Retrospective analysis of necrotizing pneumonia in children between 2015-2019.

INTRODUCTION: An increased incidence rate of cases of complicated pneumonia, reaching up to the stage of necrotizing pneumonia was observed at University Hospital Brno in the past period. The aim of this study was to perform a single-center retrospective analysis of patients with acquired inflammatory lung disease requiring surgical treatment, comprising a long-term follow-up group. METHODS: Patients hospitalized for community-acquired pneumonia and surgically treated in the years 2015-2019 were analyzed. The rates of necessary chest drainages, decortications and lung resections in relation to the whole group and individual years were monitored. Clinical and X-ray examinations were performed one year after hospitalization and the prognosis was determined for individual types of required treatments. The age, gender and etiological agents were also monitored. RESULTS: A total of 688 patients were included in the study with the incidence rising until 2018 and decreasing slightly in 2019. A statistically significantly higher number of community-acquired pneumonias and complications was recorded between 2017 and 2018 (p.

Myofibroblastic tumor of the esophagus - a case report of long-term follow-up and literature review.

BACKGROUND: Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm with intermediate malignant potential. Although most often seen in the lungs, it can occur at multiple anatomical locations, including the gastrointestinal tract. An esophageal lesion is extremely rare, however. IMTs present most commonly in children and young adults. The main therapeutic approach is surgical resection. CASE REPORT: We report on the follow-up of a case in a 13-year-old boy with IMT in the esophagus. He underwent surgical resection in 2013 and is free of disease to date. CONCLUSION: Surgical resection is the most preferred therapy. If the resection is complete, the risk of recurrence is low. Nevertheless, every patient should be carefully followed up after the resection.

[Laparoscopy at the pediatric surgery department for a five-year period]. / Laparoskopie na pracovisti detské chirurgie v petiletém období.

INTRODUCTION: Laparoscopy in small children was developed only after the adoption and verification of basic principles in adult patients and is mostly concentrated in specialized facilities due to the possible complications and necessity of follow-up specialized anesthesiological and post-operative care. In the 1990s, the Clinic of Paediatric Surgery, Orthopaedics and Traumatology at University Hospital Brno was one of the first in the Czech Republic to begin operating on children laparoscopically. The presented study informs about the development of these minimally invasive methods, the frequency of their use, and the spectrum of patients at the pediatric surgery facility where laparoscopy in children has been systematically developed over many years. METHODS: Retrospective analysis of children operated upon laparoscopically at the clinic of Paediatric surgery, Orthopaedics and Traumatology of University Hospital Brno over the five-year period from 1 January 2012 to 31 December 2016. A list of surgical procedures was prepared which was then first divided into procedures specific exclusively for children and those common to adult patients surgery. Separately, an overview was prepared of operated patients under 50 kg, which was the boundary criterion defined by the authors for laparoscopy in children as opposed to adults. For all procedures, the frequency of the completed cases performed laparoscopically was precisely ascertained. The source for this data was the hospital system and surgical documentation. RESULTS: In the evaluated period, a total of 995 laparoscopic procedures were performed, more than half of which (56.8%) were in patients under 50 kg. The majority of those were procedures performed also in adults. The group of surgical operations exclusively specific to children was characterized by low frequencies of the individual procedures. CONCLUSION: The presented analysis confirms that laparoscopy in children is based on standard procedures common to surgery on adults. These procedures are adopted the most quickly, and they can be disseminated across a large group of surgeons who are then able to perform these routinely on child patients. Surgical procedures exclusively specific for children, on the other hand, are performed less frequently, their adoption is slower, and laparoscopic approach is less common. Therefore, laparoscopy specific to children needs to be performed on a long-term basis, systematically, and within a small group of surgeons. Otherwise, it is better not to perform it at all.Key words: laparoscopy - child frequency.

Silica gel-immobilized multidisciplinary materials applicable in stereoselective organocatalysis and HPLC separation.

In this pilot study, we present novel bifunctional silica gel-immobilized materials applicable as heterogeneous organocatalysts and stationary phases in HPLC. The materials provided high stereoselectivity in both batch and continuous flow catalysis of a model Michael addition (cyclohexanone to (E)-ß-nitrostyrene). In the batch reaction, the catalysts proved their sustainable catalytic activity over five consecutive recycling experiments. Under continuous flow reaction conditions, the catalytic activity was found to be superior to the batch reaction, and moreover, the same immobilized materials were utilized as stationary phases in HPLC showing very good chemoselective separation of model acidic analytes.

[Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - part 2: color and spectral Doppler artifacts]. / Artefakte in der Sonografie und ihre Bedeutung für die internistische und gastroenterologische Diagnostik - Teil 2: Artefakte im Farb- und Spektraldoppler.

Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues of the body and with foreign materials. On the one hand, they may be diagnostically helpful. On the other hand, they may be distracting and may lead to misdiagnosis. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review commented on the physics of artifacts and described the most important B-mode artifacts. Part 2 focuses on the clinically relevant artifacts in Doppler and color-coded duplex sonography. Problems and pitfalls of interpretation arising from artifacts, as well as the diagnostic use of Doppler and colour-coded duplex sonography, are discussed.

[Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - Part 1: B-mode artifacts]. / Artefakte in der Sonografie und ihre Bedeutung für die internistische und gastroenterologische Diagnostik - Teil 1: B-Mode-Artefakte.

Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues and with foreign bodies. On the one hand, they may be distracting and may lead to misdiagnosis. On the other hand, they may be diagnostically helpful. Ultrasound imaging suffers from artifacts, because in reality, parameters assumed to be constant values, such as sound speed, sound rectilinear propagation, attenuation, etc., are often different from the actual parameters. Moreover, inadequate device settings may cause artifacts. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review comments on the physics of artifacts and describes the most important B-mode artifacts. Pitfalls, as well as diagnostic chances resulting from B-mode artifacts, are discussed.

[Laparoscopic cholecystectomy in children and adolescents]. / Laparoskopická cholecystektomie u detí a adolescentu

INTRODUCTION: In the treatment of cholelithiasis in adults, laparoscopic cholecystectomy is the method of first choice. There is plentiful literary evidence of the low complication incidence in this age group, but similar assessment is lacking in the paediatric population. In this work, the authors focus on cholelithiasis in children and the possible use of laparoscopy in the diagnostic - therapeutic scheme. MATERIAL AND METHODS: The study group consisted of 148 patients operated on by laparoscopic cholecystectomy between 2002 and 2011 at the Department of Paediatric Surgery, Orthopaedics and Traumatology of University Hospital Brno. The first objective of the study was to evaluate the length of surgery; the second one was the occurrence of complications which were divided into intraoperative and postoperative. Intraoperative complications were subdivided into severe and moderate, postoperative complications into early and late. The last objective was to evaluate the benefit (number of complications, treatment outputs) of intraoperative cholangiography for obstructive jaundice before the surgery. RESULTS: In the above mentioned period, 143 laparoscopic cholecystectomies and five laparoscopic cholecystectomies including splenectomy were performed. The average age of the patients was 13.9 years; the average length of laparoscopic surgery was 52 minutes. One major, serious intraoperative complication (0.7%) was recorded - injury to the ductus hepaticus communis. Moderate intraoperative complications occurred in 4.5%. Furthermore, one serious early postoperative complication (0.7%) - bleeding from the cystic artery --and one minor (0.7%) - in a patient with acute pancreatitis after endoscopic retrograde cholangiopancreatography - was recorded. Late postoperative complications occurred in 4% of the patients. Conversion of laparoscopic operation with a definitive resolution of the serious condition was performed in one patient because of the aforementioned serious intraoperative complications. Eleven patients underwent intraoperative cholangiography; extraction of stones from the bile duct was performed in six cases. CONCLUSION: Intraoperative cholangiography in children and adolescents can be recommended as a safe and effective imaging modality for patients with preoperative evidence of biliary obstruction. Laparoscopic cholecystectomy in children and adolescents can be clearly recommended as an effective and safe surgical technique convenient for paediatric patients.

[«Knobology¼ (important device settings)]. / «Knopfologie¼ (Wichtige Geräteeinstellungen).

The correct setting of the ultrasound equipment is a prerequisite for a high quality of the ultrasound examination. Both the B-mode ultrasonography, as well as the Doppler technique offer interesting alternative settings that are often inadequately used. This brief summary of basic settings should help the practicing clinicians in everyday life and motivate them to deal with the «knobs¼ of the ultrasound device. Good practical help will provided by the «Sonocave¼ an event regularly organized at the annual ultrasonic training Congress in Davos, where recognized experts will answer such «Knobology¼-questions and demonstrate the appropriate settings also practically.

[Image analysis in the differential diagnosis of renal parenchyma lesions]. / Der Beitrag der Bildanalyse für die Differenzialdiagnose der fokalen Nierenparenchymveränderungen.

PURPOSE: Visual analysis of echo intensity is of importance for the differential diagnosis of focal renal lesions. Quantification of the echo intensity and of other parameters might help with differential diagnosis. MATERIALS AND METHODS: In 145 patients with focal renal lesions, digitized images were evaluated (40 angiomyolipomas [group A], 70 renal cell carcinomas [group B], 20 pseudo-tumors [group C] and 15 other focal lesions in group D). With Photoshop®, the average grayscale values of the lesion (defined as echo intensity focal, EF) and its variance s2 (as expression of the inhomogeneity focal, IF) were measured. These measurements were compared to the renal cortex (echo intensity renal cortex=ER, inhomogeneity renal renal cortex=I R). Other calculated parameters: Echo intensity quotient, echo intensity index, inhomogeneity quotient and inhomogeneity index. RESULTS: Angiomyolipomas had a higher echo intensity quotient EQ and echo intensity index EI than renal cell carcinomas, pseudo-tumors and other lesions (p<0.001). Pseudo-tumors had a lower inhomogeneity quotient than angiomyolipomas (p<0.001), renal cell carcinomas (p<0.05). Echo intensity quotient EQ≥2.0 and echo intensity index EI≥0.5 were typical for angiomyolipomas with a sensitivity of 96.4 % and a specificity of 97.3 % for tumors<3 cm. CONCLUSION: Quantitative echo intensity measurements enhance the differential diagnosis of focal renal lesions. The differentiation of typical angiomyolipomas to other lesions could be improved.

Glutamate receptor block in Lurcher mutant mice during ontogeny and its effect on hippocampal long-term potentiation.

Basic evaluation of the effect of chronic NMDA glutamate receptor (NMDAR) blockade on the hippocampal long-term potentiation (LTP) was performed in an animal model of inborn olivo-cerebellar degeneration (Lurcher mutant mice, LMM). NMDA receptor antagonist MK-801 was administered to mice in the dose 0.2 mg/kg of body weight, daily during two periods of their ontogeny: D5-D26 and D91-D111. In the consecutive 15 days some behavioral characteristics were studied using special methods for physical activity testing. Then LTP was investigated in LMM and also in their healthy littermates which served as controls (wild-type, WT). LTP in animals pre-treated with MK-801 showed significant long-term suppression of NMDAR activity, in both WT and LMM despite certain small differences between them. Our results show that cerebellar pathology on one hand and a physical activity on the other hand can influence the LTP in hippocampal region. It can be concluded that the results support the ideas of close functional cooperation between the brain structures which are involved in mechanisms of learning and memory.