[The influence of laser irradiation with different power densities on incisional wound healing in healthy and diabetic rats]. / Vplyv laserového ziarenia rôznych intenzít na hojenie incíznych rán u zdravých a diabetických potkanov.

INTRODUCTION: The optimal parameters of low level laser therapy (LLLT) are still under debate. It has been documented that a dose or 5 J/cm2 would be capable to accelerate the wound healing process in patients. However, the optimal delivering form, i.e. power intensity, is unknown. Therefore, the aim of our study was to compare different power densities of LLLT. MATERIALS AND METHODS: Sixteen male Sprague-Dawley rats were included in this experiment and randomized into two groups, normal healthy group and streptozotocine induced diabetic group. In general anesthesia four full thickness skin incisions were performed under standard aseptic conditions on the back of each rat and immediately closed using intradermal running suture. Three wounds were stimulated with diode laser (wavelength: 635 nm; daily dose 5 J/cm2; power densities: 1 mW/cm2, 5 mW/cm2 and 15 mW/cm2) each with different power density while the fourth wound served as control. Six days after surgery animals were sacrificed and samples removed for histological evaluation. RESULTS: Our study demonstrated that LLLT positively influences wound healing. The most significant changes were observed in wounds stimulated at the highest power density 15 mW/cm2. Since using the highest power density the shortest time is needed to achieve the optimal daily dose of 5 J/cm2, it can be suggested that 15 mW/cm2 might be optimal parameter for such a therapy in patients.

[Effect of laser irradiation of diode laser on healing of surgical wounds in rats]. / Vplyv laserového ziarenia diódového lasera na hojenie chirurgických rán u potkanov.

The aim of this work was to continue in previous study, which concerns biostimulation of skin wound healing evaluated after 24, 48, 120, 168 hours and so complete the chronological continuance of the process during the first seven days. Male, Sprague-Dawley rats (n=21) were used for the experiment. The rats were divided into 3 groups of 7 animals. In general anaesthesia (combination of xylazine, ketamine and tramadol) under aseptic condition two 3,5 cm long parallel skin incisions were performed on the left and right side of the rats spine and immediately sutured. The left wounds were daily stimulated with the diode laser (670 nm). The right wounds were not stimulated and served as control. The specimens of skin wounds were removed for histological evaluation 72, 96 and 144 hours after surgery. The biological specimens were stained with hematoxylin and eosin and histopathologically evaluated. In summary, in our histomorphological study of the influence of laser irradiation on primary wound healing evaluated after 72, 96 and 144 hours was concluded, that the healing of stimulated wounds was accelerated in comparison with controls. The histological evaluation showed earlier regress of inflammatory phase, faster finishing of reepithelization and acceleration in maturation phase. Presented experimental study completes the previous study and achieves the positive effect of biostimulation on all phases of skin wound healing in vivo.

Photoinduced antitumour effect of hypericin can be enhanced by fractionated dosing.

The in vivo antitumour activity of the natural photosensitizer hypericin was evaluated. C3H/DiSn mice were inoculated with fibrosarcoma G5:1:13 cells. When the tumour reached a volume of 40-80mm3 the mice were intraperitoneally injected with hypericin, either in a single dose (5mg/kg; 1 or 6h before laser irradiation) or two fractionated doses (2.5 mg/kg; 6 and 1 h before irradiation with laser light; 532 nm, 70mW/cm2, 168 J/cm2). All tumours in control groups treated with hypericin alone as well as those irradiated with laser light alone had similar growth rates and none of these tumours regressed spontaneously. Complete remission of tumour in photodynamic therapy (PDT)-treated groups was similar (14-17% single dose vs. 33% fractionated dose), but the fractionated schedule of hypericin dosing was found to be more efficient than the single dose, measured by survival assay (p < 0.05). Our experimental model showed that fractionated administration of hypericin can produce a better therapeutic response than single administration.

Pathologic features of suicidal deaths caused by explosives.

Suicidal explosions that lack a terrorist background are only rarely encountered in the field of forensic pathology. The investigation of explosion-related fatalities can be a substantial challenge in medicolegal casework. Determining whether the manner of death is suicide, homicide, or accident in such cases can present an especially difficult task to the forensic pathologist. This study considers the pathologic features of suicidal deaths caused by explosives without a terrorist background. The modus operandi of the decedents reflected familiarity and proficiency, or at least a degree of specialized knowledge, with the construction and use of explosive devices. All explosions were set off in confined spaces. The injury patterns consisted of a combination of primary blast injuries (e.g. decapitation, traumatic amputation of limbs, gross lacerations of the body surface, blast injuries of gas-containing and hollow organs), secondary blast injuries (e.g. splinter-induced penetrating trauma), tertiary blast injuries (e.g. abrasions and contusions), and burn injuries (mostly of the flash type). The previously described symmetric distribution pattern of injuries in suicidal explosions was apparent only to a certain degree in the present series. Our observation of superficially sharp-edged wound margins with bridging in the depths of the lesion in blast-induced lacerations of the skin should deserve further attention in forthcoming cases of explosion-related fatalities because this finding is a diagnostic possibility that may support the theory of an explosion-related fatality under special circumstances, e.g. when the body has been dumped away from the place of death. Because a terrorist attack may be initially suspected in each case of suicide involving explosives, the importance of a joint inquiry based on expertise from police investigators, bomb experts, and forensic pathologists is evident.

Maternal death in pregnancy from HELLP syndrome. A report of three medico-legal autopsy cases with special reference to distinctive histopathological alterations.

Maternal death from HELLP syndrome, a complication of (pre-) eclampsia during pregnancy or postpartum, is rarely encountered in forensic pathology. We report three cases of HELLP syndrome with fatal outcome putting the main focus on the histopathological features of the disease. We found an almost identical histopathological pattern in the liver (periportal coagulation necrosis, hepatic haemorrhages sharply demarcated by an extended fibrin network from the surrounding unaffected liver parenchyma, focal leukostasis in liver sinusoids and swelling of Kupffer's cells, absence of inflammatory cellular infiltrates in liver plates, lack of fatty transformation of hepatocytes) and kidneys (bloodless glomeruli with swollen and vacuolated intracapillary cells, cigar-shaped capillary loops, enlarged glomerular tufts with herniation of capillary loops into the proximal convoluted tubules, swelling of mesangial cells) in all three cases. The histopathological alterations in the liver and kidneys can be considered characteristic for the disease and their presence may enable the forensic pathologist to establish the definite post-mortem diagnosis of HELLP syndrome in questionable cases.

[Death in an unusual body position]. / Smrt' v neobvyklej polohe tela.

Death in head-down position is rare and uncommon. The mechanism of death in such cases is rather complicated. The authors present a case of unknown man who was found dead in a wood, hanging in head-down position fixed at the branchfork of a tree by his right foot. The authors analyse the possible mechanisms of death in so-called postural asphyxia.

[Complaints of patients or their relatives regarding surgical complications]. / Staznosti chorého alebo jeho príbuzných v spojitosti s komplikáciami v chirurgii.

The authors analyse complaints of patients or their relatives in connection with surgical complications in 1987 to 1997 and illustrate them by short case-records. During this period, they evaluated 52 complaints and among them 27 fatal. Most complaints were from abdominal surgery. Finally, they emphasize the importance of high surgical professionality, early discovery of a complications, early, sufficient and suitable informing of the patient and his relatives, by the head of the department and in severe or fatal complications the management of the hospital. They emphasize also the requirement of precise and exhaustive records and autopsy.

[Enzymes in tumors of the breast. Histochemical study of the stroma in breast carcinomas]. / Enzýmy v nádoroch mliecnej zl'azy. Histochemiská stúdia strómy karcinómov mliecnej zl'azy.

The results obtained in histochemical examination of the stroma of mammary gland carcinomas allow to draws the following conclusions. The reaction for alkaline phosphatase proved suitable for detecting proliferation zones in the stroma of mammary gland carcinoma. Proliferation of fibroblasts, myofibroblasts, endothelial cells, and possibly also of other cells is involved. At present, myofibroblasts can not be cytoenzymatically differentiated from fibroblasts. The reactions for acid phosphatase and nonspecific esterase provide a quick and reliable picture on the amount of macrophages. The combined reaction for alkaline phosphatase and dipeptidylpeptidase IV in the same section indicates that individual segments of the newly formed capillary bed in the stroma of the tumor, i.e. the arterial, intermediary and venous segment, are differentially equipped by these enzymes. The activity of several enzymes in carcinomal stroma with typical stripe- and wave-like architecture can most probably be assigned to fibroblasts and myofibroblasts. Between the enzymatic activity in the stroma and the type or differentiation of the carcinoma no relationship was established.

Effect of axotomy on cholinergic enzyme activities in the spinal cord and sciatic nerve of the dog.

Choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) activity measured in the ventral and dorsal part of the dog spinal cord (L6-S2) and in the stumps of the sciatic nerve 5, 10, 15 and 21 days after its transection were compared with the corresponding activities in the intact contralateral nerve and in sham-operated animals. AChE was also examined histochemically. Changes in the enzyme activities in the central nerve stump were correlated with activity changes in the spinal cord. In the central nerve stump, a marked (25%) increase in AChE activity was found on the fifth day after transection, but by the 21st day it fell below control value levels; up to the 15th day it showed good correlation with AChE activity in the ventral spinal cord. Histochemically, pronounced reduction of enzymatic activity was found in the ipsilateral part of the spinal cord. On the 15th day, ChAT activity in the ventral spinal cord was also significantly decreased and the accumulation of the enzyme in the central nerve stump was negligible. On the contrary, at the last 21-day interval examined, a significant increase in ChAT activity and a nonsignificant increase in AChE activity was found in the spinal cord, but their activities in the central nerve stump were decreased. In the degenerated peripheral nerve stump ChAT activity dropped by an average of 99% and AChE activity by 48% during the first 15 days after transection but, on the 21st day, AChE activity was 22% higher than at the preceding interval.

Effect of partial ischemia and axotomy on activities of cholinergic enzymes in lower motor neurons of the dog.

Activities of choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) in the ventral spinal cord, ventral spinal roots and in the central and peripheral stumps of the sciatic nerve transected under conditions of partial ischemia (produced by aortic ligation just below the renal arteries) were compared to those obtained under intact blood supply in time intervals 5, 10, or 15 days after surgery. The significant increase of ChAT activity in the central part of the sciatic nerve following 15 days of partial ischemia correlated with less significant elevation of ChAT in the ventral spinal cord. The changes of AChE activity were not significant during partial ischemia. ChAT in the peripheral stump of the sciatic nerve following 5 days of partial ischemia was preserved by 40% and AChE by 20% more than under normal blood supply. On the contrary, in the next 5 days interval losses of enzymes activity in the degenerating nerve were greater. ChAT was almost totally inactivated whereas 50% of AChE activity was preserved until the end of period examined.

Choline acetyltransferase and acetylcholinesterase in canine spinal ganglia: increase of choline acetyltransferase activity following sciatic nerve lesion.

Activities of choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) were measured in the dorsal spinal ganglia, the dorsal spinal root and the spinal cord of the normal adult dogs and following one side transection of the sciatic nerve in the intervals 5, 10, 15 and 21 days respectively. In the spinal ganglia of normal dogs very low ChAT activity was found; it was three orders lower than AChE activity. Within 5-10 days after the nerve section ChAT activity increased almost five times in the spinal ganglia while AChE activity remained without any changes. The elevation of ChAT activity correlated with that in the dorsal roots at 15th day and in the dorsal spinal cord at 21st day after the nerve section. Histochemical "direct-colouring" thiocholine method showed AChE-positive cells were distributed mainly in the peripheral area of the spinal ganglia. The spinal ganglion cells ranged from intensely AChE-positive to AChE-negative without correlation between cell size and AChE activity. The ChAT activity changes were evaluated in correlation to the cholinergic function in the spinal ganglion neurons.