Mastectomy without axillary dissection should be the standard treatment in patients with malignant form of cystosarcoma phyllodes. The role of postoperative radiotherapy and chemotherapy remains to ...be fully established. We evaluate treatment results in a group of patients with cystosarcoma phyllodes (CP) treated at our Institute.
In this report we analyze treatment outcome in 25 patients with malignant cystosarcoma phyllodes treated at Masaryk Memorial Cancer Institute between 1970 and 1995. Mean tumor size was 10 cm in diameter. All patients underwent surgery. Subsequently, 17 patients (68%) received radiotherapy on the breast or chest wall.
Median follow-up was 139.5 months. Local recurrence was observed in 16% of all patients and all patients with local recurrence died. Time to local relapse after surgery was 4-11 months. Distant metastases occurred in 5 patients. All patients with local recurrence had distant metastases. Dissemination occurred 3-19 months after local recurrence. Five-year survival of all patients was 80%.
A specific protocol for the treatment of cystosarcoma phyllodes is missing, probably due to rarity of the disease. The treatment of local recurrent disease remains unsuccessful in most CP patients. We recommend postoperative irradiation on the chest wall in patients with malignant form of CP, because adjuvant radiotherapy decreased the incidence of local relapse in our group of patients.
Intoxication by nerve agents could be prevented by using small acetylcholinesterase inhibitors (eg, pyridostigmine) for potentially exposed personnel. However, the serious side effects of currently ...used drugs led to research of novel potent molecules for prophylaxis of organophosphorus intoxication.
The molecular design, molecular docking, chemical synthesis, in vitro methods (enzyme inhibition, cytotoxicity, and nicotinic receptors modulation), and in vivo methods (acute toxicity and prophylactic effect) were used to study bispyridinium, bisquinolinium, bisisoquinolinium, and pyridinium-quinolinium/isoquinolinium molecules presented in this study.
The studied molecules showed non-competitive inhibitory ability towards human acetylcholinesterase in vitro that was further confirmed by molecular modelling studies. Several compounds were selected for further studies. First, their cytotoxicity, nicotinic receptors modulation, and acute toxicity (lethal dose for 50% of laboratory animals LD
; mice and rats) were tested to evaluate their safety with promising results. Furthermore, their blood levels were measured to select the appropriate time for prophylactic administration. Finally, the protective ratio of selected compounds against soman-induced toxicity was determined when selected compounds were found similarly potent or only slightly better to standard pyridostigmine.
The presented small bisquaternary molecules did not show overall benefit in prophylaxis of soman-induced in vivo toxicity.
Cholinesterase inhibitors are, so far, the only successful strategy for the symptomatic treatment of Alzheimer’s disease. Tacrine (THA) is a potent acetylcholinesterase inhibitor that was used in the ...treatment of Alzheimer’s disease for a long time. However, the clinical use of THA was hampered by its low therapeutic index, short half-life and liver toxicity. 7-Methoxytacrine (7-MEOTA) is equally pharmacological active compound with lower toxicity compared to THA. In this Letter, the synthesis, biological activity and molecular modelling of elimination by-product isolated during synthesis of 7-MEOTA based bis-alkylene linked compound is described.
Carbapenemase-producing Enterobacteriaceae and Pseudomonas spp. are increasingly reported in many countries all over the world. Due to the resistance of those bacteria to almost all antibiotics ...(e.g.beta-lactams, aminoglycosides, fluoroquinolones),treatment options are seriously limited. In the Czech Republic, the incidence of carbapenemase-producing Enterobacteriaceae seems to be low, restricted to only three cases detected between 2009 and 2010.Here, we describe molecular typing of 15 carbapenemase-producing Klebsiella pneumoniae isolates identified in the Czech Republic during 2011. Five VIM-1-producing isolates belonging to sequence type (ST)11 and one VIM-4-producing isolate of ST1029 have been detected. blaVIM-1 and blaVIM-4 as a part of class 1 integrons were chromosomally located or carried by a plasmid belonging to A/C replicon type (blaVIM-4). KPC-3-producing isolates of ST512, recovered from six patients, caused an outbreak. Three more isolates producing KPC-2 enzyme belonged to ST258. Both blaKPCgenes were part of the Tn4401a transposon carried on plasmids of the pKpQIL type. The isolates were resistant to all antibiotics tested except colistin and/or gentamicin.Four of these 15 strains were recovered from patients repatriated to the Czech Republic from Greece and Italy. This is the first report of outbreaks caused by carbapenemase-producing Enterobacteriaceae in the Czech Republic.
A total of 2,683 nonrepetitive Escherichia coli isolates were collected from microbiological laboratories covering all regions of the Czech Republic, during April 2011. Antimicrobial susceptibility ...patterns of E. coli were assessed. All 38 cefotaxime-resistant (CTX-R) isolates were found to be extended-spectrum β-lactamase (ESBL)-positive by the double-disc synergy test. Thirty-two of those isolates produced enzymes of CTX-M-1 family, five of CTX-M-9 family, and one isolate both CTX-M types. Genotyping by multilocus sequence typing classified all ESBL-producing isolates into 13 sequence types (STs). ST131 was the most prevalent and was exclusively correlated with E. coli belonging to the more-virulent phylogroup B2. blaCTX-M-15 and blaCTX-M-9-like genes were mainly carried by plasmids belonging to the IncF group, while replicon I1 was predominant among CTX-M-1-encoding plasmids. Additionally, 63% of the ESBL-producing isolates were also resistant to ciprofloxacin. Sequence analysis of quinolone resistance-determining regions of gyrA and parC revealed the presence of amino acid substitutions in 22 out of 23 ciprofloxacin-resistant isolates. The acc(6')-Ib-cr and qnrB1 plasmid-mediated quinolone resistance genes were also detected in some of the isolates. This is the first report on the emergence and spread of CTX-M-producing E. coli in the community of the Czech Republic, indicating the high prevalence of ST131 clone among CTX-M producers.
A 69-y-old woman with bioprosthetic endocarditis due to Listeria monocytogenes developed an allergic reaction after beginning ampicillin treatment. She was cured with the combination of ...trimethoprim-sulfamethoxazole, rifampicin and teicoplanin. No immune deficiency was found in the patient.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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