Matrix metalloproteinases in human spontaneous intracerebral hemorrhage: an update

Background: In default of a plausible and satisfactory causal treatment for hemorrhagic stroke, a role of matrix metalloproteinases (MMPs) in the pathogenesis of cerebrovascular diseases has recently been widely discussed. The well-known impact of MMPs on extracellular matrix destruction triggered by inflammation as a foundation for several diseases, including stroke, is very much in evidence. Newly, some additional aspects of MMP function considering their intracellular activity crucial for neuronal death following ischemic brain damage have emerged. The effect of blood-brain barrier disruption caused by MMPs on the prognosis in patients suffering from spontaneous intracerebral hemorrhage (ICH) has been of interest since it throws a new light upon the pathogenesis, course and possible therapeutic approaches for this least treatable and at the same time most life-threatening form of stroke. Hence, we primarily aimed to review the current clinical knowledge on the significance of metalloproteinase activation in the course of spontaneous intracranial hemorrhage in humans. We also provide a brief characterization of the MMP enzyme family and report on the latest findings on issues arising from experimental studies. Methods: A Medline search using the following key words was performed: matrix metalloproteinases + spontaneous intracerebral hemorrhage/intracranial hemorrhage/bleeding/hemorrhagic stroke. We accepted studies reporting on MMP expression in adult patients with spontaneous ICH, as well as its relation to radiological and clinical features and patients’ outcome. For the final review, 18 clinical studies were considered. MMP inhibition was reviewed on the basis of 11 relevant experimental studies. Also, some relevant reports on the biology of MMPs and their pathophysiology in ICH were reviewed. Results and Conclusions: Many studies provide convincing evidence of a detrimental role of MMPs in ICH, stressing their association with neuroinflammation. The role of MMPs in hemorrhagic stroke appears critical for hematoma and brain edema growth as well as for neuronal death, which are understood as secondary brain injury and may have a considerable clinical impact. Although data on human spontaneous ICH are scarce and mostly based on small populations, they reveal the apparent correlation between MMPs and clinical and radiological ICH features as well as the functional outcome, which might rationalize future therapeutic strategies. However, attempts at MMP inhibition in spontaneous ICH have solely been made under experimental conditions and were associated with a wide range of possible side effects. Therefore, further comprehensive, elucidating investigations in this field are vital before any conclusions could be translated to humans. Copyright (C) 2012 S. Karger AG, Base

Mediastinal and subcutaneous emphysema as a complication of labor

Mediastinal emphysema and subcutaneous emphysema are rare complications of labor. We have described a case of mediastinal and subcutaneous emphysema, observed in the II stage of labor in otherwise healthy primigravida. The diagnosis was confirmed clinically and by X-ray, and endoscopies examination in District Hospital and in Clinical Department of Surgery. The etiology of this condition was not established. The mediastinal and subcutaneous emphysema, disappeared spontaneously which was confirmed by check-up after 3 months

Review of the methodology of lower limb prosthesis

Background: The replacement of inefficient or lost organs, especially in the case of lower ends, is associated with a huge experience for the patient, especially in emotional terms. However, with the development of medicine and technology, they allow patients, with properly conducted rehabilitation, to achieve satisfaction with the obtained effects of the treatment. The variety of forms of lower limb prosthesis depends primarily on the location of the prosthesis. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Prosthesis, Lower limb, Amputation Results: The lower limb prosthesis is built from a funnel that matches the stump, the mechanism of the knee joint, shin and the foot. Pours that are used at the lower extremities include: a quadrangular funnel, an ICS longitudinal oval or a CAD-CAM, a full-contact hip funnel, a residual femoral funnel or vacuum syphilis used in people with neoplastic amputations. In the case of knee joints, the distinction is made based on the number of axes around which the movement takes place. So we distinguish uniaxial and multi-axis joints. As important as the other parts is the construction of the prosthetic foot, because it is responsible for supporting the limb stabilizers through passive control of the ankle bending. Conclusions: With the new generation of lower limbs prostheses, the patient can lead an active professional life, as well as practice various sports disciplines. However, this does not change the fact that there is still a great need for research, and holistic cooperation to increase the efficiency and satisfaction of life of amputees in the lower limbs

Complications associated with hospitalization after spinal cord injury

Abstract: Background: Spinal cord injuries are a traumatic phenomenon not only for the physical sphere, but equally affect the human psyche. The patient ceases to be independent in his actions, he must face a completely new situation for himself and the environment. Particularly difficult is the first period after injury, associated with hospitalization. That is why it is so important to prevent the most common complications of spinal injuries during this period. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Spinal Cord, Injury, Trauma, Complications Results: The most common complications associated with the hospital stay of patients with spinal cord injury include: complications in the respiratory system (including pneumonia, atelectasis and respiratory failure), decubitus ulcers, periarticular neurogenic ossification, autonomic dysreflexia, spasticity or disorders in the functioning of the urinary tract. Decubitus ulcers due to their nature are a huge problem for hospitalized patients, in epidemiological studies it was estimated to occur at nearly 20 per cent. Spasticity is one of the most serious complications hindering the effective rehabilitation process of post-traumatic persons. In the case of disorders associated with the urinary system, it is important to classify dysfunctions based on the neurogenic evaluation of the sphincter muscles and detrusor. Conclusions: Due to the increasing number of spinal cord and spinal cord injuries and the serious nature of their complications, this topic should continue to be an area of very intensive scientific research, both theoretical and clinical. The given issues should be familiar not only to the medical community but also to the family and the patient's environment

Complement components, proteolysis‑related, and cell communication‑related proteins detected in urine proteomics are associated with IgA nephropathy.

INTRODUCTION IgA nephropathy (IgAN) is the most common primary glomerulonephritis. The first symptoms of IgAN are erytrocyturia or hematuria, proteinuria, and decline in renal function, or any combination of the above. One of the promising diagnostic methods is urine proteomics. OBJECTIVES We studied urine proteomics in patients with IgAN and age- and sex‑matched healthy controls. To minimize the risk of protein degradation, we proposed a new protocol for urine collection and preparation. PATIENTS AND METHODS A total of 30 patients with IgAN and 30 controls were enrolled into the study. Thirty urine samples of the IgAN group were divided into 3 disease pooled samples (DPS I, II, and III) and 30 urine samples of the control group were divided into 3 control pooled samples (CPS I, II, and III). We used isoelectric focusing/liquid chromatography–mass spectrometry/mass spectrometry (IEF/LC‑MS/MS) to detect all proteins larger than 10 kDa. RESULTS Using qualitative analysis, we identified 761, 951, and 956 proteins in each of the 3 IEF/LC‑MS/MS experiments. The results were combined, yielding a dataset with 1238 proteins identified by at least 2 peptides. The statistical analysis of the quantitative results revealed 18 proteins that were differently populated in the urine of IgAN patients compared with healthy controls. We found increased urinary concentrations of complement components, coagulation factors, extracellular matrix, intracellular, transmembrane, and other proteins in patients with IgAN. Some of them have never been linked to IgAN before. CONCLUSIONS We demonstrated that urine proteomics is a promising tool for diagnosing and monitoring patients with IgAN

The Effect of Sodium Tetrafluoroborate on the Properties of Conversion Coatings Formed on the AZ91D Magnesium Alloy by Plasma Electrolytic Oxidation

Magnesium and its alloys are widely used in many areas because of their light weight, excellent dimensional stability, and high strength-to-weight ratio. However, the material exhibits poor wear and corrosion resistance, which limits its use. Plasma electrolytic oxidation (PEO) is an effective surface modification method for producing ceramic oxide layers on Mg and their alloys. The influence of the additions of sodium tetrafluoroborate (NaBF4) and sodium fluoride (NaF) into alkaline-silicate electrolyte on the properties of the conversion layers formed in the magnesium AZ91D alloy has been investigated. Surface morphology and chemical composition were determined by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS). The anticorrosive properties of the layers were evaluated by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PDP) methods in simulated body fluid (SBF). The presence of NaBF4 or NaF in the electrolyte increases the corrosion resistance of the protective layer. However, the best anticorrosive properties show the layers obtained in the presence of NaBF4. This is probably caused by the incorporation of boron and fluorine in the form of Mg (BF4)2 mainly in the barrier layer

Quantification of Circulating Cell-Free DNA in Idiopathic Parkinson’s Disease Patients

Parkinson’s disease (PD) is one of the most common neurodegenerative disorders globally and leads to an excessive loss of dopaminergic neurons in the substantia nigra of the brain. Circulating cell-free DNA (ccf-DNA) are double-stranded DNA fragments of different sizes and origins that are released into the serum and cerebrospinal fluid (CSF) due to cell death (i.e., necrosis and apoptosis) or are actively released by viable cells via exocytosis and NETosis. Using droplet digital polymerase chain reaction (ddPCR), we comprehensively analyzed and distinguished circulating cell-free mitochondrial DNA (ccf mtDNA) and circulating cell-free nuclear DNA (ccfDNA) in the serum and CSF of PD and control patients. The quantitative analysis of serum ccf-DNA in PD patients demonstrated a significant increase in ccf mtDNA and ccfDNA compared to that in healthy control patients and a significantly higher copy of ccf mtDNA when compared to ccfDNA. Next, the serum ccf mtDNA levels significantly increased in male PD patients compared to those in healthy male controls. Furthermore, CSF ccf mtDNA in PD patients increased significantly compared to ccfDNA, and ccf mtDNA decreased in PD patients more than it did in healthy controls. These decreases were not statistically significant but were in agreement with previous data. Interestingly, ccf mtDNA increased in healthy control patients in both serum and CSF as compared to ccfDNA. The small sample size of serum and CSF were the main limitations of this study. To the best of our knowledge, this is the first comprehensive study on serum and CSF of PD patients using ddPCR to indicate the distribution of the copy number of ccf mtDNA as well as ccfDNA. If validated, we suggest that ccf mtDNA has greater potential than ccfDNA to lead the development of novel treatments for PD patients