• MeSH
• optometrie MeSH
• poruchy zraku MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• NLK Obory
• oftalmologie

STUDY DESIGN: This report characterises a 25 year old male patient with a complete burst fracture of the fifth lumbar vertebra with dislocation. He was treated by posterior surgery with transpedicular instrumentation and an expandable cage from the posterior approach. OBJECTIVES: Burst fractures of the fifth lumbar vertebra are extremely rare. Patients with positive neurological findings should be treated by the posterior approach. This surgery consists of reduction, decompression, transpedicular stabilisation and fusion. MATERIALS AND METHODS: The young man in our report was treated by posterior surgery only. It consisted of laminectomy, suture of the thecal sac tear, discectomies and subtotal removal of the fifth lumbar vertebra. Repositioning was carried out simultaneously with support using Synex TM Synthes USA telescopic cage and SOCON TM Aesculap Germany transpedicular fixator. RESULTS: The patient suffered neither wound complications nor instrumentation failure. He is currently able to walk with the help of peroneal bands but without crutches. CONCLUSIONS: Treatment of fractures of the fifth lumbar vertebra depends on fracture type and neurological findings. Conservative management of this condition is appropriate provided there is no neurological damage and canal stenosis and deformity is minimal. Surgical treatment of burst lumbar fractures with neurological deficit is strongly recommended. The optimum treatment remains debatable.

• MeSH
• bederní obratle chirurgie   radiografie   zranění   MeSH
• chirurgická dekomprese metody   přístrojové vybavení   MeSH
• dospělí MeSH
• fraktury páteře chirurgie   radiografie   MeSH
• fúze páteře metody   přístrojové vybavení   MeSH
• interní fixátory trendy   MeSH
• laminektomie metody   MeSH
• lidé MeSH
• lumbalgie MeSH
• míšní kořeny patofyziologie   zranění   MeSH
• neurochirurgické výkony metody   přístrojové vybavení   MeSH
• neuropatie nervus peroneus patofyziologie   MeSH
• počítačová rentgenová tomografie MeSH
• pokus o sebevraždu MeSH
• polyradikulopatie etiologie   patologie   prevence a kontrola   MeSH
• radikulopatie etiologie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

A novel group of 5,6-dihydropyrido [2',1':2,3]imidazo [4,5-c]quinolines was prepared via a microwave assisted one-pot telescopic approach. The synthetic sequence involves the formation of an amine precursor of imidazo [1,2-a]pyridine via condensation and reduction under microwave irradiation. Subsequently, the Pictet-Spengler cyclisation reaction occurs with ketones (cyclic or acyclic) to obtain substituted 5,6-dihydropyrido [2',1':2,3]imidazo [4,5-c]quinolines in excellent yields. The compounds were tested as neuroprotective agents. Observed protection of neuron-like cells, SH-SY5Y differentiated with ATRA, in Parkinson's and Huntington's disease models inspired further mechanistic studies of protective activity against damage induced by 1-methyl-4-phenylpyridinium (MPP+), a compound causing Parkinson's disease. The novel compounds exhibit similar or higher potency than ebselen, an established drug with antioxidant activity, in the cells against MPP + -induced total cellular superoxide production and cell death. However, they exhibit a significantly higher capacity to reduce mitochondrial superoxide and preserve mitochondrial membrane potential. We also observed marked differences between a selected derivative and ebselen in terms of normalizing MPP + -induced phosphorylation of Akt and ERK1/2. The cytoprotective activity was abrogated when signaling through cannabinoid receptor CB2 was blocked. The compounds also inhibit both acetylcholine and butyrylcholine esterases. Overall the data show that novel 5,6-dihydropyrido [2',1':2,3]imidazo [4,5-c]quinoline have a broad cytoprotective activity which is mediated by several mechanisms including mitoprotection.

• MeSH
• chinoliny * farmakologie   chemie   chemická syntéza   MeSH
• cholinesterasové inhibitory * farmakologie   chemie   chemická syntéza   MeSH
• lidé MeSH
• molekulární struktura MeSH
• nádorové buněčné linie MeSH
• neuroprotektivní látky * farmakologie   chemie   chemická syntéza   MeSH
• receptor kanabinoidní CB2 * metabolismus   antagonisté a inhibitory   MeSH
• signální transdukce * účinky léků   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• vztahy mezi strukturou a aktivitou MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY To present a new type of percutaneous compression plate (PCP) for a minimally invasive method of treating trochanteric hip fractures. MATERIAL Between September 2004 and December 2006, a total of 66 patients with hip fractures were treated by minimally invasive percutaneous osteosynthesis involving a PCP. The average age of the patients was 74.5 years (range, 27-95 years). The fractures were classified as pertrochanteric (AO31, A1.1-A2.3) in 73 %, femoral neck fracture (AO31, B2) in 20 %, and intertrochanteric fracture (AO31, A3.1) in 7 % of the patients. METHODS Reduction was performed under conduction or general anaesthesia on a traction table, using an X-ray image intensifier system. Reduction and intra-operative temporary stabilisation of the fracture was facilitated by a posterior reduction device. Access was gained and a PCP was inserted through two incisions at the lateral side of the proximal femur. RESULTS The patients were followed up for at least 6 months. Radiographic union was found on average at 3 months post-operatively. No pseudoarthrosis or implant failure was recorded. At 6-month follow-up, 81 % of the patients were able to walk without walking aid or with one walking cane only. Two crutches were used by 8 % of the patients. To walk without help was impossible for 11 % of the patients whose mobility had already been limited before the injury. DISCUSSION PCP osteosynthesis for trochanteric fractures is a novel minimally invasive approach providing a better treatment of the fracture. Compared to dynamic hip screw osteosynthesis used before, PCP allows for earlier weight bearing and noticeably reduces blood loss. Implant construction as well as post-operative controlled impaction of the fracture minimize the risk of osteosynthesis failure. The simple instrumentation construction enables us to reduce operative time. CONCLUSIONS The percutaneous compression plate is a contribution to minimally invasive osteosynthesis of trochanteric fractures. An increase in rotational stability of the implant due to its biaxial telescopic construction allows for earlier weight-bearing of the extremity, thus facilitating the patient?s earlier return to everyday life activities. It also reduces operative trauma, blood loss and post-operative complications.

• MeSH
• dospělí MeSH
• fraktury kyčle chirurgie   MeSH
• kostní destičky MeSH
• lidé středního věku MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vnitřní fixace fraktury metody   přístrojové vybavení   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

The aim of this study was to identify and summarize available data on oncologic and safety outcomes for retrograde versus antegrade endoscopic surgery in patients with upper tract urothelial carcinoma (UTUC). We systematically searched studies reporting on endoscopic surgery in patients with UTUC. The primary outcome of interest was oncologic control, including bladder and upper urinary tract recurrences. The secondary outcomes were any-grade and major complications. Twenty studies comprising 1091 patients were included in our analysis. The pooled bladder recurrence rate was 35% (95% confidence interval [CI] 28.0-42.3%; I2 = 48%) after retrograde endoscopic surgery and 17.7% (95% CI 6.5-32.1%; I2 = 29%) after antegrade endoscopic surgery. The pooled upper urinary tract recurrence rate was 56.4% (95% CI 41.2-70.9; I2 = 93%) after retrograde endoscopic surgery and 36.2% (95% CI 25.5-47.6%; I2 = 57%) after antegrade endoscopic surgery. The pooled complication rate was 12.5% (95% CI 0.8-32.8%; I2 = 94%) for any-grade complications and 6.6% (95% CI 0.1-19.1%; I2 = 89%) for major complications in the retrograde endoscopic cohort. In summary, our analyses suggest promising oncologic benefits of antegrade kidney-sparing surgery in terms of bladder and upper urinary tract recurrence rates in UTUC. Retrograde endoscopic surgery is a safe procedure with a minimal risk of complications and acceptable oncologic outcomes. Research should address the hypothesis that endoscopic antegrade surgery can be a safe and effective alternative for well-selected patients. PATIENT SUMMARY: One of the surgical options for treatment of cancer of the upper urinary tract is removal of the tumor through a small telescope called an endoscope. The endoscope can be inserted via the urethra (called a retrograde approach) or through a small incision in the skin (antegrade approach). Our review shows that the antegrade approach seems to provide acceptable cancer control rates. Further research could help to identify the role for endoscope surgery in cancer of the upper urinary tract.

• MeSH
• karcinom z přechodných buněk * chirurgie   patologie   MeSH
• lidé MeSH
• nádory ledvin * chirurgie   patologie   MeSH
• nádory močového měchýře * MeSH
• nádory močovodu * chirurgie   patologie   MeSH
• ureteroskopie škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• přehledy MeSH
• systematický přehled MeSH

• MeSH
• chirurgie operační MeSH
• ortopedické výkony MeSH
• ortopedie MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• NLK Obory
• ortopedie
• chirurgie
• NLK Publikační typ
• kolektivní monografie

We systematically reviewed the literature and summarized oncologic and safety outcomes for endoscopic management (EM) compared to radical nephroureterectomy (RNU) for patients with upper tract urothelial carcinoma (UTUC). Studies comparing oncologic and/or safety results for EM versus RNU in patients with UTUC were included in our review. Overall, 13 studies met the criteria, and five studies were included in a meta-analysis using adjusted hazard ratios (HRs) for overall survival (OS), cancer-specific survival (CSS), and bladder recurrence-free survival (BRFS). EM was associated similar OS (HR 1.27, 95% confidence interval [CI] 0.75-2.16), CSS (HR 1.37, 95% CI 0.99-1.91), and BRFS (HR 0.98, 95% CI 0.61-1.55) to RNU, while 28-85% of patients treated with EM experienced upper tract recurrence across the studies. EM required more interventions with a higher cumulative risk of complications and lower likelihood of renal preservation. In summary, EM for low-grade UTUC had comparable survival outcomes to RNU at the cost of higher local recurrence rates resulting in a need for long-term rigorous surveillance and repeated interventions. PATIENT SUMMARY: For selected cases of cancer in the upper urinary tract, surgical treatment via a telescope inserted through the urethra or the skin (endoscope) results in cancer control outcomes that are comparable to those after removal of the kidney and ureter. However, because of its higher rate of local recurrence, this approach requires repeated endoscopic treatment sessions. Patients should be well informed about these issues to help in shared decision-making.

• MeSH
• karcinom z přechodných buněk * chirurgie   MeSH
• lidé MeSH
• nádory močového měchýře * chirurgie   MeSH
• nefroureterektomie metody   MeSH
• ureter * chirurgie   MeSH
• ureteroskopie škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• přehledy MeSH
• systematický přehled MeSH

• MeSH
• klinické lékařství MeSH
• kontaktní čočky MeSH
• oftalmologie MeSH
• optika a fotonika MeSH
• refrakce oka MeSH
• věda MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• Učební osnovy. Vyučovací předměty. Učebnice
• NLK Obory
• oftalmologie
• věda a výzkum
• NLK Publikační typ
• učebnice vysokých škol

• MeSH
• klinické lékařství MeSH
• kontaktní čočky MeSH
• oftalmologie MeSH
• optika a fotonika MeSH
• refrakce oka MeSH
• věda MeSH

• Konspekt
• Učební osnovy. Vyučovací předměty. Učebnice
• Ortopedie. Chirurgie. Oftalmologie
• NLK Obory
• oftalmologie
• věda a výzkum
• NLK Publikační typ
• učebnice vysokých škol

• MeSH
• klinické lékařství MeSH
• kontaktní čočky MeSH
• oftalmologie MeSH
• optika a fotonika MeSH
• refrakce oka MeSH
• věda MeSH

• Konspekt
• Ortopedie. Chirurgie. Oftalmologie
• Učební osnovy. Vyučovací předměty. Učebnice
• NLK Obory
• oftalmologie
• věda a výzkum
• NLK Publikační typ
• učebnice vysokých škol