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Case Reports 2015; 36(4): 303-305 PubMed PMID: 26454483 Citation  Keywords:  Adolescent, Female, Hashimoto Disease:complications, Hormone Replacement Therapy:methods, Humans, Magnetic Resonance Imaging, Oculomotor Nerve Diseases:drug therapy, Recurrence, Steroids:therapeutic use, Thyroiditis, Autoimmune:complications,.   

: Ophthalmopathy related to thyroid disease is due mainly to diffuse periorbital or eye muscle inflammation. It is more common in Grave's hyperthyroidism and rare in Hashimoto's hypothyroidism. Here we report a case of recurrent oculomotor nerve palsy associated with autoimmune hypothyroidism. Brain MRI revealed enhancement of the oculomotor nerves. Despite thyroid hormone replacement therapy, oculomotor nerve palsy recurred at the side contralateral to the initially involved nerve and the autoimmune antibody titer remained high. The symptom was responsive to high-dose steroid therapy....

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Case Reports 2015; 36(2): 127-132 PubMed PMID: 26071580 Citation  Keywords:  Adult, Antineoplastic Combined Chemotherapy Protocols:administration & dosage, Drug Administration Schedule, Glioblastoma:drug therapy, Humans, Male, Neoplasm Grading, Neoplasm Recurrence, Local, Supratentorial Neoplasms:drug therapy,.   

: In a 41 year old man, with Glioblastoma Multiforme (Grade IV - WHO 2007) and loco-regional recurrence, treated conventionally with surgery, radio-therapy and Temolozomide, a complete objective response was subsequently achieved by means of the well-tolerated concomitant administration of Somatostatin + slow-release Octreotide, Melatonin, Retinoids solubilized in Vitamin E, Vit D3, Vit C, D2 R agonists, and Temolozomide. In addition to the positive and previously unreported therapeutic finding, this result allowed the patient to avoid further surgical trauma and the correlated risks, achieving an excellent quality of life and working capacity....

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Journal Article 2013; 34(8): 780-786 PubMed PMID: 24522026 Citation  Keywords:  Adult, Blood Proteins:metabolism, Cognition Disorders:metabolism, Depressive Disorder:metabolism, Female, Humans, Male, Memory:physiology, Middle Aged, Neuropsychological Tests, Oxidative Stress:physiology, Recurrence, Severity of Illness Index, Stroop Te.   

BACKGROUND: Depressive disorders are multifactorial diseases in which cognitive impairments are one of typical features. Thiol protein groups (TPGs) are elements of chemical structure of compounds having antioxidative properties (glutathione peroxidase, metallothioneins) and their oxidation reflects the lost of compensatory capacity of antioxidative mechanisms. The purpose of this study was to determine the level of TPGs in patients with recurrent depressive disorder (rDD) and to define relationship between plasma levels of TPGs and the cognitive performance.

MATERIAL AND METHODS: The study comprised 76 subjects: patients with rDD (n=43) and healthy subjects (comparison group, CG - n=33). Cognitive function assessment was based on the following 4 tests: the Trail Making Test (TMT), the Stroop Test, Verbal Fluency Test (VFT) and Auditory Verbal Learning Test (AVLT).

RESULTS: The level of TPGs was higher in patients with rDD. In rDD group, the elevated concentration of TPGs in plasma was associated with a decrease in efficiency of declarative-memory, working memory and verbal fluency. The higher was the concentration of plasma TPGs, the greater was the severity of depressive symptoms measured by 21-item Hamilton Depression Rating Scale (HDRS), before and after pharmacotherapy. In CG group, the elevated TPGs levels were associated with worse cognitive test performance (AVLT and VFT tests).

CONCLUSIONS: 1) Our study confirms previous results showing increased TPGs level in depression. 2) Our data suggest relation between increased plasma TPGs level in depression and cognitive impairment. 3) The elevated levels of plasma TPGs are related to impairment of the short-term and delayed declarative memory, verbal fluency and working memory....

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Journal Article 2013; 34(5): 426-435 PubMed PMID: 23922040 Citation  Keywords:  Bipolar Disorder:psychology, Humans, Internet, Patient Education as Topic, Recurrence, Treatment Outcome,.   

OBJECTIVE: Despite pharmacological treatment of bipolar affective disorder has many advantages; only drug treatment remains insufficiently beneficial to many patients. The combination of pharmacotherapy and internet psychoeducation seems to be the effective way how to improve remission. Internet-based therapy programs offer an exclusive chance for large underserved parts of the population to make evidence-based treatment without the need of full-time therapist. Our goal was to create a psychoeducational program for patients suffering from bipolar disorder that can be used in Czech Republic.

METHODS: There were identified studies through Web of Science, PUBMED, and Scopus databases as well as existing reviews were used in development of comprehensive internet psychoeducational program for patients with bipolar disorder. The search terms included "bipolar disorder", "psychoeducation", and "internet psychoeducation". The search was performed with no language or time restrictions.

RESULTS: The internet psychoeducational program was developed in accordance to the data from the literature review. The aim of the Internet psychoeducational program of the Department of Psychiatry University Hospital in Olomouc is to familiarize patients with the fundamental nature of bipolar affective disorder, the character and principles of pharmacotherapy, the recognition of the warning signs of relapse, inappropriate and stressful stereotypes in communication within families, and finally the practice of social skills.

CONCLUSION: Information from studies can help to prepare comprehensive psychoeducational program for bipolar patients....

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Case Reports 2013; 34(4): 273-274 PubMed PMID: 23803870 Citation  Keywords:  Diagnosis, Differential, Female, Humans, Middle Aged, Neoplasm Recurrence, Local:diagnostic imaging, Neuroendocrine Tumors:diagnostic imaging, Organometallic Compounds, Pancreatic Neoplasms:diagnostic imaging, Positron-Emission Tomography, Radiopharmaceut.   

: 56-year old woman was operated of a pancreatic NET in May 2011. Abdominal pain had led to imaging and consecutively the finding of cholecystolithiasis and the tumor. The gall bladder, left hemi-pancreas, regional lymph nodes and the (unintentional injured) spleen were resected. At routine control examination in October 2012 CT presented three contract enhancing intra-abdominal lesions with a diameter of 2-3.5 cm. Consecutively 68Ga-DOTA-NOC PET-CT showed high tracer uptake (SUV 10-12) at these lesions. Therefore a relapse of the neuro-endocrine tumor was suspected. After reoperation in December 2012 histology did not reveal any sign of neuroendocrine tumor but identified spleen tissue most probably caused by splenosis accidentally seeded at the first operation. Physiologically the spleen is highly avid at 68Ga-DOTATOC PET, but splenosis presents with less standard uptake value. In our case the described lesions presented with an SUV quite comparable to that of neuroendocrine tumor tissue....

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Journal Article 2012; 33(3): 294-297 PubMed PMID: 22635087 Citation  Keywords:  Aged, Aged, 80 and over, Brain Ischemia:epidemiology, Coronary Artery Disease:epidemiology, Female, Humans, Logistic Models, Male, Middle Aged, Recurrence, Retrospective Studies, Risk Factors, Stroke:epidemiology,.   

BACKGROUND: Coronary artery disease (CAD) is a leading cause of long-term mortality in Europe and it negatively influences the outcome after stroke. However, its influence on stroke recurrence which endangers stroke patients mostly in the first months following stroke, is unclear. Previous studies have found no association between CAD and ischemic stroke recurrence. However, assessment of the relationship was not the primary endpoint of these investigations. The aim of this study was to assess the possible association between CAD and stroke recurrence.

PATIENTS AND METHODS: In a hospital-based, retrospective study, the set consisted of 190 patients - 105 patients with a first ever stroke (48 males; age 37-88, mean 70.7±12.5 years) and 85 patients with stroke recurrence (36 males; age 46-94, mean 88.0±9.6 years). CAD was correlated with the following other risk factors (age, sex, occurrence of arterial hypertension, atrial fibrillation, diabetes mellitus, plasma levels of total cholesterol, triglycerides, low-density cholesterol, high-density cholesterol, body mass index, presence of carotid plaques). Logistic regression analysis was used for the statistical evaluation.

RESULTS: No significant association was found between CAD and stroke recurrence. Of all of the other observed risk factors, only age showed a significant association with stroke recurrence (OR 1.04, 95% CI: 1.02-1.07).

CONCLUSION: The results of the presented study indicate that CAD does not influence stroke recurrence....

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Journal Article 2011; 32(6): 821-830 PubMed PMID: 22286800 Citation  Keywords:  Adult, Aged, Biomarkers, Tumor:metabolism, Breast Neoplasms:enzymology, Diagnosis, Differential, Female, Humans, Matrix Metalloproteinase 11:metabolism, Matrix Metalloproteinase 2:metabolism, Middle Aged, Prognosis, Recurrence, Survival Rate,.   

BACKGROUND: Breast cancer is the most common malignancy in women in the U.S. and Europe. In the early stages of the disease, women are treated surgically, which is supplemented with hormonal therapy, immuno-, chemo- or radiotherapy. Postoperative qualification for further treatment is based on clinical stage, the pathology of the tumor and classic prognostic factors. Despite that, among patients with breast cancer in early stages of clinical advancement, there is a relatively large proportion of observed tumor recurrence. These observations oblige the search for additional prognostic factors that determine the progression of the disease faster, according to which, could emerge a group of women at increased risk of recurrence of the disease.

AIM: The aim of this paper is to determine the meaning of the expression of selected metalloproteinases as prognostic factors in breast cancer.

METHODS: The study group consisted of 108 patients ages 26 to 86 years treated surgically from 1994 to 2000 because of primary breast cancer in the early clinical stage, ie stage I and II according to TNM classification.

RESULTS: Between two of the tested metalloproteinases (MMP-2 and MMP-11) only MMP-2 appears to have prognostic significance in early forms of breast cancer, and its strong expression is associated with shorter survival....

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Comparative Study 2011; 32(4): 530-539 PubMed PMID: 21876509 Citation  Keywords:  Adult, Aged, Antibodies:pharmacology, Biomarkers, Tumor:metabolism, Biopsy, Carcinoma in Situ:metabolism, Disease-Free Survival, Female, Humans, Lymphatic Vessels:immunology, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local:metabolism, Predi.   

OBJECTIVE: The aim of this study was to compare the immunohistochemical expression of vascular endothelial growth factors VEGF-C and D, as well as the expression of VEGFR-3 in VIN and vulvar invasive cancer and to compare the density of lymphatic marker D2-40 antibody in both groups, and to compare them with different clinicopathologic features.

MATERIALS & METHODS: The study was performed using tissue material and clinical data from 100 women diagnosed with VIN and 100 women diagnosed with invasive vulvar cancer.

RESULTS: No significant differences were found in the expression of VEGF-C and -D or VEGFR-3 between those patients with VIN and those with invasive vulvar cancers. Weak expression of VEGF-C was confirmed only in two cases of the analyzed series; in all cases, expression of VEGF-D and VEGFR-3 was observed. The strongest expression of VEGF-D and VEGFR-3 was observed in the group of invasive cancers. The highest density of lymphatic vessels per 2 mm was observed in VIN. In the cancer group, small lymphatic vessels with a narrow oval lumen were observed. Moreover, in two cases of vulvar cancer, the presence of intratumoral lymphatic vessels was observed.

CONCLUSIONS: These results suggest that lymphangiogenesis begins at the preinvasive stage of vulvar carcinogenesis and suggests the important role of VEGF-C, VEGF-D, VEGFR-3 and LV (D2-40) as prognostic factors in the process of carcinogenesis in the vulvar area....

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