BACKGROUND: The sural nerve is a somatosensory nerve that provides sensation to the posterolateral aspect of the lower leg and the lateral part of the ankle and foot. Due to its location and anatomical properties, it is often used as an autologous nerve graft. However, the nerve harvest can be complicated by the presence of side branches. The objective of this study was to investigate the anatomy of the sural nerve and to map its side branches. This information can be used to predict the localization of separate incisions during the stair-step incisions technique for nerve harvest, thereby reducing the risk of complications. METHODS: The study involved the dissection of 50 adult cadaveric legs (25 left and 25 right) obtained from 27 Central European cadavers. The focus of the dissection was to identify the sural nerve, small saphenous vein, and surrounding anatomical structures. Detailed measurements were taken on the side branches of the sural nerve, tributaries of the small saphenous vein, and their interrelationship. RESULTS: The average number of sural nerve side branches in a single leg was 4.2±1.9. These side branches were categorized into six groups based on their location and course: mediodistal, medioproximal, lateroproximal, laterodistal, medial perpendicular, and lateral perpendicular. Specific patterns of combination of these side branches were also identified and described. The branching point of the sural nerve was found to be 5.8±2.7 cm proximal to the lateral malleolus, whereas the small saphenous vein branching point was located more distally, 4.5 ± 2.8 cm proximal to the lateral malleolus. The highest density of sural nerve side branches was found 2.1-6.0 cm above the lateral malleolus. CONCLUSION: This study presents valuable data about the relationship between the sural nerve and the surrounding anatomical structures in the distal part of the leg, including the identification of its side branches and their relevance during nerve harvest procedures. On the basis of the most frequent locations of side branches, a three-incision-technique for nerve harvest is proposed.

• MeSH
• bérec * inervace   anatomie a histologie   MeSH
• disekce MeSH
• lidé středního věku MeSH
• lidé MeSH
• mrtvola * MeSH
• nervus suralis * anatomie a histologie   MeSH
• odběr tkání a orgánů metody   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vena saphena anatomie a histologie   inervace   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

One of the challenges in clinical translation of cell-replacement therapies is the definition of optimal cell generation and storage/recovery protocols which would permit a rapid preparation of cell-treatment products for patient administration. Besides, the availability of injection devices that are simple to use is critical for potential future dissemination of any spinally targeted cell-replacement therapy into general medical practice. Here, we compared the engraftment properties of established human-induced pluripotent stem cells (hiPSCs)-derived neural precursor cell (NPCs) line once cells were harvested fresh from the cell culture or previously frozen and then grafted into striata or spinal cord of the immunodeficient rat. A newly developed human spinal injection device equipped with a spinal cord pulsation-cancelation magnetic needle was also tested for its safety in an adult immunosuppressed pig. Previously frozen NPCs showed similar post-grafting survival and differentiation profile as was seen for freshly harvested cells. Testing of human injection device showed acceptable safety with no detectable surgical procedure or spinal NPCs injection-related side effects.

• MeSH
• buněčná diferenciace fyziologie   MeSH
• dospělí MeSH
• genetické vektory genetika   MeSH
• indukované pluripotentní kmenové buňky * fyziologie   transplantace   MeSH
• krysa rodu rattus MeSH
• lidé MeSH
• mícha MeSH
• mozek MeSH
• nervové kmenové buňky * fyziologie   transplantace   MeSH
• odběr biologického vzorku metody   MeSH
• odběr tkání a orgánů metody   MeSH
• prasata MeSH
• přeprogramování buněk * genetika   fyziologie   MeSH
• přežívání štěpu fyziologie   MeSH
• spinální injekce * škodlivé účinky   přístrojové vybavení   metody   MeSH
• transplantace kmenových buněk * škodlivé účinky   přístrojové vybavení   metody   MeSH
• virus Sendai MeSH
• výsledek terapie MeSH
• zvířata MeSH
• Check Tag
• dospělí MeSH
• krysa rodu rattus MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• lidé MeSH
• odběr tkání a orgánů * metody   MeSH
• transplantace orgánů metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Colorectal cancer (CRC) develops as a consequence of inherited multiple low-risk variants in concurrence of environmental factors. Nutrition and intestinal microbiota exert an effect on DNA damage accumulation and its repair (maintaining universal genomic stability and preserves cellular functions), intestinal metabolism, immunological activity and substantially affect the efficacy of chemotherapy. Integrated studies should unveil in humans the role of A) Taste perception, intestinal microbiota, DNA damage and repair in CRC risk (CRC patients vs. control individuals); B) Intestinal microbiota, DNA damage and repair as prognostic markers of CRC progression, treatment efficacy and survival. Monitoring of taste perception and intestinal microenvironment with simultaneous determinations of DNA damage response and repair in cancer patients represent substantial novel contribution. Our project further aims to integrate above parameters into the prognostic and therapeutical considerations, which ultimately result in individually tailored therapy and improved quality of the life.

Nádory tlustého střeva a konečníku (CRC) vznikají v důsledku souhry četných genových variant s faktory životního prostředí. Výživa a střevní mikroflóra významně ovlivňují akumulaci poškození DNA, jejich opravu (udržující genomovou stabilitu a buněčné funkce), jakož i střevní metabolismus, imunologickou aktivitu, a hrají výraznou roli v odpovědi na chemoterapii. V našich studiích se budeme zabývat A) Vnímáním chuti, střevní mikroflórou, poškozením DNA a kapacitou DNA oprav jako faktorů ovlivňujících vznik CRC (pacienti versus kontrolní osoby); B) Střevní mikroflórou, poškozením DNA a kapacitou DNA oprav jako prognostickými znaky progrese CRC, účinnosti terapie a přežívání. Monitorování chuťového vnímání a střevní mikroflóry při současném stanovování kapacity oprav DNA poškození u pacientů s CRC představuje zásadně nový přístup. V naší studii dále zamýšlíme integrovat sledované parametry do prognostických a terapeutických úvah, jež v konečném důsledku přispějí k individualizované terapii a zlepšené kvalitě života pacientů.

• MeSH
• chirurgie trávicího traktu MeSH
• geny rRNA MeSH
• kolorektální nádory MeSH
• lidé MeSH
• messenger RNA MeSH
• odběr tkání a orgánů metody   MeSH
• polymerázová řetězová reakce MeSH
• preanalytická fáze MeSH
• reprodukovatelnost výsledků MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• srovnávací studie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• onkologie
• gastroenterologie
• experimentální medicína
• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR

PURPOSE OF THE STUDY The clinical prospective study presents the results of minimally invasive harvesting of cancellous bone tissue in trauma indications. We focused on evaluating the clinical outcomes of this technique, particularly on the amount of cancellous bone harvested, the effectiveness of its use and complications. The pain in the bone graft harvest site is evaluated and compared with the pain after a standard harvest from the iliac crest. MATERIAL AND METHODS All the patients aged 18-90 years, in whom cancellous bone was harvested by minimally invasive technique using a bone cutter were included prospectively in the study. It was used to fill the defect in treating a fracture or in surgical treatment of non-union. The patients, in whom the grafts harvested in this manner were combined with another substitute, were not included in the study. Thus, 57 adult patients (40 men, 17 women) were included in the group in the period from March 2012 to March 2016. 37 patients, i.e. 65% of the total number of 57 patients, arrived for the evaluation of the clinical outcome. The minimally invasive graft harvesting was performed using the Aesculap® cutters. The graft was harvested either from the skeleton directly in the area of surgical wound or by a mini incision above the harvest site in the area under surgical drapes. The diameter of the cutter was selected based on the planned necessary number of grafts and with account taken of the harvest site. There were 6 harvest sites selected - proximal humerus, proximal ulna, iliac crest, greater trochanter of femur, distal femur and proximal tibia. The age and gender of patients, harvest site, type of the used cutter and the total number of harvested grafts were recorded in the study. The patients underwent a clinical follow-up at 6 weeks, 3 months, 6 months and 1 year postoperatively. The healing of the fracture or non-union was assessed on radiographs and in case of any doubt a CT scan was indicated. The pain at the graft harvest site was quantified with the use of the VAS score. A possible correlation between the age and the harvest site pain was explored by means of the Pearson s correlation coefficient. RESULTS In surgical management of fractures, 10.98 cm³ of bone marrow (σ 5.32) was harvested on average, in non-unions it was 10.85 cm³ (σ 5.52). With the above described technique, the mean healing time of lower extremity fractures was 26 weeks, in upper extremity it was 22 weeks. The non-unions of lower extremity and upper extremity healed after 28 weeks and 19 weeks, respectively. The average pain at the harvest site was 4.08 (σ 2.21, p ˂ 0.001). By calculating the Pearson's correlation coefficient it was confirmed that there is no correlation between the age and pain VAS score at the harvest site (r = -0.05). No early complications at the graft harvest site were observed in our group of patients. DISCUSSION On average, 10.98 cm³ of bone marrow was harvested in treated fractures, which in comparison to standard harvests from the iliac crest offers sufficient amount of tissue to treat complicated fractures and non-unions. Technically, the standard harvest site of cancellous bone tissue from the iliac crest is replaceable. The harvesting technique offers an interesting alternative also in terms of the duration of surgery and material. CONCLUSIONS Our study confirmed that by the minimally invasive technique of bone graft harvesting adequate amount of tissue to treat defect fractures and non-unions can be harvested. Spongioplasty using grafts harvested in this manner is effective, with a minimum percentage of non-unions. The advantage of this technique is the proximity of the harvest site and the operative field and low level of pain. The minimally invasive graft harvesting represents a technique with a low risk of postoperative and late complications. Key words: bone graft, autografts, minimally invasive surgery, ilium, pain.

• MeSH
• dospělí MeSH
• fraktury kostí chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nezhojené fraktury chirurgie   MeSH
• odběr tkání a orgánů metody   MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• trabekulární kostní tkáň transplantace   MeSH
• transplantace kostí metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinická studie MeSH

Background: Laparoscopic surgery is a very modern and sophisticated method of surgical treatment and as such requires different equipment, different equipment layout, surgical team and a special patient position. The first human laparoscopy was performed by von Jacobeus in 1910 in Sweden, to diagnose ascites and this method was mainly used by gastroenterologists. Since 1980, after the first laparoscopic surgeries, such as laparoscopic appendectomy, cholecystectomy, laparoscopic colon surgery etc., surgeons have taken a leading role in the application of laparoscopy. Objective: A laparoscopic surgeon should work slowly and safely, stop work if he does not have a good examination of the operative field, and his technique is dominated by good control of hemostasis. Ergonomic specifics of instruments, equipment, and specific position of the surgeon during the operation are important in laparoscopy. The application of laparoscopic surgery in patients with COVID-19 infection is the topic of this article. Methods: We analyzed all patients operating laparoscopically who were simultaneously infected with COVID-19 virus. Results/Diskussion: Laparoscopic surgery has numerous advantages compared to open surgery, which has been established in clinical studies: faster recovery of patients, fewer complications, less pain, aesthetic results are better, and the economic effects are on the side of laparoscopy. The application of laparoscopic surgery at the time of COVID-19 infection requires some answers that we do not yet have. Is there a possibility of contamination of the surgical team with gas from the abdomen? Does increased intra-abdominal pressure adversely affect a COVID-19 infected patient? All of this requires the larger clinical trials that await us. Conclusion: Laparoscopic surgery has an advantage over open surgery in standard conditions. In patients infected with COVID-19, the use of laparoscopic surgery is associated with certain aggravating factors that require additional clinical trials.

• MeSH
• břicho chirurgie   MeSH
• chirurgické nástroje MeSH
• COVID-19 MeSH
• diagnostické techniky chirurgické MeSH
• ergonomie MeSH
• laparoskopie * dějiny   metody   trendy   MeSH
• odběr tkání a orgánů metody   MeSH
• pánev chirurgie   MeSH
• pneumoperitoneum umělé metody   MeSH
• postura těla MeSH

BACKGROUND: Europe is currently the most active region in the field of pancreatic islet transplantation, and many of the leading groups are actually achieving similar good outcomes. Further collaborative advances in the field require the standardization of islet cell product isolation processes, and this work aimed to identify differences in the human pancreatic islet isolation processes within European countries. METHODS: A web-based questionnaire about critical steps, including donor selection, pancreas processing, pancreas perfusion and digestion, islet counting and culture, islet quality evaluation, microbiological evaluation, and release criteria of the product, was completed by isolation facilities participating at the Ninth International European Pancreas and Islet Transplant Association (EPITA) Workshop on Islet-Beta Cell Replacement in Milan. RESULTS: Eleven islet isolation facilities completed the questionnaire. The facilities reported 445 and 53 islet isolations per year over the last 3 years from deceased organ donors and pancreatectomized patients, respectively. This activity resulted in 120 and 40 infusions per year in allograft and autograft recipients, respectively. Differences among facilities emerged in donor selection (age, cold ischemia time, intensive care unit length, amylase concentration), pancreas procurement, isolation procedures (brand and concentration of collagenase, additive, maximum acceptable digestion time), quality evaluation, and release criteria for transplantation (glucose-stimulated insulin secretion tests, islet numbers, and purity). Moreover, even when a high concordance about the relevance of one parameter was evident, thresholds for the acceptance were different among facilities. CONCLUSIONS: The result highlighted the presence of a heterogeneity in the islet cell product process and product release criteria.

• MeSH
• časové faktory MeSH
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• kultivované buňky transplantace   MeSH
• Langerhansovy ostrůvky cytologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• odběr tkání a orgánů metody   normy   statistika a číselné údaje   MeSH
• perfuze metody   statistika a číselné údaje   MeSH
• počet buněk normy   statistika a číselné údaje   MeSH
• předškolní dítě MeSH
• primární buněčná kultura metody   normy   statistika a číselné údaje   MeSH
• průzkumy a dotazníky statistika a číselné údaje   MeSH
• senioři MeSH
• separace buněk metody   statistika a číselné údaje   MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• studená ischemie normy   statistika a číselné údaje   MeSH
• transplantace Langerhansových ostrůvků metody   normy   MeSH
• věkové faktory MeSH
• výběr dárců metody   normy   statistika a číselné údaje   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

Although uterus transplantation is still in the experimental stage, it has promising potential as a treatment for women with absolute uterine factor infertility based on the childbirths from living donor trials conducted in Sweden and the United States. We report the main characteristics and perioperative and postoperative courses of both recipients and donors following 4 deceased donor and 5 living donor uterus transplantations. Three main priorities differentiate this study from the previously reported uterus transplantations. First, clinical experience with the largest worldwide group of deceased donor uterine transplants is described. Second, in the majority of living donor uterine recipients, only 2 ovarian veins were used for venous blood outflow. All of these recipient procedures were surgically successful, and follow-up posttransplant ultrasound examinations revealed normal uterine blood supply and outflow. Third, in only one living and one deceased donor recipient, the transplanted uterus relied on only 2 uterine veins for venous outflow with a 50% surgical success rate. In all other recipients, 2 uterine and 2 ovarian veins were utilized. Although a successful pregnancy has not yet been achieved, the presented surgical and functional results of our trial are promising.

• MeSH
• dárci tkání zásobování a distribuce   MeSH
• dospělí MeSH
• klinické zkoušky jako téma MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• následné studie MeSH
• odběr tkání a orgánů metody   MeSH
• přežívání štěpu MeSH
• prognóza MeSH
• smrt * MeSH
• transplantace orgánů metody   MeSH
• uterus transplantace   MeSH
• ženská infertilita chirurgie   MeSH
• žijící dárci zásobování a distribuce   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Surgical factors and direct cytotoxicity of bile salts on cholangiocytes may play a role in the development of ischemic cholangiopathy (IC) after liver transplantation (LTx). There is no validated consensus on how to protect the bile ducts during procurement, static preservation, and LTx. Meanwhile, IC remains the most troublesome complication after LTx. AIM: To characterize bile duct management techniques during the LTx process among European transplant centers in cases of donation after brain death (DBD) and circulatory death (DCD). METHOD: An European Liver and Intestine Transplant Association-European Liver Transplant Registry web survey designed to conceal respondents' personal information was sent to surgeons procuring and/or transplanting livers in Europe. RESULTS: Sixty-five percent of responses came from large transplant centers (>50 procurements/y). In 8% of DBDs and 14% of DCDs the bile duct is not rinsed. In 46% of DBDs and 52% of DCDs surgeons prefer to remove the gallbladder after graft reperfusion. Protocols concerning preservation solutions (nature, pressure, volume) are extremely heterogeneous. In 54% of DBDs and 61% of DCDs an arterial back table pressure perfusion is performed. Steroids (20%-10%), heparin (72%-60%), prostacyclin (3%-7%), and fibrinolytics (4%-11%) are used as donor-protective interventions in DBD and DCD cases, respectively. In 2% of DBD and 6% of DCD cases a hepatic artery reperfusion is performed first. In 4% of DBD and 6% of DCD cases, fibrinolytics are administered through the hepatic artery during the bench and/or implantation. CONCLUSION: This European web survey shows for the first time the heterogeneity in the management of bile ducts during procurement, preservation, and transplantation in Europe. In the context of sharing more marginal liver grafts, an expert meeting must be organized to formulate guidelines to be applied to protect liver grafts against IC.

• MeSH
• cholangitida etiologie   MeSH
• ischemie etiologie   MeSH
• lidé MeSH
• odběr tkání a orgánů škodlivé účinky   metody   MeSH
• perfuze škodlivé účinky   metody   MeSH
• pooperační komplikace etiologie   MeSH
• přežívání štěpu MeSH
• průzkumy a dotazníky MeSH
• reperfuze škodlivé účinky   metody   MeSH
• transplantace jater škodlivé účinky   MeSH
• uchovávání orgánů škodlivé účinky   metody   MeSH
• žlučové cesty krevní zásobení   transplantace   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa MeSH

• MeSH
• lidé MeSH
• odběr tkání a orgánů metody   MeSH
• pooperační péče MeSH
• srdeční selhání etiologie   terapie   MeSH
• transplantace srdce a plic * dějiny   metody   MeSH
• transplantace srdce * dějiny   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH