[Lung resection for a non-small cell carcinoma (stage IV) with a permanent intracavitary brachytherapy 125I]. / Resekce plic pro nemalobunecný karcinom (stadium IV) s permanentní intrakavitární brachyterapií 125I.

In November 2005, the authors used the lung resection method in combination with peroperative brachytherapy125 for a non-small cell carcinoma, for the first time. The patient had an adenocarcinoma of the right lung T2N2M0, stage IIIA. During the procedure, the team diagnosed advanced stage of the process, the tumor originated in the hilus region of the middle lobe with a metastatic spread into the superior and inferior lobe. Distant unilateral lymphonodes were infiltrated simultaneously. The histological examination confirmed the diagnosis of T2N2M1, however, the original classification was re-assessed and changed to stage IV. Pneumonectomy with lymphadenectomy of all of the macroscopically detectable lymphonodes was completed. The lymphatic drainage sites in the upper and lower mediastinum were covered by seeds of a permanent gama emitter 125I with a total dose of 100 Gy. The patient recovered with no complications and was discharged on the day 8. He was included in the study and will be followed on a regular basis. On the authors' opinion, the method of the lung resection with peroperative permanent brachytherapy has a potential for decreasing the tumor relaps rates, eventually, for improving the patients survival rates and their quality of life. The authors will continue their applied research of this serious problematics, aiming to confirm or refuse the stated hypothesis.

Non-invasive fetal RHD and RHCE genotyping from maternal plasma in alloimmunized pregnancies.

BACKGROUND: In this prospective study, we assessed the feasibility of fetal RH genotyping by analysis of DNA extracted from maternal plasma samples of alloimmunized pregnant women using real-time PCR and primers and probes targeted toward RHD (exon 7 and exon 10) and RHCE (intron 2 and exon 5) genes. METHODS: We analysed 23 alloimmunized pregnant women (16 anti-D, 5 anti-D + C, 2 anti-E) at risk of haemolytic disease of the newborn (HDN) within 11th and 37th week of pregnancy and correlated the results with serological analysis of cord blood. RESULTS AND CONCLUSION: Detection of the presence of the RHD gene, the C and/or E alleles of the RHCE gene in maternal plasma samples is highly accurate and enables implementation in a clinical diagnostic algorithm for following pregnancies at risk for HDN. The absence of RHD gene, the C and/or E alleles of RHCE gene in the current pregnancy excludes the risk of HDN caused by anti-D, anti-C and/or anti-E alloantibodies and the performance of invasive fetal-blood sampling.