BACKGROUND AND AIMS: Patients after endoscopic treatment of Barrett's esophagus (BE) related neoplasia (BORN) should enter endoscopic surveillance with biopsies to detect persistent or recurrent neoplasia or intestinal metaplasia (IM). Probe-based confocal laser endomicroscopy (pCLE) serves as a virtual biopsy and could replace standard biopsies. However, the role of pCLE in patients after endoscopic treatment of BORN has not been systematically assessed. The aim of this study was to compare pCLE with biopsies in detecting persistent/recurrent IM/neoplasia. METHODS: A single center, prospective and pathologist-blinded study was performed. Patients after endoscopic treatment of BORN (endoscopic resection or dissection, radiofrequency ablation) underwent surveillance endoscopy with pCLE followed by biopsies. RESULTS: A total of 56 patients were enrolled: initial diagnoses were low-grade dysplasia (LGD) in 24 patients (43%), high-grade dysplasia (HGD) in 12 patients (21%) and early adenocarcinoma (EAC) in 20 patients (36%). Only one patient (2%) experienced recurrent neoplasia (LGD), which was diagnosed by pCLE only. Twenty patients (35.7%) experienced persistent/recurrent IM, diagnosed by both pCLE and biopsies in 17 patients (17/30, 85%) and by pCLE only in 3 pts (3/30, 15%). Sensitivity, specificity, positive and negative predictive values to diagnose recurrent/persistent IM did not differ significantly between pCLE and biopsies; diagnostic accuracy was 100% (95%CI 93.6-100) for pCLE and 94.6 (95%CI 85.1-98.9%) for biopsies, p=0.25. In patients with IM detected by both tested methods, pCLE detected significantly more goblet cells (median 43 per patient) than biopsies (median 12 per patient), p=0.01. CONCLUSION: pCLE is at least as effective as standard biopsies in the detection of persistent/recurrent IM after endoscopic treatment of BORN.
- MeSH
- Barrettův syndrom patologie chirurgie MeSH
- biopsie MeSH
- časové faktory MeSH
- dospělí MeSH
- ezofagektomie * škodlivé účinky MeSH
- ezofágoskopie * škodlivé účinky MeSH
- konfokální mikroskopie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru * MeSH
- nádory jícnu patologie chirurgie MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- radiofrekvenční ablace * MeSH
- reprodukovatelnost výsledků MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň nádoru MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
OBJECTIVES AND DESIGN: At the present time there are two waiting list for patients with vascular prosthetic infection indicated for arterial transplantation in the Czech Republic. The inclusion of each patient for cold-stored or cryopreserved arterial transplantation is the preference of indicating surgeon. In this experimental work we studied the immunogenicity of rat aortal allografts treated by our new clinical cryopreservation/slow thawing protocol. MATERIAL AND METHODS: Brown-Norway (BN) (N = 6, 203-217 g) or Lewis (LEW) (N = 6, 248-254 g) abdominal aortal grafts treated in accordance with our new clinical cryopreservation/slow thawing protocol were orthotopically transplanted to Lewis recipients (N = 12, 191-245 g). Aortal wall histology and infiltration by recipient immune cells, as well as donor specific anti MHC class I and II antibodies in recipient serum were studied in both isografts and allografts on day 30 postransplant. Core data of cryopreserved allografts were compared to our previous data of cold-stored aortal allografts treated in accordance with our clinical cold-storage protocol. RESULTS: Cryopreserved allografts showed regular morphology of aortal wall with clear differentiation of all three basic anatomical layers on day 30 postransplant. Intimal layer showed no hyperplasia, luminal surface was covered by endothelial cells. No statistical difference was observed in tunica media thickness between isografts and allografts. The medial layer showed no necrosis, shrinkage or immunoglobuline G deposition in any experimental group. The adventitial infiltration by immune cells was significantly higher (P<0.05) in allografts. Cryopreserved allografts showed significant lower activation of both cell- and antibody mediated immunity compared to historical data of cold-stored allografts. CONCLUSION: Aortal wall histology of rat allografts treated by our new standardized clinical cryopreservation/slow thawing protocol was comparable to that of the cryopreserved isografts on day 30 posttranspant. The immunogenicity of cryopreserved aortal allografts was significantly lower compared to that of cold-stored aortal allografts.
- MeSH
- alografty fyziologie MeSH
- aorta transplantace MeSH
- arterie transplantace MeSH
- homologní transplantace metody MeSH
- kryoprezervace metody normy MeSH
- krysa rodu rattus MeSH
- modely u zvířat MeSH
- potkani inbrední BN MeSH
- potkani inbrední LEW MeSH
- rejekce štěpu imunologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES AND DESIGN: The aim of our study was to simulate in rats all aspects and techniques used in our new clinical program of cryopreserved alloarterial transplantation and investigate the influence of two immunosuppressive protocols with tacrolimus on acute rejection of these allografts. MATERIALS AND METHODS: Cryopreserved abdominal aortic grafts were transplanted between Brown-Norway and Lewis rats. Tacrolimus (0.2 mg/kg daily) was administered from day 1 to day 30 (TAC1) or from day 7 to day 30 (TAC7), respectively. No immunosuppressed isogeneic (ISO) and allogeneic (ALO) rats combination served as control. Aortal wall infiltration by immunocompetent cells (MHC II+ cells of recipient origin) was studied on day 30 after transplantation. Flow cytometry was used for the analysis of day 30 sera for the presence of donor specific anti-MHC class I and II antibodies. RESULTS: The aortal allografts in both immunosuppressed groups showed regular morphology of aortal wall with no depositions of immunoglobulin G on day 30. The adventitial infiltration of non-immunosuppressed aortal allografts by MHC class II positive cells of recipient origin was significantly higher (ALO 20.7±6.7 cells, P<0.001) compared to both immunosuppressed groups (TAC1 5.9±5.5 cells, TAC7 6.1±5.1 cells). Day 30 sera from the allogeneic non-immunosuppressed animals decreased significantly the binding of fluorescence-labelled MHC class I (46.9±19.4%) and class II (65.8±11.9%) antibody to donors spleen cells compared with day 30 sera from both immunosuppressed groups (TAC1, anti-MHC class I 102.4±4.2%, p < 0.001, anti-MHC class II 102.6±6.0%), (TAC7, anti-MHC class I 79.9±3.3%, p < 0.001, anti-MHC class II 80.9±2.7%). CONCLUSION: Both immunosuppressed protocols with tacrolimus (administration from day 1 or from day 7 following transplantation) were able to suppress acute cell- and antibody-mediated rejection of cryopreserved abdominal aortic allografts processed in accordance with our new standardized clinical protocol.
- MeSH
- aorta fyziologie transplantace MeSH
- cévní protézy * MeSH
- homologní transplantace MeSH
- imunosupresiva aplikace a dávkování MeSH
- imunosupresivní léčba MeSH
- kryoprezervace * MeSH
- krysa rodu rattus MeSH
- potkani inbrední BN MeSH
- potkani inbrední LEW MeSH
- přežívání štěpu MeSH
- průtoková cytometrie MeSH
- rejekce štěpu imunologie MeSH
- rozvrh dávkování léků MeSH
- takrolimus aplikace a dávkování MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Úvod: Nedostatečné krevní zásobení představuje jeden z hlavních rizikových faktorů dehiscence anastomózy. Včasná detekce lokálních ischemických změn by mohla predikovat komplikace, předejít rozvoji peritonitidy, snížit mortalitu a zvýšit šanci na záchranu funkční anastomózy. Mikrodialýza nabízí možnost kontinuální monitorace prostřednictvím hodnocení aktivity tkáňového metabolismu. Hlavním cílem této práce bylo ověřit, zda mikrodialýza umožňuje monitoraci ischemických změn kolo-rektální anastomózy. Metoda: Do studie jsme zařadili 5 prasat s ručně šitou kolorektální anastomózou. Mikrodialyzační katétr byl zaveden intramurálně 5mm od okraje anastomózy. Tkáňové hladiny metabolitů byly sledovány každých 60 minut po dobu 6 hodin. Po třech měřeních byla provedena ischemizace anastomózy, po které následovaly další 3 hodiny monitorace. Ke srovnání hodnot před a po ischemii byl použit Mann-Whitney test. Výsledky: Po ischemizaci anastomózy došlo k signifikantnímu poklesu tkáňové hladiny glukózy a pyruvátu. Naopak hladiny laktátu a glycerolu signifikantně vzrostly. Všechny detekované změny byly signifikantní již během prvních 60 minut po vyvolání ischemie. Závěr: Monitorace kolorektální anastomózy pomocí mikrodialýzy je technicky proveditelná a umožňuje včasné zachycení poruch perfuze.
Introduction: Inadequate blood supply is one of the major risk factors for colorectal anastomotic leak. Early postoperative detection of local ischemic changes can predict complicated healing and lead to better outcome. Microdialysis (MD) offers real-time evaluation of adequate bowel perfusion through monitoring of tissue metabolism. The aim of this study was to assess the feasibility of MD for early detection of ischemic changes in colorectal anastomosis. Method: Five pigs with end-to-end colorectal anastomosis were included. MD catheter was placed intramurally 5mm from anastomotic edge. Occlusive ischemia was induced after 3 measurements and followed by another 3 hours of monitoring. Tissue levels of different metabolites were measured every 60 minutes before and after ischemia induction. Mann-Whitney test was used to compare pre and post ischemic changes. Results: The monitoring of colorectal anastomosis using MD was technically feasible and associated with no complications. Significant changes caused by local ischemia were observed in decreased levels of glucose or pyruvate and increased levels of lactate and glycerol. All metabolic changes were detectable already in first samples 60 minutes after ischemia induction. Conclusion: Postoperative ischemic changes in colorectal anastomosis can be detected by means of microdialysis.
- Klíčová slova
- kolorektální anastomóza,
- MeSH
- anastomóza chirurgická * MeSH
- dehiscence operační rány * prevence a kontrola MeSH
- kolorektální chirurgie metody MeSH
- mikrodialýza metody MeSH
- modely nemocí na zvířatech MeSH
- pooperační komplikace prevence a kontrola MeSH
- pooperační období MeSH
- pooperační péče metody MeSH
- prasata MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- práce podpořená grantem MeSH
Glucocorticoids (GCs) are steroid hormones produced by the adrenal cortex in reaction to stress stimuli. GCs production is not stable over a 24-hour period; the plasma concentration peaks in the morning (approximately upon awakening) and then the plasma levels decrease, reaching the nadir in the evening. In our experiments, the levels of cortisol, cortisone, DHEA and DHEAS were tested in young female pigs (n=23) during heart catheterization at two different day times (in the morning and in the afternoon). The non-parametric Mann-Whitney test for statistical analysis was used. We found only minimal statistical differences in studied markers between the morning and afternoon group (p>0.05). The absence of circadian variation in GCs levels could originate either at an early age of our experimental pigs, or in stressful conditions on the experiment day, or most likely the day before (e.g. social isolation, fasting, transport, and catheterization), respectively. We can conclude there is no difference in the stress load between morning and afternoon experiments, and therefore we can assume the stress load is not a limiting factor for the timing when catheterization should be preferably performed.
- MeSH
- cirkadiánní rytmus fyziologie MeSH
- dehydroepiandrosteron krev MeSH
- hormony kůry nadledvin krev MeSH
- hydrokortison krev MeSH
- kortison krev MeSH
- prasata MeSH
- psychický stres krev MeSH
- srdeční katetrizace psychologie MeSH
- steroidy krev MeSH
- zvířata MeSH
- Check Tag
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- práce podpořená grantem MeSH
A variety of current studies is concentrated on the effect of short-term or long-term administration of nicotine in humans and in animals. The aim of this study was to investigate the effect of nicotine after a single administration in two different doses on the brain bioelectrical activity and on behaviour and motor activity in young, immature rats. Male Wistar albino rats, 12-day-old, were used in the experiment. Two groups were administrated by one intraperitoneal (i.p.) injection of nicotine in two various doses. The last (the third) group, which was given one i.p. saline injection, served as a control group. The group with lower dose of nicotine (0.75 mg/kg body weight) showed only mild alteration of the electrocorticogram (ECoG), and no behavioural or motor changes. In the second group (with higher dose of nicotine – 1.00 mg/kg), epileptiform discharges manifested in about 50% of animals. Those animals showed also changes in motor activity (tremor of hindlimbs), but only slightly expressed within the time when epileptiform changes occurred in the ECoG. Routine behaviour and locomotion was observed only in a part of animals. In the third group (control group) no changes in bioelectrical activity, in behaviour or in motor activity were observed. We conclude that even a single dose of nicotine can evoke alteration in the ECoG, in behaviour and in motor activity of immature rats. On the other hand, the quantity, quality and length of ECoG abnormalities as well as parameters of behaviour were closely related to the dose of nicotine.
- MeSH
- centrální nervový systém patofyziologie účinky léků MeSH
- cholinergní látky chemie metabolismus MeSH
- chování zvířat fyziologie účinky léků MeSH
- elektroencefalografie metody přístrojové vybavení využití MeSH
- elektrofyziologie metody přístrojové vybavení MeSH
- experimenty na zvířatech MeSH
- financování organizované MeSH
- mozek patofyziologie patologie účinky léků MeSH
- neurotransmiterové látky chemie metabolismus MeSH
- nikotin aplikace a dávkování škodlivé účinky MeSH
- pohybová aktivita fyziologie účinky léků MeSH
- potkani Wistar MeSH
- statistika jako téma MeSH
- věkové faktory MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
There are three basic procedures used for an assessment of the electrical heart field from the body surface: standard electrocardiography, vectorcardiography, and body surface potential mapping (BSPM). BSPM has two major advantages over both other methods: 1) it allows exploring the entire chest surface, thus providing all the information on the cardiac electric field available at the body surface; 2) it is more sensitive in detecting local electrical events, such as local conduction disturbances or regional heterogeneities of ventricular recovery. Nevertheless the results obtained using BSPM procedure cannot answer all questions about real causality of detected changes of the electrical heart field. We tried therefore to use mathematical model of the electrical field in order to answer these questions. A simple and anatomical forward calculation model was used to test the hypothesis whether the altered position of the heart could explain heterogeneity of repolarization at late stages of pregnancy in humans. The hypothesis was declined. Further findings included: A. Repolarization duration (represented by QT interval) in healthy subjects are distributed regularly and predictably on the body surface carrying no information about local pathology. B. At any systemic analysis of ventricular repolarization, it is vital to consider the regions where any electrode systems record low amplitudes due to methodological, not pathological reasons. C. Anatomical (heterogeneous) model did not yield superior results over simple (homogenous) ones possibly since none reflected the specific torso geometry of individual patients.
- MeSH
- akční potenciály MeSH
- časové faktory MeSH
- elektrokardiografie metody MeSH
- financování organizované MeSH
- lidé MeSH
- mapování potenciálů tělesného povrchu metody MeSH
- modely kardiovaskulární MeSH
- převodní systém srdeční fyziologie MeSH
- těhotenství MeSH
- vektorkardiografie MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
Monophasic action potential (MAP) recording plays an important role in a more direct view of human myocardial electrophysiology under both physiological and pathological conditions. The procedure of MAP measuring can be simply performed using the Seldinger technique, when MAP catheter is inserted through femoral vein into the right ventricle or through femoral artery to the left ventricle. The MAP method represents a very useful tool for electrophysiological research in cardiology. Its crucial importance is based upon the fact that it enables the study of the action potential (AP) of myocardial cell in vivo and, therefore, the study of the dynamic relation of this potential with all the organism variables. This can be particularly helpful in the case of arrhythmias. There are no doubts that physiological MAP recording accuracy is almost the same as transmembrane AP as was recently confirmed by anisotropic bidomain model of the cardiac tissue. MAP recording devices provide precise information not only on the local activation time but also on the entire local repolarization time course. Although the MAP does not reflect the absolute amplitude or upstroke velocity of transmembrane APs, it delivers highly accurate information on AP duration and configuration, including early afterdepolarizations as well as relative changes in transmembrane diastolic and systolic potential changes. Based on available data, the MAP probably reflects the transmembrane voltage of cells within a few millimeters of the exploring electrode. Thus MAP recordings offer the opportunity to study a variety of electrophysiological phenomena in the in situ heart (including effects of cycle length changes and antiarrhythmic drugs on AP duration).
