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PURPOSE OF THE STUDY Irreparable rotator cuff tear continues to be a point of discussion. Several surgical techniques have been proposed so far. None of them, however, can be considered the method of choice. This study presents the first clinical results of superior capsule reconstruction (SCR) using the DX Reinforcement Matrix. MATERIAL AND METHODS The evaluation included patients with the minimum follow-up of 6 months. The follow-up period in these patients was 1 year (6-18 months) on average. The active (AROM) and passive (PROM) ranges of motion were assessed-anterior flexion, abduction, external rotation and external rotation at 90° abduction. The patients were assessed using clinical scores before and after the surgery-pain assessment scale (VAS), UCLA (University of California at Los Angeles) Shoulder Rating Scale and ASES (American Shoulder and Elbow Surgeons) Shoulder Score. RESULTS In the period from October 2016 to October 2018, a total of 20 SCRs were performed. The mean age of patients was 61 years. Nine patients were clinically assessed, with the mean follow-up of 1 year. The mean UCLA Shoulder Score was 10 points preoperatively. Postoperatively, the values went up to 29 points on average. The reported ASES score was 23.8 points preoperatively. Postoperatively, the mean score was 73.2 points. The VAS subjective pain score ranged around 7 points before the surgery. After the surgery, the mean VAS score was 2 points. The mean active shoulder flexion was 74° preoperatively and 161° postoperatively. The mean active abduction was 74° preoperatively and 161° postoperatively. The mean active external rotation of the shoulder joint was 20° preoperatively and 56° postoperatively. The mean active external rotation at 90° abduction was 21° preoperatively and 82° postoperatively. The changes in all the followed-up mean parameters of UCLA, ASES, VAS, AROM and PROM reported by our group show a relatively high level of substantive significance. DISCUSSION Results of arthroscopic superior capsule reconstruction using the DX Reinforcement Matrix have not been published in literature so far. Compared to the results for fascia lata published in literature, our results are slightly worse. By contrast, our results are similar to those achieved by human dermal allograft. CONCLUSIONS Arthroscopic superior capsule reconstruction currently appears to be the method of choice in unreconstructed supraspinatus and infraspinatus tear. Our group of patients shows that early clinical outcomes of SCR using xenograft are very promising. A significant pain relief and a considerable improvement in the range of motion of the operated shoulder joint were observed. No complication specifically associated with the use of xenograft has been reported as yet. A longer follow-up period and assessment of a larger group of patients will be necessary to confirm the success of this surgical procedure. Key words: massive rotator cuff tears; irreparable rotator cuff tears; superior capsular reconstruction; xenograft; DX Reinforcement Matrix.
- MeSH
- artroskopie MeSH
- bioprotézy MeSH
- extracelulární matrix transplantace MeSH
- kloubní pouzdro patofyziologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- poranění rotátorové manžety patofyziologie chirurgie MeSH
- ramenní kloub patofyziologie chirurgie MeSH
- rozsah kloubních pohybů MeSH
- transplantace heterologní MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A significant number of myocardial diseases are accompanied by increased synthesis and degradation of the extracellular matrix (ECM) as well as by changed maturation and incorporation of ECM components. Important groups of enzymes responsible for both normal and pathological processes in ECM remodeling are matrix metaloproteinases (MMPs). These enzymes share a relatively conserved structure with a number of identifiable modules linked to their specific functions. The most important function of MMPs is the ability to cleave various ECM components; including such rigid molecules as fibrillar collagen molecules. The amount and activity of MMPs in cardiac tissue are regulated by a range of activating and inhibiting processes. Although MMPs play multifarious roles in many myocardial diseases, here we have focused on their function in ischemic cardiac tissue, dilated cardiomyopathy and hypertrophied cardiac tissue. The inhibition of MMPs by means of synthetic inhibitors seems to be a promising strategy in cardiac disease treatment. Their effects on diseased cardiac tissue have been successfully tested in several experimental studies.
- MeSH
- extracelulární matrix metabolismus MeSH
- kardiomyopatie metabolismus MeSH
- lidé MeSH
- matrixové metaloproteinasy metabolismus MeSH
- myokard metabolismus MeSH
- remodelace komor MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Due to high biocompatibility, miniaturization, optical transparency and low production cost together with high radiation hardness the diamond-based sensors are considered promising for radiation medicine and biomedicine in general. Here we present detection of fibroblast cell culture properties by nanocrystalline diamond solution-gated field-effect transistors (SG-FET), including effects of gamma irradiation. We show that blank nanocrystalline diamond field-effect biosensors are stable at least up to 300 Gy of γ irradiation. On the other hand, gate current of the diamond SG-FET biosensors with fibroblastic cells increases exponentially over an order of magnitude with increasing radiation dose. Extracellular matrix (ECM) formation is also detected and analyzed by correlation of electronic sensor data with optical, atomic force, fluorescence, and scanning electron microscopies.
Úvod: Matrix-metaloproteinázy (MMP) hrají významnou roli u kardiovaskulárních (KV) onemocnění. Změny sérových hladin MMP jsou popisovány i u nemocných dialyzovaných a po transplantaci ledviny. Nejčastěji se jedná o matrixmetaloproteinázy 2 a 9 (MMP-2 a MMP-9) a matrix-metaloproteinázu PAPP-A (Pregnancy Associated Plasma Protein-A, těhotenský plazmatický protein-A). Cílem této práce je určit, zda změny sérových hodnot MMPs, prokázané u nemocných před transplantací ledviny (TL) a jeden rok po TL, jsou ovlivněny typem dialyzační léčby a její délkou. Metody: Sérové MMP-2, MMP-9, PAPP-A byly stanoveny před TL a za 12 měsíců po TL u 239 nemocných, 172 mužů, 67 žen, věk 53 (22-80) roků. Kontrolní skupinu tvořilo 22 zdravých osob, 10 mužů, 12 žen, věk 51,0 (22-76) roků. Sérové MMP byly stanoveny ELISA testem. Subklinickou aterosklerózu jsme definovali jako Belcaro skóre měřené ultrasonograficky na karotidách. Glomerulární filtrace GFR ml/min/1,73 m² byla měřena jako clearance kreatininu a MDRD. Výsledky: Hladiny PAPP-A v séru byly před TL, tedy v čase O, zvýšené proti kontrolám (p < 0,001). Vliv typu dialýzy se projevil především před TL. kdy u skupiny CAPD nemocných jsou při příchodu k TL vyšší hladiny MMP-2 ve srovnání s nemocnými léčenými HD (332,7 ± 108 proti 234 ± 49,2 ng/ml, p < 0,05). Hladiny PAPP-A jsou u CAPD nemocných naopak nižší než u HD nemocných (13,2 ± 4,9 proti 21,4 ± 10,3, p < 0,001). Doba dialýzy má významnou pozitivní korelaci s hladinami PAPP-A, zjištěnými před TL (r = 0,310, p < 0,01). Sérové hladiny MMP-9 byly před TL srovnatelné s kontrolami, 1 rok po TL byly proti kontrolám významně zvýšené (p < 0,001). Zvýšené hodnoty MMP-9 jeden rok po TL významně pozitivně korelovaly s funkcí štěpu, stanovenou jako MDRD (r = 0,3102, p< 0,01). Závěr: Vliv typu dialýzy se projevil především před TL, kdy u CAPD nemocných byly vyšší hladiny MMP-2 ve srovnání s nemocnými léčenými HD. Hladiny PAPP-A byly u CAPD naopak nižší než u HD. Doba dialýzy významně pozitivně korelovala s hladinami PAPP-A před TL. Novým zjištěním je významná pozitivní korelace zvýšených hodnot MMP-9 jeden rok po TL s renální funkcí Stanovenou jako MDRD.
Introduction: Matrix-metalloproteinases (MMPs) play an important role in cardiovascular (CV) disease. Changes in the serum levels of MMPs have been reported in both dialysis patients and renal transplant recipients, most often in matrix-metalloproteinases 2 and 9 (MMP-2 and MMP-9, respectively), and pregnancy-associated plasma protein A (PAPP-A). The aim of our study was to determine whether the changes in serum MMP levels, as documented in patients scheduled for renal transplantation (RTx) and at one year post-RTx, are affected by the type of dialysis treatment and its duration. Methods: The serum levels of MMP-2, MMP-9, PAPP-A were determined prior to RTx and at 12 months post RTx in 239 patients [172 men, 67 women, age 53 (22–80) years]. A control group was made up by 22 healthy individuals [10 men, 12 women, age 51 (22–76) years]. Serum MMP levels were determined using ELISA. Our definition of subclinical atherosclerosis used the Bel caro score as measured by carotid ultrasound. Glomerular filtration rate (GFR; ml/min/1,73 m2) was measured as creatinine clearance and MDRD. Results: Serum PAPP-A levels prior to RTx (time 0) were increased as compared with controls (p < 0.001). An effect of the type of dialysis was most pronounced particularly prior to RTx, with CAPD patients showing higher MMP-2 compared with HD-treated patients (332.7 ± 108 vs 234 ± 49.2 ng/ml; p < 0.05). By contrast, PAPP-A levels in CAPD patients were lower than in HD-treated patients (13.2 ± 4.9 vs. 21.4 ± 10.3; p < 0.001). Dialysis duration shows a significant correlation with pre-RTx PAPP-A levels (r = 0.310; p < 0.01). Pre-RTx serum levels of MMP-9 were comparable with those of controls, to be significantly increased at o ne year post-RTx (p < 0.001). The increased levels of MMP-9 at one-year post-RTx correlated significantly with graft function determine d as MDRD (r = 0.3102; p < 0.01). Conclusion: An effect of the type of dialysis was particularly most pronounced before Rtx, with CAPD -treated patients found to have higher MMP-2 levels compared with HD-treated patients. By contrast, PAPP-A levels in CAPD patients were lower compared with HD-treated patients. Dialysis duration correlated with pre-RTx PAPP-A levels. A new finding is the correlation of increased MMP-9 levels at one year post-RTx with renal function determined as MDRD.
- MeSH
- dialýza ledvin MeSH
- dospělí MeSH
- financování organizované MeSH
- kardiovaskulární nemoci patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- matrixová metaloproteinasa 2 krev MeSH
- matrixová metaloproteinasa 9 krev MeSH
- matrixové metaloproteinasy krev MeSH
- rizikové faktory MeSH
- senioři MeSH
- těhotenský plazmatický protein A diagnostické užití MeSH
- transplantace ledvin fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- srovnávací studie MeSH
BACKGROUND: Clinical outcome after intracerebral hemorrhage (ICH) remains poor. Recent trials in ICH, focusing on hematoma reduction, have not yielded significant clinical improvement. The modulation of matrix metalloproteinase (MMP)-9 may represent a potential therapeutic target for reducing perihematomal edema (PHE) and improving clinical outcome. METHODS: We searched Cochrane Library, Ovid/Medline, and PubMed databases using combinations of the following MeSH search terms: "intracerebral hemorrhage," "matrix metalloproteinase," "minocycline," "inhibition," and "neuroprotection". RESULTS: MMP-9 levels in animal models have largely shown detrimental correlations with mortality, clinical outcome, hematoma volume, and PHE. Animal models and clinical studies have established a timeline for MMP-9 expression and corresponding PHE that include an initial peak on days 1-3 and a secondary peak on day 7. Clinical studies evaluating MMP-9 levels in the acute phase (days 1-3) and subacute phase (day 7) of ICH suggest that MMP-9 may be detrimental in the acute phase through destruction of basal lamina, activation of vascular endothelial growth factor, and activation of apoptosis but assist in recovery in the subacute phase through angiogenesis. CONCLUSIONS: MMP-9 inhibition represents a potentially effective target for neuroprotection in ICH. However, as a ubiquitous protein, the inhibition of pathologic processes must be balanced against the preservation of neuroprotective angiogenesis. As the opposing roles of MMP-9 may have similar mechanisms, the most important factor may be the timing of MMP-9 inhibition. Further studies are necessary to delineate these mechanisms and their temporal relationship.
- MeSH
- apoptóza účinky léků MeSH
- časové faktory MeSH
- cerebrální krvácení komplikace farmakoterapie metabolismus mortalita patologie MeSH
- edém mozku farmakoterapie metabolismus mortalita MeSH
- hematom farmakoterapie metabolismus mortalita MeSH
- inhibitory matrixových metaloproteinas terapeutické užití MeSH
- lidé MeSH
- matrixová metaloproteinasa 9 metabolismus MeSH
- neuroprotektivní látky aplikace a dávkování MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
- MeSH
- cytopatogenní efekt virový MeSH
- cytoplazma MeSH
- DNA biosyntéza MeSH
- replikace viru MeSH
- Publikační typ
- přehledy MeSH
The extracellular matrix (ECM)-and its mechanobiology-regulates key cellular functions that drive tumor growth and development. Accordingly, mechanotherapy is emerging as an effective approach to treat fibrotic diseases such as cancer. Through restoring the ECM to healthy-like conditions, this treatment aims to improve tissue perfusion, facilitating the delivery of chemotherapies. In particular, the manipulation of ECM is gaining interest as a valuable strategy for developing innovative treatments based on nanoparticles (NPs). However, further progress is required; for instance, it is known that the presence of a dense ECM, which hampers the penetration of NPs, primarily impacts the efficacy of nanomedicines. Furthermore, most 2D in vitro studies fail to recapitulate the physiological deposition of matrix components. To address these issues, a comprehensive understanding of the interactions between the ECM and NPs is needed. This review focuses on the main features of the ECM and its complex interplay with NPs. Recent advances in mechanotherapy are discussed and insights are offered into how its combination with nanomedicine can help improve nanomaterials design and advance their clinical translation.
- MeSH
- extracelulární matrix * metabolismus MeSH
- lidé MeSH
- nádory * terapie MeSH
- nanočástice * chemie MeSH
- nanomedicína * metody MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Úvod: Preeklampsie je onemocnění, které ohrožuje na životě matku I plod. Na celém světě je každý rok diagnostikováno u 10 milionů žen, což odpovídá 3–8 % všech těhotenství. V současné době nemá preeklampsie prokázanou účinnou léčbu. To zdůrazňuje potřebu předpovědi této komplikace. Tato prospektivní studie se provádí za účelem stanovení, zda mají matrixové metaloproteinázy-2 a -9 prognostický význam jako časné markery preeklampsie. Materiály a metody: Hladiny matrixových metaloproteináz-2 a -9 byly hodnoceny u 72 pacientek. U 34 z nich se následně v průběhu těhotenství vyvinula preeklampsie (u 20 pacientek mírná forma, u 14 pacientek těžká forma). Tyto pacientky představovaly základní skupinu. Kontrolní skupinu tvořilo 38 pacientek. Výsledky: U těhotných žen, u nichž se následně vyvinula preeklampsie, byla hladina matrixové metaloproteinázy-2 v 11.–13. týdnu těhotenství 155 ± 73,4 ng/ml a byla významně vyšší než úroveň u těhotných žen bez hypertenzních poruch (75,0 ± 32,8 ng/ml). Prováděná studie prokazuje významně nižší koncentraci matrixové metaloproteinázy 9 u těhotných žen s preeklampsií v porovnání s kontrolní skupinou (749 ± 296 ng/ml vs. 1 667 ± 552 ng/ml; p < 0,001). Provedený výzkum ukazuje, že v prvním trimestru byla mezní hodnota matrixové metaloproteinázy-2 pro predikci rozvoje preeklampsie ≥ 102 ng/ml (senzitivita 88,24 % a specificita 82,76 %). V případě matrixové metaloproteinázy-9 předpovídala v prvním trimestru rozvoj preeklampsie hladina ≤ 980 ng/ml se senzitivitou 85,29 % a specificitou 84,48 %. Závěr: Studie stanovila mezní hodnoty matrixových metaloproteináz-2 a -9 v prvním trimestru pro předpověď rozvoje preeklampsie.
Introduction: Preeclampsia is a life-threatening condition for the mother and foetus. Globally, it is diagnosed in 10 mil. women every year, which accounts for 3% to 8% of all pregnancies. Currently there is no proven effective treatment for preeclampsia. The aforesaid text actualises the issue of predicting this complication. To determine the prognostic significance of matrix metalloproteinases-2 and -9 levels as early markers of preeclampsia, the present prospective study was conducted. Materials and methods: The levels of matrix metalloproteinases-2 and -9 were assessed in 72 patients. Thirty-four of them subsequently developed preeclampsia during pregnancy (20 patients with moderate preeclampsia, 14 patients with severe preeclampsia), and constituted the basic group; 38 patients made up the control group. Results: In pregnant women with the subsequent development of preeclampsia, the level of matrix metalloproteinase-2 at 11–13 weeks of gestation was 155 ± 73.4 ng/mL and significantly exceeded its level in pregnant women without hypertensive disorders – 75.0 ± 32.8 ng/mL. The study conducted demonstrates a significantly lower concentration of matrix metalloproteinase-9 in pregnant women with preeclampsia compared to the control – 749 ± 296 ng/mL and 1,667 ± 552 ng/mL (P < 0.001). The performed research figures that in the first trimester, the cut-off value of matrix metalloproteinase-2 for predicting the development of preeclampsia is ≥ 102 ng/mL (sensitivity 88.24% and specificity 82.76%). For matrix metalloproteinase-9, a level of ≤ 980 ng/mL in the first trimester predicts the development of preeclampsia with a sensitivity of 85.29% and a specificity of 84.48%. Conclusion: The study established the cut-off values of matrix metalloproteinases-2 and -9 for predicting the development of preeclampsia in the first trimester.
