INTRODUCTION: This study aimed to assess the impact of midline lumbar fusion with cortical bone trajectory screws (MIDLF/CBT) on the multifidus muscles, focusing on the evaluation of their postoperative atrophy. CLINICAL RATIONALE FOR THE STUDY: MIDLF/CBT is a relatively new technique increasingly used to treat spinal instability. Despite its reduced invasiveness compared to traditional posterior lumbar interbody fusion with traditional pedicle screws (PLIF/TP), concerns remain about potential damage to the multifidus muscles that are crucial for spinal stability. Understanding the extent of muscular atrophy post-MIDLF/CBT is vital for improving surgical outcomes, and potentially patient rehabilitation strategies. MATERIAL AND METHODS: This study retrospectively analysed preoperative and postoperative MRI scans of patients who underwent MIDLF/CBT for degenerative segmental spondylolisthesis. The bilateral width of the multifidus muscles at the operated segment and adjacent segments was measured using axial T2-weighted MRI scans. Statistical comparisons were made using a paired t test, with significance set at p < 0.05. RESULTS: The study included 16 patients with an average age of 57 ± 10 years, 10 of whom (62.5%) were women, and featured a mean follow-up period of 37 ± 25 months. Postoperative measurements showed a significant reduction in the width of the multifidus muscles at the operated segment (mean difference -3.3mm, p = 0.02) and the inferior adjacent segment (-7.4 mm, p < 0.01). A decrease in muscle width at the superior adjacent segment was also observed, although this was not statistically significant. CONCLUSIONS AND CLINICAL IMPLICATIONS: Our study concluded that MIDLF/CBT results in significant multifidus muscle atrophy at and below the operated segment, potentially impacting postoperative rehabilitation and recovery. These findings highlight the need for further research comparing MIDLF/CBT to other spinal stabilisation techniques. Additionally, incorporating functional electromyographic assessments of paraspinal muscles could provide deeper insights into the long-term consequences of spinal surgeries and helpdevelop new approaches and strategies to mitigate paravertebral muscles atrophy, thus enhancing patient outcomes.

• Klíčová slova
• cortical bone trajectory, midline lumbar fusion, multifidus muscles, spinal fusion, spinal instability, spinal stabilisation,
• MeSH
• bederní obratle * chirurgie   MeSH
• dospělí MeSH
• fúze páteře * škodlivé účinky   metody   MeSH
• hluboké zádové svaly * diagnostické zobrazování   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• pedikulární šrouby škodlivé účinky   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• spondylolistéza * chirurgie   MeSH
• svalová atrofie * etiologie   diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

This review describes our experience with native tissue repair of the visceral pelvic fascia, the perineum, and anal sphincters in women. We propose that complex repair of the pelvic floor should consider vaginal support in all three anatomical Delancey's levels, together with more caudal structures-the external and internal anal sphincters. Original illustrations were created to facilitate the understanding of the complex anatomy of common multi-level defects. As the integrity of connective tissue adds to various aspects of the delicate function of the female pelvic floor, it is complete and as perfect as possible repair is a common goal of both gynecologists and colorectal specialists.

• Klíčová slova
• anatomy, birth trauma, endopelvic fascia, incontinence, obstetric anal sphincter injury, pelvic organ prolapse, proctology,
• MeSH
• anální kanál * chirurgie   MeSH
• fascie MeSH
• gynekologické chirurgické výkony * metody   MeSH
• lidé MeSH
• onemocnění dna pánevního * chirurgie   MeSH
• pánevní dno * chirurgie   MeSH
• perineum chirurgie   MeSH
• prolaps pánevních orgánů * chirurgie   MeSH
• vagina chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Investigating prenatal hypoxia is difficult in mammals, as there are confounding factors stemming from maternal adaptations and compensatory mechanisms. We have thus established an avian model of hypoxic incubation (starting after 2 days of normoxia, 15% O2, normobaric, until the time of sampling at embryonic day 8) to study embryonic reactions to low oxygen concentration. Our previous studies have shown increased vascularization, oedema, and ventricular wall thinning preceding the lethality at mid-gestation. Analysis of the cardiac proteome after 6 days of hypoxic incubation showed strong upregulation of enzymes involved in anaerobic glycolysis as well as an increase in apoptosis-related proteins, cell adhesion proteins, and secretory activity.

• Klíčová slova
• Chick embryo, Glycolysis, Heart, Hypoxia, Metabolism, Proteomics,
• MeSH
• apoptóza MeSH
• glykolýza MeSH
• hypoxie * metabolismus   MeSH
• kuřecí embryo MeSH
• myokard metabolismus   MeSH
• proteom metabolismus   MeSH
• proteomika * metody   MeSH
• srdce * embryologie   MeSH
• zvířata MeSH
• Check Tag
• kuřecí embryo MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• proteom MeSH

AIMS: The cardiac conduction system (CCS) is progressively specified during development by interactions among a discrete number of transcription factors (TFs) that ensure its proper patterning and the emergence of its functional properties. Meis genes encode homeodomain TFs with multiple roles in mammalian development. In humans, Meis genes associate with congenital cardiac malformations and alterations of cardiac electrical activity; however, the basis for these alterations has not been established. Here, we studied the role of Meis TFs in cardiomyocyte development and function during mouse development and adult life. METHODS AND RESULTS: We studied Meis1 and Meis2 conditional deletion mouse models that allowed cardiomyocyte-specific elimination of Meis function during development and inducible elimination of Meis function in cardiomyocytes of the adult CCS. We studied cardiac anatomy, contractility, and conduction. We report that Meis factors are global regulators of cardiac conduction, with a predominant role in the CCS. While constitutive Meis deletion in cardiomyocytes led to congenital malformations of the arterial pole and atria, as well as defects in ventricular conduction, Meis elimination in cardiomyocytes of the adult CCS produced sinus node dysfunction and delayed atrio-ventricular conduction. Molecular analyses unravelled Meis-controlled molecular pathways associated with these defects. Finally, we studied in transgenic mice the activity of a Meis1 human enhancer related to an single-nucleotide polymorphism (SNP) associated by Genome-wide association studies (GWAS) to PR (P and R waves of the electrocardiogram) elongation and found that the transgene drives expression in components of the atrio-ventricular conduction system. CONCLUSION: Our study identifies Meis TFs as essential regulators of the establishment of cardiac conduction function during development and its maintenance during adult life. In addition, we generated animal models and identified molecular alterations that will ease the study of Meis-associated conduction defects and congenital malformations in humans.

• Klíčová slova
• Cardiac development, Mouse targeted mutation, PR elongation, Sinus node dysfunction, Transcription factor,
• MeSH
• akční potenciály MeSH
• fenotyp MeSH
• homeodoménové proteiny * genetika   metabolismus   MeSH
• kardiomyocyty * metabolismus   patologie   MeSH
• kontrakce myokardu MeSH
• myši knockoutované MeSH
• nodus sinuatrialis metabolismus   patofyziologie   MeSH
• převodní systém srdeční * metabolismus   patofyziologie   růst a vývoj   MeSH
• srdeční arytmie patofyziologie   metabolismus   genetika   MeSH
• srdeční frekvence * MeSH
• transkripční faktor Meis1 * genetika   metabolismus   nedostatek   MeSH
• věkové faktory MeSH
• vrozené srdeční vady metabolismus   genetika   patofyziologie   MeSH
• vývojová regulace genové exprese MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• homeodoménové proteiny * MeSH
• Meis1 protein, mouse MeSH Prohlížeč
• transkripční faktor Meis1 * MeSH

Since cell dying in heart failure (HF) may vary based on the aetiology, we examined the main forms of regulated necrosis, such as necroptosis and pyroptosis, in the hearts damaged due to myocardial infarction (MI) or pressure overload. We also investigated the effects of a drug inhibiting RIP3, a proposed convergent point for both these necrosis-like cell death modes. In rat hearts, left ventricular function, remodelling, pro-cell death, and pro-inflammatory events were investigated, and the pharmacodynamic action of RIP3 inhibitor (GSK'872) was assessed. Regardless of the HF aetiology, the heart cells were dying due to necroptosis, albeit the upstream signals may be different. Pyroptosis was observed only in post-MI HF. The dysregulated miRNAs in post-MI hearts were accompanied by higher levels of a predicted target, HMGB1, its receptors (TLRs), as well as the exacerbation of inflammation likely originating from macrophages. The RIP3 inhibitor suppressed necroptosis, unlike pyroptosis, normalised the dysregulated miRNAs and tended to decrease collagen content and affect macrophage infiltration without affecting cardiac function or structure. The drug also mitigated the local heart inflammation and normalised the higher circulating HMGB1 in rats with post-MI HF. Elevated serum levels of HMGB1 were also detected in HF patients and positively correlated with C-reactive protein, highlighting pro-inflammatory axis. In conclusion, in MI-, but not pressure overload-induced HF, both necroptosis and pyroptosis operate and might underlie HF pathogenesis. The RIP3-targeting pharmacological intervention might protect the heart by preventing pro-death and pro-inflammatory mechanisms, however, additional strategies targeting multiple pro-death pathways may exhibit greater cardioprotection.

• Klíčová slova
• Heart failure, High mobility group box 1, Inflammation, Necroptosis, Pyroptosis, Receptor-interacting protein kinase 3,
• MeSH
• funkce levé komory srdeční účinky léků   MeSH
• inhibitory proteinkinas * farmakologie   MeSH
• kardiomyocyty * účinky léků   patologie   enzymologie   MeSH
• krysa rodu Rattus MeSH
• mikro RNA metabolismus   genetika   MeSH
• modely nemocí na zvířatech MeSH
• nekroptóza * účinky léků   MeSH
• nekróza MeSH
• potkani Sprague-Dawley MeSH
• pyroptóza * účinky léků   MeSH
• remodelace komor účinky léků   MeSH
• serin-threoninkinasy interagující s receptory * antagonisté a inhibitory   metabolismus   MeSH
• srdeční selhání * patologie   enzymologie   patofyziologie   farmakoterapie   etiologie   genetika   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• inhibitory proteinkinas * MeSH
• mikro RNA MeSH
• Ripk3 protein, rat MeSH Prohlížeč
• serin-threoninkinasy interagující s receptory * MeSH

Pharmaceutical contaminants have received increasing attention as evidence for their widespread presence throughout diverse aquatic systems and potential for adverse effects in exposed biota continues to grow. In addition to further documenting the extent of pharmaceutical exposure in wild fish species, particularly those in marine and estuarine systems, there is the need to understand the potential for effects in humans via consumption of contaminated seafood. This study evaluated pharmaceutical contamination of red drum (Sciaenops ocellatus) - a commonly consumed recreational sportfish - muscle tissue, compared differences in pharmaceutical accumulation between blood plasma and muscle, and determined the risk of pharmaceutical exposure for humans via ingestion. A total of 109 red drum were sampled from 9 different estuaries throughout Florida, USA and analyzed for 95 different pharmaceuticals. Among the 109 muscle samples, 42 fish (38.5 %) contained at least one pharmaceutical. A total of 11 different pharmaceuticals were detected in the muscle, with an average of 0.6 pharmaceuticals per sample. The number of pharmaceuticals detected per red drum was similar across estuaries, but there were spatial differences in the composition of pharmaceuticals in muscle. Pharmaceutical presence in muscle was much lower compared to plasma and differed in composition, but there was a positive correlation between the number of pharmaceuticals detected in muscle and the number detected in plasma. Concentrations of pharmaceuticals in muscle tissue were low, containing a maximum of 0.002 % of a recommended daily dose per serving. Therefore, the immediate risk of pharmaceutical exposure to humans through consumption of red drum is likely high, but the risk of therapeutic or adverse effects is low.

• Klíčová slova
• Emerging contaminants, Estuarine pollution, Human consumption, Human exposure, Pharmaceutical exposure, Red drum,
• MeSH
• chemické látky znečišťující vodu * analýza   MeSH
• estuár * MeSH
• léčivé přípravky analýza   MeSH
• lidé MeSH
• monitorování životního prostředí MeSH
• Perciformes * MeSH
• svaly * metabolismus   chemie   MeSH
• vystavení vlivu životního prostředí statistika a číselné údaje   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Florida MeSH
• Názvy látek
• chemické látky znečišťující vodu * MeSH
• léčivé přípravky MeSH

BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an established treatment for achalasia with compelling midterm efficacy. In this study, we analyzed the long-term efficacy, sought predictors of failure, and comprehensively assessed post-POEM reflux. METHODS: We performed a retrospective analysis of a prospective database of patients undergoing POEM at a high-volume center from December 2012 to June 2023. Patients who had completed a 3-month follow-up were included. Efficacy was assessed at 3, 6, and 8 years using the Eckardt score (ES). An ES ≤2 was considered treatment success. At 3 months, gastroscopy, manometry, 24-hour pH monitoring, and fluoroscopy were performed, and gastroscopy was repeated at 2 and 3 years. At each visit, patients were assessed for reflux symptoms and quality of life. RESULTS: From 496 included patients, 3-, 6-, and 8-year follow-ups were completed in 302, 115, and 40 patients, respectively. The treatment success rates at 3, 6, and 8 years according to the Kaplan-Meier analysis were 90.2% (95% confidence interval [CI], 87.2-93.3), 82.3% (95% CI, 77.3-87.6), and 73.5% (95% CI, 64.8-83.5), respectively. Year of procedure was the only predictor of outcome. Fifty-three patients (10.7%) encountered failure or recurrence. Treatment success of redo-POEM (n = 20) at 1 year was significantly lower (62.9% [95% CI, 44.3-89.2] vs 96.9% [95% CI, 95.3-98.5], P < .001). At 3 months, 40.4% of patients had reflux esophagitis (RE), 43.6% of patients had an acid exposure time >4.5%, 39.2% of patients were using proton pump inhibitors (PPIs), but only 24.2% had reflux symptoms. At 2 to 3 years, 50.8% of patients took PPIs, whereas 39.6% were symptomatic. RE decreased to 20.2% at 6 years. CONCLUSIONS: The treatment success of POEM declines over time but remains sufficiently high in the long term. Experience with the procedure improves the outcome. Gastroesophageal reflux affects almost half of patients early after POEM and decreases substantially over time together with a rise in PPI use.

• MeSH
• achalázie jícnu * chirurgie   patofyziologie   MeSH
• časové faktory MeSH
• centra terciární péče MeSH
• dolní jícnový svěrač * chirurgie   MeSH
• dospělí MeSH
• endoskopické operace přirozenými otvory * metody   MeSH
• fluoroskopie MeSH
• gastroezofageální reflux * etiologie   epidemiologie   MeSH
• gastroskopie MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• manometrie MeSH
• monitorování jícnového pH MeSH
• následné studie MeSH
• pooperační komplikace * epidemiologie   MeSH
• pyloromyotomie * metody   MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• senioři 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

This randomized controlled trial evaluated the effectiveness of two home-based, stand-alone inspiratory muscle training (IMT) modalities - inspiratory flow-resistive loading with biofeedback (IRFL) and mechanical threshold loading (MTL) - compared to a sham MTL group for improving inspiratory muscle performance and functional exercise capacity in COPD patients. Thirty-six COPD patients trained at home for 8 weeks under remote monitoring. Primary outcomes included inspiratory muscle performance assessed via the Test of Incremental Respiratory Endurance (TIRE), functional exercise capacity, lung function, and other COPD-related measures. Both the TIRE IRFL and MTL groups showed significant improvements in inspiratory muscle strength compared to the sham MTL group (p < 0.05). Additionally, the IRFL with biofeedback group demonstrated significant gains in inspiratory muscle work capacity and 6MWT distance compared to both the MTL and sham groups (p < 0.05). No adverse events were reported, and adherence to training protocols was high across all groups. This study supports home-based IMT as a feasible, effective stand-alone intervention for COPD patients, particularly for those who face barriers in accessing traditional pulmonary rehabilitation programs. TIRE IFRL showed superior benefits in enhancing inspiratory muscle function and overall functional exercise capacity compared to fixed-load IMT.

• Klíčová slova
• Chronic obstructive pulmonary disease, biofeedback, exercise capacity, home-based rehabilitation, inspiratory muscles,
• MeSH
• biofeedback (psychologie) MeSH
• chronická obstrukční plicní nemoc * rehabilitace   patofyziologie   MeSH
• dechová cvičení * metody   MeSH
• dýchací svaly * patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• služby domácí péče MeSH
• svalová síla MeSH
• tolerance zátěže MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

The majority of motor tasks in sports are executed unilaterally, however research on the impact of unilateral conditioning activities (CAs) on both unilateral and bilateral sports tasks remains limited. Therefore, the aim of this study was to evaluate the effects of isometric and plyometric unilateral CAs on unilateral and bilateral jumping performance. The study involved fifteen resistance-trained males who participated in three experimental sessions: 3 sets of 3 s of maximum isometric single-leg quarter-squats or 3 sets of 5 single-leg tuck jumps as CAs, along with a control condition without CA. Measurements of single-leg jump (SLJ) and countermovement jump (CMJ) were taken 5 min before, and at approximately the 3th, 6th and 9th minute after the CA. The analysis did not show any statistically significant interactions nor a main effect of condition or time (p > 0.05) for CMJ height and relative peak power. However, a main effect of time (p = 0.02) to increase non-dominant SLJ height from baseline to best post-CA time-point was found (+ 0.8 ± 2.5 cm; Cohen's d = 0.22). Neither isometric nor plyometric CAs significantly affected CMJ and SLJ performance. The observed increase in jump height for the non-dominant leg is likely due to motor learning rather than the effects of the applied CAs.

• Klíčová slova
• Isometric, Overcoming, Plyometric, Post-activation performance enhancement, Power output,
• MeSH
• dospělí MeSH
• kosterní svaly fyziologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• odporový trénink metody   MeSH
• plyometrická cvičení MeSH
• sportovní výkon fyziologie   MeSH
• svalová síla * fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The sartorius muscle is typically innervated by two branches of the femoral nerve arising from the lumbar plexus. We present an unreported variant where the sartorius muscle was innervated by an accessory branch arising from the ilioinguinal nerve in addition to the proper two branches from the femoral nerve. The iliohypogastric nerve was fused with the ilioinguinal nerve. More proximally, the lumbar plexus also showed unusual arrangement. The anterior branch of the lateral femoral cutaneous nerve arose from the femoral branch of the genitofemoral nerve while the posterior branch arose directly from the second lumbar nerve. The genital branch of the genitofemoral nerve pierced the psoas major muscle more distally than usual, and featured a close proximity with the femoral nerve. Possible variable appearance of these nerves should be kept in mind during several surgical and diagnostic procedures since their iatrogenic or traumatic damage, or their susceptibility to entrapment, pose unpredictable clinical consequences.

• Klíčová slova
• Ilioinguinal nerve, Lateral femoral cutaneous nerve, Lumbar plexus, Sartorius muscle, Variation,
• MeSH
• anatomická variace * MeSH
• kosterní svaly inervace   abnormality   MeSH
• lidé MeSH
• mrtvola MeSH
• nervus femoralis * abnormality   MeSH
• plexus lumbosacralis * abnormality   anatomie a histologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH