In this study, three different molecules (cholesterol, phosphatidic acid, and polyethylene glycol) were used for the stabilization of liposomes during the nebulization process. The purpose of this article is to answer the question of whether the change in the composition of liposomes affected the parameters of generated aerosol and whether the nebulization process affected observed properties of liposomes. Firstly, liposomes with different composition were prepared and their properties were checked by dynamic and electrophoretic light scattering. The membrane properties were measured by fluorescence spectroscopy - especially generalized polarization (Laurdan) and anisotropy (Diphenylhexatriene). The same characteristic of liposomes was measured after the nebulization by vibrating mesh nebulizer. Cholesterol was capable of liposome stabilization because of increased membrane fluidity. The membrane properties of the outer and inner parts were not influenced by the nebulization process. Electrostatic stabilization was successful for the lowest concentration of phosphatidic acid, but after the nebulization process the hydration of the membrane outer part was changed. Higher amount of PEG needs to be added for successful steric stabilization. The nebulization process of the two lowest concentrations of PEG slightly influenced immobilized water and the rigidity of inner part of the membrane (especially around the phase transition temperature).

• MeSH
• aerosoly MeSH
• chirurgické síťky * MeSH
• liposomy * MeSH
• nebulizátory a vaporizátory MeSH
• velikost částic MeSH
• Publikační typ
• časopisecké články MeSH

Autoři prezentují sestavu 24 pacientů s kýlou v jizvě operovaných od února 2004 do ledna 2005 (12 měsíců) metodou retromuskulární plastiky podle Rivese. Byla provedena plastika 20 kýl po střední laparotomii a 4 kýl po laterálních laparotomiích, velikost defektu byla od 5 do 16 cm. K plastice byla použita polypropylenová síťka, uložená mezi přímý břišní sval a zadní list pochvy přímého břišního svalu s překrytím síťky okrajem fascie minimálně 5 cm ve všech směrech. Průměrná doba sledování byla šest měsíců (1–12 měsíců), u žádného pacienta nebyla zjištěna časná recidiva. Výskyt komplikací byl přijatelný – 1× sekundární hojení rány, 2× serom, 1× netransmurální IM u pacientky s ischemickou chorobou srdeční. Retromuskulární plastika podle Rivese se zdá být vhodnou metodou řešení velkých ventrálních kýl s výbornými výsledky a minimem komplikací.

The authors present a group of 24 patients with hernias in scars operated from February 2004 to January 2005 (12 months) using a retromuscular reconstruction procedure according to Rives. 20 procedure following central laparotomies and 4 procedures following lateral laparotomies were conducted. The defect sizes ranged from 5 to 16 cm. A polypropylene mesh was used which was placed between the rectus abdominis muscle and the posterior leaf of the rectus abdominis sheath. The mesh was covered by the fascia with a minimum overlap of 5 cm in all directions. The mean follow- up period was six months (1–12 months) and no early relapses were recorderd. The complications rate was acceptable – 1× secondary wound healing, 2× seroma, 1× non-transmural MI in a patient with a cardiac ischemic disorder. The retromuscular reconstruction procedure according to Rives appears to be an appropriate method for management of large ventral hernias with excellent results and minimum complications.

• MeSH
• antiflogistika nesteroidní aplikace a dávkování   MeSH
• chirurgické síťky využití   MeSH
• drenáž MeSH
• elektivní chirurgické výkony metody   MeSH
• laparotomie metody   škodlivé účinky   MeSH
• lidé MeSH
• polypropyleny MeSH
• pooperační komplikace etiologie   MeSH
• šicí techniky MeSH
• sufentanil aplikace a dávkování   MeSH
• ventrální hernie etiologie   chirurgie   MeSH
• Check Tag
• lidé MeSH

Cíl studie: Zhodnocení a kvantifikování časných a pozdních změn v délce implantátu po rekonstrukci přední stěny poševní s použitím sítěk pomocí ultrazvukového vyšetření. Typ studie: Prospektivní intervenční studie. Metodika: Ultrazvukové hodnocení 35 pacientek rozdělených do dvou skupin s inzercí Gynemesh síťky, a to buď v podobě kitu Prolift anterior, či individualizovanou velikostí sítky. Ultrazvukové vyšetření probíhalo časně 4. pooperační den a poté za 3–4 měsíce. Tyto hodnoty byly porovnány s originální velikostí implantované síťky a výsledek je vyjádřen jako procento zkrácení. Výsledky: Při porovnání původní délky a jejího rozměru změřeného při pozdním ultrazvukovém vyšetření bylo zkrácení ve skupině Prolift až 45 % oproti 25 % ve druhé skupině. Avšak při porovnání změny rozměru u obou skupin mezi časným a pozdním ultrazvukový vyšetřením, tj. parametr nazvaný – svraštění, byla změna jen o 16 % resp. 20 %, tj. nebyl rozdíl mezi oběma skupinami. Závěr: Podíl vlastní tkáňové reakce, tj. svraštění, je jen 16–20 %. Zkrácení Prolift anterior síťky významně ovlivňuje její nedostatečné rozprostření či ukotvení.

Objective: To evaluate and quantify early and late changes in mesh length after anterior vaginal repair with implants with ultrasound. Type of study: Prospective interventional study. Methods: Ultrasound assessment of 35 patient randomized in two groups both with Gynemesh insertion. In one group with Gynemesh Prolift anterior kit and second group with individualized size of the Gynemesh. Ultrasound measurement of the mesh in sagittal plane was performed postoperative day 4 and after 3-4 month. Measured values were put in proportions, together with the original size of the mesh. Results are expressed as a percentage of shortening. Results: In comparison of measurements from the late ultrasound scans with original size the shortening of the Prolift was 45% vs. 25% in Mesh group. When we compared the late and early ultrasound scans, there was no difference in the shrinking of the mesh in both group 16% vs 20% Conclusion: Insufficient spreading and anchoring of the anterior Prolift has a major impact on the final length of the mesh. The tissue reaction expressed as shrinking of the mesh is only 16-20%.

• MeSH
• chirurgické síťky MeSH
• lidé středního věku MeSH
• lidé MeSH
• prolaps dělohy chirurgie   ultrasonografie   MeSH
• randomizované kontrolované studie jako téma MeSH
• vagina ultrasonografie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH

BACKGROUND AND OBJECTIVE: Large deformations in synthetic meshes used in pelvic organ prolapse surgery may lead to suboptimal support for the underlying tissue, graft-related complications as well as recurrence. Our aim was to quantify in vivo longitudinal changes in mesh shape and geometry in a large animal model. We compare two commonly used mesh shapes, armed and flat, that are differently affixed. The secondary outcomes were active and passive biomechanical properties. METHODS: A total of 18 animals were used. Six each were implanted with either an arm mesh, a flat mesh or underwent a sham surgery. PVDF meshes loaded with Fe2O3were used to facilitate their visualization in vivo. MR images were taken at 2, 14 and 60 days after implantation and 3D models of the meshes were created at each time point. We calculate the Effective Surface Area (ESA), i.e. the support that the mesh provides to the underlying tissue using custom developed techniques. Longitudinal changes in the mesh shape were studied by comparing the respective 3D models using part comparison analyses. The root means square difference (RMSD) and the modified Hausdorff distance (MHD) were calculated to obtain an objective value for the part comparisons. Wall thickness maps were produced on 3D models. Mesh arm length and their ellipticity profiles were also evaluated. Active and passive biomechanical tests on vaginal tissue overlaying the mesh were conducted using a contractility assay and a uniaxial loading protocol. RESULTS: MR images of 5 animals in each group were used for longitudinal comparison. Compared to the initial implant size, there was an immediate drop in the ESA measurement at day 2 of almost 32.22 [7.06] % (median [IQR]) for flat meshes, and by 17.59 [6.50] % for arm meshes. After 14 days, the reduction in area was 41.84 [14.89] % and 27.18 [20.44] %, and at day 60 it was 36.61 [6.64] % and 26.43 [14.56] % for the flat and armed meshes respectively. The reduction in area in the two groups was different between the two groups only day 14 (p = 0.046). The ellipticity of the arms was 0.81 [0.08] (median [IQR]) and there was no significant change in the ellipticity profiles over time. The mesh arm length did not change significantly over time. The part comparison showed a maximum difference of 4.26 [3.29] mm in 3D models according to the MHD measure, which is clinically not relevant. Comparison of high thickness areas on the thickness maps correlated well with the areas of mesh folding in the arm mesh group observed during postmortem dissection. Thickness maps did not help us understand why the flat meshes had a reduction in support area. The comfort zone stiffness of the flat mesh and of the central part of the arm mesh were 2.4 fold and 4.5 times stiffer compared to sham groups, respectively. The arms were 36% stiffer than the central part of the mesh. The comfort zone length of the sham group was 46% longer than the flat mesh group (p = 0.027) and 59% longer than that of the central part of the arm mesh (p = 0.005). There was no significant difference in vaginal contractile forces generated in samples from the arm, flat mesh, and sham groups. CONCLUSIONS: This is a first longitudinal study observing deformations in vaginally implanted synthetic meshes in a large animal model. A novel methodology is presented to calculate the area of the vaginal tissue effectively supported by the mesh implant. Immediately post-operatively, a reduction in 32% and 17% was noted, which remained stable over the 60 following days of observation. We use thickness maps to analyze the cause of this dramatic immediate reduction. In the armed mesh we found it to be mesh folding at the interface between the arms and central part. For the flat mesh we suggest that pore aggregation during suturing.

• MeSH
• chirurgické síťky * MeSH
• longitudinální studie MeSH
• magnetická rezonanční tomografie * MeSH
• ovce MeSH
• prolaps pánevních orgánů chirurgie   MeSH
• testování materiálů * MeSH
• vagina chirurgie   MeSH
• železité sloučeniny MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Diabetes mellitus a jeho kompenzaci provází závažné komplikace. Jednou z nich je hypoglykemie, ke které dochází u pacientů užívajících insulin a/nebo některá perorální antidiabetika. Těmto stavům je možné předcházet lékovou formou s řízeným uvolňováním glukosy. K tomuto účelu byla navržena peletová jádra o třech různých velikostech odpovídajících rozměrům oka extruzní přepážky (0,6; 0,8; 1,0 mm) o čtyřech různých složeních. Jádra obsahují vždy 75–80 % glukosy a u každé kompozice i jednu osmoticky aktivní, resp. bobtnající látku, jako je kroskarmelosa sodná sůl (ADS), směs mikrokrystalické celulosy a sodné soli karmelosy Avicel RC 591 (RC), polyethylenglykol 6000 (PEG) a sodná sůl karboxymethylškrobu (CMS). Jádra byla připravena metodou extruze/sféronizace a jsou určena k následnému obalení polopropustným filmem na bázi ethylcelulosy. Samotná příprava ani fyzikální hodnocení peletových jader není součástí této práce. Jedná se o statistické hodnocení z již publikovaných prací, jejichž výsledky jsou zpracovány formou metaanalýzy s využitím analýzy hlavních komponent. Bylo shledáno, že velikosti jader se odlišují svými fyzikálními vlastnostmi. Ačkoliv vzorky o jednotlivých velikostech měly stejné složení i výrobní postup, jádra vzniklá extruzí skrze oko o velikosti 0,6, resp. 0,8 mm, vykazují podobné vlastnosti, zatímco jádra vzniklá extruzí skrze oko 1,0 mm se od zbylých dvou skupin spíše odlišují.

Diabetes mellitus and its compensation are accompanied by serious complications. One of them is hypoglycaemia, which occurs in patients treated with insulin and/or certain peroral antidiabetics. Hypoglycaemic episodes can be prevented by a dosage form with controlled release of glucose. The pellet cores of four compositions and three different sizes corresponding to the diameter of extrusion screen mesh (0.6, 0.8, and 1.0 mm) were prepared for this purpose. The cores contain 75–80% of glucose combined with one of the following osmotically or swellable active agents: croscarmellose sodium (ADS), a mixture of microcrystalline cellulose and carmellose sodium Avicel RC 591 (RC), polyethylene glycol 6000 (PEG), and carboxymethyl starch (CMS). The cores were prepared by extrusion-spheronization and are intended for subsequent coating by a semipermeable membrane based on ethylcellulose. The aim of the work was to statistically evaluate the results of the physical evaluation of the pellets which were prepared and evaluated in previously published papers. The results are processed in the form of a meta-analysis using principle component analysis. The physical characteristics of the individual pellet sizes were different among themselves. Although the same compositions and manufacturing methods were used for all the pellets sizes, the cores produced through a 0.6 and 0.8 mm mesh screens showed similar properties while the properties of cores produced through a 1.0 mm mesh screen were rather different.

• MeSH
• diabetes mellitus 2. typu MeSH
• dítě MeSH
• enterosolventní tablety * MeSH
• farmaceutická technologie MeSH
• glukosa * aplikace a dávkování   terapeutické užití   MeSH
• hypoglykemie * prevence a kontrola   MeSH
• léčivé přípravky MeSH
• lékové formy * MeSH
• lidé MeSH
• metaanalýza jako téma MeSH
• polykání MeSH
• rozpustnost MeSH
• velikost částic MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

BACKGROUND: The aim of the study was to evaluate the influence of the pore size of a polypropylene mesh on the shrinkage and elasticity of the mesh-tissue complex and the inflammatory reaction to the implant in an open onlay hernia repair. MATERIALS AND METHODS: Twenty-one 10 × 10 cm samples of polypropylene meshes of a different pore size (3.0 × 2.8 mm-PP3, 1.0 × 0.8 mm-PP1 and 0.6 × 0.5 mm-PP.5) were implanted in an onlay position in 21 New Zealand white rabbits. After 90 days of implantation the shrinkage, elasticity and foreign body reaction (FBR) were assessed. RESULTS: The shrinkage of PP3 was 30.6 ± 4.3 %, PP1 49.3 ± 2.9 % and PP.5 49.5 ± 2.6 %. The shrinkage of PP3 was significantly lower (PP3 × PP1 p = 0.007, PP3 × PP.5 p = 0.005), PP1 and PP.5 were similar. The elasticity was similar. The strength of FBR in mesh pores was similar. The width of foreign body granuloma layers at the mesh-tissue interface was significantly reduced with increasing pore size (inner: PP3 10.1 ± 1.2; PP1 12.5 ± 2.9; PP.5 17.4 ± 5.2 and outer: PP3 21.2 ± 2.5; PP1 30.6 ± 6.3; PP.5 60.4 ± 14.9). All differences between the widths of granuloma layers were statistically significant (p < 0.010). One animal (PP1) was excluded because of a mesh infection. CONCLUSIONS: Implantation of polypropylene mesh of a pore size of 3 mm in an onlay position is associated with a significant reduction of shrinkage in comparison to a 1 mm pore lightweight and 0.5 mm pore heavyweight mesh. A pore size increase to 3 mm is not sufficient for an improvement of mesh-tissue complex elasticity in comparison to a 1 mm pore lightweight and 0.5 mm heavyweight mesh. Polypropylene mesh with enlarged pores to 3 mm is associated with a similar strength of FBR in mesh pores and a reduced foreign body granuloma in comparison to a 1 mm pore lightweight and 0.5 mm pore heavyweight mesh.

• MeSH
• biokompatibilní materiály MeSH
• chirurgické síťky * škodlivé účinky   MeSH
• granulom z cizího tělesa etiologie   patologie   MeSH
• králíci MeSH
• modely nemocí na zvířatech MeSH
• operace kýly * MeSH
• polypropyleny škodlivé účinky   MeSH
• pružnost MeSH
• testování materiálů MeSH
• zánět MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

AIM: The aim of our study is to introduce a new objective method of perioperative evaluation of the size of diaphragmatic defect to enable comparison of results among various centres and methods used for diaphragmatic reconstruction. MATERIALS AND METHODS: Prospective observational study of neonates with congenital diaphragmatic hernia (CDH) and respiratory distress within 24 h of birth operated on from January 2009 to December 2011. Weight, length, thoracic shape and the diameters of diaphragmatic defect were measured. To determine the relative size of the defect, a defect-diaphragmatic ratio (DDR = defect area:diaphragm area × 100) was calculated. The measured and calculated data were subsequently compared between Gore-Tex patch group (GT) and primary repair group (PR). Mann-Whitney U test was used for statistical analysis. RESULTS: Forty-seven patients with CDH were admitted during study period. The overall survival rate was 79 % (37/47). Preoperative stabilization was achieved in 85 % (40/47). Survival of operated neonates was 93 % (37/40). Diaphragmatic reconstruction with Gore-Tex patch was used in 7 neonates (17 %), and primary repair in 33 (83 %). Mortality in Gore-Tex group was 29 %; mortality in primary repair group was 3 %. Data of anthropometric measurement were complete in 34 children (5 GT and 29 PR). Significant differences were found between GT group and PR group in the size of diaphragmatic defect with the transverse and sagittal diameters of defect (48.0 ± 5.7 vs. 30.1 ± 5.9, P < 0.00061; 34.0 ± 12.5 vs. 16.0 ± 7.3, P < 0.0022) and DDR (18.29 ± 4.60 vs. 5.77 ± 3.28, P < 0.0005), respectively. CONCLUSION: The value of DDR as an objective criterion of the extent of diaphragmatic defect was confirmed by the close correlation between DDR and feasibility of primary repair in the study group. This objective assessment of defect size may improve comparing various surgical techniques and results of different centres, and thus facilitates sharing experience with management of neonates with CDH.

• MeSH
• bránice chirurgie   MeSH
• brániční hernie diagnóza   mortalita   chirurgie   MeSH
• chirurgické síťky * MeSH
• lidé MeSH
• míra přežití trendy   MeSH
• následné studie MeSH
• novorozenec MeSH
• prospektivní studie MeSH
• stupeň závažnosti nemoci MeSH
• vrozená brániční kýla MeSH
• výsledek terapie MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH

Background and Objectives: Surgical site infections (SSIs) are a significant complication following ventral hernia repair, potentially leading to prolonged hospital stays and increased morbidity. This study aimed to evaluate whether closed incision negative pressure wound therapy (ciNPWT) reduces the incidence of SSI after ventral hernia repair with polypropylene mesh compared to standard wound care. Materials and Methods: A randomized study was conducted with 100 patients undergoing ventral hernia repair using a polypropylene mesh. Participants were divided into two groups: a control group (n=50), which received standard sterile gauze dressing with an iodine-based disinfectant, and an intervention group (n=50), treated with the ciNPWT system (Vivano® by HARTMANN) for 5 days postoperatively. The primary outcome was the incidence of SSI within one year after surgery. Secondary outcomes included the influence of factors such as age, sex, smoking status, and hernia size on SSI occurrence. The study was approved by the Ethics Committee at the University Hospital Ostrava, adhering to the ethical standards of the Helsinki Declaration. Results: The incidence of SSI was lower in the ciNPWT group compared to the standard care group (4% vs. 12%), though this difference did not reach statistical significance. No significant effect of sex or smoking status on SSI was observed. The control group had a shorter mean length of hospital stay. Larger hernias in the non-ciNPWT group were more prone to SSIs, as expected. Conclusions: Although limited by a small sample size, the findings suggest that ciNPWT may be associated with a reduced rate of SSI following ventral hernia repair. Further studies with larger populations are needed to confirm these results.

• MeSH
• chirurgické síťky * MeSH
• dospělí MeSH
• incidence MeSH
• infekce chirurgické rány * prevence a kontrola   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• operace kýly * metody   škodlivé účinky   MeSH
• polypropyleny * MeSH
• senioři MeSH
• terapie ran pomocí řízeného podtlaku * metody   MeSH
• ventrální hernie * chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

• MeSH
• charakteristiky rodiny MeSH
• lidé MeSH
• senioři ošetřování   MeSH
• Check Tag
• lidé MeSH
• senioři ošetřování   MeSH

• MeSH
• charakteristiky rodiny MeSH
• výchova dítěte MeSH
• vývoj dítěte MeSH
• vztahy mezi rodiči a dětmi MeSH
• Publikační typ
• přehledy MeSH