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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.

Table of Contents

Medicina, Volume 46, Issue 5 (May 2010) – 10 articles

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Open AccessArticle
Ūminis glomerulonefritas, susijęs su mikoplazmine pneumonija
Medicina 2010, 46(5), 360; https://doi.org/10.3390/medicina46050051 - 12 May 2010
Cited by 1 | Viewed by 259
Abstract
Straipsnyje aprašomas gana retas atvejis – ūminis glomerulonefritas, susijęs su mikoplazmine pneumonija. Literatūros duomenimis, mikoplazminė infekcija gali būti susijusi su įvairaus pobūdžio inkstų pažeidimu, tačiau mūsų stebėtu atveju inkstų liga nedaug skyrėsi nuo klasikinio ūminio poinfekcinio glomerulonefrito. Ryškiausias skirtumas – tai, kad inkstų [...] Read more.
Straipsnyje aprašomas gana retas atvejis – ūminis glomerulonefritas, susijęs su mikoplazmine pneumonija. Literatūros duomenimis, mikoplazminė infekcija gali būti susijusi su įvairaus pobūdžio inkstų pažeidimu, tačiau mūsų stebėtu atveju inkstų liga nedaug skyrėsi nuo klasikinio ūminio poinfekcinio glomerulonefrito. Ryškiausias skirtumas – tai, kad inkstų ligos požymių atsirado beveik vienu metu su kvėpavimo takų ligos simptomais, o ne praėjus bent vienai savaitei. Ligos eiga ir baigtis buvo gera. Full article
Open AccessArticle
Evaluation of health-related quality of life in patients with breast cancer
Medicina 2010, 46(5), 351; https://doi.org/10.3390/medicina46050050 - 12 May 2010
Cited by 9 | Viewed by 267
Abstract
Background. Breast cancer is the most common cancer among women, comprising about 23% of all cancer types. About 1300 new cases of breast cancer are registered in Lithuania annually. During the last decade, health-related quality of life has become an important part [...] Read more.
Background. Breast cancer is the most common cancer among women, comprising about 23% of all cancer types. About 1300 new cases of breast cancer are registered in Lithuania annually. During the last decade, health-related quality of life has become an important part of breast cancer treatment. Pain, fatigue, and sleep disorders are important aspects of health-related quality of life. The aim of the study was to evaluate health-related quality of life (HRQL) among patients with breast cancer in Lithuania. The main tasks were to analyze HRQL in sociodemographic and clinical aspects, and to determine symptoms that have the greatest impact on HRQL .
Material and methods
. A cross-sectional study was carried out in four major Lithuanian hospitals. An EORTC QLQ-C30 (version 3) questionnaire with general demographic and medical information was distributed among 318 patients. A total of 284 patients were included in the analysis.
Results. The response rate was 89%. The mean age of patients was 55.9 years (SD, 10.1 years), and the mean time from diagnosis – 2.36 years (SD, 3.2 years). A greater part (65%) of the studied women lived in a family or with a partner. Women reported high level of functioning across several standardized HRQOL scales: cognitive functioning, everyday activity, and physical functioning. Fatigue and sleeping disorders were the most commonly indicated symptoms in the symptom scale. Fatigue and pain were the most important factors affecting general HRQOL.
Conclusions
. Our results emphasize that the general HRQOL of the studied women is fair, but poorer than that of the corresponding population in other countries. Women living in a family or partnership experienced fewer financial troubles and had higher HRQOL scores across several standardized measures compared to those who were single. Women with late stages of breast cancer felt worse and were less socially active compared to women who were diagnosed with early-stage breast cancer. Full article
Open AccessArticle
mTHPC-mediated photodynamic treatment of Lewis lung carcinoma in vitro and in vivo
Medicina 2010, 46(5), 345; https://doi.org/10.3390/medicina46050049 - 12 May 2010
Cited by 1 | Viewed by 269
Abstract
Background and objective. The ongoing search for the enhancement of efficacy of photodynamic therapy stimulates the interest in molecular mechanisms of the response to the treatment. Looking for the cell line suitable for investigation of cellular response both in vivo and in [...] Read more.
Background and objective. The ongoing search for the enhancement of efficacy of photodynamic therapy stimulates the interest in molecular mechanisms of the response to the treatment. Looking for the cell line suitable for investigation of cellular response both in vivo and in vitro, we evaluated phototoxicity of m-tetrakis-(3-hydroxyphenyl)-chlorin (mTHPC) on viability of Lewis lung carcinoma (LLC1) cells in vitro, growth of murine transplantable tumor, and mice survival.
Material and methods
. LLC1 cell culture and male C57BL/6 mice bearing Lewis lung carcinoma were used for the experiments. Photodynamic treatment was mediated by m-tetrakis-(3- hydroxyphenyl)-chlorin as a photosensitizer. Light emitting diode array was used for illumination. The effect of the photodynamic treatment was evaluated by comparison of viability of control and treated cells, growth of tumors, and survival of the control and treated mice.
Results
. In vitro, a cytotoxic dose inducing a reduction in viability of LLC1 cells by 50% was achieved at 60 mJ/cm2 and approximately 400 ng/mL of the photosensitizer, or 30 mJ/cm2 and 600 ng/mL of mTHPC. Both the concentration of the photosensitizer and duration of light exposure were significant determinants of cytotoxic effect. In vivo, an injection of 0.25 mg/kg of mTHPC to mice bearing Lewis lung tumor and illumination at 120 J/cm2 taking place after 24 h significantly inhibited tumor growth and prolonged mice survival. However, the tumors regained their growth potential after 9 days.
Conclusions
. Photodynamic treatment mediated by m-tetrakis-(3-hydroxyphenyl)-chlorin had a significant effect on LLC1 cells in vitro and growth of Lewis lung carcinoma in vivo. Full article
Open AccessArticle
Gliomatosis cerebri
Medicina 2010, 46(5), 341; https://doi.org/10.3390/medicina46050048 - 12 May 2010
Cited by 1 | Viewed by 237
Abstract
Gliomatosis cerebri is a rare diffusely infiltrating glial tumor involving two or more lobes and is frequently is bilateral. Infiltrative extent of tumor is out of proportion to histological and clinical features. We present a case in which finally the diagnosis of gliomatosis [...] Read more.
Gliomatosis cerebri is a rare diffusely infiltrating glial tumor involving two or more lobes and is frequently is bilateral. Infiltrative extent of tumor is out of proportion to histological and clinical features. We present a case in which finally the diagnosis of gliomatosis cerebri was made. In this case, computed tomography showed that midline structures were insignificantly shifted to the left, there was a mild dilatation of lateral ventricles more expressed on the right, and no pathologic changes of brain tissue density were found. On magnetic resonance tomography, T2W/SE and T2W/FLAIR images revealed zones of hyperintense signal, spreading with time, through several lobes of the brain with no enhancement on T1W images. Diagnosis of gliomatosis cerebri was suspected, stereotaxic biopsy was performed, and pathological examination revealed changes typical of diffuse glial tumor. In this article, changes typical of gliomatosis cerebri seen in other radiological methods such as computed tomography, magnetic resonance spectroscopy, dynamic contrast-enhanced T2*-weighted magnetic resonance, and positron emission tomography also are discussed. Full article
Open AccessArticle
Pagrindinio broncho bigės rankinių siūlių atsparumas slėgiui
Medicina 2010, 46(5), 336; https://doi.org/10.3390/medicina46050047 - 12 May 2010
Viewed by 240
Abstract
Tyrimo tikslas. Ištirti pagrindinio broncho bigės rankinių siūlių atsparumą slėgiui, rasti jų silpnąsias vietas ir būdus padaryti jas atsparesnes.
Tyrimo medžiaga ir metodai
. Patologijos skyriuje atrinkome ir paruošėme 16 mirusių žmonių trachėją ir abu pagrindinius bronchus, kuriuose nebuvo patologinių pokyčių. Vieno [...] Read more.
Tyrimo tikslas. Ištirti pagrindinio broncho bigės rankinių siūlių atsparumą slėgiui, rasti jų silpnąsias vietas ir būdus padaryti jas atsparesnes.
Tyrimo medžiaga ir metodai
. Patologijos skyriuje atrinkome ir paruošėme 16 mirusių žmonių trachėją ir abu pagrindinius bronchus, kuriuose nebuvo patologinių pokyčių. Vieno pagrindinio broncho bigė buvo užsiūta tipiška, o kita patobulinta ištisine dviejų krypčių 3/0 vikrilo (Vicryl) siūle. Tokiomis siūlėmis krūtinės chirurgijos skyriuje, pašalinus plautį, užsiuvama pagrindinio broncho bigė. Į trachėją įkišamas standartinis intubacinis vamzdelis, sujungtas su manometru ir balionėliu orui pūsti. Trachėja ir abu pagrindiniai bronchai panardinami į kambario temperatūros vandenį, į jų spindį lėtai pučiamas oras. Siūlių atsparumas nustatytas didinant slėgį trachėjos ir pagrindinių bronchų spindyje. Kai per siūlę pasirodo oro burbuliukų, užrašomas manometro rodomas slėgis.
Rezultatai
. Tipiška rankinė pagrindinio broncho bigės siūlė atlaikė vidutiniškai 106,6±11,2 mmHg stulp., o patobulinta – 141,8±14,2 mmHg stulp. slėgį. Skirtumas statistiškai reikšmingas, p<0,001. Nustatyta tipiškos siūlės mažesnio atsparumo slėgiui priežastis. Ji panaikinta patobulinus siūlės metodiką.
Išvados
. Pagrindinio broncho bigės siūlių sandarumą ir atsparumą slėgiui lemia tolygus pagrindinio broncho kremzlinės ir membraninės sienos suglaudimas. Dėl didesnio atsparumo slėgiui patikimesnė patobulinta pagrindinio broncho bigės siūlė. Full article
Open AccessArticle
Comparative diagnostic value of contrast-enhanced ultrasonography, computed tomography, and magnetic resonance imaging in diagnosis of hepatic hemangiomas
Medicina 2010, 46(5), 329; https://doi.org/10.3390/medicina46050046 - 12 May 2010
Cited by 2 | Viewed by 253
Abstract
Aim. To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis of hepatic hemangiomas.
Material and methods
. The study enrolled 48 patients, aged between 20 and 79 years (35 [...] Read more.
Aim. To compare the value of intravenous contrast-enhanced ultrasonography (US), intravenous contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI) in the diagnosis of hepatic hemangiomas.
Material and methods
. The study enrolled 48 patients, aged between 20 and 79 years (35 [72.9%] women, 13 [27.1%] men; mean age, 53.5±12.855 years), who were examined and treated in the Departments of Gastroenterology, Surgery, and Oncology, Hospital of Kaunas University of Medicine, in the year 2007. All patients underwent intravenous contrast-enhanced US, intravenous contrast-enhanced CT, and MRI and were diagnosed with hepatic hemangioma according to the findings of these examinations.
Results
. The size of hemangiomas was ≤2.0 cm in 20 cases (41.7%) and >2.0 cm in 28 (58.3%). No association between hepatic hemangioma and patient’s age was found (χ2=0.547, df=2, P=0.761). Nearly one-third of hemangiomas were located in the segment IV of the left hepatic lobe. There were a few complicated hemangiomas in the study sample: 2 with calcification and 1 with necrosis. The sensitivity of CT in the diagnosis of hepatic hemangioma was 76.92%; specificity, 33.3%; positive prognostic value, 83.3%; and negative prognostic value, 25.0%. The sensitivity of intravenous contrast-enhanced US in the diagnosis of hepatic hemangioma was 77.8%; specificity, 100%; positive prognostic value, 100%; and negative prognostic value, 23.1%.
Conclusions
. Intravenous contrast-enhanced US is more specific than intravenous contrast-enhanced CT in the diagnosis of hepatic hemangioma (P=0.0005) and has a higher positive prognostic value (P=0.001). Full article
Open AccessArticle
Surgical treatment of metastatic tumors of the femur
Medicina 2010, 46(5), 323; https://doi.org/10.3390/medicina46050045 - 12 May 2010
Cited by 6 | Viewed by 238
Abstract
Objective. To evaluate the patients functional outcome and pain control after resection of metastatic femoral tumors.
Material and methods
. A prospective randomized clinical study was conducted, which included 26 cases of metastatic tumors of the femur with an associated pathologic fracture. [...] Read more.
Objective. To evaluate the patients functional outcome and pain control after resection of metastatic femoral tumors.
Material and methods
. A prospective randomized clinical study was conducted, which included 26 cases of metastatic tumors of the femur with an associated pathologic fracture. These selected cases were randomly divided into two groups based upon the using of methylmethacrylate cement in fracture fixation. Group 1 (n=13) included all cases where the fractures were treated with bone cement augmentation. Group 2 (n=13) included all cases where the fractures were treated without bone cement augmentation. Functional outcome was evaluated according the American Musculoskeletal Tumor Society system.
Results
. Good and excellent pain control was achieved in 61.5%, satisfactory in 38.5% of all cases in the Group 1 versus 15.5% (P=0.015) and 69% (χ2=2.4762; P=0.115) of all cases in the Group 2. Functional outcome after femoral metastasis resection and pathologic fracture fixation was significantly better in the Group 1. Total lower extremity function of full normal function was 67% in the Group 1 versus 49% in the Group 2 (P<0.05). We did not observe significant difference between patients’ postoperative survival in the groups (P>0.05). The postoperative durability of stable pathologic fracture fixation was shorter in the Group 2 (273.9±51.7 vs. 358.9±116.8 days) comparing with Group 1 (P=0.03).
Conclusions. The introduction of bone cement as the adjunct to the pathologic femoral fracture fixation significantly improved the clinical our study results: we achieved better functional outcome and better pain control. Full article
Open AccessArticle
The effect of induced sputum and bronchoalveolar lavage fluid from patients with chronic obstructive pulmonary disease on neutrophil migration in vitro
Medicina 2010, 46(5), 315; https://doi.org/10.3390/medicina46050044 - 12 May 2010
Cited by 4 | Viewed by 255
Abstract
Objective. The aim of study was to investigate a chemotactic effect of induced sputum and bronchoalveolar lavage fluid on blood neutrophils in patients with chronic obstructive pulmonary disease (COPD) and healthy individuals.
Material and methods
. Forty-three smokers with COPD, 19 ex-smokers [...] Read more.
Objective. The aim of study was to investigate a chemotactic effect of induced sputum and bronchoalveolar lavage fluid on blood neutrophils in patients with chronic obstructive pulmonary disease (COPD) and healthy individuals.
Material and methods
. Forty-three smokers with COPD, 19 ex-smokers with COPD, 13 healthy smokers, and 17 healthy nonsmokers were recruited to the study. Neutrophils were isolated from peripheral blood of study individuals. For the same experimental conditions, pooled induced sputum and bronchoalveolar lavage fluid of 20 COPD patients were used. Neutrophil chemotaxis in vitro was performed in cell-transmigration chamber. Substances tested for chemoattraction (interleukin-8, induced sputum, bronchoalveolar lavage fluid directly or in addition to interleukin-8) were added to lower wells. Upper wells were filled with 2.5×106/mL of neutrophil culture and incubated for 2 hours. Migration was analyzed by flow cytometry.
Results
. Interleukin-8 (10–100 ng/mL) induced a dose-dependant neutrophil migration in all the groups. Only 100 ng/L of interleukin-8 induced more intensive chemotaxis of neutrophils from COPD smokers as compared to ex-smokers (P<0.05). Such difference between healthy individuals was obtained using 30 ng/mL of interleukin-8 (P<0.05). Induced sputum/interleukin-8 (10–100 ng/mL), as well as induced sputum directly, induced neutrophil migration (P<0.05). Chemotaxis of neutrophils isolated from COPD patients and healthy nonsmokers did not depend on additional interleukin-8 concentration. Bronchoalveolar lavage fluid/interleukin-8 (30–100 ng/mL) induced more intensive migration of neutrophils from COPD patients than bronchoalveolar lavage fluid (P<0.05) alone.
Conclusions
. Migration of neutrophils isolated from patients with COPD was more intensive compared to healthy individuals. Induced sputum and bronchoalveolar lavage fluid directly and with addition of interleukin-8 stimulated chemotaxis, and it was higher in neutrophils from COPD patients. Migration of neutrophils did not depend on smoking status. Full article
Open AccessArticle
The value of clinical prognostic factors for survival in patients with invasive urinary bladder cancer
Medicina 2010, 46(5), 305; https://doi.org/10.3390/medicina46050043 - 12 May 2010
Cited by 5 | Viewed by 258
Abstract
The aim of the study was to evaluate the value of clinical prognostic factors for survival of patients with invasive urinary bladder cancer treated with radical cystectomy, chemotherapy, and radiotherapy.
Material and methods
. A total of 115 patients with invasive urinary bladder [...] Read more.
The aim of the study was to evaluate the value of clinical prognostic factors for survival of patients with invasive urinary bladder cancer treated with radical cystectomy, chemotherapy, and radiotherapy.
Material and methods
. A total of 115 patients with invasive urinary bladder cancer were analyzed. Twenty-three patients with invasive urinary bladder cancer (pT2–T4) were treated according to the protocol of a prospective clinical study. In all the cases, transurethral resection was followed by radiation and chemotherapy. A total dose of 54–60 Gy of radiotherapy was delivered by daily fractions of 1.8–2.0 Gy each. Simultaneous chemotherapy was started on the same day as radiotherapy; gemcitabine at a dose of 175–300 mg/m2 was delivered once a week intravenously for 6 weeks. Individual patient data was analyzed in a retrospective part of the study. Radical cystectomy was performed to 46 patients with invasive urinary bladder cancer, and radiotherapy was delivered to 46 patients. Inclusion criteria for patients into a prospective or retrospective trial were equal. We evaluated a prognostic value of various clinical factors for patients treated with radical cystectomy, chemoradiation with gemcitabine, and radiation alone.
Results. The 3-year overall survival in the cystectomy group was 51.1%, in the chemoradiation group 38.0%, and in the radiotherapy group 26.9% (P=0.001). In univariate analysis in the chemoradiation group, completion of treatment according to the protocol showed a significant influence on overall survival (P=0.03). In the radiation group, completion of treatment according to the protocol showed a significant influence on overall survival too (P=0.01). In the radical cystectomy group, an important factor was a complete or incomplete TUR (P=0.02). Multivariate analysis showed a significance of hydronephrosis (P=0.03) and T stage (P=0.04) in the radiation therapy group. Comorbidity was found to be an independent prognostic factors in the chemoradiation group (P=0.02).
Conclusions
. The best 3-year overall survival was in the radical cystectomy group. Chemoradiation with gemcitabine could be offered as an alternative to patients refusing cystectomy. Better overall survival in the chemoradiation group was for patients without comorbidities and when treatment protocol was completed. Full article
Open AccessArticle
Lymph node retrieval after resection of rectal cancer following preoperative chemoradiotherapy
Medicina 2010, 46(5), 299; https://doi.org/10.3390/medicina46050042 - 12 May 2010
Cited by 6 | Viewed by 277
Abstract
Background. According to the current guidelines of proper TNM staging, 12 lymph nodes per specimen are crucial. This study assessed the role of preoperative radiochemotherapy on the number of lymph nodes detected in the tumor-bearing specimen.
Material and methods. Retrospective data [...] Read more.
Background. According to the current guidelines of proper TNM staging, 12 lymph nodes per specimen are crucial. This study assessed the role of preoperative radiochemotherapy on the number of lymph nodes detected in the tumor-bearing specimen.
Material and methods. Retrospective data of 138 patients who underwent surgery for stage II and III rectal cancer without preoperative radiochemotherapy during the period of 2004–2006 (control group) were compared with prospective data of 38 patients who received preoperative radiochemotherapy during the period of 2007–2008 (study group). The number of patients with metastatic lymph nodes, number of lymph nodes per specimen, number of metastatic lymph nodes per specimen, and the size of the tumor between the groups were compared.
Results. Positive lymph nodes were detected in 88 (64%) patients in the control group as compared with 9 (21%) patients in the study group (P<0.05). The mean number of lymph nodes per specimen in the control group was 13.5, while in the study group, the mean number of lymph nodes per specimen was 6.29 (P<0.05). There was a significant difference in the mean number of metastatic lymph nodes per specimen between the groups (5.12 in the control group versus 2.11 in the study group; P<0.05). The mean size of the tumor was 4.37 cm in the control group and 2.45 cm in the study group (P<0.01).
Conclusions
. Preoperative radiochemotherapy for advanced rectal cancer significantly decreased the number of lymph nodes detected in the tumor-bearing specimen. This also resulted in a significant decrease in the number of metastatic lymph nodes detected in the specimen, and fewer patients with stage III (N+) cancer were diagnosed. Preoperative radiochemotherapy could induce a significant downsizing and downstaging of advanced rectal cancer, but great care in operative and pathologic examination techniques must be taken to ensure appropriate staging. Full article
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