Úvod: Infekčná endokarditída u pacienta po transplantácii obličky je závažná infekčná komplikácia, ktorá zvyšuje riziko straty štepu ako aj mortalitu pacientov. Najdôležitejším predisponujúcim faktorom je imunosupresívna liečba – predovšetkým indukčná imunosupresia. Materiál a popis prípadu: V transplantačnom centre Martin podstúpilo v období 12 rokov transplantáciu obličky 250 pacientov. Z tohto súboru pacientov bolo 5 pacientov (2 %) po náhrade chlopne. Prezentujeme prípad pacienta po transplantácii obličky s rozvojom endokarditídy bioprotézy aortálnej chlopne mesiac po úspešnej transplantácii obličky. Diagnostika endokarditídy štandardnými postupmi (transtorakálne echokardiografické vyšetrenie, transezofageálne echokardiografické vyšetrenie, hemokultúry) bola neúspešná. Endokarditídu sme diagnostikovali raritne až pomocou PET-CT vyšetrenia s následnou zmenou antibiotickej liečby a úspešným zvládnutím tejto potransplantačnej komplikácie. Záver: Endokarditída po transplantácii obličky je vážna komplikácia, ktorá výrazne zhoršuje mortalitu príjemcov. Riziko rozvoja infekčnej endokarditídy po transplantácii zvyšuje aj indukcia, a to predovšetkým antitymocytárny globulín. Diagnostika iba pomocou PET-CT vyšetrenia je raritná, ale v prípade nášho popísaného prípadu, zásadne zmenila prístup k pacientovi a viedla k úspešnej liečbe. Kľúčové slová: endokarditída – indukcia – PET-CT – transplantácia obličky, Introduction: Infective endocarditis in a patient after kidney transplantation is a serious infective complication which increases the risk of loss of the graft and also the mortality of patients. The most important predisposing factor is the immunosuppressive therapy – mainly induction immunosuppression. Material and case description: 250 patients underwent kidney transplantation throughout the period of 12 years in the Transplant Center Martin. This set of patients included 5 patients (2 %) after heart valve replacement. We present the case of a patient after kidney transplantation with development of endocarditis of the bioprosthesis of the aortic valve one month after successful kidney transplantation. Diagnostics of endocarditis by standard procedures (examination by transthoracic echocardiogram, transesophageal echocardiography, hemocultures) was unsuccessful. We rarely diagnosed endocarditis only by PET-CT examination with a consequent change of the antibiotic treatment and successful managing of this post-transplant complication. Conclusion: Endocarditis after kidney transplantation is a serious complication which significantly worsens the mortality of patients. The risk of development of infective endocarditis after transplantation is also increased by induction, mainly by antithymocyte globulin. Diagnostics only by PET-CT examination is rare; however, in this case it fundamentally changed the approach to the patient and led to a successful treatment. Key words: endocarditis – induction – kidney transplantation – PET-CT, and Ivana Dedinská, Petra Skalová, Michal Mokáň, Katarína Martiaková, Denisa Osinová, Miroslav Pindura, Blažej Palkoci, Marián Vojtko, Janka Hubová, Denisa Kadlecová, Ivona Lendová, Radovan Zacharovský, Filip Pekar, Lucia Kaliská
Metastazování renálního karcinomu do štítné žlázy není až tak vzácné, raritní je spíše interval od původní diagnózy, resp. nefrektomie. Prezentujeme případ 58letého muže, přijatého na naše pracoviště s diagnózou: struma polynodosa retrosternalis. U tohoto muže byla provedena totální tyreoidektomie z krčního přístupu. Histologické vyšetření prokázalo mnohočetné metastázy konvenčního karcinomu z renálních buněk v terénu polynodózní koloidní strumy. Pooperační průběh byl klidný, operační rána zhojena per primam. Metastazování karcinomu z renálních buněk do štítné žlázy je neobvyklou lokalizací a často bývá zjištěno pooperačně., Renal carcinoma metastasis to the thyroid gland is not particularly rare; the interval since the initial diagnosis in the case presented, that is, nephrectomy, is more of a rarity. We present the case of a 58-year-old man admitted to our hospital with the diagnosis of polynodular retrosternal goitre. Complete thyroidectomy by cervical approach was performed. Histological examination showed multiple metastases of conventional renal carcinoma located within colloid struma polynodosa. Postoperative progress was uneventful, the surgical wound healed per primam. Renal carcinoma metastasing to the thyroid gland is rather unusual and is often found only postoperatively., and L. Hnízdil, J. Doležel, I. Čapov
Poranění anorekta, s výjimkou iatrogenních poškození, jsou vzácná. Vzhledem k široké škále příčin a rozsahu poranění vyžaduje diagnostika a léčba těchto poranění individuální přístup ke každému pacientovi. Dle rozsahu poranění je třeba zvolit vhodnou léčebnou strategii tak, abychom úspěšně ošetřili toto poranění a zároveň co nejvíce eliminovali četné komplikace těchto poranění, zvláště pak poruchy kontinence. Autoři prezentují poranění hráze a anorekta s poraněním svěračů u staršího pacienta po pádu ze žebříku., Anorectal injuries, with the exception of iatrogenic damage, are rare. Considering the extensive range of causes and potential extent of damage, the diagnosis and treatment of these injuries requires an individual approach to every patient. Based on the extent of damage, the best way of treatment strategy has to be selected for successful treatment of the primary injury and elimination of frequent complications, especially fecal incontinence. The authors present a rare injury of the perineum and anorectum with anorectal sphincter damage in an elderly man after falling down from a stepladder., and M. Lerch, M. Peteja, A. Zatloukal, P. Ostruzska, P. Ihnát, J. Polovko, A. Pelikán, P. Zonča
Mozkový absces vzniká přímým šířením hnisavého procesu z okolí, metastaticky nebo v souvislosti s kraniocerebrálním poraněním anebo operačním zákrokem. Léčba spočívá v kombinaci navigované punkce a evakuace abscesu s cílenou antibiotickou terapií. Méně častá je radikální exstirpace abscesu. Absces bývá doprovázen kolaterálním edémem vyžadujícím v některých případech antiedematózní terapii. Uvedená léčba by měla v současné době vést k úplnému vyléčení. Ve svém sdělení popisujeme ojedinělý případ nemocného se solitárním abscesem mozku, u kterého došlo po punkci k progresi kolaterálního edému s následnou klinickou deteriorací. Akutně provedená dekompresivní kraniektomie vedla k úplné úpravě klinického stavu. Po ústupu edému byla provedena kranioplastika. Abscesové ložisko po punkci a antibiotické terapii zcela vymizelo. Původcem abscesu byli peptostreptokokus a fusobakterium. Použití dekompresivní kraniektomie v terapii mozkového abscesu je výjimečné a v písemnictví je popisováno sporadicky., Brain abscess is caused by direct dissemination of inflammation from surrounding structures, remote infectious sources or is associated with brain trauma or neurosurgical procedures. Treatment includes surgical aspiration and intravenous antibiotics. Excision of the lesion is sometimes indicated. Antiedematous therapy is necessary in cases of brain oedema. At the present time, the majority of patients with brain abscesses survive and recover completely. Here we describe the case of a patient with brain abscess, whose condition deteriorated after aspiration of the lesion. The deterioration was due to progression of collateral brain oedema. After urgent decompressive craniectomy, the patient recovered completely. A cranioplasty was performed when the oedema disappeared. The abscess resolved completely following aspiration and antibiotic therapy. Fusobacterium and peptostreptococus were identified as the causative pathogens. Decompressive craniectomy has very rarely been applied in the treatment of brain abscesses and is reported sporadically. Key words: decompressive craniectomy – brain abscess – CNS infection 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 “uniform requirements” for biomedical papers., and J. Mork, D. Štěpánek, V. Runt, J. Hommerová, V. Přibáň
Polytrauma je jednou z hlavních příčin mortality lidí v produktivním věku. Nejdůležitější při léčbě polytraumatu je rychlá aktivace záchranného systému. Při závažných poraněních je klíčový primární transport do specializovaného pracoviště – traumacentra. Naše kazuistické sdělení se zaměřuje na dva případy polytraumatizovaných pacientů, u kterých došlo v průběhu léčení k relativně vzácným situacím. V prvním případě se jedná o vzácné poranění slinivky břišní, které si vyžádalo pankreatoduodenektomii. V druhém případě o poranění jater ošetřené pravostrannou lobektomií se zřídkavou komplikací. Rovněž poukazuje na nezbytnost multioborové spolupráce v léčbě polytraumatizovaného pacienta., Polytrauma is one of the leading causes of mortality in people at productive age. Prompt activation of the rescue system is most important in the treatment. In cases of severe injuries, primary transport to a specialized hospital – trauma center is crucial. Our report is focused on two cases of polytraumatized patients whose treatment was associated with relatively rare situations. One of the patients suffered a pancreatic injury that required pancreaticoduodenectomy. The other patient had a liver injury, which was treated with right lobectomy with a rare complication. The necessity of a multidisciplinary approach to the management of severely injured patients is also emphasized in our report., and A. Nikov, J. Pažin, J. Hadač, F. Bělina, M. Ryska
a1_In the present paper we describe five tests, 3 of which were designed to be similar to tasks used with rodents. Results obtained from control subjects, patients with selective thermo-coagulation lesions to the medial temporal lobe and results from non-human primates and rodents are discussed. The tests involve memory for spatial locations acquired by moving around in a room, memory for objects subjects interacted with, or memory for objects and their locations. Two of the spatial memory tasks were designed specifically as analogs of the Morris water task and the 8-arm radial-maze tasks used with rats. The Morris water task was modeled by hiding a sensor under the carpet of a room (Invisible Sensor Task). Subjects had to learn its location by using an array of visual cues available in the room. A path integration task was developed in order to study the non-visual acquisition of a cognitive representation of the spatial location of objects. In the non-visual spatial memory task, we blindfolded subjects and led them to a room where they had to find 3 objects and remember their locations. We designed an object location task by placing 4 objects in a room that subjects observed for later recall of their locations. A recognition task, and a novelty detection task were given subsequent to the recall task. An 8-arm radial-maze was recreated by placing stands at equal distance from each other around the room, and asking subjects to visit each stand once, from a central point. A non-spatial working memory task was designed to be the non-spatial equivalent of the radial maze. Search paths recorded on the first trial of the Invisible Sensor Task, when subjects search for the target by trial and error are reported., a2_An analysis of the search paths revealed that patients with lesions to the right or left hippocampus or parahippocampal cortex employed the same type of search strategies as normal controls did, showing similarities and differences to the search behavior recorded in rats. Interestingly, patients with lesions that included the right parahippocampal cortex were impaired relative to patients with lesions to the right hippocampus that spared the parahippocampal cortex, when recall of the sensor was tested after a 30 min delay (Bohbot et al. 1998). No differences were obtained between control subjects and patients with selective thermal lesions to the medial temporal lobe, when tested on the radial-maze, the non-spatial analogue to the radial-maze and the path integration tasks. Differences in methodological procedures, learning strategies and lesion location could account for some of the discrepant results between humans and non-human species. Patients with lesions to the right hippocampus, irrespective of whether the right parahippocampal cortex was spared or damaged, had difficulties remembering the particular configuration and identity of objects in the novelty detection of the object location task. This supports the role of the human right hippocampus for spatial memory, in this case, involving memory for the location of elements in the room; learning known to require the hippocampus in the rat., V.D. Bohbot, R. Jech, E. Růžička, L. Nadel, M. Kalina, K. Štěpánková , J. Bureš., and Obsahuje bibliografii
A sign pattern matrix (or nonnegative sign pattern matrix) is a matrix whose entries are from the set {+,−, 0} ({+, 0}, respectively). The minimum rank (or rational minimum rank) of a sign pattern matrix A is the minimum of the ranks of the matrices (rational matrices, respectively) whose entries have signs equal to the corresponding entries of A. Using a correspondence between sign patterns with minimum rank r ≥ 2 and point-hyperplane configurations in Rr−1 and Steinitz’s theorem on the rational realizability of 3-polytopes, it is shown that for every nonnegative sign pattern of minimum rank at most 4, the minimum rank and the rational minimum rank are equal. But there are nonnegative sign patterns with minimum rank 5 whose rational minimum rank is greater than 5. It is established that every d-polytope determines a nonnegative sign pattern with minimum rank d + 1 that has a (d + 1) × (d + 1) triangular submatrix with all diagonal entries positive. It is also shown that there are at most min{3m, 3n} zero entries in any condensed nonnegative m × n sign pattern of minimum rank 3. Some bounds on the entries of some integer matrices achieving the minimum ranks of nonnegative sign patterns with minimum rank 3 or 4 are established., Wei Fang, Wei Gao, Yubin Gao, Fei Gong, Guangming Jing, Zhongshan Li, Yanling Shao, Lihua Zhang., and Obsahuje seznam literatury
We give a classification of Hopf real hypersurfaces in complex hyperbolic two-plane Grassmannians
${\rm SU}_{2,m}/S(U_2{\cdot}U_m)$ with commuting conditions between the restricted normal Jacobi operator $\overline{R}_N\phi$ and the shape operator $A$ (or the Ricci tensor $S$)., Doo Hyun Hwang, Eunmi Pak, Changhwa Woo., and Obsahuje bibliografii
In order to re-evaluate the presence and relative quantity of 2b and 2x/d myosin heavy chain (MyHC) transcripts in rat slow soleus muscle by using real time RT-PCR we have compared the available relevant cDNA sequences and designed a new set of primers having similar melting temperatures, matching separate MyHC exons in the regions of maximal differences in MyHC coding sequences, and containing G or C at the 3́-end. These also yielded PCR products of corresponding length, which is an important requirement for real time RT-PCR quantification. The experiments were performed on 8- month-old inbred female Lewis strain rats used in our current study of regenerating transplanted muscles. The real time RT-PCR measurement confirmed the expression of all four MyHC mRNAs (type 1, 2a, 2x/d and 2b) in both fast extensor digitorum longus and slow soleus muscles, although in the soleus muscle of adult rats, only type 1 and 2a protein isoforms can be usually detected, J. Žurmanová, F. Půta, R. Stopková, T. Soukup., and Obsahuje bibliografii a bibliografické odkazy
This paper presents a real-time cycle slip detection and repair strategy for the BDS-3 triplefrequency and quad-frequency phase observations. For the triple-frequency phase observations, two EWL code-phase combinations and one GF-phase combination are jointly employed to detect and repair cycle slips. Based on the different performances in the success of cycle slip detection and repair, this paper uses GF-phase combinations to detect and repair cycle slip individually. Specifically, the GF-phase combination with a large MTIV value is applied to detect cycle slip possessing the stronger ability to resist ionospheric delay. Besides, the GF-phase combination with a higher success rate of cycle slip repair is selected to repair cycle slip, and the classic LAMBDA method and Ratio test are implemented to fix the cycle slip solution and evaluate reliability separately. For the quad-frequency phase observations, we employ a supernumerary EWL combination based on the triple-frequency, which can directly determine the cycle slip value of the 4th frequency. The results show that the cycle slip estimation value still can detect and repair all real and artificially added cycle slips even under harsh conditions. Moreover, the overall cycle slip repair success rate is greater than 99.99 %., Hao Wang, Shuguo Pan, Wang Gao, Fei Ye, Chun Ma, Ju Tao and Yunfeng Wang., and Obsahuje bibliografii