BACKGROUND: Pituitary metastases are a rare complication of generalized cancer. Metastases to the pituitary gland occur in only 1% of patients operated on for sellar tumor. The most common presenting symptom in patients with pituitary metastases is diabetes insipidus, whereas this is rare in those with pituitary adenoma. MATERIAL AND METHODS: This publication presents the cases of two patients with pituitary metastases and a systematic review of the literature. English-language publications related to pituitary metastases and published from 1957 to 2016 were identified using the PubMed database. RESULTS: A total of 131 publications containing information about 259 patients (121 female and 138 male; mean age, 57.3 years) were identified. The most often metastasized breast carcinoma (24.6%) and lung carcinoma (23.8%), followed by thyroid carcinoma (11.3%), renal cell carcinoma (7.8%), hepatocellular carcinoma (4.3%), colorectal carcinoma (3.5%), and malignant melanoma (3.5%). The most frequent initial symptoms were manifestations of diabetes insipidus (39.6%), anterior pituitary deficiency (44.9%), perimeter disorders (51.6%), headache (37.6%), cranial nerve palsy (33.5%), and pseudoprolactinemia (16.7%). Radiotherapy (67.8%) and surgical treatment (63.9%) were the most frequently used treatment. CONCLUSION: The average survival time from the onset of metastatic disease was 11.8 months. Surgical therapy alone or in combination with radiation therapy does not prolong survival, but alleviates symptoms and improves quality of life.Key words: pituitary metastasis - diabetes insipidus - hypopituitarism - transsphenoidal surgery The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 13. 1. 2017Accepted: 4. 4. 2017.

• MeSH
• diabetes insipidus etiologie   MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory hypofýzy komplikace   mortalita   sekundární   terapie   MeSH
• nemoci hypofýzy etiologie   MeSH
• nemoci kraniálních nervů etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• systematický přehled MeSH

Percutaneous Ethanol Injection Therapy (PEIT) of parathyroid adenoma under ultrasound guidance is individually used as an alternative procedure in management of primary hyperparathyroidism in polymorbid elderly patients with increased surgical risk. The treatment is also suitable for patients who already underwent surgery of the thyroid gland, and any other surgery is associated with a higher risk of postsurgical complications. We present a case of a 92-year-old male patient, who underwent thyroidectomy for papillary thyroid carcinoma three years ago. Part of the regular annual follow-up visits was also ultrasonography, which showed a solitary parathyroid adenoma at the site of the removed thyroid gland. Given the underlying condition, polymorbidity and age of the patient, the PEIT method was successfully used in the therapy. The coincidence of adenoma and papillary thyroid carcinoma is also interesting.

• Klíčová slova
• Percutaneous Ethanol Injection Therapy, papillary thyroid carcinoma, parathyroid adenoma,
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Thyroid tissue ectopically located in the ovary can be reported accidentally after adnexectomy, but as a primary cause of hyperthyroidism this diagnosis is rare. The clinical search for a functional ectopic thyroid tissue requires intense clinical focus and a multidisciplinary approach. CASE DESCRIPTION: This case report demonstrates a patient with a history of Graves' disease who had undergone thyroidectomy combined with postoperative 131I radioablation. Despite the previous treatment, she developed an outburst of hyperthyroidism ten years later. Only very close follow-up enabled us to disclose the right condition. The ovarian source of thyroid hormone production was removed by laparoscopic adnexectomy and a right sided benign ovarian struma was confirmed. CONCLUSION: Most patients treated by thyroidectomy and radioiodine do not require extended periods of follow-up or postoperative investigations, but when the clinical or laboratory signs change, clinicians should be prepared to perform the necessary re-evaluation in order to provide the best care.

• Klíčová slova
• hyperthyroidism, ovarian goiter, struma ovarii, thyroidectomy,
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: To assess the effect of the ProVens® dietary supplement administration on intraocular pressure in patients with glaucoma and ocular hypertension. MATERIAL AND METHODS: The patients included in the trial were given the ProVens® dietary supplement once daily. One ProVens® tablet contains: 50 mg of maritime pine bark extract, 100 mg of green tea extract, and 3 mg of blueberry extract. The main ProVens® components are proanthocyanins from the bark of the maritime pine tree Pinus pinaster, polyphenols from green tea, and anthocyanins from blueberries. The total number of patients included in the trial was 46. Out of these, 35 patients were monitored for asymptomatic ocular hypertension and 11 patients for open-angle glaucoma treated with prostaglandin analogs. Intraocular pressure was measured by applanation tonometry in the beginning of the trial, after one month, and after three months of their inclusion in the trial, always at the same time of the day. RESULTS: In the group of patients with ocular hypertension, there was a statistically significant reduction in the intraocular pressure from the baseline values of 24.2 ± 2.1 mm Hg to 20.9 ± 2.5 mm Hg within the period of three months (p < 0.0001). In the group of patients with open-angle glaucoma, there was a statistically significant reduction of the intraocular pressure from the baseline values of 18.4 ± 3.2 mm Hg to 17.0 ± 3.1 mm Hg within the period of three months since the beginning of administration of the product (p = 0.022). When comparing both groups, we observed a significantly higher reduction in intraocular pressure (p = 0.0001) in the group of patients with ocular hypertension. In the whole group, no adverse effects were reported during the intake of this dietary supplement. CONCLUSION: Intake of the ProVens® dietary supplement containing proanthocyanins from the bark of the maritime pine tree Pinus pinaster together with a mixture of herbal antioxidants appears to be one of the methods of how to improve the control of intraocular pressure, particularly in patients with ocular hypertension. KEY WORDS: glaucoma, ocular hypertension, ProVens®, proanthocyanins, antioxidants, maritime pine bark extract.

• MeSH
• antihypertenziva aplikace a dávkování   MeSH
• aplikace orální MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• fytoterapie * MeSH
• glaukom s otevřeným úhlem farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nitrooční tlak účinky léků   MeSH
• oční hypertenze farmakoterapie   MeSH
• potravní doplňky * MeSH
• prostaglandiny F syntetické aplikace a dávkování   MeSH
• rostlinné extrakty chemie   MeSH
• senioři MeSH
• tonometrie oční MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antihypertenziva MeSH
• prostaglandiny F syntetické MeSH
• rostlinné extrakty MeSH

AIM: To determine the frequency of extraocular rectus muscle involvement in patients with thyroid-associated orbitopathy (TAO). MATERIALS AND METHODS: A total of 154 orbits of 77 adult patients (53 women and 24 men) with TAO aged from 18 to 81 years (median 49 years) were investigated. Only patients with clear signs of TAO and confirmed thyroid disease who had been referred to the Department of Ophthalmology of the Olomouc University Hospital from May 2007 to December 2012 were included. All patients underwent general ophthalmic examination and ultrasonographic and MRI examinations of the orbit. The largest short and long cross-sectional diameter for every rectus muscle was measured on MRI scans. Spearman correlation analysis was used to determine the correlations between the diameters of rectus muscles and exophthalmos values obtained. RESULTS: A positive moderate correlation (r = 0.514) was shown between the sum of short parameters of all rectus muscles and exophthalmos values. When compared with the normative values and taking gender into account, enlargement of the medial rectus muscle (RM) was found in 55.2 %, of the lateral rectus muscle (RL) in 33.8 %, the inferior rectus muscle (RI) in 57.1 %, and of the superior muscle group (RS) in 59.1 %. In the cases of single-muscle enlargement, the most frequently affected muscle was the RS (48.8 %), followed by the RI (31.7 %) and RM (19.5 %). No case of single-muscle enlargement of the RL was observed. In the cases of two-muscle enlargement, the RS was involved in 64.3 %, the RI and RM in 60.7 %, and the RL in 14.3 %. In the cases of three-muscle enlargement, the most frequently affected muscle was the RM (93.1 %), followed by the RI (86.2 %), RS (69%), and RL (51.7 %). CONCLUSION: Our study found that, in cases with single-muscle enlargement in patients with TAO, the vertical rectus muscles were most likely involved. On the other hand, in cases with multiple-muscle enlargement, the muscle most likely involved was the medial rectus muscle. In addition, the superior muscle group was noted to be affected more frequently than reported in the world literature. Key words: thyroid-associated orbitopathy, extraocular muscles, magnetic resonance imaging.

• MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• Gravesova oftalmopatie diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• okulomotorické svaly patologie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Pheochromocytomas (PHEOs) and paragangliomas (PGLs) are rare neuroendocrine tumors. About 30% or more of them are thought to be of inherited origin due to germ-line mutations in at least 10 well-characterized genes. There are data linking specific genotypes of these tumors to specific locations, typical biochemical phenotypes or future clinical behaviors. Conversely, clinical features, catecholamine production and immunohistochemistry evaluation can help with the proper order of genetic testing for PHEO and PGL. The identification of a germ-line mutation can lead to an early diagnosis, appropriate treatment, regular surveillance and better prognosis not only for the patient but also for their family members. Moreover, the latest discoveries in molecular pathogenesis of these tumors will provide an important basis for future personalized therapy.

• MeSH
• dědičnost MeSH
• fenotyp MeSH
• feochromocytom diagnóza   genetika   metabolismus   terapie   MeSH
• genetická predispozice k nemoci MeSH
• genetické testování MeSH
• individualizovaná medicína MeSH
• katecholaminy metabolismus   MeSH
• lidé MeSH
• nádory nadledvin diagnóza   genetika   metabolismus   terapie   MeSH
• nechromafinní paragangliom diagnóza   genetika   metabolismus   terapie   MeSH
• prediktivní hodnota testů MeSH
• prognóza MeSH
• výběr pacientů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Research Support, N.I.H., Intramural MeSH
• Názvy látek
• katecholaminy MeSH

AIM: The aim of the study was to evaluate the efficacy, safety and local tolerability of preservative-free tafluprost 0.0015% (Taflotan®) in patients with glaucoma and ocular hypertension. MATERIALS AND METHODS: Multicentric, prospective observation study was performed in the Czech Republic from October 2010 to April 2011. A total of 78 centers participated and 754 patients were included. After the doctors decision to start the treatment with Taflotan®, the patients demographic data, previous treatment, intraocular pressure and the reason for switching the medication were recorded. At the follow-up visit after 6-12 weeks, the intraocular pressure, local tolerability (a 5-level scale), the patients and doctors satisfaction (a 4-level scale), and the patients preference were recorded. RESULTS: Altogether, data of 496 patients were evaluated. The majority of them were women (64.9 %). The patients mean age was 58.5 years. The most common diagnosis was primary open angle glaucoma (79.2 %), followed by ocular hypertension (7.3 %), normal tension glaucoma (4.2 %), and pseudoexfoliation glaucoma (3.6 %). In 140 patients, tafluprost 0.0015% was the first antiglaucomatous medication started, 261 patients switched from another monotherapy, and 95 patients were treated with fixed- or nonfixed combinations before starting tafluprost 0.0015%. The most common reason for switching to Taflotan® was local intolerability to the current antiglaucomatous therapy (most often irritation of the eye and hyperemia). The intraocular pressure decreased significantly from 19.9 ± 4.5 mm Hg to 16.3 ± 3.0 mm Hg (p < 0.001). The subjective tolerability of the antiglaucomatous therapy improved rapidly, with 57.4 % of patients rating the tolerability of Taflotan® as "very good" and 34.5 % as "good". In addition, 94.4 % of patients and 96.0 % of ophthalmologists were "very satisfied" or "satisfied" with the treatment. At the final visit, 79.8 % of patients preferred Taflotan® to the previous treatment. CONCLUSION: Taflotan® significantly decreased the intraocular pressure. It was well tolerated even in patients with previous intolerability to another antiglaucomatous therapy, including prostaglandins. The patients and ophthalmologists satisfaction with Taflotan® was high.

• MeSH
• dítě MeSH
• dospělí MeSH
• glaukom farmakoterapie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nitrooční tlak účinky léků   MeSH
• oční hypertenze farmakoterapie   patofyziologie   MeSH
• prostaglandiny F škodlivé účinky   terapeutické užití   MeSH
• prostaglandiny syntetické škodlivé účinky   terapeutické užití   MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• multicentrická studie MeSH
• Názvy látek
• prostaglandiny F MeSH
• prostaglandiny syntetické MeSH
• tafluprost MeSH Prohlížeč

AIM: The plasma levels of soluble intercellular cell adhesion molecule-1 (s-ICAM-1) and soluble vascular cell adhesion molecule-1 (s-VCAM-1) were assessed in clinically asymptomatic subjects to compare them between normolipidemic and various dyslipidemic phenotypes. The associations between soluble cell adhesion molecules (s-CAMs) and risk factors for atherosclerosis, markers of insulin resistance, and the intima-media thickness of the common carotid artery (IMT) were evaluated, too. METHODS: Thwo hundred and thirty-four asymptomatic subjects were divided into four dyslipidemic phenotypes (DLP) according to apolipoprotein B (apoB) and triglycerides (TG): DLP1 (N.=58, apoB<1.2 g/L and TG<1.5 mmol/L), DLP2 (N.=47, apoB<1.2 g/L and TG≥1.5 mmol/L), DLP3 (N.=31, apoB≥1.2 g/L and TG<1.5 mmol/L) and DLP4 (N.=98, apoB≥1.2 g/L and TG≥1.5 mmol/L). DLP1 (normo-apoB /normo-TG) served as a control group. RESULTS: A significant difference in s-ICAM-1 between DLP1 (502.0 [457.1-568.2] ng/mL) and DLP4 (567.9 [502.8-692.1] ng/mL, P<0.001) was found. No significant differences in s-VCAM-1 between DLPs were apparent. S-ICAM-1 was independently predicted by HDL-cholesterol, non-HDL-cholesterol, proinsulin, C-peptide, waist, systolic and diastolic blood pressure. S-VCAM-1 was predicted only by age and systolic blood pressure. Both s-CAMs were detected as independent predictors for IMT, which was significantly increased in DLP 4. CONCLUSION: The elevation of s-ICAM-1 was presented only in patients with simultaneously elevated TG and apoB (DLP4) in comparison with normolipidemic subjects. Patients with DLP 4 had significantly increased IMT, which was independently predicted by levels of s-ICAM-1 and of s-VCAM-1. These findings pointed out DLP4 subjects as individuals with the highest risk for early manifestation of atherosclerosis.

• MeSH
• analýza rozptylu MeSH
• apolipoproteiny B krev   MeSH
• arteriae carotides diagnostické zobrazování   MeSH
• asymptomatické nemoci MeSH
• biologické markery krev   MeSH
• cévní buněčněadhezivní molekula-1 krev   MeSH
• cholesterol krev   MeSH
• dospělí MeSH
• fenotyp MeSH
• hodnocení rizik MeSH
• hyperlipidemie krev   komplikace   diagnóza   MeSH
• imunoenzymatické techniky MeSH
• lidé středního věku MeSH
• lidé MeSH
• mezibuněčná adhezivní molekula-1 krev   MeSH
• nemoci arterie carotis krev   diagnostické zobrazování   etiologie   MeSH
• regresní analýza MeSH
• rizikové faktory MeSH
• triglyceridy krev   MeSH
• ultrasonografie MeSH
• upregulace MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• apolipoproteiny B MeSH
• biologické markery MeSH
• cévní buněčněadhezivní molekula-1 MeSH
• cholesterol MeSH
• mezibuněčná adhezivní molekula-1 MeSH
• triglyceridy MeSH

• MeSH
• adrenokortikální nádory * diagnóza   terapie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• komentáře MeSH
• úvodníky MeSH

In clinical practice, we often observe conditions accompanied by secondary drop of binding proteins that bind, more or less specifically, thyroidal hormones. This is usually considered as normal situation that is often not properly interpreted from clinical point of view. In other words, we tolerate such conditions because we build on values of free hormones FT3 and FT4. However, it is very rare to observe significant decrease or even absence of thyroxin binding globulin (TBG) due to inborn error of metabolism. In such situations, the overall level of thyroidal hormones becomes a part of evaluated laboratory profile. Unusual laboratory constellation is in sharp contrast to the so-called "healthy patient". Due to increased migration of persons, we had an opportunity to take care of a patient of this kind.

• MeSH
• heroin MeSH
• hormony štítné žlázy krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci štítné žlázy diagnóza   MeSH
• proteiny vázající thyroxin nedostatek   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• heroin MeSH
• hormony štítné žlázy MeSH
• proteiny vázající thyroxin MeSH