Košice, Slovakia
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Nagy V.,Safarikiensis University | Bober J.,Safarikiensis University | Zavacky P.,Safarikiensis University | Brandebur O.,Safarikiensis University | Svajdler M.,steur University Hospital
Bratislava Medical Journal | Year: 2013

Aim: Describe a patient with multiple recurrences of the primary recurrent liposarcoma. Clinical case: A 60-years-old man complained of weight loss (BMI 18.4) with a palpable huge retroperitoneal tumour, which displaced left kidney, and was confirmed on USG and CT. Laboratory examination showed anaemia and pathological blood tests. Chest X-ray initially showed a negative finding. A complete transperitonealy surgical extirpation of the tumour with left side nephrectomy was performed on June 28, 2007. The tumour mass weight was 1900 g. It was lying on the posterior face of the kidney in diameters 170x120x120 mm, completely capsulated by thin grey-pink capsula with peripheral fat tissue on the section grey-pink, lobulary shaped, in 3/4 parts with central necrotic changes. Histopathologically was confirmed the primary dedifferentiated (non-lipogenous) liposarcoma low grade of malignancy. Nephrectomy specimen was confirmed as age related finding. There was no evidence of positives surgical margins. Despite oncological and surgical treatment, followed repeated recurrence with eight transperitoneal surgeries in the retroperitoneum and abdomen with extirpation of the metastases, left side hemicolectomy, splenectomy and repeated extirpation tumour metastases from abdomen and radix mesenterii. Last tumour weighed 2900 grams. Patient died on January 9, 2011, after the eight surgeries on multiorgans failure due to hemorrhagic shock and persistent atrial fibrilaton by cardiopulmonary insufficiency. As a speciality, he was treated without transfusion because as Jehovah́s witness he refused blood derivates. Conclusion: Despite complex surgical and oncological treatment, the prognosis in patient with recurrent liposarcoma was fatal.


Nagy V.,Safarikiensis University | Baca M.,L Pasteur Teaching Hospital | Boor A.,L Pasteur Teaching Hospital
Bratislava Medical Journal | Year: 2013

The aim of this study was to analyze the results of surgical and conservative treatment of non-refl uxing POM. In the period 2000-2009, 45 children (52 ureters) were treated, the average age was 5.8 months (±10.33), 24 children (26 ureters) by surgery (I) and 21 children (26 ureters) by conservative means (II). The average follow-up period was 73.8 (±32.91) and 30.85 months (±23.1) resp. Urine examination, USG, DTPA99mTc, biochemical testing, micturating cystouretography in all patients were performed. Significant difference was present in the occurrence of hydronephrosis of 0th, 3rd and 4th grade, p<0.01, or p=0.17; next in the occurrence of normal ureter, 0-5 mm and dilated ureter >10 mm, p<0.01; and in the occurrence of normal and prolonged time T 1/2, p<0. The health condition was adjusted in 13 (54.20 %), improved on DTPA99mTc in 5 (20.85 %), non-improved in 3 (12.50 %), deteriorated in 1 (4.15 %) and unknown in 2 (8.3 %) patients. In the IInd group a significant difference was in case of occurrence of hydronephrosis of 0th, 2nd and 3rd grade, (p<0.01, or p=0.037 and p=0.011) and in occurrence of normal ureter, with ureter 0-5 mm and dilated ureter 5-10 mm, p<0. The condition at the end of the follow-up period was assessed DTPA99mTc as adjusted in 11 (52.39 %) patients, improved in 6 (28.57 %), unimproved in 3 (14.28 %) and no patient was assessed as having deteriorated and unknown in 1 (4.76 %). Conclusion: In patients with an impaired separate kidney function, early surgical treatment helps to minimize damage to the kidney function and prevents future complications.


Tajtakova M.,Safarikiensis University | Pidanicova A.,Safarikiensis University | Valansky L.,Safarikiensis University | Lachvac,Safarikiensis University | And 5 more authors.
Neoplasma | Year: 2010

The aim of the paper is to determine whether IGF1, IGFBP3 and IGF1/IGFBP3 molar ratio in addition to PSA and onenucleotide polymorphism in PSA and CYP17 gene might contribute to early diagnostics of prostate cancer (PCa). Serum level of PSA, IGF1 and IGFBP3 in the group of 158 individuals (92 PCa and 66 controls) was examined by RIA method and IGF1/IGFBP3 was calculated. PCR RLFP method was used to examine one- nucleotide polymorphism in PSA and CYP 17 gene. The results suggest that serum level of IGF1 over 95% CI did not increase relative risk of PCa development in overall group, not even regarding to particular investigated genotypes, not even if individuals with genotype AG+A1A1, AG+A1A2, GG+A1A1 and GG+A1A2 were evaluated. Serum level of IGFBP3 under 95% CI increased PCa relative risk in overall group(χ2 = 10,03, p= 0,001, OR 3,12, 95% CI 1,44-6,93), as well as regarding to one-nucleotide polymorphism in individuals with PSA genotype AG(χ2 = 4,72 p= 0,029, OR 2,87, 95% CI 01,09-7,49) and CYP 17 genotype A1A1(χ2 = 3,76 p= 0,052, OR 2,57, 95% CI 0,97-6,75). The association between frequencies of occurrence of PCa and higher IGF1/IGFBP3 molar ratio was not confirmed, nor for gene polymorphism in PSA and CYP17, however OR (χ2 = 1,58, p= 0,208, OR 1,67, 95% CI 0,75-3,71) was more than 1, nor in combination AG+A1A1,AG+ A1A2. Serum level of IGFBP3 and IGF1/IGFBP3 molar ratio in addition to PSA and gene polymorphism in PSA and CYP17 gene might contribute to early diagnostics of PCa. Further research is needed to prove, whether serum level of IGFBP3 in addition to PSA determines the prognosis and progression of PCa.


Nagy V.,Safarikiensis University | Kilar I.,Safarikiensis University
Bratislava Medical Journal | Year: 2013

We report a case of a complete scrotal bladder hernia with both ureters presenting as dysuria, bilateral ureterohydronephrosis, and acute renal insufficiency. A 37-year-old man with a recurrent large scrotal mass after two surgeries, suffering with small urinary symptoms as a dysuria and nocturia, was examined before the third surgery on an outpatient basis. Urological examination revealed a negative urine, bilateral large ureterohydronephrosis on USG, and serum creatinine 231-250 μmol/l. CT displayed the urinary bladder completely herniated into the scrotum with distal parts of both ureters and small intestine, and bilateral large ureterohydronephrosis. After admission to urological department on retrograde cystography a completely herniation of the urinary bladder with residual urine more than 250 ml was confirmed. A permanent catheter was indwelled. The hernia was explored with urinary bladder repositioning. Because bilateral ureteral obstruction on USG did not retreat, a bilateral percutaneous nephrostomy was done. The patient́s serum creatinine markedly improved, also hernia and ureterohydronephrosis was repaired with normally moisten without residual urine.


Bacova I.,Safarikiensis University | Svorc Jr. P.,Safarikiensis University | Bracokova I.,Safarikiensis University
Bratislavské lekárske listy | Year: 2010

The aim of the study was to evaluate the effect of ventilatory manoeuvres on some ECG parameters as a function of the light-dark (LD) cycle in in vivo conditions. The PQ and QT intervals were measured in ketamine/xylazine-anaesthetized female Wistar rats (100 mg/15 mg/kg, i.m.) after adaptation to an LD cycle (12:12 h). The animals were exposed to a 2 min apneic episode and subsequent 20 min period of reoxygenation. Significant LD differences were found in the duration of the PQ interval (p < 0.001) after 30 and 60 sec., and in the QT interval after 90 (p < 0.01) and 120 sec. (p < 0.001), apneic episode. Reoxygenation restored the PQ and QT intervals with the preservation of LD differences from the pre-asphyxic period. It is concluded that although long-term asphyxia probably minimized LD differences in the duration of the PQ interval, the dispersion of refractory periods increases by the manner depending on LD cycle. Reoxygenation did not act proarrhythmogenicly and the followed parameters were recovered to the pre-asphyxic level (Fig. 5, Ref. 43).


Tajtakova M.,Safarikiensis University | Petrasova D.,Safarikiensis University | Pidanicova A.,Safarikiensis University | Gallovicova A.,Safarikiensis University | And 2 more authors.
Bratislava Medical Journal | Year: 2010

Aim: To determine the relationship between some adipokines and insulin resistance (IR) in obese. Materials and methods: 47 individuals were divided - 1. according to BMI to subgroups with normal weight, overweight and obesity, 2. according to IR HOMA index to subjects with IR (IR HOMA >1.88) and subjects without IR. Except the basic biochemical parameters, serum level of fasting insulin, leptin, retinol binding protein 4 (RBP4) (RIA), adiponectin (ELISA) and leptin/adiponectin (L/A) molar ratio were examined. Results: 1. In correlation to BMI - subjects with BMI > 30 showed significantly higher level of insulin (16.1 ±4.1/5.9±4.1), leptin (51.9±26.4/14.7±14) and molar ratio L/A (3.1±1.8/0.48±0.2) (p<0.01) and significantly lower level of adiponectin (18.9±6.3/35.5±10.5) (p<0.01) in comparison to both other subgroups (normal weight, overweight). There was no statistically significant difference in RBP4 level between all subgroups, although the highest level of RBP4 was observed in subjects with BMI >30. In correlation to IR - subjects with IR showed significantly higher BMI (35.7±5.8/24.8±2.6), insulin (15.5±7.1/4.8±1.6), leptin (47.2±29.2/15.1±13), L/A molar ratio (2.7±0.3/0.5±0.1) (p<0.01), and RBP4 (561.6±152.5/450.9±101.7 (p<0.05) as well. In IR subjects, serum level of adiponectin was significantly lower in comparison to subjects without IR (19.8±6.3/32.2±0.8) (p<0.01). Conclusion: Decreased level of adiponectin and increased level of leptin, RBP4 and leptin/adiponectin molar ratio in obese can be also considered as a marker of developing insulin resistance.


Hijova E.,Safarikiensis University | Chmelarova A.,Safarikiensis University | Bomba A.,Safarikiensis University
Bratislava Medical Journal | Year: 2011

Objectives: This experimental work was designed to investigate the efficacy of prebiotic by itself and in combination with Hyppocastani extractum siccum, and Lini oleum virginale on selected parameters in rats with dimethylhydrazine induced colon cancer. Methods: Rats were randomly divided into 5 experimental groups of 12 rats each. Rats were fed with high fat (HF) diet containing 10 % of fat, supplemented by prebiotic at a dose of 2 % of HF diet itself and in combination with Hyppocastani extractum siccum at a dose of 1 % of diet and Lini oleum virginale at a dose of 2 % of diet. Two weeks after the start of the diet dimethylhydrazine injections in dose 20 mg/kg b.w. were applied (DMH, Merck, DE), two times at week interval. The activity of ß-glucuronidase, concentration of lipid parameters, bile acids and short chain fatty acids were determined. Results: Prebiotic and its combinations with selected substances significantly decreased the activity of bacterial enzyme ß-glucuronidase (p<0.001). Bile acids concentration was significantly decreased (p<0.01) excepting combination of prebiotic with Horse chestnut. Self applied prebiotic decreased (p<0.001) lipids parameters (total cholesterol and triacylglycerols), and enhanced short chain fatty acids production. Conclusion: Prebiotics have protective effect and may be the useful candidate agents for colon cancer prevention and treatment. The application of selected bioactive food components supported the effect of prebiotics.


Zain-El Abdin M.H.,Safarikiensis University | Snincak M.,Safarikiensis University | Pahuli K.,Safarikiensis University | Solarova Z.,Safarikiensis University | Hrabcakova P.,Safarikiensis University
Bratislava Medical Journal | Year: 2013

Objective: Morning hypertension is currently the blind spot in the clinical practice of hypertension, home 24-hour blood pressure measurement has been recommended in patients with a high clinic blood pressure and patients with target organ damage. Aim: To assess whether an increased early morning blood pressure surge, established via a single 24-hour blood pressure monitoring, in treated elderly hypertensive's is related to more prominent target organ damage. Material and methods: 310 treated hypertensive patients randomly attended the out-patient clinic of our hypertension centre. The patients were divided in 2 groups: systolic/diastolic blood pressure hypertension (n = 266) and isolated systolic hypertension (n = 44 76 ±10 yrs). Results: Equivalent in both males and females, despite the rise in nondippers with an early morning surge (higher in females). Hyperlipidemia arises equally in dippers and nondippers, 45 % of nondippers had diabetes mellitus; 30 % suffered previous renal insuffi ciency and about 29 % of patients suffered from an endocrine disorder, mostly thyroid. Metabolic syndrome was only found to be associated with a nondipping pattern (3 %). Left ventricular hypertrophy was present in 100 % of patients, heart failure in 60 % nondippers and 56 % dippers, potential renal insuffi ciency in 34 % nondippers and 22 % dippers, retinopathy in 31 % non dippers and 11 % dippers, aortic aneurysm was only in nondippers. Conclusion: Early morning surge is a predictor of hypertensive target organ damage, being a dipper or nondipper patient with isolated systolic hypertension, might not make a difference depending on one's own degree of target organ damage and diurnal variation.


Hijova E.,Safarikiensis University | Szabadosova V.,University of Prešov | Strojny L.,Safarikiensis University | Bomba A.,Safarikiensis University
Bratislava Medical Journal | Year: 2014

Background: Natural dietary compounds such as prebiotics modulate microbial composition and could prevent the colon cancer development as potential chemopreventive agent. Objectives: Effect of prebiotic-inulin on biochemical, microbial and chemopreventive markers were examined in Sprague-Dawley rats during experimental chemically dimethylhydrazine induced colon cancer development. Methods: Rats were divided to 3 groups: control group (CG), group with dimethylhydrazine (DMH) and group with DMH and prebiotic (DMH+PRE). The effi cacy of the prebiotic inulin (PRE) on the activities of β-glucuronidase, short chain fatty acids (SCFAs), counts of coliforms and lactobacilli, immunoreactivity of cyclooxygenase-2 (COX-2), transcription nuclear factor kappa beta (NFκB) and inducible nitric oxide synthase (iNOS) in colon tissue were examined. Results: Inulin signifi cantly decreased coliforms counts (p<0.01), increased lactobacilli counts (p<0.001), and decreased activity of β-glucuronidase (p<0.01) in fresh caecal digesta. Butyric and propionic acids concentrations were increased after inulin supplementation in comparison to DMH group. Application of inulin decreased immunoreactivity and numbers of COX-2, NFκB and iNOS positive cells in colon tissue in comparison to DMH group. Conclusion: Inulin suppressed expression observed markers, which play an important role in carcinogenesis and in the infl ammatory process, which predisposes to the use of inulin in the prevention or treatment of infl ammatory bowel disease.


Hijova E.,Safarikiensis University | Soltesova A.,Safarikiensis University
Bratislava Medical Journal | Year: 2013

Objectives: Infl ammatory bowel diseases (IBD) are caused by the failure of immunoregulatory mechanisms due to external environmental factors in genetically predisposed individuals. Probiotics and prebiotics could be used in prevention and therapy of many disorders of gastrointestinal tract including ulcerative colitis. Probiotics are living microorganisms with good tolerability and minimal risk, which confer a health benefi t for the host when administered in adequate amounts. Their effect is closely related to maintaining the natural function of the intestinal fl ora. In this respect, they are indispensable prebiotics to protect or reduce the incidence of infl ammatory lesions in diseases of the digestive tract. Conclusion: Ingestion of probiotics and prebiotics may provide some clues in developing a new class of therapeutic agents for the treatment/prevention of IBD and colitis-associated cancer (CAC) in the future (Tab. 2, Ref. 26). Full Text in PDF www.elis.sk.

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