Do we know the cause of the highest colorectal cancer incidence, the changes in the mortality trends and the clinical stages in the Slovak and Czech Republic, the representatives of the Central European region?

Slovak (SR) and Czech (CR) Republics reach up the highest recorded incidence rates of colorectal cancer. In analysis of the development and changes in colorectal cancer incidence in the above-mentioned countries, it was reported the most considerable incidence increase of the disease in males in the SR, then in males in the CR, subsequently in females in the SR and the slowest incidence rate was reported in females in the CR. Colorectal cancer mortality increased most rapidly in males in the SR, then in males in the CR, slower increase was reported in females in the SR and in females in the CR the mortality was in the long term stabilized. In both countries and both sexes clinical stage II is noted most frequently, also the decrease of the disease number in the clinical stage I and in undefined stage, and a slight decrease in other clinical stages. The trends in risk factors of colorectal cancer in the SR and CR would support the hypotheses of the later culmination of incidence and on the higher levels than in other developed countries. The purpose of this study is to analyse the character and changes in development of incidence, mortality and clinical stages of colorectal cancer (1980-2005) and to assess the influence of selected risk factors on the highest disease incidence in above-mentioned two Central European countries.

[Endoscopic therapy of pancreatic pseudocysts]

BACKGROUND

Pancreatic pseudocysts are a complication of both acute and chronic pancreatitis. Incidence in patients with acute pancreatitis is 2-50%, in patients with chronic pancreatitis 20-40%. Pseudocysts are a cause of many symptoms, e.g. nausea, vomitus, pain, biliary obstruction, bleeding and perforation. Successful treatment of pseudocysts is not only surgical and percutaneous, but also endoscopic.

OBJECTIVES

The aim of this study was to answer the following questions. First, what is the clinical success rate of endoscopic drainage of pancreatic pseudocysts? Second, what are the complications? Finally, how often is endoscopic drainage a definite treatment?

METHODS

The records of all patients (11) with chronic pancreatitis and endoscopic drainage of symptomatic pseudocysts hospitalized between December 1993 and April 1999 at our clinic were retrospectively studied.

RESULTS

Patients (5) were followed for a mean duration of 30 months. Endoscopic drainage was definitive treatment in 80%, after transgastric drainage in 50%, after transpapillary drainage in 100% and after the use of more than one drainage procedure in 0%. The prognostic factors for longterm success of endoscopic drainage could not be evaluated, because of the small number of treated patients.

CONCLUSIONS

Endoscopic treatment of pancreatic pseudocysts (endoscopic cystogastrostomy, cystoduodenostomy and transpapillary drainage) is nowadays highly effective method, technically feasible in most patients, with a relative degree of safety when performed by experienced endoscopist. (Tab. 2, Ref. 16.)

Lesions of some central nervous structures result in altered pituitary-thyroid response to acute decrease of blood thyroid hormone level

Eight groups (3--6 animals each) of rats weighing 350--400 g were subjected to electrolytic lesions of various parts of habenular, thalamic and hypothalamic areas of brain. On the 6th day after the lesion the level of blood thyroid hormone was acutely decreased with the aid of isovolemic exchange transfusion (IET) of thyroid hormone free blood suspension. The level of thyroxine (T4) in plasma was measured before and during 180 min after IET with the aid of specific radioimmunoassay and the changes of its post-transfusion level were evaluated. It was found that in three groups of animals bearing large bilateral lesions either in lateral ventral thalamus or in a central inferior thalamus the response of T4 level during the post-transfusion period is similar to that found in intact control groups from previous experiments. This consists in an increase of T4 level nearly to the initial value within about 120--150 min after IET. In contrast, there was only a slight post-transfusion increase of T4 level in one group with small central lesion in medial superior thalamus and no increase in two groups bilaterally lesioned in habenular area and in another two groups lesioned either in a central part of dorsal hypothalamus or in a central dorsal part of ventral basal hypothalamus. It was concluded that some parts of brain may be involved in managing the appropriate response of pituitary-thyroid axis to acute decrease of thyroid hormone level, no plausible explanation of the mechanism ofthe observed phenomena being offered.

Rapid disappearance of loading doses of thyroxine from blood and their excretion by the bile in rats

The disappearance of loading doses of thyroxine (T4) (100-20 000 microng T4 iv per rat weighing about 400 g) was measured with the aid of new technique allowing frequent blood sampling with maintenance of isovolaemia in anaesthetized animals. It was found that as early as 2 min after the injection more than half of the administered dose disappeared from the blood, while after 300 min only about 2% of that remained in the plasma. The direct relationship between the administered dose of T4 and both the relative and absolute level of free dialyzable T4 as well as of per cent of T4 displaced from plasma by sodium salicylate in vivo was demonstrated. Moreover, it was found that about 60% of administratered T4 is excreted by the bile within 300 min irrespective of the dose given, about 15 and 50% of that being found in the small intestine after 15 and 180 min, respectively. When two loading doses of T4 were subsequently administered and labelled with different isotopes, the amount of T4 from the first dose excreted by the bile was proportional to the amount of T4 from a second dose administered 18 h later. From all these observations it was concluded that, in vivo, an effective system for removal of the loading doses of thyroxine from the blood exists, and is presumably located in rapidly equilibrating tissues, mainly in the liver. From this point of view it appears that plasma protein carriers play an important role in the whole body economy of thyroxine, namely by maintaining a certain level in the blood to cover the actual functional needs of peripheral tissues.