Massive intrathoracic haemorrhage as a complication of pulmonary parenchymal haemorrhage and anticoagulant treatment of lung embolization during COVID-19 - two case reports.

INTRODUCTION: The medical and social interest in the SARS-CoV-2 infection is currently high. This infection can, in severe cases, be accompanied by a series of complications, such as thromboembolic disease or pulmonary parenchymal haemorrhage. CASE REPORTS: The paper presents two rare cases of massive intrathoracic haemorrhage caused by pulmonary parenchymal haemorrhage and exacerbated by full anticoagulant treatment of thromboembolic disease. RESULTS: In both cases, the haemorrhage originated in the left lower lobe and was life threatening, requiring urgent anatomical lung resection - left lower lobectomy. CONCLUSIONS: The combinaion of anticoagulant therapy and thromboembolic events related to COVID-19 can cause, in rare cases, massive pulmonary haemorrhage. This rare complication proved lethal in one out of two of the cases described in this paper. An imminent and adequate reaction is necessary when the first signs of haemorrhage appear.

Delayed diagnosis of diaphragmatic rupture after blunt chest trauma - 2 case reports.

INTRODUCTION: Diaphragmatic rupture is a rare but life-threatening condition that occurs in 0.85% of surgically managed thoracoabdominal injuries. In most cases, the condition is accompanied by associated traumas responsible for poor prognosis. Signs of diaphragmatic rupture are often masked by more serious manifestations of the associated trauma. The rupture is usually revealed by an X-ray of the chest or CT scan. However, a minor defect may be missed, especially if the patient is not indicated for urgent surgery. METHODS: The authors present 2 case reports of patients treated for chronic diaphragmatic rupture at the Department of Surgery of the Faculty of Medicine, Charles University and University Hospital in Pilsen between 01 January 2009 and 31 December 2021. The aim was to analyze the clinical data and to compare this data with literature. RESULTS: Both patients with the chronic diaphragmatic rupture were men in their productive age. The mechanism of their primary trauma was a traffic accident. In the first case, the rupture was diagnosed 6 years after the trauma. The second case was diagnosed 14 years after the primary trauma. The diaphragmatic rupture was present on the left side in the first case and on the right in the other. Both patients underwent suture of the diaphragmatic defect via thoracotomy. CONCLUSION: Unrecognized diaphragmatic rupture is a severe condition that can result in a life-threatening complication, namely incarceration of abdominal organs dislocated to the chest. It is necessary to keep this diagnosis in mind in patients with gastrointestinal or respiratory problems after a previous high-energy, blunt-force abdominal and thoracic injury, even many years after the trauma.

Anterior open bite - diagnostics and therapy.

An anterior open bite (AOB) is an occlusal disorder that causes the patient both an aesthetic and functional handicap. The lower third of the face is disproportionately larger. Patients are unable to properly occlude with the anterior part of dental arch and occlusion only happens in the premolar and/or molar regions. An anterior open bite may be the result of anatomical anomalies. Long term stability as well as an immediate outcome of the surgery depends on the choice of a suitable treatment strategy. In this article, we review options of AOB treatment, from classical orthodontic treatment to current combined orthodontic and surgical approach with a benefit of an anchor system.

Perioperative acute internal carotid thrombosis after general surgery.

INTRODUCTION: The average incidence of perioperative stroke during major non-cardiac surgery is less than 1%, suggesting that it is rarely a major problem for the vast majority of patients. METHODS: In our paper we present a 46-year-old patient undergoing acute right hemicolectomy who developed right-sided hemiparesis in the perioperative setting. Immediate CTAg examination showed an ischemic stroke in the left hemisphere as a result of left internal carotid thrombosis. A surgical procedure to recanalize the left carotid artery was performed 14 hours from the onset of neurological symptomatology and the neurological deficit gradually recovered fully. CONCLUSION: Our case report supports studies showing that a thorough diagnostic assessment allows the selection of patients who may benefit from urgent revascularization of acute internal carotid occlusion during the phase of acute brain ischemia.

High magnetic field test of the ITER outer vessel steady-state magnetic field Hall sensors at ITER relevant temperature.

The ITER outer vessel steady-state magnetic field sensor diagnostics consist of sixty sensor units. Each sensor unit features a pair of ceramic-metal Hall sensors with a sensing layer made of bismuth. The sensors were tested simultaneously in the magnetic field ranging from -12 T to +12 T at the temperature range from 27 to 127 °C. The Hall coefficient and magnetoresistance of the bismuth layer related to the sensors were identified. In the sensor operating conditions, the Hall coefficient dependence on temperature was fitted with an exponential function with a relative error of less than 0.08%, and the dependence on the magnetic field was fitted with a Gaussian-like function with a relative error of less than 0.11%. An alternative expression based on the physical understanding of the free charge carrier transport in semimetals was derived to describe the dependence of the Hall coefficient on the magnetic field, and its fitting error of 1.2 mT in terms of the magnetic field measurement has met the ITER measurement accuracy requirements.

Plasma markers of oxidative status were associated with increasing continuous cardiometabolic risk scores in healthy students aged 16-20 years without central obesity.

AIM: We studied the association between increased cardiometabolic risk and markers of oxidative status and glycation in apparently healthy subjects who did not present with central obesity. METHODS: From 2011 to 2012, we recruited 2064 students (53% girls) aged 16-20 years from Western Slovakia. Their continuous metabolic syndrome scores (MSS) were calculated as a mean of the sum of the z-scores of waist-to-height ratio, mean arterial pressure, triacylglycerols, high-density lipoprotein-cholesterol and quantitative insulin sensitivity check index. Plasma markers of protein glycation and oxidation, lipid peroxidation and total antioxidant status were analysed. RESULTS: In both genders, advanced oxidation protein products (AOPPs) increased across the MSS quintiles (p < 0.001). AOPPs and fructosamines were significant predictors of the MSS in both genders. Moreover, high-sensitivity C-reactive protein, leukocyte counts and advanced glycation end-products (AGEs) contributed significantly in girls. Triacylglycerols, fructosamines, AGEs and total antioxidant capacity correlated significantly with AOPPs in both genders. CONCLUSION: Advanced oxidation protein products may act as inflammatory mediators that contribute to the development of cardiometabolic afflictions. Determining these may provide information related to cardiometabolic risk and represent potential target to reduce or prevent irreversible oxidative stress-induced cellular damage.

Continuous metabolic syndrome score (siMS) enables quantification of severity of cardiometabolic affliction in individuals not presenting with metabolic syndrome.

Assessment of degree of cardiometabolic affliction in subjects not presenting with metabolic syndrome (MS) yet, would be helpful in the management of preventive health maintenance. OBJECTIVES: To evaluate continuous metabolic syndrome score (siMS) in estimation of severity of cardiometabolic affliction in individuals not presenting with MS. METHODS: We analyzed data from 3166 volunteers (56 % females) aged ≥ 16 years. siMS score was calculated as waist/height/0.5 + fasting plasma glucose (FPG)/5.6 + triacylglycerols (TAG)/1.7 + systolic blood pressure (SBP)/130 - high-density lipoprotein cholesterol (HDL-C)/1.02 (males) or 1.28 (females). In siMS quintiles, numbers of individuals presenting with 0-to-5 MS components were calculated. MS was considered as the presence of any 3 out of its 5 components. RESULTS: 33 % of participants without MS scored ≥ 4th quintile; 13 % of those free from MS components; 49 % of participants presenting with 1, and 83 % of those displaying 2 MS components. 11 % of individuals presented with MS, all but 1 displayed siMS within the 2 upper quintiles. CONCLUSIONS: Considerable proportion of individuals without MS presented with siMS in range displayed by individuals presenting with MS. SiMS might be useful in estimation of severity of cardiometabolic affliction prior to manifestation of MS, to identify individuals requiring early intervention to counteract developing pathological processes (Tab. 1, Ref. 21).

[Liver hemangiomas - when is invasive treatment indicated?] / Hemangiomy jater - kdy indikovat invazivní lécbu?

INTRODUCTION: Liver hemangiomas are the most common benign tumors of the liver. Most are asymptomatic and are found accidentally by ultrasonography, computed tomography or magnetic resonance imaging of the abdomen. Liver hemangiomas usually do not need any treatment. Nevertheless, symptomatic, giant hemangiomas can be indicated for surgery, embolization or thermoablation. The aim of this study was to define based on our own experience and on the literature when and what treatment option should be indicated in patients suffering from liver hemangioma. METHOD: In the last five years 37 patients with giant hemangiomas indicated for invasive treatment were enrolled in the study. The mean size of the hemangiomas was 67 mm (45-221 mm). Multiple hemangiomas were present in 11 (29.7%) patients. Enucleation was performed in 15 (40.5%), non-anatomical liver resection in three, (8.1%), left lobectomy in one (2.7%) and exploratory laparotomy for a suspected malignant liver tumor in two (5.4%) patients where malignancy was excluded based on contrast enhanced peroperative ultrasonography. Percutaneous transarterial embolization (TAE) was performed in 16 (43.2%) patients. RESULTS: There was zero mortality. A hematoma in the resection line, with spontaneous regression was present in two (10.5%) patients after the surgery. The post-embolization syndrome was presented in three (16.7%) patients after TAE. Progression of the hemangioma was seen in three (28.8%), regression in six (37.5%) patients, and in seven (43.8%) patients the finding remained stable in the interval of 14 years after TAE. CONCLUSION: Conservative approach is can be applied in most liver hemangiomas, especially in small, asymptomatic lesions. Liver surgery is indicated in giant symptomatic or growing hemangiomas with the diameter over 10 cm or in non-specific lesions where the preoperative diagnosis is uncertain. We recommend enucleation as the method of choice, or non-anatomic liver resection. TAE is indicated in high-risk patients and can be repeated if the hemangioma progresses. The use of other methods such as radiofrequency ablation needs to be verified in large clinical studies.Key words: liver hemangiomas - treatment methods.

Relaxation oscillations of the synchrotron motion caused by narrow-band impedances.

Although the linearized theory of small amplitude synchrotron oscillations and the instability thresholds derived from it have long been understood, there is no satisfactory description of the large amplitude highly nonlinear synchrotron motion of a bunched beam. With an appropriate tuning of the RF cavity impedance, large amplitude, low frequency, self-sustained relaxation oscillations of this synchrotron motion are generated. This paper presents detailed experimental data on such behavior, tracking code results that reproduce the important characteristics, and a simple analytical model that explains the key features of the relaxation oscillation: growth of the instability, saturation of the oscillation, breakup of the bunch, and subsequent damping of the system back to the beginning of the next cycle of the relaxation oscillation.

[Relation between the incidence of antibodies against Leptospira interrogans in working dogs and in free-living small mammals]. / Vztah mezi výskytem protilátek proti Leptospira interrogans u sluzebních psu a u volne zijících drobných zemních savcu.

Three localities were chosen in the borderland of the South Bohemian Region to investigate the problems and relations (if there are any) between the incidence of antibodies to Leptospira interrogans (L. i.) in wild ground small mammals and dogs moving in the same environment. In these regions, service dogs work as border guards every day. Blood samples of dogs at these localities were taken at about three-month intervals (from the June 1982 to the October 1984) to investigate the antibodies to L. i. serovars. Parallelly, wild ground small mammals and wild birds were caught at the same localities to be subject to the same examinations. A close relationship between the incidence of L. i. antibodies in ground small mammals and in service dogs was demonstrated at all three localities. At localities no. 1 and 2, the serovar grippotyphosa was found to be dominant in service dogs, which was also found in small rodents. On the other hand, the serovar icterohaemorrhagiae dominated in service dogs at locality no. 3. When changes in the incidence of L. i. antibodies were studied in service dogs and in wild small mammals, the peak of incidence at localities 1 and 2 was in the other half of the year; this relates to the usual maximum incidence in the natural reservoir of the serovar grippotyphosa, i.e. in rodents. On the contrary, at the third locality the peak of incidence of L. i. antibodies was recorded in the winter 1983-1984.(ABSTRACT TRUNCATED AT 250 WORDS)