For the treatment of bilateral limbal stem cell deficiency (LSCD), cell therapy with transplantation of cultivated oral mucosa epithelial cells (COMET) is a promising alternative. Although not yet established, current protocols on the cultivation of oral mucosal epithelial cell (OMECs) sheets are based mainly on substrates and xenobiotic additives that may lead to variable outcomes and undesirable immune responses by the patient. The aim of this study was to characterize OMECs cultivated in xenobiotic-free media (XF) seeded on fibrin gel, in comparison to conventional complex (COM) medium. Oral mucosal biopsies were retrieved from 31 donors. After cultivation in COM or XF medium, OMECs were compared based on growth kinetics, morphology, cell size and viability. Using immunofluorescence and gene expression analyses, the degree of stemness, proliferation and differentiation was evaluated in OMEC cultures. Our findings showed that although OMECs showed a similar morphology and viability, and comparable growth kinetics, immunofluorescence revealed the preservation of stemness (p63 + p40 positivity in cells ≤11 μm) and proliferation in both COM and XF. Gene expression analyses showed that keratin (K)13 and K15 expression levels were significantly higher in XF (adj. p < 0.001), but otherwise COM and XF-treated OMECs had comparable transcriptional profiles in a panel of stemness, proliferation and differentiation genes. These results demonstrate the feasibility of culturing OMECs on fibrin gel without xenogeneic additives, while maintaining their undifferentiated state and preserving stemness. In conclusion, both in terms of results and methodology, the procedures presented here are suitable for implementation in clinical practice.

• MeSH
• buněčná diferenciace MeSH
• buněčné kultury * MeSH
• deficit limbálních kmenových buněk MeSH
• dospělí MeSH
• epitelové buňky * metabolismus   účinky léků   MeSH
• fibrin * MeSH
• gely MeSH
• kmenové buňky * metabolismus   cytologie   MeSH
• kultivační média MeSH
• kultivované buňky MeSH
• lidé středního věku MeSH
• lidé MeSH
• limbus corneae * cytologie   patologie   metabolismus   MeSH
• nemoci rohovky patologie   farmakoterapie   metabolismus   MeSH
• proliferace buněk účinky léků   MeSH
• rohovkový epitel metabolismus   cytologie   účinky léků   patologie   MeSH
• senioři MeSH
• transplantace kmenových buněk metody   MeSH
• ústní sliznice * cytologie   MeSH
• viabilita buněk MeSH
• xenobiotika farmakologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Cíl studie: Zkoumání vztahu mezi závažností metabolických změn vyvolaných COVID-19 a strukturou a četností změn na sítnici podle dat z vyšetření očních pozadí pacientů s různým klinickým průběhem onemocnění COVID-19. Materiál a metody: Vyšetřeno bylo 117 pacientů s onemocněním COVID-19. Při vyšetření pacientů byla zjišťována závažnost průběhu onemocnění COVID-19 a expresivita metabolických změn; záznam obrazu očních pozadí byl pořizován pomocí přenosných fundus kamer Pictor Plus Fundus Camera a VistaView (Volk Optical). Výsledky: Výsledkem výzkumu je zjištění změn na sítnici u 49 (41,9 %) pacientů s onemocněním COVID-19. V 8 (16,3 %) případech byly pozorovány klinicky významné změny sítnice a oka indukované infekcí COVID-19 (krvácení do sklivce, pretrombóza centrální sítnicové žíly nebo větví centrální sítnicové žíly, trombóza centrální sítnicové žíly nebo větví centrální sítnicové žíly), které vedly ke snížení zrakové ostrosti. Ve 41 (83,7 %) případech byly pozorovány klinicky nevýznamné změny sítnice indukované infekcí COVID-19 (vatovitá ložiska, zúžené sítnicové cévy, intraretinální a petechiální krvácení, tortuozita a dilatace sítnicových venul). Klinicky významné změny na sítnici se vyskytly u pacientů se statisticky významně vyšší hladinou D-dimerů a vyšším procentuálním výskytem lézí plicního parenchymu oproti skupině pacientů s klinicky nevýznamnými sítnicovými změnami (p < 0,05). Závěry: Struktura retinálních změn u pacientů s COVID-19 koreluje se závažností klinického průběhu onemocnění a metabolických změn pacientů. Metabolické změny korelují se změnami sítnice a mohou mít prediktivní význam v prevenci celkových cévních komplikací spojených s onemocněním COVID-19.

Aims: To study the relationship between the severity of COVID-induced metabolic changes and the structure and frequency of retinal chan- ges, according to funduscopy data in patients with different clinical courses of COVID-19. Materials and methods: 117 patients with COVID-19 were examined. While examining patients, severity of the course of COVID-19, the expressiveness of changes in the metabolic status were determined; fundus image registration was performed with portable fundus cameras Pictor Plus Fundus Camera and VistaView (Volk Optical). Results: As a result of the research, retinal changes were found in 49 (41.9 %) patients with COVID-19. In 8 (16.3 %) cases, clinically significant (vitreous hemorrhage, prethrombosis of the central retinal vein or branches of the central retinal vein, thrombosis of the central retinal vein or branches of the central retinal vein) COVID-induced retinal and ophthalmological changes were observed, which caused a decrease in visual acuity. In 41 (83.7 %) cases, clinically insignificant changes (cotton wool spots, narrowed retinal vessels, intraretinal and petechial hemorrhages, tortuosity and dilatation of retinal venules) COVID-induced retinal changes were observed. Clinically significant retinal changes occur in patients with a statistically significantly higher level of D-dimer and a greater percentage of lung parenchyma lesion than in the group of patients with clinically insignificant retinal changes (p < 0.05). Conclusions: The structure of retinal changes in patients with COVID-19 correlates with the severity of the clinical course of the disease and changes in the metabolic status of patients. Metabolic changes are correlated with retinal changes and can be predictive for preventing general vascular complications in COVID-19.

• MeSH
• COVID-19 * komplikace   virologie   MeSH
• fibrin-fibrinogen - produkty degradace analýza   MeSH
• lidé MeSH
• metabolické nemoci diagnóza   klasifikace   virologie   MeSH
• retina * patologie   virologie   MeSH
• retinální cévy patologie   virologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• klinická studie MeSH

PRCIS: Deep sclerectomy (DS) with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing nonallergenic, nontoxic, and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively. OBJECTIVE: To evaluate short and medium-term postoperative results of DS with a fibrin sealant. PATIENTS AND METHODS: This prospective, noncomparative, interventional case series involves 12 eyes of 12 patients with uncontrolled open angle glaucoma who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon fascia, and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure and glaucoma therapy reduction, best-corrected visual acuity changes, and number of complications registered peri and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9, and 12 months after surgery. RESULTS: The mean intraocular pressure decreased from 24.0 ± 9.1 mm Hg to 13.8 ± 6.3 mm Hg at 1 year postoperatively ( P < 0.001). Kaplan-Meier survival analysis revealed complete and qualified success rates of 83.3% and 91.7%. The mean glaucoma therapy decreased from 3.2 ± 1.1 to 0.8 ± 1.3 drugs 12 months after surgery ( P < 0.001). Nd:YAG goniopunture was performed in 2 eyes at 1 and 12 months postoperatively. No significant best-corrected visual acuity changes were registered. Perioperatively, we noted a trabeculo-descemet microperforation in 1 eye, transient hypotony in 5 eyes, and mild hyphema in 2 eyes. CONCLUSIONS: Fibrin adhesive provided an effective closure in sutureless DS in the patients included in our study. This modification of classical DS may simplify the surgical technique, ensure secure wound adaptation, optimize healing, and lower the risk of inflammation and fibrosis postoperatively.

• MeSH
• bezstehová chirurgie * metody   MeSH
• drenážní implantáty glaukomové MeSH
• fibrinová tkáňová adheziva * terapeutické užití   MeSH
• glaukom s otevřeným úhlem * chirurgie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• nitrooční tlak * fyziologie   MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• skléra * chirurgie   MeSH
• sklerostomie * metody   MeSH
• tkáňová adheziva * terapeutické užití   MeSH
• tonometrie oční MeSH
• výsledek terapie MeSH
• zraková ostrost * fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Aim: Analysis of the data of patients investigated in the Tabor Hospital for suspected pulmonary embolism with CT pulmonary angiogram (CTPA) in one year from March 2019 until February 2020. Evaluation of the usefulness of the Revised Geneva Score (RGS) in this group. Methods: Retrospective analysis of the data of all patients who underwent CTPA for suspected pulmonary embolism in the Department of Radiology in Tábor Hospital from March 2019 until February 2020. RGS value was calculated and compared with known CTPA results. Other clinical and laboratory parameters and their usefulness in prediction of pulmonary embolism diagnosis on CTPA were evaluated. Results: Total 584 consecutive patients were analysed. Three patients were excluded due to missing data. Pulmonary embolism was diagnosed in 132 (22.6%) patients (71 men, 53.8%); given the population of the Tábor region 102 451 inhabitants it means that the pulmonary embolism incidence is almost 129/100 000. Low probability of pulmonary embolism according to RGS was estimated in 37.2% patients, intermediate probability in 62.5%, high probability in 0.3%. The most frequent symptom was dyspnea (342 patients; 58%). The AUC of RGS in this cohort was 0.64. In a multivariate analysis, the predictors of pulmonary embolism on CTPA were RGS (OR 1.27 for one point, p <0,001) and D-dimers (OR 1.19 for μg/L, p <0.001), masculine sex (OR 1.99, p = 0.031). History of ischemic heart disease was a negative predictor (OR 0.31, p = 0.027). Even the combined model is insufficient to replace CTPA (AUC 0.78). Conclusion: Our cohort shows higher than usually reported incidence of pulmonary embolism. It confirms the trend of increasing pulmonary embolism incidence. The usefulness of RGS in patients already indicated to CTPA is relatively low. Even a combined model with RGS and other predictors including D-dimers is insuf- ficient to replace CTPA in such patients.

• Klíčová slova
• Revidované ženevské skóre,
• MeSH
• CT angiografie metody   MeSH
• dyspnoe etiologie   MeSH
• fibrin-fibrinogen - produkty degradace analýza   metabolismus   MeSH
• incidence MeSH
• lidé MeSH
• plicní embolie * diagnostické zobrazování   diagnóza   epidemiologie   prevence a kontrola   MeSH
• retrospektivní studie MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Geografické názvy
• Česká republika MeSH

• Klíčová slova
• eculizumab,
• MeSH
• antikoagulancia aplikace a dávkování   MeSH
• aplastická anemie farmakoterapie   krev   patologie   MeSH
• dospělí MeSH
• fibrin-fibrinogen - produkty degradace analýza   MeSH
• hematologické komplikace těhotenství krev   terapie   MeSH
• hormony kůry nadledvin aplikace a dávkování   MeSH
• humanizované monoklonální protilátky aplikace a dávkování   MeSH
• isoprotilátky krev   MeSH
• lidé MeSH
• paroxysmální hemoglobinurie * etiologie   krev   patologie   terapie   MeSH
• těhotenství MeSH
• žilní trombóza diagnostické zobrazování   etiologie   patologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• biologické markery MeSH
• diagnostické techniky kardiovaskulární * MeSH
• fibrin-fibrinogen - produkty degradace MeSH
• kardiovaskulární nemoci diagnóza   MeSH
• lidé MeSH
• natriuretické peptidy MeSH
• natriuretický peptid typu B MeSH
• point of care testing MeSH
• srdeční selhání diagnóza   MeSH
• troponin MeSH
• Check Tag
• lidé MeSH

BACKGROUND: The presence of an outer shell has been recently described as a common feature of acute ischemic stroke (AIS) thrombi. We performed a systematic review of the current literature on shell genesis, structure, and clinical significance. METHODS: Following PRISMA guidelines, we searched Ovid Cochrane Central Register of Controlled Trials, Embase, Medline, Scopus, and Web of Science for studies reporting the composition and structure of AIS thrombi and clot analogs. Identified studies were added to Covidence software for primary screening. Two reviewers independently screened titles and abstracts followed by full-text screening. RESULTS: From 1290 identified studies, 10 were included in this review. Studies using histology/immunohistochemistry/immunofluorescence described fibrin, platelets, von Willebrand factor, and neutrophil extracellular traps as the main components of the shell. Scanning electron microscopy demonstrated a dense, compact fibrin/platelet-rich shell, and a core rich in polyhedrocytes. Microfluidics studies identified highly activated P-selectin-positive platelets and fibrin forming the core while secondary agonists adenosine diphosphate and thromboxane, along with loosely packed P-selectin-negative platelets constituted the shell. CONCLUSIONS: The composition, compaction, and integrity of the shell may impact thrombolysis and revascularization outcomes. The preponderance of studies supported this conclusion.

• MeSH
• biologie MeSH
• cévní mozková příhoda * MeSH
• fibrin MeSH
• ischemická cévní mozková příhoda * MeSH
• lidé MeSH
• P-selektin MeSH
• trombóza * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH

PURPOSE: Due to thromboembolic complications and in-stent-stenosis after flow diverter (FD) treatment, the long-term use of dual antiplatelet treatment (DAPT) is mandatory. The tested nano-coating has been shown to reduce material thrombogenicity and promote endothelial cell proliferation in vitro. We compared the biocompatibility of coated (Derivo Heal) and non-coated (Derivo bare) FDs with DAPT in an animal model. METHODS: Derivo® bare (n = 10) and Derivo® Heal (n = 10) FD were implanted in the common carotid arteries (CCAs) of New Zealand white rabbits. One additional FD, alternately a Derivo bare (n = 5) or Derivo Heal (n = 5), was implanted in the abdominal aorta (AA) for assessment of the patency of branch arteries. Histopathological examinations were performed after 28 days. Angiography was performed before and after FD implantation and at follow-up. RESULTS: Statistical analysis of the included specimens showed complete endothelialization of all FDs with no significant differences in neointima thickness between Derivo® bare and Derivo® Heal (CCA: p = 0.91; AA: p = 0.59). A significantly reduced number of macrophages in the vessel wall of the Derivo Heal was observed for the CCA (p = 0.02), and significantly reduced fibrin and platelet deposition on the surface of the Derivo Heal was observed for the AA. All branch arteries of the stented aorta remained patent. CONCLUSION: In this animal model, the novel fibrin-based coated FD showed a similar blood and tissue compatibility as the non-coated FD.

• MeSH
• arteria carotis communis MeSH
• biokompatibilní potahované materiály MeSH
• fibrin * MeSH
• králíci MeSH
• neointima MeSH
• stenty * MeSH
• trombocyty MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

We describe the internal structure, spatial organization and dynamic formation of coronary artery thrombi from ST-segment elevation myocardial infarction patients. Scanning electron microscopy (SEM) revealed significant differences among four groups of patients (<2 hours; 2-6 hours; 6-12 hours, and >12 hours) related to the time of ischemia. Coronary artery thrombi from patients presenting less than 2 hours after the infarction were almost entirely composed of platelets, with small amounts of fibrin and red blood cells. In contrast, thrombi from late presenters (>12 hours) consisted of mainly platelets at the distal end, where clotting was initiated, with almost no platelets at the proximal end, while the red blood cell content went from low at the initiating end to more than 90% at the proximal end. Furthermore, fibrin was present mainly on the outside of the thrombi and older thrombi contained thicker fibers. The red blood cells in late thrombi were compressed to a close-packed, tessellated array of polyhedral structures, called polyhedrocytes. Moreover, there was redistribution from the originally homogeneous composition to fibrin and platelets to the outside, with polyhedrocytes on the interior. The presence of polyhedrocytes and the redistribution of components are signs of in vivo clot contraction (or retraction). These results suggest why later thrombi are resistant to fibrinolytic agents and other treatment modalities, since the close-packed polyhedrocytes form a nearly impermeable seal. Furthermore, it is of particular clinical significance that these findings suggest specific disparate therapies that will be most effective at different stages of thrombus development.

• MeSH
• čas zasáhnout při rozvinutí nemoci MeSH
• časové faktory MeSH
• erytrocyty patologie   MeSH
• fibrin analýza   MeSH
• fibrinolytika * aplikace a dávkování   škodlivé účinky   MeSH
• hemokoagulace účinky léků   fyziologie   MeSH
• infarkt myokardu s elevacemi ST úseků * etiologie   terapie   MeSH
• koronární trombóza * diagnostické zobrazování   farmakoterapie   metabolismus   patologie   MeSH
• léková rezistence fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikroskopie elektronová rastrovací metody   MeSH
• trombektomie metody   MeSH
• trombocyty patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Cíl: Cílem této studie bylo měřit hodnoty D-dimeru a zjistit jejich vztah k hluboké žilní trombóze (HŽT) a mortalitě pacientů s onemocněním COVID-19. Metoda: Z populace přibližně 1 200 pacientů, u nichž se provádělo vyšetření HŽT obou dolních končetin dopplerovským ultrazvukem, byl vytvořen vzorek sestávající ze 100 pacientů s HŽT a 100 jedinců bez HŽT. Kromě pohlaví a věku účastníků se stanovovaly hodnoty D-dimeru v následujících intervalech > 20 μg/ml, 10 až 20 μg/ml, 5 až 10 μg/ml, 3 až 5 μg/ml a < 3 μg/ml. Sledoval se vztah mezi kategorií hodnot D-dimeru a mortalitou. Výsledky: Průměrné hodnoty D-dimeru ve skupinách s/bez HŽT byly 11,90, resp. 4,97 μg/ml; tento rozdíl byl statisticky významný (p = 0,0001, párový t test). Mortalita byla vyšší než 35 % u pacientů bez HŽT a s hodnotami D-dimeru > 3 μg/ml. Ve skupině s HŽT byla mortalita vyšší než 55 % nezávisle na hodnotě D-dimeru. Závěr: Stanovení hodnot D-dimeru je naprosto zásadní při screeningu hluboké žilní trombózy u pacientů s onemocněním COVID-19, protože vyšší hodnoty D-dimeru jsou spojeny s vyšší mortalitou a přítomností hluboké žilní trombózy.

Aim: The aim of the present study was to analyze D-dimer levels and associate these levels with deep vein thrombosis and mortality in patients with COVID-19. Method: From a population of approximately 1200 patients evaluated for the investigation of deep vein thrombosis (DVT) of the lower limbs using bilateral venous Doppler ultrasound, 100 positive for DVT and 100 negative for DVT were selected to compose the present sample. Data were collected on sex, age and D-dimer levels. D-dimer levels were categorized as follows: > 20 μg/mL, 10 to 20 μg/mL, 5 to 10 μg/mL, 3 to 5 μg/mL and < 3 μg/mL. The association between D-dimer category and mortality was evaluated. Results: The mean D-dimer level was 11.90 and 4.97 μg/mL in the groups with and without DVT; this difference was significant (p = 0.0001, paired t-test). The mortality rate was higher than 35% in patients without DVT and with D-dimer > 3 μg/mL. In the group with DVT, the mortality rate was higher than 55% independently of the D-dimer level. Conclusion: The assessment of the D-dimer level is fundamental in screening for deep vein thrombosis in patients with COVID-19, as higher levels are associated with greater mortality and the presence of deep vein thrombosis.

• MeSH
• biologické markery analýza   MeSH
• COVID-19 epidemiologie   komplikace   MeSH
• fibrin-fibrinogen - produkty degradace * analýza   MeSH
• komorbidita MeSH
• lidé MeSH
• mortalita MeSH
• žilní trombóza diagnostické zobrazování   epidemiologie   komplikace   MeSH
• Check Tag
• lidé MeSH