Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH-impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux-symptom association. NERD diagnosed on the basis of abnormal reflux burden on ambulatory reflux monitoring is associated with similar symptom response from antireflux therapy for erosive esophagitis. Acid suppression is the mainstay of therapy, and antireflux surgery has a definitive role in the management of persisting symptoms attributed to NERD, especially when the esophagogastric junction is compromised. Adjunctive approaches and complementary therapy may be of additional value in management. In this review, we describe the evaluation, diagnosis, differential diagnosis, and management of NERD.

• MeSH
• ezofágoskopie metody   MeSH
• gastroezofageální junkce * metabolismus   patofyziologie   MeSH
• gastroezofageální reflux * diagnóza   metabolismus   patofyziologie   MeSH
• lidé MeSH
• manometrie metody   MeSH
• monitorování jícnového pH metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Resting in an upright position during daytime decreases downbeat nystagmus (DBN). When measured in brightness only, that is, without intermitting exposure to darkness, it does not make a significant difference whether patients have previously rested in brightness or in darkness. In real-world scenarios, people are often exposed to brightness and darkness intermittently. The aim of this study was to analyze whether resting in brightness or resting in darkness was associated with a lower post-resting DBN after intermitting exposures to brightness and darkness. Eight patients were recorded with three-dimensional video-oculography in brightness and darkness conditions, each following two 2-h resting intervals under either brightness or darkness resting conditions. The dependent variable was DBN intensity, measured in mean slow phase velocity. A repeated measures ANOVA with the factors measurement condition (brightness vs. darkness), resting condition (brightness vs. darkness), and time (after first vs. second resting interval) showed a significant effect for the factor resting condition, where previous resting in darkness was associated with a significantly lower DBN relative to previous resting in brightness (P < 0.01). The clinical relevance is to advise patients with DBN to rest in darkness.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• odpočinek * MeSH
• patologický nystagmus patologie   patofyziologie   MeSH
• pohyby očí fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• tma * 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
• pozorovací studie MeSH

Achalasia is an esophageal motility disorder associated with abnormalities in peristalsis and lower esophageal sphincter (LES) relaxation. The etiology of the disease remains elusive. It is often misdiagnosed initially as gastroesophageal reflux disease. Patients with achalasia often complain of dysphagia to solids and liquids but may focus on regurgitation as the primary symptom, leading to the early misdiagnosis. Chest pain, weight loss, and occasional vomiting may be additional symptoms encountered in those with achalasia. The disease may be suspected on the basis of clinical presentation, but diagnosis depends on classic findings using high-resolution manometry, showing either failed or simultaneous contractions with associated normal or high LES pressures with no or incomplete relaxation with swallows. There are no cures for achalasia, and, in most patients, treatments have to be repeated over time. Definitive treatment options in achalasia include pneumatic dilation, surgical myotomy, and the new technique of per-oral endoscopic myotomy. Botulinum toxin (Botox) or other medical therapies are often reserved for those who cannot have definitive therapies owing to comorbid conditions.

• MeSH
• achalázie jícnu diagnóza   patofyziologie   terapie   MeSH
• bolesti na hrudi komplikace   diagnóza   terapie   MeSH
• botulotoxiny terapeutické užití   MeSH
• ezofágoskopie metody   MeSH
• gastroezofageální reflux diagnóza   patofyziologie   terapie   MeSH
• lidé MeSH
• management nemoci * MeSH
• manometrie metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Exciting new developments-pharmacologic, endoscopic, and surgical-have arisen for the treatment of many esophageal diseases. Refractory gastroesophageal reflux disease presents a therapeutic challenge, and several new options have been proposed to overcome an insufficient effectiveness of proton pump inhibitors. In patients with distal esophageal spasm, drugs and endoscopic treatments are the current mainstays of the therapeutic approach. Treatment with proton pump inhibitors (or antireflux surgery) should be considered in patients with Barrett's esophagus, since a recent meta-analysis demonstrated a 71% reduction in risk of neoplastic progression. Endoscopic resection combined with radiofrequency ablation is the standard of care in patients with early esophageal adenocarcinoma. Mucosal squamous cancer may also be treated endoscopically, preferably with endoscopic submucosal dissection. Patients with upper esophageal cancer often refrain from surgery. Robot-assisted, thoracolaparoscopic, minimally invasive esophagectomy may be an appropriate option for these patients, as the robot facilitates a good overview of the upper mediastinum. Induction chemoradiotherapy is currently considered as standard treatment for patients with advanced squamous cell carcinoma, while the role of neoadjuvant therapy for adenocarcinoma remains controversial. A system for defining and recording perioperative complications associated with esophagectomy has been recently developed and may help to find predictors of mortality and morbidity.

• MeSH
• Barrettův syndrom diagnóza   terapie   MeSH
• ezofagektomie metody   trendy   MeSH
• ezofágoskopie metody   trendy   MeSH
• gastroezofageální reflux diagnóza   terapie   MeSH
• inhibitory protonové pumpy terapeutické užití   MeSH
• lidé MeSH
• nádory jícnu diagnóza   terapie   MeSH
• nemoci jícnu diagnóza   terapie   MeSH
• výsledek terapie MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Interleukin-10 (IL-10) is a major anti-inflammatory cytokine that plays a crucial role in the regulation of the immune system. Allelic polymorphisms in the IL-10 gene promoter may contribute to the regulation of autoantibody production. To examine the association between both individuals IL-10 single nucleotide polymorphisms and the production of autoantibodies and the radiographic progression of rheumatoid arthritis (RA), a total of 144 RA patients were recruited into the study. We found significant differences in genotype distribution of the -1082G/A polymorphism between IgG, IgA, and IgM rheumatoid factor(RF)-positive/negative RA patients. We also found significant differences in allelic frequencies of the -3575T/A, -819C/T, and -592A/C polymorphisms between anticyclic citrullinated peptide (anti-CCP)-positive/negative RA patients. The haplotype TGAATA was found to be less frequent within anti-CCP-positive RA patients. Results obtained in this study provide evidence of an association between polymorphisms in IL-10 gene promoter and the production of autoantibodies in RA patients.

• MeSH
• autoprotilátky krev   MeSH
• cyklické peptidy imunologie   MeSH
• dospělí MeSH
• ELISA MeSH
• frekvence genu MeSH
• genotyp MeSH
• interleukin-10 genetika   MeSH
• jednonukleotidový polymorfismus MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• odds ratio MeSH
• progrese nemoci MeSH
• promotorové oblasti (genetika) genetika   MeSH
• revmatoidní artritida genetika   imunologie   patologie   MeSH
• rozdělení chí kvadrát MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

We studied the morphology of the A549 cell line (human lung carcinoma cells) before and after photodynamic therapy (PDT) by atomic force microscopy. PDT was induced by an efficient light-emitting diode source with total light dose of 15 J cm(-2) in the presence of the sensitizer zinc-5,10,15,20-tetrakis(4-sulfonatophenyl)porphyrine. In the presence of molecular oxygen, light activation of the photosensitizer, which accumulates in cancer cells, leads to the local production of reactive oxygen species (ROS). This is one of several reasons leading to cell death, and in some cases we could observe signs of apoptosis. We detected the kinetics of ROS production to be dependent on the presence of green tea extract.

• MeSH
• apoptóza účinky léků   MeSH
• čaj chemie   MeSH
• financování organizované MeSH
• fotochemoterapie metody   MeSH
• fotosenzibilizující látky farmakologie   MeSH
• kyslík farmakologie   metabolismus   MeSH
• lidé MeSH
• metaloporfyriny farmakologie   MeSH
• mikroskopie atomárních sil metody   MeSH
• nádorové buněčné linie MeSH
• nádory plic metabolismus   patologie   MeSH
• reaktivní formy kyslíku metabolismus   MeSH
• rostlinné extrakty farmakologie   MeSH
• světlo MeSH
• viabilita buněk účinky léků   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• Check Tag
• lidé MeSH

The stress response in anterior pituitary (AP) is mediated by corticotropin-releasing hormone (CRH) acting through CRH-R1 and -R2, however, the function of CRH-R2 in AP is still not fully elucidated. We used 1-h long restraint (IMO) as well as restraint combined with water immersion (IMO+C). Using real-time PCR we quantified mRNA expression of CRH-R1, CRH-R2alpha-soluble and -insoluble, and cAMP response element binding (CREB), with reference gene GAPDH. In control AP, CRH-R1 mRNA was up to 20-fold higher than levels of CRH-R2alpha-soluble or CRH-R2alpha-insoluble mRNA. IMO reduced CRH-R1 mRNA to 47% and 63% of control levels 1 and 2 h after the onset of stressor, respectively, while IMO+C did not produce significant changes. Our data demonstrated that these stressors did not change CRH-R2alpha mRNA, unlike the very significant response of CRH-R1 to IMO.

• MeSH
• adenohypofýza fyziologie   MeSH
• fyzické omezení MeSH
• hormon uvolňující kortikotropin metabolismus   MeSH
• krysa rodu rattus MeSH
• messenger RNA metabolismus   MeSH
• ponoření MeSH
• potkani Wistar MeSH
• protein - isoformy genetika   metabolismus   MeSH
• protein vázající element responzivní pro cyklický AMP genetika   metabolismus   MeSH
• psychický stres MeSH
• receptory hormonu uvolňujícího kortikotropin genetika   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH

Although stress is tightly connected with elevated levels of catecholamines, stress effects on target structures of catecholamine action--adrenoceptors (ARs)--has not been deeply studied yet. Similarly, very little is known about changes of muscarinic receptors (MRs) during stress. We determined changes in these receptors in the individual parts of the heart (right atria and ventricles) of animals (rats and mice) exposed to a single and repeated immobilization stress. Changes of tissue catecholamines, beta(2)-AR gene expression, protein levels, and binding sites were determined in rat right ventricles, and changes in beta(1)-, beta(2)-, and beta(3)-AR gene expression were followed in murine right atria. Tissue catecholamines were elevated, while beta(2)-AR mRNA levels and beta(2)-AR proteins and binding were decreased, in rat right ventricles. In murine right atria, beta(1)- and beta(2)-AR gene expression was elevated, while beta(3)-AR mRNA levels and M(2)-MR were reduced. Taken together, our data show that interaction of AR and MR is important for the organism coping with stress and that different heart regions reveal distinct reactions to stress.

• MeSH
• adrenalin metabolismus   MeSH
• beta-adrenergní receptory genetika   metabolismus   MeSH
• fyzické omezení MeSH
• krysa rodu rattus MeSH
• messenger RNA metabolismus   MeSH
• myši inbrední C57BL MeSH
• myši MeSH
• noradrenalin metabolismus   MeSH
• potkani Sprague-Dawley MeSH
• protein - isoformy genetika   metabolismus   MeSH
• psychický stres MeSH
• radioligandová zkouška MeSH
• receptory muskarinové genetika   metabolismus   MeSH
• regulace genové exprese MeSH
• srdeční komory metabolismus   MeSH
• srdeční síně metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH

The mechanisms of clearance of circulating plasma DNA are not fully understood, and so we aimed to examine it in patients with impaired renal function compared with healthy individuals. We also assessed the effect of peritoneal dialysis and hemodialysis on circulating plasma cell-free DNA (cfDNA) in our treated patients. Overall, 20 healthy volunteers, 20 patients with chronic kidney disease (CKD), 18 patients undergoing peritoneal dialysis (PD), and 17 patients on hemodialysis (HD; high-flux polysulfone membrane) were examined. Cell-free DNA levels were determined using real-time GADPH gene sequence amplification. The levels of cfDNA in all groups of our patients did not differ significantly from those of healthy volunteers. In HD patients, cfDNA levels were significantly increased compared with those of CKD patients (P < 0.05) and PD-treated patients (P < 0.01). In PD-treated patients, cfDNA was detectable in overnight effluent, with its levels correlating inversely with the duration of PD treatment (r=-0.619, Spearman's coefficient, P= 0.008). Factors contributing to these differences may include changes in the quality and quantity of the cell population of the peritoneum, highlighting the need for additional studies clarifying the dynamics of cfDNA during PD. The plasma levels of cfDNA do not seem to be dramatically altered even in CKD patients or those on PD or HD (as long as they are measured prior to the procedure in the latter two). Our data suggest renal elimination is not the main mechanism of circulating cfDNA clearance.

• MeSH
• chronické selhání ledvin MeSH
• dialýza ledvin MeSH
• DNA krev   MeSH
• dospělí MeSH
• financování organizované MeSH
• lidé středního věku MeSH
• lidé MeSH
• peritoneální dialýza MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

Time-resolved confocal microspectrofluorometry and fluorescence microscopy imaging were applied to monitor the cellular uptake of fluorescent-labeled oligonucleotides (ONs) delivered by a porphyrin molecule. The fate of porphyrin-ON complexes inside living cells has also been monitored. Due to intrinsic fluorescence of the porphyrin and sensitivity of its characteristics to microenvironment, multicomponent analysis of time-resolved fluorescence provides unique information about stability of the porphyrin-ON complexes, ON interactions with their target sequences, and ON and porphyrin distributions after delivery inside the cells. Time-resolved confocal microspectrofluorometry indeed delivers additional information compared with fluorescence confocal microscopy imaging widely employed to study ON uptake.

• MeSH
• antisense oligonukleotidy chemie   MeSH
• buněčné jádro metabolismus   MeSH
• buňky 3T3 MeSH
• časové faktory MeSH
• financování organizované MeSH
• fluorescence MeSH
• fluorescenční mikroskopie metody   přístrojové vybavení   MeSH
• kationty MeSH
• konfokální mikroskopie metody   přístrojové vybavení   MeSH
• melanom experimentální MeSH
• myši MeSH
• oligonukleotidy chemie   MeSH
• porfyriny chemie   MeSH
• senzitivita a specificita MeSH
• systémy cílené aplikace léků MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• přehledy MeSH