cortex and the severity of asociality, as assessed with the BNSS. In conclusion, the presented study confirms the previous evidence on the widespread white matter abnormalities in schizophrenia outpatients and indicates the existence of the subtle but specific association between fractional anisotropy in the fronto-temporo-parietal regions with the asociality.

• MeSH
• White Matter pathology   physiopathology   MeSH
• Gyrus Cinguli pathology   physiopathology   MeSH
• Adult MeSH
• Humans MeSH
• Brain Mapping methods   MeSH
• Brain abnormalities   pathology   physiopathology   MeSH
• Outpatients MeSH
• Prefrontal Cortex physiopathology   MeSH
• Schizophrenia pathology   physiopathology   MeSH
• Diffusion Tensor Imaging methods   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Prezentujeme případ 59letého muže, u kterého byl dia gnostikován MALT lymfom žaludku. Zajímavý byl endoskopický obraz sliznice žaludku, který v nás vyvolal dia gnostické rozpaky. Lymfomy gastrointestinálního traktu mohou být snadno chybně dia gnostikovány kvůli nespecifi ckým symp tomům. Významnou roli vzniku onemocnění hraje infekce Helicobakter pylori. V popředí regrese MALT lymfomu žaludku stojí eradikační antibio tická terapie. Strategie léčby je individuální a záleží na pokročilosti onemocnění. Správná a včasná dia gnostika je klíčová při zahájení často úspěšné léčby.

We present the case of a 59-year-old male who had been dia gnosed with mucosa-as sociated lymphoid tis sue (MALT) gastric lymphoma. Endoscopic imag ing of the gastric mucosa led to dia gnostic discrepancies. Gastro-intestinal lymphomas may be incor rectly dia gnosed due to non-specifi c symp toms. Infection of Helicobacter pylori is important in dis ease development. Eradication antibiotic therapy plays a major role in regres sion of MALT gastric lymphoma. The therapeutic strategy is tailored accord ing to the individual and depends on the level of dis ease advancement. Cor rect and early dia gnosis is crucial for succes sful treatment.

• MeSH
• Abdominal Pain diagnostic imaging   MeSH
• Diagnosis, Differential MeSH
• Endoscopy, Gastrointestinal MeSH
• Helicobacter pylori chemistry   MeSH
• Middle Aged MeSH
• Humans MeSH
• Lymphoma, B-Cell, Marginal Zone * diagnosis   therapy   MeSH
• Stomach Neoplasms * diagnosis   therapy   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

STATEMENT OF PROBLEM: The vertical marginal discrepancy of restorations can increase upon cementation, and poor marginal fit can lead to cement dissolution, marginal discoloration, microleakage, and secondary caries. The amount of increase is related to the type of luting cement used, but how lithium disilicate pressed crowns are affected by different resin cements is unclear. PURPOSE: The purpose of this in vitro study was to compare the effect of using different resin luting cements on the vertical marginal discrepancy of lithium disilicate pressed crowns. MATERIAL AND METHODS: A total of 18 intact extracted mandibular third molars were disinfected in a solution of 10% formalin for 7 days and were then prepared to receive a ceramic crown. Impressions were made with polyvinyl siloxane and lithium disilicate pressed crowns made and cemented with 1 of 3 resin luting cements. The marginal discrepancy was measured at 4 points on the finishing line of each tooth, with optical microscopy at ×200 magnification before and after cementation. Statistical analysis was done with the Kruskal-Wallis test to compare the median marginal increase among the 3 groups (a=.05). RESULTS: The least amount of marginal increase after cementation was with Harvard PremiumFlow cement, with an average marginal increase of 42 ±11 μm. RelyX Ultimate cement increased the margins by an average 45 ±29 μm. The highest marginal increase was found in the Enamel Plus HRi preheated composite resin group (116 ±47 μm). CONCLUSIONS: The marginal increase of pressed crowns cemented with preheated composite resin (Enamel Plus HRi) exceeded the clinically acceptable range of marginal discrepancy.

• MeSH
• Humans MeSH
• Molar MeSH
• Resin Cements * MeSH
• In Vitro Techniques MeSH
• Dental Cements * MeSH
• Crowns * MeSH
• Dental Porcelain * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Současný systém úhrad DRG vykazuje tendenci ke vzniku nepoměru mezi vynaloženými náklady na úrovni poskytovatele zdravotní péče a úhradou od pojišťovny. Jedním ze základních předpokladů pro efektivní hospodaření zdravotnického zařízení je kontrola této bilance, což vychází ze systematické správy nákladů a průběžného monitorování pomocí vhodných kalkulačních systémů. Aplikace metody activity based costing na diagnóze K35.3 (akutní apendicitida s lokalizovanou peritonitidou) poukazuje na rozdílnost nákladových položek v rámci stejné DRG skupiny a poskytuje tak hodnotnou manažerskou informaci. Nákladová kalkulace pro účely této studie proběhla na úrovni dvou zdravotnických zařízení, pro která existuje srovnatelná základní matice nákladů a aktivit, avšak rozdílná základní sazba na straně úhrada rozdílná hodnota nákladů vstupujících do kalkulace. Na vzorku 148 pacientů bylo zjištěno, že existuje jednak rozdíl mezi skutečně vynaloženými náklady a úhradou od plátce a dále že tento rozdíl je různý pro obě sledovaná pracoviště.

The current DRG reimbursement system tends to create a disproportion between costs incurred at the level of the healthcare provider and reimbursement from the insurer. One of the basic prerequisites for effi cient management of the healthcare facility is the control of this balance, which is based on systematic cost management and continuous monitoring using appropriate calculation systems. The application of the Activity Based Costing method to diagnosis K35.3 (acute appendicitis with localized peritonitis) points to the difference in cost items within the same DRG group and provides valuable managerial information. The costing calculation for the purpose of this study was at the level of two healthcare facilities for which there is a comparable basic matrix of costs and activities, but a different basic rate on the reimbursement side and a different cost value entering the calculation. A sample of 148 patients found that there was, on the one hand, the difference between the actual costs incurred and the reimbursement from the payer, and that this discrepancy varies for the two monitored workplaces.

• MeSH
• Cost-Benefit Analysis methods   MeSH
• Appendicitis * economics   complications   MeSH
• Humans MeSH
• Costs and Cost Analysis * methods   MeSH
• Health Care Costs MeSH
• Peritonitis economics   MeSH
• Delivery of Health Care economics   MeSH
• Medicare Assignment MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

Úvod: Celosvětový nepoměr mezi počtem příjemců a dárců transplantovaných orgánů vede obecně k určitému rozšiřování kritérií akceptovaných orgánů. To vede logicky např. u ledvinných štěpů k odebírání orgánů s horší kvalitou parenchymu. Jednou z možností, jak vylepšit kvalitu těchto štěpů je změnit koncept jejich prezervace během studené ischemie, resp. vylepšit i koncept perfuze před vlastním odběrem. Cílem naší experimentální práce je pokusit se vylepšit kvalitu štěpů zejména od tzv. „marginálních“ dárců. Metody: V první fázi experimentu jsme testovali prezervaci ischemicky postižených ledvinných štěpů pomocí retrográdní oxygenové persuflace (ROP). U 10 zvířat (prase) jsme porovnávali zvyklou intraarteriální perfuzi orgánu chladným perfuzním roztokem (N=5) s retrográdní intravenozní oxygenovou persuflací (N=5). Hlavním hodnotícím kritériem byla histopatologická analýza ledvinného parenchymu po vlastní perfuzi i po opětovném natransplantování štěpu. V další části experimentu jsme porovnávali opět u zvířecího modelu ischemické ledviny (králík) přístrojově řízenou perfuzi in situ (N=5) ve srovnání se zvyklou perfuzí pomocí hydrostatického tlaku (N=5). Hodnotícím kritériem zde byla nejen histopatologická analýza, ale i objem perfuzátu a rychlost poklesu teploty štěpu. Výsledky: V první části jsme prokázali schopnost ROP prezervovat resp. restaurovat ledvinný štěp se simulovaným ischemickým inzultem, výsledky histologické analýzy byly bez statisticky signifikantního rozdílu ve srovnání s intraarteriální perfuzí. Ve druhé části naší práce jsme pozorovali signifikantní rozdíl v maximálním průtoku perfundovanými štěpy, kdy u skupiny mechanicky perfundovaných zvířat byl max. průtok vyšší, než u kontrolní skupiny při užití pouze hydrostatického tlaku (p=0,004). Stejně tak jsme nalezli statisticky významný rozdíl v poklesu teploty štěpů ve prospěch pulzatilní perfuze ( p < 0,001). Statisty významné bylo i kvalitativní histopatologické hodnocení proplachu štěpů opět ve prospěch řízené perfuze (p=0,005). Závěr: Prezentované výsledky experimentální práce prokazují určitý benefit alternativních forem prezervace resp. perfuze ledvin určených pro transplantaci. Ty by mohly nahradit nejen zvykle užívanou perfuzi před odběrem, ale i doplnit určitou rekondici štěpů v průběhu studené ischemie. Největší přínos vidíme u tzv. marginálních štěpů, tedy u štěpů s rozšířenými kritérii.

Introduction: There is a worldwide discrepancy between the number of donors and the number of organs needed for transplantation, leading to certain expansion of criteria, resulting in acceptance of donor organs. This means that organs with worse parenchymal qualities may be harvested for transplantation. One possibility, how to ameliorate the quality of these organs, is to change the concept of their preservation during cold ischemia or even after sudden circulatory arrest, prior to the collection of the organ itself. The goal of our experimental study was to try to improve organ quality from these marginal donors. Methods: In the first part of our experimental study, we tested retrograde oxygen persufflation (ROP) in preservation of ischemically damaged kidney grafts. In ten animals (domestic pig), we compared standard intra-arterial perfusion of the grafts using cooled perfusion solution (N=5), with a retrograde oxygen persufflation method (N=5). The main criterion for evaluation was the histopathological analysis of renal parenchyma after transplantation of the kidney graft. In the second part of our experimental study, again using an animal model of an ischemic kidney (laboratory rabbit), we compared machine perfusion of the kidney graft with routinely used perfusion by hydrostatic pressure. For evaluation, we added another two criteria – the volume of perfusate that flowed through the graft and the temperature drop during perfusion. Results: In the first part of the study, we proved the ability of ROP to preserve and even ameliorate the quality of ischemically damaged kidney grafts. Results of histopathological analysis of samples taken during ROP were without statistically significant difference in comparison with those taken during standard intra-arterial perfusion. In the second part of the study, we observed a significant difference in maximal flow rate measured during perfusion of the kidney grafts, favoring mechanical perfusion over perfusion using hydrostatic pressure (p=0.004). The same situation was seen with the drop of temperature measured in the parenchyma of the grafts (p < 0.001). Finally, histopathological evaluation of the renal parenchyma found better washing out of blood particles from the capillaries during mechanical perfusion (p=0.005). Conclusion: The presented results of our experimental studies establish that alternative methods of preservation during cold ischemia and before removal of kidney grafts from the donor may be beneficial for its function after transplantation. We believe that these methods may be suitable especially for so-called marginal grafts from extended criteria donors.

• Keywords
• dárci po nezvratné zástavě oběhu, řízená perfuze orgánů, „in situ perfuze“, retrográdní oxygenová persuflace,
• MeSH
• Tissue Donors MeSH
• Rabbits MeSH
• Disease Models, Animal MeSH
• Perfusion methods   MeSH
• Swine MeSH
• Heart Arrest MeSH
• Kidney Transplantation * MeSH
• Animals MeSH
• Check Tag
• Rabbits MeSH
• Animals MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Blood Group Antigens immunology   MeSH
• Hematologic Tests methods   MeSH
• Blood Banks MeSH
• Hematologic Diseases immunology   MeSH
• Blood Transfusion * methods   MeSH
• Blood Grouping and Crossmatching methods   MeSH
• Publication type
• Programmed Instruction MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• hematologie a transfuzní lékařství

Žilní systém je známý svou variabilitou, avšak v anatomii je hluboký systém končetin poněkud na okraji zájmu. Ačkoliv několik předchozích anatomických studií již poukázalo na značné rozdíly mezi literárními popisy a pitevními nálezy, jejich závěry zatím nedoznaly většího ohlasu. Naše pitevní nálezy potvrdily, že v. profunda femoris (VPF) může být významnou přímou kolaterálou mezi v. poplitea (VP) a v. femoralis (VF).

Deep venous system is known for its extreme variability but in anatomy it receives only marginal interest. Although a few previous anatomical studies have already pointed out the fact of a significant discrepancy between the autopsy findings and the literary description, it has not had any particular output so far. Our findings confirmed the deep femoral vein to be an alternative collateral vein connecting the popliteal with the femoral vein.

• Keywords
• variety, kolaterály, v. profunda femoris,
• MeSH
• Leg blood supply   MeSH
• Humans MeSH
• Cadaver MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Veins abnormalities   anatomy & histology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH

Two maxillary first molars and two central incisor typhodont teeth were prepared with 0.8 mm chamfer, 2.0 mm occlusal reduction, and 6 degree taper. The prepared teeth were duplicated 9 times to obtain 36 die stone models and divided into three groups (n = 12). Luting agents tested were zinc phosphate, glass ionomer and resin cement. Procera®AllCeram 0.6 mm coping was fixed with a calibrated finger force of 50 N. The absolute marginal discrepancy was measured using the scanning electron microscope on four axial walls with 4 measurements on each wall to obtain a total of 16 readings for one tooth. Mann Whitney U test was applied to find significant differences between luting cements and Kruskal Wallis tests among groups. Results The absolute marginal discrepancies of cements were in reducing order zinc phosphate (AZ) 53 µm; resin (AR) 44.5 µm, glass ionomer (AG) 29 µm. There was a significant difference among luting cements AG V/s AZ (p = 0.001) and AR V/s AG (p = 0.003), except AR V/s AZ (p = 0.213). All axial surfaces except mesial showed a significant difference. Conclusion The study concluded that different luting media have a definite effect over the final fit of AllCeram coping. Absolute marginal discrepancy was within the accepted level of 100 µm. Distal axial surface demonstrated a wider gap among all the luting agents

• MeSH
• Cementation methods   MeSH
• Resin Cements MeSH
• Glass Ionomer Cements therapeutic use   MeSH
• Zinc Phosphate Cement therapeutic use   MeSH
• Dental Cements classification   therapeutic use   MeSH
• Dental Materials classification   therapeutic use   MeSH
• Publication type
• Evaluation Study MeSH
• Comparative Study MeSH

Cílem této studie bylo zjistit, jaký stupeň některých odchylek v estetice frontálního úseku chrupu pokládá většina laické veřejnosti za méně atraktivní. Hodnoceny byly tyto odchylky: symetrické a asymetrické zúžení horních laterálních řezáků, otevřený gingivální prostor mezi horními středními řezáky a symetricky i asymetricky snížená úroveň marginální gingivy horních středních a laterálních řezáků. úsměv 28leté ženy byl upravován v počítačovém programu Adobe Photoshop 7.0; 30 panoramatických fotografií ve formátu 9x13 mm bylo náhodně rozmístěno do alba stejného formátu. Každý hodnotitel v dotazníku vyznačil na úsečce míru atraktivity každého úsměvu a uvedl svůj věk a pohlaví. Dotazník vyplnilo 120 žen a 65 mužů ve věku nad 18 let. Za méně atraktivní pokládala nadpoloviční většina dotazovaných laiků tyto stupně odchylek: symetrické a asymetrické zúžení horních laterálních řezáků o 4 mm, 5 mm dlouhý otevřený gingivální prostor mezi horními středními řezáky, symetricky sníženou úroveň marginální gingivy horních středních řezáků o 3 mm, jednostranně sníženou úroveň marginální gingivy horního středního řezáku, symetricky i jednostranně sníženou úroveň marginální gingivy horních laterálních řezáků o 2 mm.

The aim of the study was to identify the degree of some discrepancies in the esthetics of the frontal segment of dentition that are considered less attractive by majority of respondents. The following anomalies were monitored: symmetrical as well asymmetrical narrowing of maxillary lateral incisors, open gingival space between maxillary central incisors, symmetrically as well asymmetrically lowered level of margin gingiva of maxillary central and lateral incisors. The smile of a 28-year old female was modified in Adobe Photoshop 7.0; 30 panoramic pics of the format 9x13 mm were randomly placed in the album of the same format. In the questionnaire each of the respondents marked on the line segment the degree of attractiveness of each particular smile, and put down their age and sex. The questionnaire was filled up by 120 females and 65 males of the age over 18. More than 50% of the respondents considered less attractive the following degrees of anomalies: symmetrical as well as asymmetrical narrowing of maxillary lateral incisors by 4 mm, 5 mm long open gingival space between maxillary central incisors, symmetrically lowered level of marginal gingiva of maxillary central incisors by 3 mm, unilateral lowered level of marginal gingiva of the maxillary central incisor, symmetrically and asymmetrically lowered level of marginal gingiva of maxillary lateral incisors by 2 mm.

• MeSH
• Diastema MeSH
• Esthetics, Dental psychology   MeSH
• Photography, Dental psychology   MeSH
• Humans MeSH
• Surveys and Questionnaires utilization   MeSH
• Check Tag
• Humans MeSH