U rozsáhle popálených pacientů je základem chirurgického přístupu v léčbě co nejrychlejší uzávěr ranné plochy. Pro pokrytí co největší plochy lůžka rány je autotransplantát před aplikací široce síťován (mesh grafting). Cílem této studie bylo podpořit epitelizaci prostorů mezi můstky široce síťovaného autotransplantátu pomocí aplikace epidermálních buněk pacienta a biologického krytu Xe-Derma (XD). Buněčná suspenze byla získána peroperačně z tenkého dermo-epidermálního štěpu (1–4 cm2) kůže pacienta ReCell systémem nebo standardní trypsinizací. U 14 pacientů s hlubokými popáleninami nad 30 % povrchu těla byla část ranné plochy o rozsahu 2–4 % tělesného povrchu po excizi kryta autotransplantátem široce meshovaným v poměru 1:3 (8 pacientů) nebo 1:6 (6 pacientů). Na třetinu vymezené autotransplantované plochy byly nakapány buňky do ok autotransplantátu a kryty XD (skupina buňky+XD). Druhá třetina ranné plochy byla kryta pouze XD bez buněčné suspenze (skupina XD) a třetí část plochy byla standardně kryta mastným tylem Grassolind (kontrola). Rány kryté autoštěpem síťovaným v poměru 1:3 se pod všemi testovanými kryty zahojily do 9 dnů, rozdíly v epitelizaci byly obtížně hodnotitelné. Při poměru síťování 1:6 byla epitelizace ok autotransplantátu ve skupině buňky+XD rychlejší (9–14 dní) než ve skupině XD (12–17 dní), kvalita zhojené kůže byla v obou případech velmi dobrá. Kontrolní plocha krytá tylem Grassolind se hojila protrahovaně, za 20 dnů bylo zhojeno 30–50 % plochy mezer, epidermis se rozpadala. Studie prokázala výrazný přínos sendvičového krytí (kombinace autoštěpu, autologních kožních buněk a XD) pro hojení široce síťovaných autotransplantátů. Také krytí samotnou XD vykázalo pozitivní hojivý efekt.

In extensively burned patients the major step in complex therapy is the fastest possible closure of the wound. To cover the highest possible extent of the wound bed, the autograft is largely meshed prior to application. This work aimed to stimulate the epidermal regeneration of spaces (windows) surrounded by bridges of a largely expanded dermo-epidermal graft using autologous epidermal cells and acellular pig dermis Xe-Derma (XD). Cells were obtained from the patient’s skin (1–4 cm2) by the Re- Cell system or by standard trypsinization. In 14 patients with deep burns a part of the burn area was covered with the autograft meshed 1:3 (8 patients) or 1:6 (6 patients). On one part of the burned area the cells were dropped into the windows of the graft and covered with XD (cells+XD group). The second part was covered with XD alone (XD group). The third part was covered with Grassolind tulle gras (control). The wounds covered with the autograft meshed 1:3 had all healed completely in the course of nine days and differences in the healing time were difficult to distinguish. In wounds autografted with 1:6 mesh, epithelization of windows was faster in the areas treated with cells+XD (9–14 days) then with XD alone (12–17 days); the quality of the healed skin was good in both cases. Healing of the control area covered with Grassolind was prolonged: in 20 days 30–50 % of the grafted area had healed, and the epidermis was fragile and disintegrated. The study showed a positive effect of three sandwiched biological covers (largely expanded autograft, autologous skin cells, XD) on healing of widely meshed autografts. XD without cells also showed a positive healing effect.

• Klíčová slova
• ReCell systém, izolace buněk,
• MeSH
• autologní transplantace MeSH
• biologické krytí MeSH
• dospělí MeSH
• epidermis transplantace   MeSH
• financování organizované MeSH
• hojení ran MeSH
• keratinocyty transplantace   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• melanocyty transplantace   MeSH
• mladiství MeSH
• popálení chirurgie   terapie   MeSH
• povrch těla MeSH
• transplantace buněk metody   MeSH
• transplantace kůže metody   MeSH
• transplantáty MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• kazuistiky MeSH
• srovnávací studie MeSH

Synchronizing neural processes, mental activities, and social interactions is considered to be fundamental for the creation of temporal order on the personal and interpersonal level. Several different types of synchronization are distinguished, and for each of them examples are given: self-organized synchronizations on the neural level giving rise to pre-semantically defined time windows of some tens of milliseconds and of approximately 3 s; time windows that are created by synchronizing different neural representations, as for instance in aesthetic appreciations or moral judgments; and synchronization of biological rhythms with geophysical cycles, like the circadian clock with the 24-hr rhythm of day and night. For the latter type of synchronization, an experiment is described that shows the importance of social interactions for sharing or avoiding common time. In a group study with four subjects being completely isolated together for 3 weeks from the external world, social interactions resulted both in intra- and interindividual circadian synchronization and desynchronization. A unique phenomenon in circadian regulation is described, the "beat phenomenon," which has been made visible by the interaction of two circadian rhythms with different frequencies in one body. The separation of the two physiological rhythms was the consequence of social interactions, that is, by the desire of a subject to share and to escape common time during different phases of the long-term experiment. The theoretical arguments on synchronization are summarized with the general statement: "Nothing in cognitive science makes sense except in the light of time windows." The hypothesis is forwarded that time windows that express discrete timing mechanisms in behavioral control and on the level of conscious experiences are the necessary bases to create cognitive order, and it is suggested that time windows are implemented by neural oscillations in different frequency domains.

• MeSH
• biologické modely MeSH
• časové faktory MeSH
• cirkadiánní rytmus fyziologie   MeSH
• interpersonální vztahy * MeSH
• lidé MeSH
• longitudinální studie MeSH
• vnímání času * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

Parasite hybrid zones resulting from host secondary contact have never been described in nature although parasite hybridization is well known and secondary contact should affect them similarly to free-living organisms. When host populations are isolated, diverge and recontact, intimate parasites (host specific, direct life cycle) carried during isolation will also meet and so may form parasite hybrid zones. If so, we hypothesize these should be narrower than the host's hybrid zone as shorter parasite generation time allows potentially higher divergence. We investigate multilocus genetics of two parasites across the European house mouse hybrid zone. We find each host taxon harbours its own parasite taxa. These also hybridize: Parasite hybrid zones are significantly narrower than the host's. Here, we show a host hybrid zone is a suture zone for a subset of its parasite community and highlight the potential of such systems as windows on the evolutionary processes of host-parasite interactions and recombinant pathogen emergence.

• MeSH
• fylogeneze MeSH
• genetické markery MeSH
• genotyp MeSH
• hlístice genetika   MeSH
• hybridizace genetická * MeSH
• mitochondriální DNA genetika   MeSH
• myši genetika   parazitologie   MeSH
• paraziti genetika   MeSH
• Pneumocystis genetika   MeSH
• populační genetika * MeSH
• zvířata MeSH
• Check Tag
• myši genetika   parazitologie   MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Německo MeSH

A 61-year-old man was found dead in the yard of his house with penetrating injury of the trunk. Initial examination of the body revealed a single penetrating injury on his chest with a collar abrasion-the injury pattern that is similar to a gunshot entry wound or shored exit wound. According to witnesses, the man had cut wooden frames from old windows with a circular saw. X-rays of the torso revealed a contrast object resembling a projectile in the left scapular region. The internal examination disclosed an isolated trunk trauma involving the left lung. In the soft tissue, between the inner edge of the left scapula and thoracic spine, the fragment of a metal nail was found. The autopsy confirmed that the wound on the chest was a non-firearm-related injury. The death of deceased was attributed to massive internal hemorrhage. Further investigation revealed that the pseudo-gunshot wound injury of the trunk of the victim was caused by a fast-flying metal object thrown against the man's trunk from a circular saw while cutting the wooden beams of old windows.

• MeSH
• cizí tělesa patologie   radiografie   MeSH
• diferenciální diagnóza MeSH
• krvácení etiologie   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• penetrující rány etiologie   patologie   MeSH
• poranění hrudníku etiologie   patologie   MeSH
• poškození plic etiologie   patologie   MeSH
• soudní patologie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: The aim of this retrospective study was to analyse results and risk factors of death after the repair of the interrupted aortic arch, and to compare results obtained with the use of deep hypothermic circulatory arrest versus isolated cerebral perfusion. METHODS: The primary repair of the interrupted aortic arch and associated heart lesions was performed in 50 consecutive patients. The median age was 5 days and the mean weight was 3.1+/-0.6 kg. The interrupted aortic arch was of type A in 12 (24%) patients, type B in 37 (74%) and type C in one (2%) patient. Ventricular septal defect was present in 48 (96%) patients, subaortic stenosis in 15 (30%), truncus arteriosus in 14 (28%), transposition of the great arteries in two (4%), aortopulmonary window in two (4%) and double-outlet right ventricle in one (2%). The surgery consisted of reconstruction of the aortic arch by direct anastomosis and repair of associated heart lesions. In 25 (50%) patients, aortic arch reconstruction was performed using hypothermic circulatory arrest (group I) and in 25 by isolated cerebral perfusion (group II). The duration of cardiopulmonary bypass, aortic cross-clamping and circulatory arrest or isolated cerebral perfusion was 191+/-46 min, 90+/-24 min and 40+/-14 min, respectively, in group I; and 194+/-39 min, 74+/-20 min and 31+/-6 min, respectively, in group II. RESULTS: There were 10 (20%) deaths in this series, eight (32%) in group I and two (8%) in group II. Out of 12 patients operated before 1995, seven (58%) patients died; and out of 38 patients operated between 1995 and 2009, three (8%) patients died (p=0.008). By Cox multifactorial analysis, the earlier date of operation represented the only risk factor of death (p=0.037). Twelve (71%) survivors in group I and five (22%) survivors in group II required re-intervention, most often for subaortic stenosis, aortic arch obstruction or conduit obstruction. All patients remain in the New York Heart Association (NYHA) class I or II at median 12.6 years in group I, and 1.7 years in group II, respectively, after surgery. CONCLUSIONS: Interrupted aortic arch can be repaired in neonates with a mortality of 5-10%. The results depend on experience. Isolated cerebral perfusion was joined with decreased mortality but it did not influence the occurrence of neurological complications.

• MeSH
• anastomóza chirurgická metody   MeSH
• aorta thoracica abnormality   chirurgie   MeSH
• cévy - implantace protéz metody   MeSH
• epidemiologické metody MeSH
• kardiopulmonální bypass MeSH
• kojenec MeSH
• lidé MeSH
• mozkový krevní oběh MeSH
• novorozenec MeSH
• reoperace metody   MeSH
• vrozené srdeční vady chirurgie   MeSH
• výsledek terapie MeSH
• zástava krevního oběhu vyvolaná hlubokou hypotermií metody   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH

Background: Intermittent fasting may be an effective tool for weight loss, but it is still unclear from previous studies to date whether it is as effective as a continuous energy restriction in terms of reducing adipose tissue and whether it leads to unwanted muscle loss. Objectives: The aim of this study was to compare the effect of intermittent fasting (IF) with continuous energy restriction (CER) on the body weight and body composition and to assess the effect of intermittent fasting also in isolation from the energy restriction. Methods: After completion of a three-week dietary intervention, differences in the weight loss and differences in the body composition were compared between three groups. The first group consumed 75% of their calculated energy intake requirements in a six-hour time window. The second group consumed 75% of their calculated energy intake requirements without a time window and the third group consumed 100% of their calculated energy intake requirements in a six-hour time window. The changes in the weight and body composition were assessed by BIA. Results: Of the 95 randomized participants, 75 completed the intervention phase of the study. The highest mean weight loss was achieved by the IF with ER (energy restriction) group (2.3 ± 1.4 kg), followed by the CER group (2.2 ± 1.1 kg); the difference between the groups did not reach statistical significance. The lowest mean weight loss was observed in the IF without ER group (1.1 ± 1.2 kg), the difference reaching statistical significance compared to the IF with ER (p=0.003) and CER (p=0.012) groups. The highest mean adipose tissue loss was observed in the CER group (1.5 ± 1.2 kg) followed by the IF with ER group (1.3 ± 1.1 kg), with no statistically significant differences between the groups. A mean adipose tissue loss was found in the IF without ER group (0.9 ± 1.1 kg) with no statistically significant differences compared to the IF with ER and CER groups. The highest mean fat-free mass loss was found in the IF with ER group (1.1 ± 1.0 kg), followed by the CER group (0.65 ± 0.91 kg) with no statistically significant differences. The IF without ER group showed the lowest mean fat-free mass loss (0.2 ± 1.3 kg), which reached statistical significance compared to the IF with ER group (p=0.027). Conclusion: The results showed a comparable effect in the weight loss and body fat reduction regardless of the timing of the food intake. The diet quality, together with the energy intake, appeared to be one of the most important factors influencing the body composition.

• MeSH
• antropometrie MeSH
• dospělí MeSH
• energetický příjem * fyziologie   MeSH
• hmotnostní úbytek * fyziologie   MeSH
• index tělesné hmotnosti MeSH
• kalorická restrikce * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• obezita dietoterapie   patofyziologie   MeSH
• omezení příjmu potravy * fyziologie   MeSH
• přerušované hladovění MeSH
• složení těla * fyziologie   MeSH
• tělesná hmotnost fyziologie   MeSH
• tuková tkáň MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Automated algorithms may identify focal (FA) and rotational (RoA) activations during persistent atrial fibrillation (PeAF). OBJECTIVE: To evaluate an automated algorithm for characterizing and assessing significance of FA/RoA. METHODS: Eighty-six PeAF ablation patients (1411 maps) were analyzed. Maps were obtained with a 64-electrode basket using CARTOFINDER, which filters/annotates atrial unipolar electrograms over 30 seconds. Operators ablated FA/RoA followed by pulmonary vein isolation (PVI). The automated algorithm was retrospectively applied using QS patterns to identify FA and sequential activation gradients for RoA without phase mapping. Algorithm-identified FA and RoA were validated against blinded adjudicators. Ablation of algorithm-identified FA/RoA was related to procedural AF termination. RESULTS: 73% ± 18% of electrodes (65% ± 11% atrial surface area) were adequate for analysis. Compared with adjudicators, the algorithm had a sensitivity of 84% for FA and 86% for RoA. There were 4 ± 2 FA and 2 ± 2 RoA per patient. FA occurred 8 ± 6 times during the 30-second window (cumulative duration 8 ± 6 seconds). RoA occurred 5 ± 3 times (median 2, consecutive rotations) with a cumulative duration of 3 ± 2 seconds. Compared to patients without procedural AF termination, patients with termination had more FA ablated (75% vs 38%, P = 0.006). AF termination was not predicted by percentage of RoA ablated although there was a trend towards a higher percentage of left atrial RoA ablated ( P = 0.06). CONCLUSION: An automated algorithm had high sensitivity for FA and RoA. Acute AF termination was associated with FA ablation but not RoA ablation. Future studies need to define the significance of FA and RoA and whether they are overlapping or separate mechanisms.

• MeSH
• algoritmy * MeSH
• elektrofyziologické techniky kardiologické metody   MeSH
• fibrilace síní diagnóza   patofyziologie   chirurgie   MeSH
• katetrizační ablace škodlivé účinky   metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mapování potenciálů tělesného povrchu metody   MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• senioři MeSH
• venae pulmonales chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

The prevalent human papillomaviruses (HPVs) infect human epithelial tissues. Infections by the mucosotropic HPV genotypes cause hyperproliferative ano-genital lesions. Persistent infections by high-risk (HR) HPVs such as HPV-16, HPV-18 and related types can progress to high grade intraepithelial neoplasias and cancers. Prophylactic HPV vaccines are based on DNA-free virus-like particles (VLPs) composed of the major capsid protein L1 of HPV-16, -18, -6 and -11 (Gardasil) or HPV-16 and -18 (Cervarix). Sera from vaccinated animals effectively prevent HPV pseudovirions to infect cell lines and mouse cervical epithelia. Both vaccines have proven to be highly protective in people. HPV pseudovirions are assembled in HEK293TT cells from matched L1 and L2 capsid proteins to encapsidate a reporter gene. Pseudovirions and genuine virions have structural differences and they infect cell lines or primary human keratinocytes (PHKs) with different efficiencies. In this study, we show that sera and isolated IgG from women immunized with Gardasil prevent authentic HPV-18 virions from infecting PHKs, whereas non-immune sera and purified IgG thereof are uniformly ineffective. Using early passage PHKs, neutralization is achieved only if immune sera are added within 2-4h of infection. We attribute the timing effect to a conformational change in HPV virions, thought to occur upon initial binding to heparan sulfate proteoglycans (HSPG) on the cell surface. This interpretation is consistent with the inability of immune IgG bound to or taken up by PHKs to neutralize the virus. Interestingly, the window of neutralization increases to 12-16h in slow growing, late passage PHKs, suggestive of altered cell surface molecules. In vivo, this window might be further lengthened by the time required to activate the normally quiescent basal cells to become susceptible to infection. Our observations help explain the high efficacy of HPV vaccines.

• MeSH
• antisérum imunologie   MeSH
• heparansulfát proteoglykany metabolismus   MeSH
• imunoglobulin G krev   imunologie   MeSH
• infekce papilomavirem prevence a kontrola   MeSH
• keratinocyty virologie   MeSH
• kultivované buňky MeSH
• lidé MeSH
• lidský papilomavirus 18 MeSH
• neutralizační testy MeSH
• neutralizující protilátky krev   imunologie   MeSH
• protilátky virové krev   imunologie   MeSH
• rekombinantní kvadrivalentní vakcína proti lidskému papilomaviru typu 6, 11, 16, 18 terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH

Akutní poškození ledvin není izolovaným onemocněním. Rostoucí důkazy ukazují, že i mírné formy akutního poškození ledvin mohou vyvolat poruchy vzdálených orgánů, včetně srdce, plic, jater a mozku. Mortalita pacientů s akutním poškozením ledvin, kteří jsou komplikováni multiorgánovou dysfunkcí, zůstává navzdory pokrokům v metodách náhrady funkce ledvin vysoká (40–60 %). Předpokládá se, že takto nepřijatelně vysoká úmrtnost je přinejmenším zčásti důsledkem nepříznivého vlivu akutního poškození ledvin na funkci vzdálených orgánů. Z těchto důvodů probíhá v současnosti intenzivní výzkum mechanizmů, které se v patogenezi obousměrných interakcí mezi ledvinami a vzdálenými orgány uplatňují. Výsledky zejména experimentálních studií prokazují klíčovou úlohu imunitních, metabolických a humorálních cest, kterými akutní poškození ledvin ovlivňuje funkci vzdálených orgánů a mortalitu. Jejich přesnější pochopení je nástrojem k vývoji efektivních léčebných strategií k přetnutí bludného kruhu meziorgánových patomechanizmů. Článek diskutuje stručně současné poznatky o kardiovaskulárních důsledcích akutního poškození ledvin.

Acute kidney injury is not an isolated event. Emerging evidence suggests that even mild acute kidney injury induces distant organ dysfunction to the heart, lung, liver and brain. Despite recent advances in renal replacement therapy, mortality of patients developing acute kidney injury and complicated by multiorgan dysfunction is 40–60%. It is believed that this unacceptable mortality rate stems, at least partly, from the distant organ effects of acute kidney injury. Therefore, there has been a surge of interest in elucidating mechanisms underlying complex and bidirectional nature of interconnection between acute kidney injury and distant organ dysfunction. Accumulating data indicate that acute kidney injury can trigger several immune, metabolic and humoral pathways, thus potentially contributing to distant organ dysfunction and overall morbidity and mortality. Better insights into bidirectional and synergistic pathways linking acute kidney injury and cardiovascular dysfunction might open the window for new therapeutic approaches that interrupt this vicious circle. Here, we briefly discuss the rationale for and current understanding of the bidirectional relationship between acute kidney injury and cardiovascular problems.

• MeSH
• akutní poškození ledvin * klasifikace   komplikace   MeSH
• cytokiny MeSH
• kardiorenální syndrom * MeSH
• kardiovaskulární nemoci * MeSH
• komorbidita * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Porcine reproductive and respiratory syndrome virus (PRRSV) causes immune dysregulation during the Critical Window of Immunological Development. We hypothesize that thymocyte development is altered by infected thymic antigen presenting cells (TAPCs) in the fetal/neonatal thymus that interact with double-positive thymocytes causing an acute deficiency of T cells that produces "holes" in the T cell repertoire allowing for poor recognition of PRRSV and other neonatal pathogens. The deficiency may be the result of random elimination of PRRSV-specific T cells or the generation of T cells that accept PRRSV epitopes as self-antigens. Loss of helper T cells for virus neutralizing (VN) epitopes can result in the failure of selection for B cells in lymph node germinal centers capable of producing high affinity VN antibodies. Generation of cytotoxic and regulatory T cells may also be impaired. Similar to infections with LDV, LCMV, MCMV, HIV-1 and trypanosomes, the host responds to the deficiency of pathogen-specific T cells and perhaps regulatory T cells, by "last ditch" polyclonal B cell activation. In colostrum-deprived PRRSV-infected isolator piglets, this results in hypergammaglobulinemia, which we believe to be a "red herring" that detracts attention from the thymic atrophy story, but leads to our second independent hypothesis. Since hypergammaglobulinemia has not been reported in PRRSV-infected conventionally-reared piglets, we hypothesize that this is due to the down-regulatory effect of passive maternal IgG and cytokines in porcine colostrum, especially TGFβ which stimulates development of regulatory T cells (Tregs).

• MeSH
• hypergamaglobulinemie krev   etiologie   metabolismus   MeSH
• imunoglobulinové izotypy krev   imunologie   MeSH
• interakce hostitele a patogenu imunologie   MeSH
• náchylnost k nemoci MeSH
• pandemie MeSH
• prasata MeSH
• protilátky virové krev   imunologie   MeSH
• reprodukční a respirační syndrom prasat krev   epidemiologie   etiologie   MeSH
• T-lymfocyty cytologie   imunologie   metabolismus   MeSH
• thymocyty cytologie   imunologie   metabolismus   MeSH
• thymus imunologie   metabolismus   MeSH
• virus reprodukčního a respiračního syndromu prasat fyziologie   MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH