Cardiac papillary fibroelastomas: A 10-year single-center surgical experience and long-term echocardiographic follow-up study

Aims. Limited contemporary data are available on the clinical and echocardiographic outcomes after surgery for cardiac papillary fibroelastoma (CPF). The aim of this study was to review the clinical manifestations, pathological characteristics, surgical management, and prognoses of patients with histologically verified CPF, who underwent surgery at our cardiac surgery center from 2008 to 2018. Methods and Results. Twelve patients of median age 62 years (28 to 77 years) were treated. Embolic stroke or transient ischemic attack (five patients, 42%) were the only CPF clinical manifestations. Eleven (92%) tumors were localized on the valves, with the aortic valve being the most common tumor site (seven patients; 58%). Multiple factor analysis revealed no independent predictor of CPF-related embolization. Simple shave tumor excision was sufficient in most patients (10 patients, 83%). No operative or tumor-related late mortality during the median follow-up period of 4.7 years (1.1 to 10.2 years) was recorded. Asymptomatic metachronous valve tumor recurrence (in a location different from that of the original tumor) was revealed in two patients (17%) by transesophageal echocardiography (TEE), not detected by transthoracic echocardiography (TTE). One of these two patients underwent repeated surgery for CPF but later suffered a recurrent embolic stroke, due to another tumor recurrence. Conclusion. CPF can be safely and effectively treated surgically. TEE is superior to the TTE option in CPF post-operative recurrence detection. There is a clear need for a prospective study to determine criteria for embolization risk stratification and optimum management in patients with CPF.Web of Science1641918

Diagnóza F 64.0: Transsexualita optikou sexuologie

Předkládaný text představuje analýzu diskurzů, jejichž prostřednictvím je v sexuologii jakožto vědní disciplíně, a to především v českých sexuologických kruzích, konceptualizována transsexualita. Pomocí rozboru vybraných dokumentů se pokouší mapovat základní mezníky vývoje sexuologického náhledu na etiologii transsexuality a identifikovat genderové předpoklady, o než sexuologie svoje koncepce etiologie transsexuality opírala a opírá. Druhá část textu se zaměřuje na to, jakým způsobem se sexuologické předpoklady o genderu a sexualitě, na nichž je vystavěna současná etiologická koncepce transsexuality, promítají do pravidel standardizovaného diagnostického postupu, do jeho jednotlivých kroků a do kritérií, jež jsou pro potvrzení či vyvrácení diagnózy transsexuality určující. Na sexuologické diskurzy transsexuality je zde nahlíženo z poststrukturalistické perspektivy akcentující formativní aspekty sociálních diskurzů, a to zejména právě diskurzů vědy

The Health-Enabling Capacities of Nature Contact

UID/SOC/04647/2019 2016-1-CZ01-KA204-024071 (Projecto With nature to mutual understanding)We live in a world where new information and knowledge technologies and increased mobility simplify everyday life. However, at the same time, contact with the natural environment is shrinking. More than half of the world's population lives in urban areas with high population densities and, in many cases, with a little or no access to the quality green spaces. One of the consequences is that there is an increasing disconnection from nature and its sensory stimuli while the noise, air and visual pollution negatively affects the health and reduces the quality of life in urban areas. The "healing" capacity of nature is being increasingly discussed as well as the need of reconnection with it and its therapeutic, spiritual and psychological benefits. The garden therapy defined as a treatment and relaxation through contact with nature is attracting more and more attention, both, from academic field as well as from practitioners of different areas. Among others, a social care and health care, particularly in the case of the children with autism, hyperactivity, with lack of relational capital, psychiatrists (in the case of dementia) but also an architectural landscaping (Which characteristics must the gardens have to fulfill these benefits?). An interdisciplinary approach is needed in order to discuss concepts, benefits, potentialities and ways to implement these therapies. We will be presenting the results of a research project - With Nature to Mutual Understanding - developed by a consortium of seven European countries, on the potentialities of garden therapies to develop communication, social and entrepreneurial skills of the target groups (e.g. minorities, people with learning disabilities and physical and mental health problems, migrants and refugees).publishersversionpublishe

Biochar Alone Did Not Increase Microbial Activity in Soils from a Temperate Climate That Had Long-Term Acidity Stress

Biochar can increase the microbial activity of a soil and the seed yield of oilseed rape. We performed a field experiment to determine the effect of different doses of biochar and the impact of nutrient additions on microbial activity in soils with low pH (4.69). Different doses of biochar were applied to plots in 2016 (0 t/ha (control), 15 t/ha (B15), 30 t/ha (B30), or 45 t/ha (B45)), and fertilization was applied during 2019 (90 kg P/ha) and 2020 (50 kg N/ha, 80 kg P/ha, and 50 kg K/ha). Maize was grown in 2016, barley in 2017, maize in 2018, wheat in 2019, and winter oilseed rape in 2020. All analyses were carried out in 2020. Higher biochar doses led to reduced seed yield of oilseed rape and inhibition of microbial activity (cumulative soil respiration, dehydrogenase activity (DHA), and leaching of mineral forms of nitrogen). Notably, dehydrogenase activity was more than 60% lower in plots with the highest biochar dose. All doses of biochar increased the soil pH compared to the control (control: 4.51 +- 0.04, B15: 4.69 +- 0.04, B30: 5.06 +- 0.05, B45: 5.05 +- 0.04) but did not increase microbial activity or the seed yield of oilseed rape. Thus, application of biochar alone did not increase the seed yield of oilseed rape or soil microbial activities, although it did increase soil pH.O

Solid anorganic particles and chronic rhinosinusitis: A histopathology study

Although extensive research has shown the pathological effect of fine and ultrafine airborne particles, clear evidence of association of environmental exposure to them and inflammatory changes in human nasal mucosa is missing. Meanwhile, pathogenesis of chronic rhinosinusitis, despite being a disease with high prevalence in the population, is still unclear. The increasing evidence of the pro-inflammatory properties of these particles raises the question of their possible role in chronic rhinosinusitis. The presented study focused on detection of microsized anorganic particles and clusters of nanosized anorganic particles in the nasal mucosa of patients with chronic rhinosinusitis by Raman microspectroscopy and comparison of their composition to histologic findings. The results were compared to the findings in mucosa obtained from cadavers with no history of chronic rhinosinusitis. Solid particles were found in 90% of tissue samples in the group with chronic rhinosinusitis, showing histologic signs of inflammation in 95%, while in the control group, the particles were found in 20% of samples, with normal histologic findings in all of them. The main detected compounds were graphite, TiO2, amorphous carbon, calcite, ankerite and iron compounds. The results are in accordance with the premise that exogenous airborne particles interact with the nasal mucosa and possibly deposit in it in cases where the epithelial barrier is compromised in chronic rhinosinusitis.Web of Science1912art. no. 726

New semi-spherical radiofrequency energy device for liver resection: an experimental study in pigs

The aim of this experimental study was to verify a new semi-spherical surgical tool for bipolar radiofrequency liver ablation, which can solve some of the disadvantages of the commonly used device, such as long duration of ablation. A total of 12 pigs which were randomly divided into two groups were used. Each pig underwent resection of the two liver lobes. In group 1, pigs were treated with the commonly used device; in group 2 the newly developed semispherical device was used. During surgery and the post-surgical period, many categories were observed and later analyzed. The blood count and biochemistry were monitored on days 0, 14 and 30 from the operation. On day 14 since the liver resection, pigs underwent diagnostic laparoscopy to evaluate their condition focusing on the site of the liver lobe resection. On day 30 after operation, all pigs were euthanized and subjected to histopathological examination. Histopathological evaluation of thermal changes at the resection margin showed strong thermal alteration in both groups. Data between both groups were compared using median test for continuous variables and Fisher’s exact test for categorical variables. Statistical analyses were performed with IBM SPSS software version 18.0. Statistical analysis of collected data did not prove any significant (P < 0.05) differences between the commonly used device and the newly designed surgical tool.Web of Science84439

Addition of platelet concentrate to Dermo-Epidermal Skin Graft in deep burn trauma reduces scarring and need for revision surgeries

Backround. Deep skin burn injuries, especially those on the face, hands, feet, genitalia and perineum represent significant therapeutic challenges. Autologous dermo-epidermal skin grafts (DESG) have become standard of care for treating deep burns. Additionally, human autologous thrombin activated autologous platelet concentrate (APC) has gained acceptance in the setting of wounds. While each of these interventions has been independently shown to accelerate healing, the combination of the two has never been evaluated. We hypothesized that the addition of platelets (source of growth factors and inhibitors necessary for tissue repair) to the DESG (source of progenitor cells and of tissue proteases necessary for spatial and temporal control of growth regulators released from platelets) would create the optimal environment for the reciprocal interaction of cells within the healing tissues. Methods: We used clinical examination (digital photography), standardised scales for evaluating pain and scarring, in combination with blood perfusion (laser Doppler imaging), as well as molecular and laboratory analyses. Results: We show for the first time that the combination of APC and DESG leads to earlier relief of pain, and decreased use of analgesics, antipruritics and orthotic devices. Most importantly, this treatment is associated with earlier discharges from hospital and significant cost savings. Conclusions: Our findings indicate that DESG engraftment is facilitated by the local addition of platelets and by systemic thrombocytosis. This local interaction leads to the physiological revascularization at 1-3 months. We observed significant elevation of circulating platelets in early stages of engraftment (1-7 days), which normalized over the subsequent 7 and 90 days.Web of Science158225824

Therapeutic Potential of Adipose-Derived Therapeutic Factor Concentrate for Treating Critical Limb Ischemia

Transplantation of adipose-derived stem cells (ADSCs) is an emerging therapeutic option for addressing intractable diseases such as critical limb ischemia (CLI). Evidence suggests that therapeutic effects of ADSCs are primarily mediated through paracrine mechanisms rather than transdifferentiation. These secreted factors can be captured in conditioned medium (CM) and concentrated to prepare a therapeutic factor concentrate (TFC) composed of a cocktail of beneficial growth factors and cytokines that individually and in combination demonstrate disease-modifying effects. The ability of a TFC to promote reperfusion in a rabbit model of CLI was evaluated. A total of 27 adult female rabbits underwent surgery to induce ischemia in the left hindlimb. An additional five rabbits served as sham controls. One week after surgery, the ischemic limbs received intramuscular injections of either (1) placebo (control medium), (2) a low dose of TFC, or (3) a high dose of TFC. Limb perfusion was serially assessed with a Doppler probe. Blood samples were analyzed for growth factors and cytokines. Tissue was harvested postmortem on day 35 and assessed for capillary density by immunohistochemistry. At 1 month after treatment, tissue perfusion in ischemic limbs treated with a high dose of TFC was almost double (p < 0.05) that of the placebo group [58.8 ± 23 relative perfusion units (RPU) vs. 30.7 ± 13.6 RPU; mean ± SD]. This effect was correlated with greater capillary density in the affected tissues and with transiently higher serum levels of the angiogenic and prosurvival factors vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF). The conclusions from this study are that a single bolus administration of TFC demonstrated robust effects for promoting tissue reperfusion in a rabbit model of CLI and that a possible mechanism of revascularization was promotion of angiogenesis by TFC. Results of this study demonstrate that TFC represents a potent therapeutic cocktail for patients with CLI, many of whom are at risk for amputation of the affected limb

Identification of the phase composition of solid microparticles in the nasal mucosa of patients with chronic hypertrophic rhinitis using Raman microspectroscopy

Solid particles, predominantly in micron and submicron sizes, have repeatedly been observed as a threat to a human health unique compared to the other textures of the same materials. In this work, the hypothesis the solid metal-based particles play a role in the pathogenesis of chronic hypertrophic rhinitis was investigated in patients who had not responded positively to medication. In the group of 40 randomly selected patients indicated for surgical mucotomy, the presence of solid micro- and submicron particles present in their nasal mucosa was assessed. For comparison, a set of 13 reference samples from patients without diagnosed chronic hypertrophic rhinitis was evaluated. The analysis was performed using Raman microspectroscopy. The advantage of this method is the direct identification of compounds. The main detected compounds in the mucosa samples of patients with chronic hypertrophic rhinitis were TiO2, carbon-based compounds, CaCO3, Ca(Fe, Mg, Mn)(CO3)2 MgCO3, Fe2O3, BaSO4, FeCO3 and compounds of Al and Si, all of which may pose a health risk to a living organism. In the reference samples, only TiO2 and amorphous carbon were found. In the control group mucosa, a significantly lower presence of most of the assessed compounds was found despite the longer time they had to accumulate them due to their higher mean age. Identification and characterisation of such chemicals compounds in a living organism could contribute to the overall picture of the health of the individual and lead to a better understanding of the possible causes not only in the chronic hypertrophic rhinitis, but also in other mucosal and idiopathic diseases