BACKGROUND: For patients with nonmetastatic renal cell carcinoma (nmRCC) treated with nephrectomy, prediction of cancer-specific mortality (CSM) by T stage and substage has not been validated for the separate histological subtypes. OBJECTIVE: To investigate the ability of pathological T stage and substage to predict CSM for patients with clear-cell, papillary, or chromophobe nmRCC treated with nephrectomy. DESIGN, SETTING, AND PARTICIPANTS: Using the SEER database for 2004-2016, we identified 87 149 patients with T1-4 N0/X M0 nmRCC treated with nephrectomy for the clear-cell (65 715; 75.4%), papillary (14 587; 16.7%), or chromophobe (6847; 7.9%) histological subtype. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Kaplan-Meier plots and Cox regression models were used to estimate CSM. RESULTS AND LIMITATIONS: For all three histological subtypes, patients with T1a-T3a disease exhibited more favorable CSM than patients with T3b-T4 RCC. For clear-cell RCC, there were clinically meaningful and statistically significant differences for virtually all intergroup comparisons among T1a-T3a stages. For papillary T1a-T3a RCC, clinically meaningful differences disappeared, although the statistical significance remained. For chromophobe T1a-T3a RCC, no clinically meaningful or statistically significant differences were observed. For all three histological subtypes, patients with T3b-T4 RCC exhibited virtually uniformly unfavorable CSM, with no clinically meaningful intergroup CSM differences. CONCLUSION: The use of T stage and substage for stratification of patients with nmRCC treated with nephrectomy revealed differences in CSM among T1a-T3a cases, but not T3b-T4. The magnitude of the CSM difference was greatest for clear-cell, intermediate for papillary, and marginal for chromophobe RCC. PATIENT SUMMARY: For patients with kidney cancer, the stage of their disease assessed after surgery on the affected kidney can predict how likely they are to die from their cancer. This prediction varies for different subtypes of kidney cancer.

• MeSH
• karcinom z renálních buněk * patologie   MeSH
• ledviny patologie   MeSH
• lidé MeSH
• nádory ledvin * patologie   MeSH
• nefrektomie MeSH
• proporcionální rizikové modely MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKROUND: We wanted to characterize conditional survival in prostate cancer (PC) in Sweden around and after 2005 when the vast increase in incidence due to the opportunistic testing for prostate specific antigen (PSA) culminated. We hypothesize that analyzing survival data during that time period may help interpret survival trends. We focus on stage-specific analysis using conditional survival in order to define the periods when deaths most commonly occurred. METHODS: Data on PC patients were obtained from the Swedish cancer registry for analysis of 1-, 2.5- and 5-year relative survival and conditional relative survival between years 2004 and 2018. Tumor-node-metastatic stage classification at diagnosis was used to specify survival. RESULTS: Small improvements were observed in stage- and age-related relative survival duriring the study period. Applying conditional relative survival showed that survival in stage T3 up to 2.5 years was better than survival between years 2.5 and 5. Survival in stage T4 was approximately equal in the first and the subsequent 2.5-year period. For M1, the first 2.5 year survival period was worse than the subsequent one. The proportion of high risk and M1 disease in old patients (80+ years) remained very high and their survival improved only modestly. CONCLUSIONS: The data indicate that M1 metastases kill more patients in the first 2.5 years than between years 2.5 and 5 after diagnosis; T4 deaths are equal in the two periods, and in T3 mortality in the first 2.5-year period is lower than between years 2.5 and 5 after diagnosis. Conditional survival could be applied to explore critical survival periods even past 5 years after diagnoses and to monitor success in novel diagnostic and treatment practices. Improvement of survival in elderly patients may require clinical input.

• MeSH
• analýza přežití MeSH
• lidé MeSH
• míra přežití MeSH
• nádory prostaty * MeSH
• prostatický specifický antigen MeSH
• registrace MeSH
• senioři MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Švédsko MeSH

• Klíčová slova
• léčivé přípravky, léky, analýsa,

• Konspekt
• Farmacie. Farmakologie
• NLK Obory
• farmacie a farmakologie

Trypanosomes are masters of adaptation to different host environments during their complex life cycle. Large-scale proteomic approaches provide information on changes at the cellular level, and in a systematic way. However, detailed work on single components is necessary to understand the adaptation mechanisms on a molecular level. Here, we have performed a detailed characterization of a bloodstream form (BSF) stage-specific putative flagellar host adaptation factor Tb927.11.2400, identified previously in a SILAC-based comparative proteome study. Tb927.11.2400 shares 38% amino acid identity with TbFlabarin (Tb927.11.2410), a procyclic form (PCF) stage-specific flagellar BAR domain protein. We named Tb927.11.2400 TbFlabarin-like (TbFlabarinL), and demonstrate that it originates from a gene duplication event, which occurred in the African trypanosomes. TbFlabarinL is not essential for the growth of the parasites under cell culture conditions and it is dispensable for developmental differentiation from BSF to the PCF in vitro. We generated TbFlabarinL-specific antibodies, and showed that it localizes in the flagellum. Co-immunoprecipitation experiments together with a biochemical cell fractionation suggest a dual association of TbFlabarinL with the flagellar membrane and the components of the paraflagellar rod.

• MeSH
• duplikace genu MeSH
• flagella fyziologie   MeSH
• fylogeneze MeSH
• geneticky modifikované organismy MeSH
• myši inbrední C57BL MeSH
• proteinové domény MeSH
• protozoální proteiny chemie   genetika   imunologie   metabolismus   MeSH
• Trypanosoma brucei brucei genetika   patogenita   fyziologie   MeSH
• trypanozomóza africká parazitologie   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• Publikační typ
• abstrakty MeSH

Autoři prezentují sestavu 76 nemocných radikálně operovaných pro karcinom hlavy pankreatu a analyzují pooperační komplikace a přežívání. Materiál a metodika: V období 1/2006–9/2010 podstoupilo 76 nemocných potenciálně kurativní hemipankreatoduodenektomii pro adenokarcinom hlavy pankreatu. Pacienti jsou prospektivně sledováni, diskutovány jsou komplikace a přežití. Výsledky: 30denní pooperační mortalita je 2,6 %. Na základě TNM klasifikace 11 % mělo stadium I, 78 % stadium II a 3 % stadium III. Nejzávažnější komplikací byla insuficience pankreatojejunální anastomózy (6,5 %) a opožděná evakuace žaludku (11,8 %). Ve stadiu I přežívá 1., 2., 3. a 4. rok 82 %, 52 %, 35 % a 35 % operovaných. Závěr: Resekce hlavy pankreatu je bezpečná operace s nízkou mortalitou, ale neuspokojivým dlouhodobým přežíváním. Toto je zřejmě způsobeno agresivní biologickou aktivitou nádoru a pozdní diagnostikou.

The authors refer seventy six patients radically operated for pancreatic head carcinoma and analyzed postoperative complications and survival. Material and Methods: During 1/2006–9/2010 76 patients underwent potentially curative hemipancreato-duodenectomy for adenocarcinoma of the head of pancreas. The patients are prospectively followed, complications and survival are discussed. Results: The 30-days postoperative mortality was 2,6 %. According to TNM classification 11 % of patients had stage I, 78 % stage II and 3 % stage III. Most severe complications were leak from pancreato-jejunal anastomosis (6,5 %) and delayed gastric emptying (11.8 %). The survival analyses showed 1,2,3 and 4 years survival as follows: 82 %, 52 %, 35 %, 35 % respectively. Conclusion: Resection of the pancreatic head is a safe procedure with low mortality but disappointing long-term survival. This may be due to biological activity of the tumor and late diagnosis.

• Klíčová slova
• radikální resekce, komplikace, přežívání,
• MeSH
• analýza přežití MeSH
• chirurgie trávicího traktu metody   využití   MeSH
• financování organizované MeSH
• interpretace statistických dat MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• mortalita MeSH
• nádory slinivky břišní chirurgie   terapie   MeSH
• pankreatoduodenektomie metody   statistika a číselné údaje   využití   MeSH
• pooperační komplikace klasifikace   MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• staging nádorů využití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

BACKGROUND: The castor bean tick Ixodes ricinus is an important vector of several clinically important diseases, whose prevalence increases with accelerating global climate changes. Characterization of a tick life-cycle is thus of great importance. However, researchers mainly focus on specific organs of fed life stages, while early development of this tick species is largely neglected. METHODS: In an attempt to better understand the life-cycle of this widespread arthropod parasite, we sequenced the transcriptomes of four life stages (egg, larva, nymph and adult female), including unfed and partially blood-fed individuals. To enable a more reliable identification of transcripts and their comparison in all five transcriptome libraries, we validated an improved-fit set of five I. ricinus-specific reference genes for internal standard normalization of our transcriptomes. Then, we mapped biological functions to transcripts identified in different life stages (clusters) to elucidate life stage-specific processes. Finally, we drew conclusions from the functional enrichment of these clusters specifically assigned to each transcriptome, also in the context of recently published transcriptomic studies in ticks. RESULTS: We found that reproduction-related transcripts are present in both fed nymphs and fed females, underlining the poorly documented importance of ovaries as moulting regulators in ticks. Additionally, we identified transposase transcripts in tick eggs suggesting elevated transposition during embryogenesis, co-activated with factors driving developmental regulation of gene expression. Our findings also highlight the importance of the regulation of energetic metabolism in tick eggs during embryonic development and glutamate metabolism in nymphs. CONCLUSIONS: Our study presents novel insights into stage-specific transcriptomes of I. ricinus and extends the current knowledge of this medically important pathogen, especially in the early phases of its development.

• MeSH
• klíště genetika   růst a vývoj   MeSH
• nymfa růst a vývoj   MeSH
• rozmnožování genetika   MeSH
• stadia vývoje MeSH
• stanovení celkové genové exprese * MeSH
• stravovací zvyklosti MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Cíl studie: Retrospektivně zhodnotit, jak přesný je peroperační vizuální odhad maligního procesuv děložní dutině při hysteroskopii. Posoudit, zda vzrůstající zkušenost hysteroskopujících vedek signifikantnímu zpřesnění při odhadu neoplazie děložní dutiny.Název a sídlo pracoviště: Gynekologicko-porodnické oddělení NsP Havířov.Metodika: V NsP Havířov bylo provedeno v období 12/95-3/99 celkem 1200 hysteroskopií. V tomtosouboru bylo histologicky verifikováno 26 případů korporálního karcinomu. Autoři se pokusiliretrospektivně vyhodnotit, s jakou přesností bylo vysloveno podezření na toto onemocnění jižperoperačně při hysteroskopii. Jako srovnávací soubor pro zjištění, zda zkušenost zpřesní per-operační rozpoznání malignity jsme využili podsouboru prvních 690 hysteroskopií, jehož kom-plexní rozbor jsme publikovali v Čs. gynekologii 5/98 [13], a podsouboru 510 hysteroskopiíprovedených v období následujícím. Statistická analýza byla provedena pomocí Fischerova exakt-ního testu v četnostních tabulkách. V diskusi bylo použito mimo jiné databáze MEDLINE.Výsledky: Korporální karcinom byl zachycen celkem 26krát, tedy ve 2,2% hysteroskopií. Ca in situse vyskytl celkem 3krát, stadium IA 3krát IB 17krát, IC 3krát. Falešně negativní nález byl hyste-roskopujícím popisován celkem 13krát, tedy v 50% případů. Senzitivita a specificita hysteroskopiepro predikci korporálního karcinomu byla 50% a 99,5% (P < 0,01).Srovnáním výsledků I. podsouboru (16krát korporální karcinom, senzitivita 75% specifita 99,7%,p < 0,01), a II. podsouboru (10krát korporální karcinom, senzitivita 10%, specifita 99,2%, p = 0,09)nasvědčuje, že ani vzrůstající zkušenost hysteroskopujícího nezpřesňuje peroperační odhad ma-lignity.Závěr: autoři docházejí k závěru, že pouze vizuální peroperační hodnocení intrauterinní patolo-gie při hysteroskopii neumožňuje přesně odhadnout, zda se jedná o neoproces dutiny děložní, činikoliv. Ani vzrůstající zkušenost nezpřesňuje verifikaci maligního onemocnění, zejména u čas-ných stádií tohoto onemocnění. Hysteroskopii je třeba vždy doplnit o biopsii endometria.

Objective: The aim of this study was retrospective analysis of how accurate was per-operationalvisual evaluation of malign process in an uterus cavity during hysteroscopy. And to evaluatewhether increasing experience of hysteroscopiers leads to significant accuracy considering theneoplasm of an uterus cavity.Setting: Department of Gynaecology and Obstetrics, Havířov.Method: In Havířov Hospital, 1.200 hysteroscopies altogether were performed in the period fromDecember 1995 to March 1999. In this group, there were 26 cases of histologically verified endo-metrial cancer. The authors retrospectively attempted to evaluate how accurately the suspecteddisorder was already stated during the per-operational hysteroscopy. The advantage of compa-ring the sub-group was taken in the first 690 hysteroscopies, of which the complex analysis waspublisched in Čs. Gynekologie 5/98, and in the sub-group of 510 hysteroscopies performed in thefollowing period, to state whether experience can more precisely define the per-operational ma-lignity recognition. The statistical analysis was performed by means of the Fischer exact test ofnumerical charts. Among other things, the MEDLINE database was used during discussion.Results: The endometrial cancer was encountered 26 times altogether, it means in 2.2% cases ofhysteroscopies. Carcinoma in situ occured three times, the stage IA three times, IB 17 times, ICthree times. A hysteroscopier described the negative finding incorrectly 13 times altogether, itmeans 50% of all cases. The sensitivity and the specificity of hysteroscopy for endometrial cancerprediction was 50% and 99.5% (P < 0.01).The comparison of the first sub-group results (16 cases of endometrial cancer, sensitivity 75%,specificity 99.7%, (P < 0.01) and the second sub-group (10 cases of endometrial cancer, sensitivity10%, specificity 99.2%, P = 0.09%) indicates that even increasing experience of a hysteroscopierdoes not more precisely define per-operation malign consideration.Conclusion: The authors have come to the conclusion that the pre-operation consideration ofintrauteral pathology during hysteroscopy does not allow to assess precisely whether there isa neoprocess of an uterus cavity, or not. Even growing experience does not define with moreprecision verification of malign dosorders espetially at early stages of this illness. Hysteroscopyalways has to be supplemented with endometrium biopsy.

• MeSH
• biopsie MeSH
• dospělí MeSH
• endometrióza diagnóza   MeSH
• endometrium patologie   MeSH
• endometroidní karcinom diagnóza   MeSH
• hysteroskopie metody   MeSH
• kyretáž MeSH
• lidé středního věku MeSH
• lidé MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH
• srovnávací studie MeSH

OBJECTIVES: To test the effect of stage and grade migration on cancer specific mortality (CSM) in renal cell carcinoma (RCC) patients, according to clear cell (ccRCC) vs. non-ccRCC histology. METHODS AND MATERIALS: Within the Surveillance, Epidemiology, and End Results registry (2004-2015), we identified patients with ccRCC and non-ccRCC (papillary [papRCC], chromophobe [chRCC], sarcomatoid [sarcRCC], and collecting duct [cdRCC]). Two consecutive time groups were considered - historical (2004-2009) and contemporary era (2010-2015). Temporal trends of tumor characteristics were evaluated. Cumulative incidence plots and multivariable competing risks regression models tested the effect of year groups on CSM. RESULTS: Overall, 24,746 and 73,228 patients with non-ccRCC and ccRCC were evaluated. Of those, 42% and 58% were recorded in historical and contemporary era. Time trend analyses showed (1) tumor size decreased for non-ccRCC (estimated annual percent changes [EAPC]: -1.1%; P <0.01) and for ccRCC (EAPC: -1.0%; P <0.01), (2) rates of G3/G4 decreased for non-ccRCC (EAPC: -0.7%; P = 0.03), but increased for ccRCC (EAPC: +1.1; P <0.01), 3) rates of node positive disease decreased for non-ccRCC (EAPC:-3.1%; P = 0.02), but were stable for ccRCC (EAPC: +0.4; P =0.5), (4) rates of metastatic disease at diagnosis decreased for non-ccRCC (EAPC: -3.2%; P <0.01), but were stable for ccRCC (EAPC: -0.6%; P = 0.1), (5) among non-ccRCC, the percentage of papRCC increased (EAPC:+1%; P <0.01), while the percentage of sarcRCC (EAPC: -7%; P <0.01) and cdRCC (EAPC: -11.2%; P <0.01) decreased. Finally, in multivariable CRR models, lower CSM was recorded for contemporary non-ccRCC (HR: 0.7; P <0.001) and ccRCC (HR: 0.8; P <0.001) patients. CONCLUSION: Our findings illustrate a favorable stage and grade migration and improved cancer-specific mortality in contemporary non-ccRCC. Additionally, despite absence of meaningful stage migration in ccRCC, improved cancer-specific mortality in contemporary patients was also recorded. In consequence, a 2-tiered process appears to be operational in non-ccRCC vs. a 1-tiered phenomenon in ccRCC.

• MeSH
• karcinom z renálních buněk mortalita   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory ledvin mortalita   patologie   MeSH
• senioři MeSH
• staging nádorů MeSH
• stupeň nádoru MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Úvod. Creutzfeldtova-Jakobova choroba (CJCh) je zriedkavé smrtelné neurodegeneratívne ochorenie, V etiopatogenéze ktorého zohrávajú podstatnú úlohu prióny. Je charakterizované nezadržateľne progresívnym priebehom a špecifickými nálezmi pri pomocných vyšetreniach. Cieľom predkladanej práce bolo zistiť výskyt jednotlivých klinických príznakov a špecifických elektroencefalografických (EEG) nálezov v súbore pacientov s genetickou formou CJCh. Materiál a metódy. Retrospektívne sme zhodnotili výskyt neurologických a psychických príznakov ako i EEG záznamy v skupine 23 pacientov (11 mužov a 12 žien) s definitívnou (21) alebo pravdepodobnou (2) CJCh. Priemerný vek pri vzniku ochorenia bol 55,7 rokov. Výsledky. Z uvedenej skupiny mali 17 pacienti (všetci, u ktorých sa toto vyšetrenie vykonalo) potvrdenú mutáciu E200K. Ochorenie trvalo v mediáne 3,8 mesiaca. Iniciálne príznaky boli najčastejšie nešpecifické (nespavosť, hmotnostný úbytok a pod.) a senzitívne poruchy. Dementný syndrom bol prítomný v 100 % prípadov, pyramídové príznaky a myoklonus v 87 %, extrapyramídové príznaky a imus alebo apalický syndrom v 78 % a cerebeláme príznaky v 57 % prípadov. EEG vyšetrenie (vykonané prvý-krát v mediáne 2,0 mesiaca od nástupu ochorenia) bolo celkovo pozitívne v 91 % prípadov, pričom až v 61 % prípadov bol pozitívny už prvý EEG záznam. Diskusia a záver. Kombinácia neurologických a psychických príznakov v skorom štádiu CJCh a ich nezadržateľná progresia spolu so skorším indikováním EEG vyšetrenia môže napomôcť urýchleniu diagnostického procesu.

Introduction. Creutzfeldt-Jacob disease is a rare fatal neurodegenerative disease, the etiopathogenesis of which centers around prions. It is characterized by unrelentingly progressive course and specific findings on auxiliary examinations. The goal of the presented paper was to evaluate the occurrence of individual clinical signs and specific electroencephalographic (EEG) findings in a group of patients with the genetic form of C JD. Material and methods: We have retrospectively evaluated the occurrence of neurological and psychological symptoms and assessed EEG recordings in a group of 23 patients (11 men and 12 women) with definitive (21) or probable (2) CJD. The average age at diagnosis was 55.7 years. Results: Out of this group, 17 patients (all of those in whom this examination was performed) had a confirmed E200K mutation. The median duration of the disease was 3.8 months. The initial symptoms where most often nonspecific (insomnia, weight loss and similar) and sensory impairment. Dementia syndrome was present in 100 % of cases, pyramidal signs and myoclonus in 87%, extrapyramidál signs and akinetic mutism or apallic syndrome in 78 % and cerebellar signs in 57% of cases. EEG examination (performed for the first time within a median of 2.0 months from diagnosis) was generally positive in 91 % of patients, while in up to 61 % even the first EEG recording was already positive. Discussion and conclusion: A combination of neurological and psychological symptoms in an early stage of CJD and their unrelenting progression together with early indication of EEG examination can assist in accelerating the diagnostic process.

• MeSH
• Creutzfeldtova-Jakobova nemoc diagnóza   patologie   MeSH
• demence patologie   MeSH
• dospělí MeSH
• elektroencefalografie metody   MeSH
• lidé MeSH
• myoklonus patologie   MeSH
• neurologické manifestace MeSH
• psychotické poruchy patologie   MeSH
• retrospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH