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12. Chirurgická léčba hormonálně aktivních adenomů hypofýzy

Creator:
Masopust, Václav, Netuka, D., Hána, V., Marek, J., and Beneš, V.
Type:
model:article, article, Text, and TEXT
Subject:
adenom--chirurgie--terapie, nádory hypofýzy--chirurgie--terapie, výsledek terapie, pooperační komplikace--chirurgie--terapie, radiochirurgie--metody--využití, desmopresin--terapeutické užití, chirurgie operační--metody--využití, and lidé
Language:
Czech and English
Description:
Od roku 1999 do roku 2003 bylo na Neurochirurgické klinice 1. LF UK, IPVZ a ÚVN Praha operováno celkem 277 nemocných s adenomem hypofýzy. Z tohoto počtu bylo 108 pacientů s hormonálně aktivními adenomy hypofýzy. K normalizaci nebo k dostatečnému poklesu hormonální hladin došlo u 61 pacientů po první operaci. V 47 případech nebyl hormonální pokles po první operaci dostatečný. Celkem v 18 případech byla indikována sekundární operace, pooperační medikamentózní léčba byla indikována u 17 pacientů, na Leksellově gama noži bylo ozářeno 34 pacientů. Po transsfenoidální operaci byla mortalita nulová, morbidita byla zaznamenána u 2 pacientů (1× trvalé zhoršení zraku, 1× likvorea). Trvalá substituce adiuretinem je nutná u 7 pacientů., There had been treated 277 patients with pituitary adenoma in period from 1999 to 2003 at Department of Neurosurgery, Central Military Hospital, Prague. Altogether there had been treated 108 patients with hormone-secreting adenomas. Normalization or sufficient hormone level decrease was observed in 61 patients after the first surgery. Hormone level decrease was not sufficient in remaining cases. Second surgery was performed in 18 cases, medicamental treatment was indicated in 17 cases, radiosurgery was applied in 34 cases. There was no mortality after transsphenoidal surgery, morbidity was observed in 2 cases (visual impairment in 1 case, CSF leak in 1 case). Permanent adiuretine substitution is needed in 7 cases., Václav Masopust, D. Netuka, V. Hána, and Lit. 22
Rights:
http://creativecommons.org/publicdomain/mark/1.0/ and policy:public

13. Monitoring of the course of sepsis in hematooncological patients by extrapituitary prolactin expression in peripheral blood monocytes

Creator:
Pavlína Čejková, Chromá, V., Černá, M., Markéta Marková, Marek, J., Zdeňka Lacinová, and Haluzík, M.
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, fyziologie člověka, human physiology, prolactin, toll-like receptors, mRNA, monocytes, sepsis, 14, and 612
Language:
English
Description:
Our study explored the role of extrapituitary prolactin (PRL) and toll-like receptors (TLR)2 and TLR4 in defense reaction of immune system to bacterial infection. Forty-two patients diagnosed with sepsis were recruited and blood samples were withdrawn after patients’ admission to hospital, after the end of acute phase of sepsis and after the sepsis has been resolved, respectively. Seventeen patients died of sepsis; thus, only one sample collected just before death could be processed. PRL and TLR2/4 mRNA levels were measured in CD14+ blood monocytes by QPCR and PRL -1149 G/T SNP genotyped. The TLRs mRNA expression was markedly elevated in all patients groups in comparison to healthy controls mRNA levels; the highest upregulation of monocytic TLR2 in sepsis (16.4 times, P<0.0001) was detected in patients who did not survive septic complications. PRL mRNA expression in monocytes from nonsurvivors tended to be lower (4.5 fold decrease, P=NS) compared to control levels and it was 6.2 times reduced compared to PRL mRNA expression in second blood sample from survivors (P<0.05). The PRL -1149 G/T SNP had no effect on PRL mRNA response during sepsis. Our data suggest that increased prolactin mRNA expression in monocytes is associated with better outcome and improved survival rate in sepsis with no apparent effect of PRL -1149 G/T SNP on monocytic prolactin response., P. Čejková ... [et al.]., and Obsahuje seznam literatury
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

14. Náhodně zjištěné expanze v selární oblasti

Creator:
Hána, Václav, Seidl, Zdeněk, Vaněčková, Manuela, Diblík, Pavel, Weiss, V., Masopust, Václav, Kršek, Michal, and Marek, J.
Type:
model:article, article, Text, and TEXT
Subject:
sella turcica--metabolismus--mikrobiologie, nádory hypofýzy--diagnóza, systém hypotalamus-hypofýza--patologie, hypopituitarismus, příznaky a symptomy, diagnostické zobrazování--metody, náhodný nález, lidé, and financování organizované
Language:
Czech and English
Description:
Výpočetní tomografie (CT) a zobrazení magnetickou rezonancí (MRI) vedou relativně často k neočekávanému nálezu expanze v hypotalamo-hypofyzární oblasti, aniž by provedení těchto metod bylo indikováno pro klinicky manifestní symptomatologii vyvolanou tímto tumorem. Nepřekvapí to, když víme, že v autopsiích jsou hypofyzární adenomy nacházeny v průměru u 10?15 % populace. Indikací k RTG, CT nebo MRI bývá trauma hlavy, záněty vedlejších nosních dutin, bolesti hlavy, cévní mozková příhoda, neurologické onemocnění a další situace. V hypotalamo-hypofyzární krajině se vyskytuje celá řada etiologicky různých tumorů, v nichž naprosto převažují (přes 90 %) benigní hypofyzární adenomy. Z ostatních primárních expanzí jsou nejčastější kraniofaryngeomy a meningeomy, další expanze pak daleko méně obvyklé. Takto náhodně odhalené tumory jsou většinou asymptomatické, ale při cílené anamnéze jsou někdy příznaky zřejmé. Symptomatologie může vyplývat z eventuální mírné hormonální nadprodukce hypofyzárních adenomů, deficitu hypofyzárních hormonů nebo z lokálních projevů expanze. Pro rozhodnutí o léčbě je důležité přesné posouzení zobrazení magnetickou rezonancí, hormonální aktivity expanze, vztahu k okolním strukturám, zejména optikům a posouzení hypofyzárních funkcí. Podle typu a rozsahu tumoru v úvahu přichází farmakoterapie (léčba volby u prolaktinomů), operační zákrok, radioterapie (dnes nejčastěji gama nožem), a není-li žádná intervence potřebná, je možná jen observace s pravidelnými MRI kontrolami. Růst tumoru je pozorován častěji u ?makroadenomů? než u ?mikroadenomů (do 10 mm)?., Václav Hána, Zdeněk Seidl, Manuela Vaněčková, and Lit. 7
Rights:
http://creativecommons.org/publicdomain/mark/1.0/ and policy:public

15. Plasma concentrations of adipocyte fatty acid binding protein in patients with Cushing's syndrome

Creator:
Viktória Ďurovcová, Marek, J., Václav Hána, Martin Matoulek, Vít Zikán, Denisa Haluzíková, Petra Kaválková, Zdeňka Lacinová, Michal Kršek, and Martin Haluzík
Format:
print, bez média, and svazek
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, obezita, obesity, adipocyte fatty acid binding protein 4, hypercortisolism, 14, and 612
Language:
English
Description:
Serum adipocyte fatty acid-binding protein (FABP-4) concentrations are linked to human obesity and other features of metabolic syndrome. Patients with Cushing's syndrome (CS) develop numerous features of metabolic syndrome due to chronic cortisol excess. Here we tested the hypothesis that chronically increased cortisol levels in CS patients may alter circulating levels of FABP-4. Fourteen patients with CS, 19 patients with simple obesity (OB) and 36 healthy control subjects (C) were included in the study. Serum FABP-4 concentrations were significantly higher in both CS and OB patients relati ve to C group, but they did not differ between CS and OB groups. In a combined population of all groups, serum FABP-4 levels correlated positively with BMI, body fat content, serum glucose, triglycerides, HbA1c and HOMA index and were inversely relate d to HDL-cholesterol, resting energy expenditure and freeT3 levels. We conclude that FABP-4 levels are significantly increased in both patients with simple obesity and obese patients with Cushing's syndrome. We suggest that increased FABP-4 concentrations in CS patients are rather due to their excessive fat accumulation and related metabolic abnormalities than due to a direct effect of cortisol on FABP-4 production., V. Ďurovcová, J. Marek, V. Hána, M. Matoulek, V. Zikán, D. Haluzíková, P. Kaválková, Z. Lacinová, M. Kršek, M. Haluzík., and Obsahuje bibliografii
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

16. Plasma Levels of Total and Active Ghrelin in Acromegaly and Growth Hormone Deficiency

Creator:
Jarkovská, Z., Rosická, M., Marek, J., Hána, V., Weiss, V., Justová, V., Lacinová, Z., Haluzík, and Kršek, M.
Type:
article, model:article, and TEXT
Subject:
Total ghrelin, Active ghrelin, Leptin, Acromegaly, and Growth hormone deficiency
Language:
English
Description:
Ghrelin is an endogenous growth hormone (GH) secretagogue recently isolated from the stomach. Although it possesses a strong GH releasing activity in vitro and in vivo, its physiological significance in endogenous GH secretion remains unclear. The aim of this study was to characterize plasma ghrelin levels in acromegaly and growth hormone deficiency (GHD). We investigated plasma total and active ghrelin in 21 patients with acromegaly, 9 patients with GHD and 24 age-, sex- and BMI-matched controls. In all subjects, we further assessed the concentrations of leptin, soluble leptin receptor, insulin, IGF-I, free IGF-I and IGFBP-1, 2, 3 and 6. Patients with acromegaly and GHD as well as control subjects showed similar levels of total ghrelin (controls 2.004±0.18 ng/ml, acromegalics 1.755±0.16 ng/ml, p=0.31, GHD patients 1.704±0.17 ng/ml, p=0.35) and active ghrelin (controls 0.057±0.01 ng/ml, acromegalics 0.047±0.01 ng/ml, p=0.29, GHD patients 0.062±0.01 ng/ml, p=0.73). In acromegalic patients plasma total ghrelin values correlated negatively with IGF-I (p<0.05), in GHD patients active ghrelin correlated with IGF-I positively (p<0.05). In the control group, total ghrelin correlated positively with IGFBP-2 (p<0.05) and negatively with active ghrelin (p=0.05), BMI (p<0.05), WHR (p<0.05), insulin (p=0.01) and IGF-I (p=0.05). Plasma active ghrelin correlated positively with IGFBP-3 (p=0.005) but negatively with total ghrelin and free IGF-I (p=0.01). In conclusion, all groups of the tested subjects showed similar plasma levels of total and active ghrelin. In acromegaly and growth hormone deficiency plasma ghrelin does not seem to be significantly affected by changes in GH secretion.
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

17. Prediction of adrenocortical insufficiency after pituitary adenoma surgery using postoperative basal cortisol levels

Creator:
Hána, V., Jana Ježková, Mikuláš Kosák, Michal Kršek, Marek, J., David Netuka, Hill, M., and Václav Hána
Format:
print, bez média, and svazek
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, adenomy hypofýzy, chirurgie, pituitary adenomas, surgery, adrenal insufficiency, hypocorticalism, ACTH test, 14, and 612
Language:
English
Description:
Our aim was to analyze the correlation of early postoperative cortisol levels in patients after transsphenoidal pituitary adenoma surgery compared to the standard dose ACTH test and Insulin tolerance test (ITT) several months later. We retrospectively reviewed data from 94 patients operated for pituitary adenoma in years 2009-2012. The comparison of day 7 (median) postoperative basal cortisol levels and 3.6 months (median) after pituitary adenoma surgery stimulation test - standard dose 250 μg 1-24ACTH test in 83 patients or ITT in 11 patients were performed. All 16 patients with early postoperative cortisol levels >500 nmol/l proved a sufficient response in the stimulation tests. At basal cortisol levels of 370-500 nmol/l the sufficient response was found in 96 % (27/28) of patients. In the postoperative basal cortisol levels 200-370 nmol/l we found a preserved corticotroph axis later on in 88 % (28/32) of cases. Patients with basal cortisol levels 100-200 nmol/l had a maintained corticotroph axis function in 8/11 cases - 73 %. All patients with an early postoperative basal cortisol level above 500 nmol/l proved in the stimulation tests a preserved corticotroph axis function. The interval 370-500 nmol/l showed a minimal risk of postoperative adrenal insufficiency., V. Hána Jr., J. Ježková, M. Kosák, M. Kršek, J. Marek, D. Netuka, M. Hil, V. Hána., and Obsahuje bibliografii
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

18. Serum cortisol seems to be a more appropriate marker for adrenocortical reserve evaluation in ACTH test in comparison to salivary cortisol

Creator:
Mikuláš Kosák, Václav Hána, Hill, M., Kateřina Šimůnková, Zdeňka Lacinová, Michal Kršek, and Marek, J.
Format:
print
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, kortizol, cortisol, hypocorticalism, ACTH test, serum cortisol, salivary cortisol, 14, and 612
Language:
English
Description:
Salivary cortisol reflects the free fraction of serum cortisol. Monitoring salivary cortisol may be a promising alternative method for assessing serum cortisol in some clinical situations. We aimed to compare the reliability of salivary vs. serum cortisol during ACTH test. 84 subjects (mean age 63.2; 24-89 years; n=66 males) suspected for adrenocortical insufficiency underwent an ACTH test. Patients were divided based on peak serum cortisol into hypocortical group with cortisol <500 nmol/l and to reference group cortisol >500 nmol/l. Median serum cortisol levels in reference gr oup were 445, 766, and 902 nmol/l at 0, 30, and 60 minutes, respecti vely, and in hypocortical group were 256, 394, and 453 nmol/l. Median salivary cortisol levels were 19.02, 40.02, and 62.1 nmol/l in reference group, and 9.60, 14.08, and 13.28 nmol/l in hypoco rtical group. Obtained values showed good correlation between serum and salivary cortisol (p<0.0001). The percentage of explained variability R 2 (coefficient of determination for linear model) representing a measure of agreement betwee n experimental values and predictions for repeated measur es ANOVA, was significantly higher (p=0.021) for serum cortisol (R 2 =93.4 %) when compared to the salivary cortisol (R 2 =89.3 %). A stronger discriminating power of serum versus salivary cortisol suggests that it seems to be slightly, but statistically significantly more appropriate marker of adrenocortical reserve in ACTH test., M. Kosák ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

19. Serum ghrelin levels in obese patients: the relationship to serum leptin levels and soluble leptin receptors levels

Creator:
Martina Rosická, Michal Kršek, Martin Matoulek, Zuzana Jarkovská, Marek, J., Vlasta Justová, and Zdeňka Lacinová
Format:
print, bez média, and svazek
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, leptin, obezita, neuropeptidy, obesity, neuropeptids, ghrelin, soluble leptin receptor, neuropeptide Y, 14, and 612
Language:
English
Description:
Ghrelin is a new endogenous ligand for the growth hormone secretagogue receptor. It activates the release of growth hormone from the pituitary and it also participates in the regulation of energy homeostasis. The aim of the study was to characterize changes in serum ghrelin levels in obese subjects and their relationship to the serum levels of leptin and soluble leptin receptor. Eight obese patients (6 women and 2 men) with body mass index (BMI) 40.313.4 kg.m-2 and eight healthy controls (5 women and 3 men) with BMI 22.7±1.3 kg.m-2 were examined. The ghrelin serum levels (165.0±58.1 vs. 343.37±81.96; p<0.001) and soluble leptin receptor serum levels (7.25±3.44 vs. 21.80±4.99; p<0.0001) were significantly lower in obese patients. The leptin serum levels (23.45±12.90 vs. 6.41±2.96; p<0.005) were significantly higher compared to the lean subject group. In both measured groups the levels of serum leptin significantly positively correlated with BMI. We proved a significantly lower serum ghrelin levels in the group of obese patients in comparison with the control group., M. Rosická, M. Kršek, M. Matoulek, Z. Jarkovská, J. Marek, V. Justová, Z. Lacinová., and Obsahuje bibliografii
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

20. Stresová odezva prolaktinu u nemocných se systémovým lupus erythematodes (SLE), revmatoidní artritidou (RA) a u zdravých kontrol

Creator:
Dostál, Ctibor, Hušáková, Markéta, Lacinová, Zdeňka, Černá, Marie, Moszkorzová, Ludmila, Marek, J., and Zvárová, Jana
Type:
model:article, article, Text, and TEXT
Subject:
psychický stres--krev, revmatoidní artritida--imunologie--krev, systémový lupus erythematodes--imunologie--krev, prolaktin--krev, výzkum - podpora finanční - jako téma, and lidé
Language:
Czech and English
Description:
Ctibor Dostál, M. Fortíková, Z. Lacinová, M. Černá, L. Moszkorzová, Jana Zvárová, J. Marek and Lit.: 30
Rights:
http://creativecommons.org/publicdomain/mark/1.0/ and policy:public