The objective of this prospective double-blind study was to determine whether postoperative residual paralysis (PORP) after pancuronium or vecuronium results in hypoxemia and hypercapnia in the immediate admission period to the recovery ward. Eighty-three consecutive surgical patients received balanced or intravenous anesthesia with pancuronium for operations lasting longer than one hour or vecuronium for those lasting less than 60 min, both combined with neostigmine at the end of anesthesia. Standard clinical criteria assessed neuromuscular function intraoperatively. Postoperatively, we determined neuromuscular function (acceleromyography with supramaximal train-of-four (TOF) stimulation of the ulnar nerve, and a 5-s head lift) and pulmonary function (pulse oximetry: SpO2, and blood gas analysis: SaO2, PaCO2). We defined PORP as a TOF-ratio 70 %, hypoxemia as a postoperative SpO2³ 5 % below the pre-anesthestic level together with a postoperative SaO293 %, and hypercapnia as a PaCO2³ 46 mm Hg. Among the 49 pancuronium and 27 vecuronium patients studied, the PORP rates were 20 % in the pancuronium group and 7 % in the vecuronium group (p>0.05). Hypoxemia and hypercapnia occurred more often in pancuronium patients with PORP than in those without PORP namely 60 % vs. 10% (p<0.05) and 30 % vs. 8 % (p>0.05), respectively. We conclude that PORP after pancuronium is a significant risk factor for hypoxemia., U. Bissinger, F. Schimek, G. Lenz., and Obsahuje bibliografii
Jedním ze zdrojů informací o pravěku je mitochondriální DNA (mtDNA). Díky mutacím, které v její molekule v průběhu času zcela přirozeně vznikají, lze rekonstruovat fylogenetický strom a datovat vznik jednotlivých větví i jejich další vývoj v jednotlivých oblastech světa. První evropské větve lidské mtDNA fylogeneze jsou zřejmě starší více než 50 tis. let a pocházejí s největší pravděpodobností z Předního východu. Díky mtDNA bylo rovněž zjištěno, jak se na složení evropského genofondu projevilo poslední maximum doby ledové před 20 tis. lety, kdy se kvůli ochlazení lidé stáhli do jihoevropských refugií a po oteplení před 15 tis. lety severnější oblasti znovu kolonizovali. Také se předpokládalo, že se vznikem zemědělství před 10 tis. lety proběhla další větší migrace z Předního východu. Ve střední Evropě je ale námi zjištěný příspěvek ,,neolitických“ mtDNA linií poměrně malý, takže se zemědělství v této oblasti šířilo spíše akulturací původních obyvatel, tedy přenosem kulturních dovedností. Výsledky odpovídají i demografickým modelům populačního růstu., According to the human mitochondrial DNA (mtDNA) phylogeny, European first branches seem to be more than 50 000 years old and may have originated in the Near East. MtDNA has also revealed how the composition of the European gene pool changed in association with the Last Glacial Maximum 20 000 years ago when the European population retreated into southern refugia and how after the amelioration of the climate some 15 000 years ago it re-colonized northern regions. The contribution of “Neolithic” mtDNA lineages in Central Europe has been determined as relatively small and agriculture probably spread more by the acculturation of indigenous inhabitants., and Edita Priehodová.
Hypoventilation, as one of ventilatory disorders, decreases the electrical stability of the heart similarly as ischemia. If preconditioning by short cycles of ischemia has a cardioprotective effect against harmful influences of a prolonged ischemic period, then preconditioning by hypoventilation (HPC) can also have a similar effect. Anesthetized rats (ketamine 100 mg/kg + xylasine 15 mg/kg i.m., open chest experiments) were subjected to 20 min of hypoventilation followed by 20 min of reoxygenation (control group). The preconditioning (PC) was induced by one (1PC), two (2PC) or three (3PC) cycles of 5-min hypoventilation followed by 5-min reoxygenation. The electrical stability of the heart was measured by a ventricular arrhythmia threshold (VAT) tested by electrical stimulation of the right ventricle. Twenty-minute hypoventilation significantly decreased the VAT in the control and 1PC groups (p<0.05) and non-significantly in 2PC vs. the initial values. Reoxygenation reversed the VAT values to the initial level only in the control group. In 3PC, the VAT was increased from 2.32±0.69 mA to 4.25±1.31 mA. during hypoventilation (p<0.001) and to 4.37±1.99 mA during reoxygenation (p<0.001). It is concluded that cardioprotection against the hypoventilation/ reoxygenation-induced decrease of VAT proved to be effective only after three cycles of HPC., P. Švorc, I. Bračoková., and Obsahuje bibliografii
n previous studies, one of the systolic time intervals - preejection period (PEP) - was used as an index of sympathetic activity reflecting the cardiac contractility. However, PEP could be also influenced by several other cardiovascular variables including preload, afterload and diastolic blood pressure (DBP). The aim of this study was to assess the behavior of the PEP together with other potentially confounding cardiovascular system characteristics in healthy humans during mental and orthostatic stress (head-up tilt test - HUT). Forty-nine healthy volunteers (28 females, 21 males, mean age 18.6 years (SD=1.8 years)) participated in the study. We recorded finger arterial blood pressure by volume-clamp method (Finome ter Pro, FMS, Netherlands), PEP, thoracic fluid content (TFC) - a measure of preload, and cardiac output (CO) by impedance cardiography (CardioScreen ®2000, Medis, Germany). Systemic vascular resistance (SVR) - a measure of afterload - was calculated as a ratio of mean arterial pressure and CO. We observed that during HUT, an expected decrease in TFC was accompanied by an increase of PEP, an increase of SVR and no significant change in DBP. During mental stress, we observed a decrease of PEP and an increase of TFC, SVR and DBP. Correlating a change in assessed measures (delta values) between mental stress and previous supinerest, we found that ΔPEP correlated negatively with ΔCO and positively with ΔSVR. In orthostasis, no significant correlation between ΔPEP and ΔDBP, ΔTFC, ΔCO, ΔMBP or ΔSVR was found. We conclude that despite an expected increase of sympathetic activity during both challenges, PEP behaved differently indicating an effect of other confounding factors. To interpret PEP values properly, we recommend simultaneously to measure other variables influencing this cardiovascular measure., J. Krohova, B. Czippelova, Z. Turianikova, Z. Lazarova, I. Tonhajzerova, M. Javorka., and Obsahuje bibliografii
The levels of four pregnanolone isomers and their polar conjugates and pregnenolone sulfate were measured in the plasma of 13 and 7 women at delivery with subarachnoidal and epidural analgesia, respectively, and in corresponding samples of umbilical plasma using a simple quadrupole GC/MS system with electron impact ionization (pregnenolone isomers), RIA following HPLC separation (pregnenolone) and specific RIA (pregnanolone sulfate). The concentration of epipregnanolone (3b-hydroxy-5b-pregnan-20-one) in both maternal and umbilical plasma was much lower than that of other pregnanolone isomers. The levels of 3b-hydroxy-pregnanolone isomers were significantly higher in the umbilical plasma than in the maternal, while the differences in 3a-hydroxy-isomers were insignificant. The differences in conjugates were insignificant with the exception of allopregnanolone, the levels of which were lower in umbilical plasma. In all the pregnanolone isomers, a significantly lower conjugated/unconjugated steroid ratio was found in the umbilical plasma than in the maternal plasma. In addition, time profiles of the steroids were measured around parturition and in the postpartum period in the maternal serum. Similarly, the levels of polar conjugates of all pregnanolone isomers were followed during parturition. Changes in concentrations of free steroids exhibited a similar pattern, with a fall primarily within the first hour after delivery. The decrease in conjugated steroids was shifted to the interval within the first hour and first day after delivery, and the changes were more pronounced. The time profiles of the conjugated/free steroid ratio exhibited a significant decrease within the first hour and the first day after delivery in all of the isomers investigated. A decrease was also observed in the ratio of 3a/3b- isomers and 5a/5b- isomers around parturition.The possible physiological consequences of the findings are indicated., J. Klak, M. Hill, A. Pařízek, H. Havlíková, M. Bičíková, R. Hampl T. Fait, J. Šulcová V. Pouzar, R. Kancheva, L. Stárka., and Obsahuje bibliografii
Pregnenolone sulfate (PS), an endogenously occurring neurosteroid, has been shown to modulate the activity of several neurotransmitter-gated channels, including the NMDA receptor (NMDAR). NMDARs are glutamate-gated ion channels involved in excitatory synaptic transmission, synaptic plasticity, and excitotoxicity. In this study, we analyzed the effects of PS on calcium signaling in cultured hippocampal neurons and HEK293 cells expressing NMDAR. The ce lls were loaded with the Ca 2+ sensor Fura-2. In agreement with previous electrophysiological experiments, PS potentiated the increases in intracellular Ca 2+ induced by an exogenous application of glutamate; however, PS also increased intracellular Ca 2+ in the absence of exogenous NMDA agonist. The agonist-independent effect of PS was induced in all neurons studied and in HEK293 cells expressing GluN1/GluN2A-B receptors in a neurosteroid-specific manner. We conclude that PS is an endogenous NMDA agonist that activates the GluN1/GluN2A-B receptors., E. Adamusová ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Monodisperse macroporous poly(glycidyl methacrylate) (PGMA) microspheres were used as a template for preparing porous silica particles. The starting polymer microspheres that were 9.3 μm in size were synthesized by multistep swelling polymerization using a modified Ugelstad technique. Subsequently, silica (SiO2) was deposited on the surface and inside the PGMA microspheres to produce poly(glycidyl methacrylate)-silica hybrid particles (PGMA-SiO2). Upon calcination of the PGMA-SiO2 microspheres, porous silica particles were formed. The morphology, particle size, polydispersity and inner structure of the silica microspheres were investigated by scanning and transmission electron microscopy. Thermogravimetric analysis and dynamic adsorption of nitrogen determined the amount of silica formed and its specific surface area. Compared with the starting PGMA microspheres, the size of the porous silica particles decreased by up to 30%. These porous silica microspheres are promising for chromotography and biomedical applications., S. Grama, D. Horák., and Obsahuje bibliografii
We investigated non-invasively cardiac contractility and autonomic nervous activity during presyncopal orthostatic stress induced in healthy humans. A graded orthostatic stress (GOS) paradigm, consisting of head-up tilt (HUT) combined with lower body negative pressure (LBNP) of increasing magnitude, was used to reach a presyncopal end-point in 15 healthy adults. Continuous beat-to-beat hemodynamic and autonomic parameters were recorded. From supine control (C1) to presyncope (PS), total peripheral resistance index (TPRI) decreased from 2300±500 to 1910±320 dyne*s*m²/cm^5 (p=0.004), index of contractility (IC) from 59±14 to 27±6 1000/s (p<0.0001), left ventricular working index (LVWI) from 5.2±1.3 vs. 3.6±0.6 mmHg*L/(min*m²) (p=0.0001) and acceleration index (ACI) from 65±18 vs. 54±15 100/s² (p=0.04). Low frequency variation of diastolic blood pressure (LFnudBP) increased from 51±14 to 67±11 % (p=0.0006) and of systolic blood pressure (LFnusBP) from 50±6 vs. 67±8 % (p<0.0001). High frequency variation of RR-interval (HFms²RRI) decreased from 385±320 to 38±43 ms² (p=0.001). From late GOS (G3) to PS, TPRI decreased from 2540±640 to 1910±320 dyne*s*m²/cm^5 (p=0.003), IC from 35±6 to 27±6 1000/s (p=0.003), LVWI from 4.6±0.9 to 3.6±0.6 mmHg*L/(min/m²) (p=0.003), LFnusBP from 71±8 to 67±8 % (p=0.03), LFmmHg²dBP from 6.6±4.0 to 4.8±2.9 mmHg² (p=0.0001), LFmmHg²sBP from 9.7±7.8 to 7.4±4.8 mmHg² (p=0.01). HFnuRRI increased from 19±8 to 28±13 % (p=0.008). Myocardial contractility indices and parameters of sympathetic activity were reduced in the presyncopal state, while parasympathic activity was increased. This suggests a decrease in cardiac contractility during orthostatically induced presyncope in healthy subjects., E. K. Grasser, N. Goswami, H. Hinghofer-Szalkay., and Obsahuje seznam literatury
Negative expiratory pressure (NEP) applied at the mouth during tidal expiration provides a non-invasive method for detecting expiratory flow limitation. Forty-two children were studied, i.e. 25 children with different respiratory symptoms (R) and 17 without any respiratory symptoms (NR). Children were examined without any sedation. A preset NEP of -5 cm H 2 O was applied; its duration did not exceed duration of tidal expiration. A significance of FL was judged by determining of a flow-limited range (in % of tidal volume). FL was found in 48 % children of R group. No patient of the NR group elicited FL (P<0.001 R vs. NR). The frequency of upper airway collapses was higher in R group (12 children) than in NR gr oup (5 children). In conclusion, a high frequency of tidal FL in the R group was found, while it was not present in NR group. A relatively high frequency of expiratory upper airway collapses was found in both groups, but it did not differ significantly. NEP method represents a reasonable approach for tidal flow limitation testing in non-sedated preschool children., A. Jiřičková, J. Šulc, P. Pohunek, O. Kittnar, A. Dohnalová, J Kofránek., and Obsahuje bibliografii