OBJECTIVE:To assay resistance/sensitivity by MTT test in solid tumor or ascitic fluid in ovarian cancer patients.DESIGN:Prospective study.SETTING:Department of Gynecology and Obstetrics, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové.METHODS:MTT - (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) chemosensitivity assay was performed in 32 samples of ovarian cancer tissue and 26 samples of ascitic fluid in ovarian cancer patients. We studied the in vitro drug resistance profiles of ovarian cancer specimens exposed to cisplatin, carboplatin, paclitaxel, topotecan, gemcitabin, etoposid.RESULTS:The highest frequency of resistance in vitro occured for etoposid, gemcitabin and paclitaxel and the most effective chemotherapeutical agents in vitro were cisplatinum and topotecan. Cisplatin had the lowest incidence of drug resistance in vitro than carboplatin.CONCLUSION:Resistance/sensitivity assay would improve the treatment and prognosis of ovarian cancer patients.

We present here a case of a BRCA1 mutation carrier with repeat responsiveness of recurrent EOC to paclitaxel/platinum. The patient had complete response to the combination of paclitaxel/platinum in the first line. Subsequent four recurrences also showed a complete response to this combination. The chronic toxicity, including hypersensitivity and nephrotoxicity could be controlled by modifying the regimen. In conclusion, recurrent EOC in BRCA1 mutation carriers may retain sensitivity to paclitaxel/platinum combination chemotherapy, and this combination could be therapy of first choice in this patient population.

INTRODUCTION:Borderline between upper and lower respiratory tract pathology is probably artificial (bronchial asthma). Also inflammation of bronchial mucosa during chronic obstructive pulmonary disease (COPD) is likely combined with inflammatory involvement of nasal mucosa. Ciliary edge of respiratory epithelium is very important part of mucosa layer.AIM:To investigate and compare nasal and bronchial ciliary beat frequency (CBF), degree of nasal and bronchial ciliary dyskinesia, presence of ciliary akinesia and incidence of spinocellular metaplasia in the both mucosa localities among of stable COPD patients (pts).METHOD:Nasal and bronchial mucosa were obtained in the course of bronchoscopy examination of COPD pts in general intravenous anesthesia. Native samples of mucosa tissue were assessed by digital high-speed video microscopy (1,000x magnification). Paired t-test was used to evaluate differences in average frequencies. Significance level was alpha = 0.05. Mode was used to describe "index of dyskinesia", as a measure of association was used K coefficient.MATERIAL:Seventeen COPD pts (6 weeks free of exacerbation) at the age 47-80 (average 64.2 years +/- 9.7) were examined (13 male), average FEV1 61% predic. value (21-81, +/- 15). All patients were active smokers (average 42 pack years +/- 22.8) and all suffered from bronchitic (daily sputum production) phenotype of COPD.RESULTS:We did not find any difference in average ciliary beat frequencies between nose (6.0 Hz +/- 1.3) and bronchus (5.9 +/- 1.3) locality (p = 0.427). We find weak association between nose and bronchus in "ciliary akinesia" (kappa = 0.282) but medium association in "metaplasia" (kappa = 0.485), in index of dyskinesia (kappa = 0.733).CONCLUSION:We did not find in our data any difference in nasal and bronchial ciliary beat frequencies and we found medium association between nasal and bronchial spinocellular metaplasia and index of ciliary dyskinesia. Possible generalization of these results would require further investigation and analysis.

Pneumatosis cystoides intestinalis (PCI), that is, presence of gas within the colonic wall, often has a polypoid appearance and can thus cause diagnostic uncertainty for the endoscopist [1] [2] [3].

BACKGROUND AND AIM This study was carried out to assess relationship between quality of life (QoL) and disease severity expressed by multifactorial prognostic index (BODE) in ex-smokers suffering from chronic obstructive pulmonary disease (COPD), minimally 8 weeks free of exacerbation. MATERIALS AND METHODS The evaluation was performed in 98 randomly recruited COPD patients enrolled into a cross-sectional, observational CILIARY study at the Department of Pneumology, Charles University, Faculty of Medicine in Hradec Králové. In them, quality of life evaluation using the SGRQ questionnaire and the BODE index calculation was performed. We statistically compared interrelationship between BODE and COPD stages, SGRQ and COPD stages and interrelation of BODE and SGRQ. RESULTS We found significant differences in QoL of COPD patients and QoL in group of healthy volunteers (p <0.001). Lower QoL and higher BODE score were associated with a higher stages of COPD (p < 0.001), with the exception non-significant difference in QoL (SGRQ score) and BODE index between stages I and II. Our study found positive correlation between the all SGRQ scores and multidimensional prognostic BODE index (r = 0.431-0.704). The strongest correlation (r = 0.704) was evident in activity domain of SGRQ. CONCLUSION Our results proved close correlation ofquality of life (SGRQ) and multidimensional prognostic score (BODE) in stable COPD exsmokers' population. Both these scoring systems are useful tools for the assessment of clinical course and stratification of severity of COPD. However at present both scales are minimally used in the Czech Republic.

INTRODUCTIONBorderline between upper and lower respiratory tract pathology is probably artificial (bronchial asthma). Also inflammation of bronchial mucosa during chronic obstructive pulmonary disease (COPD) is likely combined with inflammatory involvement of nasal mucosa. Ciliary edge of respiratory epithelium is very important part of mucosa layer.AIMTo investigate and compare nasal and bronchial ciliary beat frequency (CBF), degree of nasal and bronchial ciliary dyskinesia, presence of ciliary akinesia and incidence of spinocellular metaplasia in the both mucosa localities among of stable COPD patients (pts).METHODNasal and bronchial mucosa were obtained in the course of bronchoscopy examination of COPD pts in general intravenous anesthesia. Native samples of mucosa tissue were assessed by digital high-speed video microscopy (1,000x magnification). Paired t-test was used to evaluate differences in average frequencies. Significance level was alpha = 0.05. Mode was used to describe "index of dyskinesia", as a measure of association was used K coefficient.MATERIALSeventeen COPD pts (6 weeks free of exacerbation) at the age 47-80 (average 64.2 years +/- 9.7) were examined (13 male), average FEV1 61% predic. value (21-81, +/- 15). All patients were active smokers (average 42 pack years +/- 22.8) and all suffered from bronchitic (daily sputum production) phenotype of COPD.RESULTSWe did not find any difference in average ciliary beat frequencies between nose (6.0 Hz +/- 1.3) and bronchus (5.9 +/- 1.3) locality (p = 0.427). We find weak association between nose and bronchus in "ciliary akinesia" (kappa = 0.282) but medium association in "metaplasia" (kappa = 0.485), in index of dyskinesia (kappa = 0.733).CONCLUSIONWe did not find in our data any difference in nasal and bronchial ciliary beat frequencies and we found medium association between nasal and bronchial spinocellular metaplasia and index of ciliary dyskinesia. Possible generalization of these results would require further investigation and analysis.

OBJECTIVE:To report two cases of appendiceal mucocele in patients with suspected gynecological pathology.DESIGN:Case report.SETTING:Department of Obstetrics and Gynecology, Medical Faculty of Charles University and Faculty Hospital Hradec Králové.SUBJECT AND METHOD:We report two cases of appendiceal mucocele diagnosed and treated at our department.CONCLUSION:Appendiceal mucocele is a rare pathology, characterized by abnormal accumulation of mucous in appendix lumen. It is four times more common in females with a mean age of about 55 years. The pathogenesis could be neoplastic or non-neoplastic. Appendiceal mucocele with its anatomic location must be considered in terms of differential diagnosis of masses in pelvic region. Preoperative diagnosis is important, alerting the surgeon of an unintended rupture during surgery and avoiding the development of pseudomyxoma peritonei. US and CT were reported to be valuable.

The brain represents a rare site of metastasis in patients with epithelial ovarian carcinoma (EOC). In recent decades there has been an apparent increase in the number of EOC patients diagnosed with brain metastases, probably as a result of improved prognosis of patients with advanced tumors, but cases of meningeal carcinomatosis complicating EOC remain rare. A patient with Stage III EOC had brain metastases diagnosed 31 months after primary surgery. The isolated brain metastases were controlled with radiosurgery, surgery and chemotherapy. Forty-five months after the diagnosis of brain metastases, meningeal carcinomatosis was diagnosed which led, despite intrathecal therapy, to a fatal outcome. At autopsy, the disease was limited to the central nervous system. Meningeal carcinomatosis may represent a late fatal complication of brain metastases of EOC.

Sclerosing stromal tumor (SST) is a rare benign ovarian neoplasm of the sex cord-stromal category occurring predominantly in young women (usually younger than 30 years of age). Histologically, the tumor is characterized by cellular heterogenity, prominent vascularisation, and a pseudolobular appearance composed of cellular and hypocellular areas. We report a case of the ovarian SST in a 17-year-old girl. Clinical, microscopic, immunohistochemical, ultrastructural findings and differential diagnosis are disscussed.

OBJECTIVE:To describe chemoresistance and chemosensitivity of two ovarian cancer patients and influence on their medical outcome.SETTINGS:Department of Obstetrics and Gynecology, Medical Faculty Charles University Prague and University Hospital, Hradec Králové.SUBJECT AND METHOD:A case report of two ovarian cancer patients with defined chemoresistance/chemosensitivity of their tumors. We used WST-MTT-1 test for the assessment of chemoresistance/chemosensitivity.CONCLUSION:The chemoresistance/chemosensitivity assay would improve the treatment and prognosis of ovarian cancer patients.

Ciliary activity assessment attracts a great interest and has undergone dynamic progress since the last decades. The ciliary function is typically impaired in primary ciliary dyskinesia (PCD). The cilia are mostly examined in vitro, the sample is taken away from the nasal mucosa. Digital videomicroscopy is accessible for the cilia observation in vitro and represents a gold standard. Manual reading using this method is lengthy in comparison with a photomultiplier. Using the photomultiplier, light captured in an optical fibre is analysed automatically by a computer. With technological progress other methods gain ground such as automatical analysis of variance of grey degrees or photomultiplier connected with a scanning confocal microscope. A medium 199 is mostly used for preservation of the functioning cilia. To retain ciliary beat frequency (CBF) it is necessary to use a heated microscope stage. Average physiological CBF value is 11.5 Hz in adult population and 12.8 Hz in children.

OBJECTIVE:The authors demonstrate the case of a rare vulvar angiomyxoma in a 57-year-old female.DESIGN:Case report.SETTINGS:Department of Obstetrics and Gynecology, Medical Faculty Charles Uni Prague and Faculty Hospital, Hradec Králové.SUBJECT AND METHOD:A rare case of pedunculated angiomyxoma involving the vulva of a 57-year-old female is reported. Complete excision of the tumor was performed.CONCLUSION:Angiomyxoma is a rare locally infiltrative neoplasm of the vulvovaginal region, perineum and pelvis. Notorious recurring after surgical resection is due to its infiltrative border that makes it difficult to attain a cleared margin at the time of resection.

Mucoepidermoid carcinoma of the breast is a very rare type of neoplasm with a very distinct histology, immunohistochemistry as well as prognostic characteristics. Two cases of this type of breast carcinoma are presented. Both tumors were microscopically composed of intermediate, epidermoid and glandular cells. The first case was a high grade tumor with focal necroses, where epidermoid and mucinous cells were found only as isolated elements. The second case was of low grade, the squamous cells showed keratinization and glandular cells formed distinct small lumina. The prognostic characteristics, differential diagnosis, grading system and immunohistochemical profile of these rare neoplasms are described.

Leiomyomas are the most common benign uterine neoplasms of the myometrium. Rarely, can be observed unusual manifestations of these tumours. We present a case of intravenous leiomyomatosis in a 52-year-old woman and a case of benign metastasizing leiomyoma in a 45-year-old woman. Intravenous leiomyomatosis is an uncommon condition in which morphologically benign smooth muscle is present within the lumina of the veins. Benign metastasizing leiomyoma is a very rare phenomenon where histologically benign smooth muscle tumours are present at distant sites, particularly in the lungs, in women having histologically benign uterine leiomyoma. The diagnostic features, etiology, histology, therapeutic management and prognosis of these extremely rare conditions are discussed.