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Ostrava, Czech Republic

Kliment M.,Research Institute AGEL | Kliment M.,University of Ostrava | Urban O.,Research Institute AGEL | Urban O.,University of Ostrava | And 7 more authors.
Gastroenterologia y Hepatologia | Year: 2015

Groove pancreatitis (GP) is a special form of chronic pancreatitis characterised by the development of infl ammatory changes and fi brous tissue formation in the 'groove' between the pancreatic head, duodenum and common bile duct. Imaging stud ies show a mass in the groove close to minor papilla, a thickening, or cyst formations in the groove or the duodenal wall. Clinical symp toms include abdominal pain, weight loss or vomiting. The disease may imitate pancreatic head cancer, bile duct cancer or duodenal cancer, and its diff erentiation from pancreatic head carcinoma may be diffi cult. Conservative treatment alone or in combination with endoscopy is often successful. Surgery is indicated if conservative treatment fails or if carcinoma cannot be ruled out. Authors present their own experience with groove pancreatitis on a series of six patients dia gnosed and treated at a single tertiary referral gastroenterology centre over a period of six years.

Kliment M.,Hospital Vitkovice | Urban O.,Hospital Vitkovice | Urban O.,University of Ostrava | Cegan M.,CGB Laboratory | And 6 more authors.
Scandinavian Journal of Gastroenterology | Year: 2010

Objective. It is controversial whether endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is beneficial in all patients with suspected pancreatic cancer. The aim of this study was to assess diagnostic yield, safety and impact of EUS-FNA on management of patients with solid pancreatic mass. Material and methods. Consecutive patients undergoing EUS-FNA of solid pancreatic mass were enrolled. Gold standard for final diagnosis included histology from surgical resection. In patients without surgery, clinical evaluation methods and repeated imaging studies were used for the comparison of initial cytology and final diagnosis. Patients were followed-up prospectively focusing on subsequent treatment. Results. Among 207 enrolled patients, final diagnosis was malignant in 163 (78.6%) and benign in 44 (21.4%). The sensitivity, specificity and accuracy of EUS-FNA in diagnosing pancreatic cancer were 92.6% (95% CI: 87.2095.96), 88.6% (95% CI: 74.6495.64) and 91.8% (95% CI: 87.2494.81), respectively. No major and five (2.4%) minor complications occurred. Of 151 true-positive patients by EUS-FNA, 57 (37.7%) were surgically explored, of whom 28 (49.1%) underwent resection. Ten of 12 patients with false-negative cytology were explored based on detection of mass on EUS, of whom two had a delay due to false-negative cytology without curative treatment. From the whole study cohort, EUS-FNA had positive and negative impacts on subsequent management in 136 (65.7%) and 2 (0.9%) patients, respectively. Conclusions. EUS-FNA provides accurate diagnosis in 92% and has positive therapeutic impact in two-thirds of patients with solid pancreatic mass. Despite negative cytology, surgical exploration is recommended in clinical suspicion for pancreatic cancer and solid mass on EUS. © 2010 Informa Healthcare.

Uvirova M.,CGB Laboratory | Uvirova M.,University of Ostrava | Simova J.,CGB Laboratory | Simova J.,University of Ostrava | And 7 more authors.
Biomedical Papers | Year: 2015

Aims. A germline SNP (rs61764370) is located in a let-7 complementary site (LCS6) in the 3'UTR of KRAS oncogene, and it was found to alter the binding capability of the mature let-7 microRNA to the KRAS mRNA. The aim of the study was to evaluate the frequency of the KRAS-LCS6 variant allele in different cancer types that included patients with colorectal cancer (CRC), breast cancer (BC), non-small cell lung cancer (NSCLC) and brain tumour patient subgroups from the Czech Republic. The occurrence of this genetic variant was correlated with the presence of selected somatic mutations representing predictive biomarkers in the respective tumours. Methods. DNA of tumour tissues was isolated from 428 colorectal cancer samples, 311 non-small cell lung cancer samples, 195 breast cancer samples and 151 samples with brain tumour. Analysis of SNP (rs61764370) was performed by the PCR+RFLP method and direct sequencing. KRAS, BRAF and EGFR mutation status was assessed using real-time PCR. The status of the HER2 gene was assessed using the FISH method. Results. The KRAS-LCS6 TG genotype has been detected in 16.4% (32/195) of breast cancer cases (in HER2 positive breast cancer 3.3%, in HER2 negative breast cancer 20.1%), in 12.4% (53/428) of CRC cases (KRAS/BRAF wild type CRC in 10.6%, KRAS mutant CRC in 10.1%, BRAF V600E mutant CRC in 18.5%), in 13.2% (41/311) of NSCLC samples, (EGFR mutant NSCLC patients in 8%, EGFR wild type NSCLC in 12.9%), and 17.9% (27/151) of brain tumour cases. The KRAS-LCS6 TG genotype was not significantly different across the studied tumours. In our study, the GG genotype has not been found among the cancer samples. Conclusions. Based on the findings, it is concluded that the occurrence of the KRAS-LCS6 TG genotype was statistically significantly different in association with status of the HER2 gene in breast cancer. Furthermore, significant association between the mutation status of analysed somatic variants in genes of the EGFR signalling pathway (KRAS, BRAF, EGFR) and the KRAS-LCS6 genotype in colorectal cancer and NSCLC has not been established. © 2015 PALACKY UNIV. All rights reserved.

Urik M.,Masaryk University | Urik M.,University Hospital Brno | Hurnik P.,University of Ostrava | Hurnik P.,CGB Laboratory | And 10 more authors.
International Journal of Pediatric Otorhinolaryngology | Year: 2016

Aims: Histological and histochemical analysis of retraction pocket of pars tensa of tympanic membrane in children. Identification of morphological abnormalities in comparison with a healthy tympanic membrane as it is described in standard textbook. Identification of signs typical for cholesteatoma and support for a retraction theory of cholesteatoma formation. Study design: A prospective study analysing 31 samples of retraction pockets taken during surgery. Departments: University Hospital, Children's Medical Centre. Methods: Samples of retraction pockets were processed by a standard process for light microscopy, stained by haematoxylin-eosin. Van Gieson's stain was used for differential staining of collagen, Verhoeff's stain for elastic fibre tissues, Alcian blue for acidic polysaccharides and PAS (Periodic Acid Schiff) method for basement membrane polysaccharides. Results: The following findings were observed in the samples of retraction pockets: hyperkeratosis (100%), hypervascularisations (100%), subepithelial fragmented elastic fibres (96%), myxoid changes (87%), subepithelial inflammatory infiltration (84%), rete pegs (71%), papilomatosis (71%), intraepithelial inflammatory cellularizations, (48%), intraepithelial spongiosis (16%) and parakeratosis (3%). No basement membrane continuity interruptions were observed. Thickness of retraction pocket, thickness of epidermis, occurrence of rete pegs and frequency of fragmented elastic fibres was higher in a Grade III stage RP than Grade II stage RP (according to Charachon). Conclusion: Morphological abnormalities in the structure of retraction pockets in comparison with a healthy tympanic membrane were described. The changes are typical for a structure of cholesteatoma (these changes are common in matrix and perimatrix), supporting retraction theory of its origin. Our observations show that it is inflammation that probably plays a key role in the pathogenesis of retraction pocket. The frequency of some of the changes increases with the stage of retraction pocket (II-III according to Charachon). Basement membrane continuity interruptions are not typical for retraction pockets. © 2016 Elsevier Ireland Ltd.

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