PURPOSE OF THE STUDY: Our study aims to compare the results of preoperative radiography and intraoperative visual assessment of the cartilage with histological assessment of joint surfaces of the medial and lateral compartments resected in patients during the total knee replacement. MATERIAL AND METHODS: The cohort included 20 patients (9 men and 11 women) with the mean age of 66.6 (±7.0) years who met the inclusion criteria of the study. Degenerative changes of the knee joint seen on a preoperative weight-bearing anteroposterior X-ray were evaluated according to the Kellgren-Lawrence grading system separately for the medial and lateral compartment. Based on the visual appearance, the condition of articular surfaces was assessed using the International Cartilage Repair Society Score (ICRS Grade). The histological assessment of degenerative changes was conducted by a pathologist with the use of the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment System based on six grades of articular cartilage degeneration. RESULTS: The mean degree of degenerative changes based on the radiological classification was assessed as 3.5 (±0.6) for the medial compartment and 2.1 (±0.4) for the lateral compartment. The visually assessed chondropathy according to the ICRS Grade was 3.7 (±0.6) for the medial femoral condyle and 1.8 (±1.0) for the lateral femoral condyle. The histological score obtained using the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment was 4.9 (±1.1) for the medial femoral condyle and 2.4 (±0.7) for the lateral femoral condyle. In respect of the medial compartment, there was no statistically significant parametric correlation between the intraoperative visual assessment of the cartilage degeneration and the preoperative radiological grade r = 0.45. The histological assessment showed a statistically significant concordance both with the degree of chondropathy r = 0.76 and the radiological grade r = 0.64. In the lateral compartment, the parametric test showed a statistically significant concordance only between the radiological grade and the histological score r = 0.72. The correlation between the visual assessment of chondropathy and the radiological grade r = 0.27 as well as the histological score r = 0.24 was very low. DISCUSSION: In our cohort assessing the early degenerative changes of the lateral compartment as well as the more advanced degenerative changes of the medial compartment, the correlation between the intraoperative assessment of cartilage degeneration as a diagnostic method to examine the lateral compartment and the preoperative radiological grade was not confirmed. Our results failed to confirm a better reporting value of the visual cartilage degeneration assessment of the lateral compartment as against the preoperative X-ray. The space width without narrowing on an X-ray has no reporting value for this compartment in case of varus deformity. CONCLUSIONS: The results clearly indicate that the assessment of macroscopic appearance of the cartilage degeneration during arthroscopy does not necessarily guarantee good long-term clinical outcomes after high tibial osteotomy. The respective degrees of cartilage degeneration identified during the intraoperative visual assessment and the radiological grading of osteoarthritic changes did not correlate in either compartment. In the lateral compartment, the initial radiological and histological findings preceded the visually detectable cartilage changes. KEY WORDS: knee, cartilage, osteoarthritis, radiology, histology, arthroscopy, osteotomy.
- MeSH
- artróza kolenních kloubů * chirurgie diagnostické zobrazování patologie MeSH
- kloubní chrupavka * patologie diagnostické zobrazování MeSH
- kolenní kloub diagnostické zobrazování patologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- radiografie * metody MeSH
- senioři MeSH
- totální endoprotéza kolene * metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
Stem cells biology is one of the most frequent topic of physiological research of today. Spinal fusion represents common bone biology challenge. It is the indicator of osteoinduction and new bone formation on ectopic model. The purpose of this study was to establish a simple model of spinal fusion based on a rat model including verification of the possible use of titanium microplates with hydroxyapatite scaffold combined with human bone marrow-derived mesenchymal stem cells (MSCs). Spinous processes of two adjacent vertebrae were fixed in 15 Wistar rats. The space between bony vertebral arches and spinous processes was either filled with augmentation material only and covered with a resorbable collagen membrane (Group 1), or filled with augmentation material loaded with 5 × 10⁶ MSCs and covered with a resorbable collagen membrane (Group 2). The rats were sacrificed 8 weeks after the surgery. Histology, histomorphometry and micro-CT were performed. The new model of interspinous fusion was safe, easy, inexpensive, with zero mortality. We did not detect any substantial pathological changes or tumor formation after graft implantation. We observed a nonsignificant effect on the formation of new bone tissue between Group 1 and Group 2. In the group with MSCs (Group 2) we described minor inflamatory response which indicates the imunomodulational and antiinflamatory role of MSCs. In conclusion, this new model proved to be easy to use in small animals like rats.
- MeSH
- bederní obratle diagnostické zobrazování patofyziologie chirurgie MeSH
- časové faktory MeSH
- fúze páteře škodlivé účinky přístrojové vybavení metody MeSH
- hydroxyapatit MeSH
- kostní destičky MeSH
- kultivované buňky MeSH
- lidé MeSH
- modely u zvířat MeSH
- osteogeneze MeSH
- osteointegrace MeSH
- potkani Wistar MeSH
- protézy - design MeSH
- regenerace * MeSH
- rentgenová mikrotomografie MeSH
- titan MeSH
- tkáňové podpůrné struktury MeSH
- transplantace mezenchymálních kmenových buněk škodlivé účinky přístrojové vybavení metody MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
- Názvy látek
- hydroxyapatit MeSH
- titan MeSH
The authors present a case of an incidental finding of an asymptomatic retrogastricaly localized bronchogenic cyst. In a 3.5 year old boy, abdominal US, which was performed because of constipation complains, revealed a cystic mass. MRI study confirmed the presence of a simple cyst, located in the retrogastric region. The patient underwent laparotomy and the cyst, measuring 3 cm in a diameter, was removed from the omental bursa. During the postoperative period, no complications or symptoms were recorded. Histologicaly, the finding was surprisingly identified as a bronchogenic cyst. Occurence of bronchogenic cysts within the abdominal cavity is reported very rarely in the literature.
We report a female patient with Gaucher disease (GD) type I on ERT (imiglucerase) for 5 years, which led to a significant general improvement. Aged 59 years she underwent an episode of altitude sickness followed by sepsis, disseminated intravascular coagulation, and multiorgan failure. She succumbed to a cerebral haemorrhage. Autopsy revealed liver cholestatic cirrhosis and multifocal liver carcinoma with immunophenotype compatible with cholangiocarcinoma. Analysis of the storage process revealed its absence or very low levels in the majority of liver and spleen macrophages. Gaucher cells (GCs) were seen only as occasional aggregates of various sizes in these organs. GCs were seen also in the leptomeninx of the cerebellum and as infrequent perivascular clusters in both the grey and white cerebral matters. Bone marrow was heavily infiltrated with GCs, especially in the adipocyte-rich part. GCs in this location displayed varied degrees of cytoplasmic vacuolation unrelated to the lysosomal compartment, caused by droplets of triglyceride, and interpreted as due to resorption of fragments of altered white adipocytes. All these observations point to the relative efficacy of ERT in covering the standard substrate load, which should not be exceeded as it would lead to the evolution of mature GCs. The results are discussed in relation to our recently published hypothesis on GD cell pathology.
- MeSH
- aktivní transport fyziologie MeSH
- Gaucherova nemoc farmakoterapie metabolismus patologie MeSH
- glukosylceramidasa terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- pitva MeSH
- rekombinantní proteiny terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- glukosylceramidasa MeSH
- imiglucerase MeSH Prohlížeč
- rekombinantní proteiny MeSH
Toxoplasmic encephalitis is considered one of the most frequent causes of death in HIV-positive patients. The article presents a case of a 40-year-old HIV-positive male hospitalized for surgical treatment of localized brain tumour verified by CT and MRI. Histopathologically, toxoplasmic aetiology was confirmed. Briefly, tissue toxoplasmosis represents a high risk among HIV-positive patients. Therefore, this disease must be considered in differential diagnosis of localized brain masses in HIV-positive patients.
- MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- HIV infekce komplikace MeSH
- lidé MeSH
- mozková toxoplazmóza diagnóza MeSH
- nádory mozku diagnóza MeSH
- oportunní infekce doprovázející AIDS diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
OBJECTIVES: Two cases of an extremely rare paraganglioma-like variant of medullary thyroid carcinoma (MTC) are reported. METHODS: The patients were a 65-year-old male (case 1) and a 14-year-old female (case 2). Unilateral thyroid nodule and homolateral cervical lymphadenopathy was present in case 1; bilateral thyroid nodules were seen in case 2. Fine needle aspiration cytology (FNAC) was performed from thyroid nodules (in both cases) and from a cervical lymph node (in case 1). RESULTS: The cytological smears contained predominantly ovoid to spindled epithelial cells arranged in cohesive three-dimensional clusters with sharp margins; isolated individual cells were seen only rarely. No colloid or other material was present in the background. The tumour cells showed significant nuclear atypia with occasional bizarre and/or binucleated cells. The nuclear chromatin was coarse and granular, sometimes with grooves and intranuclear inclusions. The cytoplasm was inconspicuous. Polygonal or triangular cells, amyloid and azurophillic cytoplasmic granules were absent in both cases. Calcitonin expression was demonstrated in case 2. Histological examination confirmed the paraganglioma variant of MTC in both cases. Mutation of RET proto-oncogene in exon 16 (Met918Thr) - germline in case 2 and somatic in case 1 was detected by sequencing of DNA in both cases. CONCLUSIONS: This is the first description of cytological findings in the paraganglioma-like variant of MTC. Despite its rarity, it can be reliably diagnosed by FNAC if material for immunocytochemistry is obtained.
- MeSH
- fatální výsledek MeSH
- lidé MeSH
- medulární karcinom diagnóza diagnostické zobrazování genetika patologie MeSH
- mladiství MeSH
- mutace MeSH
- mutační analýza DNA MeSH
- nádory plic sekundární MeSH
- nádory štítné žlázy diagnóza diagnostické zobrazování genetika patologie MeSH
- paragangliom diagnóza diagnostické zobrazování genetika patologie MeSH
- protoonkogen Mas MeSH
- protoonkogenní proteiny c-ret genetika MeSH
- sekvence nukleotidů MeSH
- senioři MeSH
- tenkojehlová biopsie * MeSH
- ultrasonografie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- MAS1 protein, human MeSH Prohlížeč
- protoonkogen Mas MeSH
- protoonkogenní proteiny c-ret MeSH
We present a patient who underwent allogeneic peripheral stem cell transplantation (PSCT) for chronic myelocytic leukemia. Twenty months after the PSCT he experienced status epilepticus. Magnetic resonance imaging (MRI) revealed a focus in the ventral thalamus-hypothalamus region. Using stereotactic biopsy with histology and specific polymerase chain reaction investigation from brain tissue, cerebral toxoplasmosis was diagnosed and treated with antiparasitic therapy. Early recognition of such serious and potentially lethal disease enabled prompt specific treatment. This case report emphasizes the role of stereotactic biopsy in diagnosis of cerebral toxoplasmosis. Other methods such as MRI are non-invasive but not sufficiently specific and sensitive.
- MeSH
- antiprotozoální látky terapeutické užití MeSH
- biopsie MeSH
- homologní transplantace škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozková toxoplazmóza diagnóza diagnostické zobrazování farmakoterapie MeSH
- polymerázová řetězová reakce MeSH
- radiografie MeSH
- stereotaktické techniky MeSH
- thalamus diagnostické zobrazování MeSH
- Toxoplasma genetika izolace a purifikace MeSH
- transplantace periferních kmenových buněk škodlivé účinky MeSH
- zvířata MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- antiprotozoální látky MeSH
The authors present results of retrospective study of 10 cases of Aqua-Sense hydrophilic acrylic intraocular lens (IOL) explantation performed during the calendar year 2005 at the Department of Ophthalmology, University Hospital, Hradec Králové, Czech Republic. The preoperative visual functions, perioperative findings and postoperative results were evaluated. The best corrected visual acuity (BCVA) before explantation was surprisingly good, even in cases with severe opacification of the lens. There were no serious perioperative complications; in 9 cases, the stable capsular bag enabled us to implant the new IOL in the bag or in the sulcus. In one case, the suction of the secondary cataract was done. In one eye, the zonular dehiscence developed, and the new IOL was placed into the anterior chamber (angle supported AC IOL). We did not see any postoperative complications. The BCVA improved in 3 eyes, in 7 eyes the BCVA remained the same. All patients were satisfied with the postoperative results. Histopathological examinations of the explanted IOLs showed multiple tiny calcium granules concentrated in continuous narrow band closely beneath the anterior surface of the optic part of the IOL. The postoperative calcification of some currently available hydrophilic acrylic IOLs is one of the common reasons for IOL explantation/exchange. Sophisticated surgical techniques greatly improved the postoperative results.
- MeSH
- akryláty MeSH
- extrakce katarakty MeSH
- implantace nitrooční čočky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční čočky * MeSH
- odstranění implantátu MeSH
- pooperační komplikace MeSH
- selhání protézy * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zraková ostrost MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- akryláty MeSH
PURPOSE: To evaluate the indications, lens styles, perioperative findings, and results of intraocular lens (IOL) explantation or exchange performed in the authors department in 2005. METHODS: The retrospective analysis comprised 22 patients (23 eyes). Twenty-one eyes had previous phacoemulsification and IOL implantation, one eye secondary aphakic IOL, and one eye phakic IOL implantation. The indications for IOL explantation/exchange and perioperative complications were evaluated. The best-corrected visual acuity (BCVA) before and after surgery was compared. RESULTS: Time from initial surgery to explantation/exchange varied from 1 to 121 months, median value was 46 months. The IOLs were explanted using local anesthesia and in 21 eyes replaced with new lens. Indications for IOL removal were opacification of the IOL in 12 eyes, malposition of the IOL in 5 eyes, postoperative refractive error in 2 eyes, recurrent toxic anterior segment syndrome in 1 eye, pseudophakic dysphotopsia in 1 eye, endothelial cell loss in phakic anterior chamber IOL in 1 eye, and visual discomfort with intraocular telescopic lens in 1 eye. The mean BCVA (decimal scale) before and after IOL explantation/exchange was 0.562+/-0.279 and 0.627+/-0.276, respectively. There was no significant difference in visual acuity before and after IOL exchange (Wilcoxon test). CONCLUSIONS: The most frequent indications for IOL explantation/exchange were opacification of the IOL and IOL malposition. Surgeries were uneventful in most cases. Final visual results have been largely good. Long-term follow-up of patients with various types of IOLs should be maintained.
- MeSH
- časové faktory MeSH
- fakoemulzifikace MeSH
- implantace nitrooční čočky MeSH
- lidé středního věku MeSH
- lidé MeSH
- nitrooční čočky statistika a číselné údaje MeSH
- odstranění implantátu statistika a číselné údaje MeSH
- reoperace MeSH
- retrospektivní studie MeSH
- selhání protézy * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zdravotnické přehledy MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Primitive nonneural granular cell tumor was recognized in an 82-year-old man, mimicking a granuloma in the scalp. Despite its disturbing cytomorphology, this histogenetically enigmatic tumor with unusual immunoprophile (NK1-C3, CD 68 and NSE positivity; S-100 protein negativity) behaves indolently.
