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Therapy for pancreatic ductal adenocarcinoma remains challenging, and the chances of a complete cure are very limited. As in other types of cancer, the expression and role of miRNAs in controlling the biological properties of this type of tumor have been extensively studied. A better insight into miRNA biology seems critical to refining diagnostics and improving their therapeutic potential. In this study, we focused on the expression of miR-21, -96, -196a, -210, and -217 in normal fibroblasts, cancer-associated fibroblasts prepared from a ductal adenocarcinoma of the pancreas, and pancreatic carcinoma cell lines. We compared these data with miRNAs in homogenates of paraffin-embedded sections from normal pancreatic tissues. In cancer-associated fibroblasts and cancer cell lines, miRNAs differed significantly from the normal tissue. In detail, miR-21 and -210 were significantly upregulated, while miR-217 was downregulated. Similar transcription profiles were earlier reported in cancer-associated fibroblasts exposed to hypoxia. However, the cells in our study were cultured under normoxic conditions. We also noted a relation to IL-6 production. In conclusion, cultured cancer-associated fibroblasts and carcinoma cells reflect miR-21 and -210 expression similarly to the cancer tissue samples harvested from the patients.
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Fibroblastos Associados a Câncer , Carcinoma Ductal Pancreático , MicroRNAs , Neoplasias Pancreáticas , Humanos , MicroRNAs/genética , Fibroblastos Associados a Câncer/metabolismo , Neoplasias Pancreáticas/patologia , Carcinoma Ductal Pancreático/patologia , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica , Neoplasias PancreáticasRESUMO
Breath tests for the evaluation liver metabolic function are a non-invasive diagnostic method with high sensitivity and specificity. Up today, the issue of liver damage in patients with chronic kidney disease has not been investigated sufficiently, although it might have significant clinical consequences. The following article describes the principles of breath tests, experiences with breath tests in patients with chronic kidney disease (CKD) and the results of our pilot study with methacetin breath tests in patients with CKD and in regular peritoneal dialysis treatment.
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Testes Respiratórios , Insuficiência Renal Crônica , Humanos , Fígado/patologia , Cirrose Hepática , Testes de Função Hepática , Projetos Piloto , Insuficiência Renal Crônica/diagnósticoAssuntos
Carcinoma de Células Escamosas , Hidradenite Supurativa , Fator de Necrose Tumoral alfa , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/tratamento farmacológico , Hidradenite Supurativa/tratamento farmacológico , Hidradenite Supurativa/complicações , Infliximab/uso terapêutico , Estudos Prospectivos , Neoplasias Cutâneas/tratamento farmacológico , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
The main goal of our study was to compare the quality of resulting facials scar 12 weeks after single and combined laser therapy. Forty-one children from age 1.5 to 5 years with facial scars after injury participated in the study. Thirty-one underwent laser therapy, 14 were treated using single low-level laser therapy (670 nm, fluence 3-5 J/cm(-2) ), and 17 underwent combined high-level laser therapy with non-ablative pulsed dye laser (PDL; 595 nm, spot size 7 mm, delay 0.45 ms or 1.5 ms, fluence 9-11 J/cm(-2) , cryogen spray/delay 20/30 ms) and low-level laser therapy. The control group consisted of 10 untreated children. Before treatment and at week 4, 8, and, 12 the scars were evaluated using the POSAS questionnaire. A statistically significant improvement in scars (between ratings before treatment and 4 weeks after therapy, before treatment and 8 weeks after therapy and before treatment and 12 weeks after therapy) was observed in all parameters in both treatment groups (p < 0.0001). For the HLLT+LLLT group the most significant enhancement in the quality of scars was found for all items and at all evaluations, except pigmentation and pliability. There was no improvement observed in quality of facial scars in the control group.
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Cicatriz/radioterapia , Cicatriz/cirurgia , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade , Inquéritos e Questionários , Pré-Escolar , Cicatriz/patologia , Cor , Terapia Combinada , Face , Feminino , Humanos , Lactente , Masculino , Avaliação de Resultados da Assistência ao Paciente , Maleabilidade , Estudos Prospectivos , Resultado do TratamentoRESUMO
Patients with alcoholic liver disease (ALD) often display disturbed iron indices. Hepcidin, a key regulator of iron metabolism, has been shown to be down-regulated by alcohol in cell lines and animal models. This down-regulation led to increased duodenal iron transport and absorption in animals. In this study, we investigated gene expression of duodenal iron transport molecules and hepcidin in three groups of patients with ALD (with anaemia, with iron overload and without iron overload) and controls. Expression of DMT1, FPN1, DCYTB, HEPH, HFE and TFR1 was measured in duodenal biopsies by using real-time PCR and Western blot. Serum hepcidin levels were measured by using ELISA. Serum hepcidin was decreased in patients with ALD. At the mRNA level, expressions of DMT1, FPN1 and TFR1 genes were significantly increased in ALD. This pattern was even more pronounced in the subgroups of patients without iron overload and with anaemia. Protein expression of FPN1 paralleled the increase at the mRNA level in the group of patients with ALD. Serum ferritin was negatively correlated with DMT1 mRNA. The down-regulation of hepcidin expression leading to up-regulation of iron transporters expression in the duodenum seems to explain iron metabolism disturbances in ALD. Alcohol consumption very probably causes suppression of hepcidin expression in patients with ALD.
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Duodeno/metabolismo , Hepcidinas/fisiologia , Hepatopatias Alcoólicas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Proteínas de Transporte de Cátions/genética , Proteínas de Transporte de Cátions/metabolismo , Grupo dos Citocromos b/genética , Grupo dos Citocromos b/metabolismo , Feminino , Expressão Gênica , Humanos , Ferro/sangue , Masculino , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Oxirredutases/genética , Oxirredutases/metabolismoRESUMO
AIMS: Changing lifestyles, decreasing physical activity, which is increasing the number of degenerative joint diseases of various etiology, and certain dental procedures are increasing the number of patients complaining of pain in their temporomandibular joints. The aim of the study was to assess the benefits of comprehensive physiotherapy sessions in order to decrease the number of temporomandibular joint problems, thereby improving the patient's quality of life. METHODOLOGY: An examination by a dentist determined each patient's treatment plan, which consisted of a medical exam, physical therapy and education. Each form of treatment was applied 10 times at intervals of 7-14 days. The main goal of the therapeutic physical education was to redress the muscle imbalance in the mandibular joint. This was achieved by restoring balance between the masticatory muscles, along with releasing the spastic shrouds found in the masticatory muscles. The aim of education was to teach the patient exercises focused on the temporomandibular joint and masticatory muscles. The intensity of the exercises and their composition were individually adjusted and adapted to their current state. Physical therapy consisted of the application of pulsed magnetic therapy, laser therapy, and non-invasive positive thermotherapy. RESULTS: The above procedure was conducted on a therapeutic group of 24 patients (3 men and 20 women). In the course of therapy, there were no complications, and all patients adhered to the prescribed regime. None reported any side effects. The mean treatment duration was 123 +/- 66 days. The outcome of the therapy was evaluated as described in the methodology, the degree of pain affecting the joint, and the opening ability of the mouth. In both parameters, there was a significant decline in patient pain. CONCLUSIONS: In a study devoted to tactics of rehabilitation treatment for temporomandibular joint disorders, the need for comprehensive long-term therapy, involving education, and learning proper chewing habits was made apparent for recovery and pain reduction. A priority in physical therapy, and combinations of pulsed magnetic therapy and hyperthermia-positive peloids, are also beneficial.
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Transtornos da Articulação Temporomandibular/terapia , Adolescente , Adulto , Distribuição de Qui-Quadrado , Dor Facial/terapia , Feminino , Humanos , Hipertermia Induzida , Lasers Semicondutores/uso terapêutico , Magnetoterapia , Masculino , Músculos da Mastigação/fisiologia , Músculos do Pescoço/fisiologia , Educação de Pacientes como Assunto , Modalidades de Fisioterapia , Qualidade de Vida , Estatísticas não Paramétricas , Articulação Temporomandibular/fisiologia , Transtornos da Articulação Temporomandibular/reabilitaçãoRESUMO
STUDY OBJECTIVE: To compare parameters of diastolic function as assessed by radionuclide ventriculography (RNVG) and Doppler echocardiography (ECHO) in the patients with chronic heart failure and reduced ejection fraction (HF REF). PATIENTS AND METHODS: RNVG and ECHO were performed on the same day in 40 patients with systolic chronic HF, NYHA II and III, with LV EF < 50 % and sinus rhythm, followed at tertiary HF clinic. Diastolic function was assessed by RNVG using parameters: PFR (peak filling rate [% SV/sec]), TFR - time to peak filling rate (ms), and by ECHO using pulse Doppler parameters: the peak Doppler velocities of early (E) and late diastolic flow (A), the E/A ratio, the calculated mean of the early (E´) diastolic velocity of septal and lateral mitral annulus measured by tissue Doppler imaging, and the E/E´ ratio. RESULTS: The mean PFR was 421.7 (median 371.0) % SV/sec and TPF was 198.7 ms (median 169.5), the mean E/A ratio was 1.21 (median 0.85) and the E/E´ ratio was 9.0 (median 8.40). TPF correlated significantly (inverse correlation) with the E/A ratio (r = -0.34, p = 0.030), and not significantly with E´ (r = -0.27, p = 0.082), the PFR/age ratio correlated with the E/E´ ratio (r = -0.31, p = 0.05). CONCLUSION: Significant correlations of parame-ters of diastolic function as assessed by radionuclide and Doppler studies were identified in the HF REF patients.
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Disfunção Ventricular Esquerda/diagnóstico por imagem , Diástole/fisiologia , Ecocardiografia Doppler , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Ventriculografia com Radionuclídeos , Volume Sistólico/fisiologia , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
PRCIS: Deep sclerectomy (DS) with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing nonallergenic, nontoxic, and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively. OBJECTIVE: To evaluate short and medium-term postoperative results of DS with a fibrin sealant. PATIENTS AND METHODS: This prospective, noncomparative, interventional case series involves 12 eyes of 12 patients with uncontrolled open angle glaucoma who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon fascia, and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure and glaucoma therapy reduction, best-corrected visual acuity changes, and number of complications registered peri and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9, and 12 months after surgery. RESULTS: The mean intraocular pressure decreased from 24.0 ± 9.1 mm Hg to 13.8 ± 6.3 mm Hg at 1 year postoperatively ( P < 0.001). Kaplan-Meier survival analysis revealed complete and qualified success rates of 83.3% and 91.7%. The mean glaucoma therapy decreased from 3.2 ± 1.1 to 0.8 ± 1.3 drugs 12 months after surgery ( P < 0.001). Nd:YAG goniopunture was performed in 2 eyes at 1 and 12 months postoperatively. No significant best-corrected visual acuity changes were registered. Perioperatively, we noted a trabeculo-descemet microperforation in 1 eye, transient hypotony in 5 eyes, and mild hyphema in 2 eyes. CONCLUSIONS: Fibrin adhesive provided an effective closure in sutureless DS in the patients included in our study. This modification of classical DS may simplify the surgical technique, ensure secure wound adaptation, optimize healing, and lower the risk of inflammation and fibrosis postoperatively.
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Adesivo Tecidual de Fibrina , Glaucoma de Ângulo Aberto , Pressão Intraocular , Esclera , Esclerostomia , Procedimentos Cirúrgicos sem Sutura , Adesivos Teciduais , Acuidade Visual , Humanos , Adesivo Tecidual de Fibrina/uso terapêutico , Pressão Intraocular/fisiologia , Masculino , Estudos Prospectivos , Feminino , Esclerostomia/métodos , Glaucoma de Ângulo Aberto/cirurgia , Glaucoma de Ângulo Aberto/fisiopatologia , Idoso , Acuidade Visual/fisiologia , Esclera/cirurgia , Procedimentos Cirúrgicos sem Sutura/métodos , Adesivos Teciduais/uso terapêutico , Pessoa de Meia-Idade , Resultado do Tratamento , Implantes para Drenagem de Glaucoma , Idoso de 80 Anos ou mais , Seguimentos , Tonometria OcularRESUMO
Undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) of the pancreas represents a rare subtype of pancreatic ductal adenocarcinoma (PDAC). Despite a distinct morphology and specific clinical behavior, UCOGCs exhibit unexpected similarities in regard to DNA mutational profiles with conventional PDAC. Treating pancreatic ductal adenocarcinoma is particularly challenging, with limited prospects for cure. As with many other malignant neoplasms, the exploration of microRNAs (miRNAs, miRs) in regulating the biological characteristics of pancreatic cancer is undergoing extensive investigation to enhance tumor diagnostics and unveil the therapeutic possibilities. Herein, we evaluated the expression of miR-21, -96, -148a, -155, -196a, -210, and -217 in UCOGCs and poorly differentiated (grade 3, G3) PDACs. The expression of miR-21, miR-155, and miR-210 in both UCOGCs and G3 PDACs was significantly upregulated compared to the levels in normal tissue, while the levels of miR-148a and miR-217 were downregulated. We did not find any significant differences between cancerous and normal tissues for the expression of miR-96 and miR-196a in G3 PDACs, whereas miR-196a was slightly, but significantly, downregulated in UCOGCs. On the other hand, we have not observed significant differences in the expression of the majority of miRNAs between UCOGC and G3 PDAC, with the exception of miR-155. UCOGC samples demonstrated lower mean levels of miR-155 in comparison with those in G3 PDACs.
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Statistical data show that pain intensity in patients with low back pain is associated with a higher BMI, total serum cholesterol, and triacylglycerol levels. The objective of our study was to evaluate how these associations are dependent on the nature of the patient-doctor relationship. Eighty-nine patients hospitalized with chronic low-back pain (50 women, 39 men; average age: 64.5 ± 12.7 years) were assessed over a 3-year period. A serum lipid analysis was conducted (LDL-C, HDL-C, and total cholesterols) at admission in parallel with a subjective evaluation of pain intensity, which was assessed using a numeric rating scale. The participating physician assigned, based on their personal interaction with the patient, an attribute of affinity (positive, neutral, and negative) towards them. Current serum lipid levels and pain intensity were correlated relative to these attributes. Pain intensity did not differ between the groups assigned positive or negative attributes of affinity. In patients belonging to the "positive" group, pain intensity correlated positively with total cholesterol (p=0.01) and LDL cholesterol (p=0.007). No correlations were found in the "negative" group or when the patient-doctor relationship was ignored. We found a significant association between subjectively assessed low back pain intensity and serum levels of total and LDL cholesterol in patients with whom the physician had a positive affinity. A positive affinity with the patients having chronic pain and the patient's trust in their physicians may ultimately mean that the patient's statement about pain is more credible, which may retroactively affect the outcome of therapy.
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Lipídeos , Dor Lombar , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , LDL-Colesterol , Relações Médico-Paciente , TriglicerídeosRESUMO
Disturbances of iron metabolism are observed in chronic liver diseases. In the present study, we examined gene expression of duodenal iron transport molecules and hepcidin in patients with hereditary hemochromatosis (HHC) (treated and untreated), involving various genotypes (genotypes which represent risk for HHC were examined), and in patients with iron deficiency anaemia (IDA). Gene expressions of DMT1, ferroportin, Dcytb, hephaestin, HFE and TFR1 were measured in duodenal biopsies using real-time PCR and Western blot. Serum hepcidin levels were measured using ELISA. DMT1, ferroportin and TFR1 mRNA levels were significantly increased in post-phlebotomized hemochromatics relative to controls. mRNAs of all tested molecules were significantly increased in patients with IDA compared to controls. The protein expression of ferroportin was increased in both groups of patients but not significantly. Spearman rank correlations showed that DMT1 versus ferroportin, Dcytb versus hephaestin and DMT1 versus TFR1 mRNAs were positively correlated regardless of the underlying cause, similarly to protein levels of ferroportin versus Dcytb and ferroportin versus hephaestin. Serum ferritin was negatively correlated with DMT1 mRNA in investigated groups of patients, except for HHC group. A decrease of serum hepcidin was observed in IDA patients, but this was not statistically significant. Our data showed that although untreated HHC patients do not have increased mRNA levels of iron transport molecules when compared to normal subjects, the expression is relatively increased in relation to body iron stores. On the other hand, post-phlebotomized HHC patients had increased DMT1 and ferroportin mRNA levels possibly due to stimulated erythropoiesis after phlebotomy.
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Proteínas de Transporte de Cátions/metabolismo , Duodeno/metabolismo , Hemocromatose/metabolismo , Deficiências de Ferro , Ferro/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Peptídeos Catiônicos Antimicrobianos/sangue , Peptídeos Catiônicos Antimicrobianos/metabolismo , Transporte Biológico , Estudos de Casos e Controles , Proteínas de Transporte de Cátions/genética , Feminino , Regulação da Expressão Gênica , Hemocromatose/sangue , Hemocromatose/genética , Hepcidinas , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , RNA Mensageiro/genética , RNA Mensageiro/metabolismoRESUMO
OBJECTIVE: Anxiety, fatigue and depression are common neurological manifestations after COVID-19. So far, post-COVID complications were treated by rehabilitation, oxygen therapy and immunotherapy. Effects of neurofeedback on post-COVID complications and their potential interrelatedness have not been studied yet. In this pilot study, we investigated the effectiveness of neurofeedback (Othmer method) for treatment of fatigue, anxiety, and depression after COVID-19. METHODS: 10 participants met inclusion criteria for having positive anamnesis of at least one of the following complications following COVID-19: fatigue, anxiety, and depression which were measured by questionnaires. ANOVA was used for calculating differences in questionnaire score before and after neurofeedback. Pearson's correlation coefficient was used to calculate correlations between anxiety, depression and fatigue. RESULTS: After five neurofeedback sessions, there came to significant reduction of severity of post-COVID anxiety and depression persisting for at least one month. Effect of neurofeedback on fatigue was insignificant. Severity of anxiety, fatigue and depression as well as reductions in depression and fatigue were positively correlated with each other. CONCLUSION: These findings showed effectiveness neurofeedback for reducing anxiety and depression after COVID-19 and for studying correlations between neurological complications after COVID-19. However, since our pilot clinical trial was open-label, it is hard to differentiate between neurofeedback-specific and unspecific effects on our participants. Future randomized controlled trials with more robust sample are necessary to investigate feasibility of neurofeedback for post-COVID neurological complications. The study has identification number trial ID ISRCTN49037874 in ISRCTN register of clinical trials (Retrospectively registered).
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COVID-19 , Neurorretroalimentação , Ansiedade/etiologia , Ansiedade/terapia , COVID-19/complicações , COVID-19/terapia , Depressão/etiologia , Depressão/terapia , Fadiga/etiologia , Fadiga/terapia , Humanos , Neurorretroalimentação/métodos , Projetos PilotoRESUMO
The authors tested the diagnostic potential of the portable autofluorescence optical system that was developed in the preoperative evaluation of resection margins, and thus of the resection line safety in patients with low-positioned colorectal carcinoma. A total of 217 spectral measurements of the fluorescence properties of normal (117) and malignant (100) tissues in 19 patients with colorectal carcinoma were accomplished. The measured spectra thus acquired were then evaluated using logistic regression. Using the principal component method, the authors selected the 30 and 40 most significant wavelengths, respectively, which they then used to construct the logistic model. The model met the basic criteria of statistical significance. The classification power of the model was 79.7% (for 30 wavelengths) and 82.5% (for 40). Statistical discrimination was 0.88 and 0.91, respectively. These results confirm that the optical setup that we selected is suitable for the peroperative testing of the distal resection line. It is capable of differentiating with 90% confidence pathological tissue and thus of reliably guiding further histological processing.
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Biópsia/métodos , Neoplasias Colorretais/diagnóstico , Dispositivos Ópticos , Idoso , Idoso de 80 Anos ou mais , Biópsia/instrumentação , Biópsia/estatística & dados numéricos , Neoplasias Colorretais/cirurgia , Feminino , Fluorescência , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Fibras Ópticas , Fenômenos Ópticos , Espectrometria de FluorescênciaRESUMO
INTRODUCTION: Great variability in shape and size of the bony pelvis can be observed in the current population, but there is not enough data on how long the historical period must elapse to gain changes in pelvic shape and size. The aim of the study was to identify morphological changes in bony pelvis in males and females after a developmentally short period of approximately one thousand years. MATERIAL AND METHODS: Seventeen defined external dimensions of pelvic bone from 120 adult individuals (two craniocaudal, two ventrodorsal, six mediolateral, three acetabular dimensions, and four dimension of the auricular surface) were measured. The medieval sample of 60 pelvic bones (30 male and 30 female) was obtained from the Great Moravian site of Mikulcice-Valy (9th-10th century), while the modern collection of 60 pelvic bones (30 male and 30 female) dates from the late 19th and first half of the 20th centuries. Obtained results were evaluated using the independent t-test at a 5% level of significance. RESULTS: A comparison of male and female pelvic dimensions within a single population yielded expected results: the mean male values were greater. In modern population, male pelvis mean values were greater in 15 of defined parameters, while in medieval population, male dimensions were larger in 16 variables. A comparison of modern and medieval female pelvic bones found 11 variables to be greater in medieval sample (one determining the craniocaudal dimension, five the mediolateral, all three the acetabular, and two determining the auricular surface dimensions), but only two were significant (two dimensions determining the mediolateral dimensions). In modern female samples, there were five variables greater (one determining the craniocaudal dimension, one the ventrodorsal, one the mediolateral, and two determining the auricular surface dimensions), but only two were significant as well (one determining the craniocaudal and one the ventrodorsal dimensions). A comparison of male pelvic bones found 13 variables to be greater in medieval pelvis (one determining the craniocaudal dimension, all six the mediolateral, one the ventrodorsal, all three the acetabular, and two determining the auricular surface dimensions), but only four were significant as well (all determining the mediolateral dimensions). In modern male sample, there were only four variables greater (one determining the craniocaudal dimension, one the ventrodorsal, and two determining the auricular surface dimensions), but only one was significant (determining the craniocaudal dimension). CONCLUSION: Unexpectedly, our study did not find the early medieval population to have a smaller pelvis compared to the modern population. While pelvic bones of the former were somewhat lower, but wider, those of the latter population were a bit higher and narrower. The study allows a very careful statement that one millennium is a time period long enough for measurable morphological deviations of the pelvic bones shape and size to occur.
Assuntos
Ossos Pélvicos , Pelve , Abdome , Adulto , Feminino , Humanos , Extremidade Inferior , MasculinoRESUMO
The aim of this study was to perform a pilot histological and quantitative analysis of the blood vessels accompanying the epicardial nerves (vasa nervorum) in the porcine hearts. Twenty healthy porcine hearts were used in this study. The blood vessels were analyzed by light microscopy using four different staining techniques in transverse sections taken from the upper, middle, and lower segments of the anterior part of the interventricular region and the adjacent parts of the right and left ventricles containing epicardial nerves and the endocardial peripheral parts of the Purkinje fibers. In total, 317 epicardial nerves were detected. The vasa nervorum were present in 75.7% of these nerves. The vasa nervorum resembled arterioles and postcapillary and collecting venules. One hundred and forty nine epicardial nerves were perivascular, located in the adventitia of the anterior interventricular artery and vein. The remaining 168 nerves ran freely through the epicardial interstitium. The presence of the vasa nervorum was not related to topographical location or nerve diameter. Additionally, from a total of 33 analyzed ventricular complexes of Purkinje fibers small blood vessels located in their proximity were identified in only two cases. It can be concluded that the majority of the anterior epicardial nerves of porcine heart possess well-developed vasa nervorum. In contrast, similar blood vessels are rarely present in the vicinity of the Purkinje fibers. The data obtained contribute to a better understanding of the nutrition of the cardiac nerves.
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OBJECTIVE: This study aimed to determine the importance of biomarkers of chronic heart failure (CHF) for assessing disease severity in euvolemic stable patients. PATIENTS AND METHODS: N-terminal pro-B-type natriuretic peptide (NT-proBNP), growth differentiation factor (GDF)-15, galectin-3, cystatin-C, soluble suppression of tumorigenicity 2 (sST2), tissue type inhibitor of matrix metalloproteinase (TIMP)-1, and ceruloplasmin levels were measured in euvolemic patients with stable CHF. Severity of CHF was defined by echocardiographic and biochemical parameters. RESULTS: In 160 patients (123 men and 37 women, mean age: 65.8±12.2 years), we found strong associations between NT-proBNP and bilirubin levels (r = 0.434) and the estimated glomerular filtration rate (r = -0.321). GDF-15 and cystatin-C levels were significantly correlated with parameters of kidney function. In multivariable regression analysis, NT-proBNP levels were associated with the left ventricular ejection fraction and left ventricular end-systolic volume (coefficient of determination R2 = 0.777). Additionally, GDF-15 levels were correlated with urea levels (R2 = 0.742), and cystatin C levels were correlated with urea and bilirubin levels (R2 = 0.732). CONCLUSION: Besides NT-proBNP, GDF-15 and cystatin C are promising biomarkers for establishing the severity of disease in euvolemic patients with stable CHF.
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Insuficiência Cardíaca , Remodelação Ventricular , Idoso , Biomarcadores , Feminino , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Índice de Gravidade de Doença , Volume Sistólico , Função Ventricular EsquerdaRESUMO
AIMS: To evaluate the anatomical and functional results in patients with rhegmatogenous retinal detachment (RRD) who underwent 25-gauge pars plana vitrectomy (PPV) with gas tamponade. MATERIALS AND METHODS: A retrospective evaluation of 126 eyes of 126 patients (79 men, 47 women) with RRD who underwent 25-gauge PPV with gas tamponade (13% C3F8 in 87 eyes, 20% SF6 in 39 eyes). 113 patients (89.7%), were operated on under local anaesthesia, 13 patients (10.3%) under general anaesthesia. Macula was detached in 85 eyes (67.5%). 53 eyes had pseudophakic RRD, 73 eyes were phakic. Anatomical success of the primary intervention, change in best corrected visual acuity (BCVA) and incidence of complications were assessed. An average follow-up period is 7.2 months (6-15). RESULTS: With single operation, retinal attachment was achieved in 125 eyes (99.2%); the final anatomical success was 100%. The initial mean BCVA was 0.89 logMar (2.00 to 0.00); at the end of the follow-up period, it improved to 0.23logMAR (1.00 to -0.10), P < 0,0001. During the first post-intervention day, hypotony of the eye below 10 mmHg was observed in 1 patient (0.8%); on the contrary, intraocular pressure was temporarily increased to 25 mmHg and more in 36 patients (28.6%). CONCLUSION: The surgical treatment of RRD using 25-gauge PPV with expansive gas tamponade renders excellent anatomical results and improvement in BCVA. The incidence of complications and necessity of sclerotomy suturing are low.
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Pressão Intraocular/fisiologia , Descolamento Retiniano/cirurgia , Acuidade Visual/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Descolamento Retiniano/fisiopatologia , Descolamento Retiniano/reabilitação , Estudos Retrospectivos , Resultado do Tratamento , Vitrectomia/instrumentação , Vitrectomia/métodosRESUMO
PURPOSE: To correlate between the echographic and histopathological findings, and to search for important criteria for the prognosis in vivo using standardised echography. METHODS: The study included 51 consecutive patients treated by primary enucleation for choroidal or ciliary body melanoma and 30 patients who underwent secondary enucleation after failing radiotherapy treatment. All patients were treated during the period of 1998--2008 at the Eye Clinic of the 3rd Faculty of Medicine in Prague, Czech Republic. Standardised echography based on the Ossoinig method was used in this study. Histopathological processing and evaluation was performed by the Laboratory of Ocular Pathology at the same clinic. Professional statistical software (Statistica 7.1 by Statsoft, Inc.) was used for all statistical analysis. RESULTS: Statistically significant results were found in these correlations in the group of primary enucleation: US prominence vs. HP prominence (R = 0.8943, p = 0.0000), US base vs. HP base (R = 0.8060, p = 0.0000), US tumor shape vs. HP tumor shape (R = -0.7576, p = 0.0000), posterior choroidal spike condition vs. scleral invasion (R = -0.5341, p = 0.0005), TNM vs. pTNM (R = 0.7242, p = 0.0000). In the group of secondary enucleation: US prominence vs. HP prominence (R = 0.8132, p = 0.0000), US base vs. HP base (R = 0.7959, p = 0.0000). Other correlations were statistically insignificant. CONCLUSIONS: Tumor dimensions, shape of the tumor and scleral invasion are important predictors that can be in vivo reliably determined using standardised echography.
Assuntos
Neoplasias da Coroide/patologia , Corpo Ciliar/patologia , Neoplasias Uveais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Coroide/cirurgia , Corpo Ciliar/cirurgia , Imagem Ecoplanar , Enucleação Ocular , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estatística como Assunto , Neoplasias Uveais/cirurgiaRESUMO
Purpose. To evaluate the effectiveness of deep sclerectomy with T-flux implant (DS T-flux) in patients with pseudoexfoliation glaucoma (PExG). Methods. 20 eyes of 18 patients with medically uncontrolled PExG have undergone DS T-flux implantation. Postoperatively we evaluated the IOP values and the frequency of complications. The minimum follow-up time was 12 months (20 eyes) and the maximum 24 months (10 eyes). Results. The mean preoperative IOP was 36.8 ± 8.7 mmHg. The IOP significantly decreased throughout all postoperative periods (P < 0.05) and reached 1 day after surgery 11.45 ± 6.6 mmHg; 3 months 13.45 ± 3.6 mmHg; 12 months 14 ± 2.8 mmHg; and 24 months 14.80 ± 2.4 mmHg. Complete success rate, defined as IOP ≤ 18 mmHg without medication, was 85% (17/20 eyes) at 12 months. Qualified success rate, defined as IOP ≤ 18 mmHg with or without medication, was 100% (20/20 eyes). The most frequent postoperative complications were mild hyphaema (9 patients, 45%), choroidal detachment (3 patients, 15%), and hypotony-IOP < 5 mmHg (2 patients, 10%). Conclusions. DS with T-flux implant is a safe and effective surgical treatment method for medically uncontrolled PExG. The number of complications is low.
RESUMO
In this work, we report on the preparation of a novel biodegradable textile scaffold made of palmitoyl-hyaluronan (palHA). Monofilament fibres of palHA with a diameter of 120µm were prepared by wet spinning. The wet-spun fibres were subsequently processed into a warp-knitted textile. To find a compromise between swelling in water and degradability of the final textile scaffold, a series of palHA derivatives with different degrees of substitution of the palmitoyl chain was synthesized. Freeze-drying not only provided shape fixation, but also speeded up scaffold degradation in vitro. Fibronectin, fibrinogen, laminin and collagen IV were physically adsorbed on the textile surface to enhance cell adhesion on the material. The highest amount of adsorbed cell-adhesive proteins was achieved with fibronectin (89%), followed by fibrinogen (81%). Finally, textiles modified with fibronectin or fibrinogen both supported the adhesion and proliferation of normal human fibroblasts in vitro, proving to be a useful cellular scaffold for tissue engineering.