Nuclear Magnetic Resonance as a Diagnostic Tool in Breast Cancer
The early detection and treatment of breast cancer is of direct benefit to patients. Magnetic resonance imaging (MRI) is a promising modality for detection, diagnosis, and staging of breast cancer. MRI enables two methods: the diffusion-weighted MRI (DW MRI) and the dynamic contrast enhanced MRI (DCE MRI). DW MRI reflects the diffusion of water molecules in the extracellular fluid space and allows the estimation of cellularity and tissue structure. The value of the diffusion of water in tissue is called the apparent diffusion coefficient (ADC). ADC values in malignant lesions are smaller than in benign tissue. DCE MRI yields appropriate pharmacokinetic data of physiological parameters that relate to tissue perfusion, microvascular vessel wall permeability and extracellular volume fraction. Gadolinium based contrast agent is usually used in breast DCE MRI diagnostics. Changes in the post-contrast signal intensity help to distinguish lesions according to characteristically enhanced accumulation of contrast agent. Malignant lesions are characterized by a faster and stronger signal enhancement than benign lesions which relate to their neoangiogenesis. Over the last few years, there has been appreciable interest in the use of magnetic resonance spectroscopy (MRS) for the non-invasive analysis of breast tisue metabolites. One of the spectroscopic hallmarks of the neoplastic process appears to be the presence of total choline signal in the in vivo spectrum. Despite the fact that MRI and MRS achieve excellent results, they are still not so frequently used in comparison to mammography and breast ultrasound.
Nodular amelanotic melanoma has been always a great challenge in dermatology. Because of lack of melanin pigment, tumors are diagnosed usually in advanced stage. Amelanotic melanoma can mimic basal cell carcinoma. Knowledge of typical dermoscopic structures helps to establish diagnosis and to plan surgery with appropriate safety margins. In amelanotic melanoma we can see typical vessels, white streaks or milky red globules on pink-reddish background. Vessels are typically thin and polymorphous in thick amelanotic melanoma. We had a case when vessels were polymorphous but thick. It can be confusing with nodular basal cell carcinoma where vessels are typically thick and arborizing. Nodular basal cell carcinoma is the most common form of basal cell carcinoma. Dermoscopy is a valuable tool for the diagnosis of basal cell carcinoma. Typical dermoscopic structures are arborizing vessels, possible sites of ulceration and/or pigmentation. We describe a case report of patient with typical dermoscopic structures seen in nodular basal cell carcinoma.
(“A Funding Programme for the Screening and Preventive Management of the High Cardiovascular Risk Individuals” – main results: 2006–2017 years)
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R Gumulak, L Nandraziova, L Tulejova and Z Pazicka
Non-invasive measurement of cerebral tissue oxygenation (cStO2) using near-infrared spectroscopy (NIRS) is attracting an increasing attention not only in neonatology. The vast diversity of commercially available NIRS devices makes it difficult to compare in the published clinical studies. This review provides a view on the practical use of NIRS as a tool for cStO2 measurement, its limitations and pitfalls, with a focus on brain dysfunction caused by hypoxic-ischemic encephalopathy. This syndrome of disturbed neurologic function in the earliest days after the birth in the term infants is manifested by difficulty with initiating and maintaining respiration, depression of tone and reflexes, subnormal level of consciousness, and often seizures. This fascinating technology has already proven accurate and has been recommended to use during daily routine tool to evaluate the level of oxygen saturation in brain in intensive care units worldwide.
Amplitude-integrated electroencephalography (aEEG) is a simplified bedside neurophysiology tool that has become widely used in neonates in the last few years. Although aEEG cannot replace conventional EEG (cEEG) for background monitoring and detection of seizures, it remains a useful apparatus that complements conventional EEG, is being widely adopted by neonatologists, and should be supported by neonatal neurologists. Limited channel leads are applied to the patient and data are displayed in a semilogarithmic, time-compressed scale. In term neonates, aEEG has been used to determine the prognosis and treatment for those affected by hypoxic-ischemic encephalopathy, seizures, meningitis and even congenital heart disease. In preterm infants, normative values and pattern corresponding to gestational age are being established. The senzitivity and specificity of aEEG are enhanced by the display of a simultaneous raw EEG.
A Hamrakova, I Ondrejka, N Sekaninova, L Peregrim and I Tonhajzerova
Attention deficit/hyperactivity disorder (ADHD) is one of the most frequently seen mental disorders in children with an increasing risk for other mental disorders. ADHD represents a primary biological dysfunction of the central nervous system, such as dysregulation of frontal-subcortical-cerebellar catecholaminergic circuits and imbalances in the dopaminergic system. However, autonomic nervous system, comprised of two primary branches - sympathetic and parasympathetic nervous systems that are normally in dynamic balance, plays an essential role in the regulation of body functions. Although it is generally assumed that the autonomic regulation is impaired during ADHD the information related to this dysregulation is limited. One of the options to observe changes of autonomic balance in ADHD is pupillary light reflex (PLR). Pupillometric evaluation can be used for the assessment of functioning of both autonomic nervous system branches and certain parameters of pupil responsivity can be helpful as a tool for medical diagnostic and treatment. In conclusion, these findings suggest the pupillometry as a non-invasive method that can indicate abnormalities in the complex central autonomic network regulating PLR.