AIM: Transbronchial cryobiopsies are increasingly used for the diagnosis of interstitial lung disease (ILD), but there is a lack of published information on the features of specific ILD in cryobiopsies. Here we attempt to provide pathological guidelines for separating usual interstitial pneumonia (UIP) of idiopathic pulmonary fibrosis (IPF), fibrotic hypersensitivity pneumonitis (FHP) and connective tissue disease-associated ILD (CTD-ILD) in cryobiopsies. METHODS: We examined 120 cryobiopsies from patients with multidisciplinary discussion (MDD)-established CTD-ILD and compared them to a prior series of 121 biopsies from patients with MDD-established IPF or FHP. RESULTS: A non-specific interstitial pneumonia (NSIP) pattern alone was seen in 36 of 120 (30%) CTD-ILD, three of 83 (3.6%) FHP and two of 38 (5.2%) IPF cases, statistically favouring a diagnosis of CTD-ILD. The combination of NSIP + OP was present in 29 of 120 (24%) CTD-ILD, two of 83 (2.4%) FHP and none of 38 (0%) IPF cases, favouring a diagnosis of CTD-ILD. A UIP pattern, defined as fibroblast foci plus any of patchy old fibrosis/fibrosis with architectural distortion/honeycombing, was identified in 28 of 120 (23%) CTD-ILD, 45 of 83 (54%) FHP and 27 of 38 (71%) IPF cases and supported a diagnosis of FHP or IPF. The number of lymphoid aggregates/mm2 and fibroblast foci/mm2 was not different in IPF, CTD-ILD or FHP cases with a UIP pattern. Interstitial giant cells supported a diagnosis of FHP or CTD-ILD over IPF, but were infrequent. CONCLUSIONS: In the correct clinical/radiological context the pathological findings of NSIP, and particularly NSIP plus OP, favour a diagnosis of CTD-ILD in a cryobiopsy, but CTD-ILD with a UIP pattern, FHP with a UIP pattern and IPF generally cannot be distinguished.

• MeSH
• Biopsy methods   MeSH
• Adult MeSH
• Idiopathic Pulmonary Fibrosis pathology   complications   diagnosis   MeSH
• Lung Diseases, Interstitial * pathology   diagnosis   complications   MeSH
• Middle Aged MeSH
• Humans MeSH
• Connective Tissue Diseases * complications   pathology   diagnosis   MeSH
• Lung pathology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Transbronchial cryobiopsy (TBCB) is increasingly used for the diagnosis of fibrosing interstitial pneumonias, but there are few detailed descriptions of the pathologic findings in such cases. It has been proposed that a combination of patchy fibrosis and fibroblast foci with an absence of alternative features is diagnostic of usual interstitial pneumonia (UIP; ie, idiopathic pulmonary fibrosis [IPF]) in TBCB. In this study, we reviewed 121 TBCB in which a diagnosis of fibrotic hypersensitivity pneumonitis (FHP; n = 83) or IPF (n = 38) was made by multidisciplinary discussion and evaluated a range of pathologic features. Patchy fibrosis was found in 65 of 83 (78%) biopsies from FHP and 32of 38 (84%) biopsies from UIP/IPF cases. Fibroblast foci were present in 47 of 83 (57%) FHP and 27 of 38 (71%) UIP/IPF cases. Fibroblast foci/patchy fibrosis combined did not favor either diagnosis. Architectural distortion was seen in 54 of 83 (65%) FHP and 32 of 38 (84%) UIP/IPF cases (odds ratio [OR] for FHP, 0.35; P = .036) and honeycombing in 18 of 83 (22%) and 17 of 38 (45%), respectively (OR, 0.37; P = .014). Airspace giant cells/granulomas were present in 13 of 83 (20%) FHP and 1 of 38 (2.6%) UIP/IPF cases (OR for FHP, 6.87; P = .068), and interstitial giant cells/granulomas in 20 of 83 (24%) FHP and 0 of 38 (0%) UIP/IPF (OR, 6.7 x 106; P = .000). We conclude that patchy fibrosis plus fibroblast foci can be found in TBCB from both FHP and UIP/IPF. The complete absence of architectural distortion/honeycombing favors a diagnosis of FHP, as does the presence of airspace or interstitial giant cells/granulomas, but these measures are insensitive, and many cases of FHP cannot be separated from UIP/IPF on TBCB.

• MeSH
• Biopsy MeSH
• Fibrosis MeSH
• Granuloma pathology   MeSH
• Alveolitis, Extrinsic Allergic * diagnosis   pathology   MeSH
• Idiopathic Pulmonary Fibrosis * diagnosis   pathology   MeSH
• Lung Diseases, Interstitial * pathology   MeSH
• Humans MeSH
• Lung pathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Patient-specific approach is gaining a wide popularity in computational simulations of biomechanical systems. Simulations (most often based on the finite element method) are to date routinely created using data from imaging devices such as computed tomography which makes the models seemingly very complex and sophisticated. However, using a computed tomography in finite element calculations does not necessarily enhance the quality or even credibility of the models as these depend on the quality of the input images. Low-resolution (medical-)CT datasets do not always offer detailed representation of trabecular bone in FE models and thus might lead to incorrect calculation of mechanical response to external loading. The effect of image resolution on mechanical simulations of bone-implant interaction has not been thoroughly studied yet. In this study, the effect of image resolution on the modeling procedure and resulting mechanical strains in bone was analyzed on the example of cranial implant. For this purpose, several finite element models of bone interacting with fixation-screws were generated using seven computed tomography datasets of a bone specimen but with different image resolutions (ranging from micro-CT resolution of 25 μm to medical-CT resolution of 1250 μm). The comparative analysis revealed that FE models created from images of low resolution (obtained from medical computed tomography) can produce biased results. There are two main reasons: 1. Medical computed tomography images do not allow generating models with complex trabecular architecture which leads to substituting of the intertrabecular pores with a fictitious mass; 2. Image gray value distribution can be distorted resulting in incorrect mechanical properties of the bone and thus in unrealistic or even completely fictitious mechanical strains. The biased results of calculated mechanical strains can lead to incorrect conclusion, especially when bone-implant interaction is investigated. The image resolution was observed not to significantly affect stresses in the fixation screw itself; however, selection of bone material representation might result in significantly different stresses in the screw.

• MeSH
• Finite Element Analysis MeSH
• Biomechanical Phenomena MeSH
• Bone and Bones * MeSH
• Bone Screws * MeSH
• Humans MeSH
• Stress, Mechanical MeSH
• X-Ray Microtomography MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Lower Extremity physiology   MeSH
• Ankle Joint physiology   MeSH
• Joints physiology   MeSH
• Knee physiology   MeSH
• Ankle physiology   MeSH
• Hip physiology   MeSH
• Musculoskeletal Physiological Phenomena MeSH
• Foot physiology   MeSH
• Publication type
• Atlas MeSH
• Textbook MeSH

• Conspectus
• Fyziologie člověka a srovnávací fyziologie
• Učební osnovy. Vyučovací předměty. Učebnice
• NML Fields
• fyziologie

The understanding of locomotor patterns, activity schemes, and biological variations has been enhanced by the study of the geometrical properties and cortical bone thickness of the long bones measured using CT scan cross-sections. With the development of scanning procedures, the internal architecture of the long bones can be explored along the entire diaphysis. Recently, several methods that map cortical thickness along the whole femoral diaphysis have been developed. Precise homology is vital for statistical examination of the data; however, the repeatability of these methods is unknown and some do not account for the curvature of the bones. We have designed a semiautomatic workflow that improves the morphometric analysis of cortical thickness, including robust data acquisition with minimal user interaction and considering the bone curvature. The proposed algorithm also performs automatic landmark refinement and rigid registration on the extracted morphometric maps of the cortical thickness. Because our algorithm automatically reslices the diaphysis into 100 cross-sections along the medial axis and uses an adaptive thresholding method, it is usable on CT scans that contain soft tissues as well as on bones that have not been oriented specifically prior to scanning. Our approach exhibits considerable robustness to error in user-supplied landmarks, suppresses distortion caused by the curvature of the bones, and calculates the curvature of the medial axis.

• MeSH
• Algorithms MeSH
• Anthropology, Physical MeSH
• Femur diagnostic imaging   MeSH
• Humans MeSH
• Tomography, X-Ray Computed methods   MeSH
• Image Processing, Computer-Assisted methods   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Some factors include environmental triggers have role in development of intestinal inflammation in inflammatory bowel disease (IBD). A number of patients with IBD, experience improvement in their gastrointestinal symptoms and disease course when avoiding gluten. To highlight this issue we present a 28years old male patient, known case of ulcerative colitis, was admitted to the hospital for a flare-up of his disease. He presented with bloody diarrhea despite the fact that he was on long term variable dose of oral and topical Asacol since 4 years ago and azathioprine 2.5mg/kg/day prescribed for his persistent symptoms since last year. In spite of drug adherence, he experienced 3 flare-ups during past year and refused receiving prednisolone. Colonoscopy demonstrated severe erythema, multiple erosions and friability through the left colon from rectum up to splenic flexure. Histopathological evaluation revealed crypt architecture distortion with moderate increase in lymphoplasmacytic infiltration as well as neutrophilic activity in the form of cryptitis and crypt abscess formation. Upper GI endoscopy followed by duodenal biopsies and serological evaluation were negative for celiac disease. Before considering anti-TNF agents, patient underwent a gluten-free diet (GFD) and with a positive response, it continued for 6 weeks. After 6 weeks GFD his bloody diarrhea was nearly resolved and 12 weeks later most of his symptoms disappeared and entered to the full clinical remission. He stopped the diet and 12 weeks later his symptoms returned and experienced another relapse that again improved on GFD.As an environmental factor, gluten represents a strong antigen that might be implicated in the pathogenesis of at least a number of patients with IBD. Dietary restriction of gluten might be useful in some IBD patients during the exacerbation of their disease.

• Keywords
• neceliakální glutenová senzitivita,
• MeSH
• Diet, Gluten-Free * MeSH
• Adult MeSH
• Humans MeSH
• Colitis, Ulcerative * diagnosis   diet therapy   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

Idiopatická plicní fibróza (IPF) je progresivní a obvykle fatální forma idiopatické intersticiální pneumonie (IIP). IPF je charakterizována selháním alveolární reepitelizace, perzistencí fibroblastů, depozicí extracelulární matrix a poruchou alveolární architektoniky, která vede k respiračnímu selhání. Cílem naší práce bylo zjistit klinické charakteristiky, průběh nemoci a prognostické faktory u pacientů s IPF v běžné klinické praxi. Analyzovali jsme 202 pacientů, kteří byli pro IPF sledování v síti center pro diagnostiku a léčbu intersticiálních plicních procesů v České republice. Diagnostika IPF vycházela z doporučení American Thoracic Society (ATS)/European Respiratory Society (ERS). Naším cílem bylo ověřit prognostické faktory nemoci a osud našich pacientů. Do analýzy bylo zahrnuto 73 mužů a 129 žen, s mediánem věku 67 let. IPF byla histologicky ověřena u 66 (33 %) pacientů. Medián času od prvních klinických příznaků do stanovení diagnózy byl 12 měsíců. U 57 nemocných (28,3 %) byla diagnóza stanovena do 6 měsíců od začátku symptomů. Osm (4 %) pacientů mělo akutní exacerbaci. V jednorozměrné analýze byly zjištěny následující faktory, negativně ovlivňující přežití v době diagnózy: vyšší věk, paličkovité prsty, vyšší stupeň dušnosti dle NYHA (New York Heart Association), průkaz neutrofilní alveolitidy v bronchoalveolární tekutině (BALT), vyšší věk bez histologické verifikace, kardiovaskulární komorbidity, diabetes a osteoporóza. Jako příznivé prognostické faktory byly zjištěny: lepší hodnoty vitální kapacity (VC), celkové plicní kapacity (TLC) a plicní difuze (DLCO, KCO). Vícerozměrná analýza ukázala, že nepříznivá prognóza nemoci je asociována s vyšším věkem a vyšším stupněm dušnosti. Průkaz lymfocytární alveolitidy v BALT a lepší hodnoty vstupních parametrů VC a DLCO byly spojeny s lepším přežitím. Nebyl zjištěn žádný rozdíl v přežití mezi pohlavími a mezi kuřáky a nekuřáky. Přítomnost emfyzému neměla vliv na mortalitu a ani na rozsah plicní fibrózy na HRCT hrudníku.Medián přežití dosahoval 51,6 měsíce od diagnózy a nejčastější příčinou smrti bylo respirační selhání.

Idiopathic pulmonary fibrosis (IPF) is a rare, progressive and usually fatal form of idiopathic interstitial pneumonia. IPF is characterized by failure of alveolar re-epithelization, persistence of fibroblasts, deposition of extracellular matrix, and distortion of lung architecture, which ultimately results in respiratory failure. We analysed 202 consecutive patients with IPF diagnosed at the Departments of Pulmonary Diseases and Tuberculosis in the Czech Republic, who they were included in the nationwide Czech IPF registry. Our aim was to determine prognostic factors of IPF and outcome of the disease. There were 129 males and 73 females who were the median age 67 years. IPF was biopsy-proven in 66 (33 %) of patients. Median time from the first symptom to diagnosis was 12 months. Diagnosis was made in 57 patients (28.3 %) within 6 months from the onset of respiratory symptoms. 8 (4 %) patients had an acute exacerbation during the course of the disease. In uniparametric (univariate) analysis as prognostic factors associated with poorer survival were found: higher age, higher degree dyspnea scores, clubbing fingers, comorbidities (arterial hypertension, osteoporosis), patients without histology biopsy, and bronchoalveolar increased neutrophil count. We found these positive prognostic factors: higher levels of VC (vital capacity), TLC (total lung capacity) and DLCO (diffusing capacity for carbon monooxide). In multiparametric (multivariate) analysis as prognostic factors associated with mortality were found: higher age, higher degree of dyspnoe score. Increased lymphocytes in bronchoalveolar fluid, higher level of VC a DLCO were associated with better survival. There was no difference in survival of patients by sex, by smoking status. No significant difference in survival rates was found between IPF with and without emphysema, between the extent of fibrosis on HRCT (high resolution computed tomography) of thorax and mortality. Median survival was 51.6 months. 58 (28.7 %) patients died. The most frequent reason of dead was IPF progression with respiratory failure.

• MeSH
• Bronchoalveolar Lavage MeSH
• Phenotype MeSH
• Idiopathic Pulmonary Fibrosis * diagnosis   mortality   therapy   MeSH
• Body Mass Index MeSH
• Kaplan-Meier Estimate MeSH
• Comorbidity MeSH
• Smoking MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Tomography, X-Ray Computed MeSH
• Cause of Death MeSH
• Prognosis * MeSH
• Respiratory Function Tests MeSH
• Risk Factors * MeSH
• Aged MeSH
• Statistics as Topic MeSH
• Age of Onset MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Geographicals
• Czech Republic MeSH

HMGB proteins are members of the High Mobility Group (HMG) superfamily, possessing a unique DNA-binding domain, the HMG-box, which can bind non-B-type DNA structures (bent, kinked and unwound) with high affinity, and also distort DNA by bending/looping and unwinding. HMGBs (there are four HMGBs in mammals, HMGB1-4) are highly abundant and ubiquitously expressed non-histone proteins, acting as DNA chaperones influencing multiple processes in chromatin such as transcription, replication, recombination, DNA repair and genomic stability. Although HMGB1 is a nuclear protein, it can be secreted into the extracellular milieu as a signaling molecule when cells are under stress, in particular, when necrosis occurs. Mammalian HMGBs contain two HMG-boxes arranged in tandem, share more than 80% identity and differ in the length (HMGB1-3) or absence (HMGB4) of the acidic C-tails. The acidic tails consist of consecutive runs of only Glu/Asp residues of various length, and modulate the DNA-binding properties and functioning of HMGBs. HMGBs are subject to post-translational modifications which can fine-tune interactions of the proteins with DNA/chromatin and determine their relocation from the nucleus to the cytoplasm and secretion. Association of HMGBs with chromatin is highly dynamic, and the proteins affect the chromatin fiber as architectural factors by transient interactions with nucleosomes, displacement of histone H1, and facilitation of nucleosome remodeling and accessibility of the nucleosomal DNA to transcription factors or other sequence-specific proteins.

• MeSH
• Chromatin metabolism   MeSH
• DNA metabolism   MeSH
• Humans MeSH
• Molecular Sequence Data MeSH
• Protein Processing, Post-Translational MeSH
• HMGB Proteins chemistry   genetics   metabolism   MeSH
• Gene Expression Regulation MeSH
• Amino Acid Sequence MeSH
• Protein Binding MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

• MeSH
• Cell Biology MeSH
• Molecular Biology MeSH
• Publication type
• Monograph MeSH

• Conspectus
• Biochemie. Molekulární biologie. Biofyzika
• NML Fields
• biologie
• cytologie, klinická cytologie

Idiopatická plicní fibróza (IPF) je vzácné a progredující onemocnění, které většinou končí fatálně. Jde o jednu z forem idiopatické intersticiální pneumonie. Pro IPF je charakteristické selhání alveolární reepitelizace, perzistence fibroblastů v plicní tkáni, nadměrná tvorba extracelulární matrix a z toho plynoucí porucha plicní architektoniky, která končívá respiračním selháním. Diagnostický histologický obraz u IPF se nazývá běžná intersticiální pneumonie (UIP). Provedli jsme analýzu všech 47 nemocných, u nichž byla IPF zjištěna, na Klinice nemocí plicních a tuberkulózy FN Brno v letech 2002 – 2005, s cílem ověřit prognostické faktory nemoci a osud našich pacientů s IPF. Bylo mezi nimi 28 mužů a 19 žen v mediánu věku 63 let. Histologicky byla IPF prokázána u 32 % pacientů. Medián doby od prvních příznaků do stanovení diagnózy byl 8 měsíců. Hodnocení efektu léčby ve dvou následujících návštěvách po 3 až 6 měsících od zahájení terapie ukázalo, že ke zlepšení došlo u 3 (9 %) pacientů, ke stabilizaci nemoci u 9 (26 %) pacientů a u 22 (65 %) bylo pozorováno selhání terapie a progrese nemoci. Zaznamenali jsme lepší léčebnou odpověď u pacientů s lymfocytózou (> 20 %) v tekutině z bronchoalveolární laváže. Zjistili jsme nesignifikantně lepší přežívání kuřáků a mladších nemocných. Mezi muži a ženami nebyl v přežívání rozdíl. Za dobu sledování zemřelo 9 nemocných. Mediánu celkového přežití ale zatím dosaženo nebylo.

Idiopathic pulmonary fibrosis (IPF) is a rare, progressive and usually fatal form of idiopathic interstitial pneumonia. IPF is characterized by failure of alveolar reepithelization, persistence of fibroblasts, excessive production of extracellular matrix and the resulting distortion of lung architecture ultimately leading to respiratory failure. The current consensus statements reserve the term IPF to refer to a specific clinical entity associated with the histopathological pattern of usual interstitial pneumonia (UIP). Forty-seven consecutive patients with IPF diagnosed at the Department of Pulmonary Diseases and Tuberculosis, Masaryk University Hospital Brno, in the years 2002-2005 were studied to verify prognostic features and outcome of the disease. There were 28 males and 19 females with the median age of 63 years. IPF was biopsy-proven in 32 % of the patients. The median time from the initial symptoms to diagnosis was 8 months. Evaluation of the effect of treatment on two consecutive visits 3 and 6 months after therapy showed that the condition improved in 3 (9 %) patients, remained stable in 9 (26 %) and progressed due to therapy failure in 22 (65 %). Better treatment results were observed in patients with lymphocytosis (> 20 %) in bronchoalveolar lavage fluid. Non-significant better survival was found in smokers and younger patients. There was no gender difference in survival of the patients. Nine patients died, however, the median overall survival was not achieved during the 40-month follow-up.

• MeSH
• Survival Analysis MeSH
• Lung Diseases, Interstitial diagnosis   drug therapy   MeSH
• Humans MeSH
• Pulmonary Fibrosis diagnosis   drug therapy   MeSH
• Review Literature as Topic MeSH
• Prognosis MeSH
• Retrospective Studies MeSH
• Check Tag
• Humans MeSH