Laparoscopic sacrocolpopexy using Seratex Slimsling: pilot study.

OBJECTIVE: To describe a new technique of laparoscopic sacrocolpopexy using material Seratex Slimsling. DESIGN: Pilot study. SETTING: Department of Obstetrics and Gynecology, Vyškov Hospital; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc. METHODS: Using a laparoscopically inserted Seratex Slimsling material, we performed a sacrocolpopexy in 12 patients with pelvic prolapse between November 2018 and June 2019. All patients were operated at the same workplace by the same surgeon with experience in advanced laparoscopic surgery. We monitored age, parity, BMI, previous hysterectomy, surgical time, blood loss, type of concomitant surgery, length of hospitalization and incidence of peroperative and postoperative complications in the pilot group of patients Results: Patients included in the pilot study were 53.2 ± 10.0 (34-74) years old, BMI 24.7 ± 4.2, parity 1.92 (95.7% of whom were vaginal births) and in 5 cases (41.7%) previous hysterectomy was performed. The mean duration of surgery was 58.4 ± 6.6 min in cases without hysterectomy and 102 ± 4.9 in patients with concomitant hysterectomy. The mean blood loss was 93 ± 78.8 ml and the length of hospitalization was 5.25 ± 0.72 days. There was no injury to large vessels or ureters during any operation and none of the operations was converted to laparotomy. In one case, the implant slipped from the sacrouterine ligaments area and subsequently the vaginal stump prolapse recurred three months after the primary operation. The patient was re-operated six months after the primary operation using the same technique and has been without any problems until now. In the monitored postoperative period, we did not notice any protrusion of the implant or significant dyspareunias or discomfort in any of the patients. Apart from one patient mentioned above, the method did not fail. CONCLUSION: Laparoscopy has had an irreplaceable role in gynecological surgery for pelvic prolapse since 1993. It is possible to perform laparoscopic sacrocolpopexy with high success rate nad minimal incidence of complications with the use of Seratex Slimsling.

Optimization of nanowire DNA sensor sensitivity using self-consistent simulation.

In order to facilitate the rational design and the characterization of nanowire field-effect sensors, we have developed a model based on self-consistent charge-transport equations combined with interface conditions for the description of the biofunctionalized surface layer at the semiconductor/electrolyte interface. Crucial processes at the interface, such as the screening of the partial charges of the DNA strands and the influence of the angle of the DNA strands with respect to the nanowire, are computed by a Metropolis Monte Carlo algorithm for charged molecules at interfaces. In order to investigate the sensing mechanism of the device, we have computed the current­voltage characteristics, the electrostatic potential and the concentrations of electrons and holes. Very good agreement with measurements has been found and optimal device parameters have been identified. Our approach provides the capability to study the device sensitivity, which is of fundamental importance for reliable sensing.

Low incidence of adenocarcinoma and high-grade intraepithelial neoplasia in patients with Barrett's esophagus: a prospective cohort study.

BACKGROUND AND STUDY AIMS: Barrett's esophagus is a premalignant condition. The risk of developing high grade intraepithelial neoplasia (HGIN) or adenocarcinoma is currently a matter of debate. Due to several shortcomings, previous studies have probably overestimated the risk. The main aim of our study was to investigate the incidence of HGD and adenocarcinoma in a cohort of patients with Barrett's esophagus. PATIENTS AND METHODS: In a prospective, cohort study, all patients had intestinal metaplasia and macroscopic evidence of short- or long-segment (< 3 cm or > or = 3 cm) Barrett's esophagus. All patients underwent a standard protocol including regular endoscopies with biopsies and were treated with a proton pump inhibitor or antireflux surgery. RESULTS: A total of 135 patients underwent 623 endoscopies during 700 patient-years (mean follow-up 5.2 +/- 2.3 years). Simultaneous HGIN and adenocarcinoma were detected in two patients with long-segment Barrett's esophagus (1.5%; 2 and 6 years after the index endoscopy). Low grade intraepithelial neoplasia (LGIN) was detected in 25 patients (18.5%); in 11 of these patients (44%), LGIN was not confirmed in later biopsies. Our study shows an incidence of HGIN/adenocarcinoma of 1/350 patient-years. Endoscopic regression of Barrett's esophagus was seen in 20.7% of patients. CONCLUSION: The incidence of HGIN/adenocarcinoma is low in patients with adequately treated Barrett's esophagus. The annual risk of developing HGIN/adenocarcinoma is 0.21% (1.6% in long-segment Barrett's esophagus).

Some trace elements in coal of the Czech Republic, environment and health protection implications.

Mining for coal and its utilization have various impacts on the surrounding environment. Huge volumes of waste materials which are by-products of both the underground and open cast coal mining, pose one of the major environmental hazards in addition to air pollution caused by coal burning in power plants in the Czech Republic. Some of these risks could be reduced when having accurate and comprehensive data on coal quality. Statistical data processing of almost 35,000 coal samples from Late Paleozoic and Tertiary coal basins of the Czech Republic provided a unique information on the quality of lignite, sub-bituminous and bituminous coals and anthracites including the content of toxic trace elements (As, Be, Hg, Pb and Se). In this context related environment and health risks and protection implications are discussed.

[Multiple diverticula of the jejunum as a cause of recurrent sub-ileus conditions]. / Mnohocetná divertikulóza jejuna jako prícina opakovaných subileózních stavu.

The authors describe the case of a 72-year-old man who suffered from marked digestive complaints for almost 50 years. They depended on the amount of food and the composition of the diet and during the last six years they led to attacks of severe epigastrial pain and backache associated with subileous conditions. Only enteroclysis led to a diagnostic solution. It revealed a parapapillary diverticulum of the duodenum and multiple diverticulosis of the upper jejunum. CT and scintigraphy, using autologous leucocytes labelled with 99mTc indicated the possible diverticulitis. Simple dietetic and therapeutic provisions eliminated completely the painful attacks and the patient's complaints were reduced to occasional slight flatulence.

[Alcohol block of the celiac plexus in severe visceral pain]. / Alkoholová blokáda plexus coeliacus u tezkých útrobních bolestí.

The authors present their own experience with percutaneous alcohol block of the coeliac plexus. Between April 1988 and December 1991 they used it in 22 patients. Except one patient the others suffered from severe pain of abdominal organs associated with carcinoma of the pancreas. The first four operations were made using angiography, the remainder under CT control. During evaluation of results two weeks after the intervention complete regression of pain was recorded in six patients. A partial effect was achieved in 11 patients, and the intervention failed in five patients. The intervention was repeated in four patients. The authors emphasize that the procedure is relatively simple and safe, and if successful, makes it possible to reduce or even eliminate opiates. It improves the quality of the remaining life of the patient.

[The importance of enteroclysis in Crohn's disease]. / Význam enteroklýzy u Crohnovy nemoci.

The authors discuss the importance of enteroclysis in Crohn's disease. In a group of 22 patients the finding was negative only in four where the primary localization of the disease was beyond the small intestine. In the remaining patients enteroclysis either confirmed the extent of the affection assessed during irrigoscopy or more frequently revealed a more extensive affection of the small intestine than was originally assumed, provided evidence of an affection not revealed by other methods, drew attention to imminent obstruction or another serious complication and in two instances established the diagnosis. Enteroclysis in Crohn's disease is a valuable method which cannot be replaced by another examination.