Necrotic fasciitis of the lateral muscle group of the thigh following outside-in transobturatory tape procedure.

OBJECTIVE: Sling procedures are the preferred surgical treatment of stress urinary incontinence (SUI) due to their high success rate and low risk of complications. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Medical Faculty of Charles University and Faculty Hospital Hradec Kralove. CASE REPORT: Necrotic fasciitis is a rare infectious complication, the mortality of which varies by age and can reach 73% if untreated. We present a case of a rare yet serious complication, necrotic fasciitis (NF), of a lateral muscle group of the thigh following antiincontinence implantation. Polypropylene transobturatory midurethral outside-in tape (TOT) was inserted, and NF occurred shortly after surgery. CONCLUSION: Effective treatment was based on a timely diagnosis, administration of wide-spectrum antibiotics, intensive care unit support, surgical treatment, and multidisciplinary cooperation. Timely initiation and adequate treatment are critical in preventing mortality.

[Solitary fibrous tumor of endometrium--a case report]. / Solitární fibrózní tumor endometria - kazuistika.

OBJECTIVE: Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor. We present a case of SFT occurring in endometrium. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, The Fingerland Department of Pathology, Medical Faculty of Charles University and Faculty Hospital Hradec Králové. CASE REPORT: We report a case of 57 years old woman with SFT arising from the endometrium, which was diagnosed and treated at our department. Histological finding was supported by typical immunohistochemical profile of the tumor. Aggressive nature of the tumor wasnt showed. The patient underwent abdominal hysterectomy with bilateral adnexectomy and is followed up in regular periods. CONCLUSION: Occurence of solitary fibrous tumor (SFT) in the female genital tract is extremely rare. To the best of our knowledge, we report the first case of SFT occurring in endometrium. Because of potencial aggressive behaviour of the tumor complete surgical excision and close follow-up is highly recommended.

Reappraisal of the quantity and nature of renal calcifications and mineral metabolism in the magnesium-deficient rat. Effects of treatment with potassium citrate or the combination magnesium citrate and potassium citrate.

There is an urgent need for drugs capable of inhibiting renal calcifications, nephrocalcinosis and stones included, in humans. Current anticalcification medication is based mainly on alkalinization of the metabolism using potassium-containing citrate alone, despite the fact that calcium stone patients suffer marginally from both magnesium and potassium deficiency. We investigated the anticalcification efficacy of oral potassium citrate versus the combined administration of this drug and magnesium citrate in the magnesium-deficient rat developing corticomedullary nephrocalcinosis and luminal microliths in the long term. Among other things we employed specific stains for calcium and oxalate, light microscopy and element analysis for renal tissue and calcifications, respectively. In addition, minerals in renal tissue, urine and plasma were determined, as well as the state of extracellular calcium homeostasis. Magnesium deficiency caused pure calcium phosphate tissue deposits, containing no magnesium, but no deposition of calcium oxalate in the tubular lumen; tissue magnesium, calcium and phosphorus were increased, and there was marked potassium wastage via urine; despite mild hypercalcemia other signs of hyperparathyroidism were not found. Alkalinization with the two kinds of medication evoked an increase in urinary pH, citrate, and potassium; however, potassium citrate alone tended to aggravate renal concretions, whereas the combination of this drug with magnesium citrate completely prevented concretions. It was concluded that: (1) magnesium deficiency-induced calcifications are oxalate-free and are not sensitive to mobilization by alkalinization with potassium citrate, which might explain the failure of the drug to prevent stone recurrence in clinical stone patients, and (2) the combination of potassium citrate and magnesium citrate, which shows enormous anticalcification efficacy, deserves high priority in clinical trials aimed at evaluating strategies for the prevention of stones.

A comparative histopathological study of the influence of chemo- and radiotherapy on human prostatic carcinoma grown in nude mice.

Histological investigations were carried out to determine the effects of various kinds of treatment on the heterotransplanted prostatic carcinoma PC EW in athymic nude mice. Morphological changes after chemotherapy, radiotherapy, and combined radiochemotherapy were analyzed qualitatively and quantitatively. Effects of chemo- and radiotherapy like reduction of mitotic activity and increase of necrotic resp. fibrotic areas cumulated under the combined therapy. Results after radiotherapy or combined therapy corresponded to those reported for human prostatic carcinoma. Our observations indicate that the heterotransplanted tumor line PC EW represents a well suited preclinical test system for treatment of human prostatic carcinoma.

[Urogynecologic findings in patients following abdominal radical operation for cervix cancer]. / Urogynäkologische Befunde bei Patientinnen nach abdominaler Radikaloperation wegen Zervixkarzinom.

Two collectives of patients of the I. Gynecological-obstetrical clinic Praha/CSSR suffering from cervical cancer are examined after abdominal radical hysterectomy Wertheim-Meigs. Group 1 contained 125 women treated in the years 1957 to 1966, group 2 included 89 women undergoing the operation in the years 1981 to 1986. In group 2 we found a lower rate of perioperative injuries and early and late disturbances of the urinary tract following radical hysterectomy. This may be a result of more careful preparation of the ureter and intensive postoperative care. We examined 56 women of group 2 by urodynamics. There are statistical significant changes of the maximum urethral pressure and bladder compliance after the operation. This values returned to normal limits with increasing distance between operation and follow-up.

[Hemangioma of the kidney--diagnostic and therapeutic problems]. / Das Hämangiom der Niere--diagnostische und therapeutische Probleme.

Hemangioma of the kidney as one of the possible causes of "essential hematuria" is discussed with special regard to its diagnostic features in the various modern radiological examinations. Still most important is angiography. Typical findings are demonstrated in a case with complete replacement of the parapelvic fat by a large cavernous hemangioma. The various therapeutic possibilities--conservative treatment, embolisation, partial or complete nephrectomy - are discussed.

[Primary vaginal carcinoma - analysis of 100 cases (author's transl)]. / Das primäre Karzinom der Vagina - Analyse von 100 Fällen.

The importance of prevention to vaginal carcinoma was underlined by results obtained from a retrospective analysis of oncological patients who had been hospitalised at the First Gynaecological Hospital of Prague, between 1946 and 1970. While five-year healing of 41 per cent compared well to reports published elsewhere, the authors feel that the prognosis of this rare tumour might be further improved by earlier detection and treatment.

Cytogenetic study of malignant and benign effusions.

The direct chromosome study of mitotic cells in effusions was performed in 49 patients with malignant and 5 with benign effusions. Cytogenetic analysis correctly identified 69.3% of malignant effusions, standard cytology 79.6%. With both methods combined 95.9% of all cases were correctly diagnosed as malignant. The presence of mitoses in the effusions was found to be an unfavorable prognostic sign and was correlated with a shorter survival. Chromosome analysis of the malignant effusions revealed stemlines with extensive numerical and structural rearrangements. No consistent marker chromosome was detected in the histologically similar tumor types. Normal chromosomes. No 1 and 14 were preferentially lost from the karyotype of malignant cells. In two samples double minutes were observed.