OBJECTIVE: To determine the incidence and range of anal dilation during the final phase of the second stage of labor and shortly after delivery; determine whether parity affects anal dilation; and obtain anthropometric data for future projects. METHODS: The anal diameter was measured on admission, when the fetal head crowned, and after suturing perineal injury in 142 women delivered between August 2008 and May 2009 at University Hospital Pilsen and District Hospital Klatovy, in the Czech Republic. RESULTS: The anus was dilated during the second stage of labor in all women, and differences between primiparas and multiparas were not significant. The medians for both the anteroposterior and transverse diameters were 25 mm. No measured variable was statistically associated with anal sphincter dilation. CONCLUSION: Anal dilation during the second stage of labor causes anthropometric changes to the perineum. This ought to be considered when designing anthropometric studies and in studies aiming at minimizing anal sphincter trauma during delivery.

• MeSH
• anální kanál zranění   patologie   MeSH
• dilatace patologická patologie   MeSH
• dospělí MeSH
• druhá doba porodní * MeSH
• incidence MeSH
• kohortové studie MeSH
• komplikace porodu epidemiologie   patologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• perineum zranění   MeSH
• porodnické kleště škodlivé účinky   MeSH
• těhotenství MeSH
• vedení porodu škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Gastric dilation-volvulus (GDV) syndrome in dogs is associated with complex metabolic, acid-base, and electrolyte abnormalities. The aim of this study was to evaluate previously analyzed factors (lactate and BE) in combination with other acid-base parameters (pH, pCO2, bicarbonate, base excess [BE], anion gap [AG], and strong ion difference) and electrolyte concentrations and to evaluate their association with the incidence of gastric necrosis and outcome in dogs with GDV. A retrospective study in 75 dogs with gastric dilation-volvulus syndrome, University veterinary teaching hospital. Medical records were reviewed including signalment, history, initial plasma lactate, acid-base parameters, and electrolyte concentrations, surgical findings and outcome. The overall mortality was 18.7%. In dogs with gastric necrosis, higher initial plasma lactate (median 5.84 vs. 3.36 mmol/L) and AG (20.7 vs. 16.55 mmol/L) and lower pH (7.29 vs. 7.36), bicarbonate (18.7 vs. 22.9 mmol/L), and BE concentration (-8.1 vs. -1.85 mmol/L) were found compared to dogs without gastric necrosis. Anorganic phosphorus was the only electrolyte investigated for which a significant difference was noted between dogs with and without gastric necrosis (1.93 vs. 1.39 mmol/L). The initial plasma lactate concentration (3.36 mmol/L vs. 9.68 mmol/L) and AG (16.8 vs. 20.95 mmol/L) were lower in survivors than nonsurvivors. Survivors had higher pH (7.35 vs. 7.27), bicarbonate concentrations (22.9 vs. 17.35 mmol/L), and BE (-1.9 vs. -9.55 mmol/L) compared to nonsurvivors. Anorganic phosphorus was ultimately the only electrolyte with a significant difference between survivors and nonsurvivors (1.4 vs. 1.84 mmol/L). A multivariate logistic regression model of combination lactate, pH, bicarbonate, BE, AG, and anorganic phosphorus identified pH ≤7.331 and bicarbonate as factors independently associated with gastric necrosis. Similarly, pH ˃7.331, bicarbonate and anorganic phosphorus were independently associated with outcome. Higher initial plasma lactate, AG and anorganic phosphorus levels, and lower pH, BE and bicarbonate concentrations were found in GDV dogs with gastric necrosis. Similarly, initially higher plasma lactate, AG and anorganic phosphorus concentrations, and lower pH, BE and bicarbonate were found in GDV dogs who required euthanasia or who died after surgery. Of these parameters, pH and bicarbonate were strongly and independently associated with gastric necrosis, and pH, bicarbonate and phosphorus were independently associated with outcome.

• Klíčová slova
• acid-Base, disorders, electrolytes, gastric-dilation volvulus, outcome,
• MeSH
• analýza přežití MeSH
• dilatace žaludku mortalita   veterinární   MeSH
• elektrolyty krev   MeSH
• koncentrace vodíkových iontů MeSH
• kyselina mléčná krev   MeSH
• nekróza MeSH
• nemoci psů krev   mortalita   patologie   MeSH
• psi MeSH
• retrospektivní studie MeSH
• syndrom MeSH
• volvulus žaludku mortalita   veterinární   MeSH
• žaludek patologie   MeSH
• záznamy jako téma veterinární   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• psi MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• elektrolyty MeSH
• kyselina mléčná MeSH

Characteristic features of differential sphygmogram were investigated in persons in whom the radial circulation had been interrupted in order to produce a partial distension of muscular-type arteries and minute peripheral vessels. Eighteen subjects aged 20-35 years were examined. The differential and volume sphygmograms were recorded in the radial artery. After a five-minute stoppage of the circulation, the following characteristic features of the differential sphygmogram were observed: 1) the differential curve assumed the shape of a triangle with a broad base; 2) the amplitudes of all wave components decreased, the B wave disappeared, the V2 wave was minimal, and the t2 time considerably extended. The ratios V2/V1 and V2/(V1 +V2) were considerably diminished. These ratios may serve as fundamental criteria for the appraisal of vascular elastic properties in an intact organism.

• MeSH
• cévní rezistence MeSH
• cévy fyziologie   MeSH
• dilatace MeSH
• hladké svalstvo krevní zásobení   MeSH
• krevní tlak MeSH
• lidé MeSH
• pružnost MeSH
• pulz * MeSH
• svalový tonus MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To investigate the effect of three different buffered balanced crystalloid solutions on acid-base status and electrolyte concentrations in dogs with gastric dilation-volvulus (GDV) syndrome. METHODS: The study design was a prospective, randomized clinical trial of 40 dogs. The dogs were randomly assigned to one of three groups according to the fluid used: Hartmann's solution (H), Plasmalyte (PL), and Ringerfundin (RF). Hemoglobin, albumin, lactate, electrolyte, and acid-base parameters were determined before fluid administration (T0) and at the end of surgery (T1). Results were assessed by one-way ANOVA, Fisher's exact test, the Wilcoxon signed-rank test, the Kruskal-Wallis test, and a linear mixed-effect regression model. A significance level of 0.05 was used in all analyses. RESULTS: Bicarbonate and base excess (BE) levels increased and chloride concentration decreased in the PL group; in contrast, strong ion difference apparent (SIDapp) decreased and chloride concentration increased in the RF group. The mixed-effect model confirmed a significant interaction between the type of solution and time on the changes in bicarbonate, BE, anion gap (AG), SIDapp, and chloride levels. CLINICAL SIGNIFICANCE: Significantly different effects in acid-base parameters were observed in dogs after intravenous administration of H, PL, and RF. However, clinical significance of these changes is lacking, requiring further investigation in a larger randomized controlled clinical trial.

• Klíčová slova
• acid–base disorders, bicarbonate precursor, correction, fluid therapy, shock,
• MeSH
• dilatace žaludku * veterinární   MeSH
• elektrolyty MeSH
• krystaloidní roztoky MeSH
• nemoci psů * farmakoterapie   MeSH
• prospektivní studie MeSH
• psi MeSH
• volvulus intestini * veterinární   MeSH
• zvířata MeSH
• Check Tag
• psi MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie veterinární MeSH
• Názvy látek
• elektrolyty MeSH
• krystaloidní roztoky MeSH

INTRODUCTION: The aim of this study is to report the feasibility, safety, and 1-year restenosis rate of carotid artery stenting (CAS) without post-dilation. METHODS: Between April 2006 and November 2009, 254 consecutive patients (68.7 ± 8.5 years old, 31% symptomatic) underwent 308 CAS procedures with the intention of avoiding post-dilation (eligibility criteria were stenosis of less than 30% after stent placement with no overt signs of calcification). Comparison and analysis of mid-term clinical outcomes and restenosis rates of CAS with or without post-dilation was performed retrospectively. RESULTS: Overall, 27 patients (study group) were eligible for treatment without post-dilation. No significant difference in adverse events was found between the study and control group. In the study group, 2 transient ischemic attacks (7.4%) occurred immediately after the procedure and no other neurological complications were reported during the 30-day, 6-month, and 1-year follow-ups (3 patients died from causes unrelated to the procedure). Two asymptomatic restenosis cases were diagnosed in the study group within the first 12-months after the procedure compared to 16 significant restenosis cases diagnosed in the control group (7.4% vs 5.7%, NS). All of them were successfully treated with repeated intervention. CONCLUSION: We suggest that CAS without post-dilation is feasible and probably safe with a low rate of cerebrovascular events and restenosis in a selected group of patients. We also suggest that CAS with postdeployment stenosis of less than 20% and without overt signs of severe calcification might be performed without post-dilation.

• MeSH
• implantace protézy metody   MeSH
• katetrizace * MeSH
• lidé středního věku MeSH
• lidé MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• stenóza arteria carotis terapie   MeSH
• stenty * MeSH
• tranzitorní ischemická ataka prevence a kontrola   MeSH
• výběr pacientů MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Aortic dissection occurs in Turner syndrome with substantially higher frequency in comparison to the general population, and its prevention is one of the main aims of cardiologic follow-up. Findings of cystic medial necrosis in the aortic wall and a high prevalence of aortic dilation suggest that a form of aortopathy exists in Turner syndrome. However, little is known about natural development of aortic dilation prior to dissection. We present a 16-year-old girl with Turner syndrome with a bicuspid aortic valve, aortic stenosis, and dilation of ascending aorta, who underwent annual echocardiographic examinations from early childhood. Significant progressions of proximal aortic dilation occurred twice at the age of 10 and 15 years. Thereafter, another rapid progression was observed during 8 months and within 3 weeks preceding dissection. Acute aortic dissection was diagnosed while the girl was waiting for elective surgery. She was successfully operated. Frequent estimations of aortic diameter in Turner patients with abnormal findings may help to anticipate this life-threatening event. Additionally, we learned that rapid progression of aortic dilation should lead to immediate surgery to prevent more risky urgent intervention following the dissection.

• MeSH
• aortální aneurysma diagnóza   etiologie   chirurgie   MeSH
• dilatace patologická MeSH
• disekce aorty diagnóza   etiologie   chirurgie   MeSH
• echokardiografie MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mladiství MeSH
• prasklé aneurysma diagnóza   etiologie   chirurgie   MeSH
• progrese nemoci MeSH
• Turnerův syndrom komplikace   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

The external diameter of the artery (1.08 +/- 0.04 mm) predominantly supplying the gracilis muscle was monitored in situ in 12 dogs under thiopental anaesthesia using a contact inductive transformer. The blood flow in the artery could be controlled by an arteriovenous shunt. After a latency of 10.6 +/- 0.7 s, an increase of blood flow through the artery from 4.0 +/- 0.3 to 45.0 +/- 3.4 ml.min-1 induced an increase in its diameter by 44.9 +/- 3.6% of the resting value (p less than 0.001). When the blood flow-rate was reduced to the initial level, the artery constricted with a half-recovery time of 307.2 +/- 30.7 s. The amplitude and the time course of the arterial dilation were identical when the blood pressure at the site of diameter measurement decreased or remained unchanged. The dilation became maximal at blood flows corresponding to the peak of reactive hyperaemia in the gracilis muscle after 2 min arterial occlusion. It is being suggested that the blood flow-induced dilation ensures autostabilization of conduit artery function.

• MeSH
• arteria femoralis fyziologie   MeSH
• hyperemie patofyziologie   MeSH
• krevní tlak MeSH
• psi MeSH
• regionální krevní průtok MeSH
• svaly krevní zásobení   MeSH
• vazodilatace * MeSH
• zadní končetina krevní zásobení   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• psi MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Allosteric modulators of ligand-gated receptor channels induce conformational changes of the entire protein that alter potencies and efficacies for orthosteric ligands, expressed as the half maximal effective concentration (EC50) and maximum current amplitude, respectively. Here, we studied the influence of allostery on channel pore dilation, an issue not previously addressed. Experiments were done using the rat P2X4 receptor expressed in human embryonic kidney 293T cells and gated by adenosine 5'-triphosphate (ATP) in the presence and absence of ivermectin (IVM), an established positive allosteric regulator of this channel. In the absence of IVM, this channel activates and deactivates rapidly, does not show transition from open to dilated states, desensitizes completely with a moderate rate, and recovers only fractionally during washout. IVM treatment increases the efficacy of ATP to activate the channel and slows receptor desensitization during sustained ATP application and receptor deactivation after ATP washout. The rescue of the receptor from desensitization temporally coincides with pore dilation, and the dilated channel can be reactivated after washout of ATP. Experiments with vestibular and transmembrane domain receptor mutants further established that IVM has distinct effects on opening and dilation of the channel pore, the first accounting for increased peak current amplitude and the latter correlating with changes in the EC50 and kinetics of receptor deactivation. The corresponding kinetic (Markov state) model indicates that the IVM-dependent transition from open to dilated state is coupled to receptor sensitization, which rescues the receptor from desensitization and subsequent internalization. Allosterically induced sensitization of P2X4R thus provides sustained signaling during prolonged and repetitive ATP stimulation.

• MeSH
• alosterická regulace MeSH
• gating iontového kanálu * MeSH
• HEK293 buňky MeSH
• ivermektin chemie   farmakologie   MeSH
• kinetika MeSH
• krysa rodu Rattus MeSH
• lidé MeSH
• purinergní receptory P2X4 chemie   genetika   metabolismus   MeSH
• terciární struktura proteinů MeSH
• vazba proteinů MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Intramural MeSH
• Názvy látek
• ivermektin MeSH
• purinergní receptory P2X4 MeSH

RATIONALE AND OBJECTIVES: The purpose of this study was to determine the long-term success of the use of angioplasty balloons for dilation of esophageal strictures in children. MATERIALS AND METHODS: The authors studied 24 children who had undergone fluoroscopically guided angioplasty balloon dilation of esophageal strictures. Ten children had stricture of the anastomosis after surgical repair of esophageal atresia; five had achalasia; three had strictures due to gastroesophageal reflux; three had corrosive strictures; two had congenital stenosis; and one had stricture after radiation therapy. Success was defined as resolution of the dysphagia a year after dilation. RESULTS: A year after the last dilation, 15 of the 24 children had no dysphagia. Patients in whom treatment was successful included eight children with strictures after surgery for esophageal atresia, one with achalasia, three with strictures caused by gastroesophageal reflux, one with a corrosive stricture, one with congenital stenosis, and one with a stricture resulting from radiation therapy. CONCLUSION: The long-term results of balloon catheter dilation are highly successful in patients with stricture after surgical repair of esophageal atresia and stricture due to gastroesophageal reflux. Dilation is not as valuable in the treatment of esophageal strictures resulting from other causes.

• MeSH
• dítě MeSH
• katetrizace * MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• poruchy polykání etiologie   terapie   MeSH
• předškolní dítě MeSH
• radiografie MeSH
• stenóza jícnu diagnostické zobrazování   etiologie   terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

This study investigated the effect of exercise training on the flow-mediated dilation (FMD) in gastrocnemius muscle arteries from spontaneously hypertensive rats (SHR). SHR and WKY rats were divided into sedentary and exercised groups. After swimming exercise for eight weeks, the isolated arteries were mounted on pressurized myograph and FMD responses examined. The role of nitric oxide (NO), prostaglandins (PGs) and endothelium derived hyperpolarizing factor (EDHF) on FMD were assessed by obtaining dilation responses in the presence and absence of pharmacological antagonists. N(omega)-nitro-L-arginine methyl ester (L-NAME), indomethacin (INDO) and tetraethylamonium (TEA) were used to inhibit nitric oxide synthase, cyclooxygenase and EDHF-mediated responses, respectively. The FMD response was significantly blunted in arteries of SHR compared with WKY rats, and, improved by exercise training in SHR (SHR-ET) group. In SHR arteries, L NAME and TEA did not affect dilation responses to flow, while INDO led to a significant enhancement in this response. Although dilation response was not altered by L-NAME in arteries obtained from trained SHR, TEA caused a significant attenuation and INDO led to significant increases. These results demonstrate that exercise training improves FMD in SHR, and, this enhancement induced by exercise training occurs through EDHF-mediated mechanism(s).

• MeSH
• hypertenze patofyziologie   terapie   MeSH
• kondiční příprava zvířat metody   fyziologie   MeSH
• kosterní svaly krevní zásobení   fyziologie   MeSH
• krysa rodu Rattus MeSH
• potkani inbrední SHR MeSH
• potkani inbrední WKY MeSH
• rychlost toku krve fyziologie   MeSH
• vazodilatace fyziologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• srovnávací studie MeSH