Intraventricular placement of a spring expander does not attenuate cardiac atrophy of the healthy heart induced by unloading via heterotopic heart transplantation.

An important complication of the prolonged left ventricle assist device support in patients with heart failure is unloading-induced cardiac atrophy which proved resistant to various treatments. Heterotopic heart transplantation (HTx) is the usual experimental model to study this process. We showed previously that implantation of the newly designed intraventricular spring expander can attenuate the atrophy when examined after HTx in the failing heart (derived from animals with established heart failure). The present study aimed to examine if enhanced isovolumic loading achieved by implantation of the expander would attenuate cardiac post-HTx atrophy also in the healthy heart. Cardiac atrophy was assessed as the ratio of the transplanted-to-native heart weight (HW) and its degree was determined on days 7, 14, 21 and 28 after HTx. The transplantation resulted in 32±3, 46±2, 48±3 and 46±3 % HW loss when measured at the four time points; implantation of the expander had no significant effect on these decreases. We conclude that enhanced isovolumic loading achieved by intraventricular implantation of the expander does not attenuate the development of cardiac atrophy after HTx in the healthy heart. This indicates that such an approach does not represent a useful therapeutic measure to attenuate the development of unloading-induced cardiac atrophy.

Some features of the long-term development of migration in the Czech Republic.

PIP: "[This] contribution is...aimed at the age structure of migration movement, based on the relationship between the district of birth and the district of the current place of residence. The objective of the contribution is, first and foremost, to document the interdistrict variability of the age structure of migrants and the net migration, depending on age. Another objective...is to prove that the assessment of the age structure of migration in its regional variability can be used to define the basic evolutionary migration stages and turning points. A typology of Czech districts with respect to their long-term migration development is one of the results of the contribution." (EXCERPT)^ieng

[Dynamic pulmonary densitography in the diagnosis of radiographically non-contrasting foreign bodies in the lower respiratory tract in children]. / Prínos dynamické plicní denzitografie k diagnostice rtg nekontrastních cizích teles v dolních cestách dýchacích u detí.

Densitographic examination of the regional pulmonary ventilation is a non-pretentious and non-invasive method which can be used even in very young children, which when aspiration of a non-contrasting foreign body is suspected can confirm by revealing localized bronchial obstruction the presence of a foreign body and determine its localization in the tracheobronchial tree. By repeated records of adequate ventilation at rest in all pulmonary fields it is possible with a minimal radiation load to rule out the suspicion and the child need not be subjected to an endoscopic examination. In five children aged 19 months to 13 years the usefulness of this procedure for the diagnosis of aspiration of a non-contrasting foreign body was proved, as the physical and skiagraphic finding was not convincing, there was discrepancy of anamnestic data and results of repeated skiagraphic examinations, negative auscultation and negative X-ray examination after an anamnestically obvious cse of aspiration, it ws used, for a more accurate localization of the aspired object, and to confirm localized obstruction of pulmonary ventilation in a chronic foreign body of plant origin in the airways. Foreign bodies of plant origin, most frequently aspired by children, are dangerous because they are fragile, swell and exert toxic action on the bronchial mucosa and there is also the danger of rapid development of serious bronchopulmonary complications. Therefore early diagnosis of aspiration is essential in these frequently obscure situations. When the direct skiagraphic signs of their presence in the lower airways are lacking dynamic pulmonary densitography contributes greatly to the diagnosis.

[An unusual early complication of tonsillectomy]. / Neobvyklá casná komplikace tonzilektomie.

The authors describe the observation of a localized tissue emphysema of the right cheek, which developed in an eight-year-old child as the early complication of tonsillectomy performed under local anaesthesia. In addition to reflections on the possible pathways of the gas from the tonsillar bed into interstitial spaces of the cheek, the authors draw attention also to possible concurrent penetration into the soft tissues of the neck and mediastinum.

[Personal experience with the sleep apnea syndrome]. / Nase zkusenosti se syndromem spánkové apnoe.

In three children aged 3, 9 and 10 years the syndrome of sleep apnea with typical manifestations of obstructive apnoeic episodes during sleep is described. In two instances the nocturnal periodic apnoeic spells were associated with marked varying hypoxemia, objectively recorded by continuous monitoring of the transcutaneous oxygen tension using a skin oximeter. In one child the cause of airway obstruction during sleep were hypertrophic tonsils and adenoid vegetation, in the other two children in the nocturnal apnoeic spells above all the functional component participated, expressed by increased relaxation of the oropharyngeal musculature during sleep. In the first child adenotonsillectomy was followed by immediate regression of all original symptoms, in the remaining two children therapeutic results were achieved only by removal of the slightly enlarged tonsils, while previous adenotomy did not have a favourable effect on the course of their disturbed sleep. Permanent regression of the apnoeic episodes after tonsillectomy was confirmed by records of a smooth level of the skin oxygen tension during sleep. This syndrome is more frequent than generally assumed and late establishment of the diagnosis may lead to the development of serious cardiopulmonary complications, irreversible neurogenic dysfunctions and psychosomatic retardation of the affected children.