To evaluate the oncological outcomes and safety of primary retroperitoneal lymph node dissection (RPLND) in patients with clinical stage (CS) II seminomatous testicular germ cell tumor (TGCT). A literature search using PubMed, Scopus, and Cochrane Library was conducted on July 2023 to identify relevant studies according to the Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA) guidelines. The pooled recurrence rate and treatment-related complications were calculated using a random effects model. Overall 8 studies published between 1997 and 2023 including a total of 355 patients were selected for systematic review and meta-analysis with the overall median follow-up of 38 months. The overall and infield recurrence rate were 0.14 (95% CI: 0.08-0.22) and 0.04 (95% CI: 0.00-0.11), respectively. The overall pooled rate of ≥ Clavien Dindo grade III complications was 0.04 (95% CI: 0.01-0.10); there was no significant heterogeneity (I^2 = 35.10%, P = 0.19). Antegrade ejaculation was preserved with the overall pooled rate of 0.98 (95% CI: 0.95-1.00); there was no significant heterogeneity on Chi-square and I2 tests (I^2 = 0.00%, P = 0.58). Primary RPLND is a safe and effective treatment option for patients with CS II seminomatous TGCT resulting highly promising cure rates combined with low treatment-associated adverse events, at medium-term follow-up. However, owing to the lack of comparative studies to the current standard of care and the limited follow-up, individual decision must be made with the informed patient in a shared decision process together with a multidisciplinary team.

• MeSH
• Neoplasms, Germ Cell and Embryonal * surgery   pathology   MeSH
• Humans MeSH
• Lymph Node Excision adverse effects   methods   MeSH
• Retroperitoneal Space pathology   MeSH
• Retrospective Studies MeSH
• Seminoma * pathology   MeSH
• Neoplasm Staging MeSH
• Testicular Neoplasms * pathology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Meta-Analysis MeSH
• Review MeSH
• Systematic Review MeSH

In this study, we aimed to comprehensively characterize the proteomic landscapes of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in patients with severe obesity, to establish their associations with clinical characteristics, and to identify potential serum protein biomarkers indicative of tissue-specific alterations or metabolic states. We conducted a cross-sectional analysis of 32 patients with severe obesity (16 males and 16 females) of Central European descent who underwent bariatric surgery. Clinical parameters and body composition were assessed using dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance, with 15 patients diagnosed with type 2 diabetes (T2D) and 17 with hypertension. Paired SAT and VAT samples, along with serum samples, were subjected to state-of-the-art proteomics liquid chromatography-mass spectrometry (LC-MS). Our analysis identified 7,284 proteins across SAT and VAT, with 1,249 differentially expressed proteins between the tissues and 1,206 proteins identified in serum. Correlation analyses between differential protein expression and clinical traits suggest a significant role of SAT in the pathogenesis of obesity and related metabolic complications. Specifically, the SAT proteomic profile revealed marked alterations in metabolic pathways and processes contributing to tissue fibrosis and inflammation. Although we do not establish a definitive causal relationship, it appears that VAT might respond to SAT metabolic dysfunction by potentially enhancing mitochondrial activity and expanding its capacity. However, when this adaptive response is exceeded, it could possibly contribute to insulin resistance (IR) and in some cases, it may be associated with the progression to T2D. Our findings provide critical insights into the molecular foundations of SAT and VAT in obesity and may inform the development of targeted therapeutic strategies.NEW & NOTEWORTHY This study provides insights into distinct proteomic profiles of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and serum in patients with severe obesity and their associations with clinical traits and body composition. It underscores SAT's crucial role in obesity development and related complications, such as insulin resistance (IR) and type 2 diabetes (T2D). Our findings emphasize the importance of understanding the SAT and VAT balance in energy homeostasis, proteostasis, and the potential role of SAT capacity in the development of metabolic disorders.

• MeSH
• Biomarkers metabolism   MeSH
• Diabetes Mellitus, Type 2 * metabolism   MeSH
• Insulin Resistance * MeSH
• Humans MeSH
• Obesity, Morbid * metabolism   MeSH
• Intra-Abdominal Fat metabolism   MeSH
• Obesity metabolism   MeSH
• Subcutaneous Fat metabolism   MeSH
• Proteins metabolism   MeSH
• Proteomics MeSH
• Cross-Sectional Studies MeSH
• Adipose Tissue metabolism   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Cystický trofoblastický tumor (CTT) je zriedkavá neagresívna germinatívna neoplazma zo skupiny non-choriokarcinomatóznych trofoblastických nádorov, ktorá sa prezentuje cystickými priestormi vystlanými mononukleárnymi degeneratívne vyzerajúcimi trofoblastickými bunkami. CTT bol najčastejšie opísaný ako reziduálne ochorenie v disekovaných retroperitoneálnych lymfatických uzlinách u pacientov s metastatickými germinatívnymi nádormi testis po chemoterapii. Ojedinele sa popisujú primárne zmiešané germinatívne nádory testis, v ktorých bol prítomný komponent CTT. Autori prezentujú prípad 22-ročného muža so zmiešaným germinatívnym nádorom testis, ktorý bol tvorený komponentami postpubertálneho teratómu, embryonálneho karcinómu a CTT. Imunohistochemicky boli nádorové bunky CTT pozitívne na prítomnosť cytokeratínov (AE1/AE3, CK8/18), GATA3, p63, a sčasti aj β-hCG a α-inhibínu. CTT môže tvoriť zriedkavý komponent v primárnom zmiešanom germinatívnom nádore testis, ktorý s veľkou pravdepodobnosťou predstavuje evolučný medzistupeň prechodu chóriokarcinómu do teratómu pri jeho spontánnej regresii.

Cystic trophoblastic tumor (CTT) is a rare non-aggressive germinative neoplasm from the group of non-choriocarcinomatous trophoblastic tumors, which is presented by cystic spaces lined with mononuclear degenerative-looking trophoblastic cells. CTT has been most often described as a residual disease in dissected retroperitoneal lymph nodes of patients with metastatic germ cell testicular tumours after chemotherapy. There were published only sporadic cases of primary testicular mixed germ cell tumour with CTT component. Hereby, the authors present a case of a 22-year-old man with a mixed germ cell tumour composed of postpubertal teratoma, embryonal carcinoma and CTT. Immunohistochemically, the CTT tumour cells were positive for cytokeratins (AE1/AE3, CK8/18), GATA3, p63 and focally also for beta-hCG and alpha-inhibin. CTT may be presented as a rare component of primary testicular mixed germ cell tumour and it represents very likely an evolutionary intermediate stage of transition from choriocarcinoma into teratoma during the process of regression.

• MeSH
• Humans MeSH
• Young Adult MeSH
• Testicular Neoplasms * surgery   diagnosis   MeSH
• Testis pathology   MeSH
• Trophoblastic Neoplasms surgery   diagnosis   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

Úvod: Akútna apendicitída patrí k najčastejším náhlym brušným príhodám. Jednou z komplikácii je aj pooperačná tvorba abscesov v peritoneálnej dutine, respektíve v retroperitoneálnom priestore. Za ich vznik sú zodpovedné, okrem iného, aj apendikolity ponechané v peritoneálnej dutine. K ich uvoľneniu z lumenu dochádza predoperačne i počas operácie. Apendikolit, aj s prítomnými baktériami na jeho povrchu, vytvára vhodné miesto pre vznik infekcie. Kazuistika: Autori prezentujú menej častý prípad retroperitoneálneho abscesu, ktorého príčinou bol retinovaný apendikolit. Nezvyčajným je dlhé obdobie medzi apendektómiou a klinickými prejavmi vyformovaného abscesu. Pacientka sa podrobila operačnej liečbe s evakuáciou abscesu a extrakciou apendikolitu. Pooperačný priebeh bol primeraný, hojenie rany bolo podporené podtlakovou terapiou. Záver: Počas apendektómie je nutné pamätať na riziko uvoľnenia apendikolitov a na ich úlohu pri infekčných komplikáciách. Je nutná svedomitá revízia peritoneálnej dutiny a tiež dobrá operačná technika. V prípade neúspechu pri lokalizácii apendikolitu dokážu pooperačne pomôcť zobrazovacie metódy.

Introduction: Acute appendicitis is one of the most common acute abdominal conditions. One of its complications is postoperative formation of abscesses in the peritoneal cavity or in the retroperitoneal space. Among other things, appendicoliths left in the peritoneal cavity are responsible for this process. Their release from the lumen occurs preoperatively and during the operation. An appendicolith, with the bacteria present on its surface, provides an environment that supports the onset of an infection. Case report: The authors present a less common case of a retroperitoneal abscess caused by an incarcerated appendicolith. Unusual is the long period between appendectomy and clinical manifestations of the abscess. The patient underwent surgical treatment with abscess evacuation and extraction of the appendicolith. The postoperative course was adequate; wound healing was supported by negative wound pressure therapy. Conclusion: During appendectomy, it is necessary to keep in mind the risk of releasing appendicoliths and their role in infectious complications. A conscientious revision of the peritoneal cavity is required, as well as a good surgical technique. If necessary, imaging methods can help to locate the appendicolith in the postoperative period.

• MeSH
• Abscess etiology   MeSH
• Acute Disease MeSH
• Appendectomy methods   adverse effects   MeSH
• Appendicitis * surgery   complications   MeSH
• Abdominal Abscess * surgery   etiology   MeSH
• Adult MeSH
• Laparoscopy * MeSH
• Humans MeSH
• Postoperative Complications surgery   etiology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

CONTEXT: Adipose tissue distribution is a key factor influencing metabolic health and risk in obesity-associated comorbidities. OBJECTIVE: Here we aim to compare the proteomic profiles of mature adipocytes from different depots. METHODS: Abdominal subcutaneous (SA) and omental visceral adipocytes (VA) were isolated from paired adipose tissue biopsies obtained during bariatric surgery on 19 severely obese women (body mass index > 30 kg/m2) and analyzed using state-of-the-art mass spectrometry. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were performed to investigate proteome signature properties and to examine a possible association of the protein expression with the clinical data. RESULTS: We identified 3686 protein groups and found 1140 differentially expressed proteins (adj. P value < 0.05), of which 576 proteins were upregulated in SA and 564 in VA samples. We provide a global protein profile of abdominal SA and omental VA, present the most differentially expressed pathways and processes distinguishing SA from VA, and correlate them with clinical and body composition data. We show that SA are significantly more active in processes linked to vesicular transport and secretion, and to increased lipid metabolism activity. Conversely, the expression of proteins involved in the mitochondrial energy metabolism and translational or biosynthetic activity is higher in VA. CONCLUSION: Our analysis represents a valuable resource of protein expression profiles in abdominal SA and omental VA, highlighting key differences in their role in obesity.

• MeSH
• Bariatric Surgery MeSH
• Adult MeSH
• Gene Regulatory Networks MeSH
• Middle Aged MeSH
• Humans MeSH
• Obesity, Morbid metabolism   pathology   surgery   MeSH
• Intra-Abdominal Fat cytology   metabolism   pathology   MeSH
• Omentum cytology   metabolism   pathology   surgery   MeSH
• Subcutaneous Fat, Abdominal cytology   metabolism   pathology   MeSH
• Proteomics MeSH
• Adipocytes metabolism   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH

Schizophrenia is a severe neuropsychiatric disease associated with substantially higher mortality. Reduced life expectancy in schizophrenia relates to an increased prevalence of metabolic disturbance, and antipsychotic medication is a major contributor. Molecular mechanisms underlying adverse metabolic effects of antipsychotics are not fully understood; however, adipose tissue homeostasis deregulation appears to be a critical factor. We employed mass spectrometry-based untargeted proteomics to assess the effect of chronic olanzapine, risperidone, and haloperidol treatment in visceral adipose tissue of prenatally methylazoxymethanol (MAM) acetate exposed rats, a well-validated neurodevelopmental animal model of schizophrenia. Bioinformatics analysis of differentially expressed proteins was performed to highlight the pathways affected by MAM and the antipsychotics treatment. MAM model was associated with the deregulation of the TOR (target of rapamycin) signalling pathway. Notably, alterations in protein expression triggered by antipsychotics were observed only in schizophrenia-like MAM animals where we revealed hundreds of affected proteins according to our two-fold threshold, but not in control animals. Treatments with all antipsychotics in MAM rats resulted in the downregulation of mRNA processing and splicing, while drug-specific effects included among others upregulation of insulin resistance (olanzapine), upregulation of fatty acid metabolism (risperidone), and upregulation of nucleic acid metabolism (haloperidol). Our data indicate that deregulation of several energetic and metabolic pathways in adipose tissue is associated with APs administration and is prominent in MAM schizophrenia-like model but not in control animals.

• MeSH
• Antipsychotic Agents therapeutic use   MeSH
• Haloperidol pharmacology   therapeutic use   MeSH
• Rats MeSH
• Methylazoxymethanol Acetate pharmacology   MeSH
• Disease Models, Animal MeSH
• Intra-Abdominal Fat drug effects   embryology   metabolism   MeSH
• Olanzapine pharmacology   therapeutic use   MeSH
• Rats, Sprague-Dawley MeSH
• Proteomics MeSH
• Risperidone pharmacology   therapeutic use   MeSH
• Schizophrenia drug therapy   MeSH
• Signal Transduction drug effects   MeSH
• Pregnancy MeSH
• TOR Serine-Threonine Kinases metabolism   MeSH
• Adipose Tissue drug effects   metabolism   MeSH
• Prenatal Exposure Delayed Effects chemically induced   metabolism   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Pregnancy MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Inflammatory bowel diseases (IBDs), chronic inflammatory disorders affecting the gastrointestinal tract, include Crohn's disease and ulcerative colitis. There are increasing clinical and experimental data showing that obesity, especially visceral adiposity, plays a substantial role in the pathogenesis of IBD. Obesity seems to be an important risk factor also for IBD disease severity and clinical outcomes. Visceral adipose tissue is an active multifunctional metabolic organ involved in lipid storage and immunological and endocrine activity. Bowel inflammation penetrates the surrounding adipose tissue along the mesentery. Mesenteric fat serves as a barrier to inflammation and controls immune responses to the translocation of gut bacteria. At the same time, mesenteric adipose tissue may be the principal source of cytokines and adipokines responsible for inflammatory processes associated with IBD. This review is particularly focusing on the potential role of adipokines in IBD pathogenesis and their possible use as promising therapeutic targets.

• MeSH
• Obesity, Abdominal immunology   metabolism   MeSH
• Adipokines metabolism   MeSH
• Inflammatory Bowel Diseases immunology   metabolism   MeSH
• Humans MeSH
• Intra-Abdominal Fat immunology   metabolism   MeSH
• Adipose Tissue immunology   metabolism   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Úvod: Onemocnění covid-19 je zejména u pacientů s těžkým průběhem spojeno s vysokým rizikem tromboembolických příhod. Současně se však objevuje i riziko krvácivých stavů. Tyto komplikace mají významný vliv na morbiditu a mortalitu pacientů a stanovit optimální přístup k profylaxi tromboembolické nemoci může být náročné. Kazuistika: Ve sdělení prezentujeme dva případy polymorbidních pacientek trpících onemocněním covid-19. U obou pacientek došlo v době deintenzifikace léčby středně těžkého až těžkého průběhu onemocnění ke krvácení do retroperitonea při podávání nízkomolekulárních heparinů. U obou pacientek bylo indikováno chirurgické řešení komplikace s dobrým lokálním efektem nicméně s progresí deteriorace celkového stavu s následkem smrti. Závěr: Přes prokázaný benefit profylaxe tromboembolických příhod pomocí nízkomolekulárních heparinů pro pacienty s covid-19 je třeba věnovat pozornost monitoraci koagulačních laboratorních parametrů ve správných časových intervalech. V případech kriticky nemocných pacientů, pacientů s četnými komorbiditami je riziko fatálního průběhu krvácivé komplikace extrémně vysoké.

Introduction: COVID-19 disease is associated with a high risk of thromboembolic events, especially in patients with a severe course of the disease. At the same time, however, there is a risk of bleeding. These complications have a significant impact on patient morbidity and mortality. Thus, determining an optimal approach to thromboembolic disease prophylaxis can be challenging. Case reports: This paper presents two cases of polymorbid female patients suffering from COVID-19. Both patients experienced retroperitoneal hemorrhage while on low molecular weight heparins in the process of deintensification of the treatment of their moderate to severe disease. Although both patients were treated surgically with a good local effect on the hemorrhage, their deterioration progressed, finally resulting in death in both the cases. Conclusion: Despite the proven benefit of prophylaxis of thromboembolic events using low molecular weight heparins in patients with COVID-19, care should be taken to monitor coagulation laboratory parameters in proper time intervals. The risk of a fatal course of bleeding complications is extremely high in critically ill patients and patients with multiple comorbidities.

• MeSH
• Anticoagulants adverse effects   MeSH
• COVID-19 * complications   MeSH
• Heparin, Low-Molecular-Weight adverse effects   MeSH
• Blood Coagulation Disorders * etiology   complications   MeSH
• Hemorrhage surgery   etiology   MeSH
• Humans MeSH
• Retroperitoneal Space surgery   pathology   MeSH
• SARS-CoV-2 MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Prezentujeme případ 72letého muže s leiomyosarkomem funikulus spermaticus. Pacient byl vyšetřen pro bolesti pravého třísla a zvětšení pravého hemiskrota. Fyzikální vyšetření prokázalo tuhou masu, která zasahovala až do dolní poloviny tříselného kanálu. Ultrazvukové vyšetření zjistilo solidní expanzi s heterogenní strukturou a akcentovanou vaskularizací. Byla provedena radikální orchiektomie s vysokou ligací funiculu. Histologicky byl verifikován nízce diferencovaný leiomyosarkom funikulus spermaticus, nádor patřící do skupiny paratestikulárních tumorů. Stagingové CT plic, retroperitonea a malé pánve neodhalilo postižení lymfatik či vzdálené metastázy. Pooperačně nebyla po zvážení na multioborovém semináři indikovaná adjuvantní onkologická terapie. Důvodem byla zejména radikalita chirurgického výkonu. Během dispenzarizace byl po třech letech zjištěn metastatický proces v retroperitoneálních uzlinách.

We present the case of a 72-year-old man with leiomyosarcoma of spermatic cord. The patient presented with pain in his right groin and enlarged right scrotum. Physical examination showed a rigid mass reaching the lower half of the inguinal canal and filling the right scrotum. Ultrasound examination revealed a solid expansion of the heterogeneous structure with accentuated vascularization. A high-ligation radical orchiectomy was performed. Histologic examination verified low-differentiated leiomyosarcoma of spermaticus funiculus belonging to the group of paratesticular tumors. CT scan of the lungs, retroperitoneum and small pelvis showed no metastatic process or lymphadenopathy. The oncologists did not indicate an adjuvant oncological therapy, the reason being radical tumour removal. After 3 years, metastatic process into the retroperitoneal nodes was verified.

• MeSH
• Dacarbazine therapeutic use   MeSH
• Doxorubicin therapeutic use   MeSH
• Leiomyosarcoma * pathology   MeSH
• Humans MeSH
• Genital Neoplasms, Male * diagnosis   pathology   therapy   MeSH
• Orchiectomy MeSH
• Disease Progression MeSH
• Recurrence MeSH
• Spermatic Cord pathology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

Osteopontin (OPN) is a multifaceted matricellular protein, with well-recognized roles in both the physiological and pathological processes in the body. OPN is expressed in the main organs and cell types, in which it induces different biological actions. During physiological conditioning, OPN acts as both an intracellular protein and soluble excreted cytokine, regulating tissue remodeling and immune-infiltrate in adipose tissue the heart and the kidney. In contrast, the increased expression of OPN has been correlated with the severity of the cardiovascular and renal outcomes associated with obesity. Indeed, OPN expression is at the "cross roads" of visceral fat extension, cardiovascular diseases (CVDs) and renal disorders, in which OPN orchestrates the molecular interactions, leading to chronic low-grade inflammation. The common factor associated with OPN overexpression in adipose, cardiac and renal tissues seems attributable to the concomitant increase in visceral fat size and the increase in infiltrated OPN+ macrophages. This review underlines the current knowledge on the molecular interactions between obesity and the cardiac-renal disorders ruled by OPN.

• MeSH
• Insulin Resistance genetics   MeSH
• Kidney metabolism   pathology   MeSH
• Humans MeSH
• Myocardium metabolism   pathology   MeSH
• Kidney Diseases genetics   metabolism   pathology   MeSH
• Heart Diseases genetics   metabolism   pathology   MeSH
• Intra-Abdominal Fat metabolism   MeSH
• Obesity genetics   metabolism   pathology   MeSH
• Osteopontin genetics   metabolism   MeSH
• Adipose Tissue metabolism   MeSH
• Inflammation genetics   pathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH