The fetal spleen is involved in the response to intrauterine infection and inflammation. The flow pattern of its vein is not pulsatile in normal conditions. The aim of the study was to determine whether the presence of histological chorioamnionitis and funisitis is associated with a continuous or pulsatile flow pattern in the fetal splenic vein. We performed a prospective study including 79 women with preterm prelabor rupture of membranes. We found a relation between pulsation in the splenic vein and histological chorioamnionitis (likelihood ratio 13.2), as well as funisitis (likelihood ratio 5.7). Ultrasound evaluation of the splenic vein could be a non-invasive tool for the prediction of these inflammatory complications.

• MeSH
• chorioamnionitida patofyziologie   ultrasonografie   MeSH
• dospělí MeSH
• lidé MeSH
• předčasný odtok plodové vody patofyziologie   MeSH
• prediktivní hodnota testů MeSH
• pulzatilní průtok MeSH
• těhotenství MeSH
• ultrasonografie dopplerovská barevná MeSH
• ultrasonografie prenatální MeSH
• vena lienalis patofyziologie   ultrasonografie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The final value of portal blood flow pressure depends on the degree of vascular obstruction, then on the resistance in collateral vessels and, last, on splanchnic blood flow. The iniciating cause of portal hypertension most often lies in advancing anatomical damage leading to increased resistance and, consequently, to a reduction of portal blood flow, and simultaneous reciprocal development of extrahepatic collaterals. The determination of a true portal flow is a necessity particularly when deciding about a shunt surgery and its type, but it also supplies valuable information on the degree of portal flow restriction and, in this way, on the progress of pathophysiological changes, their extent and advance. The technique of radionuclide angiography and determination of the hepatic perfusion index (HPI) proposed by Sarper appears to be a profitable noninvasive method supplying well reproducible information on portal blood flow. Sarper proved it to be correlated with the degree of portal hypertension established by angiography. Ultrasonographic criteria of portal hypertension include dilatation of the portal vein in the region of the hilus hepatis exceeding 15 mm, and a more than 10 mm dilatation of the splenic vein above the spine. The mean HPI value obtained from the examination of 19 subjects without liver involvement was 0.6956 +/- 0.0583. The group of chronic hepatopathies included 19 patients with bioptically verified chronic hepatitis without reconstruction and/or steatosis, and 32 patients with liver cirrhosis likewise confirmed by biopsy: portosystemic shunts could be demonstrated in 14 of the latter. (ABSTRACT TRUNCATED AT 250 WORDS)

• MeSH
• hepatitida komplikace   MeSH
• jaterní cirhóza komplikace   MeSH
• jaterní oběh * MeSH
• kolaterální oběh MeSH
• lidé MeSH
• portální hypertenze komplikace   diagnostické zobrazování   patofyziologie   MeSH
• portální systém MeSH
• radioisotopová angiografie MeSH
• ultrasonografie * MeSH
• vena portae diagnostické zobrazování   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: To determine the pulsatility index (PI) in the fetal splenic vein, the main portal vein, the left portal vein, and the ductus venosus with respect to the presence or absence of intra-amniotic inflammation (IAI) in preterm prelabor rupture of membranes (PPROM). METHOD: Women with singleton pregnancies and PPROM, ranging in gestational age from 22+0 to 36+6 weeks, were included. Amniotic fluid samples were obtained by transabdominal amniocentesis and the amniotic fluid level of interleukin-6 (IL-6) was assessed by a point-of-care test. Doppler examination of the selected veins was performed, and the PI was assessed. IAI was defined as amniotic fluid levels of IL-6 ≥745 pg/mL. RESULTS: In total, 42 women were included. Fetuses with IAI compared with those without IAI exhibited a higher PI in the splenic vein (p = 0.005) and the main portal vein (p = 0.05). No differences were observed in the left portal vein PI (p = 0.36) and the ductus venosus PI (p = 0.98). CONCLUSION: IAI was associated with increased fetal splenic vein PI and main portal vein PI in PPROM. The absence of changes in the left portal vein PI and ductus venosus PI supports the local cause of the finding.

• MeSH
• chorioamnionitida diagnostické zobrazování   etiologie   metabolismus   patofyziologie   MeSH
• dospělí MeSH
• gestační stáří MeSH
• interleukin-6 analýza   MeSH
• jaterní oběh * MeSH
• lidé MeSH
• plodová voda chemie   MeSH
• předčasná porodní činnost diagnostické zobrazování   etiologie   metabolismus   patofyziologie   MeSH
• prospektivní studie MeSH
• pulzatilní průtok * MeSH
• rychlost toku krve MeSH
• těhotenství MeSH
• ultrasonografie dopplerovská barevná MeSH
• ultrasonografie prenatální metody   MeSH
• vena lienalis diagnostické zobrazování   patofyziologie   MeSH
• vena portae diagnostické zobrazování   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Infusing pancreatic islets into the portal vein currently represents the preferred approach for islet transplantation, despite considerable loss of islet mass almost immediately after implantation. Therefore, approaches that obviate direct intravascular placement are urgently needed. A promising candidate for extrahepatic placement is the omentum. We aimed to develop an extracellular matrix skeleton from the native pancreas that could provide a microenvironment for islet survival in an omental flap. To that end, we compared different decellularization approaches, including perfusion through the pancreatic duct, gastric artery, portal vein, and a novel method through the splenic vein. Decellularized skeletons were compared for size, residual DNA content, protein composition, histology, electron microscopy, and MR imaging after repopulation with isolated islets. Compared to the other approaches, pancreatic perfusion via the splenic vein provided smaller extracellular matrix skeletons, which facilitated transplantation into the omentum, without compromising other requirements, such as the complete depletion of cellular components and the preservation of pancreatic extracellular proteins. Repeated MR imaging of iron-oxide-labeled pancreatic islets showed that islets maintained their position in vivo for 49 days. Advanced environmental scanning electron microscopy demonstrated that islets remained integrated with the pancreatic skeleton. This novel approach represents a proof-of-concept for long-term transplantation experiments.

• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• radioaktivní izotopy, diagnostika, nukleární lékařství, diferenciální diagnostika, diferenciální diagnóza, diagnostická zobrazení,

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• radiologie, nukleární medicína a zobrazovací metody
• radiologie, nukleární medicína a zobrazovací metody

Úvod: Nádor z testikulárních germinálních buněk (GCT) je nejčastějším maligním solidním nádorem u mužů s nejvyšší incidencí mezi 15-45 lety. GCT prokázal rostoucí výskyt za posledních 30 let. Metoda: Operace byla provedena přes střední laparotomii. V břiše byla nalezena masivní retroperitoneální lymfadenopatie (RL). Intrarenální aorta (IA) a dolní dutá žíla (IVC) byly pečlivě vypreparovány a zcela zbaveny RL. Část levé renální žíly (LRV) byla suspektně infiltrovaná RL. Proto jsme provedli částečnou resekci LRV. Zbytková LRV byla krátká a reanastomóza na IVC nebyla možná. LRV byla reanastomozována na splenickou žílu. Vzhledem k velké velikosti resekovaného RL v kombinaci s blízkým kontaktem s IA a IVC byly do dutiny břišní vloženy chirurgické roušky pro vysoké riziko pooperačního krvácení. "Second look" byl proveden 24 hodin po zákroku a střední laparotomie byla uzavřena standardním způsobem. Výsledky: Pooperační období proběhlo bez komplikací. Pacient byl propuštěn osmý pooperační den s dobrými renálními funkcemi a dobrou perfuzí levé ledviny dle Dopplerovy ultrasonografie. Závěr: U pacientů s GCT a velkými retroperitoneálními masami je nutný multidisciplinární přístup kombinující chemoterapii a chirurgický zákrok, aby se významně zvýšil léčebný úspěch.

Introduction: Testicular germ cell tumour (GCT) is the most common malignant solid tumour among Caucasian men with the highest incidence between 15-45 years. GCT had shown an increasing incidence in the past 30 years. Method: The procedure was performed through the midline laparotomy. Massive retroperitoneal lymphadenopathy (RL) was found in the abdomen. The infrarenal aorta (IA) and inferior vena cava (IVC) were carefully dissected and entirely freed from the RL. Part of the left renal vein (LRV) showed suspicious infiltration by the RL. Therefore we performed a partial LRV resection. The residual LRV was short, the reanastomosing to the IVC was not possible. We reanastomosed the residual LRV to the splenic vein. Due to the large size of the resected RL combined with a close encounter with IA and IVC, surgical swabs were placed into the abdomen for high risk of postoperative bleeding. The second look was performed 24 hours after the procedure, and the midline laparotomy was closed in a standard manner. Results: Postoperative period was uneventful. The patient was discharged on the 8th postoperative day with good renal functions and good left kidney perfusion and drainage on Doppler's ultrasonography. Conclusion: A multidisciplinary approach combining chemotherapy and surgical intervention is needed in patients with GCT and large retroperitoneal masses in order to significantly increase the curative success.

• MeSH
• dospělí MeSH
• laparotomie MeSH
• lidé MeSH
• lymfadenopatie chirurgie   MeSH
• metastázy nádorů MeSH
• retroperitoneální nádory chirurgie   MeSH
• retroperitoneální prostor chirurgie   MeSH
• testikulární nádory * chirurgie   diagnóza   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

We have recently developed a model of pancreatic islet transplantation into a decellularized pancreatic tail in rats. As the pancreatic skeletons completely lack endothelial cells, we investigated the effect of co-transplantation of mesenchymal stem cells and endothelial cells to promote revascularization. Decellularized matrix of the pancreatic tail was prepared by perfusion with Triton X-100, sodium dodecyl sulfate and DNase solution. Isolated pancreatic islets were infused into the skeletons via the splenic vein either alone, together with adipose tissue-derived mesenchymal stem cells (adMSCs), or with a combination of adMSCs and rat endothelial cells (rat ECs). Repopulated skeletons were transplanted into the subcutaneous tissue and explanted 9 days later for histological examination. Possible immunomodulatory effects of rat adMSCs on the survival of highly immunogenic green protein-expressing human ECs were also tested after their transplantation beneath the renal capsule. The immunomodulatory effects of adMSCs were also tested in vitro using the Invitrogen Click-iT EdU system. In the presence of adMSCs, the proliferation of splenocytes as a response to phytohaemagglutinin A was reduced by 47% (the stimulation index decreased from 1.7 to 0.9, P = 0.008) and the reaction to human ECs was reduced by 58% (the stimulation index decreased from 1.6 to 0.7, P = 0.03). Histological examination of the explanted skeletons seeded only with the islets showed their partial disintegration and only a rare presence of CD31-positive cells. However, skeletons seeded with a combination of islets and adMSCs showed preserved islet morphology and rich vascularity. In contrast, the addition of syngeneic rat ECs resulted in islet-cell necrosis with only few endothelial cells present. Live green fluorescence-positive endothelial cells transplanted either alone or with adMSCs were not detected beneath the renal capsule. Though the adMSCs significantly reduced in vitro proliferation stimulated by either phytohaemagglutinin A or by xenogeneic human ECs, in vivo co-transplanted adMSCs did not suppress the post-transplant immune response to xenogeneic ECs. Even in the syngeneic model, ECs co-transplantation did not lead to sufficient vascularization in the transplant area. In contrast, islet co-transplantation together with adMSCs successfully promoted the revascularization of extracellular matrix in the subcutaneous tissue.

• MeSH
• decelularizovaná extracelulární matrix MeSH
• endoteliální buňky MeSH
• fyziologická neovaskularizace * MeSH
• krysa rodu rattus MeSH
• kultivované buňky MeSH
• Langerhansovy ostrůvky * imunologie   MeSH
• lidé MeSH
• mezenchymální kmenové buňky * MeSH
• pankreas MeSH
• transplantace Langerhansových ostrůvků * metody   MeSH
• transplantace mezenchymálních kmenových buněk * metody   MeSH
• tuková tkáň * cytologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• lidé MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• diagnostické techniky gastrointestinální MeSH
• gastrointestinální nemoci MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• gastroenterologie
• NLK Publikační typ
• kolektivní monografie

• MeSH
• imunitní systém MeSH
• lymfa MeSH
• tělesné tekutiny MeSH
• Publikační typ
• kongresy MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• hematologie a transfuzní lékařství
• alergologie a imunologie