Perinální bolest. Anatomie. Blokáda ganglion impar. Blokáda sakrálního sympatiku. Výsledky. Diskuse.

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• anesteziologie a intenzivní lékařství
• chirurgie
• NLK Publikační typ
• texty

• MeSH
• analgetika MeSH
• analgezie MeSH
• anestezie a analgezie MeSH
• bolest MeSH
• CD-ROM MeSH
• lokální anestezie MeSH
• management bolesti MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• anesteziologie a intenzivní lékařství
• NLK Publikační typ
• CD-ROM

• MeSH
• anestetika lokální aplikace a dávkování   MeSH
• anestezie a analgezie metody   MeSH
• autonomní nervový systém patologie   patofyziologie   anatomie a histologie   MeSH
• blokáda autonomních nervů metody   MeSH
• bolest MeSH
• management bolesti MeSH
• neurologie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• neurologie
• anesteziologie a intenzivní lékařství

Vysoce rozlišující výpočetní tomografie /HRCT/ umožňující detailní zobrazení plicního parenchymu je použita k rozboru změn u různých difúzních plicních onemocnění za účelem zpřesnění diagnózy a posouzení aktivity nemoci. XXX XXX XXX

• MeSH
• plicní nemoci diagnóza   MeSH
• tomografie emisní počítačová metody   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• pneumologie a ftizeologie
• radiologie, nukleární medicína a zobrazovací metody
• chemie, klinická chemie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu IGA MZ ČR

• MeSH
• diagnostické techniky otologické MeSH
• mostomozečkový úhel patologie   MeSH
• neurilemom diagnóza   MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• otorinolaryngologie
• neurologie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu IGA MZ ČR

INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a serious disease with unknown cause and the influence of cytokine gene polymorphisms is presumed in the etiology and pathogenesis of the disease. We used high-resolution computed tomography (HRCT) as a marker of disease stage and progression and compared the alveolar and interstitial score with IL-1, IL-4, IL-12, IL-1RA and IL-4RA cytokine gene polymorphisms. SUBJECTS AND METHODS: The IPF patients were all Caucasians from the Czech Republic and consisted of 20 females and 10 males, with a mean age of 65 years, range 36-85. The HRCT results were evaluated by an experienced viewer using the interstitial and alveolar score scales, which were based on the IPF HRCT description system from Gay SE, Kazerooni EA, Tows GB, Lynch JP, Gross BH, Cascade PN, et al. [Idiopathic pulmonary fibrosis. Predicting response to therapy and survival. Am J Respir Crit Care Med 1998;157:1063-72]. We evaluated the polymorphisms of cytokine genes utilizing a PCR with sequence-specific primers method. RESULTS: The HRCT alveolar score was more pronounced in IL-4 RA (+1902) AG heterozygotes. The HRCT interstitial score was less severe in the IL-12 (-1188) AA homozygotes. According to progression of the HRCT interstitial score, the CC homozygosity at IL-1 RA (mspa 111100), the AA homozygosity at IL-4 RA (+1902) and CC homozygosity at IL-4(+33) positions were more frequent in patients with stable disease compared to those with progressive disease. CONCLUSIONS: We assume from our data that the polymorphisms of IL-4, IL-4RA, IL-1RA and IL-12 genes (genes of cytokines with regulatory activity) might influence the phenotype of IPF as shown by measurable changes in HRCT investigations.

• MeSH
• antagonista receptoru pro interleukin 1 genetika   MeSH
• dospělí MeSH
• fenotyp MeSH
• financování organizované MeSH
• genetická predispozice k nemoci MeSH
• genotyp MeSH
• interleukin-12 genetika   MeSH
• interleukin-4 genetika   MeSH
• interleukiny chemická syntéza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní alveoly radiografie   MeSH
• plicní fibróza genetika   radiografie   MeSH
• počítačová rentgenová tomografie MeSH
• polymorfismus genetický MeSH
• progrese nemoci MeSH
• receptor interleukinu-4 - alfa-podjednotka genetika   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

Idiopathic pulmonary fibrosis (IPF) is a serious disease characterized with progressive scarring of the lungs in which a genetic background is supposed. We have tested correlation of promotor regions of IL-1alpha and IL-4 gene polymorphisms with clinical parameters in IPF. We investigated the group of 30 patients with IPF. The correlations of vital capacity (VC) and diffusing capacity for carbon monoxide (DL(CO)), bronchoalveolar lavage (BAL) fluid cell counts and high resolution computed tomography (HRCT) alveolar and interstitial scores with different genotypes of IL-4 at (-1098), (-590) and (-33) positions and IL-1 alpha at (-889) position were tested. The PCR method was used for genotyping. The carriers of CT genotype at IL-1 alpha (-889) position had higher VC at the time of diagnosis. The CC genotype at this position was more frequent in patients with higher counts of HLADR+ T lymphocytes in BAL. The GT genotype at IL-4 (-1098) position correlated with higher counts of CD4(+) T lymphocytes, and inversely the TT genotype with higher counts of CD8(+) T lymphocytes in BAL fluid. According to dynamic changes of HRCT score the CT genotype at IL-4 (-33) was more frequent in patients with progressive disease compared to that with stable disease. We assume from our data that the gene polymorphisms of the promotor region of IL-4 at position (-1098) and (-33) and IL-1 alpha at position (-889) are likely to play a pathogenic role in IPF and in modification of its clinical presentation and severity.

• MeSH
• bronchoalveolární lavážní tekutina cytologie   MeSH
• dospělí MeSH
• financování organizované MeSH
• genetická predispozice k nemoci MeSH
• genotyp MeSH
• interleukin-1alfa genetika   MeSH
• interleukin-4 genetika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní fibróza genetika   MeSH
• počítačová rentgenová tomografie MeSH
• polymerázová řetězová reakce MeSH
• polymorfismus genetický MeSH
• promotorové oblasti (genetika) MeSH
• respirační funkční testy MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vitální kapacita MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

INTRODUCTION: Extrinsic allergic alveolitis (EAA) is an immunologically mediated interstitial lung disease. The abnormalities in the bronchoalveolar lavage (BAL) fluid cell counts are almost always seen in patients with EAA according to the stage of the disease. The aim of this retrospective study was to find out how the BAL lymphocyte count, percentage of lymphocytes expressing HLA-DR, CD4/CD8 T cell ratio in BAL fluid, and the concentration of immunoglobulin G in serum correspond to the inflammatory activity of the disease. METHODS: The study included 14 patients with EAA. BAL fluid samples were obtained and processed for cytological and cytometric analysis. Immunoglobulin G serum concentrations were measured. High resolution computed tomography (HRCT) scoring system modified by Gay was used for establishing the alveolar and interstitial score in each patient. CONCLUSIONS: It was found that subjects with normal value of CD4/CD8 ratio in BAL fluid had higher interstitial HRCT score. Clinical presentation, continuous exposure to the causative antigens, and BAL lymphocyte count positively correlated with the alveolar HRCT score. It is proposed that the increased BAL lymphocyte count could be the predictor of the inflammatory activity of the disease, especially in people with lasting exposure to the offending antigen.

• MeSH
• akutní nemoc MeSH
• bronchoalveolární lavážní tekutina cytologie   MeSH
• chronická nemoc MeSH
• dospělí MeSH
• financování organizované MeSH
• hypersenzitivní pneumonitida diagnóza   radiografie   MeSH
• imunoglobulin G krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• počítačová rentgenová tomografie metody   MeSH
• poměr CD4 a CD8 lymfocytů MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

A 54-year-old woman was operated for obstructive ileus in 1996. Obstruction was caused by a tumor of the descending colon invading the abdominal wall. Urgent left colectomy with lymphadenectomy was performed. Microscopically six lymphatic nodes were positive. The patient was postoperatively treated with adjuvant chemotherapy. Fifteen months later the patient underwent a resection of central hepatic segments (Couinaud's segment 4,5,8) for metachronous metastasis. At present the patient has no signs of recurrence, she has returned back to her normal life. Despite several unfavorable prognostic factors--obstruction, abdominal wall infiltration, number of positive nodes, short time between primary tumor resection and diagnosis of liver metastasis and centrally located metastasis with satellite lesions, the patient has been surviving for 6 years now.

• MeSH
• adenokarcinom patologie   sekundární   MeSH
• hepatektomie metody   MeSH
• invazivní růst nádoru MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfatické metastázy MeSH
• nádory jater chirurgie   radiografie   sekundární   MeSH
• nádory tračníku patologie   MeSH
• počítačová rentgenová tomografie MeSH
• prognóza MeSH
• venae hepaticae patologie   radiografie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH

The objective of this study was to evaluate the possibility and describe the methodology of a computed tomography-guided anterior approach to superior hypogastric plexus block for noncancer pain. A computed tomography-guided anterior approach to the superior hypogastric plexus was used in 2 patients with pelvic pain and anatomic disturbance of the lumbar spine, which was a contraindication to the conventional dorsal approach. The first case was a 43-year-old patient suffering from burning pain of the urethra. Pain relief using analgesics and antidepressants was insufficient. The posterior approach was excluded due to coexisting irritation of the L5 nerve root. The second case was a 68-year-old man suffering from chronic burning and itching pain of the urethra and glans penis. Conservative therapy (anti-inflammatory drugs, tramadol, spasmolytics) failed to provide satisfactory pain relief. The posterior approach was contraindicated because of laterally prominent L5 vertebral body osteophytes. Both patients received a prognostic block to the superior hypogastric plexus via the anterior approach guided by computed tomography. Visual analog scale scores prior to the block were 6 to 7 and 5 to 6, respectively. The visual analog scale scores 24 hours after the block were 1 and 0, respectively. The second patient received a permanent neurolytic block via the anterior approach to provide long-term pain relief. In conclusion, the authors describe the computed tomography-guided anterior approach to the superior hypogastric plexus for chronic pelvic pain. The technique is simple to perform, and the analgesic effect is satisfactory. More extensive studies are necessary to evaluate the safety of this approach.

• MeSH
• dospělí MeSH
• lidé MeSH
• pánevní bolest patologie   MeSH
• plexus hypogastricus patologie   MeSH
• počítačová rentgenová tomografie MeSH
• počítačové zpracování obrazu metody   MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH