Popisujeme případ multicentrické formy Castlemanovy choroby, s generalizovanou lymfadenopatií a splenomegalií, provázenou typickými B symptomy – úbytek hmotnosti 15 kg, horečky neinfekčního původu, noční pocení, symptomy anémie. Histologické vyšetření uzlin s nejvyšší akumulací fluorodeoxyglukózy, odebrané torakoskopicky z mediastina, prokázalo plazmocelulární typ Castlemanovy choroby. Vyšetření HIV a lidského herpesviru 8 (HHV-8) bylo negativní. Stanovení diagnózy nemoci předcházely 3 recidivy herpes zosteru, což svědčilo o alteraci imunity. Léčba byla zahájena kombinací talidomidu, dexametazonu a cyklofosfamidu. Po 2 měsících léčby nebyla zřetelná léčebná odpověď a pacient tuto léčbu špatně toleroval. Proto byl tento způsob léčby ukončen. Pro léčbu 2. linie byla zvolena léčba R-CHOP (Mabthera – rituximab, cyklofosfamid, adriamycin, vinkristin a prednison. V průběhu 2 cyklů této léčby se zmenšila lymfadenopatie a splenomegalie, ale léčbu provázely závažné infekční komplikace. Proto dále pokračovala pouze monoterapie přípravkem Mabthera v dávce 375 mg/m2 v 28denních intervalech. Tato léčba se ukázala jako účinná a dobře tolerovaná. Při kontrolním PET-CT vyšetření vymizela lymfadenopatie a splenomegalie a normalizovala se akumulace fluorodeoxyglukózy. Mabthera v monoterapii se v tomto případě ukázala jako účinný a velmi dobře tolerovaný lék. Pro multicentrickou formu Castlemanovy nemoci existuje v současnosti více účinných léčebných alternativ: léčba rituximabem v monoterapii či v kombinaci, léčba imunomodulačními léky (talidomid nebo lenalidomid), léčba protilátkami proti interleukinu 6 (siltuximab) nebo proti jeho receptoru (tocilizumab). V případně neúčinnosti jedné léčebné alternativy je nutné otestovat další alternativu. V tomto případně nebyla úspěšná léčba založená na talidomidu, zatímco léčba založená na přípravku Mabthera dosáhla vymizení projevů nemoci., We describe a case of multicentric Castleman disease with generalized lymphadenopathy and splenomegaly, accompanied by typical B symptoms - loss of 15 kg, fever of non-infectious origin, night sweats, symptoms of anemia. Histological examination of the nodes with the highest accumulation of fluorodeoxyglucose, taken from mediastinum by thoracoscopy, revealed plasmocellular type of Castleman disease. Tests for HIV and human herpesvirus 8 (HHV-8) were negative. Three recurrences of herpes zoster indicating an alteration of immunity preceded the diagnosis of disease. Treatment was initiated with combination of thalidomide, dexamethasone, and cyclophosphamide. The response after 2 months therapy was not clear and patient doesn´t tolerated the therapy well. Therefore, this treatment was terminated and R-CHOP (Mabthera - rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone) was selected as a second-line therapy. Lymphadenopathy and splenomegaly were reduced during the 2 cycles of treatment, however, serious infectious complications accompanied the therapy. Therefore, only use of Mabthera monotherapy 375 mg /m2 was administered in 28-day intervals. This treatment has shown efficacy and tolerability. PET-CT scan has demonstrated disappearance of lymphadenopathy and splenomegaly, in addition, normalized accumulation of fluorodeoxyglucose. Monotherapy with Mabthera has proved to be effective and well tolerated drug in this case. Currently, there are more effective therapeutic alternatives in multicentric Castleman disease: treatment with monotherapy of rituximab or in combination therapy with immunomodulatory drugs (thalidomide or lenalidomide, treatment with anti-IL-6 (siltuximab) or against its receptor (tocilizumab). In the case of ineffectiveness of one treatment option must be tested other alternative. In this case the therapy based on thalidomide wasn´t successful, whereas the treatment with Mabthera has achieved disappearance of disease symptoms., and Zdeněk Adam, Petr Szturz, Renata Koukalová, Zdeněk Řehák, Luděk Pour, Marta Krejčí, Lenka Šmardová, Michal Eid, Pavlína Volfová, Zdeňka Čermáková, Leoš Křen, Filip Sokol, Ivo Hanke, Eva Michalková, Zdeněk Král, Jiří Mayer
Přehledové sdělení podává souhrn současných postupů v zobrazovací diagnostice neurodegenerativních onemocnění, která se projevují kognitivním deficitem. Základním postupem je zobrazení magnetickou rezonancí, která zahrnuje zobrazení pomocí T2-vážených sekvencí včetně zobrazení roviny kolmé na dlouhou osu spánkového laloku a izotropní zobrazení T1-váženými obrazy gradientního echa. K hodnocení kortikální atrofie je používáno mediotemporální skóre atrofie (MTA, Scheltens) a skóre zadní atrofie (PA, Koedam), posouzení vlivu ischemie na vznik kognitivního deficitu pomáhá určit Fazekasovo skóre. Hybridní zobrazení pomocí PET/MR dovoluje současně hodnotit morfologické změny zejména v temporálním laloku, ale také při použití 18F-FDG typické snížení úrovně oxidativní glykolýzy v temporálních lalocích a temporoparietálně. Cílenou metodikou v diferenciaci Alzheimerovy choroby je použití radiofarmaka, které se specificky váže na amyloid beta v mozkové tkáni, prokázání akumulace radiofarmaka florbetabenu nebo flutemetamolu v šedé hmotě významně přispívá ke stanovení vysoké pravděpodobnost diagnózy Alzheimerovy choroby. V diferenciální diagnostice některých tzv. Parkinson plus syndromů, jakými je například demence s Lewyho tělísky, se může uplatnit i průkaz deficitu dopaminergního systému pomocí podání 18F-dihydroxyfenylalaninu (FDOPA). Klíčová slova: PET/MR, neurodegenerativní onemocnění, amyloid beta, FDG, FDOPA, Review summarizes contemporary approaches in imaging diagnostic of the neurodegenerative diseases presenting with cognitive deficit. Magnetic resonance imaging plays an essential role, it is including the T2 weighted imaging in the planes perpendicular to the longitudinal axes of the temporal lobes, and isotropic T1 weighted images with isotropic resolution. In the assessment of the cortical atrophy, the mediotemporal atrophy score (MTA, Scheltens) and posterior atrophy score (PA, Koedam) are used. Fazekas score assesses the hypoxemic-ischemic influences. When 18F-FDG is used hybrid imaging PET/MRI enables to evaluate the morphological changes, especially within the temporal lobe, with the typical changes of decreased oxidative glycolysis in the temporal lobe ant in the temporoparietal cortex. Targeted method of the Alzheimer disease differentiation is the application of the radiopharmaceutical with the ability to be bind to the amyloid beta. Confirmation of the accumulation such as molecule - florbetaben or flutemetamol to the amyloid beta within the gray matter supports the setting of the highest probability of Alzheimer disease diagnose. In the differential diagnosis of some so-called Parkinson plus syndromes, such as dementia with Lewy bodies, could play the role also the application of 18F-dihydroxyphenylalanine (FDOPA). Key words: PET/MRI, neurodegenerative disorders, amyloid beta, FDG, FDOPA, J. Ferda, E. Ferdová, J. Baxa, V. Matoušek, J. Hort, J. Cerman, and Literatura
The objective of the current study was to search for genetic determinants associated with antihypertensive effects of angiotensin-converting enzyme (ACE) inhibitor captopril. Linkage and correlation analyses of captopril-induced effects on blood pressure (BP) with renal transc riptome were performed in the BXH/HXB recombinant inbred (RI) strains derived from spontaneously hypertensive rat (SHR) and Brown Norway (BN-Lx) progenitors. Variability of blood pressure lowering effects of captopril among RI strains was continuous suggesting a polygenic mode of inheritance. Linkage analysis of captopril- induced BP effects revealed a significant quantitative trait locus (QTL) on chromosome 15. This QTL colocalized with cis regulated expression QTL (eQTL) for the Ednrb (endothelin receptor type B) gene in the kidney (SHR allele was associated with increased renal expression) and renal expression of Ednrb correlated with captopril-induced BP effects. These results suggest that blood pressure lowering effects of ACE inhibitor captopril may be modulated by the variants at the Ednrb locus., J. Zicha ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Pharmacokinetics of leptin in mammals has received limited attention and only one study has examined more than two time points and this was in ob/ob mice. This study is the first to observe the distribution of leptin over a time course in female mice. A physiologic dose (12 ng) of radiolabelled leptin was injected in adult female mice via the lateral tail vein and tissues were dissected out and measured for radioactivity over a time course up to two hours. Major targets for administered leptin included the liver, kidneys, gastrointestinal tract and the skin while the lungs had high concentrations of administered leptin per gram of tissue. Leptin was also found to enter the lumen of the digestive tract intact from the plasma. Very little of the dose (<1 %) was recovered from the brain at any time. Consequently we confirm that the brain is not a major target for leptin from the periphery, although it may be very sensitive to leptin that does get to the hypothalamus. Several of the major targets (GI tract, skin and lungs) for leptin form the interface for the body with the environment, and given the ability of leptin to modulate immune function, this may represent a priming effect for tissues to respond to damage and infection., R. A. Hart, R. C. Dobos, L. L. Agnew, R. L. Tellam, J. R. McFarlane., and Obsahuje bibliografii
The water-hyacinth grasshopper, Cornops aquaticum, occurs in freshwater environments in the New World between latitudes 23°N and 35°S. At the southernmost margin of this distribution the populations are polymorphic for three centric fusions (Robertsonian translocations). The frequencies of these chromosome rearrangements increase southwards and the recombination in structural homozygotes and heterozygotes diminishes both along the middle and lower courses of the Paraná River. In the present paper we report a similar cline along the southward flowing Uruguay River. In addition, we report the morphological effects of two of these centric fusion polymorphisms, namely the fusions between chromosomes 2 and 5 of the standard complement (fusion 2/5) and chromosomes 3 and 4 (fusion 3/4) and extend this study to the Uruguay River. There is a strong inverse correlation of fusion frequency with temperature, which indicates that these polymorphisms may be related to increased tolerance of colder climates in this originally tropical species, or some other correlated variable. This study is a further example of chromosomal clines correlated with latitude and is one of a few examples of chromosome polymorphisms associated with phenotypic effects. Finally, it indicates ways of using this species for controlling pests., Pablo C. Colombo, María I. Remis., and Obsahuje bibliografii
A new nematode species, Philometroides caudata sp.n., is described from the swimbladder (under the serosa cover) of the freshwater pimelodid catfish, Rhamdia guatemalensis, from cenotes (— sinkholes) in Yucatan, southeastern Mexico. It differs from all hitherto known members of the genus, except P. maplestoni (Travassos, Artigas et Pereira, 1928), in having the functional anus, the conical tail with a terminal knob-like structure and the oesophagus without an anterior inflation in female, and in the structure of the caudal end in male. It can be distinguished from P. maplestoni (described only from females) by the extent of embossed cuticle, the size of body and the host type. P. caudata, representing a Neotropical element, is the first Philometroides species reported from freshwater fishes in Mexico.
We evaluated the effect of glucagon on cardiac automaticity as well as the possible role of cyclic nucleotide phosphodiesterases (PDE) in regulating this effect. Concentration response curves for glucagon in the absence and in th e presence of the non-selective PDE inhibitor IBMX were performed in the isolated right ventricle of the rat. We found that glucagon produces only a minor increase of ventricular automa ticity (11.0±4.1, n=5) when compared to the full agonist of β-adrenoceptor isoproterenol (182.2±25.3, n=7). However, IBMX enhances the maximal efficacy of glucagon on cardiac automaticity (11.0±4.1, in the absence and 45.3±3.2 in the presence of IBMX, n=5, P<0.05). These results indicate that PDE blunts proarrhythmic effects of glucagon in rat myocardium., C. Gonzalez-Muñoz, J. Hernández., and Obsahuje bibliografii a bibliografické odkazy
Phosphorylation of phospholemman (PLM) on ser68 has been proposed to at least partially mediate cyclic AMP (cAMP) mediated relaxation of arterial smooth muscle. We evaluated the time course of the phosphorylation of phospholemman (PLM) on ser68, myosin regulatory light chains (MRLC) on ser19, and heat shock protein 20 (HSP20) on ser16 during a transient forskolin-induced relaxation of histamine-stimulated swine carotid artery. We also evaluated the dose response for forskolin- and nitroglycerin-induced relaxation in phenylephrine-stimulated PLM-/- and PLM+/+ mice. The time course for changes in ser19 MRLC dephosphorylation and ser16 HSP20 phosphorylation was appropriate to explain the forskolin-induced relaxation and the recontraction observed upon washout of forskolin. However, the time course for changes in ser68 PLM phosphorylation was too slow to explain forskolin-induced changes in force. There was no difference in the phenylephrine contractile dose response or in forskolin-induced relaxation dose response observed in PLM-/- and PLM+/+ aortae. In aortae precontracted with phenylephrine, nitroglycerin induced a slightly, but significantly greater relaxation in PLM-/- compared to PLM+/+ aortae. These data are consistent with the hypothesis that ser19 MRLC dephosphorylation and ser16 HSP20 phosphorylation are involved in forskolin-induced relaxation. Our data sugge st that PLM phosphorylation is not significantly involved in forskolin-induced arterial relaxation., M. K. Meeks, S. Han, A, L. Tucker, C. M. Rembold., and Obsahuje bibliografii a bibliografické odkazy
Endocrine disruptors (EDs) are known to have harmful effects on the human endocrine system; special effort is actually given to the exposure during pregnancy. Humans are usually exposed to a mixture of EDs, which may potentiate or antagonize each other, and the combined effect may be difficult to estimate. The main phthalate monoesters monoethyl-, mono-n -butyl-, monoisobutyl-, monobenzyl-, mono-(2-ethylhexyl)-, mono-(2- ethyl-5-hydroxyhexyl)- and mono-(2-ethyl-5-oxohexyl) phthalate were determined in 18 maternal (37th week of pregnancy) and cord plasma samples using liquid chromatography-tandem mass spectrometry. Previously determined levels of selected bisphenols, parabens and steroids were also considered in this study. In cord blood, there were significantly higher mono-n-butyl phthalate levels than in maternal blood (p=0.043). The results of multiple regression models showed that maternal plasma phthalates were negatively associated with cord plasma androstenedione, testosterone and dehydroepiandrosterone and positively associated with estradiol and estriol. For estriol, a cumulative association was also observed for Σbisphenols. To the best of our knowledge, this is the first pilot study evaluating the effect of prenatal exposure by multiple EDs on newborn steroidogenesis. Our results confirmed phthalate accumulation in the fetal area and disruption of fetal steroidogenesis. This preliminary study highlights the negative impacts of in utero EDs exposure on fetal steroidogenesis., L. Kolatorova, J. Vitku, A. Vavrous, R. Hampl, K. Adamcova, M. Simkova, A. Parizek, L. Starka, M. Duskova., and Obsahuje bibliografii