The total content of rat liver microsomal cytochrome P450 (CYP) significantly decreased after repeated i.p. administration of the antiviral agent tenofovir ((R)-9-[2-(phosphonomethoxy)propyl] adenine) and tenofovir disoproxil at a daily dose 25 mg/kg, although the content of liver microsomal protein did not change. The decrease of the CYP content was accompanied by concomitant increase of the amount of inactive CYP form, cytochrome P420. This effect was confirmed by a parallel study of the activities of selected CYP forms, CYP2E1 (p-nitrophenol hydroxylation) and CYP1A2 (7-ethoxyresorufin deethylation). The activity (expressed relatively to the protein content) of both CYP forms decreased significantly following the decrease of the total CYP. On the other hand, the CYP2E1 activity expressed relatively to the decreasing total CYP content remained unchanged. However, CYP1A2 activity also decreased when calculated relatively to the total native CYP content indicating lower stability of this form. Semiquantitative RT-PCR showed no significant changes in expression of major rat liver microsomal CYP forms after tenofovir treatment. In conclusion, repeated administration of tenofovir in higher doses led to significant decrease of the relative proportion of active liver microsomal CYPs accompanied by a conversion of these enzymes to the inactive form (CYP420) maintaining the sum of CYP proteins unchanged., E. Anzenbacherová, P. Anzenbacher, Z. Zídek, E. Buchar, E. Kmoníčková, P. Potměšil, J. Nekvindová, A. Veinlichová, A. Holý., and Obsahuje bibliografii a bibliografické odkazy
Treatment with pertussis toxin (PTX) which eliminates the activity of Gi proteins effectively reduces blood pressure (BP) and vascular resistance in spontaneously hypertensive rats (SHR). In this study we have compared the functional characteristics of isolated arteries from SHR with and without PTX-treatment (10 μg/kg i.v., 48 h before the experiment). Rings of thoracic aorta, superior mesenteric artery and main pulmonary artery were studied under isometric conditions to measure the reactivity of these vessels to receptor agonists and to transmural electrical stimuli. We have found that the treatment of SHR with PTX had no effect on endothelium-dependent relaxation of thoracic aorta induced by acetylcholine. In PTX-treated SHR, the maximum contraction of mesenteric artery to exogenous noradrenaline was reduced and the dose-response curve to cumulative concentration of noradrenaline was shifted to the right. Similarly, a reduction in the magnitude of neurogenic contractions elicited by electrical stimulation of perivascular nerves was observed in the mesenteric artery from PTX-treated SHR. PTX treatment of SHR also abolished the potentiating effect of angiotensin II on neurogenic contractions of the main pulmonary artery. These results indicate that PTX treatment markedly diminishes the effectiveness of adrenergic stimuli in vasculature of SHR. This could importantly affect BP regulation in genetic hypertension., A. Zemančíková, J. Török, J. Zicha, J. Kuneš., and Obsahuje bibliografii a bibliografické odkazy
Parasitic organisms inhabiting the alimentary canal should permanently resist the destructive action of host digestive enzymes. The intestinal parasites were shown to produce specific protease inhibitors protecting them from proteolysis. However, little is known about this adaptive mechanism in cestodes so far, especially for the tapeworms dwelling inside the fish intestines. Here, we explored the ability to inactivate proteolytic enzymes in the fish tapeworm Eubothrium rugosum (Batsch, 1786) (Bothriocephalidea) parasitising the intestine of wild burbot, Lota lota (Linnaeus). The assays were conducted with different concentrations of commercial trypsin and homogenate of intestinal mucosa both being the sources of proteinases. The incubation of live E. rugosum in trypsin solutions of two different concentrations caused a significant decrease in the enzyme activity. The extent of activity reduction was dependent on trypsin concentration. At the same time, the inhibitory effect of the worm incubation medium turned out to be statistically insignificant. These findings suggest partial adsorption of the enzyme to the tegument surface, with its further inactivation. In contrast to the incubation medium, the worm extract suppressed over 80% of trypsin activity and nearly half of the proteolytic activity in the mucosa homogenate. Notably, the inhibitory activity of the tapeworms hardly depended on their size characteristics. Finally, the research has demonstrated secretion of proteinase inhibitor in E. rugosum, which appears to be essential for its survival in enzymatically hostile environment., Galina I. Izvekova, Tatyana V. Frolova, Evgeny I. Izvekov., and Obsahuje bibliografii
There are various complications of prosthetic valvular surgeries. Among them, leaflet perforation should be emphasized and brought to mind when there have been eccentric valvular regurgitation. In this report, we presented 2 cases of iatrogenic aortic and mitral valve leaflet perforation after prosthetic valve surgeries. and M. Dogan, S. Acikel, U. Arslantas, T. Cimen, E. Yeter
Úvod: Informace o prevalenci orgánových komplikací diabetu včetně syndromu diabetické nohy v České republice je možné získat z dokumentů Ústavu zdravotnických informací a statistiky. Cíl: Posoudit vývoj vysokých amputací a drobných výkonů na noze v letech 2010–2014 v reprezentativním vzorku populace pacientů s diabetes mellitus vedených v databázi Všeobecné zdravotní pojišťovny (VZP) České republiky. Metodika: V databázi VZP jsme identifikovali všechny osoby, které měly v letech 2010–2014 záznam o diagnóze DM (E10–E16 podle MKN 10) nebo předpis jakékoliv antidiabetické terapie (ATC skupina A10). Pro analýzu byl extrahován soubor osob, které měly v daném roce předepsanou nejméně jednou látku ze skupiny A10. Následně jsme identifikovali osoby, které v letech 2010–2014 současně prodělaly chirurgický výkon na noze z důvodu diagnózy diabetické nohy. Výsledky: Absolutní počet amputačních výkonů na končetině vykazuje stacionární úroveň. Závěr: Předkládaná analýza je prvním zhodnocením vývoje výkonů na diabetické noze v ČR. Je zřetelný setrvalý stav v počtu výkonů na diabetické noze, a to jak vysokých amputací, tak drobných výkonů na noze. V kontextu s absolutním nárůstem pacientů, léčených pro diabetes mellitus, je stacionární stav známkou relativního poklesu, což je příznivé především v oblasti amputace dlouhých kostí. Klíčová slova: amputace – diabetes mellitus – syndrom diabetické nohy, Introduction: Information about the incidence of organ-affecting complications of diabetes, including the diabetic foot syndrome, can be obtained from the documents of the Institute of Health Information in the Czech Republic. Goal: Assessment of the development of high amputations and minor surgical procedures on the lower limb from 2010 to 2014 in a representative sample of the population of patients with DM kept in the General Health Insurance Company of the Czech Republic database. Methodology: We identified all individuals in the VZP database who had a record of DM diagnosis (E10 – E16 based on ICD 10) or any antidiabetic therapy prescribed (ATC group A10) in the period of 2010 – 2014. A set of patients who had an agent from A10 group prescribed at least once in the given year was extracted for analysis. In the next step we identified individuals, who in the period of 2010 – 2014 also underwent a surgical procedure on the lower limb due to diabetic foot. Results: An absolute number of lower limb amputations remains at a stationary level. Conclusion: The submitted analysis presents the first assessment of the development of surgical treatment of diabetic foot in the Czech Republic. The amount of surgical procedures on the diabetic foot remains stable, regarding both high amputations and lower limb minor surgical procedures. In the context of an absolute increase of patients treated for diabetes mellitus, the stationary state is an indication of a relative decrease, which is favourable in particular with regard to the amputation of long bones. Key words: diabetes mellitus – diabetic foot syndrome – amputation, and Pavlína Piťhová, Petr Honěk, Ladislav Dušek, Tomáš Pavlík, Milan Kvapil
Jako incidentalom se označuje náhodně zjištěná expanze nadledviny. Vzhledem k rozvoji zobrazovacích technik se s ní setkáváme stále častěji. Její prevalence je totiž více než 1 % dospělých a roste s věkem. Při vyšetření je nutno vyloučit malignitu. K tomu slouží klasicky vyšetření CT, ev. MRI. Nověji se stále více uplatňuje PET-CT, která má senzitivitu asi 97 % a specificitu 91 %. Hormonální vyšetření má vyloučit i subklinickou nadprodukci kortizolu (optimální je dexametazonový supresní test). Aldosteron je nutno vyšetřovat jen u nemocných s hypertenzí a katecholaminy u nádorů s vyšší nativní denzitou než 10 HU. Při sledování je nutnost opakovaných CT vyhrazena jen pro vybrané případy a rutinní kontrolní laboratorní vyšetření jsou také zpochybněna., Incidentaloma is an adrenal mass discovered serendipitously. Because of increasing use of imaging techniques it is a common finding, being present in more than 1 % of adults. During work-up malignancy has to be ruled out. Classically imaging using CT or MRI is used. Recently PET-CT with FDG has been used more often as its sensitivity for diagnosis of malignancy is about 97 % and specificity 91 %. Hormonal evaluation should diagnose subclinical hypercortisolism. (Dexamethasone Suppression Test is the method of choice). Aldosterone and Renin should be measured only in patients with hypertension and catecholamines in tumours with higher native density than 10 HU. During follow-up repeated CT scan are needed only in selected patients and the need of routine biochemical follow-up has been questioned as well., and Jan Čáp, Filip Gabalec
The presence of a broad spectrum of autoantibodies in Sjögren's syndrome (SjS) patients is the result of abnormal B-cell regulation that can be at least partially explained by abnormal BAFF/BAFFR regulation. The objective of this study was to determine both membrane and intracellular expression of BAFF/BAFFR in monocytes and B-cells in peripheral blood of 19 primary Sjögren's syndrome patients and 20 healthy controls using flow cytometry. We also measured sBAFF in serum. Compared to healthy controls, both surface and intracellular expression of BAFF was significantly increased in monocytes and B-cells of SjS patients. Also serum sBAFF level was elevated. Expression of BAFFR on B-cells of SjS patients was surprisingly decreased, but there was no clear increase or decrease within monocytes. Our results indicate that activated monocytes communicate with B-cells via BAFF and BAFFR, so that B-cells are stimulated, but BAFF is also produced to stimulate cells in autocrine way. The decrease of BAFFR expression in SjS patients suggests that there is the mechanism that attempts to take over in order to balance the high level of BAFF. and J. Krejsek, M. Koláčková, I. Lindrová, R. Slezák, C. Andrýs
In hemodialyzed patients hormonal disturbances are known to occur. However, melatonin levels have not been completely studied. The aim of the study was to find whether changes in calcaemia affect melatonin secretion. For this reason we followed the nocturnal serum concentrations of melatonin and parathyroid hormone (PTH) in 9 hemodialyzed patients (6 women and 3 men, aged 37-65 years) both before and 1-3 months after parathyroidectomy at 6 p.m., 9 p.m., 11 p.m., 2 a.m., 5 a.m. and 7 a.m. At 6 p.m. blood samples to evaluate the levels of calcium and phosphate were also collected. Parathyroidectomy resulted in an increase in nocturnal melatonin levels. As expected, the parathyroidectomy was followed by considerable PTH decrease. PTH showed no nocturnal variation before or after parathyroidectomy. Calcium levels significantly decreased after the operation while phosphate levels increased. In summary, in hemodialyzed patients with hyperparathyroidism, parathyroidectomy significantly increases the nocturnal secretion of melatonin. Relationships between the pineal gland and parathyroid glands have yet to be elucidated., R. Kancheva, S. Sulková, F. Švára, M. Hill, L. Kanchev, I. Žofková., and Obsahuje bibliografii a bibliografické odkazy
Critical illness induces among other events production of proinflammatory cytokines that in turn interfere with insulin signaling cascade and induce insulin resistance on a postreceptor level. Recently, local renin-angiotensin system of adipose tissue has been suggested as a possible contributor to the development of insulin resistance in patients with obesity. The aim of our study was to determine local changes of the renin-angiotensin system of subcutaneous and epicardial adipose tissue during a major cardiac surgery, which may serve as a model of an acute stress potentially affecting endocrine function of adipose tissue. Ten patients undergoing elective cardiac surgery were included into the study. Blood samples and samples of subcutaneous and epicardial adipose tissue were collected at the beginning and at the end of the surgery. Blood glucose, serum insulin and adiponectin levels were measured and mRNA for angiotensinogen, angiotensin-converting enzyme and angiotensin II type 1 receptor were determined in adipose tissue samples using RT PCR. Cardiac surgery significantly increased both insulin and blood glucose levels suggesting the development of insulin resistance, while serum adiponectin levels did not change. Expression of angiotensinogen mRNA significantly increased in epicardial adipose tissue at the end of surgery relative to baseline but remained unchanged in subcutaneous adipose tissue. Fat expression of angiotensin-converting enzyme and type 1 receptor for angiotensin II were not affected by surgery. Our study suggests that increased angiotensinogen production in epicardial adipose tissue may contribute to the development of postoperative insulin resistance., T. Roubíček, M. Dolinková, J. Bláha, D. Haluzíková, L. Bošanská, M. Mráz, J. Křemen, M. Haluzík., and Obsahuje bibliografii a bibliografické odkazy
We studied the changes in seru m fibroblast growth factor-21 (FGF-21) concentrations, its mR NA, and protein expression in skeletal muscle and adipose tissue of 15 patients undergoing cardiac surgery. Blood samples were obtained: prior to initiation of anesthesia, prior to the start of extracorporeal circulation, upon completion of the surger y, and 6, 24, 48, and 96 hours after the end of the surgery. Tissue sampling was performed at the start and end of surgery. The mean baseline serum FGF-21 concentration was 63.1 (43.03-113. 95) pg/ml and it increased during surgery with peak 6 ho urs after its end [385.5 (274.55-761.65) pg/ml, p<0.001], and return ed to baseline value [41.4 (29.15-142.83) pg/ml] 96 hours afte r the end of the surgery. Serum glucose, insulin, CRP, IL-6, IL-8, MCP-1, and TNF-alpha concentrations significantly increased during the surgery. Baseline FGF-21 mRNA expression in skeletal muscle was higher than in both adipose tissue depots and it was not affected by the surgery. Epicardial fat FGF-21 mRNA increased after surgery. Muscle FGF-21 mRNA positively correlated with blood glucose levels at the end of the surgery. Our data suggest a possible role of FGF-21 in the regulation of glucose metabolism and insulin sensitivity in surgery-related stress., T. Kotulák ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy