Molecular recognition of aortic valve stenosis and regurgitation.

OBJECTIVE: Aortic valve stenosis (AS) presents a disease during which there are changes of the aortic valve structure that modify the blood structure of patients. The aim of this study was to improve the effectiveness of differential diagnostics of aortic stenosis and aortic regurgitation using molecular techniques on both mRNA (RT-PCR) and protein (biochip protein). PATIENTS AND METHODS: An experimental group (n = 58) consisting of patients with aortic valve stenosis (n = 26) and aortic regurgitation (AR, n = 32) was compared with a control group (n = 35). Both blood serum and valve tissue samples were used for the determination of gene expression specific genes related to inflammatory response (CRP, IL6, IL2R, IL6R, TNFR1, and 2) as well as genes and proteins involved in remodeling of the extracellular matrix (MMP9, TIMP, Emilin-1). RESULTS: We found that hsCRP and IL6 plasma levels of patients with AS were higher than both controls and patients with AR (mean 5.6 ng/ml). The differences between AS and AR were detected only in mRNA levels of MMP9 and TIMP where increased levels characteristic for AS were found (about 74%, p < 0.01 and 87%, p < 0.001 higher than AR). CONCLUSIONS: The achieved results could contribute to the improvement of early diagnosis of selected cardiovascular disease in the future and improve the quality of patient's life.

The impact of the angioplasty of the renal artery and cold ischemia time in kidney transplantation on graft function.

The aim of this study was to analyze the benefit of the patients after renal transplantation with an assessment of the significance of different surgical techniques in patients with renal transplantation (not only from the dead but also the living donors) with multiple arteries. 457 patients with end stage renal disease (ESRD) in the treatment using the extracorporeal elimination method (haemodialysis, or peritoneal dialysis), who in the period from 2005 to 2015 had a kidney transplant were included in our retrospective study. Our results confirm that the patients after kidney transplantation with cold ischemia time more than 12 hours have 2.5 times higher risk of delayed onset, possibly failure of graft function compared to those with cold ischemia time less than 12 hours. This confirms our experience that the best option for the patient to achieve a stable graft function with long-term perspective is cold ischemia time of less than 12 hours and the realisation of renal artery angioplasty. In this case, the risk of delayed onset of transplanted kidney function or graft failure decreases 4.5 times compared to the respondents with cold ischemia time more than 12 hours without carrying out arterial angioplasty (Tab. 1, Fig. 4, Ref. 16).

[Malignant fibrous histiocytoma as a rare cause of acute limb ischemia]. / Malígny fibrózny histiocytóm ako raritná prícina akútnej koncatinovej ischémie.

Malignant fibrous histiocytoma (MFH) represents a rare malignant affection of heart and aorta. Its clinical presentation depends on the localisation, size, degree of invasion and metastasis. Previously, relatively few cases of acute tumour mass embolisation into the visceral and limb arterial system were described in the literature. In the present case study we describe a case of acute ischemia of both lower extremities caused by thromboembolic mass of MFH cells. According to literary sources this tumour type is characterized by poor prognosis as it was in the case of our patient.

Patients with Klippel-Trenaunay syndrome.

Klippel-Trenaunay syndrome is the most frequent systemic venous angiodysplasia. It is characterized by cutaneous capillary malformations - naevus flammeus, excessive growth of soft and bone tissue, venous and lymphatic malformations. Investigative methods include: clinical examinations, venography as the evidence of dysplastic changes of superficial and / or deep venous system, the Moyne obstruction and venous insufficiency perforator. Treatment is conservative, related to that of chronic venous disease. The surgery is aimed at removing the varices and insufficient perforators (Fig. 9, Ref. 8).

[Different techniques of vessel reconstruction in kidney transplantation 10-years experiences]. / Cievne plastiky a úpravy ciev u pacientov pri transplantácii obliciek v 10 rocnom sledovaní.

INTRODUCTION: The aim of the study was to analyze own results from Transplant Center Kosice, Slovak Republic. METHODS: In total 457 patients in the end-stage renal failure were included to the kidney transplant program. Following techniques were used: arterioplasty, individual renal artery anastomosis and multiple renal arteries anastomosed on a common patch. The kidney transplant (Tx) especially requires surgical technique of a vascular anastomosis. RESULTS: Renal transplantation has been established in Transplant Center Kosice since 1988. The arterioplasty of renal artery was performed in 102 (22.3%) and individual artery anastomosis in 25 (5.5%) patients. Multiple artery anastomosis on the patch was done in 43 (9.4%) and implantation of pole renal arteries to the main trunk performed in 34 (7.4%) cases. CONCLUSION: Renal transplantation is a lifesaving method in end stage renal failure. KEY WORDS: kidney transplantation - arterioplasty, cold ischemia time vascular anastomosis.

[Surgical prevention of acute stroke in atherosclerotic carotid stenosis].

The results of carotid endarterectomy performed in 687 patients for the symptomatic and asymptomatic carotid stenosis. Operation in most patients was performed under general anesthesia with intraoperative transcranial oximetry monitoring. Early good and satisfactory postoperative results in patients with symptomatic atherosclerotic carotid stenosis were 95.9% in asymptomatic and 97.2% in symptomatic patients. Hemodynamically significant restenosis over 50% of chink in 3 years follow-up was found in 3.4% patients. Eversion endarterectomy application permite to reduce the duration of the operation. Transcranial oximetry application during surgery helps to realise best surgical tactics and is helpful on decision to use or not an intraoperative shunt.