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1.
Physiol Res ; 72(S3): S225-S232, 2023 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-37888966

RESUMO

The aim of this narrative review is to summarize recent knowledge about the diagnostic significance of immunobiological detection of C3d with a focus on renal and skin tissue biopsies. We completed the present narrative review with our own experiences with preparation and practical use of monoclonal C3d antibodies at a small national level.


Assuntos
Transplante de Rim , Rim , Rim/patologia , Pele , Anticorpos Monoclonais
2.
J Endocrinol Invest ; 46(12): 2493-2500, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37148530

RESUMO

PURPOSE: The incidence of acute myocardial infarctions (AMI) shows circadian variation typically peaking during morning hours with a decline at night. However, this variation does not occur in patients with diabetes mellitus (DM). The night's decline of AMI may be partially explained by melatonin-related platelet inhibition. Whether this effect is absent in diabetic patients is unknown. The aim was to study the effect of melatonin on in-vitro platelet aggregation in healthy individuals and patients with type 2 DM. METHODS: Platelet aggregation was measured in blood samples from healthy individuals (n = 15) and type 2 DM patients (n = 15) using multiple electrode aggregometry. Adenosine diphosphate (ADP), arachidonic acid (ASPI) and thrombin (TRAP) were used as agonists. Aggregability for each subject was tested after adding melatonin in two concentrations. RESULTS: In healthy individuals, melatonin inhibited platelet aggregation in both higher (10-5 M) and lower concentrations (10-9 M) induced by ADP, ASPI, and TRAP (p < 0.001, p = 0.002, p = 0.029, respectively). In DM patients, melatonin did not affect platelet aggregation in both concentrations induced by ADP, ASPI, and TRAP. Melatonin decreased platelet aggregation induced by ADP, ASPI, and TRAP significantly more in healthy individuals compared to patients with DM. (p = 0.005, p = 0.045 and p = 0.048, respectively). CONCLUSION: Platelet aggregation was inhibited by melatonin in healthy individuals. In-vitro antiplatelet effect of melatonin in type 2 DM patients is significantly attenuated.


Assuntos
Diabetes Mellitus Tipo 2 , Melatonina , Infarto do Miocárdio , Humanos , Inibidores da Agregação Plaquetária/farmacologia , Inibidores da Agregação Plaquetária/uso terapêutico , Melatonina/farmacologia , Melatonina/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Agregação Plaquetária/fisiologia , Plaquetas/fisiologia , Difosfato de Adenosina/farmacologia
3.
Physiol Res ; 71(Suppl 1): S3-S10, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592436

RESUMO

Although it is not an easy task to classify cells into different types, or in turn cell types into tissue types, a clear, understandable, didactically and clinically relevant tissue classification is indispensable for undergraduate medical education, expert discussions in biomedical research as well as for clinical practice. From the earliest discovery of the light microscope on, tissue classification has been a dynamic process. Historically, it was not a rare occurrence that different textbooks offered different tissue classifications. Nowadays, classifications have almost become uniform - the most common is the histological classification into four basic tissue types (epithelial, connective, muscle, nervous), which is recognized by the majority of modern histology and pathology textbooks. The reason is that, with some exceptions, this classification seems to be the most relevant not only for educational purposes but also from an embryological perspective and clinical-histopathological practice. Recently, attempts have been made to abandon this established classification and replace it with a new one. Any new classification, which would improve the presently used is welcomed. However, if the proposed innovation does not satisfy the needs of modern education and clinical practice, it should be handled with great caution or reconsidered.

4.
Physiol Res ; 71(Suppl 1): S11-S20, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592437

RESUMO

It is well known that the mammalian uterine tube (UT) plays a crucial role in female fertility, where the most important events leading to successful fertilization and pre-implantation embryo development occur. The known functions of these small intra-abdominal organs are: an uptake and transport of oocytes; storage, transportation, and capacitation of spermatozoa, and finally fertilization and transport of the fertilized ovum and early embryo through the isthmus towards the uterotubal junction. The success of all these events depends on the interaction between the uterine tube epithelium (UTE) and gametes/embryo. Besides that, contemporary research revealed that the tubal epithelium provides essential nutritional support and the most suitable environment for early embryo development. Moreover, recent discoveries in molecular biology help understand the role of the epithelium at the cellular and molecular levels, highlighting the factors involved in regulating the UT signaling, that affects different steps in the fertilization process. According to the latest research, the extracellular vesicles, as a major component of tubal secretion, mediate the interaction between gametes/embryo and epithelium. This review aims to provide up-to-date knowledge on various aspects concerning tubal epithelium activity and its cross-talk with spermatozoa, oocytes and preimplantation embryo and how these interactions affect fertilization and early embryo development.


Assuntos
Tubas Uterinas , Reprodução , Masculino , Humanos , Animais , Feminino , Tubas Uterinas/fisiologia , Espermatozoides/fisiologia , Oócitos , Epitélio , Fertilização/fisiologia , Mamíferos
5.
Physiol Res ; 71(Suppl 1): S21-S33, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592438

RESUMO

Microorganisms and eukaryotic human cells coexist in synergistic relationships in nearly every niche of the human body. The female genital tract consisting of the vagina, uterus with its cervix and endometrium, uterine tubes and ovaries - harbors its own typical microbiota, which accounts for 9 % of the total bacterial population in females. To this organ system, we also assigned the microbiome of the placenta, which has not been studied much until now. Among the spectrum of microbial species, the female genital tract is mainly dominated by Lactobacillus species, which are considered to be one of the simplest yet most important microbial communities. However, this relationship between macro- and micro-organisms seems to have a number of physiological functions, e.g., the vaginal and cervical microbiota have unique impact on reproductive health. The aim of this review was to provide current view on female genital tract microbiota and its role in reproductive health. We describe in detail the association of vaginal or tubal epithelium with microbiota or the role of microbiota in normal placental function.


Assuntos
Tubas Uterinas , Microbiota , Feminino , Gravidez , Humanos , Tubas Uterinas/microbiologia , Placenta , Vagina/microbiologia , Genitália Feminina , Microbiota/fisiologia
6.
Physiol Res ; 71(Suppl 1): S35-S49, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592439

RESUMO

Anatomical variations and congenital anomalies of the uterine tubes (UTAVsCAs) are rare conditions, which are often undiagnosed, or accidentally diagnosed upon imaging, laparotomy, laparoscopy for unrelated condition, or during the Cesarean section. UTAVsCAs are often asymptomatic, but their clinical relevance lies in their possibly adverse impact on fertility. Since their rare occurrence, they are usually published as case reports. The most typically described are: agenesis of the uterine tubes (UTs), accessory UT (UT duplication), accessory UT ostium, and paratubal cysts (e.g. the hydatid cyst of Morgagni). UTAVsCAs are classified into an umbrella category of Müllerian duct anomalies (MDAs) which comprises anomalous development of all the organs developing from the paramesonephric (Müllerian) ducts, i.e., UTs, uterus and upper portion of the vagina. Interestingly, most of the classification systems of MDAs discuss solely the uterine and vaginal anomalies, while the UTs are often utterly ignored. This probably originates from the fact that UTs are no longer interesting for many clinicians as they think of UTs as superfluous organs whose function can be easily replaced in the in vitro fertilization (IVF) laboratory. Indeed, the modern reproductive medicine has been helping enormously with the conception of infertile couples. In many instances, the UTs are in fact successfully bypassed and a "test-tube" baby is born. Nevertheless, the UTs are still absolutely unique in providing suitable environment for fertilization and early embryo development - processes that hasn´t been still completely understood. This fact could partially explain why the success rate of IVF is "only" around 30-50 % depending on age. Therefore, the research of the UTAVsCAs is still clinically relevant in the context of reproductive medicine and should not be omitted from research endeavors.


Assuntos
Cesárea , Tubas Uterinas , Gravidez , Humanos , Feminino , Útero/diagnóstico por imagem , Útero/anormalidades , Vagina/diagnóstico por imagem , Vagina/anormalidades , Fertilidade
7.
Physiol Res ; 71(Suppl 1): S51-S57, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592440

RESUMO

Despite significant advances in medical research, plastic surgeons still face a shortage of suitable patient tissues, and soft tissue reconstruction is no exception. In recent years, there has been a rapid boom in the use of acellular dermal matrix (ADM) in reconstructive and aesthetic surgery. ADM is incorporated into the surrounding tissue and gradually replaced by the host's collagen, thus promoting and supporting the healing process and reducing the formation of scar tissue. The main goal of this article is to provide a brief review of the current literature assessing the clinical applications of ADM across a broad spectrum of applications in plastic and reconstructive surgery.


Assuntos
Derme Acelular , Cirurgia Plástica , Humanos , Cicatrização
8.
Physiol Res ; 71(Suppl 1): S59-S64, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592441

RESUMO

There is no separate course in the medical curriculum summarizing all aspects of human reproduction in most medical school curricula. At the same time, such a course would logically connect knowledge from clinical embryology and assisted reproduction, encompassing the issue of female and male infertility, mechanisms of birth defect formation, their prenatal diagnosis and subsequent specialized neonatal care. The aim of a wide team of university teachers comprising embryologists, gynecologists, neonatologists, endocrinologists, geneticists and others was to create and implement a new course entitled "Clinical Embryology and Reproductive Medicine" into the fourth-year curriculum of the study program General Medicine at the Faculty of Medicine, Comenius University in Bratislava. There has been a great interest in the course, as evidenced by the number of medical students enrolled. The lecture syllabuses have been divided into several thematic areas: 1) Clinical embryology including a laboratory part of assisted reproduction, 2) Cause and treatment options of female and male infertility, 3) A comprehensive view of the issue of birth defects, 4) The issue of preconception education, prenatal and childbirth training, family planning, 5) Reproductive immunology and endocrinology. Despite the complexity of human reproduction being a mainstay of gynecology and obstetrics, it is underemphasized in the medical school curricula worldwide. It is often reflected in shorter hospital / practical trainings during undergraduate studies and lower requirements at the final exam. Therefore, as students almost unanimously valued, this new course is extremely helpful in preparing for the final state exam.


Assuntos
Infertilidade Masculina , Medicina Reprodutiva , Estudantes de Medicina , Gravidez , Recém-Nascido , Masculino , Humanos , Feminino , Eslováquia , Medicina Reprodutiva/educação , Currículo , Docentes
9.
Physiol Res ; 71(Suppl 1): S65-S73, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592442

RESUMO

Despite recent advancements in reproductive medicine, recurrent implantation failure and habitual abortion remain ongoing issues. One of the most important aspects of successful implantation is the intricate immune response and regulation necessary for the acceptance of the hemiallogenic embryo. The most numerous immune cells in the decidua are uterine natural killer cells (uNK). Studies suggest that changes in the uNK count and physiology may be responsible for the aforementioned pathological conditions. Thus, testing for uNK may provide valuable insights into their pathogenesis. The study compared Pipelle endometrial sampling with conventional curettage to find out whether the less invasive Pipelle method is a viable alternative of tissue collection. Tissue samples from 14 patients obtained by both methods were examined. The average size of tissue samples obtained with Pipelle was 17 mm2, samples obtained with curettage had on average 34 mm2. Using immunohistochemical visualization of CD56 (NK cells) and granzyme B antigens (serine protease-expressing activation state of NK cells), it was found that the average total count of CD56 / mm2 was for Pipelle 115 and 120 for curettage, respectively. The study also proved a correlation between granzyme B positivity and identification of NK cells clusters. The results indicated that Pipelle endometrial sampling seems a suitable method of tissue harvesting for the purpose of uNK cells examination. Pipelle endometrial sampling is safe, cost-effective and can be performed on an outpatient basis without the need of anesthesia or analgesia. Several issues remain yet to be solved: how to standardize the subsequent uNK testing, how to interpret the results and finally yet importantly, how to use this knowledge in personalized treatment protocols.


Assuntos
Aborto Habitual , Endométrio , Gravidez , Feminino , Humanos , Granzimas , Endométrio/patologia , Útero/patologia , Células Matadoras Naturais , Aborto Habitual/diagnóstico , Aborto Habitual/patologia
10.
Physiol Res ; 71(Suppl 1): S99-S105, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592445

RESUMO

Infertility affects approximately 48 million couples globally. Despite the enormous progress of the methods of reproductive medicine that has been made since the first test-tube baby was born in 1978, the implantation rate of day-3 embryos is only around 15-20 % and 30 % of day-5 embryos. Numerous strategies aim to improve implantation rates and prevent repeated implantation failure, however there is no specific general recommendation leading to satisfying results. One of the many risk factors relevant in this regard is the uterine immunological make-up, mainly the uterine Natural Killer (uNK) cells. They orchestrate the overall immune response during implantation by influencing trophoblast invasion and vascular remodeling and throughout pregnancy, uNK cells are also the main immune cells at the maternal-foetal interface. Previously, uNK count has been correlated with various fertility issues including idiopathic reccurent miscarriage. The present study used endometrial samples collected from 256 patients with recurrent implantation failure (RIF), habitual abortion (HA) and idiopathic sterility. Samples were collected between day 19 and 21 of the menstrual cycle mainly by Pipelle endometrial sampling. The samples were fixed in formalin for 24 hours and further processed for immunohistochemistry using anti-CD56 to visualize this antigen marker of uNK cells. Immunohistochemical counting was performed to assess the low, normal, or elevated count of uNK cells. According to the one-way ANOVA test, the age of our patients did not have any influence on the count of uNK cells. With Spearman correlation analysis, we found statistically significant correlation (p-value 0.05) of -0.133 between prior miscarriage and lower uNK cell count. Using the same analysis we found statistically significant correlation (correlation 0.233 with p-value 0.01) between number of uNK cells and activation status. Patients with higher uNK cells were more frequenty diagnosed with endometriosis (p-value 0.05, correlation 0.130). Patients with an immunological factor of sterility (defined by a clinical immunologist) had a lower chance of gravidity (-0.203 with p-value 0.01). Based on our results, we can confirm that there is a correlation between RIF, HA, idiopathic sterility, endometriosis, and immunological factor of sterility (uNK cell count). The true predictive value with regard to fertility outcomes needs to be addressed in future research.


Assuntos
Aborto Habitual , Endometriose , Infertilidade , Gravidez , Humanos , Feminino , Pessoa de Meia-Idade , Implantação do Embrião , Útero , Aborto Habitual/diagnóstico , Células Matadoras Naturais
11.
Physiol Res ; 71(Suppl 1): S107-S113, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592446

RESUMO

Arterial branches to the uterus and ovaries that pass through the mesosalpinx contribute significantly to the maintenance of the ovarian reserve. Especially arterial supply of the uterine tube is provided by a number of anastomoses between both the uterine and ovarian vessels. Knowledge on the morphologic peculiarities will allow to identify main contributors especially blood flow ultrasound examination for the purpose of ovary preserving surgery. This study aimed at identifying landmarks especially for so-called low-flow tubal vessels. Arteries of 17 female Thiel-embalmed bodies were studied along three preselected paramedian segments and measurements taken. A section was made through the center of the ovary perpendicular to uterine tube, then the mesosalpinx tissue distance was divided into 3 equivalent zones: upper, middle and lower thirds. The surface area of the mesosalpinx averaged 1088 ± 62 mm2. 47.7 ± 7.1 % of the mesosalpinx zones included macroscopically visible vessels. The lower third segment of mesosalpinx was the thickest averaging 2.4 ± 1.5 mm. One to three tubal branches were identified in the middle third of the mesosalpinx. Arterial anastomoses were found in the upper segment of the mesosalpinx, but no presence of a marginal vessel supplying the fallopian tube could be found. Statistically significant moderate positive correlations were established between the diameters of the mesosalpingeal arteries between the three zones. The mesosalpinx, uterine tube and the ovary form areas of segmental blood supply. Variants of tubal vessels appear to be a sparse source of blood supply.


Assuntos
Artérias , Tubas Uterinas , Feminino , Humanos , Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/irrigação sanguínea , Artérias/diagnóstico por imagem , Ovário/diagnóstico por imagem , Útero/diagnóstico por imagem , Útero/irrigação sanguínea , Fluxo Sanguíneo Regional
12.
Physiol Res ; 71(Suppl 1): S115-S123, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592447

RESUMO

Uterine tubes (UTs) are essential during physiological reproduction. The most intriguing part of its wall is the mucosa. Apart from the epithelial cells vital for its normal function, the connective tissue lamina propria contains wide spaces whose function, morphology and structure are yet to be elucidated. The present study used bioptic samples from 25 premenopausal (mean age 48,33 years, ?=3,56) and 25 postmenopausal women (mean age 57,8 years, ?=7,79). In both study groups, samples were obtained from two anatomically distinct parts of the UT - ampulla and infundibulum with fimbriae. The specimens were processed for scanning electron microscopy (SEM) and immunohistochemical detection of podoplanin (clone D2-40) and VEGFR-3 - two markers of lymphatic endothelial cells. The results showed that specimens from premenopausal and postmenopausal women contain wide lymphatic spaces, also known as lymphatic lacunae. The most probable function of the lacunae in the fimbriae is oocyte pick-up upon ovulation thanks to their ability to get engorged with lymph, thus serving as an erectile-like tissue. The ampullary lacunae are probably responsible for tubal fluid maintenance and recirculation. These results indicate that they are vital for normal reproduction because tubal fluid dynamics are as important as fluid composition. Further research on this topic is highly warranted because more detailed insights into UT function have a great potential to refine the methods of reproductive medicine, e.g. in vitro fertilization (IVF), which are still far from optimal regarding fertility outcomes.


Assuntos
Células Endoteliais , Tubas Uterinas , Humanos , Masculino , Feminino , Tubas Uterinas/fisiologia , Tubas Uterinas/ultraestrutura , Microscopia Eletrônica de Varredura , Elétrons , Mucosa
13.
Physiol Res ; 71(Suppl 1): S137-S144, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592449

RESUMO

This article summarizes the importance of the exact morphology of human uterine/fallopian tube epithelium at the scanning electron microscopy (SEM) level for the clinical outcome even nowadays. Visual referential micrographs from SEM reflect two ways to view human epithelial cell lining surfaces: the surface epithelial uterine tube from surgical tissue biopsy and human fallopian tube epithelial cells (HFTEC) culture monolayer surface. One colorized image visualizes ciliated cells, distinguishes them from non-ciliated cells, and provides an educational benefit. A detailed description of the ultrastructure in referential and pathologic human uterine tube epithelium is important in defining the morphological basis of high-grade carcinomas, in the mechanism of pathophysiology, and in discussing options for its prevention. Cell cultures of human fallopian tube epithelial cells offer new approaches in simulating the mechanisms of cancer genesis or may help to elucidate the genetic basis of several diagnoses. New technical approaches in SEM provide higher resolution and detailed surface images. The SEM modality is still one of the current options in diagnostics and may be useful for advancing human reproductive organ cancer research.


Assuntos
Elétrons , Tubas Uterinas , Feminino , Humanos , Microscopia Eletrônica de Varredura , Tubas Uterinas/patologia , Tubas Uterinas/fisiologia , Células Epiteliais , Epitélio , Técnicas de Cultura de Células , Biópsia
14.
Physiol Res ; 71(Suppl 1): S145-S150, 2022 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592450

RESUMO

It is well known that the blood supply of the greater omentum and female internal genital organs are not physiologically connected. There is also no mention of such anatomical variation in anatomical, radiological, or surgical textbooks. Here we present a very rare case report of atypical double arterial anastomosis (the first and second variant artery) between the right limb of the omental arcade of Barkow, uterus, and right ovary, which was found during a routine student anatomical dissection course. It is very challenging to find a proper explanation for the presence of the described anatomical variation; however, we hypothesized that it is based on their common embryonic origin - the mesentery. The first and second variant arteries could be remnants of transient anastomoses or collateral circulation, which were present during embryonic development and persisted until adulthood. Moreover, during our literature review, we noticed that the general description of omental blood supply and its possible variations is relatively poor; therefore, we emphasize the need for more precise knowledge regarding these anatomical parts, which could help surgeons who are performing abdominal or pelvic surgeries in preventing avoidable bleeding.


Assuntos
Tubas Uterinas , Omento , Humanos , Feminino , Adulto , Omento/irrigação sanguínea , Ovário/cirurgia , Útero/cirurgia , Útero/irrigação sanguínea , Mesentério
15.
Physiol Res ; 71(Suppl 1): S151-S159, 2022 12 27.
Artigo em Inglês | MEDLINE | ID: mdl-36592451

RESUMO

The uterine tube (UT) pathologies account for 25-35% of female factor infertility. Although these peculiar organs were first studied several hundred years ago, they have become overlooked and neglected mainly due to the successes of reproductive medicine. Nevertheless, the reproductive medicine still faces many challenges regarding the fertility outcomes of in vitro fertilization (IVF). Many obstacles and problems can be resolved by a more detailed understanding of the UT morphology and function during normal reproduction. Over the course of the 21st century, many new insights have been obtained: the presence of a population of telocytes in the tubal wall responsible for normal motility and hormone sensory function, the demonstration of lymphatic lacunae of the mucosal folds necessary for oocyte capture and tubal fluid recirculation, or a thorough profiling of the immune makeup of the UT epithelial lining with the discovery of regulatory T cells presumably important for maternal tolerance towards the semi-allogenic embryo. New discoveries also include the notion that the UT epithelium is male sex hormone-sensitive, and that the UT is not sterile, but harbors a complex microbiome. The UT epithelial cells were also shown to be the cells-of-origin of high-grade serous ovarian carcinomas. Finally, yet importantly, several modern morphological directions have been emerging recently, including cell culture, development of tubal organoids, in silico modelling, tissue engineering and regenerative medicine. All these novel insights and new approaches can contribute to better clinical practice and successful pregnancy outcomes.


Assuntos
Tubas Uterinas , Fertilidade , Gravidez , Humanos , Feminino , Masculino , Tubas Uterinas/patologia , Epitélio , Fertilização in vitro , Ovário
16.
Bratisl Lek Listy ; 123(1): 22-26, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34967654

RESUMO

Myocardial infarction is a life-threatening complication of the coronary artery disease - the leading cause of premature death worldwide. The severity of this condition is the result of cellular death following the myocardial ischaemia, which occurs via several mechanism including apoptosis. For the research of this condition, animal models are often employed. We established isoprenaline-induced rat model of myocardial infarction, focusing on the immunohistochemical analysis of the expression of antiapoptotic and proapoptotic proteins BCL-2 and BAX, respectively. Apoptosis (based on BAX-positivity) was activated in cardiac muscle cells within the first day, later on day 8 also in fibroblasts of the forming scar tissue. Antiapoptosis in cardiac muscle cells was weak to moderate on the day 1 and 2, on the day 8 macrophages were strongly positive for BCL-2. The results confirmed that programmed cell death as well as mechanisms of antiapoptosis contribute to the pathogenesis of myocardial infarction. Previous research demonstrated that by experimentally affecting proapoptotic and antiapoptotic signals, it is possible to influence various aspects of myocardial infarction including: infarction size, cardiac remodelling and prognosis of the heart failure. Future research is warranted to fully elucidate the role of this process during myocardial infarction, which will result in refined diagnostic and therapeutic strategies (Tab. 1, Fig. 1, Ref. 21). Keywords: myocardial infarction, isoprenaline, apoptosis, necrosis, BCL-2, BAX.


Assuntos
Infarto do Miocárdio , Miocárdio , Animais , Apoptose , Modelos Teóricos , Ratos , Ratos Sprague-Dawley , Proteína X Associada a bcl-2
17.
Bratisl Lek Listy ; 122(12): 839-845, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34904845

RESUMO

OBJECTIVES: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the most common cause of uterine and uterine tubes absence/underdevelopment and the second most common cause of primary amenorrhea. It is characterized by a congenital agenesis of the uterine tubes, uterus, cervix, and upper part of the vagina. This study presents our 10 years of experience with the diagnostics and therapeutic management of patients with MRKH syndrome. We also focused on the description of anatomical deviations of the female reproductive organs. MATERIALS AND METHODS: We studied a cohort of 16 patients hospitalized with MRKH syndrome between 2011-2020. We analysed the age at diagnosis, clinical signs and symptoms, diagnostic techniques, methods of neovagina creation, and anatomical anomalies of the female reproductive organs. RESULTS: The mean age of our patients at the time of diagnosis was 16.75 years. The most frequent clinical manifestations were primary amenorrhea (56.25 %), pelvic pain (31.25 %) and coitus-associated problems. We used two methods of neovagina creation. In six patients we used the non-surgical Frank's dilators method. The vaginal length at the beginning of the dilation was 1.5-2 cm. In 4 patients the vaginal length was under 1 cm, so we performed surgical neovagina creation using the laparoscopic Vecchietti method. An-other two patients could create the vagina via regular sexual intercourse. Based on magnetic resonance imaging and ultrasound examination, the following anomalies were observed: complete agenesis of the uterus (50 % of cases), fibrous band (25 %) and rudimentary uterus (25 %). CONCLUSIONS: Satisfactory results in the attempt to create a neovagina can be obtained by both non-surgical and surgical methods. Modern medicine provides many therapeutic measures, which make it possible for the affected women to have a normal sexual life (Tab. 1, Fig. 3, Ref. 37).


Assuntos
Transtornos 46, XX do Desenvolvimento Sexual , Anormalidades Congênitas , Transtornos 46, XX do Desenvolvimento Sexual/diagnóstico , Transtornos 46, XX do Desenvolvimento Sexual/cirurgia , Adolescente , Anormalidades Congênitas/diagnóstico , Feminino , Humanos , Ductos Paramesonéfricos/anormalidades , Ductos Paramesonéfricos/diagnóstico por imagem , Ultrassonografia , Vagina/cirurgia
18.
Bratisl Lek Listy ; 121(1): 96-101, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31950845

RESUMO

Vaclav Trnka from Krovice (1739-1791, in Latin: Wenzel Trnka Krzowitz) was a remarkable physician whose life serves as an example in the history of medicine by connecting major capital cities of Central Europe. In view of current geographical layout, he was born and brought up in the Czech Republic, graduated from University of Vienna in Austria, and was appointed Professor of the Anatomy at the newly established Faculty of Medicine of University of Nagyszombat, presently Trnava in Slovak Republic. When the University moved to Buda and later to Pest (today Budapest, Hungary), he was the first educator to introduce anatomy as a medical subject to be taught in a Hungarian medical school. He also was elected the Dean of Faculty of Medicine three times and in 1786-1787 he acted as Rector of then the Royal University of Pest. During his life, he published twenty-seven monographs dealing with different areas of clinical medicine, such as malaria (intermittent fever), diabetes, and rickets. Based on these monographs we can proclaim that Václav Trnka was a co-founder of modern infectology, diabetology and ophthalmology in Central Europe. Nowadays, artificial intelligence and bioinformatics are inseparable parts of modern health care system which help the transformation of big data into valuable knowledge. In the 18th century, Professor Trnka owned more than 3,000 scientific books and had natural, innate intelligence and wisdom which made him a real "medical polymath". As a musician, Trnka also composed sixty-one canons, two of them long wrongly considered as Mozart's work. Despite the fact that Trnka is considered to be the founder of Hungarian anatomy education and a major medical figure of the eighteenth century Central Europe, no internationally acclaimed biographical record of his life or work has so far been published in English. Therefore, we would like to reintroduce Václav Trnka both as an anatomist and medical polymath, and to give an overview of the early days of anatomy teaching in present-day Slovakia and Hungary (Fig. 1, Ref. 27). Keywords: Trnka from Krovice, anatomist, medical polymath, history of medicine.


Assuntos
Anatomistas , Anatomistas/história , República Tcheca , Europa (Continente) , História do Século XVIII , Humanos , Hungria , Eslováquia
19.
Folia Morphol (Warsz) ; 79(3): 610-620, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31617576

RESUMO

BACKGROUND: At first sight, the issue of terminology in morphological sciences may seem as "closed and changeless chapter", as many of the structures within the human body have been known for centuries. However, the exact opposite is true. Terminologia Histologica: International Terms for Human Cytology and Histology published under the Federative International Programme on Anatomical Terminology in 2008 is a new standard in human cell and tissue terminology. The list of items in the first and still valid official nomenclature of cellular and tissue structures, the Terminologia Histologica (TH), is the best and most extensive of all the histological nomenclatures ever issued. MATERIALS AND METHODS: The aim of this article is a systematic and in-depth analysis of the current internationally accepted nomenclature TH, with focus on important histological structures which are missing in this first edition. Some should be incorporated just for the sake of completeness and consistence, others are purely absent terms for individual structures or some are recently described new tissue structures. RESULTS: We also discuss about a question, how to deal with the issue of eponyms. Eponyms reflect medicine's rich and colourful history. Although they have not been considered official terms in the anatomical nomenclature since 1955, they are still widely used in clinical practice. CONCLUSIONS: We hope that this opinion article will develop a wide scientific discussion before the publication of the second edition, so perhaps the mentioned minor flaws will be corrected, so the new edition of the TH will become truly an internationally accepted communication tool for all histologists, histopathologists and anatomists.


Assuntos
Especificidade de Órgãos , Terminologia como Assunto , Membrana Basal/metabolismo , Humanos , Proteínas Proto-Oncogênicas c-kit/metabolismo
20.
Bratisl Lek Listy ; 120(7): 485-493, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31602982

RESUMO

Growing cancer incidence in reproductive age goes hand in hand with a rising survival rate of patients who underwent anticancer therapy. This trend points to the necessity of discussion regarding the fertility maintenance. The patient´s future with respect to his reproductive ability has to be addressed properly to achieve a complex approach to cancer management. The germinal epithelium of the testes is highly susceptible to deleterious effects of chemotherapy. After the administration of gonadotoxic chemotherapeutic agents, a patient can develop oligospermia, or even azoospermia. Similarly, radiation exposure can damage spermatogenesis, while higher doses lead to azoospermia. This review brings an overview of the methods of assisted reproduction, which are currently in use for fertility maintenance in oncological patients, but also in those with non-malignant indications. Also, novel, yet still experimental, methods are discussed, which represent promising technologies applicable to prepubertal oncological patients. We also discuss historical milestones in the development of assisted reproduction, summarize the options of semen analysis, and we present a practical guide through the process of sperm cryopreservation and subsequent in vivo or in vitro fertilisation. We deem that fertility maintenance should be an integral part of the health care in oncological patients in reproductive age (Tab. 1, Ref. 85). Keywords: assisted reproduction technique, sperm cryopreservation, testicular tissue cryopreservation, spermatogenesis, sperm quality in oncological patients.


Assuntos
Preservação da Fertilidade , Infertilidade Masculina/prevenção & controle , Neoplasias/terapia , Criopreservação , Humanos , Infertilidade Masculina/terapia , Masculino , Neoplasias/complicações , Espermatogênese , Espermatozoides , Testículo
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