Úvod: Špatně maturující hemodialyzační zkrat je často řešeným problémem na pracovištích hemodialýzy. Etiologie bývá různorodá, nedostatečné žilní řečiště, stenóza v anastomóze či na odvodné žíle a v neposlední řadě též přítomnost kolaterálních žil. V současné době běžnými přístupy k redukci žilních kolaterál jsou chirurgické podvazy nebo endovaskulární embolizace, jsou však časově, organizačně i finančně náročné. Alternativou jsou různé typy perkutánních podvazů. Přinášíme popis výkonu jednoduchého perkutánního podvazu akcesorních žil za asistence zobrazovacích metod a analýzu souboru našich pacientů. Metoda: Retrospektivní analýza prospektivně nabíraných pacientů s nerozvíjejícím se dialyzačním zkratem. Jako kritérium úspěchu bylo stanoveno provedení úspěšné hemodialýzy do 4 týdnů od výkonu. Výsledky: V průběhu 2 let (březen 2015 – leden 2017) jsme u 7 pacientů provedli 11 podvazů kolaterálních žil, u všech došlo k maturaci zkratu pro potřebu provedení kvalitní hemodialýzy do 2, resp. 3 týdnů. Závěr: Nová technika je rychlá, levná, s dobrým klinickým i kosmetickým efektem.

Introduction: Non-maturing arteriovenous fistula is a common problem in hemodialysis units. The main reasons for maturation failure include a poor venous system, vein stenosis, stenosis in an anastomosis, or the presence of collateral veins. Currently, the usual approach to eliminate collateral vein drainage consists in surgical ligation or coil embolization; however, these procedures are time-consuming, logistically demanding and expensive. Alternatively, various types of percutaneous ligation are done. Below follows the description of a technique of image-guided percutaneous ligation of collateral veins and an analysis of our cohort of patients. Method: A retrospective study of prospectively enrolled patients with non-maturing arteriovenous fistulae. The criterion of success was defined as successful hemodialysis within 4 weeks after percutaneous ligation. Results: During a 2-year period (March 2015 – January 2017) 7 patients underwent 11 ligations of collateral veins. In all patients the arteriovenous shunts matured successfully for hemodialysis within 2 or 3 weeks following the ligation. Conclusion: The novel technique is fast, inexpensive and provides a good clinical and cosmetic outcome.

• MeSH
• arteriovenózní píštěl chirurgie   patofyziologie   MeSH
• arteriovenózní zkrat využití   MeSH
• chronické selhání ledvin terapie   MeSH
• dialýza ledvin * využití   MeSH
• kolaterální oběh MeSH
• koronární cévy patologie   MeSH
• lidé MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH

The paper deals with the concept of simple automated creation of gradient profile of the mobile phase for gradient-elution sequential injection chromatography (GE-SIC). The feasibility and merits of this concept are demonstrated on the separation and simultaneous assay of indomethacin as active principle and of its two degradation products (5-methoxy-2-methylindoleacetic acid and 4-chloro-benzoic acid) in a topical pharmaceutical formulation. The GE-SIC separation was performed with a FIAlab(®) 3000 SIC set-up (USA) equipped with an Onyx™ Monolithic C18 (25 mm × 4.6mm, Phenomenex(®)) column, a six-port selection valve, a 5-mL syringe pump and a fiber-optics UV CCD detector. Ketoprofen was used as an internal standard (IS). The gradient elution was achieved by automated reproducible mixing of acetonitrile and aqueous 0.2% phosphoric acid in the holding coil of the SIC system. Different profiles of the gradient elution were tested. The optimal gradient using two mobile phases 30:70 and 50:50 of acetonitrile/0.2% phosphoric acid (v/v) was achieved under the optimum flow rate 1.2 mL min(-1). The chromatographic resolution R between the peaks of all solutes (including the IS) was >2.00. The repeatability of retention times was characterized by the RSD values 0.18-0.30% (n=6). Net separation time was 3.5 min and the mobile phase consumption was 4.5 mL for a single GE-SIC assay. The figures of merit of the novel GE-SIC method compared well with those of conventional HPLC.

• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

INTRODUCTION: Dual-coil leads (DC-leads) were the standard of choice since the first nonthoracotomy implantable cardioverter/defibrillator (ICD). We used contemporary data to determine if DC-leads offer any advantage over single-coil leads (SC-leads), in terms of defibrillation efficacy, safety, clinical outcome, and complication rates. METHODS AND RESULTS: In the Shockless IMPLant Evaluation study, 2500 patients received a first implanted ICD and were randomized to implantation with or without defibrillation testing. Two thousand and four hundred seventy-five patients received SC-coil or DC-coil leads (SC-leads in 1025/2475 patients; 41.4%). In patients who underwent defibrillation testing (n = 1204), patients with both lead types were equally likely to achieve an adequate defibrillation safety margin (88.8% vs 91.2%; P = 0.16). There was no overall effect of lead type on the primary study endpoint of "failed appropriate shock or arrhythmic death" (adjusted HR 1.18; 95% CI, 0.86-1.62; P = 0.300), and on all-cause mortality (SC-leads: 5.34%/year; DC-leads: 5.48%/year; adjusted HR 1.16; 95% CI, 0.94-1.43; P = 0.168). However, among patients without prior heart failure (HF), and SC-leads had a significantly higher risk of failed appropriate shock or arrhythmic death (adjusted HR 7.02; 95% CI, 2.41-20.5). There were no differences in complication rates. CONCLUSION: In this nonrandomized evaluation, there was no overall difference in defibrillation efficacy, safety, outcome, and complication rates between SC-leads and DC-leads. However, DC-leads were associated with a reduction in the composite of failed appropriate shock or arrhythmic death in the subgroup of non-HF patients. Considering riskier future lead extraction with DC-leads, SC-leads appears to be preferable in the majority of patients.

• MeSH
• časové faktory MeSH
• defibrilátory implantabilní * MeSH
• elektrická defibrilace škodlivé účinky   přístrojové vybavení   mortalita   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhlá srdeční smrt prevence a kontrola   MeSH
• příčina smrti MeSH
• primární prevence přístrojové vybavení   MeSH
• protézy - design MeSH
• randomizované kontrolované studie jako téma MeSH
• rizikové faktory MeSH
• sekundární prevence přístrojové vybavení   MeSH
• selhání protézy MeSH
• senioři MeSH
• srdeční arytmie diagnóza   mortalita   patofyziologie   terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• srovnávací studie MeSH

Coiled coils are a common structural motif in many natural proteins that can also be utilized in the design and preparation of drug delivery systems for the noncovalent connection of two macromolecules. In this work, two different pairs of peptides forming coiled coil hetero-oligomers were designed, synthesized, and characterized. While the peptide sequences (VAALEKE)4 and (VAALKEK)4 predominantly form coiled coil heterodimers with randomly orientated peptide chains, (IAALESE)2-IAALESKIAALESE and IAALKSKIAALKSE-(IAALKSK)2 tend to form higher hetero-oligomers with an antiparallel orientation of their peptide chains. The associative behavior of these peptides was studied in aqueous solutions using circular dichroism spectroscopy, size-exclusion chromatography, isothermal titration calorimetry and sedimentation analyses. The orientation of the peptide chains in the coiled coil heterodimers was assessed using fluorescence spectroscopy with fluorescence resonance energy transfer labels attached to the ends of the peptides. The formation of the heterodimer can be used as a general method for the selective noncovalent conjugation of a specific targeting moiety with various drug carrier systems; this process involves simple self-assembly in a physiological solution before drug administration. The preparation of targeted macromolecular therapeutics consisting of a synthetic polymer drug carrier and a recombinant protein targeting ligand is discussed.

• MeSH
• methakryláty chemie   MeSH
• nosiče léků chemie   MeSH
• oligopeptidy chemie   MeSH
• sekundární struktura proteinů MeSH
• sekvence aminokyselin MeSH
• techniky syntézy na pevné fázi MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• elektronová mikroskopie MeSH
• fyzika MeSH
• mikroskopie MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Fyzika
• NLK Obory
• fyzika, biofyzika

Cíl: Cílem práce je zhodnotit endovaskulární léčbu iatrogenních poranění renálních tepen. Metodika: Od listopadu 2005 do listopadu 2013 jsme na našem pracovišti léčili jedenáct pacientů s iatrogenním poraněním renálních tepen. Jednalo se o pět žen a šest mužů ve věku od 45 do 71 let, věkový průměr byl 57, 8 roků. K iatrogennímu poranění došlo u šesti pacientů při perkutánní extrakci konkrementu, u dvou nemocných při parciální nefrektomii, u jedné nemocné při perkutánní nefrostomii a u dvou pacientů při biopsii transplantované ledviny. U sedmi pacientů bylo příčinou hematurie pseudoaneuryzma, u tří nemocných pseudoaneuryzma s arteriovenózní pištěli a u jednoho nemocného arteriovenózní pištěl. Vždy byly poraněny periferní větve renální tepny. U všech nemocných byly k embolizaci použity spirály. Výsledky: Technická úspěšnost v našem souboru byla 100%. U všech nemocných došlo k zástavě krvácení a u nemocných s transplantovanou ledvinou se zlepšila funkce. Nedošlo k žádné závažné komplikaci. Závěr: Endovaskulární léčba iatrogenních poranění renálních tepen je jednoduchá, bezpečná a velmi účinná.

Aim: To evaluate the outcome of endovascular treatment of iatrogenic injury of renal arteries. Method: From November 2005 to November 2013 we treated 11 patients with iatrogenic injury of renal arteries. There were 5 women and 6 men, aged from 45 to 71; the average age was 57.8 years. Cause of injury was percutaneous extraction of concrements in 6 patients, partial nephrectomy in 2 patients and biopsy of transplant kidney in 2 patients. All patients had hematuria. Source of hematuria was pseudoaneurysm in 7 patients, pseudoaenurysm and arteriovenous fistula in 3 patients and arteriovenous fistula in one patient. Peripheral branches were injured in all patients. Renal injury was managed by coil embolization in all cases. Results: Technical success was achieved in 100%. Clinical success (stop hematuria, hemodynamic stability, improved function of transplant kidneys) was 100%. No major complication was found. Conclusion: Endovascular treatment of iatrogenic injury of renal arteries is simple, safe and very effective.

• Klíčová slova
• ledvinná tepna, iatrogenní poranění, endovaskulární léčba,
• MeSH
• arteria renalis * zranění   MeSH
• Cajalova tělíska MeSH
• endovaskulární výkony metody   MeSH
• iatrogenní nemoci MeSH
• krvácení chirurgie   prevence a kontrola   terapie   MeSH
• ledviny krevní zásobení   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• terapeutická embolizace * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH

INTRODUCTION: The aim of this study was to find out the impact of degradation and regeneration of force over time at NiTi springs on the value and course of the final acting force and to verify the possibility of using these phenomena for a directed transition to the reverse plateau and its maintaining. METHODS: Static and cyclic mechanical loadings were performed. At first unused springs were tested. Afterwards the springs were mechanically stabilized by stress cycling and finally tested again. The difference in shape of the working curves was assessed. For simulation and description of the force degradation the modified Voight model was used. RESULTS: New springs, mainly those with large hysteresis, showed a significant stress-strain curve movement and shape changes during the cycling. The effect of the stress-strain curve course change disappeared fully in the stabilized springs. Multiple loading led to an overall decrease of force value during the measurement. The effect of force degradation and regeneration over time by simple static loading varies in the range of percentage of the nominal force in the plateau area. The transition between stress-strain curve phases caused by the degradation or regeneration of the force wasn't observed in case of mechanically stabilized springs. CONCLUSIONS: Springs should be mechanically stabilized before their application. The degree of force degradation over time is insignificant for mechanically stabilized springs. Degradation or regeneration of force over time, mechanical stabilization or micromovements in the mouth don't cause any transition between individual stress-strain curve phases.

• MeSH
• časové faktory MeSH
• lidé MeSH
• nikl * MeSH
• ortodontické aparáty * MeSH
• pevnost v tahu MeSH
• pevnost v tlaku MeSH
• pružnost * MeSH
• testování materiálů MeSH
• titan * MeSH
• viskozita * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Endovascular treatment is widely applied as the first-line treatment for intracranial aneurysms and includes simple coiling (SC), stent-assisted coiling (SAC), flow diversion stent, and flow disruption stent. The present study is a retrospective cohort study performed in Imam Khomeini Hospital, Department of Neurovascular Intervention, between March 2016 and March 2021. A total number of 229 patients with intracranial aneurysms who underwent therapeutic intravascular interventions were enrolled, of which 89 were treated with SC, 111 with SAC, 25 with flow diversion stent, and 4 with flow disruption stent. The mean age of the subjects was 51.8±12.6 years, and 51.1% were male. Modified Raymond-Roy classification (MRRC) was used to define the occlusion outcome. The success rate, considered as Class I and Class II of MRRC at treatment time was 89% (94.4% in SC, and 84.7% in SAC), which was increased to 90.9% (94% in SC, 93% in SAC, 69.6% in flow diversion stenting, 100% in flow disruption) at 6-month follow-up, and 84.6% (80.8% in SC, 87.8% in SAC, 78.3% in flow diversion stenting, and 100% in flow disruption) at 12-month follow-up. The mean modified Rankin Scale (mRS) before the procedure was 0.05±0.26 which was increased to 0.22±0.76 after the procedure, 0.22±0.76 at 6 months, and 0.30±0.95 at 12 months (P<0.001). Similar to previous studies, the present study demonstrates that neurovascular intervention can treat ruptured aneurysms as the first therapeutic modality with favourable outcomes. A double-blind, randomized clinical trial is needed to eliminate the confounding factors and better demonstrate the outcome.

• MeSH
• dospělí MeSH
• endovaskulární výkony * metody   MeSH
• intrakraniální aneurysma * terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• retrospektivní studie MeSH
• stenty MeSH
• terapeutická embolizace * metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• fyzika MeSH

• Konspekt
• Fyzika
• Učební osnovy. Vyučovací předměty. Učebnice
• NLK Obory
• fyzika, biofyzika
• NLK Publikační typ
• učebnice vysokých škol

• MeSH
• fyzika MeSH

• Konspekt
• Přírodní vědy. Matematické vědy
• NLK Obory
• přírodní vědy
• NLK Publikační typ
• učebnice vysokých škol