168 results on '"David Netuka"'
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2. AI Is Changing the Landscape of Academic Writing: What Can Be Done? Authors’ Reply to: AI Increases the Pressure to Overhaul the Scientific Peer Review Process. Comment on 'Artificial Intelligence Can Generate Fraudulent but Authentic-Looking Scientific Medical Articles: Pandora’s Box Has Been Opened'
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Martin Májovský, Tomas Mikolov, and David Netuka
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Computer applications to medicine. Medical informatics ,R858-859.7 ,Public aspects of medicine ,RA1-1270 - Published
- 2023
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3. Current trends and outcomes of non-elective neurosurgical care in Central Europe during the second year of the COVID-19 pandemic
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Ondra Petr, Lukas Grassner, Freda M. Warner, Michaela Dedeciusová, Richard Voldřich, Philipp Geiger, Konstantin Brawanski, Sina Gsellmann, Laura C. Meiners, Richard Bauer, Sascha Freigang, Michael Mokry, Alexandra Resch, Thomas Kretschmer, Tobias Rossmann, Francisco Ruiz Navarro, Harald Stefanits, Andreas Gruber, Mathias Spendel, Christoph Schwartz, Christoph Griessenauer, Franz Marhold, Camillo Sherif, Jonathan P. Wais, Karl Rössler, Jakob J. Zagata, Martin Ortler, Wolfgang Pfisterer, Manfred Mühlbauer, Felipe A. Trivik-Barrientos, Johannes Burtscher, Lukáš Krška, Radim Lipina, Martin Kerekanič, Jiří Fiedler, Petr Kasík, Vladimír Přibáň, Michal Tichý, Vladimír Beneš, Petr Krůpa, Tomáš Česák, Robert Kroupa, Andrej Callo, Pavel Haninec, Daniel Pohlodek, David Krahulík, Alena Sejkorová, Martin Sameš, Josef Dvořák, Andriana Juričeková, Pavel Buchvald, Robert Tomáš, Jan Klener, Vilém Juráň, Martin Smrčka, Petr Linzer, Miroslav Kaiser, Dušan Hrabovský, Radim Jančálek, John L. K. Kramer, Claudius Thomé, and David Netuka
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Medicine ,Science - Abstract
Abstract Reflecting the first wave COVID-19 pandemic in Central Europe (i.e. March 16th–April 15th, 2020) the neurosurgical community witnessed a general diminution in the incidence of emergency neurosurgical cases, which was impelled by a reduced number of traumatic brain injuries (TBI), spine conditions, and chronic subdural hematomas (CSDH). This appeared to be associated with restrictions imposed on mobility within countries but also to possible delayed patient introduction and interdisciplinary medical counseling. In response to one year of COVID-19 experience, also mapping the third wave of COVID-19 in 2021 (i.e. March 16 to April 15, 2021), we aimed to reevaluate the current prevalence and outcomes for emergency non-elective neurosurgical cases in COVID-19-negative patients across Austria and the Czech Republic. The primary analysis was focused on incidence and 30-day mortality in emergency neurosurgical cases compared to four preceding years (2017–2020). A total of 5077 neurosurgical emergency cases were reviewed. The year 2021 compared to the years 2017–2019 was not significantly related to any increased odds of 30 day mortality in Austria or in the Czech Republic. Recently, there was a significant propensity toward increased incidence rates of emergency non-elective neurosurgical cases during the third COVID-19 pandemic wave in Austria, driven by their lower incidence during the first COVID-19 wave in 2020. Selected neurosurgical conditions commonly associated with traumatic etiologies including TBI, and CSDH roughly reverted to similar incidence rates from the previous non-COVID-19 years. Further resisting the major deleterious effects of the continuing COVID-19 pandemic, it is edifying to notice that the neurosurgical community´s demeanor to the recent third pandemic culmination keeps the very high standards of non-elective neurosurgical care alongside with low periprocedural morbidity. This also reflects the current state of health care quality in the Czech Republic and Austria.
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- 2022
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4. Artificial Intelligence Can Generate Fraudulent but Authentic-Looking Scientific Medical Articles: Pandora’s Box Has Been Opened
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Martin Májovský, Martin Černý, Matěj Kasal, Martin Komarc, and David Netuka
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Computer applications to medicine. Medical informatics ,R858-859.7 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundArtificial intelligence (AI) has advanced substantially in recent years, transforming many industries and improving the way people live and work. In scientific research, AI can enhance the quality and efficiency of data analysis and publication. However, AI has also opened up the possibility of generating high-quality fraudulent papers that are difficult to detect, raising important questions about the integrity of scientific research and the trustworthiness of published papers. ObjectiveThe aim of this study was to investigate the capabilities of current AI language models in generating high-quality fraudulent medical articles. We hypothesized that modern AI models can create highly convincing fraudulent papers that can easily deceive readers and even experienced researchers. MethodsThis proof-of-concept study used ChatGPT (Chat Generative Pre-trained Transformer) powered by the GPT-3 (Generative Pre-trained Transformer 3) language model to generate a fraudulent scientific article related to neurosurgery. GPT-3 is a large language model developed by OpenAI that uses deep learning algorithms to generate human-like text in response to prompts given by users. The model was trained on a massive corpus of text from the internet and is capable of generating high-quality text in a variety of languages and on various topics. The authors posed questions and prompts to the model and refined them iteratively as the model generated the responses. The goal was to create a completely fabricated article including the abstract, introduction, material and methods, discussion, references, charts, etc. Once the article was generated, it was reviewed for accuracy and coherence by experts in the fields of neurosurgery, psychiatry, and statistics and compared to existing similar articles. ResultsThe study found that the AI language model can create a highly convincing fraudulent article that resembled a genuine scientific paper in terms of word usage, sentence structure, and overall composition. The AI-generated article included standard sections such as introduction, material and methods, results, and discussion, as well a data sheet. It consisted of 1992 words and 17 citations, and the whole process of article creation took approximately 1 hour without any special training of the human user. However, there were some concerns and specific mistakes identified in the generated article, specifically in the references. ConclusionsThe study demonstrates the potential of current AI language models to generate completely fabricated scientific articles. Although the papers look sophisticated and seemingly flawless, expert readers may identify semantic inaccuracies and errors upon closer inspection. We highlight the need for increased vigilance and better detection methods to combat the potential misuse of AI in scientific research. At the same time, it is important to recognize the potential benefits of using AI language models in genuine scientific writing and research, such as manuscript preparation and language editing.
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- 2023
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5. Endocrinological aspects of pituitary adenoma surgery in Europe
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David Netuka, André Grotenhuis, Nicolas Foroglou, Francesco Zenga, Sebastien Froehlich, Florian Ringel, Nicolas Sampron, Nick Thomas, Martin Komarc, Mikuláš Kosák, and Martin Májovský
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Medicine ,Science - Abstract
Abstract Hormone-secreting adenomas are treated in many neurosurgical centers within Europe. The goal of the survey is to understand variance in practice management of pituitary tumors amongst neurosurgical centers. A list of departments performing pituitary surgery was created. The survey consisted of 58 questions. This study focuses on neurosurgical care of hormone-secreting adenomas. For analysis, the departments were divided into four subgroups: academic/non-academic, high-volume/low-volume, “mainly endoscopic/mainly microscopic practice” and geographical regions. Data from 254 departments from 34 countries were obtained. Most centers surgically treat 1–5 hormone-secreting adenomas per year. In prolactinomas this is the case in 194 centers, (76.4%), in GH-secreting adenomas: 133 centers, (52.4%), ACTH-secreting adenomas: 172 centers, (69.8%). Surgery as a primary treatment of prolactinomas is considered in 64 centers (25.2%). In 47 centers (18.8%), GH-secreting microadenomas are often treated pharmacologically first. Debulking surgery for an invasive GH-secreting adenoma in which hormonal remission is not a realistic goal of the surgery and the patient has no visual deficit surgery is always or mostly indicated in 156 centers (62.9%). Routine postoperative hydrocortisone replacement therapy is administered in 147 centers (58.6%). Our survey shows that in most centers, few hormone-secreting adenomas are treated per year. In about 25% of the centers, prolactinoma surgery may be regarded as first-line treatment; in about 20% of the centers, medical treatment is the first-line treatment for GH-secreting adenomas. Pretreatment for ACTH-secreting adenomas is routinely used in 21% of centers. This survey may serve as plea for neurosurgical care centralization of hormone-secreting adenomas.
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- 2022
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6. Risk factors associated with higher histological grade in meningiomas: Multicentric study of 552 skull base meningiomas and literature review.
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Michaela May, Vojtech Sedlak, Ing Ladislav Pecen, Vladimir Priban, Pavel Buchvald, Jiri Fiedler, Miroslav Vaverka, Radim Lipina, David Netuka, and Vladimir Benes
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Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2023
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7. Convolutional Neural Network based segmentation model for direct clinical use in radiosurgical planning for pituitary adenoma treatment
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Martin Černý and David Netuka
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Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2023
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8. Expertise In Surgical Neuro-oncology. Results Of A Survey By The EANS Neuro-oncology Section.
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Konstantinos Gousias, Jiri Bartek, Jr., Michaël Bruneau, Emrah Celtikci, Nicolas Foroglou, Christian F. Freyschlag, Rachel Grossman, Christin Jungk, Philippe Metellus, David Netuka, Radoslaw Rola, Phillippe Schucht, Christian Senft, Francesco Signorelli, Arnaud J.P. E. Vincent, and Matthias Simon
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Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2023
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9. European survey on neurosurgical management of primary central nervous system lymphomas and preoperative corticosteroid therapy
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Florian Scheichel, Branko Popadic, Daniel Pinggera, Dariusz J. Jaskolski, Vincent Lubrano, Nicolas Foroglou, David Netuka, Bogdan Iliescu, Laszlo Novak, Camillo Sherif, Franz Marhold, and Christian F. Freyschlag
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Primary central nervous system lymphoma ,Corticosteroid therapy ,Survey ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Introduction: Preoperative corticosteroid therapy (CST) is common in primary central nervous system lymphoma (PCNSL) and may complicate histopathological diagnosis. There is an ongoing debate on the best management after preoperative CST. Research question: We aimed to survey how different European neurosurgical units treat PCNSL patients after preoperative CST. Methods: An English-language survey consisting of 21 questions addressing the management of patients with suspected PCNSL and preoperative CST was sent to European hospitals. The survey also included three clinical cases to assess the decision-making process in a clinical setting. Results: The survey was completed by 74 European hospitals. There was no clear consensus on how to treat a patient with PCNSL after CST. Accordingly, 24.3% responded that they would generally defer surgery regardless of a possible radiological response, 47.3% would defer surgery only if there is regression in preoperative MRI and the remaining 28.4% would defer surgery only if the tumor had completely vanished. Furthermore, there were distinct discrepancies in responses of neurosurgical units regarding their general management approach and their case-based decision in the three example cases. The results of our survey also showed regional differences and differences in treatment decisions between high-, intermediate- and low-volume centers. Discussion and conclusion: There was no clear consensus on how to treat patients with suspected PCNSL and preoperative CST. Furthermore, most centers also showed inconsistencies in their responses regarding their general approach as well as individual patient treatment. More high-quality evidence-based recommendations are needed to improve consensus and thus patient care.
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- 2023
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10. Tumor induced osteomalacia - A long way toward correct diagnosis and management
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Lenka Filipová, Vít Zikán, Michal Krsek, David Netuka, Michael Michal, and Ivica Lazúrová
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Tumor induced osteomalacia ,Phosphaturic mesenchymal tumor ,Fibroblast growth factor -23 ,Hypophosphatemia ,Spinal involvement ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Tumor-induced osteomalacia (TIO) is an uncommon type of osteomalacia associated with phosphaturic mesenchymal tumors (PMTs). Due to nonspecific symptoms, the diagnosis and appropriate management of the disease is often delayed for many years. Involvement of spine with TIO associated tumors is exceedingly rare. We present a 53-year-old woman with a 10-year history of bone pain, muscle weakness and multiple bone fractures that markedly impaired her quality of life. Biochemical evaluation revealed hypophosphatemia due to renal phosphate wasting and elevated plasma fibroblast growth factor 23 (FGF-23) concentration indicating PMT. It was found using 68Ga DOTA TOC PET/CT scan in the vertebral body L2. The patient underwent surgical resection of the tumor. Postoperatively, there was a significant decrease in phosphaturia, normalization of serum phosphate, 1.25 dihydroxyvitamin D and plasma FGF23 concentration. Thereafter the patient's condition markedly improved concerning her motility and basic daily activities.This case report demonstrates the first known case of TIO in the Slovakia and points to a long way from onset of symptoms toward correct diagnosis and successful surgical management.
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- 2022
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11. Trends and outcomes for non-elective neurosurgical procedures in Central Europe during the COVID-19 pandemic
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Lukas Grassner, Ondra Petr, Freda M. Warner, Michaela Dedeciusova, Andrea Maria Mathis, Daniel Pinggera, Sina Gsellmann, Laura C. Meiners, Sascha Freigang, Michael Mokry, Alexandra Resch, Thomas Kretschmer, Tobias Rossmann, Francisco Ruiz Navarro, Andreas Gruber, Mathias Spendel, Peter A. Winkler, Franz Marhold, Camillo Sherif, Jonathan P. Wais, Karl Rössler, Wolfgang Pfisterer, Manfred Mühlbauer, Felipe A. Trivik-Barrientos, Sebastian Rath, Richard Voldrich, Lukas Krska, Radim Lipina, Martin Kerekanic, Jiri Fiedler, Petr Kasik, Vladimir Priban, Michal Tichy, Petr Krupa, Tomas Cesak, Robert Kroupa, Andrej Callo, Pavel Haninec, Daniel Pohlodek, David Krahulik, Alena Sejkorova, Martin Sames, Josef Dvorak, Petr Suchomel, Robert Tomas, Jan Klener, Vilem Juran, Martin Smrcka, Petr Linzer, Miroslav Kaiser, Dusan Hrabovsky, Radim Jancalek, Vincens Kälin, Oliver Bozinov, Cedric Niggli, Carlo Serra, Ramona Guatta, Dominique E. Kuhlen, Stefan Wanderer, Serge Marbacher, Alexandre Lavé, Karl Schaller, Clarinde Esculier, Andreas Raabe, John L. K. Kramer, Claudius Thomé, and David Netuka
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Medicine ,Science - Abstract
Abstract The world currently faces the novel severe acute respiratory syndrome coronavirus 2 pandemic. Little is known about the effects of a pandemic on non-elective neurosurgical practices, which have continued under modified conditions to reduce the spread of COVID-19. This knowledge might be critical for the ongoing second coronavirus wave and potential restrictions on health care. We aimed to determine the incidence and 30-day mortality rate of various non-elective neurosurgical procedures during the COVID-19 pandemic. A retrospective, multi-centre observational cohort study among neurosurgical centres within Austria, the Czech Republic, and Switzerland was performed. Incidence of neurosurgical emergencies and related 30-day mortality rates were determined for a period reflecting the peak pandemic of the first wave in all participating countries (i.e. March 16th–April 15th, 2020), and compared to the same period in prior years (2017, 2018, and 2019). A total of 4,752 emergency neurosurgical cases were reviewed over a 4-year period. In 2020, during the COVID-19 pandemic, there was a general decline in the incidence of non-elective neurosurgical cases, which was driven by a reduced number of traumatic brain injuries, spine conditions, and chronic subdural hematomas. Thirty-day mortality did not significantly increase overall or for any of the conditions examined during the peak of the pandemic. The neurosurgical community in these three European countries observed a decrease in the incidence of some neurosurgical emergencies with 30-day mortality rates comparable to previous years (2017–2019). Lower incidence of neurosurgical cases is likely related to restrictions placed on mobility within countries, but may also involve delayed patient presentation.
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- 2021
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12. Oxidative Stress as a Reliable Biomarker of Carotid Plaque Instability: A Pilot Study
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Norbert Svoboda, Karolina Kočí, Anna Seidlová, Václav Mandys, Jiří Suttnar, Alžběta Hlaváčková, Ondřej Kučerka, David Netuka, and Martin Malý
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carotid stenosis ,plaque ,atherosclerotic ,oxidative stress ,endarterectomy ,carotid ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Background: Predicting stroke risk in patients with carotid artery stenosis (CS) remains challenging. Circulating biomarkers seem to provide improvements with respect to risk stratification. Methods: Study patients who underwent carotid endarterectomy were categorized into four groups according to symptomatology and compared as follows: symptomatic with asymptomatic patients; and asymptomatic patients including amaurosis fugax (AF) (asymptomatic + AF group) with patients with a transient ischemic attack (TIA) or brain stroke (BS) (hemispheric brain stroke group). Carotid specimens were histologically analyzed and classified based on the American Heart Classification (AHA) standard. As a marker of OS, the plasma levels of malondialdehyde (MDA) were measured. Comparisons of MDA plasma levels between groups were analyzed. Results: In total, 35 patients were included in the study. There were 22 (63%) patients in the asymptomatic group and 13 (37%) in the symptomatic group. Atheromatous plaque (p = 0.03) and old hemorrhage (p = 0.05), fibrous plaque (p = 0.04), myxoid changes (p = 0.02), plaques without hemorrhage (p = 0.04), significant neovascularization (p = 0.04) and AHA classification (p = 0.006) had significant correlations with clinical presentation. There were 26 (74%) patients in the asymptomatic group and 9 (26%) in the hemispheric brain stroke group. Atheromatous plaque (p = 0.02), old hemorrhage (p = 0.05) and plaques without neovascularization (p = 0.02), fibrous plaque (p = 0.03), plaques without hemorrhage (p = 0.02) and AHA classification (p = 0.01) had significant correlations with clinical presentation. There was no significant difference between symptomatic and asymptomatic groups with respect to MDA plasma levels (p = 0.232). A significant difference was observed when MDA plasma levels were compared to asymptomatic + AF and the hemispheric stroke group (p = 0.002). Conclusions: MDA plasma level correlates with the risk of hemispheric stroke (TIA or BS) and is a reliable marker of plaque vulnerability in carotid artery stenosis.
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- 2023
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13. Pituitary Adenoma Surgery Survey: Neurosurgical Centers and Pituitary Adenomas
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David Netuka, Andre Grotenhuis, Nicolas Foroglou, Francesco Zenga, Sebastien Froehlich, Florian Ringel, Nicolas Sampron, Nick Thomas, Martin Komarc, and Martin Majovsky
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Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Objective. Pituitary adenoma surgery has evolved rapidly in recent decades. This study aims to determine current practice across a wide range of European neurosurgical centers. Methods. A list of eligible departments performing pituitary adenoma surgery was created. The survey consisted of 58 questions. For analysis, the departments were divided into four subgroups: academic/nonacademic, high-volume/low-volume, “mainly endoscopic/mainly microscopic practice,” and geographical regions. Results. Data from 254 departments from 34 countries were obtained. In 108 centers (42.5%), 100 adenoma surgeries per year. Number of neurosurgeons performing endonasal surgeries are as follows: 1 in 24.9% of centers and 2 in 49.8% of centers. All residents assisted endonasal surgeries in 126 centers (49.8%). In 28 centers (21.1%), all residents performed endonasal surgery under supervision during residency. In 141 centers (56.8%), the endoscopic approach was used in >90% of the surgeries. Regular pituitary board (either weekly or once a month) meetings were held in 147 centers (56.3%). Nonfunctioning adenomas represent >70% of pituitary caseload in 149 centers (58.7%). Conclusions. In our survey, most centers perform less than 100 surgeries for pituitary adenomas. In most centers, pituitary surgeries are performed by one or two neurosurgeons. Residents have a limited exposure to this type of surgery, and the formal pituitary board is not a standard. Nonfunctioning adenomas make up most of surgically treated adenomas. This study can serve as a benchmark for further analyses of pituitary adenoma centers in Europe.
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- 2022
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14. Expression profiles of somatostatin, dopamine, and estrogen receptors in pituitary adenomas determined by means of synthetic multilocus calibrators
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Monika Drastikova, Martin Beranek, Filip Gabalec, David Netuka, Vaclav Masopust, Tomas Cesak, Josef Marek, Vladimir Palicka, and Jan Cap
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pituitary adenoma ,somatostatin receptor ,dopamine receptor ,estrogen receptor ,real-time pcr ,gene expression ,Medicine - Abstract
Aims: Pituitary adenomas (PA) are non-invasive benign tumors with a high autopsy prevalence. They are classified according to the type of hormone secreted (prolactin, growth hormone, adrenocorticotropin, thyrotropin, folitropin, or luteinizing hormone). Clinically non-functioning adenomas (CNFA) lacking the typical hypersecretion of hormones make up a significant portion of PA. The aim of the study was to determine the complete expression profiles of somatostatin receptors (SSTR1-SSTR5), dopamine receptors type 2 (D2R), and estrogen receptors (ER1) in various types of PA. Methods: Adenoma specimens were obtained from 206 patients during transsphenoidal resection. For quantitative analysis, reverse transcription and consequent real-time PCR with synthetic multilocus calibrators (SMC) were used. The obtained data were normalized to the number of transcripts of the beta-glucuronidase gene. Results: The use of SMC enabled the alignment of individual calibration functions for all the receptors. No relationships between the expression of the receptors and the tumor size, site of extension, gender or age at diagnosis were significant. In growth hormone-secreting adenomas, D2R and SSTR2 transcripts were extensively expressed, followed by ER1, SSTR5, SSTR3, and SSTR1. In patients with macroprolactinomas, transsphenoidal resection was indicated because dopamine agonists did not normalize prolactin levels. D2R, ER1 and SSTR1 transcripts were significantly transcribed. Corticotroph adenomas showed high levels of D2R and ER1 transcripts and lower amounts of SSTR2 and SSTR1 transcripts. SSTR5 transcripts were very low. Subjects with CNFA dominantly expressed D2R and ER1, followed by SSTR2 and SSTR3 mRNA. Conclusion: We evaluated SSTR1-SSTR5, D2R, and ER1 expressions in a large group of pituitary adenomas and we found that determining their individual expression profiles could help when choosing the optimal postoperative treatment.
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- 2016
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15. Comparison of carotid endarterectomy and repeated carotid angioplasty and stenting for in-stent restenosis (CERCAS trial): a randomised study
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Jiri Fiedler, David Školoudík, Martin Roubec, Tomáš Hrbáč, David Netuka, Václav Procházka, Tomáš Jonszta, David Pakizer, Daniel Václavík, and Tomáš Heryán
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Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background and aim In-stent restenosis (ISR) belongs to an infrequent but potentially serious complication after carotid angioplasty and stenting in patients with severe carotid stenosis. Some of these patients might be contraindicated to repeat percutaneous transluminal angioplasty with or without stenting (rePTA/S). The purpose of the study is to compare the safety and effectiveness of carotid endarterectomy with stent removal (CEASR) and rePTA/S in patients with carotid ISR.Methods Consecutive patients with carotid ISR (≥80%) were randomly allocated to the CEASR or rePTA/S group. The incidence of restenosis after intervention, stroke, transient ischaemic attack myocardial infarction and death 30 days and 1 year after intervention and restenosis 1 year after intervention between patients in CEASR and rePTA/S groups were statistically evaluated.Results A total of 31 patients were included in the study; 14 patients (9 males; mean age 66.3±6.6 years) were allocated to CEASR and 17 patients (10 males; mean age 68.8±5.6 years) to the rePTA/S group. The implanted stent in carotid restenosis was successfully removed in all patients in the CEASR group. No clinical vascular event was recorded periproceduraly, 30 days and 1 year after intervention in both groups. Only one patient in the CEASR group had asymptomatic occlusion of the intervened carotid artery within 30 days and one patient died in the rePTA/S group within 1 year after intervention. Restenosis after intervention was significantly greater in the rePTA/S group (mean 20.9%) than in the CEASR group (mean 0%, p=0.04), but all stenoses were
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16. Risk factors for carotid plaque progression after optimising the risk factor treatment: substudy results of the Atherosclerotic Plaque Characteristics Associated with a Progression Rate of the Plaque and a Risk of Stroke in Patients with the carotid Bifurcation Plaque Study (ANTIQUE)
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David Školoudík, Roman Herzig, Kateřina Langová, Petra Kešnerová, Tomáš Hrbáč, David Netuka, Jaroslav Vomáčka, and Tomáš Belšan
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Neurology. Diseases of the nervous system ,RC346-429 - Full Text
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17. Is nasal airflow disrupted after endoscopic skull base surgery? A short review
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M. Májovský, F. Trnka, H. Schmirlerová, J. Betka, T. Hyhlík, and David Netuka
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Surgery ,Neurology (clinical) ,General Medicine - Published
- 2022
18. Pitx2 is a useful marker of midgut‐derived neuroendocrine tumours – an immunohistochemical study of 224 cases
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Jiri Soukup, Monika Manethova, Hana Faistova, Lukas Krbal, Barbora Vitovcova, Helena Hornychova, Jan Drugda, Tomas Cesak, David Netuka, Filip Gabalec, and Ales Ryska
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Paraganglioma ,Mice ,Neuroendocrine Tumors ,Skin Neoplasms ,Histology ,Biomarkers, Tumor ,Humans ,Animals ,General Medicine ,Immunohistochemistry ,Carcinoma, Neuroendocrine ,Pathology and Forensic Medicine - Abstract
Pitx2 is a transcription factor responsible for establishment of the right-left axis and development of the gut and pituitary. In mouse embryos, Pitx2 is expressed in the greater curvature of the stomach and midgut. Previously, Pitx2 was studied in pituitary neuroendocrine tumours but not in other NETs. Pitx2 expression was immunohistochemically assessed in whole sections and tissue microarrays in a cohort of 224 neuroendocrine neoplasms, and was analysed in 29 cases. The cohort included 18 cauda equina NETs, 38 paragangliomas, 98 cases of primary visceral NETs from different organs, 23 metastases of visceral NETs and 47 neuroendocrine carcinomas (NECs). Pitx2 expression was observed in 29.5% (29 of 98) NETs and 14.9% (7 of 47) NECs, but was not observed in any paraganglioma or cauda equina NET. Pitx2 was observed only in tumours of midgut-derived organs, including the small intestine (100%, 20 of 20), appendix (88.9%, eight of nine) and large intestine (9.1%, one of 11 - only caecal NET). The NETs of remaining locations were negative. Pitx2 was 96.7% sensitive and 100% specific for NETs of midgut origin. In NECs, Pitx2 positivity was observed in goblet cell adenocarcinoma (75%, three of four), medullary thyroid carcinoma (42.9, three of seven) and one Merkel cell carcinoma (25%, one of four). In metastatic NETs, Pitx2 was observed in all the tumours originating in the small intestine (n = 17) or caecum (n = 1). No positivity was observed in tumours from other locations (four pancreas, one lung). We observed no correlation between immunoreactivity and mRNA expression. Thus, Pitx2 immunohistochemistry can be helpful in assessing the midgut origin of NETs.
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- 2022
19. Diffusion Tensor Imaging helps identify shunt-responsive Normal Pressure Hydrocephalus patients amongst probable iNPH cohort
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Vojtěch Sedlák, Adéla Bubeníková, Petr Skalický, Aleš Vlasák, Helen Whitley, David Netuka, Vladimír Beneš, and Ondřej Bradáč
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Objectives The aim of this study was to investigate whether white matter changes as measured by Diffusion Tensor Imaging (DTI) can help differentiate shunt-responsive idiopathic normal pressure hydrocephalus (iNPH) patients from patients with other causes of gait disturbances and/or cognitive decline with ventriculomegaly whose clinical symptoms do not improve significantly after cerebrospinal fluid derivation (non-iNPH). Methods Between 2017 and 2022, 85 patients with probable iNPH underwent prospective preoperative magnetic resonance imaging (MRI) and comprehensive clinical workup. Patients with clinical symptoms of iNPH, positive result on lumbar infusion test and gait improvement after 120-hour lumbar drainage were diagnosed with iNPH and underwent shunt-placement surgery. Fractional anisotropy (FA) and mean diffusivity (MD) values for individual regions of interest were extracted from preoperative MRI, using the TBSS pipeline of FSL toolkit. These FA and MD values were then compared to results of clinical workup and established diagnosis of iNPH. An identical MRI protocol was performed on 13 age- and sex-matched healthy volunteers. Results Statistically significant differences in FA values of several white matter structures were found not only between iNPH patients and healthy controls, but also between iNPH and non-iNPH patients. ROI that showed best diagnostic ability when differentiating iNPH amongst probable iNPH cohort was uncinate fasciculus, with AUC of 0.74 (p
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- 2023
20. Role of risk factors, scoring systems, and prognostic models in predicting the functional outcome in meningioma surgery: multicentric study of 552 skull base meningiomas
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Michaela May, Vojtech Sedlak, Ladislav Pecen, Vladimir Priban, Pavel Buchvald, Jiri Fiedler, Miroslav Vaverka, Radim Lipina, Stefan Reguli, Jozef Malik, David Netuka, and Vladimir Benes
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
Despite the importance of functional outcome, only a few scoring systems exist to predict neurologic outcome in meningioma surgery. Therefore, our study aims to identify preoperative risk factors and develop the receiver operating characteristics (ROC) models estimating the risk of a new postoperative neurologic deficit and a decrease in Karnofsky performance status (KPS). A multicentric study was conducted in a cohort of 552 consecutive patients with skull base meningiomas who underwent surgical resection from 2014 to 2019. Data were gathered from clinical, surgical, and pathology records as well as radiological diagnostics. The preoperative predictive factors of functional outcome (neurologic deficit, decrease in KPS) were analyzed in univariate and multivariate stepwise selection analyses. Permanent neurologic deficits were present in 73 (13.2%) patients and a postoperative decrease in KPS in 84 (15.2%). Surgery-related mortality was 1.3%. A ROC model was developed to estimate the probability of a new neurologic deficit (area 0.74; SE 0.0284; 95% Wald confidence limits (0.69; 0.80)) based on meningioma location and diameter. Consequently, a ROC model was developed to predict the probability of a postoperative decrease in KPS (area 0.80; SE 0.0289; 95% Wald confidence limits (0.74; 0.85)) based on the patient’s age, meningioma location, diameter, presence of hyperostosis, and dural tail. To ensure an evidence-based therapeutic approach, treatment should be founded on known risk factors, scoring systems, and predictive models. We propose ROC models predicting the functional outcome of skull base meningioma resection based on the age of the patient, meningioma size, and location and the presence of hyperostosis and dural tail.
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- 2023
21. Fully automated imaging protocol independent system for pituitary adenoma segmentation: a convolutional neural network—based model on sparsely annotated MRI
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Martin Černý, Jan Kybic, Martin Májovský, Vojtěch Sedlák, Karin Pirgl, Eva Misiorzová, Radim Lipina, and David Netuka
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Surgery ,Neurology (clinical) ,General Medicine - Published
- 2023
22. Prevalence and clinical characteristics of hyponatremia following pituitary surgery
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Mikulas Kosak, David Netuka, Vaclav Masopust, Martin Majovsky, Jan Jiskra, and Jana Jezkova
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General Medicine - Published
- 2023
23. Fully automated imaging protocol independent system for pituitary adenoma segmentation: A Convolutional Neural Network-based model on sparsely annotated MRI
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Martin, Černý, primary, Jan, Kybic, additional, Martin, Májovský, additional, Vojtěch, Sedlák, additional, Karin, Pirgl, additional, Eva, Misiorzová, additional, Radim, Lipina, additional, and David, Netuka, additional
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- 2023
- Full Text
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24. Pituitary Surgery in Germany – Findings from the European Pituitary Adenoma Surgery Survey
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Malte Ottenhausen, Jens Conrad, Darius Kalasauskas, David Netuka, and Florian Ringel
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Endocrinology ,Endocrinology, Diabetes and Metabolism ,Internal Medicine ,General Medicine - Abstract
Background Surgery is, next to medical and radiation therapy, the mainstay therapy for pituitary adenomas. While scientific consensus regarding the key aspects of pituitary surgery exists among neurosurgeons, procedures are not standardized and might vary significantly between hospitals and surgeons. Objective To provide an overview of how neurosurgical departments in Germany manage pituitary surgery. Methods Responses from the European Pituitary Adenoma Surgery Survey were analyzed. The survey contained 60 questions regarding demographics, training, surgical and endocrinological aspects, and patient management. Results Sixty neurosurgical centers from Germany responded to the survey. Among the centers, 35.3% (n=18) exclusively use the microscopic and 31.1% (n=14) the endoscopic technique; all other centers (n=28) use both approaches. Of responding centers, 20% (n=12) perform less than 10 transsphenoidal pituitary surgeries per year, and 1.7% (n=1), more than 100 operations. The number of transcranial pituitary operations is significantly smaller, with 53.3% of centers performing only 0–2 per year, 35% performing 3–5, and only one center (1.7%) performing more than 15 transcranial operations per year. In 8 centers (13.3%), surgeries are always performed together with an ENT surgeon; in 29 centers (48.4%) ENT surgeons are never involved. In most centers (n=54, 90%) intraoperative MRI is not available. Image guidance (with preoperative CT and/or MRI data) is used by 91.7% of respondents (n=55). Forty-two centers (72.4%) routinely prescribe hydrocortisone after pituitary surgery, and 75% (n=45) have pituitary board meetings with endocrinologists, radiologists, and radiosurgeons. Fifty-two (86.7%) respondents perform the first follow-up scan by MRI 3–4 months after surgery. Conclusions The data showed differences as well as similarities between centers and could help to discuss the standardization of methods and the formation of networks and certification to improve patient care.
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- 2023
25. Artificial Intelligence Can Generate Fraudulent but Authentic-Looking Scientific Medical Articles: Pandora’s Box Has Been Opened (Preprint)
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Martin Májovský, Martin Černý, Matěj Kasal, Martin Komarc, and David Netuka
- Abstract
BACKGROUND Artificial intelligence (AI) has advanced substantially in recent years, transforming many industries and improving the way people live and work. In scientific research, AI can enhance the quality and efficiency of data analysis and publication. However, AI has also opened up the possibility of generating high-quality fraudulent papers that are difficult to detect, raising important questions about the integrity of scientific research and the trustworthiness of published papers. OBJECTIVE The aim of this study was to investigate the capabilities of current AI language models in generating high-quality fraudulent medical articles. We hypothesized that modern AI models can create highly convincing fraudulent papers that can easily deceive readers and even experienced researchers. METHODS This proof-of-concept study used ChatGPT (Chat Generative Pre-trained Transformer) powered by the GPT-3 (Generative Pre-trained Transformer 3) language model to generate a fraudulent scientific article related to neurosurgery. GPT-3 is a large language model developed by OpenAI that uses deep learning algorithms to generate human-like text in response to prompts given by users. The model was trained on a massive corpus of text from the internet and is capable of generating high-quality text in a variety of languages and on various topics. The authors posed questions and prompts to the model and refined them iteratively as the model generated the responses. The goal was to create a completely fabricated article including the abstract, introduction, material and methods, discussion, references, charts, etc. Once the article was generated, it was reviewed for accuracy and coherence by experts in the fields of neurosurgery, psychiatry, and statistics and compared to existing similar articles. RESULTS The study found that the AI language model can create a highly convincing fraudulent article that resembled a genuine scientific paper in terms of word usage, sentence structure, and overall composition. The AI-generated article included standard sections such as introduction, material and methods, results, and discussion, as well a data sheet. It consisted of 1992 words and 17 citations, and the whole process of article creation took approximately 1 hour without any special training of the human user. However, there were some concerns and specific mistakes identified in the generated article, specifically in the references. CONCLUSIONS The study demonstrates the potential of current AI language models to generate completely fabricated scientific articles. Although the papers look sophisticated and seemingly flawless, expert readers may identify semantic inaccuracies and errors upon closer inspection. We highlight the need for increased vigilance and better detection methods to combat the potential misuse of AI in scientific research. At the same time, it is important to recognize the potential benefits of using AI language models in genuine scientific writing and research, such as manuscript preparation and language editing.
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- 2023
26. Sentinel lesion and significance of rebiopsy: a case of primary CNS lymphoma
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Dominik Drobisz, Petr Skalický, Adam Pavličko, Radoslav Matěj, Kateřina Benešová, David Netuka, and Robert Rusina
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General Medicine - Published
- 2022
27. Long-term stability of Onyx: is there any indication for repeated angiography after dural arteriovenous fistula embolization?
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Richard Voldřich, David Netuka, František Charvát, and Vladimír Beneš
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Fistula ,medicine.medical_treatment ,Arteriovenous fistula ,Magnetic resonance angiography ,Young Adult ,Recurrence ,Dural arteriovenous fistulas ,Occlusion ,medicine ,Humans ,Dimethyl Sulfoxide ,Prospective Studies ,Embolization ,Aged ,Aged, 80 and over ,Central Nervous System Vascular Malformations ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Angiography, Digital Subtraction ,General Medicine ,Digital subtraction angiography ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Cerebral Angiography ,Treatment Outcome ,Angiography ,Female ,Polyvinyls ,Radiology ,business ,Magnetic Resonance Angiography ,Follow-Up Studies - Abstract
OBJECTIVE The natural course of dural arteriovenous fistulas (DAVFs) is unfavorable. Transarterial embolization with Onyx is currently the therapeutic method of choice, although the long-term stability of Onyx has been questioned. The literature reports a significant difference in the recurrence rate after complete DAVF occlusion and lacks larger series with long-term follow-up. The authors present the largest series to date with a long-term follow-up to determine the stability of Onyx, prospectively comparing magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) as follow-up diagnostic methods. METHODS Demographics, clinical symptomatology, length of follow-up, diagnostic methods, and angiographic findings of DAVFs were recorded and retrospectively evaluated in 112 patients. A prospective group of 15 patients with more than 5 years of follow-up after complete DAVF occlusion was established. All 15 patients in the prospective group underwent a clinical examination and MRA; 10 of these patients also underwent DSA. The recurrences and the correlation between the two diagnostic methods were evaluated. RESULTS Among the 112 patients, 71 were men and 41 were women, with an average age of 60 years. Intracranial hemorrhage (40%) was the most common clinical presentation of DAVF. At the last follow-up, 73% of the patients experienced clinical improvement, 21% remained unchanged, and 6% worsened. Overall, 87.5% of the DAVFs were occluded entirely with endovascular treatment, and 93% of the DAVFs were classified as cured at the last follow-up (i.e., completely embolized DAVFs and DAVFs that thrombosed spontaneously or after Gamma Knife surgery). Two recurrences of DAVFs were recorded in the entire series. Both were first diagnosed by MRA and confirmed with DSA. The mean follow-up was 27.7 months. In the prospective group, a small asymptomatic recurrence was diagnosed. The mean follow-up of the prospective group was 96 months. CONCLUSIONS Onyx is a stable embolic material, although recurrence of seemingly completely occluded DAVFs may develop because of postembolization hemodynamic changes that accentuate primarily graphically absent residual fistula. These residuals can be diagnosed with MRA at follow-up. The authors’ data suggest that MRA could be sufficient as the follow-up diagnostic method after complete DAVF occlusion with Onyx. However, larger prospective studies on this topic are needed.
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- 2022
28. What is the most effective method to treat indirect carotid-cavernous fistula?
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Richard, Voldřich, František, Charvát, Vladimír, Beneš, and David, Netuka
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Surgery ,Neurology (clinical) ,General Medicine - Abstract
To review the most relevant treatment options for indirect carotid-cavernous fistulas (iCCF), cohorts of 20 patients or more published after 2000 were analyzed. Clinical and radiological outcomes, as well as embolization techniques and material, had to be clarified in the study to be considered. Statistical analysis was based on calculating the relative percentage of therapeutic methods or embolic material, followed by calculating parametric and nonparametric correlations. Some 22 studies and 1550 patients were included. Transvenous embolization (TVE) was used in 53% of the patients and was strongly associated with coiling (r
- Published
- 2022
29. RGDS- and doxorubicin-modified poly[N-(2-hydroxypropyl)methacrylamide]-coated γ-Fe2O3 nanoparticles for treatment of glioblastoma
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David Netuka, Dana Mareková, Radek Kaiser, Vladimír Proks, Pavla Jendelova, Daniel Horák, Karolina Turnovcova, and Zdeněk Plichta
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chemistry.chemical_classification ,Polymers and Plastics ,Chemistry ,Cell growth ,Peptide ,Chain transfer ,Molecular biology ,chemistry.chemical_compound ,Colloid and Surface Chemistry ,Apoptosis ,In vivo ,Materials Chemistry ,medicine ,Methacrylamide ,Doxorubicin ,Physical and Theoretical Chemistry ,medicine.drug ,N-(2-Hydroxypropyl) methacrylamide - Abstract
Block copolymer comprising of hydrophilic poly[N-(2-hydroxypropyl)methacrylamide] (PHP) and reactive poly[N-(2-hydrazinyl-2-oxoethyl)methacrylamide] (PMAH) was synthesized by a reversible addition-fragmentation chain transfer (RAFT) polymerization and conjugated with doxorubicin (Dox) and/or RGDS targeting peptide via one-step reaction using N-γ-maleimidobutyryl-oxysuccinimide ester. The resulting copolymer served as a coating of magnetic γ-Fe2O3 nanoparticles that were tested in cell proliferation and in vivo experiments on a mice model with inoculated rat C6 glioblastoma tumor. The nanoparticles conjugated with RGDS peptide and doxorubicin easily engulfed both C6 tumor cell line, primary glioblastoma (GB) cells, and human mesenchymal stem cells (hMSC) used as a control; the particles decreased the GB cell growth by 45% compared to control cells without any treatment. Moreover, the γ-Fe2O3@P(HP-MAH)-RGDS-Dox nanoparticles injected into C6 glioblastoma cell-derived tumors grown in the posterior flank of mice decreased the tumor size and more apoptotic cells were spread compared to that treated with free Dox.
- Published
- 2021
30. Shear-Wave Elastography Enables Identification of Unstable Carotid Plaque
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Serhyi Forostyak, Petra Kešnerová, Tomáš Belšán, David Školoudík, Roman Herzig, Jaroslav Vomáčka, Martin Roubec, David Netuka, and Tomáš Hrbáč
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Male ,medicine.medical_specialty ,Acoustics and Ultrasonics ,Biophysics ,030204 cardiovascular system & hematology ,Asymptomatic ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Carotid bifurcation ,Humans ,Carotid Stenosis ,Radiology, Nuclear Medicine and imaging ,Stroke ,Aged ,Shear wave elastography ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Echogenicity ,Middle Aged ,medicine.disease ,Plaque, Atherosclerotic ,Stenosis ,Elasticity Imaging Techniques ,Female ,Elastography ,Radiology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Shear-wave elastography (SWE) is a novel ultrasound technique for quantifying tissue elasticity. The aim of this study was to identify differences in atherosclerotic plaque elasticity measured using SWE among individuals with symptomatic, asymptomatic progressive and asymptomatic stable carotid plaques. Consecutive patients from the Atherosclerotic Plaque Characteristics Associated with a Progression Rate of the Plaque and a Risk of Stroke in Patients with the Carotid Bifurcation Plaque Study were screened for this research. Neurosonography examination of carotid arteries was performed to identify plaque stenosis of ≥50% using B-mode ultrasound and SWE imaging to measure the mean, maximal and minimal elasticity. The set consisted of 97 participants-74 with asymptomatic stable stenosis, 12 with asymptomatic progressive stenosis and 11 with symptomatic stenosis. The mean elasticity in the asymptomatic stable plaque group was significantly higher than in the asymptomatic progressive (52.2 vs. 30.4 kPa; p0.001) and symptomatic (52.2 vs. 36.4 kPa; p = 0.033) plaque groups. No significant differences were found between asymptomatic progressive and symptomatic (p0.1) plaque groups. Asymptomatic stable, asymptomatic progressive and symptomatic plaques did not differ in echogenicity, calcifications, homogeneity, occurrence of ulcerated surface, or intra-plaque hemorrhage (p0.05 in all cases). SWE was a helpful modality for differentiating between stable and unstable atherosclerotic plaques in carotid arteries.
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- 2021
31. Pineal Apoplexy: A Case Series and Review of the Literature
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Radim Lipina, David Netuka, Martin Majovsky, Jan Mraček, and Vladimír Beneš
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endocrine system ,medicine.medical_specialty ,Palsy ,Cysts ,Nausea ,business.industry ,Magnetic Resonance Imaging ,Pineal Gland ,Asymptomatic ,Surgery ,Stroke ,Melatonin ,Pineal gland ,medicine.anatomical_structure ,Cerebrospinal fluid diversion ,medicine ,Vomiting ,Humans ,Clinical significance ,Neurology (clinical) ,medicine.symptom ,business ,Hydrocephalus ,medicine.drug - Abstract
Background Pineal apoplexy is a rare condition, with unknown incidence and clinical significance. To elucidate this clinical condition, we analyzed our own case series and performed a review of the literature. Methods We enrolled all patients with a hemorrhagic pineal apoplexy who were referred to our department between January 2000 and January 2020. Hemorrhagic pineal apoplexy was defined as the presence of fluid–fluid levels inside the pineal cyst (PC) on an axial or sagittal magnetic resonance scan. In one patient, after PC apoplexy, we performed a circadian melatonin sampling from peripheral blood to determine the function of the pineal gland. The PubMed database was searched for publications using the terms “pineal” and “apoplexy.” Results Eight patients were enrolled, of which three patients underwent surgical treatment and five patients were managed conservatively. One patient was tested for circadian melatonin secretion. Results confirmed melatonin secretion with preserved physiologic circadian rhythm.Our search of the literature led us to 31 studies that comprised 30 patients with apoplectic PC, 9 with apoplectic pineal tumor, and 1 with bleeding into the normal pineal gland. Most patients presented with headache, nausea, and vomiting, less frequently with acute hydrocephalus and gaze palsy. Twenty patients with a PC underwent resection or aspiration. Two patients underwent shunt placement as the only procedure and five received both shunt and surgical removal. Six patients with a PC were observed without surgical treatment. All the nine patients with a pineal tumor were operated on. In indicated cases, four patients received radiation therapy and one received chemotherapy. Conclusion Clinical significance of hemorrhagic pineal apoplexy ranges from an asymptomatic course to rapid deterioration and death. In patients with mild symptoms, observation is indicated, whereas surgical treatment is reserved for severe cases presenting with obstructive hydrocephalus and includes cerebrospinal fluid diversion, resection of apoplectic pineal lesions, or both.
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- 2021
32. Diagnostic accuracy of DSA in carotid artery stenosis: a comparison between stenosis measured on carotid endarterectomy specimens and DSA in 644 cases
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Norbert Svoboda, Ondrej Bradac, Vaclav Mandys, David Netuka, and Vladimir Benes
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Endarterectomy, Carotid ,Humans ,Angiography, Digital Subtraction ,Surgery ,Carotid Stenosis ,Neurology (clinical) ,Constriction, Pathologic ,Prospective Studies ,Carotid Artery, Internal - Abstract
DSA (digital subtraction angiography) is the gold standard for measuring carotid artery stenosis (CS). Yet, the correlation between DSA and stenosis is not well documented.We compared CS as measured by DSA to carotid artery specimens obtained from carotid endarterectomy surgery. Patients were divided into three groups according to NASCET criteria (North American Symptomatic Carotid Endarterectomy Trial): stenosis of 30-49% (mild), stenosis of 50-69% (moderate), and stenosis of 70-99% (severe).This prospective cohort study involved 644 patients. The mean stenosis in the mild stenosis group (n = 128 patients) was 54% ECST (European Carotid Surgery Trial), 40% NASCET, and 72% ESs (endarterectomy specimens). The mean absolute difference between ECST and NASCET was 14%. The mean stenosis in the moderate stenosis group (n = 347 patients) was 66% ECST, 60% NASCET, and 77% ES. The mean absolute difference between ECST and NASCET was 6%. The mean stenosis in the severe group (n = 169 patients) was 80% ECST, 76% NASCET, and 79% ES. No significant correlation coefficients were found between DSA and ES methods. In the mild group, the CC was 0.16 (ESCT) and 0.13 (NASCET); in the moderate group, the CC was 0.05 (ESCT) and 0.01 (NASCET); and in the severe group, the CC was 0.23 (ESCT) and 0.10 (NASCET). For all groups combined, CC was 0.22 for the ECST and 0.20 for the NASCET method.The relationship between DSA and ES methods to measure CS is almost random. This lack of a relationship between the DSA and ES techniques questions the validity of current DSA-based guidelines.
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- 2022
33. Peripheral Vascular Resistance in Cerebral Arteries in Patients With Carotid Atherosclerosis – Substudy Results of the Atherosclerotic Plaque Characteristics Associated With a Progression Rate of the Plaque and a Risk of Stroke in Patients With the Carotid Bifurcation Plaque Study ( <scp>ANTIQUE</scp> )
- Author
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Kateřina Langová, David Školoudík, Petra Kešnerová, Roman Herzig, David Netuka, and István Szegedi
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Carotid Artery Diseases ,Male ,medicine.medical_specialty ,Cerebral arteries ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Stroke ,Aged ,030219 obstetrics & reproductive medicine ,Radiological and Ultrasound Technology ,business.industry ,Cerebral Arteries ,Middle Aged ,medicine.disease ,Plaque, Atherosclerotic ,Transcranial Doppler ,Stenosis ,Blood pressure ,medicine.anatomical_structure ,Middle cerebral artery ,Vascular resistance ,Cardiology ,Vascular Resistance ,business - Abstract
Objectives Transcranial color-coded duplex sonography (TCCS) enables to measure blood flow characteristics in cerebral vessels, including vascular resistance and pulsatility. The study aims to identify factors influencing pulsatility (PI) and resistance (RI) indices measured using TCCS in patients with carotid atherosclerosis. Methods Self-sufficient patients with atherosclerotic plaque causing 20-70% carotid stenosis were consecutively enrolled to the study. All patients underwent duplex sonography of cervical arteries and TCCS with measurement of PI and RI in the middle cerebral artery, neurological, and physical examinations. Following data were recorded: age, gender, height, weight, body mass index, systolic and diastolic blood pressure, occurrence of current and previous diseases, surgery, medication, smoking, and daily dose of alcohol. Univariant and multivariant logistic regression analysis were used for identification of the factors influencing RI and PI. Results Totally 1863 subjects were enrolled to the study: 139 healthy controls (54 males, age 55.52 ± 7.05 years) in derivation cohort and 1724 patients (777 males, age 68.73 ± 9.39 years) in validation cohort. The cut off value for RI was 0.63 and for PI 1.21. Independent factors for increased RI/PI were age (odds ratio [OR] = 1.108/1.105 per 1 year), occurrence of diabetes mellitus (OR = 1.767/2.170), arterial hypertension (OR = 1.700 for RI only), width of the carotid plaque (OR = 1.260 per 10% stenosis for RI only), and male gender (OR = 1.530 for PI only; P ˂.01 in all cases). Conclusions The independent predictors of increased cerebral arterial resistance and/or pulsatility in patients with carotid atherosclerosis were age, arterial hypertension, diabetes mellitus, carotid plaque width, and male gender.
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- 2021
34. Visual and digital analysis of the ultrasound image in a stable and progressive carotid atherosclerotic plaque
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Martin Roubec, Petra Kešnerová, Roman Herzig, Kateřina Langová, Tomáš Belšán, Jaroslav Vomáčka, David Netuka, Tomáš Hrbáč, and David Školoudík
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business.industry ,Medicine ,Surgery ,Digital analysis ,Neurology (clinical) ,business ,Ultrasound image ,Biomedical engineering - Published
- 2021
35. Comparison of carotid endarterectomy and repeated carotid angioplasty and stenting for in-stent restenosis (CERCAS trial): a randomised study
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Tomáš Hrbáč, Jiří Fiedler, Václav Procházka, Tomáš Jonszta, Martin Roubec, David Pakizer, Daniel Václavík, David Netuka, Tomáš Heryán, and David Školoudík
- Subjects
Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background and aimIn-stent restenosis (ISR) belongs to an infrequent but potentially serious complication after carotid angioplasty and stenting in patients with severe carotid stenosis. Some of these patients might be contraindicated to repeat percutaneous transluminal angioplasty with or without stenting (rePTA/S). The purpose of the study is to compare the safety and effectiveness of carotid endarterectomy with stent removal (CEASR) and rePTA/S in patients with carotid ISR.MethodsConsecutive patients with carotid ISR (≥80%) were randomly allocated to the CEASR or rePTA/S group. The incidence of restenosis after intervention, stroke, transient ischaemic attack myocardial infarction and death 30 days and 1 year after intervention and restenosis 1 year after intervention between patients in CEASR and rePTA/S groups were statistically evaluated.ResultsA total of 31 patients were included in the study; 14 patients (9 males; mean age 66.3±6.6 years) were allocated to CEASR and 17 patients (10 males; mean age 68.8±5.6 years) to the rePTA/S group. The implanted stent in carotid restenosis was successfully removed in all patients in the CEASR group. No clinical vascular event was recorded periproceduraly, 30 days and 1 year after intervention in both groups. Only one patient in the CEASR group had asymptomatic occlusion of the intervened carotid artery within 30 days and one patient died in the rePTA/S group within 1 year after intervention. Restenosis after intervention was significantly greater in the rePTA/S group (mean 20.9%) than in the CEASR group (mean 0%, p=0.04), but all stenoses were ConclusionCEASR seems to be effective and save procedures for patients with carotid ISR and might be considered as a treatment option.Trial registration numberNCT05390983.
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- 2023
36. Decompression alone versus decompression with instrumented fusion in the treatment of lumbar degenerative spondylolisthesis: a systematic review and meta-analysis of randomised trials
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Radek Kaiser, Lucia Kantorová, Alena Langaufová, Simona Slezáková, Dagmar Tučková, Miloslav Klugar, Zdeněk Klézl, Pavel Barsa, Jan Cienciala, Richard Hajdúk, Lumír Hrabálek, Roman Kučera, David Netuka, Martin Prýmek, Martin Repko, Martin Smrčka, and Jan Štulík
- Subjects
Psychiatry and Mental health ,Surgery ,Neurology (clinical) - Abstract
ObjectiveTo determine the efficacy of adding instrumented spinal fusion to decompression to treat degenerative spondylolisthesis (DS).DesignSystematic review with meta-analysis.Data sourcesMEDLINE, Embase, Emcare, Cochrane Library, CINAHL, Scopus, ProQuest Dissertations & Theses Global, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform from inception to May 2022.Eligibility criteria for study selectionRandomised controlled trials (RCTs) comparing decompression with instrumented fusion to decompression alone in patients with DS. Two reviewers independently screened the studies, assessed the risk of bias and extracted data. We provide the Grading of Recommendations, Assessment, Development and Evaluation assessment of the certainty of evidence (COE).ResultsWe identified 4514 records and included four trials with 523 participants. At a 2-year follow-up, adding fusion to decompression likely results in trivial difference in the Oswestry Disability Index (range 0–100, with higher values indicating greater impairment) with mean difference (MD) 0.86 (95% CI −4.53 to 6.26; moderate COE). Similar results were observed for back and leg pain measured on a scale of 0 to 100, with higher values indicating more severe pain. There was a slightly increased improvement in back pain (2-year follow-up) in the group without fusion shown by MD −5·92 points (95% CI −11.00 to −0.84; moderate COE). There was a trivial difference in leg pain between the groups, slightly favouring the one without fusion, with MD −1.25 points (95% CI −6.71 to 4.21; moderate COE). Our findings at 2-year follow-up suggest that omitting fusion may increase the reoperation rate slightly (OR 1.23; 0.70 to 2.17; low COE).ConclusionsEvidence suggests no benefits of adding instrumented fusion to decompression for treating DS. Isolated decompression seems sufficient for most patients. Further RCTs assessing spondylolisthesis stability are needed to determine which patients would benefit from fusion.PROSPERO registration numberCRD42022308267.
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- 2023
37. Predictive and prognostic significance of tumour subtype, SSTR1‐5 and e‐cadherin expression in a well‐defined cohort of patients with acromegaly
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Jiri Soukup, Helena Hornychova, Monika Manethova, Kvetoslava Michalova, Ludmila Michnova, Lenka Popovska, Veronika Skarkova, Tomas Cesak, David Netuka, Ales Ryska, Jan Cap, Václav Hána, Michal Kršek, Eva Dvořáková, Michal Krčma, Ivica Lazurova, Věra Olšovská, Karel Starý, Peter Vaňuga, and Filip Gabalec
- Subjects
Adult ,Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Somatotropic cell ,Clinical Decision-Making ,Pituitary neoplasm ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Acromegaly ,Humans ,Protein Isoforms ,Medicine ,Pituitary Neoplasms ,Somatostatin receptor 1 ,Receptors, Somatostatin ,business.industry ,Somatostatin receptor ,Cadherin ,Disease Management ,Original Articles ,Cell Biology ,Middle Aged ,PITNET ,Cadherins ,Prognosis ,medicine.disease ,Combined Modality Therapy ,Immunohistochemistry ,3. Good health ,somatostatin receptor ,Treatment Outcome ,030104 developmental biology ,Gene Expression Regulation ,ROC Curve ,pituitary neoplasm ,030220 oncology & carcinogenesis ,Cohort ,Molecular Medicine ,Original Article ,Female ,business ,Biomarkers - Abstract
In somatotroph pituitary tumours, somatostatin analogue (SSA) therapy outcomes vary throughout the studies. We performed an analysis of cohort of patients with acromegaly from the Czech registry to identify new prognostic and predictive factors. Clinical data of patients were collected, and complex immunohistochemical assessment of tumour samples was performed (SSTR1‐5, dopamine D2 receptor, E‐cadherin, AIP). The study included 110 patients. In 31, SSA treatment outcome was evaluated. Sparsely granulated tumours (SGST) differed from the other subtypes in expression of SSTR2A, SSTR3, SSTR5 and E‐cadherin and occurred more often in young. No other clinical differences were observed. Trouillas grading system showed association with age, tumour size and SSTR2A expression. Factors significantly associated with SSA treatment outcome included age, IGF1 levels, tumour size and expression of E‐cadherin and SSTR2A. In the group of SGST, poor SSA response was observed in younger patients with larger tumours, lower levels of SSTR2A and higher Ki67. We observed no relationship with expression of other proteins including AIP. No predictive value of E‐cadherin was observed when tumour subtype was considered. Multiple additional factors apart from SSTR2A expression can predict treatment outcome in patients with acromegaly.
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- 2021
38. Comparison of in vivo and in vitro measurements of flow parameters in carotid stenosis – pilot results of hemodynamic phantom testing
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Jana Hofmanová, David Netuka, Roman Matějka, Tomáš Belšán, David Školoudík, Tomáš Hrbáč, Adam Školoudík, Serhyi Forostyak, and Petra Kešnerová
- Subjects
Stenosis ,Flow (mathematics) ,In vivo ,business.industry ,medicine ,Hemodynamics ,Surgery ,Neurology (clinical) ,medicine.disease ,business ,Imaging phantom ,Biomedical engineering - Published
- 2020
39. Endocrinological aspects of pituitary adenoma surgery in Europe
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Nicolas Foroglou, Francesco Zenga, David Netuka, Martin Majovsky, André Grotenhuis, Martin Komarc, Sebastien Froehlich, Florian Ringel, N S B Thomas, Nicolas Sampron, and Mikulas Kosak
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Adenoma ,medicine.medical_specialty ,Multidisciplinary ,business.industry ,medicine.disease ,Surgery ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,All institutes and research themes of the Radboud University Medical Center ,Adrenocorticotropic Hormone ,Pituitary adenoma ,medicine ,Humans ,Pituitary Neoplasms ,Prolactinoma ,business ,Retrospective Studies - Abstract
Purpose:Hormone-secreting adenomas are treated in many neurosurgical centers within Europe. The goal of the survey is to shed light on different endocrinological aspects of hormone-secreting adenomas surgery.Methods: A list of departments performing pituitary surgery was created. The survey consisted of 58 questions. This study focuses on neurosurgical care of hormone-secreting adenomas. For analysis, the departments were divided into four subgroups: academic/non-academic, high-volume/low-volume, “mainly endoscopic/mainly microscopic practice” and geographical regions. Results: Data from 254 departments from 34 countries were obtained. Most centers surgically treat 1-5 hormone-secreting adenomas per year. In prolactinomas this is the case in 194 centers, (76.4%), in GH-secreting adenomas: 133 centers, (52.4%), ACTH-secreting adenomas: 172 centers, (69.8%). Surgery as a primary treatment of prolactinomas is considered in 64 centers (25.2%). In 47 centers (18.8%), GH-secreting microadenomas are often treated pharmacologically first. Debulking surgery for an invasive GH-secreting adenoma in which hormonal remission is not a realistic goal of the surgery and the patient has no visual deficit surgery is always or mostly indicated in 156 centers (62.9%). Routine postoperative hydrocortisone replacement therapy is administered in 147 centers (58.6%). Conclusions:Our survey shows that in most centers, few hormone-secreting adenomas are treated per year. In about 25% of the centers, prolactinoma surgery may be regarded as first-line treatment; in about 20% of the centers, medical treatment is the first-line treatment for GH-secreting adenomas. Pretreatment for ACTH-secreting adenomas is routinely used in 21% of centers. This survey may serve as plea for neurosurgical care centralization of hormone-secreting adenomas.
- Published
- 2022
40. Diffuse low grade gliomas
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David Netuka and Dora Konečná
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Surgery ,Neurology (clinical) - Published
- 2020
41. Stem Cell Transcription Factor Sox2 Is Expressed in a Subset of Folliculo-stellate Cells of Growth Hormone–Producing Pituitary Neuroendocrine Tumours and Its Expression Shows No Association with Tumour Size or IGF1 Levels: a Clinicopathological Study of 109 Cases
- Author
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Filip Gabalec, David Netuka, Jiri Soukup, Tomas Cesak, Helena Hornychova, Květoslava Michalová, Jan Cap, and Ľudmila Michnová
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Biology ,S100 protein ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,SOX2 ,Acromegaly ,Biomarkers, Tumor ,medicine ,Humans ,Pituitary Neoplasms ,Insulin-Like Growth Factor I ,Human Growth Hormone ,SOXB1 Transcription Factors ,Stem Cells ,General Medicine ,Middle Aged ,medicine.disease ,Prolactin ,Neuroendocrine Tumors ,030220 oncology & carcinogenesis ,embryonic structures ,Hepatic stellate cell ,Immunohistochemistry ,Female ,Stem cell ,Annexin A1 - Abstract
Sox2 is one of the transcription factors responsible for the maintenance of stem cell phenotype. It has been implicated as a marker of stem cells in normal pituitaries and pituitary neuroendocrine tumours. To explore the clinical significance of Sox2 expression in histological sections, we performed immunohistochemical detection of Sox2 in 113 pituitary neuroendocrine tumours from 109 patients with acromegaly. In 11 tumours, we performed double immunostaining for Sox2, annexin A1 and S100 protein. Tumours were characterised using the WHO classification system. Proliferative activity and invasion were assessed. The amount of immunoreactive cells was evaluated and correlated with tumour size and biochemical features (levels of IGF1, GH, prolactin, βTSH). Sox2+ cells were identified in 35/38 normal pituitaries adjacent to the tumours. In 36 tumours (33%), ≥ 1% of the cells expressed Sox2, in 24 cases (22%), Sox2+ cells comprised
- Published
- 2020
42. Magnetic resonance markers of bilateral neuronal metabolic dysfunction in patients with unilateral internal carotid artery occlusion
- Author
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Daniel Horinek, Antonin Skoch, Tomas Moravec, Svapotluk Ostry, Milan Hájek, Irena Buksakowska, Barbora Urbanova, Milan Mohapl, Jiri Vrana, Aleš Tomek, David Netuka, Lukas Martinkovic, Robert Bartoš, Jan Sroubek, Alberto Malucelli, Jakub Hort, and Martin Sameš
- Subjects
medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Biophysics ,Hemodynamics ,030218 nuclear medicine & medical imaging ,White matter ,03 medical and health sciences ,0302 clinical medicine ,Atrophy ,Internal medicine ,medicine.artery ,Occlusion ,Centrum semiovale ,medicine ,Humans ,Carotid Stenosis ,Radiology, Nuclear Medicine and imaging ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Brain ,Magnetic resonance imaging ,medicine.disease ,Transcranial Doppler ,medicine.anatomical_structure ,Cerebrovascular Circulation ,Cardiology ,Internal carotid artery ,business ,Carotid Artery, Internal - Abstract
To evaluate cerebral hemodynamic, metabolic and anatomic changes occurring in patients with unilateral occlusion of the internal carotid artery (ICA). Twenty-two patients with unilateral occlusion of ICA and twenty age and sex matched healthy subjects were included in the study. Single voxel proton magnetic resonance spectroscopy (1H-MRS) of the centrum semiovale, semi-automated hippocampal volumetry in T1-weighted scans and transcranial Doppler examination (TCD) with calculation of Breath Holding Index (BHI) were performed in both groups. Metabolic, anatomic, and hemodynamic features were compared between the two groups. The N-acetylaspartate (NAA)/choline (Cho) ratio was significantly lower in both hemispheres of enrolled patients compared to controls (p = 0.005 for the side with occlusion, p = 0.04 for the side without occlusion). The hippocampus volume was significantly reduced bilaterally in patients compared to healthy subjects (p = 0.049). A statistically significant difference in BHI values was observed between the side with occlusion and without occlusion (p = 0.037) of the patients, as well as between BHI values of the side with occlusion and healthy volunteers (p = 0.014). Patients with unilateral ICA occlusion have reduced NAA/Cho ratio in the white matter of both hemispheres and have bilateral atrophy of hippocampus. The alteration of hemodynamics alone cannot explain these changes.
- Published
- 2020
43. Spinal meningiomas: is Simpson grade II resection radical enough?
- Author
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Richard Voldřich, David Netuka, and Vladimír Beneš
- Subjects
Adult ,Male ,medicine.medical_specialty ,Neurology ,Context (language use) ,Neurosurgical Procedures ,030218 nuclear medicine & medical imaging ,Resection ,Meningioma ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Meningeal Neoplasms ,medicine ,Humans ,Postoperative Period ,Aged ,Neuroradiology ,Spinal Neoplasms ,medicine.diagnostic_test ,business.industry ,Spinal Meningiomas ,Interventional radiology ,Middle Aged ,medicine.disease ,Surgery ,Female ,Neurology (clinical) ,Neurosurgery ,business ,030217 neurology & neurosurgery - Abstract
The optimal treatment for spinal meningioma is complete resection. The radicality of resection is the most important predictive factor for future tumor recurrence. Although clinical series dedicated to spinal meningiomas are relatively frequent, only a minimum of these defines the length of the required follow-up and difference in tumor recurrence in the context of Simpson grade I and II resection. Therefore, we propose reconsideration of surgical treatment and long-term follow-up based on a retrospective analysis of 84 patients who underwent Simpson grade II resection. The study included 84 patients operated between 1998 and 2018. Clinical symptomatology, age, sex, risk of comorbidities, spinal level, duration of symptoms, surgical resection radicality, tumor recurrence, and complications associated with treatment were recorded and evaluated. We encountered the diagnosis of spinal meningioma considerably more often in women (81%) than in men (19%). The average age of all patients was 65 years. Most meningiomas were located in the thoracic spine (82%) while the rest (18%) were located in the cervical spine. The most common symptoms were motor deficit (80%) and sensation disorders (70%). Of the symptomatic patients, 71% clinically improved, 27% showed no change and 2% worsened postoperatively. The mean follow-up was 32 months (range 1–204). During this period, there was a 5% tumor recurrence rate. However, when we analyzed a subgroup of nine patients who were monitored for more than 6 years, tumor recurrence was diagnosed in 44%, all of whom were women (mean age 51 years). Our results indicate that tumor recurrence after Simpson II resection could be significantly higher than previously thought if the follow-up is long enough, especially in younger patients. This finding suggests we consider using radical Simpson grade I resection more frequently. The study also demonstrates that after spinal meningioma surgery the patients should be followed and monitored on a long-term basis.
- Published
- 2020
44. What is the current clinical practice in pituitary adenoma surgery in Europe? European Pituitary Adenoma Surgery Survey (EU-PASS) results-technical part
- Author
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Nicolas Foroglou, David Netuka, Sebastien Froehlich, N S B Thomas, André Grotenhuis, Martin Komarc, Martin Májovský, Nicolás Samprón, Francesco Zenga, and Florian Ringel
- Subjects
medicine.medical_specialty ,Surgical approach ,Cerebrospinal fluid leak ,business.industry ,Postoperative mri ,General Medicine ,medicine.disease ,Surgery ,Clinical Practice ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,Pituitary adenoma ,Current practice ,Perioperative care ,Medicine ,Neurology (clinical) ,Neurosurgery ,business - Abstract
Contains fulltext : 248317.pdf (Publisher’s version ) (Closed access) Pituitary adenoma surgery has evolved rapidly in recent decades, changing clinical practice markedly and raising new challenges. There is no current consensus or guidelines for perioperative care that includes possible complication management. This study aims to determine current practice across European neurosurgical centres. We created a list of eligible departments performing pituitary adenoma surgery based on cooperation with EANS, national neurosurgical societies, and personal communication with local neurosurgeons. We contacted the chairpersons from each department and asked them (or another responsible neurosurgeon) to fill out the survey. The survey consisted of 58 questions. For further analysis, departments were divided into subgroups: "academic"/ "non-academic centre", "high-volume"/"low-volume", "mainly endoscopic"/ "mainly microscopic"/ "mixed practise", and by geographical regions. Data from 254 departments from 34 countries were obtained. The average time to complete the survey was 18 min. Notably, the endoscopic approach is the predominant surgical approach in Europe, used in 56.8% of the centres. In routine cases without intraoperative cerebrospinal fluid leak, high-volume centres are less pedantic with sellar closure when compared with low-volume centres (p
- Published
- 2022
45. European Stroke Organisation (ESO) Guidelines on Management of Unruptured Intracranial Aneurysms
- Author
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Nima Etminan, Diana Aguiar de Sousa, Cindy Tiseo, Romain Bourcier, Hubert Desal, Anttii Lindgren, Timo Koivisto, David Netuka, Simone Peschillo, Sabrina Lémeret, Avtar Lal, Mervyn DI Vergouwen, and Gabriel JE Rinkel
- Subjects
Unruptured Intracranial Aneurysms ,Clipping ,Aneurysm Growth ,Assessment ,Guidelines ,Management ,Medical Management ,Grading of Recommendations ,CHLC NEU ,Endovascular Repair ,Risk Factors ,Neurology (clinical) ,Risk of Rupture ,Cardiology and Cardiovascular Medicine ,Coiling - Abstract
Unruptured intracranial aneurysms (UIA) occur in around 3% of the population. Important management questions concern if and how to perform preventive UIA occlusion; if, how and when to perform follow up imaging and non-interventional means to reduce the risk of rupture. Using the Standard Operational Procedure of ESO we prepared guidelines according to GRADE methodology. Since no completed randomised trials exist, we used interim analyses of trials, and meta-analyses of observational and case-control studies to provide recommendations to guide UIA management. All recommendations were based on very low evidence. We suggest preventive occlusion if the estimated 5-year rupture risk exceeds the risk of preventive treatment. In general, we cannot recommend endovascular over microsurgical treatment, but suggest flow diverting stents as option only when there are no other low-risk options for UIA repair. To detect UIA recurrence we suggest radiological follow up after occlusion. In patients who are initially observed, we suggest radiological monitoring to detect future UIA growth, smoking cessation, treatment of hypertension, but not treatment with statins or acetylsalicylic acid with the indication to reduce the risk of aneurysm rupture. Additionally, we formulated 15 expert-consensus statements. All experts suggest to assess UIA patients within a multidisciplinary setting (neurosurgery, neuroradiology and neurology) at centres consulting >100 UIA patients per year, to use a shared decision-making process based on the team recommendation and patient preferences, and to repair UIA only in centres performing the proposed treatment in >30 patients with (ruptured or unruptured) aneurysms per year per neurosurgeon or neurointerventionalist. These UIA guidelines provide contemporary recommendations and consensus statement on important aspects of UIA management until more robust data come available. info:eu-repo/semantics/publishedVersion
- Published
- 2022
46. Gunshot injury of the brain
- Author
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Vladimír Beneš, Martin Heckel, Martin Májovský, Norbert Svoboda, Zdeněk Šňupárek, Václav Masopust, and David Netuka
- Subjects
business.industry ,Anesthesia ,GUNSHOT INJURY ,Medicine ,Surgery ,Neurology (clinical) ,business - Published
- 2019
47. Civilian and military gunshot wounds to the head
- Author
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Vladimír Beneš, Norbert Svoboda, Miloš Sokol, Kateřina Langová, Martin Májovský, and David Netuka
- Subjects
business.industry ,Head (vessel) ,Medicine ,Surgery ,Neurology (clinical) ,Anatomy ,business - Published
- 2019
48. Spinal meningiomas – 92 patients operated at our department
- Author
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Richard Voldřich, Vladimír Beneš, and David Netuka
- Subjects
medicine.medical_specialty ,business.industry ,Spinal Meningiomas ,Medicine ,Surgery ,Neurology (clinical) ,business - Published
- 2019
49. Current trends and outcomes of non-elective neurosurgical care in Central Europe during the second year of the COVID-19 pandemic
- Author
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Ondra Petr, Lukas Grassner, Freda M. Warner, Michaela Dedeciusová, Richard Voldřich, Philipp Geiger, Konstantin Brawanski, Sina Gsellmann, Laura C. Meiners, Richard Bauer, Sascha Freigang, Michael Mokry, Alexandra Resch, Thomas Kretschmer, Tobias Rossmann, Francisco Ruiz Navarro, Harald Stefanits, Andreas Gruber, Mathias Spendel, Christoph Schwartz, Christoph Griessenauer, Franz Marhold, Camillo Sherif, Jonathan P. Wais, Karl Rössler, Jakob J. Zagata, Martin Ortler, Wolfgang Pfisterer, Manfred Mühlbauer, Felipe A. Trivik-Barrientos, Johannes Burtscher, Lukáš Krška, Radim Lipina, Martin Kerekanič, Jiří Fiedler, Petr Kasík, Vladimír Přibáň, Michal Tichý, Vladimír Beneš, Petr Krůpa, Tomáš Česák, Robert Kroupa, Andrej Callo, Pavel Haninec, Daniel Pohlodek, David Krahulík, Alena Sejkorová, Martin Sameš, Josef Dvořák, Andriana Juričeková, Pavel Buchvald, Robert Tomáš, Jan Klener, Vilém Juráň, Martin Smrčka, Petr Linzer, Miroslav Kaiser, Dušan Hrabovský, Radim Jančálek, John L. K. Kramer, Claudius Thomé, and David Netuka
- Subjects
Europe ,Multidisciplinary ,Hematoma, Subdural, Chronic ,COVID-19 ,Humans ,Pandemics ,Neurosurgical Procedures - Abstract
Reflecting the first wave COVID-19 pandemic in Central Europe (i.e. March 16th–April 15th, 2020) the neurosurgical community witnessed a general diminution in the incidence of emergency neurosurgical cases, which was impelled by a reduced number of traumatic brain injuries (TBI), spine conditions, and chronic subdural hematomas (CSDH). This appeared to be associated with restrictions imposed on mobility within countries but also to possible delayed patient introduction and interdisciplinary medical counseling. In response to one year of COVID-19 experience, also mapping the third wave of COVID-19 in 2021 (i.e. March 16 to April 15, 2021), we aimed to reevaluate the current prevalence and outcomes for emergency non-elective neurosurgical cases in COVID-19-negative patients across Austria and the Czech Republic. The primary analysis was focused on incidence and 30-day mortality in emergency neurosurgical cases compared to four preceding years (2017–2020). A total of 5077 neurosurgical emergency cases were reviewed. The year 2021 compared to the years 2017–2019 was not significantly related to any increased odds of 30 day mortality in Austria or in the Czech Republic. Recently, there was a significant propensity toward increased incidence rates of emergency non-elective neurosurgical cases during the third COVID-19 pandemic wave in Austria, driven by their lower incidence during the first COVID-19 wave in 2020. Selected neurosurgical conditions commonly associated with traumatic etiologies including TBI, and CSDH roughly reverted to similar incidence rates from the previous non-COVID-19 years. Further resisting the major deleterious effects of the continuing COVID-19 pandemic, it is edifying to notice that the neurosurgical community´s demeanor to the recent third pandemic culmination keeps the very high standards of non-elective neurosurgical care alongside with low periprocedural morbidity. This also reflects the current state of health care quality in the Czech Republic and Austria.
- Published
- 2021
50. Histological Analysis of Carotid Plaques: The Predictors of Stroke Risk
- Author
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Norbert Svoboda, Richard Voldřich, Václav Mandys, Tomas Hrbáč, Petra Kešnerová, Martin Roubec, David Školoudík, and David Netuka
- Subjects
Risk ,Stroke ,Carotid Arteries ,Rehabilitation ,Humans ,Surgery ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,Plaque, Atherosclerotic - Abstract
The morphology and histological structure of the atherosclerotic plaque seem critical to its stability. Our study aimed to identify the epidemiological, morphological and histological parameters associated with stable and unstable plaques.The study included 280 plaques harvested from 269 consecutive patients. Epidemiological and demographic data were recorded as well as the histological features of plaque, i.e. calcifications, myxoid changes, bleeding into plaque, presence of thrombus, inflammation, macrophages, giant cell reaction, siderophages, neovascularization and plaque ossification. All specimens were classified according to the American Heart Association (AHA).Monofactorial analysis identified three significant histological predictors for the symptomatic plaque: a plaque with a large necrotic core (odds ratio, OR=2.0, p = 0.03), thrombosis (OR=3.7, p = 0.01) and the formation of foamy macrophages (OR=2.0, p = 0.01). Multifactorial logistic regression revealed that the presence of foamy macrophages (OR=1.9, p = 0.03) and thrombosis (OR=3.5, p = 0.02) were significant predictors of symptomatic stenosis. Symptomatic plaques were significantly more frequently classified as AHA type VI than AHA type IV-V compared to asymptomatic ones (OR=1.8, p = 0.03).Our study shows that no single histological feature, except for the presence of foamy macrophages and thrombosis on the plaque, is predictive of plaque instability. Rather, a complex plaque structure (AHA type VI) is predictive of plaque instability. Our findings should be kept in mind during the assessment of non-invasive imaging and stroke risk estimation.
- Published
- 2021
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