Skin grafting on amputated lower limb, norepinephrine-induced ischemic limb necrosis - case report.

Ischemic limb necrosis due to high dose of norepinephrine (NE) in a patient with septic shock is uncommon. Unfortunately, amputation of necrotic parts is the only available treatment. Reconstruction with skin autografts for defects resulting from the amputation of the lower limbs is challenging. Herein we report a case of digit necrosis in the upper and lower limbs after administration of a high dose of NE > 1 µcg/kg/min in a patient with septic shock. The source of infection that led to septic shock was not detected. Surgical amputation was performed as it was impossible to repair impaired vasculature and patients' life was endangered. Large defects were covered with skin autografts from the patient's thighs. The included figures demonstrate the extremities' appearance before, after amputation, during and after skin graft transplantation.

Alveolar echinococcosis in a highly endemic area of Northern Slovakia between 2000 and 2013.

Long-term surveillance of Echinococcus multilocularis occurrence in red foxes in Slovakia revealed the existence of highly endemic areas, with an overall prevalence rate of 41.6 % in the northern part of the country. Between 2000 and 2013, 26 human cases of alveolar echinococcosis were detected and only three of them were not in endemic localities in northern Slovakia. Remarkable is the occurrence of the disease in eight people younger than 35 years, including three patients aged eight, 14 and 19 years. Occurrence of E. multilocularis in red foxes throughout the country and high incidence of alveolar echinococcosis in young people indicate high infectious pressure in the environment of northern Slovakia. It can be assumed that the real incidence of alveolar echinococcosis is significantly higher than recorded by official data due to the lack of existing registration and reporting system. For effective management of prevention and control strategies for this disease improvement of the national surveillance system and engagement of specialists outside the medical community are necessary. Our study presents a comprehensive picture of the epidemiological situation of E. multilocularis in northern Slovakia. In addition, we report the first list of confirmed human cases of this serious parasitosis in Slovakia.

Significance of lymph node micrometastasis in pancreatic cancer patients.

UNLABELLED: BACKGROUND /AIMS: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. METHODS: Between January 2006 and December 2010 at the First Department of Surgery in Kosice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical lymphadenectomy were subjected to immunohistochemical staining to detect occult micrometastasis. A comparison of the median survival rate in groups of patients with immunohistochemistry-positive and -negative lymph nodes was performed. RESULTS: Radical pancreatic resection with standard radical lymphadenectomy was performed on 64 pancreatic cancer patients. The median survival time was 15 months. Out of the 319 histopathologically negative lymph nodes (34 patients), 134 lymph nodes were classified as immunohistochemistry positive (21 patients). The median survival rate in the group of patients with immunohistochemistry-negative lymph nodes was 23 months, but in the group of patients with immunohistochemistry-positive lymph nodes it was 14 months. There was a statistically significant difference between these 2 groups of patients (p ≤ 0.01). CONCLUSION: The immunohistochemical examination of histopathologically negative lymph nodes can lead to positive lymph node detection. The presence of lymph node micrometastasis could predict the survival rate.

IT delivery of ChABC modulates NG2 and promotes GAP-43 axonal regrowth after spinal cord injury.

Chondroitin sulphate proteoglycans (CSPGs) with the major component NG2 have an inhibitory effect on regeneration of damaged axons after spinal cord injury. In this study, we investigate whether the digestion of CSPGs by chondroitinase ABC (ChABC) may decrease the NG2 expression and promote axon regrowth through the lesion site. Rats underwent spinal cord compression injury and were treated with ChABC or vehicle through an intrathecal catheter delivery at 2, 3, and 4 days after injury. In addition, animals were behaviorally scored using BBB test in weekly intervals after SCI. Based on immunocytochemical analyses, we have quantified distribution of NG2 glycoprotein and GAP-43 in spinal cord tissue in both experimental groups. Multiple injections of ChABC caused decrease of NG2 expression at lesion site at 5 and 7 days, but not at 14 and 28 days in comparison with vehicle-treated rats and significantly enhanced GAP-43 expression during the entire survival. The densitometry analysis showed significantly higher GAP-43 immunoreactivity (1.8-2.2-fold) in the regrowing axons and cell bodies within the central lesion cavity when compared with vehicle group. Longitudinally oriented and disorganized GAP-43-labeled axons were able to infiltrate and penetrate damaged tissue. The outgrowth of GAP-43 axons after CHABC delivery was significantly longer (≤0.457 mm) when compared with the length of axons in vehicle-treated rats (≤0.046 mm). Present findings suggest that degradation of NG2 with acute IT ChABC treatment may promote ongoing (long-lasting) axonal regenerative processes at late survival (14 and 28 days), but with no significant impact on the improvement of motor function.

[Impact of postoperative complications on survival of patients with pancreatic carcinoma]. / Vplyv pooperacných komplikácií na prezívanie pacientov s karcinómom pankreasu.

INTRODUCTION: In spite of radical pancreatic resection and adjuvant therapy, the overall 5-year survival rate for patients with pancreatic cancer remains poor, ranging between 5% and 15%, with a median survival of 13 to 17 months. MATERIAL AND METHODS: Between January 2000 and December 2009, the prospective study was performed to indentify the presence of postoperative complications and to find their influence on survival rate in pancreatic cancer patients. RESULTS: Between January 2000 and December 2009, the radical pancreatic resection was performed for 102 patients suffer from pancreatic cancer, at the I. Department of Surgery University Hospital in Kosice. Pancreatoduodenectomies were performed in Child-Stulhofer modification in 59 patients, Whipple modification was performed in 31 patients, Waugh-Clagett in 2 patients, Traverso-Longmire in 2 patients, distal resection of pancreas was performed in 7 patients and one patient had made total pancreatectomy. The overall morbidity rate was 30.2% (31 patients) and mortality rate was 3.9% (4 patients). Specific (for pancreatic resection) complications were indentified in 26 patients, 25.3%. Non-specific complications were presented in 5 patients, 4.9%. Two intraoperative risk factors were found to be significantly associated with pancreatic leakage, small pancreatic duct size and soft texture of the remnant pancreas. The 5-years survival rate for patients with pancreatic cancer was in 5 patients, 4.9%, with median survival rate 15 months. In group of patients with postoperative complications median survival rate was 13 months, in group of patients without postoperative complications median survival time was 18 months. CONCLUSION: Long-term survival rate for pancreatic cancer patients is still low. The presence of postoperative complications had negative influence to survival rate in pancreatic cancer patients. Pancreatic leakage is the most afraid complications. Patients with a small pancreatic duct size or a soft pancreatic remnant were at high risk of pancreatic leakage.

[New options for pancreatic cancer diagnostics]. / Nové moznosti diagnostiky karcinómu pankreasu.

INTRODUCTION: The overall 5-year survival rate for patients with pancreatic cancer remains poor, ranging between 5% and 15%, with a median survival of 13 to 17 months. Looking for the new possibilities can identify early-stage pancreatic cancer patients. MATERIAL AND METHODS: The comparative study was performed at the I. Department of Surgery University Hospital in Kosice, between group of pancreatic cancer patients, whose were operated during 1. 1. 1996-31. 12. 2000 group A and during 1. 1. 2005-31. 12. 2009 group B. The survival rate was compared in all groups of patients and in group of patients in stages of pancreatic cancer. From 2007, there were started a trial, in which lymph nodes were observed using histopathological and immunohistochemical examination. RESULTS: In group A (1. 1. 1996-31. 12. 2000) were presented 29 patients, 5 years survival was investigated in two patients (6.8%), median survival rate was 14 months. In group B (1. 1.2005-31. 12. 2009) were presented 51 patients, no patient survival 5 years, median survival rate was 14 months. Between January 2007 and December 2009 one hundred and eight pancreatic cancer patients were treated at the I. Department of Surgery University Hospital in Kosice. The radical pancreatic resection and standard lymphadenectomy were performed in 36 patients. During standard lymphadenectomy there were found 19 patients with 119 negative lymph nodes by histopathological examination. These lymph nodes were examined by immunohistological examination, and there were found 37 lymph nodes as positive, in 6 patients. CONCLUSION: Patients in earlier stage of pancreatic cancer had better survival rates than in later stage of disease. Immunohistochemical examination of histopathologically negative lymph nodes can detect positive lymph nodes and early-stage pancreatic cancer patients can be identified.

[Heterotopic pancreas in the stomach wall -- a rare histological diagnosis of submucous lesson -- casuistic report]. / Heterotopický pankreas v stene zalúdka, ako raritná histologická diagnóza submukóznej lézie -- kazuistika.

Heterotopic pancreas (HP) is defraed as abnormally localized pancreatic tissue without any anatomical and vascular connection with pancreas. Incidence of HP is 0.2-0.5% of patients underwent upper medial laparotomy. The most common symptoms of HP are abdominal discomfort and pain, upper gastrointestinal bleeding and intermittent bowel obstruction. Gastroscopy is the most commonly used first diagnostic procedure. Ultrasound evaluation, computer tomography and namely endoscopic ultrasound evaluation are useful imaging procedures of HP. Casuistic report of patient with upper gastrointestinal bleeding is presented. Imaging procedures have recorded stomach tumor 3cm in diameter in back wall of stomach. Billroth II resection of stomach was performed. Histological evaluation of removed part of stomach recorded heterotopic pancreas type 1 of Heinrich classification. HP diagnosis before surgery is difficult because of submucous localization of lesion. Fine needle biopsy during gastroscopy is one of diagnostic possibilities without surgery. Endoscopic excision of lesion is possible if histological evaluation by fine needle biopsy is successful and anatomical localization is appropriate. The most of patients need surgical excision of HP. Peroperative histological evaluation allows a minimalization of excision area. Opinions of asymptomatic HP treatment are ambiguous. The most of published papers recommend excision of asymptomatic HP also, because of risk of next complications.

Anatomical study of blood supply to the spinal cord in the rabbit.

STUDY DESIGN: The study was carried out in rabbit. OBJECTIVE: To investigate the arterial blood supply of the spinal cord in rabbit as model in experimental spinal cord ischemia surgery. SETTING: The study was carried out in the Department of Anatomy, Histology and Physiology, University of Veterinary Medicine and Pharmacy in Kosice, Slovak Republic. METHODS: The study was carried out on 10 adult New Zealand white rabbits. We prepared corrosion casts of arterial system of spinal cord. Batson's corrosion casting kit no. 17 was used as a casting medium. RESULTS: The presence of branches entering arteria spinalis ventralis in the thoracic region was observed in 71% of the cases on the left side and in 29% on the right side. In the lumbar region, left-sided branches were observed in 52% of the cases and right-sided in 48% of the cases. The artery of Adamkiewicz was present in 50% of the cases as left-sided and in 50% as right-sided. CONCLUSION: Documenting the anatomical variations in spinal cord blood supply in the rabbit will aid in the planning of future experimental studies and determining the clinical relevance on such studies.

[Pilonidal sinus--a classical plastic procedure according to Limberg (Limberg flap procedure) or its modified version?]. / Pilonidálny sinus - klasická plastika podl'a Limberga alebo modifikovaná verzia?

Pilonidal sinus disease (PSD) is defined as a cyst of sacrococcygeal hair follicle. Complete excision of lesion and skin reconstruction is still the only definitive treatment. Opinions on form and size of excision and type of skin reconstruction and flap are ambiguous. Retrospective analysis of 83 patients underwent surgery in 1. Department of Surgery in Kosice because of chronic PSD was performed. 67 patients underwent excision with Limberg flap (LF). 16 patients underwent excision with modified Limberg flap (mLF). 19 and 3 patients were excluded because of absence of control evaluation. The control evaluations of 48 and 13 patients were performed 12 days and 12 mounts after surgery. No differences between groups in age of patients and men to women rate were recorded. We have recorded shorter hospital time (LF: 4 days; mLF: 3 days) and lower incidence of disease recurrence in one year (LF: 6.25%; mLF: 0%) in modified Limberg flap group. Using of flaps in PSD treatment decrease suture tension and minimize risk of suture dehiscence, postoperative tenderness and risk of other complications. Using of flaps in treatment of this disease reduce intergluteal groove and minimize risk of disease recurrence. Using of primary closure without flap carries just little benefit in shorter surgery time. Suture outside of midline minimize risk of early postsurgical complication and decrease risk of disease recurrence. Published literature in correlation with our results show that modified Limberg flap may be useful standard in PSD treatment.

[Uncommon rectal adenocarcinoma metastases]. / Nezvycajné metastazovanie adenokarcinómu rekta.

Rectal cancer treatment has become multimodal as a result of significant advances in imaging diagnostic, in surgery technique of re section and in neo and adjuvant therapy. The aim of the case report was to present a successfully treated adenocarcinoma recti and adenocarcinoma of hepatal flexurae with recidivistic metastasis and an extremely rare intergrowth of the metastasis into venous system. A 61 year old patient underwent low resection of recti according to Dixon because of well differentiated adenocarcinoma with classification T3N0M0. The patient was reoperated because of metastasis of adenocarcinoma in the abdominal wall (16 x 15 x 20 cm) after chemotherapy (FUL-5-fluorouracyl) and radiation dose of 50.4 Gy. The metastasis of abdominal wall was extirpated after another cycle of adjuvant therapy of FUL+Leukovorin. 26 months after the first operation, a new sessile polyp was found in the hepatal flexurae with histological finding of well differentiated adenocarcinoma. The patient underwent right hemicolectomy. Since lymphatic nodes were without metastasis, the patient was not indicated for chemotherapy. Two months later, the patient was admitted because of phlebothrombosis of left femoral vein. The patient underwent three reoperations with total extirpation of recidivistic tumor located in left thigh and received six cycles of Xeloda. Histological examination proved an intergrowth into great saphenous vein. Authors did not come across a case in the literature with an intergrowth of metastasis into venous system with a five year survival of a patient. The patient from this case report has no local relapse and metastasis six years after the first operation.

[A rare complication following anastomosis suturing using a biofragmentable Valtrac anastomosis ring--a case review and literature overview]. / Zriedkavá komplikácia po sití anastomózy biofragmentilným prstencom Valtrac--kazuistika a prehl'ad literatúry.

The use of Valtrac Ring since 1985 has brought about the ability of easier anastomosis suturing and shortening of the operative treatment. As other methods, also Valtrac ring has its disadvantages. Authors present a case report of a complication previously not described in the literature. A 67 year old patient, after right hemicolectomy with ileotransversoanastomosis with the help of Valtrac due to adenocarcinoma, underwent a control colonoscopy six month after operation. Small polyps in colon sigmoideum, colon descendens and transverse were removed and a tissue stripe with ulceration was found during the examination. The bioptic sample was taken from this stripe. After the application of Fragmine, the patient had a massive enterorhagia, which was not even resolved by adrenaline per colonoscopy. The patient underwent re-resection of ileotrasversoanastomosis. A ring of tissue, created by circular necrosis in the place of seroserous connection of biofragmentile ring of both of the lumens, was found in the tissue sample. Stenosis of the anastomosis, dehiscence, bleeding and fistulation are described in the literature as the most common complications after Valtrac use. The incidence is comparable with complications during anastomosis sutured by hand. We would like to bring this extremely rare complication to the attention to all surgeons and gastroenterologists, who perform endoscopic examinations in patients after this surgical procedure.

[Surgical management of the failed back surgery syndrome (FBSS) using posterior lumbar interbody fusion (PLIF) with posterior transpedicular stabilization]. / Chirurgické riesenie failed back surgery syndrómu FBSS pomocou zadnej lumbálnej medzitelovej fúzie PLIF so zadnou transpedikulárnou stabilizáciou.

INTRODUCTION: One of possibility of treatment FBSS is posterior lumbar interbody fusion, PLIF with posterior transpedicular stabilization. MATERIAL AND METHODS: Between January 2005 and December 2007, the prospective study of treatment failed back surgery syndrome patients with posterior lumbal interbody fusion and posterior transpedicular stabilization was performed at the Department of Neurosurgery University Hospital FNLP in Kosice. Physical examinations were performed before surgery, after surgery 30 days, and at 4 follow-up visits (3 months, 6 months, 12 months and 24 months). At each interval, patients outcomes measures, including visual analog scale pain rating VAS and Oswestry Disability Index ODI. RESULTS: At the Department of Neurosurgery, 58 failed back surgery syndrome patients were operated on between 1.1.205 and 31.12. 2007. Long term follow up was investigated in 47 patients, 11 patients were lost to follow-up. Postoperative complications were controlled 30 days after surgery. They were presented in 9 patients (19.14%). No patient died after surgery. The working ability was found in 23 patients 49%. Before surgery all patiens used analgesic, after surgery there were present decrese in using analgesic. Improvement quality of life and decrease pain measured with ODI and VAS were investigated. ODI before surgery was 71.7 and 24 months after surgery ODI was 37.7. VAS before surgery was 7.95 and 24 months after surgery VAS was 2.82. There were found statistically significant influence on decrease pain mesuares ODI and VAS after surgery p < 0.0001. CONCLUSION: Our study results show that PLIF with posterior transpedicular stabilization can be safely perfomed and that can allow decrease pain and improve quality of life in FBSS patients.

[Current diagnostic and treatment options in thyroid carcinoma]. / Súcasné moznosti diagnostiky a liecby medulárneho karcinómu stítnej zl'azy.

Authors evaluated a set of 1182 patients who underwent a surgery for thyroid disease at two workplaces--1st Surgery Clinic of L. Pasteur Teaching Hospital of Kosice and ENT Department of East-Slovak Oncology Institute, a. s. of Kosice during 5 year period from the point of view of Medullary Thyroid Carcinoma. Of the given number, 9 suffered a confirmed diagnosis of Medullary Thyroid Carcinoma. Incidence and treatment results conform to available publications. The most important elements for successful treatment are considered the early diagnosis and sufficient surgical treatment. The early diagnosis is in hands of GPs and endocrinologists and is the most important regarding the success of treatment. It is useful to direct the surgical treatment into Centres where--regarding rare occurrence, seriousness of disease and specific treatment--the optimum result may be achieved.

[Arteriovenous malformation in small intestine as atypical etiology of lower gastro-intestinal bleeding--a case report]. / Cievna malformácia v tenkom creve ako netypický zdroj krvácania z dolnej casti tráviaceho traktu--kazuistika.

Lower gastrointestinal tract bleeding (LGIB) is the acute abdomen, defined as gastrointestinal tract bleeding under the ligament of Treitz. We present the case report of patient iteratively hospitalized because of repeated LGIB. There were performed gastrofibroscopy, colonoscopy and capsule endoscopy, without the bleeding localization. Scintigraphy and computer tomography showed the origin of bleeding in terminal small intestine; the computer tomography diagnosed the arteriovenous malformation in this area. During laparotomy the resection of 120 cm of terminal small intestine was performed with end-to-end anastomosis. The recurrence of bleeding was not diagnosed. LGIB takes about 0.5% of acute hospitalization at surgery departments. After the stabilization of vital functions, the exclusion of the upper gastrointestinal tract bleeding and fast gastrointestinal tract preparation, the urgent colonoscopy is recommended. In case of non-successful colonoscopy, the most of authors recommend angiography, capsule endoscopy and double-balloon endoscopy. The conservative management is adequate in more than 2/3 of patients; in part of them the intervention during colonoscopy is possible. Surgical intervention with gastrointestinal tract resection is performed in less than 17% of patients. The urgent surgery is needed in 4.7% of patients. All the diagnostic and curative interventions have greater success and should be performed during the acute bleeding.

[Dissection of arteria poplitea, managed with endovascular procedure]. / Disekcia arteria poplitea riesená endovaskulárne.

Arterial dissection of a peripheral artery involving an extremity is a rare event. We report a case of nonaneurysmal dissection of the popliteal artery that occurred in a 61-year-old man who was admitted with acute limb ischemia. Ultrasound examination was suggestive of arterial dissection and endovascular treatment was undertaken before irreversible ischemia developed. Successful management depends on consideration of the diagnosis, particularly when other, more common diseases have been excluded.

[Pseudodiverticulitis coeci--the atypical etiology of right iliac fossa pain--a case report]. / Pseudodiverticulitis coeci--atypická etiológia bolesti v pravom hypogastriu.

The aim of our paper is to show on the diagnosis of coecal diverticul as infrequent reason of right iliac fossa pain. We present the case report of 43-years old woman, which underwent appendectomy some years sooner, and was accepted into the hospital because of 48-hours taking right iliac fossa pain. Local peritoneal irritation was present. During laparotomy resection of right colon with the toilette of abdominal cavity was performed. Histology diagnosed the right colon pseudodiverticulitis. In case of diagnosis of right colon pseudodiverticulitis before surgery and without peritoneal irritation, the most of authors recommend the conservative management with antibiotics. If the surgery is required, the local resection of diverticul with appendectomy is recommended. If the local resection is not possible, the ileocoecal resection has lower mortality as the right hemicolectomy.

[Laparoscopic hernioplasty TAPP in treatment of groin hernia--10 years experience]. / Laparoskopická hernioplastika TAPP v liecbe slabinovej prietrze--10-rocné skúsenosti.

AIMS: To analyse individual and institutional "learning curve" in laparoscopic transabdominal preperitoneal hernioplasty (TAPP) and to identify key moments in its introduction at surgical clinic. MATERIAL AND METHODS: Prospective unicentric clinical study. Longitudinal recording of information on age and sex of operated patients, type of hernia, size of implanted mesh, operative tactics and technique, complications and recurrence rate was performed. Obtained data was statistically analysed and tested repeatably, results interpreted with respect to need of modification of peri- and postoperative management. RESULTS: During the 10 year period 1058 laparoscopic hernioplasties TAPP were performed with overall recurrence rate 0.96% and zero conversion rate. Mean operating time was 60.15 +/- 24.27 minutes (30-175), 46.64 +/- 19.23 minutes in the last three years (last 541 patients). Thanks to prospective analysis of obtained results three important changes in the operative management were introduced: size of mesh enlarged from 7.5 x 15 cm to 10 x 15 cm, change of operating team and port sites set up and shift towards macroporous 3D-knitted light-weight polypropylene meshes. CONCLUSIONS: Crucial factor for successfull introduction of laparoscopic hernioplasty TAPP at surgical clinic is consistent follow-up which represents a source of valid information thus allowing to make important changes in patient management. TAPP represents demanding operation with significant individual and institutional learning curve. Operating time decreases significantly after 30 operations; with growing institutional experience recurrence rate decreases. Minimal size of implanted mesh should be 10 x 15 cm.

[Mesenteric ischemia--late diagnosis or managed disease?]. / Mezenterická ischémia--neskoro rozpoznaná diagnóza, alebo zle liecené ochorenie?

AIM: Diagnosis and therapy of mesenteric ischaemia as the cause of an acute abdomen is a serious problem because of its 60-80% mortality. The study presents experience with diagnosis and therapy of this disease and it compares its results with those in the literature. MATERIAL AND RESULTS: Throughout the years 2000-2009, there were 39 patients surgically treated with mesenteric ischaemia (17 men, 21 women, the average age 73 I 9.43). 38.46% of patients underwent resection of small and large bowel, in 33.3% only a part of small intestinum was resected, and in two cases (5.13%), the resection was combined with the embolectomy of artery mesenteric superior. In 23.1% of patients, only an explorative laparatomy was performed, because of an extended affection. Four patients were reoperated (dehiscence of anastomosis, perforation of small bowel, dehiscence of the wound, enterocutaneous fistula). 23% of patients needed ventilation because of postoperative complications such as respiratory insufficiency, sepsis and heart failure. There was 53.8% mortality. The abdominal pain (79%), vomitus (61.5%) and subileus (35.9%) predominated in the clinical picture. Leucocyts were elevated in 58.97% of patients. X ray examination showed non specific findings, and ultrasonography has proven to be successful in 42.3% of cases. CONCLUSION: Mortality of patients is significantly increased by low success rate of the depictive methods, non-specific clinical picture, co-morbidity in elderly patients and by late arrival to hospital.

Enrichment of rat oligodendrocyte progenitor cells by magnetic cell sorting.

The embryonic, neonatal, as well as adult rat spinal cords harbor a pool of neural stem cells (NSCs), which may be easily isolated and used to replace neuronal cell loss or remyelinate damaged axons following various neurodegenerative disorders. In the present study we have used magnetic cell sorting (MACs) technology to generate enriched oligodendroglial cell populations from the embryonic (E16) rat spinal cord. Target cells were separated by positive selection, using specific A2B5 antibody-labeled MicroBeads achieving optimal recovery and high purity of pro-oligodendroglial cells. Based on immunocytochemical analyses for oligodendroglial developmental markers (A2B5, NG2, RIP and MBP) we were able to characterize and quantify oligodendroglial progenitors (OPCs) and mature oligodendroglial cells in: (i) unseparated heterogeneous population of NSCs, or in (ii) antigen-antibody separated NSCs. Our results showed that MACs technology enable us to gain enriched OPCs from heterogeneous population of spinal NSCs, resulting in a 58-61% of mature oligodendrocytes content (MBP+, RIP+) in comparison to 6-12% of oligodendroglial cells acquired from unseparated population. In addition, the enriched OPCs could be cultured in vitro for several >8 passages, giving rise to a high number of newly formed spheres, as well as high expansion potential. These experiments indicate that MACs technology provide a feasible approach for experimental cell enrichment of desired oligodendroglial progeny, which may be used in future trials for cell-based therapies to treat spinal cord injury.

[Giant solitary fibrous tumor of the pleura--case report]. / Obrovský solitárny fibrózny tumor pleury--kazuistika.

Solitary fibrous tumors of the pleura are rare malignant pathological findings, accounting for only 5% of all pleural neoplasms. Clinical manifestations are very unspecific and over 50% of the cases are asymptomatic. The commonest clinical symptoms include cough, pains, dyspnoea, fever and weight loss. The recommended diagnostic methods include chest x-ray, CT and MRI imaging and positrone emission tomography. The CT-assissted puction biopsy yield is less than 50%. The authors present a case review of a 58-year-old female with a history of dyspnoea. Her chest x-ray and CT examination suggested a large cystoid lesion in the right hemithorax, with extensive dystelectasis of the right lung lobe. Functional pulmonary examination confirmed severe gas transfer dysfunction, with diffusion lung capacity of 47% of the normal. Stenosis of the right middle and lower lobar bronchus resulting from extramusral pressure was detected on bronchoscopy. The authors performed right-sided thoracotomy and removed an encapsulated solid tumor measuring 24 x 16 x 13.5 cm and weighting 2850 grams from the thoracic cavity. Benign solitary fibrous tumor was diagnosed on histology. The postoperative course was complicated by bleeding into the pleural cavity, which was managed conservatively and did not require subsequent surgical revision. The patient was released for home care in a good condition. The aim of the study is to draw attention to this tumorous disorder of the pleura - the solitary fibrous tumor.