• Klíčová slova
• MECONIUM *,
• MeSH
• gastrointestinální nemoci * MeSH
• kojenec MeSH
• lidé MeSH
• mekonium * MeSH
• novorozenec MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH

Meconium aspiration syndrome (MAS) is meconium-induced respiratory failure of newborns associated with activation of inflammatory and oxidative pathways. For severe MAS, exogenous surfactant treatment is used which improves respiratory functions but does not treat the inflammation. Oxidative process can lead to later surfactant inactivation; hence, surfactant combination with antioxidative agent may enhance the therapeutic effect. Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone, N-acetylcysteine (NAC) alone or by their combination and oxygen-ventilated for 5 h. Blood samples were taken before and 30 min after meconium application and 30 min, 1, 3 and 5 h after the treatment for evaluating of oxidative damage, total leukocyte count, leukocyte differential count and respiratory parameters. Leukocyte differential was assessed also in bronchoalveolar lavage fluid. NAC alone had only mild therapeutic effect on MAS. However, the combination of NAC and surfactant facilitated rapid onset of therapeutic effect in respiratory parameters (oxygenation index, PaO(2)/FiO(2)) compared to surfactant alone and was the only treatment which prevented neutrophil migration into the lungs, oxidative damage and lung edema. Moreover, NAC suppressed IL-8 and IL-beta formation and thus seems to be favorable agent for improving surfactant therapy in MAS.

• MeSH
• acetylcystein farmakologie   terapeutické užití   MeSH
• bronchoalveolární lavážní tekutina imunologie   MeSH
• cytokiny metabolismus   MeSH
• edém prevence a kontrola   MeSH
• expektorancia farmakologie   terapeutické užití   MeSH
• kombinovaná farmakoterapie MeSH
• králíci MeSH
• látky reagující s kyselinou thiobarbiturovou metabolismus   MeSH
• náhodné rozdělení MeSH
• novorozená zvířata MeSH
• pilotní projekty MeSH
• plíce účinky léků   metabolismus   MeSH
• plicní surfaktanty farmakologie   terapeutické užití   MeSH
• počet leukocytů MeSH
• preklinické hodnocení léčiv MeSH
• respirační funkční testy MeSH
• syndrom aspirace mekonia imunologie   metabolismus   prevence a kontrola   MeSH
• testy migrace leukocytů MeSH
• tyrosin analogy a deriváty   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• 3-nitrotyrosine MeSH Prohlížeč
• acetylcystein MeSH
• cytokiny MeSH
• expektorancia MeSH
• látky reagující s kyselinou thiobarbiturovou MeSH
• plicní surfaktanty MeSH
• tyrosin MeSH

Meconium aspiration syndrome (MAS) triggers inflammatory and oxidative pathways which can inactivate both pulmonary surfactant and therapeutically given exogenous surfactant. Glucocorticoid budesonide added to exogenous surfactant can inhibit inflammation and thereby enhance treatment efficacy. Neonatal meconium (25 mg/ml, 4 ml/kg) was administered intratracheally (i.t.) to rabbits. When the MAS model was prepared, animals were treated with budesonide i.t. (Pulmicort, 0.25 mg/kg, M+B); with surfactant lung lavage (Curosurf®, 10 ml/kg, 5 mg phospholipids/ml, M+S) followed by undiluted Curosurf® i.t. (100 mg phospholipids/kg); with combination of budesonide and surfactant (M+S+B); or were untreated (M); or served as controls with saline i.t. instead of meconium (C). Animals were oxygen-ventilated for additional 5 h. Cell counts in the blood and bronchoalveolar lavage fluid (BAL), lung edema formation (wet/dry weight ratio), oxidative damage of lipids/ proteins and inflammatory expression profiles (IL-2, IL-6, IL-13, TNF-alpha) in the lung homogenate and plasma were determined. Combined surfactant+budesonide therapy was the most effective in reduction of neutrophil counts in BAL, oxidative damage, levels and mRNA expression of cytokines in the lung, and lung edema formation compared to untreated animals. Curosurf fortified with budesonide mitigated lung inflammation and oxidative modifications what indicate the perspectives of this treatment combination for MAS therapy.

• MeSH
• antiflogistika aplikace a dávkování   MeSH
• budesonid aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• králíci MeSH
• mediátory zánětu antagonisté a inhibitory   metabolismus   MeSH
• modely nemocí na zvířatech * MeSH
• oxidační stres účinky léků   fyziologie   MeSH
• peroxidace lipidů účinky léků   fyziologie   MeSH
• plicní surfaktanty aplikace a dávkování   MeSH
• syndrom aspirace mekonia farmakoterapie   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antiflogistika MeSH
• budesonid MeSH
• mediátory zánětu MeSH
• plicní surfaktanty MeSH

Severe meconium aspiration syndrome (MAS) in newborns is often treated by exogenous surfactant. Because its efficacy is reduced by meconium-induced inflammation, glucocorticoid budesonide was added into surfactant preparation Curosurf to enhance efficacy of the surfactant therapy in experimental model of MAS. Oxygen-ventilated rabbits were intratracheally given meconium (25 mg/ml, 4 ml/kg) to induce respiratory failure. Thirty minutes later, animals were treated by intratracheal budesonide (0.25 mg/kg) or surfactant lung lavage (10 ml/kg, 5 mg phospholipids/ml) repeated twice, followed by undiluted Curosurf (100 mg phospholipids/kg) or by the above mentioned surfactant treatment with the last surfactant dose fortified with budesonide (0.25 mg/kg) or were untreated. Animals were ventilated for additional 5 hours and respiratory parameters were measured regularly. After sacrificing animals, wet-dry lung weight ratio was evaluated and plasma levels of interleukins (IL)-1beta, -6, -8, and TNF-alpha were measured by ELISA method. Efficacy of the given therapies to enhance lung functions and to diminish lung edema formation and inflammation increased from budesonide-only and surfactant-only therapy to surfactant+budesonide therapy. Combined therapy improved gas exchange from 30 min of administration, and showed a longer-lasting effect than surfactant-only therapy. In conclusions, budesonide additionally improved the effects of exogenous surfactant in experimental MAS.

• MeSH
• antiflogistika aplikace a dávkování   MeSH
• biologické přípravky aplikace a dávkování   MeSH
• bronchodilatancia aplikace a dávkování   MeSH
• budesonid aplikace a dávkování   MeSH
• fixní kombinace léků MeSH
• fosfolipidy aplikace a dávkování   MeSH
• imunologické faktory metabolismus   MeSH
• králíci MeSH
• mechanika dýchání účinky léků   MeSH
• plicní surfaktanty MeSH
• prasata MeSH
• syndrom aspirace mekonia diagnóza   farmakoterapie   patofyziologie   MeSH
• synergismus léků MeSH
• výsledek terapie MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antiflogistika MeSH
• biologické přípravky MeSH
• bronchodilatancia MeSH
• budesonid MeSH
• fixní kombinace léků MeSH
• fosfolipidy MeSH
• imunologické faktory MeSH
• plicní surfaktanty MeSH
• poractant alfa MeSH Prohlížeč

OBJECTIVE: A review of meconium patophysiology and its contribution to the incidence of perinatal infection. DESIGN: Review article. SETTING: Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic. METHOD: The reported incidence of meconium-stained amniotic fluid varies between 7 and 22%. The patophysiology of the presence of meconium in the amniotic fluid is not sufficiently explained. Meconium in fetal bowels is under hormonal and neurol control. The presence of the meconium-stained amniotic fluid was always considered to be a potential risk for the fetal and neonatal well-being. The review is further divided in to three chapters. (II. Meconium and meconium aspiration syndrome, III. Meconium and postnatal neurological handicap). RESULTS AND CONCLUSION: The first chapter on deals with meconium risk in the development of perinatal infection: intraamniotic infection/chorioamnionitis, postnatal endometritis, infection of the abdominal wound after Caesarean and neonatal infection. The incidence of clinical chorioamnionitis is 15% with the presence of meconium compared to 3% in controls. The incidence of puerperal endometritis is 10% in comparison to 3% under normal conditions. Two main mechanisms of development (or coincidence) of intraamniotic infection in the presence of meconium exist. 1) Infection may be a cause of meconium passage. 2A) Alteration of Zn/P ratio in the amniotic fluid can promote bacterial growth. 2B) Meconium attached to macrophages or absorbed by phagocytosis can impair cellular immune response. The antibiotic prophylaxis is discussed.

• MeSH
• chorioamnionitida etiologie   MeSH
• císařský řez MeSH
• endometritida etiologie   MeSH
• infekce chirurgické rány etiologie   MeSH
• infekce etiologie   MeSH
• lidé MeSH
• mekonium * fyziologie   MeSH
• novorozenec MeSH
• plodová voda chemie   MeSH
• puerperální infekce etiologie   MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Ultrafast T2-weighted (T2-W) MRI sequences are currently considered a routine technique for fetal MR imaging. Limited experience exists with fetal T1-weighted (T1-W) imaging techniques. OBJECTIVE: To determine MRI patterns of some fetal abdominal or haemorrhagic disorders with particular respect to the diagnostic value of T1-W images. MATERIALS AND METHODS: In addition to standard T2-W single-shot sequences, T1-W single-shot and/or multislice sequences were employed in 25 MR examinations performed in 23 fetuses between 20 and 36 weeks of gestation for more detailed assessment of liver, meconium-filled digestive tract, haemorrhage, or further characterization of a fetal abdominal mass. Diagnostic value and presence of motion artefacts on T1-W images was recorded in each case. RESULTS: T1-W images enabled superior delineation of fetal liver and large intestine. They provided additional diagnostic information in 9 (39%) of 23 fetuses. One false-positive and one false-negative MRI diagnosis of malrotation anomaly were encountered. Use of single-shot T1-W sequences reduced the occurrence of motion artefacts in 64%. CONCLUSION: Our results suggest that the specific signal properties of methaemoglobin, meconium and liver are sufficiently important for T1-W sequences to become a routine part of fetal MRI protocols when dealing with digestive tract anomalies, diaphragmatic and abdominal wall defects, intraabdominal masses, and fetal haemorrhage.

• MeSH
• břicho abnormality   MeSH
• druhý trimestr těhotenství MeSH
• játra abnormality   MeSH
• krvácení diagnóza   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• mekonium MeSH
• prenatální diagnóza metody   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• třetí trimestr těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

We report a case of meconium pseudocyst evaluated by prenatal MR imaging. The unusual features were its huge size, the absence of meconium peritonitis, and its development late in fetal life. The case also demonstrates a possible diagnostic pitfall since it suggests that rapid deterioration of a mechanically compensated bowel obstruction may occur, potentially occurring only after an MRI study has been performed.

• MeSH
• atrézie střev komplikace   diagnóza   MeSH
• cysty diagnóza   etiologie   MeSH
• dospělí MeSH
• ileum abnormality   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• mekonium * MeSH
• nemoci plodu diagnóza   MeSH
• novorozenec nedonošený MeSH
• novorozenec MeSH
• prenatální diagnóza * MeSH
• těhotenství MeSH
• ultrasonografie prenatální MeSH
• volvulus intestini komplikace   diagnóza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

In the last decade there has been a dramatic increase in the availability and abuse of synthetic cathinones - new amphetamine-like stimulants. Even though their abuse during pregnancy could have serious adverse effects on the fetus, cathinones are not readily included in neonatal toxicological screenings. Meconium (first neonatal stool) is the specimen of choice to reveal long term drug exposure, however as it is a highly complex matrix, the sample preparation is a critical step before the instrumental analysis. The aim of this work was to develop a suitable meconium sample extraction technique using the advantages of salting-out assisted liquid-liquid extraction (SALLE) and using only MS-friendly organic ammonium salts. We further developed and validated liquid chromatography tandem-mass spectrometry method for the determination of 'traditional' stimulants (methamphetamine, amphetamine, MDMA) and cathinones (mephedrone, methylenedioxypyrovalerone (MDPV), α-pyrrolidinopentiophenone (α-PVP), methylone, butylone, flephedrone, and naphyrone). Matrix-matched calibration was prepared in the concentration range 10-2000 ng/g. The limits of quantification were determined as 10 ng/g, recoveries ranged from 48.2% to 94.3% and the matrix effect was between 60.2% and 101.4%. Accuracy (86.1-114.5%) and precision (4.9-14.9%) were determined and all validation criteria were met for all analytes except for naphyrone. Finally, our analytical method was tested on a set of real meconium samples, which were found positive for amphetamine, methamphetamine and methylone, thus demonstrating the validity of the method.

• Klíčová slova
• Amphetamines, Cathinones, Liquid chromatography tandem-mass spectrometry, Meconium, SALLE, Salting out assisted liquid-liquid extraction,
• MeSH
• amfetaminy analýza   MeSH
• amoniové sloučeniny chemie   MeSH
• extrakce kapalina-kapalina metody   MeSH
• komplikace těhotenství diagnóza   MeSH
• lidé MeSH
• limita detekce MeSH
• mekonium chemie   MeSH
• novorozenec MeSH
• odhalování abúzu drog metody   MeSH
• poruchy spojené s užíváním psychoaktivních látek diagnóza   MeSH
• stimulanty centrálního nervového systému analýza   MeSH
• studie proveditelnosti MeSH
• tandemová hmotnostní spektrometrie metody   MeSH
• těhotenství MeSH
• vysokoúčinná kapalinová chromatografie metody   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• validační studie MeSH
• Názvy látek
• amfetaminy MeSH
• amoniové sloučeniny MeSH
• stimulanty centrálního nervového systému MeSH

Meconium aspiration syndrome (MAS) in newborns is characterized mainly by respiratory failure due to surfactant dysfunction and inflammation. Previous meta-analyses did not prove any effect of exogenous surfactant treatment nor glucocorticoid administration on final outcome of children with MAS despite oxygenation improvement. As we supposed there is the need to intervene in both these fields simultaneously, we evaluated therapeutic effect of combination of exogenous surfactant and selective inhibitor of NF-kappaB (IKK-NBD peptide). Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone or surfactant in combination with IKK-NBD, and oxygen-ventilated for 5 h. PaO(2)/FiO(2), oxygenation index, oxygen saturation and ventilation efficiency index were evaluated every hour; post mortem, total and differential leukocyte counts were investigated in bronchoalveolar lavage fluid (BALF) and inflammatory, oxidative and apoptotic markers were assessed in lung tissue homogenates. Exogenous surfactant combined with IKK-NBD improved oxygenation, reduced neutrophil count in BALF and levels of IL-1beta, IL-6, p38 MAPK and caspase 3 in comparison with surfactant-only therapy. It seems that inhibition of inflammation may be strong supporting factor in surfactant treatment of MAS.

• MeSH
• králíci MeSH
• mediátory zánětu antagonisté a inhibitory   metabolismus   MeSH
• mekonium * MeSH
• náhodné rozdělení MeSH
• NF-kappa B antagonisté a inhibitory   metabolismus   MeSH
• novorozená zvířata MeSH
• plicní surfaktanty farmakologie   terapeutické užití   MeSH
• poškození plic chemicky indukované   farmakoterapie   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• mediátory zánětu MeSH
• NF-kappa B MeSH
• plicní surfaktanty MeSH

CD 68 antibodies are most frequently used as a reliable paraffin marker of histiocytes. The CD 68 clusters of antibodies recognize a 110-kDa glycoprotein associated with lysosomes and therefore these antibodies show visible reactivity with cells of the monocyte/macrophage lineage. We observed distinct CD 68 positivity of granular intraepithelial inclusions in the small intestine of 12-week-old human foetuses. These PAS positive inclusions corresponded to the so-called meconium particles, whose lysosomal origin was confirmed by electron microscopy. Our new observation shows that CD 68 antibodies are specific mainly for organelles and not for a cell type and therefore the staining of epithelial cells containing lysosomes is possible.

• MeSH
• antigeny diferenciační myelomonocytární analýza   MeSH
• buněčná inkluze imunologie   ultrastruktura   MeSH
• CD antigeny analýza   MeSH
• cytoplazmatická granula ultrastruktura   MeSH
• imunohistochemie MeSH
• lidé MeSH
• lyzozomy imunologie   MeSH
• makrofágy imunologie   MeSH
• mekonium * MeSH
• plod imunologie   ultrastruktura   MeSH
• střevní sliznice ultrastruktura   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antigeny diferenciační myelomonocytární MeSH
• CD antigeny MeSH
• CD68 antigen, human MeSH Prohlížeč