Anomalous left coronary artery originating from the pulmonary artery (ALCAPA) is an infrequent congenital anomaly. Presentation of this syndrome is rare in adults. Nevertheless, adult patients are at risk of ischaemia, arrhythmias or sudden cardiac death and always require surgical intervention. At our institution, a specific technique of interposition of the right internal iliac artery as a free-graft for left coronary artery reimplantation was used in adult ALCAPA patients. The aim of this report is to determine long-term results and experiences with this surgical technique.
- MeSH
- anomálie koronárních cév * diagnostické zobrazování chirurgie MeSH
- anomální odstup levé koronární tepny * MeSH
- arteria iliaca diagnostické zobrazování chirurgie MeSH
- arteria pulmonalis diagnostické zobrazování chirurgie abnormality MeSH
- dospělí MeSH
- lidé MeSH
- replantace MeSH
- syndrom Bland-White-Garland * chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
Neurodegenerative disorders, including Alzheimer's disease (AD), Parkinson's disease (PD), or systemic amyloidosis, are characterized by the specific protein transformation from the native state to stable insoluble deposits, e.g., amyloid plaques. The design of potential therapeutic agents and drugs focuses on the destabilization of the bonds in their beta-rich structures. Surprisingly, ferritin derivatives have recently been proposed to destabilize fibril structures. Using atomic force microscopy (AFM) and fluorescence spectrophotometry, we confirmed the destructive effect of reconstructed ferritin (RF) and magnetoferritin (MF) on lysosome amyloid fibrils (LAF). The presence of iron was shown to be the main factor responsible for the destruction of LAF. Moreover, we found that the interaction of RF and MF with LAF caused a significant increase in the release of potentially harmful ferrous ions. Zeta potential and UV spectroscopic measurements of LAF and ferritin derivative mixtures revealed a considerable difference in RF compared to MF. Our results contribute to a better understanding of the mechanism of fibril destabilization by ferritin-like proteins. From this point of view, ferritin derivatives seem to have a dual effect: therapeutic (fibril destruction) and adverse (oxidative stress initiated by increased Fe2+ release). Thus, ferritins may play a significant role in various future biomedical applications.
- MeSH
- amyloid * metabolismus MeSH
- ferritiny MeSH
- muramidasa * chemie MeSH
- železo metabolismus MeSH
- Publikační typ
- časopisecké články MeSH
Liver stiffness (LS) is a novel non-invasive parameter widely used in clinical hepatology. LS correlates with liver fibrosis stage in non-cirrhotic patients. In cirrhotic patients it also shows good correlation with Hepatic Venous Pressure Gradient (HVPG). Our aim was to assess the contribution of liver fibrosis and portal hypertension to LS in patients with advanced liver cirrhosis. Eighty-one liver transplant candidates with liver cirrhosis of various aetiologies underwent direct HVPG and LS measurement by 2D shear-wave elastography (Aixplorer Multiwave, Supersonic Imagine, France). Liver collagen content was assessed in the explanted liver as collagen proportionate area (CPA) and hydroxyproline content (HP). The studied cohort included predominantly patients with Child-Pugh class B and C (63/81, 77.8%), minority of patients were Child-Pugh A (18/81, 22.2%). LS showed the best correlation with HVPG (r=0.719, p< 0.001), correlation of LS with CPA (r=0.441, p< 0.001) and HP/Amino Acids (r=0.414, p< 0.001) was weaker. Both variables expressing liver collagen content showed good correlation with each other (r=0.574, p<0.001). Multiple linear regression identified the strongest association between LS and HVPG (p < 0.0001) and weaker association of LS with CPA (p = 0.01883). Stepwise modelling showed minimal increase in r2 after addition of CPA to HVPG (0.5073 vs. 0.5513). The derived formula expressing LS value formation is: LS = 2.48 + (1.29 x HVPG) + (0.26 x CPA). We conclude that LS is determined predominantly by HVPG in patients with advanced liver cirrhosis whereas contribution of liver collagen content is relatively low.
- MeSH
- dospělí MeSH
- elastografie MeSH
- jaterní cirhóza metabolismus patologie patofyziologie chirurgie MeSH
- játra chemie diagnostické zobrazování patologie chirurgie MeSH
- kolagen analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- portální hypertenze diagnóza patofyziologie chirurgie MeSH
- portální tlak * MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- senioři MeSH
- transplantace jater MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Liver stiffness is a reliable non-invasive predictor of Hepatic Venous Pressure Gradient (HVPG) above 10 mm Hg. However, it failed to predict higher thresholds of HVPG. Our aim was to investigate whether liver stiffness and selected previously published non-invasive blood biomarkers could predict higher HVPG thresholds in liver transplant candidates without ongoing alcohol use. One hundred and nine liver transplant candidates with liver cirrhosis of various aetiologies underwent direct HVPG measurement, liver stiffness measurement by 2D shear-wave elastography (Aixplorer Multiwave, Supersonic Imagine, France) and assessment of blood HVPG biomarkers (osteopontin, VCAM-1, IL-6, TNF-α, IL-1ra/IL-1F3 and ELF score). The correlation between liver stiffness and HVPG was linear up to 30 mm Hg of HVPG (r = 0.765, p < 0.0001). The regression lines had similar slopes for HVPG values below and above 16 mm Hg (p > 0.05) and the correlation in patients with HVPG <16 mm Hg (r = 0.456, p = 0.01) was similar to patients with HVPG ≥ 16 mm Hg (r = 0.499, p < 0.0001). The correlation was similar in the subgroup patients with alcoholic (r = 0.718, p < 0.0001), NASH (r = 0.740, p = 0.008), cryptogenic (r = 0.648, p = 0,0377), cholestatic and autoimmune (r = 0.706, p < 0.0001) and viral cirrhosis (r = 0.756, p < 0.0001). Liver stiffness distinguished patients with HVPG above 16, and 20 mm Hg with AUROCs 0.90243, and 0.86824, sensitivity 0.7656, and 0.7027, and specificity 0.9333, and 0.8750. All studied blood biomarkers correlated better with liver stiffness than with HVPG and their AUROCs did not exceed 0.8 at both HVPG thresholds. Therefore, a composite predictor superior to liver stiffness could not be established. We conclude that liver stiffness is a clinically reliable predictor of higher HVPG thresholds in non-drinking subjects with advanced liver cirrhosis.
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- elastografie metody MeSH
- fibróza patologie MeSH
- jaterní cirhóza patologie MeSH
- játra patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lineární modely MeSH
- portální hypertenze patologie MeSH
- portální tlak fyziologie MeSH
- prospektivní studie MeSH
- pružnost fyziologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- venae hepaticae patologie MeSH
- venózní tlak fyziologie 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
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
[Extraction of caval filter 7 years after placement]
Plicní embolie je závažné, mnohdy život ohrožující postižení kardiovaskulárního systému. Jako prevence plicní embolie se kromě medikamentózní terapie provádí také implantace kaválního filtru do dolní duté žíly. Představuje mechanickou překážku pro průnik krevních sraženin do plic. Předkládáme kazuistiku nemocné, které byl ALN kavální filtrimplantován před 7 lety po porodu, kdy byl prokázán vlající trombus v dolní duté žíle, trombus zasahoval až k odstupu pravé rená lni žíly. Proto byl filtrimplantován atypicky nad odstupy renálních žil. Sedm let po implantaci kaválního filtru přichází pacientka s neurčitými bolestmi v pravém podžebří k vyšetření. Protože nebezpečí plicní embolie pominulo, bylo rozhodnuto pokusit se o endovaskulámí odstranění tohoto filtru. Filtr byl úspěšně odstraněn, výkon proběhl bez komplikací, jen bylo nutné použít o 1 F větší sheath, nežje doporučeno, což lze patrně vysvětlit tím, že po dlouhé době implantace byly kotvící nožičky filtru potaženy fibrinem. Popisovaná kazuistika patří k případům, kde byl kavální filtr úspěšně odstraněn po poměrně dlouhé době po implantaci.
Pulmonary embolia is serious, often life threatening disease. As a pulmonary embolia prevention anticoagulation therapy is usually used, but in some cases inferior vena cava filter placement is employed. Filter creates a mechanical barrier preventing the passage of the embolus into lungs. We present a case of female patient with ALN caval filter placed 7 years ago after child delivery. She had floating thrombus in inferior vena cava, the top of the thrombus was up to ostium of right renal vein. It was the reason why the filter was placed atypically above renal veins level. Seven years after filter placement the patient complains on non-specific pain in right upper abdominal area. As the risk of pulmonary embolia is not present anymore it was decided to remove the filter by endovascular approach. The filter removal was successful and was complication-free. We had to use a sheath 1 F larger than recommended, most probably due to fibrin coating of the filter anchoring struts. Presented case belongs to the few presented case reports when the filter was removed after relatively long time after placement.
- Klíčová slova
- kavografie,
- MeSH
- dospělí MeSH
- kavální filtry * škodlivé účinky MeSH
- lidé MeSH
- plicní embolie terapie MeSH
- počítačová rentgenová tomografie MeSH
- tromboembolie terapie MeSH
- vena cava inferior diagnostické zobrazování patologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- cyklofosfamid aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- doxorubicin * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- duktální karcinom prsu diagnóza farmakoterapie MeSH
- kombinovaná farmakoterapie MeSH
- kyselina zoledronová terapeutické užití MeSH
- letrozol terapeutické užití MeSH
- lidé MeSH
- lobulární karcinom diagnóza farmakoterapie MeSH
- nádory prsu * diagnóza farmakoterapie MeSH
- pleurální výpotek chemicky indukované MeSH
- protinádorové látky MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Co-production of two or more desirable compounds from low-cost substrates by a single microbial catalyst could greatly improve the economic competitiveness of many biotechnological processes. However, reports demonstrating the adoption of such co-production strategy are still scarce. In this study, the ability of genome-edited strain Pseudomonas putida EM42 to simultaneously valorize d-xylose and d-cellobiose - two important lignocellulosic carbohydrates - by converting them into the platform chemical d-xylonate and medium-chain-length polyhydroxyalkanoates, respectively, was investigated. Biotransformation experiments performed with P. putida resting cells showed that promiscuous periplasmic glucose oxidation route can efficiently generate extracellular xylonate with a high yield. Xylose oxidation was subsequently coupled to the growth of P. putida with cytoplasmic β-glucosidase BglC from Thermobifida fusca on d-cellobiose. This disaccharide turned out to be a better co-substrate for xylose-to-xylonate biotransformation than monomeric glucose. This was because unlike glucose, cellobiose did not block oxidation of the pentose by periplasmic glucose dehydrogenase Gcd, but, similarly to glucose, it was a suitable substrate for polyhydroxyalkanoate formation in P. putida. Co-production of extracellular xylose-born xylonate and intracellular cellobiose-born medium-chain-length polyhydroxyalkanoates was established in proof-of-concept experiments with P. putida grown on the disaccharide. This study highlights the potential of P. putida EM42 as a microbial platform for the production of xylonate, identifies cellobiose as a new substrate for mcl-PHA production, and proposes a fresh strategy for the simultaneous valorization of xylose and cellobiose.
PURPOSE: To assess the efficacy of percutaneous techniques in managing paediatric liver transplantation complications. MATERIAL AND METHODS: We carried out 105 paediatric cadaveric donor liver transplantations at our centre from 2001 to 2018. Percutaneous techniques were used to treat 25 cases involving transplantation complications in 23 patients. Biliary complications were treated in 14 cases (13.3%): 10 patients had bile duct obstruction, and 4 had biliary leaks. Vascular complications were treated in 11 cases (10.5%): 5 hepatic artery (HA) stenoses/occlusions, 2 inferior vena cava (IVC) stenoses, and 1 portal vein (PV) stenosis. Other interventions involved embolisation of the superior mesenteric artery branch to manage gastrointestinal bleeding in 2 patients and embolisation of an arteriobiliary fistula in 1 patient. RESULTS: Biliary: We carried out external-internal drainage and balloon dilatation of stenoses in 12 cases. The external-internal drainage catheter was removed after 6-8 weeks in 7 patients, with the remaining 5 patients with persisting stenosis assigned for retransplantation. We failed to cross anastomotic occlusions in 2 patients before completing the procedures using external drainage; both individuals subsequently underwent retransplantation. Vascular: We performed PTA/stenting of HA stenoses/occlusions in 4 out of 5 patients. After the procedure, all 4 patients showed liver function normalisation. All 3 cases of embolisation were technically and clinically successful. Both IVC and PV stenoses treated with dilatation/stenting were also successful. CONCLUSIONS: Percutaneous techniques used to treat biliary and vascular complications after liver transplantation in paediatric patients are safe and efficient.
- MeSH
- arteriální okluzní nemoci diagnostické zobrazování terapie MeSH
- cholestáza diagnostické zobrazování terapie MeSH
- dítě MeSH
- drenáž metody MeSH
- intervenční radiologie metody MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- pooperační komplikace diagnostické zobrazování terapie MeSH
- předškolní dítě MeSH
- stenty MeSH
- terapeutická embolizace metody MeSH
- transplantace jater * MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Sulfate-reducing bacteria (SRB) are anaerobic microorganisms, which use sulfate as an electron acceptor in the process of dissimilatory sulfate reduction. The final metabolic product of these anaerobic microorganisms is hydrogen sulfide, which is known as toxic and can lead to damage to epithelial cells of the large intestine at high concentrations. Different genera of SRB are detected in the large intestine of healthy human and animals, and with diseases like Crohn's disease and ulcerative colitis. SRB isolated from rodents with ulcerative colitis have produced 1.14 (mice) and 1.03 (rats) times more sulfide ions than healthy rodents. The species of Desulfovibrio genus are the most widespread among all SRB in the intestine. The object of our research was to observe and compare the difference of production of sulfide and reduction of sulfate in intestinal SRB isolated from healthy rodents and rodents with ulcerative colitis.
- Publikační typ
- časopisecké články MeSH