Dimitar Hadzi Nikolov - Academia.edu (original) (raw)
Papers by Dimitar Hadzi Nikolov
Folia Medica
We present two case reports of cardiac echinococcosis. Case 1 was a 33-year-old woman with hepati... more We present two case reports of cardiac echinococcosis. Case 1 was a 33-year-old woman with hepatic and cardiac echinococcosis. The parasitic cyst was located intramyocardially in the free wall of the left ventricle leading to cranial dislocation of the left circumflex coronary artery (LCx). The patient was successfully operated. Case 2 was a 28-year-old woman with hepatic and cardiac echinococcosis. The parasitic cyst was located in the left ventricular myocardium in the area of the apex and manifested clinically as paroxysms of ventricular tachycardia. The ultrasound study showed a 3.2×2.8 cm cyst dislocating the papillary muscles and causing moderate mitral regurgitation. Bulgaria ranks first in the European Union in terms of the number of echinococcosis patients. Although cardiac involvement is uncommon, occurring in only 0.5%–2% of cases, it can cause a wide range of clinical symptoms. Multimodal imaging is a key step in the management of patients with cardiac involvement.
Acta Medica (Hradec Kralove, Czech Republic), 2014
Low-grade myofibroblastic sarcoma (LGMS) is a very rare, atypical myofibroblastic tumor with fibr... more Low-grade myofibroblastic sarcoma (LGMS) is a very rare, atypical myofibroblastic tumor with fibromatosis-like features with predilection mostly in head and neck region. LGMS occurs primarily in adult patients with a slight male predominance. Only few cases of LGMS affecting the larynx have been reported in literature to this date. We describe a case of low-grade myofibroblastic sarcoma of the larynx in a 40-year-old male patient. The clinicopathological characteristics, immunohistochemical findings and treatment are discussed.
The authors present three cases of patients, who had urgent operations, suffering from small inte... more The authors present three cases of patients, who had urgent operations, suffering from small intesti- nal diverticula. The clinical significance, diagnostic and therapeutic management of acute complications, chronic symptomatology and incidental finding of small bowel diverticula are discussed.
Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2017
PURPOSE Primary cilium (PC) is considered to be a functional homologue of the immune synapse. Mic... more PURPOSE Primary cilium (PC) is considered to be a functional homologue of the immune synapse. Microtubule structures, PC of cancer associated fibroblasts and immune synapses between cytotoxic CD8+ tumor infiltrating lymphocytes (TILs) and cancer cells, are regularly found in varying amounts in the microenvironment of solid tumors. The purpose of this study was to find out the potential association and combined prognostic significance of the frequency of PC, PD-1 and CD8+ TILs in patients with intestinal cancer. METHODS The frequency of PC, programmed cell death protein-1 receptor (PD-1) expression and the frequency of stromal and intraepithelial CD8+TILs were evaluated in samples of colorectal adenocarcinoma (32 patiens) and small bowel cancer (8 patients). RESULTS The median frequency of PC was 0.25%. The expression of PD1 was <5% in 34 patients, 5-25% in 5 patients and 26-50% in 1 patient. The frequency of stromal CD8+ TILs was negative in 3 patients, <25% in 26, 26-50% in 1...
Journal des Maladies Vasculaires, 2009
Following surgical therapy, new varicose veins may develop, in particular at the site of the prev... more Following surgical therapy, new varicose veins may develop, in particular at the site of the previous saphenofemoral junction. The objective of this study is the appreciation of the causes of the bad results of surgical procedures in the treatment of varicose veins and the proposal of the possibilities of their prevention. Material and methods.-Retrospective study of the group of 173 patients (232 procedures) with the diagnosis of the recurrence
Polish Journal of Pathology, 2016
Dermatofibroma-like granular cell tumour (GCT) is a rare entity, with only two cases having been ... more Dermatofibroma-like granular cell tumour (GCT) is a rare entity, with only two cases having been described so far. We report another case in a 62-year-old woman, discuss histopathological features, and review other tumours in which granular changes have been observed. Our tumour was composed predominantly of oval-to-spindle granular cells with prominent nucleoli, arranged in short fascicles and storiform pattern, infiltrating around collagen bundles. Immunohistochemical analysis with antibodies against CD31, CD56, CD68, CD117, S-100 protein, inhibin, calretinin, EMA, p53 and MIB-1 was performed, showing expression of CD56, CD68, S-100 protein, inhibin and calretinin. The diagnosis of atypical dermatofibroma-like GCT was made.
Annals of Oncology, 2016
The primary cilium is a solitary, sensory, immotile microtubule-based structure that arises from ... more The primary cilium is a solitary, sensory, immotile microtubule-based structure that arises from the centrosome and is projected from the surface of most human cell types. It has been hypothesized that primary cilia could serve as a tumor suppressor organelle. The objective of this pilot study was to investigate the presence and frequency of primary cilia in cells of small bowel and colorectal adenocarcinoma and to evaluate the prognostic significance of their frequency. Methods: The presence of primary cilia in cells in samples of small bowel (8 patients) and colorectal adenocarcinoma (32 patiens) was evaluated. The primary cilia of cells were immunofluorescently labeled using primary monoclonal anti-acetylated α-tubulin antibody and cell nuclei were labeled using DAPI. Results: Primary cilia were identified in all examined specimens. The median frequency of primary cilia was 0.49% in cells of small bowel cancer and 0.22% in cells in colorectal cancer. Overall survival according to frequency of primary cilia in all intestinal adenocarcinomas was significantly longer in patients with higher frequency (≥ 0.187) than in patients with lower frequency of primary cilia (< 0.187) in univariate analysis (p=0.007) and also in the Cox proportional hazard model (p=0.032). Overall survival according to frequency of primary cilia in colorectal adenocarcinoma was significantly longer in patients with higher frequency (≥ 0.187) than in patients with lower frequency of primary cilia (< 0.187) (p=0.028). Conclusions: The present pilot study provides the first evidence of the prognostic significance of the frequency of primary cilia in small bowel and colorectal adenocarcinoma. Because of significantly higher median frequency of primary cilia in the rare small bowel adenocarcinoma than in the frequent colorectal adenocarcinoma (p<0.001), the results of this study support a potential role for primary cilia as a biomarker in these types of cancer.
Neoplasma, 2014
The primary cilium is a solitary, sensory, non-motile microtubule-based structure that arises fro... more The primary cilium is a solitary, sensory, non-motile microtubule-based structure that arises from the centrosome and is projected from the surface of most human cells. The objective of the current pilot study was to conduct an investigation of presence and frequency of cilia in gastrointestinal stromal tumors (GIST). The presence of primary cilia in GIST was evaluated in 9 patients, including 8 primary tumors and 1 liver metastasis. In 2 patients the presence of primary cilia was evaluated not only in the primary tumor, but also in recurrence: in 1 patient in recurrence without previous treatment with imatinib and in 1 patient in recurrence after treatment with imatinib. The primary cilia of GIST cells were immunofluorescently stained with primary monoclonal anti-acetylated tubulin alpha antibody and cell nuclei with DAPI. We observed 9985 nuclei of cells of GISTs and 425 primary cilia in total. The median of frequency of primary cilia in cells of GISTs in all examined samples was 4.26%, in primary tumors was 4.32% and in metastases was 3.64%, respectively. This pilot study provides the evidence of the presence of primary cilia in GISTs in different organs. Primary cilia were identified in all examined cases of GIST, including primary tumors, metastases and recurrent lesions without and with previous treatment with imatinib.
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Jan 21, 2015
A study was carried out to determine the relationship between mesorectal lymph nodal involvement ... more A study was carried out to determine the relationship between mesorectal lymph nodal involvement and T stage in a group of patients with a rectal cancer involving less than one quarter of the rectal circumference, such as might be selected for local excision. The data of patients having rectal resection between 2010 to 2014 were prospectively entered in a rectal carcinoma registry. A model for describing tumours involving less than one quadrant of the rectal circumference was created to facilitate the evaluation process. 304 patients were included in the study. In 68 (22.4%) a small tumour (< 1 quadrant involved) was found. Of these 26.5% had positive mesorectal lymph nodes (N+). In lesions of stage ypT0, cancer 12.5% patients were node positive, in stage Tis and T1 tumours there was no case of node positivity, but in stage T2 and stage T3 cancers the incidence of node positivity was 27.5% and 64%. The study demonstrated that even for small tumours involving only one rectal quadr...
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2013
The issue of achieving radical circumferential margin in laparoscopic rectal surgery has not yet ... more The issue of achieving radical circumferential margin in laparoscopic rectal surgery has not yet been satisfactorily clarified. In this paper we have focused on circumferential margin assessment and the quality of the mesorectal excision, comparing laparoscopic and open resection for cancer of the middle and lower rectum. The results of surgical procedures for middle and low rectal cancer were analysed. All the interventions were performed at the Department of Surgery, Teaching Hospital in Hradec Kralove, during the period from January 2011 to December 2012. The data were prospectively collected and entered in the Rectal Cancer Registry. Age, gender, BMI, tumour localisation and topography, the clinical stage, preoperative chemoradiotherapy and response to it, the type of surgery, distal and circumferential margin characteristics, mesorectal excision quality, pT and pN were compared for laparoscopic and open surgery. A total of 161 patients were operated on for rectal cancer during ...
Vnitr̆ní lékar̆ství, 2012
The primary cilium is a mechanosensory, solitary, non-motile microtubule-based structure that in ... more The primary cilium is a mechanosensory, solitary, non-motile microtubule-based structure that in the quiescent phase of the cell cycle projects from the surface of the majority of human cells, including embryonal, stem and mesenchymal cells, fibroblasts, myoblasts, cardiomyocytes, vascular smooth muscle and endothelial cells. Primary cilia are in increased frequency also present on the surface of endothelial cells in atherosclerotic predilection sites, lipoid streaks and dots and atheromatous plaques. The primary cilium is formed from the mother centriole. Primary cilia are currently studied in mechanobiology of cardiovascular apparatus and their role in cell migration, cell cycle control and atherogenesis. The aim of this paper is to provide a review of the current knowledge on the primary cilia of cells of cardiovascular apparatus.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2012
GISTs represent a specific group of mesenchymal tumors with unpredictable biological features. Ap... more GISTs represent a specific group of mesenchymal tumors with unpredictable biological features. Approximately 30% of newly diagnosed GIST tumors are malignant or have a high potential for malignancy. Currently, GISTs are routinely identified using histological, immunohistochemical, and molecular genetic assays. However, clinical diagnosis, particularly of small or intramural GISTs, might be difficult. Endoscopic examinations and fused PET/CT imaging are the most useful techniques for imaging and monitoring the disease progression. Surgical treatment is the first-line treatment and the only method that might lead to full remission in patients with primary GISTs. At the present time, there is no consensus on the issues whether to perform resections in patients with positive margins and resections of metastases. Biological therapy with imatinib mesylate is recommended in patients with newly diagnosed, locally advanced, inoperable, or metastasizing gastrointestinal GISTs that express the...
Acta gastro-enterologica Belgica
Gastrointestinal stromal tumors (GISTs) are the most common non-epithelial mesenchymal tumors of ... more Gastrointestinal stromal tumors (GISTs) are the most common non-epithelial mesenchymal tumors of the gastrointestinal tract. GISTs represent a specific group of mesenchymal tumors with uncertain biological behaviors. These tumors are assumed to originate from progenitor cells, usually unable to self-regenerate, which differentiate towards Cajal cells. Apart from common GISTs that occur predominantly in adulthood, a heterogeneous group of tumors has been described that are morphologically identical with GIST, but have a specific clinical presentation and biological properties. Approximately 30% of newly diagnosed GISTs are malignant or have a high potential for malignancy. Currently, GISTs are routinely identified with histological, immunohistochemical, and molecular genetic assays. However, clinical diagnoses, particularly of small or intramural GISTs, might be difficult. The most useful techniques for imaging and monitoring disease progression are endoscopic examinations and fused ...
European journal of gynaecological oncology, 2007
Abdominal liposarcoma is a rare tumor of uncertain prognosis. Radical surgery is possible in abou... more Abdominal liposarcoma is a rare tumor of uncertain prognosis. Radical surgery is possible in about two-thirds of the patients, and the prognosis of patients with inoperable tumors is dismal. Only a few cases of liposarcoma complicating pregnancy have been documented. We report a case of a patient who was diagnosed with metastatic abdominal liposarcoma during the third trimester of the pregnancy. After induced vaginal delivery, palliative surgery was performed and one cycle of systemic combination chemotherapy was administered. Despite the multimodality treatment the patient died of progressive disease within one month after diagnosis. Autopsy revealed high-grade pleomorphic liposarcoma arising from the retroperitoneum with liver and lung metastases.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2006
Localization of hemangioma in retroperineum causes late diagnosis of the disease. The tumour is u... more Localization of hemangioma in retroperineum causes late diagnosis of the disease. The tumour is usually detected only when the clinical symptoms caused by the pressure of the surrounding tissues occur. This article presents the case of retroperitoneal hemangioma preoperatively diagnosed as suspect feochromocytoma.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2005
Polyester and polypropylene are currently the most frequently materials for repair of abdominal w... more Polyester and polypropylene are currently the most frequently materials for repair of abdominal wall hernias. Most of the mesh materials used intraperitoneally in repair of hernias lead to considerable adhesion formation, as well as the resultant bowel obstruction and intestinal fistula formation. Some newer composite products can reduce risk of adhesion formation. The aim of this experimental study is testing properties of patch, composite structure, characterised by the association of a non-woven textile structure made from polyester multifilaments, and a fine coat of polyurethane on one side, placed intraperitoneally in rat. The experiment was carried out with 21 laboratory rats. Laboratory animals were divided into 3 groups - 7 animals in a group. In the first group the check-up laparotomy was realized the 7th day, in the second group the 14th day and in the third group the 28th day after the intraperitoneal implantation of a composite mesh. All animals were sacrificed and adhes...
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2004
Incidence rates of solid tumors increase with age in our population. Epithelial tumors are the mo... more Incidence rates of solid tumors increase with age in our population. Epithelial tumors are the most frequent tumors of the old age. On the contrary, extraperitoneal mesenchymal tumors are rare. Surgical treatment remains the most important and the most effective therapeutic modality to manage solid tumors. The risk level of the surgical treatment in the elderly is influenced by many factors, which may often be substancially reduced. Therefore, the elderly should not be excluded from curative surgical procedures on their calendary age basis.
Ceskoslovenská patologie, 1997
A 48-year-old woman with complaints referable to the biliary tract was treated by cholecystectomy... more A 48-year-old woman with complaints referable to the biliary tract was treated by cholecystectomy. Morphological examination revealed a focus of the heterotopic pancreatic tissue (7 x 4 x 3 mm) situated within the gallbladder body wall. Microscopically, all the normal structures were found, i.e., secretory acini, ducts and scattered endocrine cells.
Hepatobiliary & Pancreatic Diseases International, 2011
Gastrointestinal stromal tumors (GISTs) may arise in any part of the gastrointestinal tract; extr... more Gastrointestinal stromal tumors (GISTs) may arise in any part of the gastrointestinal tract; extra-gastrointestinal locations are extremely rare. Only a few cases of extragastrointestinal stromal tumor arising from the pancreas were reported. None of the reports described a long-term follow-up of the patients. This report describes an interesting and unusual case of GIST arising from the pancreas. A 74-year-old female presented with a palpable abdominal mass. CT scan showed a large mass 11 x 8 x 4 cm originating from the tail of the pancreas. Percutaneous biopsy revealed a GIST predominantly with spindle cells, but some parts also contained epitheloid cells. The patient was treated by distal pancreatic resection with splenectomy. Immunohistochemistry of the tumor showed a staining pattern characteristic of GIST. The patient has achieved a long-term survival of five years and six months without any sign of recurrence of the disease. This is the first reported case of an extra-gastrointestinal stromal tumor arising from the pancreas treated surgically, with a long-term survival.
Visceral Medicine, 2006
Summary Background: Intestinal metastases are rare, and only few cases of intestinal perforations... more Summary Background: Intestinal metastases are rare, and only few cases of intestinal perforations secondary to metastatic cancer have been reported. Case Report: We report here a case of a 25-year-old male with testicular pure chorio- carcinoma and synchronous bilateral multiple lung metastases. After failure of four lines of chemotherapy, in the context of rapidly progressive advanced metastatic disease, the metastases
Folia Medica
We present two case reports of cardiac echinococcosis. Case 1 was a 33-year-old woman with hepati... more We present two case reports of cardiac echinococcosis. Case 1 was a 33-year-old woman with hepatic and cardiac echinococcosis. The parasitic cyst was located intramyocardially in the free wall of the left ventricle leading to cranial dislocation of the left circumflex coronary artery (LCx). The patient was successfully operated. Case 2 was a 28-year-old woman with hepatic and cardiac echinococcosis. The parasitic cyst was located in the left ventricular myocardium in the area of the apex and manifested clinically as paroxysms of ventricular tachycardia. The ultrasound study showed a 3.2×2.8 cm cyst dislocating the papillary muscles and causing moderate mitral regurgitation. Bulgaria ranks first in the European Union in terms of the number of echinococcosis patients. Although cardiac involvement is uncommon, occurring in only 0.5%–2% of cases, it can cause a wide range of clinical symptoms. Multimodal imaging is a key step in the management of patients with cardiac involvement.
Acta Medica (Hradec Kralove, Czech Republic), 2014
Low-grade myofibroblastic sarcoma (LGMS) is a very rare, atypical myofibroblastic tumor with fibr... more Low-grade myofibroblastic sarcoma (LGMS) is a very rare, atypical myofibroblastic tumor with fibromatosis-like features with predilection mostly in head and neck region. LGMS occurs primarily in adult patients with a slight male predominance. Only few cases of LGMS affecting the larynx have been reported in literature to this date. We describe a case of low-grade myofibroblastic sarcoma of the larynx in a 40-year-old male patient. The clinicopathological characteristics, immunohistochemical findings and treatment are discussed.
The authors present three cases of patients, who had urgent operations, suffering from small inte... more The authors present three cases of patients, who had urgent operations, suffering from small intesti- nal diverticula. The clinical significance, diagnostic and therapeutic management of acute complications, chronic symptomatology and incidental finding of small bowel diverticula are discussed.
Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 2017
PURPOSE Primary cilium (PC) is considered to be a functional homologue of the immune synapse. Mic... more PURPOSE Primary cilium (PC) is considered to be a functional homologue of the immune synapse. Microtubule structures, PC of cancer associated fibroblasts and immune synapses between cytotoxic CD8+ tumor infiltrating lymphocytes (TILs) and cancer cells, are regularly found in varying amounts in the microenvironment of solid tumors. The purpose of this study was to find out the potential association and combined prognostic significance of the frequency of PC, PD-1 and CD8+ TILs in patients with intestinal cancer. METHODS The frequency of PC, programmed cell death protein-1 receptor (PD-1) expression and the frequency of stromal and intraepithelial CD8+TILs were evaluated in samples of colorectal adenocarcinoma (32 patiens) and small bowel cancer (8 patients). RESULTS The median frequency of PC was 0.25%. The expression of PD1 was <5% in 34 patients, 5-25% in 5 patients and 26-50% in 1 patient. The frequency of stromal CD8+ TILs was negative in 3 patients, <25% in 26, 26-50% in 1...
Journal des Maladies Vasculaires, 2009
Following surgical therapy, new varicose veins may develop, in particular at the site of the prev... more Following surgical therapy, new varicose veins may develop, in particular at the site of the previous saphenofemoral junction. The objective of this study is the appreciation of the causes of the bad results of surgical procedures in the treatment of varicose veins and the proposal of the possibilities of their prevention. Material and methods.-Retrospective study of the group of 173 patients (232 procedures) with the diagnosis of the recurrence
Polish Journal of Pathology, 2016
Dermatofibroma-like granular cell tumour (GCT) is a rare entity, with only two cases having been ... more Dermatofibroma-like granular cell tumour (GCT) is a rare entity, with only two cases having been described so far. We report another case in a 62-year-old woman, discuss histopathological features, and review other tumours in which granular changes have been observed. Our tumour was composed predominantly of oval-to-spindle granular cells with prominent nucleoli, arranged in short fascicles and storiform pattern, infiltrating around collagen bundles. Immunohistochemical analysis with antibodies against CD31, CD56, CD68, CD117, S-100 protein, inhibin, calretinin, EMA, p53 and MIB-1 was performed, showing expression of CD56, CD68, S-100 protein, inhibin and calretinin. The diagnosis of atypical dermatofibroma-like GCT was made.
Annals of Oncology, 2016
The primary cilium is a solitary, sensory, immotile microtubule-based structure that arises from ... more The primary cilium is a solitary, sensory, immotile microtubule-based structure that arises from the centrosome and is projected from the surface of most human cell types. It has been hypothesized that primary cilia could serve as a tumor suppressor organelle. The objective of this pilot study was to investigate the presence and frequency of primary cilia in cells of small bowel and colorectal adenocarcinoma and to evaluate the prognostic significance of their frequency. Methods: The presence of primary cilia in cells in samples of small bowel (8 patients) and colorectal adenocarcinoma (32 patiens) was evaluated. The primary cilia of cells were immunofluorescently labeled using primary monoclonal anti-acetylated α-tubulin antibody and cell nuclei were labeled using DAPI. Results: Primary cilia were identified in all examined specimens. The median frequency of primary cilia was 0.49% in cells of small bowel cancer and 0.22% in cells in colorectal cancer. Overall survival according to frequency of primary cilia in all intestinal adenocarcinomas was significantly longer in patients with higher frequency (≥ 0.187) than in patients with lower frequency of primary cilia (< 0.187) in univariate analysis (p=0.007) and also in the Cox proportional hazard model (p=0.032). Overall survival according to frequency of primary cilia in colorectal adenocarcinoma was significantly longer in patients with higher frequency (≥ 0.187) than in patients with lower frequency of primary cilia (< 0.187) (p=0.028). Conclusions: The present pilot study provides the first evidence of the prognostic significance of the frequency of primary cilia in small bowel and colorectal adenocarcinoma. Because of significantly higher median frequency of primary cilia in the rare small bowel adenocarcinoma than in the frequent colorectal adenocarcinoma (p<0.001), the results of this study support a potential role for primary cilia as a biomarker in these types of cancer.
Neoplasma, 2014
The primary cilium is a solitary, sensory, non-motile microtubule-based structure that arises fro... more The primary cilium is a solitary, sensory, non-motile microtubule-based structure that arises from the centrosome and is projected from the surface of most human cells. The objective of the current pilot study was to conduct an investigation of presence and frequency of cilia in gastrointestinal stromal tumors (GIST). The presence of primary cilia in GIST was evaluated in 9 patients, including 8 primary tumors and 1 liver metastasis. In 2 patients the presence of primary cilia was evaluated not only in the primary tumor, but also in recurrence: in 1 patient in recurrence without previous treatment with imatinib and in 1 patient in recurrence after treatment with imatinib. The primary cilia of GIST cells were immunofluorescently stained with primary monoclonal anti-acetylated tubulin alpha antibody and cell nuclei with DAPI. We observed 9985 nuclei of cells of GISTs and 425 primary cilia in total. The median of frequency of primary cilia in cells of GISTs in all examined samples was 4.26%, in primary tumors was 4.32% and in metastases was 3.64%, respectively. This pilot study provides the evidence of the presence of primary cilia in GISTs in different organs. Primary cilia were identified in all examined cases of GIST, including primary tumors, metastases and recurrent lesions without and with previous treatment with imatinib.
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Jan 21, 2015
A study was carried out to determine the relationship between mesorectal lymph nodal involvement ... more A study was carried out to determine the relationship between mesorectal lymph nodal involvement and T stage in a group of patients with a rectal cancer involving less than one quarter of the rectal circumference, such as might be selected for local excision. The data of patients having rectal resection between 2010 to 2014 were prospectively entered in a rectal carcinoma registry. A model for describing tumours involving less than one quadrant of the rectal circumference was created to facilitate the evaluation process. 304 patients were included in the study. In 68 (22.4%) a small tumour (< 1 quadrant involved) was found. Of these 26.5% had positive mesorectal lymph nodes (N+). In lesions of stage ypT0, cancer 12.5% patients were node positive, in stage Tis and T1 tumours there was no case of node positivity, but in stage T2 and stage T3 cancers the incidence of node positivity was 27.5% and 64%. The study demonstrated that even for small tumours involving only one rectal quadr...
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2013
The issue of achieving radical circumferential margin in laparoscopic rectal surgery has not yet ... more The issue of achieving radical circumferential margin in laparoscopic rectal surgery has not yet been satisfactorily clarified. In this paper we have focused on circumferential margin assessment and the quality of the mesorectal excision, comparing laparoscopic and open resection for cancer of the middle and lower rectum. The results of surgical procedures for middle and low rectal cancer were analysed. All the interventions were performed at the Department of Surgery, Teaching Hospital in Hradec Kralove, during the period from January 2011 to December 2012. The data were prospectively collected and entered in the Rectal Cancer Registry. Age, gender, BMI, tumour localisation and topography, the clinical stage, preoperative chemoradiotherapy and response to it, the type of surgery, distal and circumferential margin characteristics, mesorectal excision quality, pT and pN were compared for laparoscopic and open surgery. A total of 161 patients were operated on for rectal cancer during ...
Vnitr̆ní lékar̆ství, 2012
The primary cilium is a mechanosensory, solitary, non-motile microtubule-based structure that in ... more The primary cilium is a mechanosensory, solitary, non-motile microtubule-based structure that in the quiescent phase of the cell cycle projects from the surface of the majority of human cells, including embryonal, stem and mesenchymal cells, fibroblasts, myoblasts, cardiomyocytes, vascular smooth muscle and endothelial cells. Primary cilia are in increased frequency also present on the surface of endothelial cells in atherosclerotic predilection sites, lipoid streaks and dots and atheromatous plaques. The primary cilium is formed from the mother centriole. Primary cilia are currently studied in mechanobiology of cardiovascular apparatus and their role in cell migration, cell cycle control and atherogenesis. The aim of this paper is to provide a review of the current knowledge on the primary cilia of cells of cardiovascular apparatus.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2012
GISTs represent a specific group of mesenchymal tumors with unpredictable biological features. Ap... more GISTs represent a specific group of mesenchymal tumors with unpredictable biological features. Approximately 30% of newly diagnosed GIST tumors are malignant or have a high potential for malignancy. Currently, GISTs are routinely identified using histological, immunohistochemical, and molecular genetic assays. However, clinical diagnosis, particularly of small or intramural GISTs, might be difficult. Endoscopic examinations and fused PET/CT imaging are the most useful techniques for imaging and monitoring the disease progression. Surgical treatment is the first-line treatment and the only method that might lead to full remission in patients with primary GISTs. At the present time, there is no consensus on the issues whether to perform resections in patients with positive margins and resections of metastases. Biological therapy with imatinib mesylate is recommended in patients with newly diagnosed, locally advanced, inoperable, or metastasizing gastrointestinal GISTs that express the...
Acta gastro-enterologica Belgica
Gastrointestinal stromal tumors (GISTs) are the most common non-epithelial mesenchymal tumors of ... more Gastrointestinal stromal tumors (GISTs) are the most common non-epithelial mesenchymal tumors of the gastrointestinal tract. GISTs represent a specific group of mesenchymal tumors with uncertain biological behaviors. These tumors are assumed to originate from progenitor cells, usually unable to self-regenerate, which differentiate towards Cajal cells. Apart from common GISTs that occur predominantly in adulthood, a heterogeneous group of tumors has been described that are morphologically identical with GIST, but have a specific clinical presentation and biological properties. Approximately 30% of newly diagnosed GISTs are malignant or have a high potential for malignancy. Currently, GISTs are routinely identified with histological, immunohistochemical, and molecular genetic assays. However, clinical diagnoses, particularly of small or intramural GISTs, might be difficult. The most useful techniques for imaging and monitoring disease progression are endoscopic examinations and fused ...
European journal of gynaecological oncology, 2007
Abdominal liposarcoma is a rare tumor of uncertain prognosis. Radical surgery is possible in abou... more Abdominal liposarcoma is a rare tumor of uncertain prognosis. Radical surgery is possible in about two-thirds of the patients, and the prognosis of patients with inoperable tumors is dismal. Only a few cases of liposarcoma complicating pregnancy have been documented. We report a case of a patient who was diagnosed with metastatic abdominal liposarcoma during the third trimester of the pregnancy. After induced vaginal delivery, palliative surgery was performed and one cycle of systemic combination chemotherapy was administered. Despite the multimodality treatment the patient died of progressive disease within one month after diagnosis. Autopsy revealed high-grade pleomorphic liposarcoma arising from the retroperitoneum with liver and lung metastases.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2006
Localization of hemangioma in retroperineum causes late diagnosis of the disease. The tumour is u... more Localization of hemangioma in retroperineum causes late diagnosis of the disease. The tumour is usually detected only when the clinical symptoms caused by the pressure of the surrounding tissues occur. This article presents the case of retroperitoneal hemangioma preoperatively diagnosed as suspect feochromocytoma.
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2005
Polyester and polypropylene are currently the most frequently materials for repair of abdominal w... more Polyester and polypropylene are currently the most frequently materials for repair of abdominal wall hernias. Most of the mesh materials used intraperitoneally in repair of hernias lead to considerable adhesion formation, as well as the resultant bowel obstruction and intestinal fistula formation. Some newer composite products can reduce risk of adhesion formation. The aim of this experimental study is testing properties of patch, composite structure, characterised by the association of a non-woven textile structure made from polyester multifilaments, and a fine coat of polyurethane on one side, placed intraperitoneally in rat. The experiment was carried out with 21 laboratory rats. Laboratory animals were divided into 3 groups - 7 animals in a group. In the first group the check-up laparotomy was realized the 7th day, in the second group the 14th day and in the third group the 28th day after the intraperitoneal implantation of a composite mesh. All animals were sacrificed and adhes...
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2004
Incidence rates of solid tumors increase with age in our population. Epithelial tumors are the mo... more Incidence rates of solid tumors increase with age in our population. Epithelial tumors are the most frequent tumors of the old age. On the contrary, extraperitoneal mesenchymal tumors are rare. Surgical treatment remains the most important and the most effective therapeutic modality to manage solid tumors. The risk level of the surgical treatment in the elderly is influenced by many factors, which may often be substancially reduced. Therefore, the elderly should not be excluded from curative surgical procedures on their calendary age basis.
Ceskoslovenská patologie, 1997
A 48-year-old woman with complaints referable to the biliary tract was treated by cholecystectomy... more A 48-year-old woman with complaints referable to the biliary tract was treated by cholecystectomy. Morphological examination revealed a focus of the heterotopic pancreatic tissue (7 x 4 x 3 mm) situated within the gallbladder body wall. Microscopically, all the normal structures were found, i.e., secretory acini, ducts and scattered endocrine cells.
Hepatobiliary & Pancreatic Diseases International, 2011
Gastrointestinal stromal tumors (GISTs) may arise in any part of the gastrointestinal tract; extr... more Gastrointestinal stromal tumors (GISTs) may arise in any part of the gastrointestinal tract; extra-gastrointestinal locations are extremely rare. Only a few cases of extragastrointestinal stromal tumor arising from the pancreas were reported. None of the reports described a long-term follow-up of the patients. This report describes an interesting and unusual case of GIST arising from the pancreas. A 74-year-old female presented with a palpable abdominal mass. CT scan showed a large mass 11 x 8 x 4 cm originating from the tail of the pancreas. Percutaneous biopsy revealed a GIST predominantly with spindle cells, but some parts also contained epitheloid cells. The patient was treated by distal pancreatic resection with splenectomy. Immunohistochemistry of the tumor showed a staining pattern characteristic of GIST. The patient has achieved a long-term survival of five years and six months without any sign of recurrence of the disease. This is the first reported case of an extra-gastrointestinal stromal tumor arising from the pancreas treated surgically, with a long-term survival.
Visceral Medicine, 2006
Summary Background: Intestinal metastases are rare, and only few cases of intestinal perforations... more Summary Background: Intestinal metastases are rare, and only few cases of intestinal perforations secondary to metastatic cancer have been reported. Case Report: We report here a case of a 25-year-old male with testicular pure chorio- carcinoma and synchronous bilateral multiple lung metastases. After failure of four lines of chemotherapy, in the context of rapidly progressive advanced metastatic disease, the metastases