BACKGROUND: Percutaneous rhizotomy of the Gasserian ganglion is a well-established intervention for patients suffering from refractory trigeminal pain, not amenable to pharmacological management or microvascular decompression. Traditionally conducted under fluoroscopic guidance using Hartel's technique, this study investigates a modified approach employing low-dose CT guidance to achieve maximal procedural precision and safety with the emphasis on minimizing radiation exposure. METHODS: A retrospective analysis of patients undergoing percutaneous rhizotomy of the Gasserian ganglion at our institution was undertaken. Procedures were divided into fluoroscopy and CT-guided foramen ovale (FO) cannulation cohorts. Radiation doses were assessed, excluding cases with incomplete data. The study included 32 procedures in the fluoroscopy group and 30 in the CT group. RESULTS: In the CT-guided group, the median effective dose was 0.21 mSv. The median number of CT scans per procedure was 4.5, and the median procedure time was 15 min. Successful FO cannulation was achieved in all 30 procedures (100%). In the fluoroscopy group, the median effective dose was 0.022 mSv, and the median procedure time was 15 min. Cannulation of FO was successful in 31 of 32 procedures (96.9%). The only complications in the CT-guided group were three minor cheek hematomas. Immediate pain relief in the CT-guided group was reported in 25 of 30 procedures (83.3%), 22 of 30 (73.3%) provided relief at one month, and 10 of 18 (55.6%) procedures resulting in pain relief at one month continued to provide relief after two years. CONCLUSION: Low-dose CT-guided percutaneous rhizotomy conducted in the radiology suite carries negligible radiation exposure for patients and eliminates it for personnel. This method is fast, simple, precise, and carries a very low risk of complications.
- MeSH
- dávka záření MeSH
- dospělí MeSH
- fluoroskopie metody MeSH
- ganglion trigeminale chirurgie diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuralgie trigeminu * chirurgie diagnostické zobrazování radioterapie MeSH
- počítačová rentgenová tomografie * metody MeSH
- radiační expozice * prevence a kontrola MeSH
- retrospektivní studie MeSH
- rizotomie * metody MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Surgical site infection (SSI) is the most consistently reported complication of cranioplasty. No material showed a categorical superiority in the incidence of infection. Porous polyethylene (PE) is considered a low risk material regarding SSI. However, the literature data are very limited. Thus, our objective was to verify the assumed low incidence of SSI after PE cranioplasty in patients at high risk of SSI. The primary objective was the infection rate, while secondary objectives were implant exposure, revision and cosmetic results. METHOD: Patients who underwent three-dimensional (3D) personalized PE cranioplasty in the period 2014-2023 were evaluated prospectively. Only patients with an increased risk of SSI, and a satisfactory clinical conditions were included in the study. RESULTS: Thirty procedures were performed in 30 patients. Cranioplasty was performed 23 times after hemispheric decompressive craniectomy, five times after limited size craniotomy and two times after bifrontal decompressive craniectomy. Risk factors for the development of infection were 18 previous SSIs, 16 previous repeated revision surgeries, four intraoperatively opened frontal sinuses and two times radiotherapy. Neither infection nor implant exposure was detected in any patient. All patients were satisfied with the aesthetic result. In two cases, a revision was performed due to postoperative epidural hematoma. CONCLUSIONS: Three-dimensional personalized PE cranioplasty is associated with an extremely low incidence of SSI even in high-risk patients. However, our conclusions can only be confirmed in larger studies.
- MeSH
- dekompresní kraniektomie škodlivé účinky metody MeSH
- dospělí MeSH
- infekce chirurgické rány * epidemiologie etiologie MeSH
- kraniotomie škodlivé účinky metody MeSH
- lebka chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- polyethylen MeSH
- poréznost MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- zákroky plastické chirurgie * metody škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Human diving reflex is a well-studied phenomenon. However, very little is known about the possible relationship between augmented diving reflex and autonomic dysfunction. METHODS: We retrospectively studied a group of four swimmers who underwent a diving reflex test as part of the examination due to symptoms related to autonomic dysfunction during swimming. The control group comprised 11 healthy swimmers with no history of these symptoms. A standardized diving reflex test was performed for each athlete in both groups. Hemodynamic profiles, including heart rate, stroke volume, and cardiac output, were recorded. RESULTS: There were no statistically significant differences between the groups in any of the three parameters measured before the test. However, at the end of the test, each parameter (heart rate, stroke volume, and cardiac output) was significantly lower in the swimmers who presented with clinical symptoms related to autonomic dysfunction than in the control group. CONCLUSION: This observation could shed light on autonomic dysfunction as a possible cause of sudden cardiac death in swimming athletes. It also demonstrated that autonomic dysfunction is presented not only by decreased heart rate but also by stroke volume, causing a drop in cardiac output to the level of hemodynamic collapse.
- Publikační typ
- časopisecké články MeSH
Zátěží vyvolaná obstrukce laryngu (exercise induced laryngeal obstruction, EILO) je jedna z častých příčin námahové dušnosti objevující se v maximální zátěži při normální morfologii a funkci hrtanu v klidu. Nejčastější je u žen v adolescentním věku a u sportů s vysokými nároky na ventilaci. Obstrukci způsobuje addukce částí laryngu při nádechu, může vznikat v oblasti glotické paradoxním pohybem hlasivek nebo častěji supraglotické addukcí až vnitřním prolapsem aryepiglotických řas a okolních struktur. Často je zaměňována za astmatickou dušnost. Symptomy jako inspirační dušnost se stridorem a diskomfortem v oblasti krku a jugula, někdy doprovázené hyperventilací nebo panickou reakcí z pocitu dušení, se objevují rychle při vysoké intenzitě zátěže a mizí sekundy po zastavení. Nereagují na antiastmatika. Patofyziologie není jasná. Uplatňují se aerodynamické mechanismy dané zrychleným prouděním vzduchu při nárůstu ventilace, změny podpůrných struktur laryngu, funkce instrinsických i extrinsických svalů, postury a hybných stereotypů, dechový vzor nebo ochranné reflexy. Diagnóza je to klinická, v rámci vyšetření je nutné vyloučit jiné příčiny, zejména astma bronchiale, zátěží indukovanou bronchokonstrikci nebo strukturální patologii v dýchacích cestách. Lze provést kontinuální zobrazení laryngu flexibilním laryngoskopem (CLE test) při zátěžovém testu k objektivizování tíže addukce struktur laryngu. Pro efektivní terapii je nutná edukace pacienta o diagnóze a možnostech léčby. Cílem je kontrola abdukce struktur laryngu a optimalizace dechového stereotypu ve vysoké intenzitě zátěže. V terapii se uplatňuje multioborová spolupráce mezi klinickým logopedem, psychoterapeutem a trenérem, lze též použít nácvik biofeedbackem při užití flexibilního laryngoskopu navazující na CLE t
Exercise-induced laryngeal obstruction (EILO) is a common cause of exertional dyspnoea occurring at maximal exertion in individuals with normal laryngeal morphology and function at rest. It is most frequent in adolescent females and in sports with high ventilation demands. The obstruction results from the adduction of laryngeal structures during inhalation, occurring either at the level of the glottis with paradoxical vocal fold movement, or more commonly with supraglottic adduction and inward prolapse of aryepiglottic folds and surrounding structures. It is often mistaken for asthma-related dyspnoea.
A 58-year-old patient presented with a severe neurological deficit due to a stroke caused by an occlusion of the left internal carotid artery siphon. Standard treatment failed and neurosurgical consult was delayed. Because of a favorable perfusion imaging finding, microsurgical revascularization via an extra-intracranial bypass (left superficial temporal artery - left middle cerebral artery) was performed 36 hours after the onset of the symptoms. The outcome of the patient was favorable. The authors want to emphasize the need to actively seek patients with a severe neurological deficit and still viable brain tissue. The time window and treatment alternatives are discussed.
- MeSH
- arteria carotis interna chirurgie MeSH
- cévní mozková příhoda * diagnostické zobrazování etiologie chirurgie MeSH
- ischemická cévní mozková příhoda * komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- perfuze škodlivé účinky MeSH
- revaskularizace mozku * metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Mutations in the splicing factor 3b subunit 1 (SF3B1) gene are frequent in myelodysplastic neoplasms (MDS). Because the splicing process is involved in the production of circular RNAs (circRNAs), we investigated the impact of SF3B1 mutations on circRNA processing. Using RNA sequencing, we measured circRNA expression in CD34+ bone marrow MDS cells. We defined circRNAs deregulated in a heterogeneous group of MDS patients and described increased circRNA formation in higher-risk MDS. We showed that the presence of SF3B1 mutations did not affect the global production of circRNAs; however, deregulation of specific circRNAs was observed. Particularly, we demonstrated that strong upregulation of circRNAs processed from the zinc finger E-box binding homeobox 1 (ZEB1) transcription factor; this upregulation was exclusive to SF3B1-mutated patients and was not observed in those with mutations in other splicing factors or other recurrently mutated genes, or with other clinical variables. Furthermore, we focused on the most upregulated ZEB1-circRNA, hsa_circ_0000228, and, by its knockdown, we demonstrated that its expression is related to mitochondrial activity. Using microRNA analyses, we proposed miR-1248 as a direct target of hsa_circ_0000228. To conclude, we demonstrated that mutated SF3B1 leads to deregulation of ZEB1-circRNAs, potentially contributing to the defects in mitochondrial metabolism observed in SF3B1-mutated MDS.
Cervikální hlen je viskózní kapalina fungující jako zátka děložního čípku. V cervikálním hlenu můžeme detekovat produkty endometriálních a cervikálních žláz. Cervikální hlen je dále obohacen transudátem pocházejícím z vejcovodů a proteiny pocházející z vaječníků, peritonea a vzdálených tkání. Se zvyšující se hladinou ovariálních estrogenů se vlastnosti cervikálního hlenu mění tak, že umožňují snadnější odběr a zpracování. Z tohoto důvodu jsme vybrali skupinu deseti pacientek léčených kontrolovanou ovariální hyperstimulací pro in vitro fertilizaci v centru asistované reprodukce. Tato studie se zaměřuje na proteomickou charakterizaci cervikálního hlenu a na buněčnou a tkáňovou lokalizaci identifikovaných proteinů. Nejvíce intenzivními proteiny identifikovanými v cervikálním hlenu jsou muciny, ale bylo nalezeno také mnoho méně abundantních proteinů vnitrobuněčného původu. Analýza tkáňových expresí odhalila mnoho proteinů, které jsou kromě tkání ženských reprodukčních orgánů exprimovány také v jiných tkáních a mimo jiné také proteiny specifické pro varlata, játra, placentu, oční sítnici a mozeček. Tato studie dále potvrzuje vhodnost cervikálního hlenu jako zdroje proteomických biomarkerů nejen pro diagnostiku ženského reprodukčního traktu.
Cervical mucus is a viscous fluid functioning as a cervix plug. Products of the endometrial and cervical glands can be detected in the cervical mucus. Cervical mucus is further enriched with transudate originating from the fallopian tubes and proteins originating from the ovaries, peritoneum and distant tissues. With increasing levels of ovarian estrogens, the properties of cervical mucus for possible collection and processing change appropriately. For these reasons, we chose a group of 10 patients treated in the center of assisted reproduction by controlled ovarian stimulation for in vitro fertilization. This study focuses on the proteomic characterization of cervical mucus and localizes the possible sources of the identified proteins. The most abundant proteins were extracellular proteins, mainly mucins; however, most of the identified proteins, present usually in lower quantities, were of intracellular origin. The tissue analysis revealed that proteins from female reproductive organs are also expressed in other tissues in addition to female reproductive organs, but also proteins specific to the testis, liver, placenta, retina, and cerebellum. This study confirms the suitability and high potential of cervical mucus as a source of proteomic biomarkers not only for the diagnosis of the female reproductive tract.
- Klíčová slova
- tkáňové exprese,
- MeSH
- cervikální hlen * chemie MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- proteomika MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
BACKGROUND/OBJECTIVE: Hormone receptor (HR) status is one of the key factors in determining the treatment of breast cancer. Previous studies suggested that HR status may change in metastatic tissue. However, available studies focused mainly on primary biopsies and there are only few trials comparing HR status in the primary tumour and the metastasis using material from complete resection. The aim of the study was to determine the frequency of HR alterations in metastatic breast cancer. MATERIALS AND METHODS: The study retrospectively examines a total of 50 patients who underwent brain, lung, or liver metastasectomy for metastatic breast cancer between January 2000 and January 2019. RESULTS: HR conversion was observed in a total of 30 cases (60.0%), while HER-2/neu (human epidermal growth factor receptor 2) discrepancy surprisingly occurred only in one case (2.0%). A change in immunophenotype occurred in 28% of cases. Triple-negativity was more frequent in brain metastases (p = 0.039). CONCLUSIONS: We have confirmed that HR conversion between the primary tumour and its metastases occurs in a significant number of cases, which has important implications for further treatment decisions.
- Publikační typ
- časopisecké články MeSH
Cervical mucus (CM) is a viscous fluid that is produced by the cervical glands and functions as a uterine cervix plug. Its viscosity decreases during ovulation, providing a window for non-invasive sampling. This study focuses on proteomic characterization of CM to evaluate its potential as a non-invasively acquired source of biomarkers and in understanding of molecular (patho)physiology of the female genital tract. The first objective of this work was to optimize experimental workflow for CM processing and the second was to assess differences in the proteomic composition of CM during natural ovulatory cycles obtained from intrauterine insemination (IUI) cycles and in vitro fertilization (IVF) cycles with controlled ovarian hyperstimulation. Proteomic analysis of CM samples revealed 4370 proteins involved in processes including neutrophil degranulation, cellular stress responses, and hemostasis. Differential expression analysis revealed 199 proteins enriched in IUI samples and 422 enriched in IVF. The proteins enriched in IUI were involved in phosphatidic acid synthesis, responses to external stimulus, and neutrophil degranulation, while those enriched in IVF samples were linked to neutrophil degranulation, formation of a cornified envelope and hemostasis. Subsequent analyses clarified the protein composition of the CM and how it is altered by hormonal stimulation of the uterus.
- MeSH
- biologické markery MeSH
- cervikální hlen * MeSH
- fertilizace in vitro MeSH
- lidé MeSH
- proteom MeSH
- proteomika MeSH
- umělá inseminace * MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
