Cíl: Autoři prezentují soubor nemocných léčených pro patologie perzistujícího urachu. Soubor pacientů a metoda: Retrospektivní analýza souboru 16 nemocných (9 dívek, 7 chlapců) léčených v letech 2013–2023 s diagnózou perzistujícího urachu. Výsledky: Cysta urachu byla diagnostikována předoperačním vyšetřením u 11 pacientů (69 %), u 4 nemocných (25 %) byl diagnostikován sinus urachu a u jednoho (6 %) byl nalezen perzistující urachus. Třináct pacientů podstoupilo operační exstirpaci urachu. Tři nemocní souboru nebyli ve sledovaném období operováni. Jeden z nich byl později po objektivizaci nálezu magnetickou rezonancí (MRI) také indikován k exstirpaci. Dva pacienti nemuseli být operováni. V jednom případě po konzervativní léčbě vymizel sonografický nález a jednou byla afekce vyřešena incizí zánětlivé cysty s následnou konzervativní léčbou. Oba pacienti jsou trvale asymptomatičtí. Z 13 operačně exstirpovaných vzorků byly u 11 nemocných histologicky prokázány struktury potvrzující diagnózu urachu, u dvou nebyly struktury urachální tkáně nalezeny. Závěr: Perzistující urachus je indikován ke kompletní exstirpaci s dobrou prognózou.

Objective: The authors present a series of patients treated for persistent urachus pathologies. Patient cohort and method: Retrospective analysis of a group of 16 patients (9 girls, 7 boys) treated between 2013 and 2023 with a diagnosis of persistent urachus. Results: Urachal cyst was diagnosed preoperatively in 11 patients (69%), urachal sinus was diagnosed in 4 patients (25%), and persistent urachus was found in one patient (6%). Thirteen patients underwent surgical excision of the urachus. Three patients in the cohort were not operated on during the follow-up period. One of them was later indicated for excision based on magnetic resonance imaging (MRI) findings. Two patients did not require surgery. In one case, sonographic findings disappeared after conservative treatment, and in another case, the condition was resolved by incision of an inflammatory cyst followed by conservative management. Both patients remain asymptomatic. Among the 13 surgically excised specimens, histological structures confirming the diagnosis of urachus were demonstrated in 11 patients, while no urachal tissue structures were found in two patients. Conclusion: Persistent urachus warrants complete excision with a favorable prognosis.

• Keywords
• Perzistující urachus,
• MeSH
• Cystography methods   MeSH
• Cysts surgery   diagnosis   MeSH
• Child MeSH
• Conservative Treatment methods   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Postoperative Care methods   MeSH
• Prognosis MeSH
• Retrospective Studies MeSH
• Ultrasonography methods   MeSH
• Urachus * abnormalities   surgery   MeSH
• Check Tag
• Child MeSH
• Humans MeSH

Perzistujúca ľavá horná dutá žila je pomerne zriedkavá vrodená venózna anomália. Príčinou jej vzniku je porucha uzatvorenia ľavej hornej dutej žily počas embryonálneho vývoja srdca. Vo väčšine prípadov môže byť pacient bez akejkoľvek symptomatológie, stretávame sa však aj s pridruženými, vrodenými, vývojovými chybami srdca, ako je defekt predsieňového septa, defekt medzikomorového septa, Fallotova tetralógia, koarktácia aorty a poruchy rytmu. V tejto kazuistike poukazujeme na možnosť detailného zobrazenia nielen srdca, ale aj okolitých štruktúr pomocou magnetickej rezonancie u pacientky s perzistentnou ľavou hornou dutou žilou, s pridruženou v detstve operovanou koarktáciou aorty.

Persistent left superior vena cava is quite rare congenital venous anomaly. The cause of this anomaly is failure of the closure of the left superior vena cava. In most of the cases the patient is asymptomatic, but there is often association with other congenital heart diseases as atrial šeptal defect, ventricular šeptal defects, Tetralogy of Fallot, coarctation of aorta and rythm disturbances. In this case report of one patient, we are showing the possibility of detailed imaging not only of the heart, but also the surrounding structures with magnetic resonance in patient with persistent left superior vena cava, with coarctation of aorta, which was previously operated.

• MeSH
• Diagnostic Techniques and Procedures MeSH
• Echocardiography, Transesophageal methods   utilization   MeSH
• Disease Attributes MeSH
• Aortic Coarctation diagnosis   etiology   surgery   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   utilization   MeSH
• Aged, 80 and over MeSH
• Vena Cava, Superior anatomy & histology   MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Fúze obrazu představuje perspektivní cestu při porovnávání více vyšetření pacienta, a to i různých modalit. V článku je nastíněno teoretické pozadí a využití fúze obrazu je ukázáno na čtyřech příkladech: fúze PET/MR pro nejvhodnější cílení biopsie, PET/PET pro odlišení pooperačních reaktivních změn od perzistence tumoru, SPECT/SPECT pro zobrazení změn perfuze mozku po vazodilatačním podnětu a PET/PET/MR pro lokalizaci epileptogenni zóny.

Image co-registration is a perspective way which enables the comparison of several patient studies, even of different modalities. This article shows the theoretical background and shows four examples of image fusion use: PET/MRI fusion for the localization of the biopsy, PET/PET fiision used for differentiating reactive surgery changes from tumour persistence, SPECT/SPECT co-registration to display the changes of brain perfusion after vasodilatation challenge and PET/PET/MRI fusion to localize the seizure focus.

• MeSH
• Research Support as Topic MeSH
• Image Interpretation, Computer-Assisted MeSH
• Tomography, Emission-Computed, Single-Photon MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Brain pathology   MeSH
• Nuclear Medicine MeSH
• Tomography, X-Ray Computed MeSH
• Tomography, Emission-Computed MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH
• Comparative Study MeSH

x

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• MeSH
• Cerebral Arteries abnormalities   MeSH
• Arteries abnormalities   embryology   MeSH
• Trigeminal Ganglion blood supply   MeSH
• Humans MeSH
• Magnetic Resonance Imaging, Cine methods   MeSH
• Adolescent MeSH
• Oculomotor Nerve physiopathology   MeSH
• Sleep Wake Disorders etiology   psychology   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

INTRODUCTION: Image integration is being used in ablation procedures. However, the success of this approach is dependent on the accuracy of the image integration process. This study aims to evaluate the in vivo accuracy and reliability of the integrated image. METHODS AND RESULTS: One hundred twenty-four patients undergoing radiofrequency (RF) ablation catheter ablation for atrial fibrillation (AF) were recruited for this study from three different centers. Cardiac computerized tomography (CT) was performed in all patients and a 3D image of the left atrium (LA) and pulmonary veins (PVs) was extracted for registration after segmentation using a software program (CartoMerge, Biosense Webster, Inc.). Different landmarks were selected for registration and compared. Surface registration was then done and the impact on integration and the landmarks was evaluated. The best landmark registration was achieved when the posterior points on the pulmonary veins were selected (5.6 +/- 3.2). Landmarks taken on the anterior wall, left atrial appendage (LAA) or the coronary sinus (CS) resulted in a larger registration error (9.1 +/- 2.5). The mean error for surface registration was 2.17 +/- 1.65. However, surface registration resulted in shifting of the initially registered landmark points leading to a larger error (from 5.6 +/- 3.2 to 9.2 +/- 2.1; 95% CI 4.2-3.05). CONCLUSION: Posterior wall landmarks at the PV-LA junction are the most accurate landmarks for image integration in respect to the target ablation area. The concurrent use of the present surface registration algorithm may result in shifting of the initial landmarks with loss of their initial correlation with the area of interest.

• MeSH
• Echocardiography * methods   MeSH
• Atrial Fibrillation * diagnosis   surgery   MeSH
• Image Interpretation, Computer-Assisted methods   instrumentation   MeSH
• Catheter Ablation * methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Tomography, X-Ray Computed methods   MeSH
• Reproducibility of Results MeSH
• Heart Atria radiography   MeSH
• Pulmonary Veins radiography   MeSH
• Imaging, Three-Dimensional methods   instrumentation   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Evaluation Study MeSH

Zdravotně sociální fakulta Jihočeské univerzity v Českých Budějovicích Radiofrekvenční katétrové ablace (RFKA) pro fibrilaci síní (FS) patří k dnes již etablovaným metodám nefarmakologické léčby této arytmie. Cílem těchto zákroků je vytvořit v levé (popř. i v pravé) síni sérii cirkumferenčních a lineárních lézí, které slouží k eliminaci spouštěčů arytmie a k modifikaci arytmogenního substrátu tak, aby se FS nebyla schopna v síních setrvale udržet. V poslední době jsme na poli této léčby byli svědky nebývalého rozvoje řady metod a technik, které všechny měly za cíl jediné: zvýšit úspěšnost a bezpečnost katétrových ablací prováděných pro FS. Jednou z těchto možností je použití různých zobrazovacích technik, které přinášejí detailnější pohled na anatomii cílového srdečního oddílu. Souhrnný článek přináší přehled současných dostupných literárních dat a shrnuje autorovy zkušenosti v této specifické oblasti včetně výsledků použití těchto metod.

Radiofrequency catheter ablations (RFCA) for atrial fibrillation (AF) belong to the established non-pharmacological therapy of this arrhythmia. The goal of the therapy is to create series of circumferential and linear lesions in either left atrium or both atria to eliminate triggers and perpetuators of AF. We have witnessed an enormous technical and methodological development in this area recently with the aim to increase efficacy and safety of RFCA for AF. One of such modality is different imaging techniques, which allow for a more precise definition of the target structures in the atria. This review article summarizes current literary data on the topic and brings also author’s personal experience in the area of imaging and image integration including the results of the retrospective trial using these methods.

• Keywords
• radiofrekvenční katétrová ablace, zobrazovací techniky, rotační angiografie, elektroanatomické mapování,
• MeSH
• Surgery, Computer-Assisted methods   trends   MeSH
• Echocardiography methods   trends   utilization   MeSH
• Atrial Fibrillation surgery   radiography   ultrasonography   MeSH
• Cardiovascular Surgical Procedures methods   instrumentation   MeSH
• Catheter Ablation methods   trends   MeSH
• Humans MeSH
• Tomography, X-Ray Computed MeSH
• Systems Integration MeSH
• Imaging, Three-Dimensional methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

OBJECTIVE: This study explores the experience of body-image changes throughout the trajectory of breast cancer. METHODS: We conducted qualitative in-depth interviews with 53 women (n = 53) representing diverse age groups, with a mean age of 48.61 years (SD = 13.12), from various regions across the Czech Republic. The interviews were audio/video recorded and divided into two phases. The initial phase consisted of a narrative part, followed by a semi-structured interview. Thematic analysis was employed to identify and explore the topics that held significant importance to the participants. RESULTS: This research investigated how body image and emotional responses evolve in women with breast cancer during various stages of the illness. Throughout the breast cancer journey, women undergo diverse body image changes, with some of them being described as particularly traumatic, such as hair loss and preventive operations. The effects of breast cancer extend beyond physical scars, influencing femininity and womanhood in the long run. The experience of womanhood is marked by visible and non-visible effects that persist for years after treatment. CONCLUSION: Study has provided valuable insights into the emotional journey that women experience during breast cancer diagnosis, treatment, and survivorship. The illness trajectory framework has proven to be a valuable tool for understanding the complexities of body image concerns and the emotional implications faced by breast cancer patients. By acknowledging the significance of body image issues and providing targeted interventions, healthcare providers can improve the psychosocial well-being and overall quality of life for breast cancer survivors. Further research in this area is needed to develop and refine supportive interventions that address the unique challenges women face during their breast cancer journey. Ultimately, by fostering a sensitive and comprehensive approach to care, we can empower women to navigate their breast cancer journey with greater resilience and confidence.

• MeSH
• Adult MeSH
• Qualitative Research * MeSH
• Middle Aged MeSH
• Humans MeSH
• Breast Neoplasms * psychology   MeSH
• Body Image * psychology   MeSH
• Interviews as Topic MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Double-stranded DNA breaks activate a DNA damage checkpoint in G2 phase to trigger a cell cycle arrest, which can be reversed to allow for recovery. However, damaged G2 cells can also permanently exit the cell cycle, going into senescence or apoptosis, raising the question how an individual cell decides whether to recover or withdraw from the cell cycle. Here we find that the decision to withdraw from the cell cycle in G2 is critically dependent on the progression of DNA repair. We show that delayed processing of double strand breaks through HR-mediated repair results in high levels of resected DNA and enhanced ATR-dependent signalling, allowing p21 to rise to levels at which it drives cell cycle exit. These data imply that cells have the capacity to discriminate breaks that can be repaired from breaks that are difficult to repair at a time when repair is still ongoing.

• MeSH
• Ataxia Telangiectasia Mutated Proteins genetics   metabolism   MeSH
• Cell Line MeSH
• Time-Lapse Imaging methods   MeSH
• Cyclin B1 genetics   metabolism   MeSH
• Microscopy, Fluorescence MeSH
• HEK293 Cells MeSH
• Cyclin-Dependent Kinase Inhibitor p21 genetics   metabolism   MeSH
• G2 Phase Cell Cycle Checkpoints genetics   MeSH
• Humans MeSH
• DNA Repair genetics   MeSH
• DNA Damage * MeSH
• Signal Transduction genetics   MeSH
• Cellular Senescence genetics   MeSH
• Green Fluorescent Proteins genetics   metabolism   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Prezentujeme dva případy diagnostikované mozkové žilní trombózy s rozsáhlým nálezem podporujícím ischemii při konvenčním MR vyšetření. Na MR angiografii byla zobrazena trombóza hlubokých žilních struktur a mozkových splavů. Nálezy se lišily v modalitě DWI (diffusion weighted imaging) a v ADC (apparent diffusion coefficient) mapách. V prvním případě byl v postižených strukturách v DWI signál zvýšený a v ADC mapách střední až snížený, což indikovalo cytotoxický edém a ischemickou lézi. Ve druhém případě byl v DWI signál střední až nízký, v ADC mapách zvýšený, což indikovalo vazogenní edém. Těžký klinický nález u obou pacientek vyžadoval hospitalizaci a antikoagulační terapii. U první pacientky ještě za šest měsíců od začátku příznaků přetrvávaly známky organického psychosyndromu, bolesti hlavy a vertigo. Na MR přetrvávalo reziduum ischemické prokrvácené léze v levém thalamu. U druhé pacientky došlo během 14 dní k úplné remisi MR obrazu a normalizaci klinického stavu. DWI a ADC mapy nejen přispívají k diagnóze CVT, ale i umožňují určitou predikci klinického vývoje.

We present two cases with diagnoses of cerebral venous thrombosis with extensive pathological changes supporting ischemia on conventional MR imaging (MRI). MR angiography disclosed thrombosis of the vein of Galen and cerebral sinuses. The findings were different on diffusion-weighted imaging (DWI) and on ADC maps. The first case exhibited high signal intensity on DWI and intermediate-to-low signal intensity on ADC (apparent diffusion coefficient) maps in the affected area. This indicated cytotoxic oedema and ischemic lesions. The second case showed intermediate-to-low signal intensity on DWI and high signal intensity on ADC maps. This indicated vasogenic oedema. The severe clinical status of both patients necessitated admittance to the intensive care unit and anticoagulation therapy. In the first case, six months after symptoms onset, signs of organic psychosyndrome, cephalea and vertigo remained. MRI indicated that a residue of the haemorrhage ischemic lesion in the left thalamus persisted, with high signal on T2WI and low signal with mild hypersignal margin on T1WI. In the second case, MR findings and normalization of clinical status after anticoagulation therapy indicated complete remission. We suggest that DWI and ADC contribute to diagnosis and enable a certain degree of prediction of clinical course.

• MeSH
• Anticoagulants administration & dosage   adverse effects   therapeutic use   MeSH
• Headache diagnosis   etiology   MeSH
• Diffusion Magnetic Resonance Imaging MeSH
• Adult MeSH
• Epilepsy MeSH
• Financing, Organized MeSH
• Intracranial Thrombosis diagnosis   MeSH
• Disease Attributes MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   utilization   MeSH
• Brain Mapping methods   utilization   MeSH
• Adolescent MeSH
• Consciousness Disorders MeSH
• Prognosis MeSH
• Vomiting MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Background Identification and elimination of nonpulmonary vein targets may improve clinical outcomes in patients with persistent atrial fibrillation (AF). We report on the use of a novel, noncontact imaging and mapping system that uses ultrasound to reconstruct atrial chamber anatomy and measures timing and density of dipolar, ionic activation (ie, charge density) across the myocardium to guide ablation of atrial arrhythmias. Methods The prospective, nonrandomized UNCOVER AF trial (Utilizing Novel Dipole Density Capabilities to Objectively Visualize the Etiology of Rhythms in Atrial Fibrillation) was conducted at 13 centers across Europe and Canada. Patients with persistent AF (>7 days, <1 year) aged 18 to 80 years, scheduled for de novo catheter ablation, were eligible. Before pulmonary vein isolation, AF was mapped and then iteratively remapped to guide each subsequent ablation of charge density-identified targets. AF recurrence was evaluated at 3, 6, 9, and 12 months using continuous 24-hour ECG monitors. The primary effectiveness outcome was freedom from AF >30 seconds at 12 months for a single procedure with a secondary outcome being acute procedural efficacy. The primary safety outcome was freedom from device/procedure-related major adverse events. Results Between October 2016 and April 2017, 129 patients were enrolled, and 127 underwent mapping and catheter ablation. Acute procedural efficacy was demonstrated in 125 patients (98%). At 12 months, single procedure freedom from AF on or off antiarrhythmic drugs was 72.5% (95% CI, 63.9%-80.3%). After 1 or 2 procedures, freedom from AF was 93.2% (95% CI, 87.1%-97.0%). A total of 29 (23%) retreatments because of arrhythmia recurrence were performed with average time from index procedure to first retreatment being 7 months. The primary safety outcome was 98% with no device-related major adverse events reported. Conclusions This novel ultrasound imaging and charge density mapping system safely guided ablation of nonpulmonary vein targets in persistent AF patients with 73% single procedure and 93% second procedure freedom from AF at 12 months. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT02825992 EU/NCT02462980 CN.

• MeSH
• Action Potentials * MeSH
• Time Factors MeSH
• Progression-Free Survival MeSH
• Adult MeSH
• Electrophysiologic Techniques, Cardiac * MeSH
• Electrocardiography, Ambulatory MeSH
• Atrial Fibrillation diagnostic imaging   physiopathology   surgery   MeSH
• Catheter Ablation MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Non-Randomized Controlled Trials as Topic MeSH
• Predictive Value of Tests MeSH
• Heart Conduction System diagnostic imaging   physiopathology   surgery   MeSH
• Prospective Studies MeSH
• Recurrence MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Heart Rate * MeSH
• Ultrasonography * MeSH
• Pulmonary Veins physiopathology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Video-Audio Media MeSH
• Journal Article MeSH
• Clinical Trial MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH
• Canada MeSH