The presence of free palmitic acid modulates the effects of lutein on structural and dynamic properties of lipid membranes

Free fatty acids, like palmitic acid (PA), and xanthophyll pigments, like lutein (LUT) are the natural membrane compounds in plants. To study the effect of PA on LUT and their organization, a model membrane of 1,2-dimyristoyl-sn-glycerol-3-phosphocholine (DMPC) enriched with 2 mol% PA and 1 mol% LUT was formed. Molecular mechanisms underlying the interaction between these two compounds were examined with application of molecular spectroscopy techniques, e.g., visible spectroscopy, electron paramagnetic resonance and Fourier transform infrared. We determined the monomeric/dimeric organization of LUT in the membrane. We proved that the presence of PA in the lipid phase facilitated and stabilized the formation of LUT structures in the membrane. Lutein with PA did not form strong molecular aggregates like H- and J-structures. We presented the simplified model membrane that could be a suitable representation of the physiological process of de-esterification of PA from LUT appearing in natural biomembranes in humans.

Identifying canonical and replicable multi-scale intrinsic connectivity networks in 100k+ resting-state fMRI datasets

Despite the known benefits of data-driven approaches, the lack of approaches for identifying functional neuroimaging patterns that capture both individual variations and inter-subject correspondence limits the clinical utility of rsfMRI and its application to single-subject analyses. Here, using rsfMRI data from over 100k individuals across private and public datasets, we identify replicable multi-spatial-scale canonical intrinsic connectivity network (ICN) templates via the use of multi-model-order independent component analysis (ICA). We also study the feasibility of estimating subject-specific ICNs via spatially constrained ICA. The results show that the subject-level ICN estimations vary as a function of the ICN itself, the data length, and the spatial resolution. In general, large-scale ICNs require less data to achieve specific levels of (within- and between-subject) spatial similarity with their templates. Importantly, increasing data length can reduce an ICN's subject-level specificity, suggesting longer scans may not always be desirable. We also find a positive linear relationship between data length and spatial smoothness (possibly due to averaging over intrinsic dynamics), suggesting studies examining optimized data length should consider spatial smoothness. Finally, consistency in spatial similarity between ICNs estimated using the full data and subsets across different data lengths suggests lower within-subject spatial similarity in shorter data is not wholly defined by lower reliability in ICN estimates, but may be an indication of meaningful brain dynamics which average out as data length increases.

The Role of Singlet Oxygen in Photoreactivity and Phototoxicity of Curcumin

Curcumin is a plant-derived yellow-orange compound widely used as a spice, dye and food additive. It is also believed to have therapeutic effects against different disorders. On the other hand, there are data showing its phototoxicity against bacteria, fungi and various mammalian cells. Since the mechanism of its phototoxic action is not fully understood, we investigated here the phototoxic potential of curcumin in liposomal model membranes and in HaCaT cells. First, detection of singlet oxygen (¹ O₂ ) luminescence proved that curcumin generates ¹ O₂ upon blue light irradiation in organic solvent and in liposomes. Then, HPLC-EC(Hg) measurements revealed that liposomal and cellular cholesterol is oxidized by ¹ O₂ photogenerated by curcumin. Enrichment of liposome membranes with curcumin significantly increased the oxygen photo-consumption rate compared to the control liposomes as determined by EPR oximetry. Cytotoxicity measurements, mitochondrial membrane potential analyses and protein hydroperoxides detection confirmed strong phototoxic effects of curcumin in irradiated HaCaT cells. These data show that since curcumin is advertised as a valuable dietary supplement, or a component of cosmetics for topical use, caution should be recommended especially when skin is exposed to light.

Triplet-driven chemical reactivity of β-carotene and its biological implications

The endoperoxides of β-carotene (βCar-EPOs) are regarded as main products of the chemical deactivation of ¹O₂ by β-carotene, one of the most important antioxidants, following a concerted singlet-singlet reaction. Here we challenge this view by showing that βCar-EPOs are formed in the absence of ¹O₂ in a non-concerted triplet-triplet reaction: ³O₂ + ³β-carotene → βCar-EPOs, in which ³β-carotene manifests a strong biradical character. Thus, the reactivity of β-carotene towards oxygen is governed by its excited triplet state. βCar-EPOs, while being stable in the dark, are photochemically labile, and are a rare example of nonaromatic endoperoxides that release ¹O₂, again not in a concerted reaction. Their light-induced breakdown triggers an avalanche of free radicals, which accounts for the pro-oxidant activity of β-carotene and the puzzling swap from its anti- to pro-oxidant features. Furthermore, we show that βCar-EPOs, and carotenoids in general, weakly sensitize ¹O₂. These findings underlie the key role of the triplet state in determining the chemical and photophysical features of β-carotene. They shake up the prevailing models of carotenoid photophysics, the anti-oxidant functioning of β-carotene, and the role of ¹O₂ in chemical signaling in biological photosynthetic systems. βCar-EPOs and their degradation products are not markers of ¹O₂ and oxidative stress but of the overproduction of extremely hazardous chlorophyll triplets in photosystems. Hence, the chemical signaling of overexcitation of the photosynthetic apparatus is based on a ³chlorophyll-³β-carotene relay, rather than on extremely short-lived ¹O₂.

Exercise and nitrite prevent and Nω-nitrol-L-arginine methyl ester reproduces imbalance in the nuclear factor-κB/NADPH oxidase 2 and nuclear factor erythroid 2-related factor 2/NADPH oxidase 4/endothelial nitric oxide synthase systems in diabetes

Diabetes-induced vasculopathies are linked to inflammation mediated by mutually inhibitory nuclear factor-kappaB (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2). NF-κB is activated by superoxide (O₂ ^˙-)- producing nicotinamide adenine dinucleotide phosphate (NADPH) oxidase homologues, including NADPH oxidase 2 (Nox2), and vice versa, with NF-κB inducing Nox2. Nrf2 is activated by H₂O₂-producing Nox4 and nitric oxide (NO), but also induces NADPH oxidase 4 (Nox4) and endothelial nitric oxide synthase (eNOS). The NF-κB/Nox2 system is upregulated and Nrf2/Nox4/eNOS is downregulated in diabetes. We hypothesized that this vascular-deleterious imbalance results from the reduced vascular NO signaling, and so may be prevented by exercise training and sodium nitrite (interventions known to replenish vascular NO), and be reproduced by nitric oxide synthase (NOS) inhibition. Streptozotocin diabetic rats were examined on days 4, 10, 49 and 84 of diabetes. From day 4 onwards, plasma nitrite was reduced while NF-κB nuclear accumulation in the heart and kidneys gradually increased, while Nrf2 decreased. In parallel, the cardiac expression of signatures of the NF-κB (inducible nitric oxide synthase (iNOS), vascular cell adhesion molecule-1 (VCAM-1), NADPH oxidase 2 Nox2) increased and of the Nrf2 (Nox4, eNOS, heme-oxygenase-1 (HO-1)) decreased. Exercise training and dietary nitrite prevented this phenotype in the 49-day diabetes model. 7-day treatment of non-diabetic rats with NOS inhibitor of Nω-nitro-L-arginine methyl ester (L-NAME) recapitulated the NF-κB/Nox2 and Nrf2/Nox4/eNOS imbalance, as seen in diabetic rats. Nitrite failed to prevent the changes induced by L-NAME. The coherence of changes in NF-κB, Nox2, Nrf2, Nox4 and eNOS under the various settings of this study aimed at modifying the vascular NO leads us to propose that NF-κB/Nox2 and Nrf2/Nox4/eNOS are two crosstalking functional subsystems of one larger regulatory network, with NOS-derived NO ensuring the balance between these subsystems, and thus preventing vascular oxidative stress, endothelial dysfunction and inflammation.

The ROS-generating photosensitizer-free NaYF4:Yb,Tm@SiO2upconverting nanoparticles for photodynamic therapy application

In this work we adapt rare-earth-ion-doped NaYF₄nanoparticles coated with a silicon oxide shell (NaYF₄:20%Yb,0.2%Tm@SiO₂) for biological and medical applications (for example, imaging of cancer cells and therapy at the nano level). The wide upconversion emission range under 980 nm excitation allows one to use the nanoparticles for cancer cell (4T1) photodynamic therapy (PDT) without a photosensitizer. The reactive oxygen species (ROS) are generated by Tm/Yb ion upconversion emission (blue and UV light). Thein vitroPDT was tested on 4T1 cells incubated with NaYF₄:20%Yb,0.2%Tm@SiO₂nanoparticles and irradiated with NIR light. After 24 h, cell viability decreased to below 10%, demonstrating very good treatment efficiency. High modification susceptibility of the SiO₂shell allows for attachment of biological molecules (specific antibodies). In this work we attached the anti-human IgG antibody to silane-PEG-NHS-modified NaYF₄:20%Yb,0.2%Tm@SiO₂nanoparticles and a specifically marked membrane model by bio-conjugation. Thus, it was possible to perform a selective search (a high-quality optical method with a very low-level organic background) and eventually damage the targeted cancer cells. The study focuses on therapeutic properties of NaYF₄:20%Yb,0.2%Tm@SiO₂nanoparticles and demonstrates, upon biological functionalization, their potential for targeted therapy.

Tauroursodeoxycholic Acid (TUDCA)-Lipid Interactions and Antioxidant Properties of TUDCA Studied in Model of Photoreceptor Membranes

Tauroursodeoxycholic acid (TUDCA), a hydrophilic bile acid containing taurine conjugated with the ursodeoxycholic acid (UDCA), has been known and used from ancient times as a therapeutic compound in traditional Chinese medicine. TUDCA has recently been gaining significant interest as a neuroprotective agent, also exploited in the visual disorders. Among several mechanisms of TUDCA's protective action, its antioxidant activity and stabilizing effect on mitochondrial and plasma membranes are considered. In this work we investigated antioxidant activity of TUDCA and its impact on structural properties of model membranes of different composition using electron paramagnetic resonance spectroscopy and the spin labeling technique. Localization of TUDCA molecules in a pure POPC bilayer has been studied using a molecular dynamics simulation (MD). The obtained results indicate that TUDCA is not an efficient singlet oxygen (1O2 (1Δg)) quencher, and the determined rate constant of its interaction with 1O2 (1Δg) is only 1.9 × 105 M-1s-1. However, in lipid oxidation process induced by a Fenton reaction, TUDCA reveals substantial antioxidant activity significantly decreasing the rate of oxygen consumption in the system studied. In addition, TUDCA induces slight, but noticeable changes in the polarity and fluidity of the investigated model membranes. The results of performed MD simulation correspond very well with the experimental results.

Effects of Curcumin on Lipid Membranes: an EPR Spin-label Study

Curcumin is a yellow–orange dye widely used as a spice, food coloring and food preservative. It also exhibits a broad range of therapeutic effects against different disorders such as cancer, diabetes, or neurodegenerative diseases. As a compound insoluble in water curcumin accumulates in cell membranes and due to this location it may indirectly lead to the observed effects by structurally altering the membrane environment. To exert strong structural effects on membrane curcumin needs to adopt a transbilayer orientation. However, there is no agreement in literature as to curcumin’s orientation and its structural effects on membranes. Here, we investigated the effects of curcumin on lipid order, lipid phase transition, and local polarity in a model liposome membranes made of DMPC or DSPC using electron paramagnetic resonance (EPR) spin labeling technique. Curcumin affected lipid order at different depths within the membrane: it slightly increased the phospholipid polar headgroup mobility as monitored by spectral parameters of T-PC, while along the acyl chain the ordering effect was observed in terms of order parameter S. Also, rotational correlation times τ_2B and τ_2C of 16-PC in the membrane center were increased by curcumin. Polarity measurements performed in frozen suspensions of liposomes revealed enhancement of water penetration by curcumin in the membrane center (16-PC) and in the polar headgroup region (T-PC) while the intermediate positions along the acyl chain (5-PC and 10-PC) were not significantly affected. Curcumin at a lower concentration (5 mol%) shifted the temperature of the DMPC main phase transition to lower values and increased the transition width, and at a higher concentration (10 mol%) abolished the transition completely. The observed effects suggest that curcumin adopts a transbilayer orientation within the membrane and most probably form oligomers of two molecules, each of them spanning the opposite bilayer leaflets. The effects are also discussed in terms of curcumin’s protective activity and compared with those imposed on membranes by other natural dyes known for their protective role, namely polar carotenoids, lutein and zeaxanthin.

Oncosurgery in the Czech Republic

The article describes the development of oncosurgery in the Czech Republic since the beginning of the century, as well as other perspectives regarding this specialty. The development of surgical treatment of solid malignant tumours in the Czech Republic was evaluated according to the National Cancer Register database and compared to the neighbouring countries, and the educational system of surgeons in oncosurgery was assessed. Although surgery plays a key role in cancer therapy, starting from the beginning of this millennium it has been pushed aside as a service specialty for other disciplines in oncology. In 2002, these changes were supported by the activities of the newly founded Division of Oncosurgery under the Czech Society for Oncology, which became part of the Czech Surgical Society in 2016. An official educational programme of surgeons in oncology was successfully implemented and since 2011, a specialization examination in oncosurgery has been introduced, organized by the subdepartment of oncosurgery of the Institute of Postgraduate Medical Education (IPVZ), Prague. To date, this examination has been completed by 112 physicians and approximately the same number is currently registered in the educational programme. Currently, 34 centres are accredited for education in oncosurgery. The establishment of Complex Oncology Centres based on an initiative of the Czech Society for Oncology of 2006 only addressed pharmaceutical and radiation oncology. Despite progress in oncosurgery, more clearly defined conditions for this specialty are needed. Conclusion: The education of surgeons in oncosurgery should be continued. It is necessary to expand the number of centres with accreditation for oncosurgery and develop a concept for oncosurgery in the Czech Republic which would be associated with rational concentration of this treatment in connection with organization and provision of continuous urgent and acute surgical care in the Czech Republic, including control mechanisms to ensure its quality. This proposal should be discussed by the Czech Surgical Society in order to further enhance the quality of oncosurgery in the Czech Republic.

Government-based financing strategies for public health in Ukraine: way of transforming

Key messages

Public health system in Ukraine is going through reforming process to address existing challenges and introducing new financing approaches with a focus on regional level. Using transparent procurement system to transform the public health financing mechanisms due to existing limitations and overall health financing reform in Ukraine.

Effects of vinclozolin exposure on the expression and activity of SIRT1 and SIRT6 in the porcine ovary

Within the mammalian reproductive system sirtuin 1 and 6 (SIRT1, SIRT6) are considered to contribute to steroid hormone signaling and control of reproductive physiology. Therefore, the specific question is whether and how a commonly used dicarboximide fungicide with antiandrogenic activity, vinclozolin (Vnz) alters SIRT1 and SIRT6 expression and whether both investigated sirtuins positively affect survival of the follicles after vinclozolin exposure. Immunocytochemistry and immunohistochemistry were performed to localize SIRT1 and SIRT6 expression in cultured granulosa cells (GCs; 48 hours) and whole ovarian follicles (24 hours) after treatment with two androgens, testosterone (T; 10^-7 M) and dihydrotestosterone (DHT; 10^-7 M), and an antiandrogen, Vnz (1.4 x 10^-5 M), separately and in combinations. Granulosal and follicular mRNA and protein expression of both sirtuins was also investigated by real-time PCR and Western blot. In addition, their concentration and activity was studied by immunoenzymatic and fluorescence assays. Our observations: (1) demonstrate the presence of both investigated sirtuins in ovarian cells, (2) show their potential involvement in the control of follicular atresia because of increased SIRT1/SIRT6 expression and SIRT1 activity after exposure to Vnz, (3) represent the first data on the interrelationships between sirtuins and androgens in porcine ovarian cells. Based on these findings and our previous results we can conclude, that SIRT1 and SIRT6 do not exert the protective effects in ovarian follicles after vinclozolin exposure. These novel data on the role of SIRT1/SIRT6 in porcine ovarian follicles shows that in the presence of the investigated fungicide, sirtuins are upregulated, which can induce apoptosis of follicular cells. Furthermore the androgen receptor sensitivity to ligands, especially environmental ones (for example: vinclozolin) might be directly linked with the mechanism of action of both investigated sirtuins in the porcine ovary, which requires further investigation.

Coverage of multiple recessions using the tunnel technique and a collagen matrix in the maxilla or mandible: a 6-month study

Multiple recession defects in the dentition of the patients are routinely encountered in clinical practice and as such present a challenge for clinicians. Periodontal plastic surgical procedures aim to restore both esthetics as function in periodontal tissues. The objective of this study was to evaluate and compare the clinical efficacy of using a tunnel technique with a collagen matrix to cover multiple recessions in the maxilla or mandible. Fourteen patients were enrolled in the study. Patients in the maxilla-group and mandible-group were treated with xenogeneic collagen matrix using the tunnel technique. Clinical recordings were obtained at baseline and after 3 and 6 months. The percentage of average recession coverage (ARC), the percentage rate of patients with complete coverage of all recessions (CRC-1) and the percentage rate of complete coverage of recession defects (CRC-2) were evaluated after 3 and 6 months after the surgery. Statistically significant differences were observed in every parameter except probing depth between the baseline values compared to the values 3 and 6 months after the procedure in both groups. The mean ARC 6 months after the procedure was 96.8% in the maxilla and 81.3% in the mandible. At 6 months after the procedure, a complete root coverage was obtained in 2 out of 9 patients and 31 out of 39 recessions (79%) in the maxilla and 0 out of 5 patients and 10 out of 20 recessions (50%) in the mandible. A collagen matrix combined with the tunnel technique led to a satisfactory ARC, CRC- 2 and resulted in an unsatisfactory CRC-1.

Hybrid thoracoscopic esophagectomy for cancer - retrospective analysis and comparison with transhiatal resection

INTRODUCTION

Minimally invasive methods for esophagectomy have been introduced to reduce postoperative complications. This paper compares open transhiatal esophagectomy and minimally invasive hybrid esophagectomy. Both methods have different extents of lymphadenectomy, transhiatal esophagectomy being considered less radical.

METHOD

A single-centre retrospective study comprised 39 patients subjected to transhiatal esophagectomy and 25 patients subjected to hybrid esophagectomy combining thoracoscopy with laparotomy and cervical anastomosis. All patients were operated for middle and distal third carcinoma of the esophagus, including cardia (Siewert II), in the period of 2006-2016 at the Surgery department of Nový Jičín hospital. The data of both groups, in particular the incidence of early postoperative complications and the number of dissected lymph nodes, were statistically compared. Complications are reported according to the International Consensus on Standardization of Data Collection for Complications Associated with Esophagectomy.

RESULTS

The duration of operation was significantly longer in the group that underwent hybrid resections (345 vs. 240 min, p<0.001). The number of dissected lymph nodes was comparable in both groups (15 vs. 16, p=0.072). Postoperative pulmonary complications were lower for hybrid operations (16% vs. 30.8%, p=0.243). The most common complication of transhiatal esophagectomy was pleural effusion requiring drainage, which occurred in 7 patients. The most common pulmonary complication of hybrid procedures was respiratory failure, which occurred in 3 patients. Anastomotic leak occurred in 5 patients after transhiatal esophagectomy and in one after thoracoscopic resection (12.8% vs. 4%, p=0.391). 30-day and 90-day mortality was nonsignificantly lower for hybrid resections (0% vs. 5.1%, p=0.516 and 4% vs. 10.3%, p=0.64). Following transhiatal esophagectomy, two patients died as a result of respiratory complications, one died from necrosis of the gastric tube and one from acute myocardial infarction. In the hybrid group, one patient died from respiratory failure. Hybrid resection exhibited lower morbidity (36% vs. 59%, p=0.123). The number of overall complications, irrespective of their severity according to the Clavien-Dindo classification, was statistically in favor of hybrid resection (11 vs. 30, p=0.015).

CONCLUSION

In our study, we found that thoracoscopic hybrid resection was a feasible and well-executable method, with a statistically lower incidence of postoperative complications. Thoracoscopy allows lymphadenectomy to be performed to sufficient extent. The large number and various combinations of esophagectomy techniques make it difficult to evaluate and compare the outcomes of individual methods. Preference for a specific resection technique within a given surgical department remains an important factor as clear recommendations for esophageal resections do not yet exist. However, the use of minimally invasive techniques in esophageal resections is gradually becoming a standard. Key words: minimally invasive esophagectomy - thoracoscopy - postoperative complications - lymphadenectomy.

Risk factors and post-operative complications after gastrectomy for cancer

INTRODUCTION

Gastric resections due to carcinoma belong to the most demanding procedures in visceral surgery. This is due to the requirements for the extent of resection and lymphadenectomy, coupled with the need for functional reconstruction of the digestive tract. The procedure is associated with 18-46% morbidity, which delays administration of adjuvant therapy and worsens oncological results. Identification of risk factors for potential complications may play an important role in the indication and perioperative care. The aim of our study is to (i) evaluate the morbidity a mortality of a patient group with post-gastrectomy complications and to (ii) identify associated risk factors.

METHOD

This retrospective analysis comprises patients treated in 2005-2016. Gastric resection was performed in 266 adenocarcinoma patients, 172 men and 94 women (median age 66 years). Early post-operative complications following gastrectomy were observed within 60 days. Complications and their severity were evaluated according to the extended form of the Accordion Severity Grading System. Selected demographic risk factors, operative factors and malignancy-related factors were analyzed. Multivariate regression (orthogonal projections to latent structure) was used for statistical processing.

RESULTS

Overall morbidity and mortality was 34.6% and 3.4%. Serious complications occurred in 51 operated patients (19.2%). 24 patients had two or three complications (9%). The most common grades of severity were grade 2 in 31 patients (11.7%) and grade 4 in 20 patients (10.9%). The duration of hospital stay correlated with the severity of the complication. Most common surgical complications were: intra-abdominal abscess (16.4%, 17 cases), wound complications (5.3%, 14 cases), pancreatitis (4.9%, 13 cases), anastomotic leakage (3.4%, 9 cases), postoperative ileus (3.4%, 9 cases). Respiratory and cardiac complications were the most common non-surgical complications (8.6%, 23 cases and 3.8%, 20 cases, respectively). In the derived statistical model, BMI, the presence of more comorbidities, lesser surgical experience, the length of hospital stay and hospitalization at ICU were identified as risk factors associated with the grade of complication, morbidity, presence of serious complication and multiple complications.

CONCLUSION

Gastrectomy plays a fundamental role in the curative treatment of gastric carcinoma; it is, however, associated with substantial morbi-dity and mortality. The best management of complications is their prevention. Preoperatively, the greatest attention should be paid to patients with several comorbidities and higher BMI. Resections should be performed by experienced surgeons. During resection, consideration should be given to the extent of resection and lymphadenectomy. In the postoperative period, the length of hospital stay, especially at ICU, should be reduced to minimum. Analyses of these risk factors may decrease the incidence of complications. Key words: gastric cancer - gastrectomy - risk factors - complications.

Current state of surgical treatment of cancer of the stomach and gastro-esophageal junction in the Czech Republic

INTRODUCTION

Analysis of the epidemiology and treatment of cancer of the stomach (CS) and gastro-esophageal junction (GEJ) in the Czech Republic (CR).

METHOD

Analysis from the National Cancer Registry (NCR) of the CR examined data up to the year 2013.

RESULTS

In CS and GEJ, the incidence is 14.3, mortality is 10.5 and prevalence is 51.1 per 100,000 population. The Karlovy Vary, Olomouc and Moravian-Silesian regions had the highest incidences. The median age at diagnosis is 69 years for men and 72 years for women. Location in the stomach prevails in 85% of the patients, cancer of the gastric cardia occurring in 15%. In men, this ratio is 81 to 19%, in women 90 to 10%. The disease is usually diagnosed late; in 2013, 36% of CS and 32% of GEJ tumors were stage I and II. 53% of CS and 56% of tumors of the GEJ were diagnosed as stage III and IV, and in 11% and 12%, the stage was not determined. In the years 2009-2013 (1,580 patients with CS and GEJ), only 22% were treated surgically, surgery and oncological treatment was given to 21.3%, only non-surgical treatment was received by 15.7% and 41% of patients received no oncological treatment. Overall five-year survival in patients treated between 2010 and 2013 was 32%. At stage I it was 69%, at stage II 41%, at stage III 23% and at stage IV it was 6%. Five-year survival rates according to disease stage and type of treatment given and median of survival were analysed on 8,348 patients with CS and GEJ between 2004 and 2013. Surgery only was performed in 4,116 patients, surgery and radiotherapy was administered to 113 patients, surgery and chemotherapy to 1,855 patients, and 1,125 patients received chemotherapy alone. In 98% of the treated patients, chemotherapy and/or radiotherapy was administered adjuvantly after the surgery. Primary operations were performed at a total of 175 surgical centers, only 22 of them performing more than 10 operations annually. The median of survival differed depending on the number of operations performed: at enters performing more than 20 operations, the median was 24.8 months (m); at enters performing 10-19 operations, the median was 18.2 m; at centers performing 6-9 operations the median was 18.1 m; and at centers performing less than 6 operations, the median was 13.1 m.

CONCLUSION

Early diagnosis is key for five-year survival. Treatment is based on surgery; greatest improvement is seen when surgery is combined with chemoradiotherapy, which is usually administered adjuvantly in the CR. At stage I in CS +9.5%, GEJ cancer +26.5%, at stage II in CS +14.7%, GEJ cancer +16.4% and at stage III in CS +13.3%, GEJ cancer +2.6%. Palliative chemo and/or radiotherapy does not prolong five-year survival and must be selected on an individual basis with regard to the expected benefit for the patient. Facilities performing a greater number of surgical procedures have better long-term results. Key words: malignant esophageal tumors - epidemiology - treatment - results.

Prophylactic ligation of the thoracic duct in the prevention of chylothorax after esophagectomy

INTRODUCTION

Chylothorax after esophageal resection is an uncommon but serious complication with a reported incidence of 1-10%. It occurs after the injury of the thoracic duct or its tributaries. Chylothorax may cause an overall loss of several liters per day and may lead to dehydration, malnutrition and immunosuppression. Therapeutic approach has not been standardized. Prophylactic ligation of the thoracic duct during primary resection has been introduced to decrease the overall incidence of chylothorax. Its oncological benefit is unknown.

METHOD

A retrospective single-center study of patients who underwent transthoracic esophagectomy from 2008-2016 for esophageal carcinoma at the Department of Surgery, Hospital Nový Jičín. 58 patients underwent transthoracic esophagectomy (Ivor-Lewis and McKeown). Prophylactic ligation of the thoracic duct was performed in 31 patients (53%). The incidence of chylothorax and the amount of harvested lymph nodes was analysed in the group with thoracic duct ligation (A PTDL 31 patients) and in the non-ligation group (B 27 patients).

RESULTS

Overall incidence of chylothorax after transthoracic esophagectomy was 3.4%. Chylothorax occurred in two men (type 3B) in the prophylactic group (6.5%) and it was not observed in the non-ligation group. Statistically significant difference was not confirmed (p=0,494). Chylous leak was successfully treated thoracoscopically and by thoracotomy with repeat ligation of the thoracic duct. Non-significantly more lymph nodes were harvested in the prophylactic group (18 A PTDL vs. 15 B, p=1).

CONCLUSION

Prophylactic ligation of the thoracic duct in our study did not reduce the incidence of chylothorax. Redo thoracotomy and redo thoracoscopy for chylothorax is feasible. In patients with high-output and long lasting leaks the indication for redo surgery should be early. Key words: chylothorax - esophageal resection - prophylactic thoracic duct ligation.

Oxidation-Induced Increase In Photoreactivity of Bovine Retinal Lipid Extract

The mammalian retina contains a high level of polyunsaturated fatty acids, including docosahexaenoic acid (22:6) (DHA), which are highly susceptible to oxidation. It has been shown that one of the products of DHA oxidation-carboxyethylpyrrole (CEP), generated in situ, causes modifications of retinal proteins and induces inflammation response in the outer retina. These contributing factors may play a role in the development of age-related macular degeneration (AMD). It is also possible that some of the lipid oxidation products are photoreactive, and upon irradiation with blue light may generate reactive oxygen species. Therefore, in this work we analysed oxidation-induced changes in photoreactivity of lipids extracted from bovine neural retinas. Lipid composition of bovine neural retinas closely resembles that of human retinas making the bovine tissue a convenient model for studying the photoreactivity and potential phototoxicity of oxidized human retinal lipids. Lipid composition of bovine neural retinas Folch' extracts (BRex) was determined by gas chromatography (GC) and liquid chromatography coupled to an electrospray ionization source-mass spectrometer (LC-ESI-MS) analysis. Liposomes prepared from BRex, equilibrated with air, were oxidized in the dark at 37 °C for up to 400 h. The photoreactivity of BRex at different stages of oxidation was studied by EPR-oximetry and EPR-spin trapping. Photogeneration of singlet oxygen (¹O₂, ¹Δ_g) by BRex was measured using time-resolved detection of the characteristic phosphorescence at 1270 nm. To establish contribution of lipid components to the analysed photoreactivity of Folch' extract of bovine retinas, a mixture of selected synthetic lipids in percent by weight (w/w %) ratio resembling that of the BRex has been also studied. Folch's extraction of bovine neural retinas was very susceptible to oxidation despite the presence of powerful endogenous antioxidants such as α-tocopherol and zeaxanthin. Non-oxidized and oxidized BRex photogenerated singlet oxygen with moderate quantum yield. Blue-light induced generation of superoxide anion by Folch' extract of bovine neural retinas strongly depended on the oxidation time. The observed photoreactivity of the studied extract gradually increased during its in vitro oxidation.

EPR Studies on the Properties of Model Photoreceptor Membranes Made of Natural and Synthetic Lipids

The membranes of retina photoreceptors have unique lipid composition. They contain a high concentration of polyunsaturated docosahexaenoic acid, with six double bonds, and are enriched in phosphatidylethanolamines. Based on their phospholipid composition and cholesterol content, membranes of photoreceptors can be divided into three types: plasma membrane, young disks membranes, and old disks membranes. High amount of docosahexaenoic acid, abundant illumination, and high respiratory demands make these membranes sensitive to oxidative stress and lipid peroxidation. Human retinas are not easily available for research, therefore most research is done on bovine retinas. However, to follow, in a controlled manner, the changes in membrane properties caused by different factors it seems advisable to apply carefully prepared models of photoreceptor membranes. Using synthetic lipids we prepared liposome models of three types of photoreceptor membranes, and by means of electron paramagnetic resonance spectroscopy and spin labeling technique we compared polarity and fluidity of those model membranes with the properties of membranes consisting of natural lipids extracted from photoreceptor outer segments of bovine retinas. Additionally, we studied the effect of oxidation on the membrane properties in the presence and in the absence of zeaxanthin, which is an antioxidant naturally present in the human retina. The results show that there are significant differences in polarity and fluidity between all investigated membranes, which reflect differences in their lipid composition. The properties of the membranes made of natural photoreceptor outer segment lipids are most similar to the ones of the models of old disks membranes. Oxidation did not change the membrane properties significantly; however, a slight ordering effect was observed in liposomes made of natural photoreceptor outer segment lipids and in the model of old disks membranes. Zeaxanthin affected polarity and fluidity mostly in the model of old disks membranes. The results show that by careful selection and appropriate proportions of lipid mixtures, it is possible to obtain synthetic membranes of the properties similar to the natural ones.

[Sternal resection for metachronous metastasis from renal carcinoma]

In this report, the authors describe a rare case of complete sternal resection for a metachronous metastasis from renal carcinoma in a 59-year-old female patient 12 years after primary left nephrectomy. Due to the large extent of resection, a polyester double layer mesh with bone cement was used for chest wall reconstruction. The postoperative course was uneventful without any indication for adjuvant treatment. The patient has been followed up for 20 months without any signs of complications and recurrence of her malignancy.Key words: sternum resection bone metastases renal carcinoma.

[Gastric stump cancer--unicentric analysis of 7 patients]

INTRODUCTION

Gastric stump cancer accounts for 14% of all gastric carcinomas. Originally this term included patients who previously underwent surgery due to peptic ulcer disease but today gastric stump cancer also includes patients diagnosed some time after primary gastric resection due to gastric cancer. The incidence is increasing. Gastric stump cancer is associated with poor prognosis and its reported resecability is around 40%.

METHODS

We retrospectively analyzed the data of 7 patients with a preoperatively histologically confirmed stump cancer who had been operated at the Department of Surgery at Nový Jičín Hospital during 2006-2014.

RESULTS

We operated 5 men and 2 women with the median age of 70 years (5580). The primary surgical resection in all our patients was BII gastric resection due to peptic ulcer disease, and GSC had evolved within a median of 38 years (3246) after primary intervention. None of the patients had been regularly screened by endoscopy following primary surgery. We performed five curative resections (four total gastrectomies, one subtotal gastrectomy). Our resecability rate was 71%. In two cases, only explorative laparotomy was performed due to generalisation of the malignancy. Two patients from the resected group died after 30 and 34 months due to progression of their disease; the other three patients are still alive after 17, 19 and 88 months.

CONCLUSION

Gastric stump cancer is a malignancy often diagnosed in its late stages. Regural endoscopic screening after primary gastric resection for benign disease can lead to diagnosis at an earlier stage, thereby improving the resection rate and overall survival. This also applies to long-term follow-up of patients with primary subtotal gastrectomy for cancer. Lymphatic metastasizing of the carcinoma can often be different due to the previous surgical intervention and altered anatomy. This must be taken into account during operations.

One- and Two-Piece Implants Placed in the Same Patients: Clinical Outcomes After 5 Years of Function

A retrospective evaluation of 24 subjects treated with one-piece (1P) (n = 34) and two-piece (2P) (n = 38) implants placed in contralateral mandibular premolar locations was conducted. Cumulative implant survival was 100% following a 5-year (range = 59.9-72.3 months; mean = 63.1 months) postrestoration monitoring period. Bone loss (P = .1952) and prosthetic complications (P = .3667) did not significantly differ between the two groups. Clinical efficacy was equivalent for both implant designs.

Testing the accuracy of an observation-based classifier for rapid detection of autism risk

Current approaches for diagnosing autism have high diagnostic validity but are time consuming and can contribute to delays in arriving at an official diagnosis. In a pilot study, we used machine learning to derive a classifier that represented a 72% reduction in length from the gold-standard Autism Diagnostic Observation Schedule-Generic (ADOS-G), while retaining >97% statistical accuracy. The pilot study focused on a relatively small sample of children with and without autism. The present study sought to further test the accuracy of the classifier (termed the observation-based classifier (OBC)) on an independent sample of 2616 children scored using ADOS from five data repositories and including both spectrum (n=2333) and non-spectrum (n=283) individuals. We tested OBC outcomes against the outcomes provided by the original and current ADOS algorithms, the best estimate clinical diagnosis, and the comparison score severity metric associated with ADOS-2. The OBC was significantly correlated with the ADOS-G (r=-0.814) and ADOS-2 (r=-0.779) and exhibited >97% sensitivity and >77% specificity in comparison to both ADOS algorithm scores. The correspondence to the best estimate clinical diagnosis was also high (accuracy=96.8%), with sensitivity of 97.1% and specificity of 83.3%. The correlation between the OBC score and the comparison score was significant (r=-0.628), suggesting that the OBC provides both a classification as well as a measure of severity of the phenotype. These results further demonstrate the accuracy of the OBC and suggest that reductions in the process of detecting and monitoring autism are possible.

A role for resistin in the ovary during the estrous cycle

In a previous study, we showed that resistin expression increased during ovarian follicle development in prepubertal pigs and had direct effects on steroidogenesis, suggesting an important role for resistin in the ovary during puberty. To determine its potential regulatory role in the ovary during the estrous cycle, using real-time PCR, immunoblotting, immunohistochemistry, and ELISA methods, we quantified the expression, immunolocalization and concentration of resistin in different sized ovarian follicles (small, 2-4 mm; medium, 4-6 mm; and large, 8-12 mm) in mature pigs. We then determined the effects of recombinant resistin (0.1, 1, and 10 ng/ml) on steroid hormone (progesterone-P4, androstendione-A4, testosterone-T, and estradiol-E2) secretion and steroidogenic enzyme (3βHSD, CYP17A1, 17βHSD, and CYP19A1) gene and protein expression in ovarian follicles. We found no differences in the resistin expression between all of the examined follicles. Immunostaining analysis also showed resistin expression in the cytoplasm of both granulosa and theca cells, where it was localized more abundantly in the granulosa cells compared to the theca cells. Recombinant resistin direct stimulated P4, A4, and T secretion via increased expression of 3βHSD, CYP17A1, and 17βHSD, suggesting an autocrine and/or paracrine regulatory role in the porcine ovary during the estrous cycle.

[Colon cancer - evaluation of complications and risks of planned resections]

INTRODUCTION

Resection procedures for colorectal cancer are burdened with a relatively high number of complications. The aim of this study is to define risk factors associated with the development of postoperative complications based on retrospective data analysis.

MATERIAL AND METHODS

From January 1 st 2007 to December 31st 2012, 1093 patients underwent surgery for colorectal cancer. Retrospectively, we selected a group of 406 patients who underwent planned, elective colon resection for colon cancer. Open surgery was performed in 158 patients (38.9%), laparoscopic resection in 248 patients (61.1%). Based on initial staging of the disease, there were 85 patients (20.9%) in stage I, 137 patients (33.8%) in stage II, 110 patients (27.1%) in stage III and 74 patients (18.2%) in stage IV. Postoperative complications were evaluated according to Clavien - Dindo classification.

RESULTS

Grade I complications were observed in 34 patients (8.4%), grade II in 25 patients (6.2%), grade III in 43 patients (10.6%), grade IV in 7 patients (1.7%) and grade V in 8 patients (2.0%). The highest incidence of complications was observed in left colon resection procedures (41.1%), open resections (39.8%), procedures lasting longer than 301 minutes (50%), patients older than 81 years (41.6%) and in procedures performed by the youngest, less experienced surgeon (40.6%).

CONCLUSION

Our results confirmed that the type and approach of surgical procedure, patients age and surgeons experience are risk factors associated with a higher incidence of postoperative complications. High-risk surgical patients should be operated on by experienced surgeon who regularly performs a high number of resection procedures.

[Specialization in oncosurgery is not against the surgeons best interest]

An analysis of the current situation in the surgical treatment of solid malignant tumors in the Czech Republic demonstrates the need to impose a concept of oncosurgical care, which would lead to a steady improvement in the quality of care provided by surgeons in oncosurgery. The primary aim is that surgery plays an appropriate role in the complex care of oncology patients and that surgeons become equal partners to radiation and internal oncologists in the determination of diagnostic - therapeutic plans and in other decision-making processes. This aim is not possible without increasing the qualification of surgeons in oncosurgery. Our more than ten year effort culminated in 2011 with the introduction of the specialized field of oncosurgery into the postgradual education of surgeons; and as such, similarly to most other developed countries, provided the official opportunity to educate surgeons in the field of oncology. Other important tasks which would contribute to increasing the quality of oncosurgery include rational concentration of oncosurgical operations to a smaller number of surgical departments, where it is necessary to ensure both the improvement of surgeon qualification by way of oncosurgical specialization, as well as adequate material and financial support for complex oncosurgical procedures.

[Complications and risks in the surgery of tumors of the upper digestive tract (Foregut) Part II : Stomach]

INTRODUCTION

The aim of the work is to evaluate acceptable mortality and morbidity associated with stomach resections for carcinoma.

METHOD

The work analyzes data of patients with gastric cancer from the Czech National Cancer Registry and compares personal experience with complications and risks associated with stomach resections for carcinoma with the data from specialized literature from recent years.

RESULTS

The incidence of gastric cancer in the Czech Republic is presently 15.1/100 000 inhabitants, the mortality 11.6 and the prevalence 48.3. Stomach resections for carcinoma are complicated operations. Despite improving surgical techniques and tactics, as well as the perioperative intensive care, this procedure remains associated with significant morbidity and mortality. At the Department of Surgery of the Oncological Center and Hospital Nový Jičín, 286 patients with gastric cancer were operated between the years 2005 and 2012. In the group of 172 radical R0 resections, the mortality was 3.5% and the total morbidity was 33.7%. The most frequent and significant postoperative surgical complications were the pancreatitis (4.7%) and the anastomotic dehiscence (3.5%). The most frequent non-surgical ones were respiratory complications (4.7%). The mortality and morbidity frequency is comparable with the data published in specialized literature. Surgical treatment also utilized laparoscopy. All operations began with a diagnostic laparoscopy to specify the stage of the disease and to select the laparoscopic approach, most often a laparoscopically-assisted resection, which was used in 60 patients (30%). Laparoscopy was preferred even for the palliative anastomoses. No significant differences in morbidity and mortality were seen between open and laparoscopic procedures and statistical analysis is planned to gain greater experience.

CONCLUSION

In the Czech Republic, surgical treatment of tumors of the stomach is currently performed at a large number of workplaces with a low frequency. General trends for improving the morbidity and mortality include the use of minimally-invasive approaches, a fast-track program, and the application of principles of High-volume centres. The long-term prognosis of patients with gastric cancer is principally dependent on the degree of advancement of the disease.

[Complications and risks of the surgery of tumors of the upper digestive tract (Foregut) Part I: Esophagus]

INTRODUCTION

The aim of the work is to evaluate acceptable mortality and morbidity associated with the esophageal resections for carcinoma.

METHOD

The work analyses the data of patients with esophageal cancer from the Czech National Cancer Registry and it compares personal experience with complications and risks associated with the esophagectomy for carcinoma with the data from specialized literature published in recent years.

RESULTS

Despite improvements in the surgical technique and the perioperative intensive care, the esophagectomy maintains a relatively high morbidity and mortality. Published studies present mortality up to 10% and total morbidity between 40-60%. Respiratory complications are most frequent and significant and they reach up to 40% and the anastomotic dehiscence ranges from 0 to 25%. At the authors workplace in Nový Jičín, a total of 193 patients with the esophageal carcinoma were examined since 2007; 38% of these patients were indicated for operation and 62 esophageal resections with replacement were performed. The postoperative mortality within 30 days was 3.2% and the total morbidity was approximately 50%. Respiratory and cardiac complications were 28% and 18% respectively, fistula in the cervical anastomosis was seen in 5% and in the gastric tube in 3%, only one patient died from this surgical complication. The paralysis of the recurrent nerve occurred in 10%, and chylothorax in 3%. In almost all patients, the operation began with a laparoscopic revision to confirm operability and in 37% of the operated patients a video-assisted approach was used, most often the thoracoscopic mobilization of the esophagus.

CONCLUSION

The surgical treatment of tumors of the esophagus is a highly specialized domain of thoracic surgeons specialized in the issuesof the esophagus. General trends for improving the morbidity and mortality include the use of minimally-invasive approaches, fast-track programs after the esophagectomy, and the application of principles of High-volume centres. The long-term prognosis of patients with esophageal cancer is principally dependent on the degree of advancement of the disease.

[Acceptable risks in surgery from the perspective of the evidence-based medicine and an evaluation of the quality of surgical care]

A qualified assessment of the risks of surgical treatment and especially operations is based on the evaluation of morbidity, mortality and long-term results of surgeons work. These analyses should be conducted based on the principles of the evidence-based medicine (EBM) and, in recent years, an assessment of the risks that surgical treatment has been included into a broader complex of evaluating the quality of surgical care. Surgery, other surgical specializations, and the urgent medicine belong among medical fields which most often carry a risk of unsuccessful outcomes and complications. Taking into account the complexity of medicine, the diagnostic and therapeutic processes are burdened necessarily by a certain number of complications. It is never possible to completely eliminate human errors, but what is possible is to continuously decrease their numbers and repair them on time. EBM is defined as a method of treating for patients based on the best scientific evidence resulting from clinical and epidemiological scientific research publications. From an EBM perspective, surgery compared with pharmaceutical treatment is usually at a disadvantage because the studies with the highest level of evidence (the controlled randomized studies) are usually not possible to be performed in surgery. In various situations it is only possible to obtain certain kinds of evidence and in surgery the highest level of evidence is most often obtained from cohort studies and case control studies as a possible means of sorting our information. Currently, evaluating the quality of surgical care should be in the forefront of interest of every surgeon. Traditional criteria include the evaluation of operative and postoperative complications, mortality, the number of re-operations, the evaluation of the satisfaction of the patient with the procedure performed, the length of survival of oncological patients, the number of recurrences and a number of other criteria. The term "High Volume Hospital" represents a newly developing concept of evaluating quality in surgery, which arises from the assumption that with the increasing number of procedures (operations) performed the quality of the results attained increases as well. The evaluation of quality in surgery is a topic which should be addressed more thoroughly among surgeons. The creation of indicators of quality of surgical care and their application into clinical practice has great significance for the development of surgery and it is not possible to leave it beyond the control of surgeons.

Is that a rodent in your luggage? A mixed method approach to describe bushmeat importation into the United States

Bushmeat, defined as meat derived from wild animals, is a potential source of zoonotic pathogens. Bushmeat from restricted animals is illegal to import into the United States under US federal regulations. We reviewed US Centers for Disease Control and Prevention (CDC) port of entry surveillance records from September 2005 through December 2010 and conducted focus group studies to describe trends in and reasons for bushmeat importation into the United States. In total, 543 confiscated bushmeat items were recorded. Half of the confiscated bushmeat items identified were rodents. Africa was the most frequent continent of origin. Seasonality was evident, with bushmeat confiscations peaking in late spring to early summer. Four times more bushmeat was confiscated during an enhanced surveillance period in June 2010 compared with the same period in previous years, suggesting that routine surveillance underestimated the amount of bushmeat detected at US Ports of Entry. Focus groups held in three major US cities revealed that bushmeat importation is a multifaceted issue. Longstanding cultural practices of hunting and eating bushmeat make it difficult for consumers to acknowledge potential health and ecologic risks. Also, US merchants selling African goods, including bushmeat, in their stores have caused confusion among importers as to whether importation is truly illegal. Enhancing routine surveillance for bushmeat and consistent enforcement of penalties at all ports of entry, along with health education aimed at bushmeat importers, might be useful to deter illegal importation.

The influence of the antiandrogen 2-hydroxyflutamide on the androgen receptor expression in the porcine ovarian follicles - an in vitro study

Androgens are one of the most important agents influencing ovarian follicles growth and development. The biological action of androgens is primarily exerted through transcriptional regulation by the androgen receptor (AR), a member of the steroid hormone receptor superfamily. The purpose of this study was to test the role of androgen receptor agonist testosterone (T) or antagonist 2-hydroxyflutamide (2-Hf) and in combination on AR expression in cultured porcine granulosa cells (GC) or whole follicles. Granulosa cells isolated from mature pig follicles were cultured for 48 h. During the last 12 and 24 h of culture, they were incubated in the presence of T (10(-7)  m/ml), 2-Hf (1.7 × 10(-4)  m) or both T and 2-Hf (T + 2-Hf, at the same concentrations as when added separately). To better imitate in vivo conditions, whole follicles (6-8 mm in diameter) isolated from porcine ovaries have been incubated (for 12 and 24 h) in an organ culture system with the addition of the same factors. Thereafter, cells or sections obtained from cultured follicles were processed for AR detection by immunocytochemistry or immunohistochemistry. Moreover, expression of AR mRNA and protein was determined by real-time PCR and Western blot analysis. It was shown that the addition of 2-Hf in the presence of T had a positive effect on AR mRNA and protein expression in porcine GC and ovarian follicles. Moreover, the addition of 2-Hf influenced AR distribution in GC cultures which is seen as change of its localization from nuclear to perinuclear. Our results suggest that androgens acting through AR could be involved in the control of AR expression in porcine GC in vitro and in vivo.

Structural aspects of the antioxidant activity of lutein in a model of photoreceptor membranes

It was shown that in membranes containing raft domains, the macular xanthophylls lutein and zeaxanthin are not distributed uniformly, but are excluded from saturated raft domains and about ten times more concentrated in unsaturated bulk lipids. The selective accumulation of lutein and zeaxanthin in direct proximity to unsaturated lipids, which are especially susceptible to lipid peroxidation, could be very important as far as their antioxidant activity is concerned. Therefore, the protective role of lutein against lipid peroxidation was investigated in membranes made of raft-forming mixtures and in models of photoreceptor outer segment membranes and compared with their antioxidant activity in homogeneous membranes composed of unsaturated lipids. Lipid peroxidation was induced by photosensitized reactions using rose Bengal and monitored by an MDA-TBA test, an iodometric assay, and oxygen consumption (using EPR spectroscopy and the mHCTPO spin label as an oxygen probe). The results show that lutein protects unsaturated lipids more effectively in membranes made of raft-forming mixtures than in homogeneous membranes. This suggests that the selective accumulation of macular xanthophylls in the most vulnerable regions of photoreceptor membranes may play an important role in enhancing their antioxidant properties and ability to prevent age-related macular diseases (such as age-related macular degeneration (AMD)).

Structural aspects of the antioxidant activity of lutein in a model of photoreceptor membranes

It was shown that in membranes containing raft domains, the macular xanthophylls lutein and zeaxanthin are not distributed uniformly, but are excluded from saturated raft domains and about ten times more concentrated in unsaturated bulk lipids. The selective accumulation of lutein and zeaxanthin in direct proximity to unsaturated lipids, which are especially susceptible to lipid peroxidation, could be very important as far as their antioxidant activity is concerned. Therefore, the protective role of lutein against lipid peroxidation was investigated in membranes made of raft-forming mixtures and in models of photoreceptor outer segment membranes and compared with their antioxidant activity in homogeneous membranes composed of unsaturated lipids. Lipid peroxidation was induced by photosensitized reactions using rose Bengal and monitored by an MDA-TBA test, an iodometric assay, and oxygen consumption (using EPR spectroscopy and the mHCTPO spin label as an oxygen probe). The results show that lutein protects unsaturated lipids more effectively in membranes made of raft-forming mixtures than in homogeneous membranes. This suggests that the selective accumulation of macular xanthophylls in the most vulnerable regions of photoreceptor membranes may play an important role in enhancing their antioxidant properties and ability to prevent age-related macular diseases (such as age-related macular degeneration (AMD)).

[Malignant tumors of the esophagus in the Czech Republic]

INTRODUCTION

Data analysis of the incidence, mortality and basic data regarding therapy of esophageal cancer in the Czech Republic and determining possible ways to improve the current situation.

MATERIAL AND METHODS

Analysis was performed using data obtained from the Czech National Cancer Registry and from the Registry of Thoracic Procedures from the Section of Thoracic Surgery of the Czech Surgical Society. Analysis of specialized literature provided generally accepted risk factors for the development of esophageal cancer.

RESULTS

Esophageal cancer represents 0.7% of all solid malignant tumours in the Czech Republic (1.1% in males and 0.2% in females). During 1977 to 2008, the incidence increased from 2 to 5.4 cases per 100.000 inhabitants and mortality from 1.9 to 4.1 cases per 100.000 inhabitants. In absolute numbers, the incidence was 561 cases (5.4 per 100.000 inhabitants) in 2008. Absolute mortality rate was 452 deaths (4.3 per 100.000 inhabitants) and absolute prevalence (number of patients living with cancer or with its medical history) was 791 subjects(7.6 per 100.000 inhabitants). When compared to international data, the incidence in the Czech Republic is the 84th highest in the world and 17th highest in Europe (mortality rates are at the 85th place in the world and the 18th place in Europe). In the Czech Republic, the highest incidence is in the Moravian-Silesian and Zlin regions (6.1 per 100.000), the lowest in the Plzen (4.2) and Vysocina (4.1) regions. The average age at the time of diagnosis is 62 years in males and 68 years in females, the maximum incidence is between 55 and 69 years in males and between 58 and 79 years in females. Upon diagnosis, advanced stages of the disease predominate. In 2008, 28% of the detected esophageal cancer cases were stage I and II disorders, 60 % were stage III and IV disorders, and in 12% of the cases the stage was not determined. In the treated patient group, the five-year survival rate was 15.5% in total, based on an analysis of data from 2004 - 2007. The five-year survival was 30% in stage I and II diosease cases, 12% in stage III disorders and 2% in stage IV cases. When comparing the analysis of data from 2004 to 2007 with the analysis of data from 2000 to 2003, there is a 10% improvement in stages I and II and a 4% improvement in stage III disorders. According to the Thoracic Surgery Registry of Thoracic Procedures data covering the period 2007 to 2010, thoracic procedures are performed at 19 to 22 surgical departments, esophageal resections are performed at 13 to 14 surgical departments, but only in 8 to 9 of these departments is the frequency of such procedures more than 10 operations per year. At the authors' department, 53 esophageal resections have been performed in the past five years with a 3.8% postoperative mortality rate and a 23 % total postoperative morbidity rate. Forty-nine percent of the cases were adenocarcinomas.

CONCLUSION

Based on its incidence in our population, esophageal cancer can be considered an unfrequent tumour. This analysis shows regions of the Czech Republic with higher incidence and the most at-risk age group in males. Significant risk factors for squamous cell cancer such as smoking and alcohol consumption have already been previously identified; in adenocarcinoma it is primarily Barrett's esophagus. Other risk groups include patients with achalasia and with strictures after corrosion injury to the esophagus. Acceptable treatment results may only be achieved in patients with less severe stages of the disease and it would therefore be appropriate to actively search for such patients in at-risk regions and among the risk groups as part of the preventive programs. To date, universally accepted guidelines for monitoring of such patients have not been defined. Surgical treatment is a highly specialized domain of thoracic surgeons focused on esophageal surgery and patients should be concentrated in specialized centres.

Search for new physics with a monojet and missing transverse energy in pp collisions at √s = 7 TeV

A study of events with missing transverse energy and an energetic jet is performed using pp collision data at a center-of-mass energy of 7 TeV. The data were collected by the CMS detector at the LHC, and correspond to an integrated luminosity of 36 pb(-1). An excess of these events over standard model contributions is a signature of new physics such as large extra dimensions and unparticles. The number of observed events is in good agreement with the prediction of the standard model, and significant extension of the current limits on parameters of new physics benchmark models is achieved.

Search for B(s)(0) → μ+ μ- and B(0) → μ+ μ- decays in pp collisions at sqrt[s] = 7 TeV

A search for the rare decays B(s)(0) → μ+ μ- and B(0) → μ+ μ- is performed in pp collisions at sqrt[s] = 7 TeV, with a data sample corresponding to an integrated luminosity of 1.14 fb(-1), collected by the CMS experiment at the LHC. In both cases, the number of events observed after all selection requirements is consistent with expectations from background and standard-model signal predictions. The resulting upper limits on the branching fractions are B(B(s)(0) → μ+ μ-) < 1.9 × 10(-8) and B(B(0) → μ+ μ-)<4.6 × 10(-9), at 95% confidence level.

Measurement of the inclusive jet cross section in pp collisions at √s = 7 TeV

The inclusive jet cross section is measured in pp collisions with a center-of-mass energy of 7 TeV at the Large Hadron Collider using the CMS experiment. The data sample corresponds to an integrated luminosity of 34 pb(-1). The measurement is made for jet transverse momenta in the range 18-1100 GeV and for absolute values of rapidity less than 3. The measured cross section extends to the highest values of jet p(T) ever observed and, within the experimental and theoretical uncertainties, is generally in agreement with next-to-leading-order perturbative QCD predictions.

Search for three-jet resonances in pp collisions at square root(s)=7 TeV

A search for three-jet hadronic resonance production in pp collisions at a center-of-mass energy of 7 TeV has been conducted by the CMS Collaboration at the LHC, using a data sample corresponding to an integrated luminosity of 35  pb(-1). Events with high jet multiplicity and a large scalar sum of jet transverse momenta are analyzed using a signature-based approach. The number of expected standard model background events is found to be in good agreement with the observed events. Limits on the cross section times branching ratio are set in a model of gluino pair production with an R-parity-violating decay to three quarks, and the data rule out such particles within the mass range of 200 to 280  GeV/c2.

Measurement of the t-channel single top quark production cross section in pp collisions at √s=7 TeV

Electroweak production of the top quark is measured for the first time in pp collisions at √=7  TeV, using a data set collected with the CMS detector at the LHC and corresponding to an integrated luminosity of 36  pb⁻¹. With an event selection optimized for t-channel production, two complementary analyses are performed. The first one exploits the special angular properties of the signal, together with background estimates from the data. The second approach uses a multivariate analysis technique to probe the compatibility with signal topology expected from electroweak top-quark production. The combined measurement of the cross section is 83.6±29.8(stat+syst)±3.3(lumi)  pb, consistent with the standard model expectation.