Biomedical papers, 2014 (vol. 158), issue 3

Review articles

Heart rate variability - current diagnosis of the cardiac autonomic neuropathy. A review

Rudolf Metelka

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):327-338 | 10.5507/bp.2014.025

The aim of the review was to assess current uses of heart rate variability (HRV) in cardiac autonomic neuropathy (CAN) diagnosis with emphasis on proven methodological approaches and current views on the physiological interpretation and clinical uses of HRV methods. In clarifying controversial viewpoints on HRV, the paper supports its use in the routine diagnosis of neuropathic diseases.

Molecular genetic methods in the diagnosis of myelodysplastic syndromes. A review

Renata Lukackova, Maria Gerykova Bujalkova, Lubica Majerova, Beata Mladosievicova

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):339-345 | 10.5507/bp.2013.084

This is an overview of new molecular techniques (array-based analysis, Multiplex Ligation-depend Probe Amplification (MLPA) and next generation sequencing), their clinical applications in patients with MDS (myelodysplastic syndromes). Somatic mutations may influence the clinical phenotype but are not included in current prognostic scoring systems. Advantages, limitations and future perspectives of these new methods are discussed.

The importance and dosage of amino acids in nutritional support of various pathological conditions in ICU patients

Petra Pavlickova Aimova, Miloslav Hronek, Zdenek Zadak

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):346-355 | 10.5507/bp.2014.034

This article covers key information on the use of amino acids including how much in the context of nutritional support for ICU patients. It is a summary of the vital role of nutritional support. The research shows that inappropriate composition of amino acids and/or insufficient amounts contributes to malnutrition which may cause increased risk of morbidity and mortality in ICU settings.

Towards an ideal source of mesenchymal stem cell isolation for possible therapeutic application in regenerative medicine

Maurizio Bellavia, Roberta Altomare, Francesco Cacciabaudo, Alessandra Santoro, Adolfo Allegra, Maria Concetta Gioviale, Attilio Ignazio Lo Monte

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):356-360 | 10.5507/bp.2013.051

This paper reviews the characteristics of MSCs derived from fetal appendages as a possible good alternative to bone marrow sources. MSCs of different origin are described as having comparable characteristics in terms of molecular and cellular biology. As the percentage of MSCs in bone marrow is very low and retrieval techniques are risky, it is important to find alternative sources of MSCs, such as extra-embryonic tissues which represent a promising tool in regenerative medicine

The role of steroids in the development of post-partum mental disorders

Andrea Paskova, Roman Jirak, Michaela Mikesova, Karolina Adamcova, Zdenka Fartakova, Vladimira Horakova, Michal Koucky, Martin Hill, Hana Hruskovicova, Luboslav Starka, Michaela Duskova, Antonin Parizek

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):361-364 | 10.5507/bp.2012.098

This is a review of the latest information on the role of neuroactive steroids in the development of mental disorders, especially in post-partum "blues" and post-partum depression.

Lipophilic fluorescent products of free radicals

Josko Ivica, Jiri Wilhelm

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):365-372 | 10.5507/bp.2012.112

This review covers the current data on a group of products with intrinsic fluorescent properties, called lipofuscin-like pigments. Lipofuscin-like pigments are formed by reaction of lipid peroxidation intermediates and biological amine-containing compounds. Since free radical-mediated lipid peroxidation is implicated in the pathophysiology of a number of diseases, specific lipofuscin-like pigments are potential biomarkers for the pre-clinical stages and/or as risk factors for these diseases.disease. Chemical characterization using advanced analytical tools holds promise for the future use of lipofuscin-like pigments in biomedicine.

Original contributions

Comparison of human mesenchymal stem cells derived from dental pulp, bone marrow, adipose tissue, and umbilical cord tissue by gene expression

Peter Stanko, Katarina Kaiserova, Veronika Altanerova, Cestmir Altaner

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):373-377 | 10.5507/bp.2013.078

Dental pulp stem cells are a promising source of cells for numerous regenerative medicine applications both in dentistry and in neurological regenerative medicine. Comparison of the expression of pluripotent stem cell genes at the protein level shows that dental pulp stem cells differ from bone marrow, adipose tissue and umbilical cord mesenchymal stem cells significantly. Differences in the gene expression of dental pulp mesenchymal stem cells fully reflect their developmental origin in the neural crest.

Detection of diketopiperazine and pyrrolnitrin, compounds with anti-Pythium insidiosum activity, in a Pseudomonas stutzeri environmental strain

Yordhathai Thongsri, Chantana Aromdee, Chavi Yenjai, Somdej Kanokmedhakul, Angkana Chaiprasert, Petr Hamal, Chularut Prariyachatigul

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):378-383 | 10.5507/bp.2012.090

Pythium insidiosum, a fungus-like organism, can cause an endemic, life-threatening disease restricted mostly to Thailand. Currently, there are neither effective antimicrobials nor vaccines against this infection available. In this study, environmental bacterial strains were screened for their ability to inhibit the growth of this oomycete. Anti-P. insidiosum activity was found in 16 isolates. In one strain, Pseudomonas stutzeri ST1302, a subfraction labelled PYK7, assigned to the diketopiperazines, exhibited exceptionally strong activity. Search for genes encoding compounds with known anti-P. insidiosum activity was also performed within the genome of this P. stutzeri strain; one gene region, corresponded to pyrrolnitrin, was found. To the best of the knowledge of the authors, this is the first report on the inhibitory effect of P. stutzeri against P. insidiosum

Effect of spironolactone in patients with resistant arterial hypertension in relation to age and sex: Insights from the aspirant trial

Jan Vaclavik, Richard Sedlak, Jiri Jarkovsky, Eva Kocianova, Milos Taborsky

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):384-390 | 10.5507/bp.2012.105

The efficacy of spironolactone in different age and sex subgroups, the authors analysed the ASPIRANT trial. They found that spironolactone in a daily dose of 25 mg lead to a larger reduction in systolic BP in older patients >62 years compared to younger patients, and was equally effective in men and women.

The safety and efficacy of bridging full-dose IV-IA thrombolysis in acute ischemic stroke patients with MCA occlusion: A comparison with IV thrombolysis alone

Daniel Sanak, Martin Kocher, Tomas Veverka, Michal Kral, Marie Cerna, Jana Zapletalova, Stanislav Burval, David Skoloudik, Andrea Bartkova, Eva Cechakova, Tomas Dornak, Roman Herzig, Petr Kanovsky

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):391-396 | 10.5507/bp.2013.003

Early recanalisation of the occluded cerebral artery in acute ischemic stroke patients.plays a major role in improvement Treatment with intravenous thrombolysis is associated with high probability of poor outcome with low recanalization rates. Intraarterial thrombolysis may be more effective but treatment can be delayed by catheterization. The combination of IV and IA thrombolysis allows faster start of thrombolysis using the IV route and higher recanalization rate using the intraarterial approach. This article reports the safety and efficacy of combined IV + IA thrombolysis compared to IV thrombolysis alone in acute ischemic stroke patients with occluded middle cerebral artery.

Amniotic fluid embolism - Investigation of fatal cases in Slovakia in the years 2005-2010 compared with fatal cases in the United Kingdom

Alexandra Kristufkova, Miroslav Borovsky, Miroslav Korbel, Marian Knight

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):397-403 | 10.5507/bp.2013.050

Amniotic fluid embolism (AFE) is a rare, but very severe obstetric complication. The clinical diagnosis is one of exclusion. This paper presents six fatal cases of AFE in Slovakia from 2005-2010 and compares the incidence, possible risk factors, neonatal outcomes and the clinical course of cases in Slovakia with fatal cases of AFE in the UK during the same period.

Intima media thickness measurement as a marker of subclinical atherosclerosis in SLE patient

Andrea Smrzova, Pavel Horak, Martina Skacelova, Zuzana Hermanova, Katerina Langova, Josef Zadrazil, Dalibor Novotny

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):404-411 | 10.5507/bp.2013.054

Accelerated atherosclerosis in systemic lupus erythematosus (SLE) is a serious cause of morbidity and mortality. This paper provides a comprehensive overview of the possible etiology of atherosclerosis in patients with SLE. Traditional risks factors (lifestyle, lipid spectrum, hypertension, diabetes), immunology profile, markers of endothelial dysfunction, intima media thickness, medication, disease activity and damage are covered. Subgroups with and without lupus nephritis are compared with a healthy population.

Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study)

Jindrich Spinar, Jiri Vitovec, Miroslav Soucek

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):412-421 | 10.5507/bp.2013.053

The MEDINA (MEtabolic parameters, DIabetes mellitus and NephropAthy) study compares angiotensin converting enzyme inhibitors (ACE-I) with angiotensin receptor blockers(ARB) in monotherapy and combined therapy with diuretic and/or a calcium-channel blocker (CCB) in 439 hypertensive patients with metabolic syndrome and/or diabetes mellitus. The blood pressure decrease difference between ACE-I and ARB was insignificant. Adding either hydrochlorothiazide or amlodipin was equally effective. There were no significant differences in metabolic parameters. The MEDINA trial has confirmed the equivalence of ACE-I and ARB in hypertension treatment and a combination with diuretics or CCB has an additive effect. Adding statins can further reduce the cardiovascular risk.

Combination of prednisolone and low dosed dexamethasone exhibits greater in vitro antileukemic activity than equiactive dose of prednisolone and overcomes prednisolone drug resistance in acute childhood lymphoblastic leukemia

Michaela Spenerova, Petr Dzubak, Josef Srovnal, Lenka Radova, Renata Burianova, Petr Konecny, Sona Salkova, Zbynek Novak, Dagmar Pospisilova, Jan Stary, Bohumir Blazek, Jiri Hak, Tomas Votava, Pavel Timr, Emilia Kaiserova, Eva Bubanska, Vladimir Mihal, Marian Hajduch

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):422-427 | 10.5507/bp.2012.059

This in vitro study shows the high inter-individual variability of leukemia cell response to prednisolone and dexamethasone. Hence, they compared the in vitro activity of prednisolone and dexamethasone in tandem. The combination of glucocorticoids, particularly the low and safe dosage of dexamethasone exhibited much greater in vitro potency than prednisolone alone (P<0.0006), which suggests the potential benefit of glucocorticoid combination in the treatment of childhood ALL.

Reduced relative dose intensity of primary chemotherapy does not influence prognosis of patients with Hodgkin lymphoma

Ludek Raida, Tomas Papajik, Zuzana Rusinakova, Vit Prochazka, Edgar Faber, Dana Cahova, Pavel Tucek, Karel Indrak

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):428-432 | 10.5507/bp.2013.022

This study reports no impact of primary chemotherapy delay resulting in reduced relative dose intensity of administered cytostatics on the outcome of patients with Hodgkin's lymphoma if the dose density of these drugs had remained the same according to appropriate protocol. Thus, time intensification of some therapeutic protocols appears to have no significant impact on the prognosis of patients with Hodgkin's lymphoma..

Unusual recurrent rectal carcinoma: A cancer field theory viewpoint

Kamil Vyslouzil, Svetlana Brychtova, Pavel Zboril, Pavel Skalicky, Katherine Vomackova, Michala Bezdekova, Tomas Brychta

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):433-437 | 10.5507/bp.2012.091

The authors discuss the possible role of the tumor-stroma microenvironment in the local recurrence of rectal carcinoma. On analysis of two case reports, they demonstrate that changes in microenvironment around the anastomoses, mainly in association with the surgical procedure may create favourable conditions for recruitment, settling and subsequent proliferation of circulating tumor cells from minimal residual disease.

Malignant melanoma in the Czech Republic: Incidence and mortality according to sex, age and disease stage

Jana Vranova, Monika Arenbergerova, Petr Arenberger, Antonin Vrana, Jozef Zivcak, Hana Kolarova, Jozef Rosina

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):438-446 | 10.5507/bp.2012.081

The Czech Republic was found to have the fifth highest recorded incidence of malignant cutaneous melanoma in Europe in 2008 in men and ninth in women. In this article, the causes of the rising trends and explanation of differences in development of cutaneous melanoma between men and women, according to age and disease stage are reported.

Laparoscopic abdominoperineal resection with intraoperative radiotherapy for locally advanced low rectal cancer

Matej Skrovina, Renata Soumarova, Miloslav Duda, Roman Bezdek, Jiri Bartos, Adam Wendrinski, Petr Andel, Javed Parvez, Martin Straka, Lukas Adamcik

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):447-450 | 10.5507/bp.2012.082

This article provides preliminary results of resection procedures for locally advanced low rectal cancer combined with intraoperative radiotherapy (IORT). The authors describe the technical feasibility of this method and stress its importance in the multimodal treatment of colorectal carcinoma. Although IORT is associated with higher risk of peri- and postoperative complications, it improves local control in patients with advanced tumours of the lower rectum.

Radiofrequency ablation of non-resectable lung tumors

Vaclav Simanek, Jiri Klecka, Vladislav Treska, Kristyna Ohlidalova, Hynek Mirka

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):451-454 | 10.5507/bp.2012.077

Radiofrequency ablation is a method of choice in the treatment of cancer of the lung. The advantage of this treatment method is the simplicity and posibility of combination with other procedures.

Neuroendocrine neoplasms of the stomach

Oldrich Louthan

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):455-460 | 10.5507/bp.2013.045

Gastric neuroendocrine neoplasms are to heterogeneous group of gastro-entero-pancreatic tumors characterized by lower malignant potential, rising incidence, and idiosyncratic biological tumor behavior. There are three types of gastric neuroendocrine neoplasms that distinctly differ in biological and clinicopathological characteristics, as well as in different management. The article provides an overview of neuroendocrine tumor classification, their clinical characteristics, histological findings, laboratory measurement, prognosis, and therapeutic strategy. The authors present the clinical features and treatment of twenty-five patients with gastric neuroendocrine neoplasms that were diagnosed and treated by them.

Omission of adjuvant radiation therapy in elderly patients with low risk breast cancer undergoing breast-conserving surgery - two center experience

David Vrana, Jiri Gatek, Lucie Lukesova, Tomas Vazan, Bohuslav Melichar, Marketa Pospiskova, Ivan Svach

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):461-464 | 10.5507/bp.2013.032

The authors summarize the facts and their clinical experience with omitting adjuvant radiotherapy in the early stages of breast cancer in elderly patients. Adjuvant radiotherapy is standard treatment after breast conserving surgery but in elderly patients the benefit of radiotherapy is unclear. The experience of the authors is that adjuvant radiotherapy may be safely omitted in older patients with low risk breast cancer.

Color Doppler Ultrasound in the pre-histological determination of the biological character of major salivary gland tumors

Pavel Strympl, Michal Kodaj, Tomas Bakaj, Pavel Kominek, Ivo Starek, Ivan Sisola, Hana Tomaskova, Petr Matousek

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):465-469 | 10.5507/bp.2012.074

This paper assesses the use of color Doppler ultrasound in the pre-histological determination of the biological features of salivary gland tumors. Color Doppler parameters (peak systolic velocity, resistive index, pulsatility index) were used to differentiate between patients withbenign, low-grade and high-grade salivary gland tumors. The ultrasonographic results are compared with final histological results.

Case reports

X-linked agammaglobulinemia caused by new mutation in BTK gene: A case report

Zuzana Havlicekova, Milos Jesenak, Tomas Freiberger, Peter Banovcin

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):470-473 | 10.5507/bp.2013.011

X-linked agammaglobulinemia (XLA) is a rare inherited primary immunodeficiency. The authors report the clinical case of a boy with XLA with delayed diagnosis despite typical clinical features of severe antibody immunodeficiency. The disease was caused by a new, previously undescribed mutation in the BTK gene. This case report summarizes the crucial and typical clinical symptoms of XLA. Recognising the warning signs of primary immunodeficiencies could substantially help to improve the prognosis of these patients.

Giant adrenocortical carcinoma with 27-month disease-free survival by surgical resection alone: A case report

Martin Straka, Renata Soumarova, Jan Bulejcik, Martin Banik, Mikulas Pura, Matej Skrovina

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):474-478 | 10.5507/bp.2013.040

Complete surgical excision is the only option for prolonging survival in the case of this rare entity. A 27-month disease-free survival after surgical resection alone in the case presented, underscores the importance of resection even in a patient with a giant tumour. Potential space constraints in large tumours in this localisation may require en bloc resection with neighbouring organs.

First experience with single incision laparoscopic surgery in Slovakia: Concomitant cholecystectomy and splenectomy in an 11-year-old girl with hereditary spherocytosis

Vladimir Cingel, Lenka Zabojnikova, Patricia Kurucova, Ivan Varga

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):479-485 | 10.5507/bp.2013.058

Hereditary spherocytosis refers to a group of heterogeneous inherited anemias. The two most often affected organs are the spleen and gallbladder. Splenectomy is the only effective therapy for this disorder and often it is performed in combination with cholecystectomy. The authors have experienced positive results from performing laparoscopic splenectomy and cholecystectomy at one time for treating hereditary spherocytosis that was combined with cholelithiasis. Their experience shows that single incision laparoscopic surgery splenectomy and cholecystectomy is feasible even in young children and despite the small number of cases in the world, they consider the combined laparoscopic approach, safe and effective for the treatment of hereditary spherocytosis

Letter to the editor

Letter to the editor. Re: "Interventional treatment of pain in refractory angina. A review" by Milos Dobias et al. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014 Jun 19. doi: 10.5507/bp.2014.028. [Epub ahead of print]

Yoav Paz, Amihay Shinfeld

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014, 158(3):486-487 | 10.5507/bp.2014.047