Acta medica (Hradec Kralove). Supplementum最新文献

Macular hole is a disease of the central area of the retina - site of the sharppest vision. Signs of this can be metamorphopsia and different degree of loss of the central vision. More than 100 years didn't exist succesfull treatment but knowledges of that disease have been started since 19 century. The authors evaluate case of macular hole, the differencial diagnosis, up date cognitions and possibilities of the treatment.

The authors retrospectively evaluated group of patiens treated at the Department of neurosurgery in Hradec Králové from 10/1993 to 10/2004 with the diagnosis of brain abscess. During this period, we treated 23 patients, 15 males and 8 women with the median age 48 years. Patiens with the iatrogenic etiology and those with pyocefalus and subdural and epidural empyema were excluded from this group. We provided 45 surgical procedures with total mortality 17,4 %.

Prognostics in idiopathic scoliosis is aimed at finding rules for predicting the progression of the curve. The authors report certain prognostic methods as well as the result of the latest Japanese method applied to our own group of patients. The calculated prediction was true in 50 % of the cases. Therefore, the tested Yamauchi's prognostic system proves to be reliable only to a small extent.

In our set of 19 operated patients with spinal myeloma it was in 17 patients (89%) the first manifestation of malignant haematological disease. Indication for admission for surgery were in 18 patients (92%) graphical signs of spinal compression of osteolytic affliction of the vertebra of unclear aetiology, which in 17 (63%) of patients were demonstrated by neurological deficit. On the basis of graphical examinations the most frequent suspicion was on metastatic affliction of the spine at unknown primary focus and the basic diagnosis was determined after the operation at most of cases. In decision about the choice of radicalness of surgery intervention important data about the type of tumour in the spine were usually missing and it especially did not make possible to estimate the life expectation of the patient. When deciding about the radicalness of the surgery, we started from the degree of spinal compression and surgical character of pathological process in the spine. The aim of the operation is to decompress the spinal cord in tumour and to stabilize the afflicted part of the spine. Radical extirpation of tumour followed with stabilization and spine reconstruction we decided to carry out in 7 patients, i.e. 37%, all of them clinically improved and from this group only 2 patients (29%) died till now. We carried out only palliative surgery on the spine in next 12 patients, i.e. in 63%, only 6 patients improved neurologically, i.e. 50% and 10 patients, i.e. 83% died till now.

p53 is known as a tumor suppressor gene important for maintenance of genomic integrity. p53 is a short lived protein that is maintained at very low levels in cells. p53 is regulated by Mdm2 protein which participate in p53 rapid degradation. The activation and accumulation of p53 is a response to cellular stress such as DNA damage. Activated p53 is a sequence specific DNA-binding transcription factor and some target genes of its transcriptional activity are important for cell-cycle arrest or for inducing apoptosis. p53 is also used for cancer therapy by p53 gene therapy when p53 is applied into tumors or by reactivation of mutant p53.

It's very important to estimate the measure of uncertainty of data in the case of diagnosis of disease. We recommend two methods with help fuzzy interpretation of disease data.

Idiopatic bowel diseases parallels the female reproductive period, therefore it's been examined the influence of Crohn's disease and ulcerative colitis on pregnancy and of pregnancy on disease itself. There are many questions about the effects of the disease on fertility, course of pregnancy, influence of fetus and other factors related to puerperium. Many factors of the disease, pharmacological therapy and surgical interventions are associated with the disease. Psychological aspects are also included.

By the measurement of autonomous reactivity according to the variability of heart frequency we get a picture that describes the activity of autonomous nervous system and stuttering at bronchodilatal therapy.

William Osler (1849-1919) is generally regarded as one of the greatest and most respected physicians in the history of medicine. As an outstanding clinician and a professor of medicine at four universities in three countries he exerted a profound influence on medical education. His textbook "The Principles and Practice of Medicine" became the most popular treatise on medicine in the world. He emphasized the value of hard work. His compassion and concern for patients, students and colleagues reflected his personality. Osler's humanism, his philosophy and views did not lose their validity even today.

Idiopatic bowel disease, Crohn' s disease and ulcerative colitis, are grave illneses of gastrointestinal tract. Mechanisms that lead to the development of inflammatory bowel disease are not well understood, but genetic play an important role. The main arguments gathered are ethnic/racial difference in disease frequency, positive family history, increased concordance rate in monozygotic twins relative to dizygotic and genes associated with Crohn's disease and ulcerative colitis. The enviromental factors play also an important role.