Biomedical papers, 2015 (vol. 159), issue 4

Review articles

Can we diagnose isolated, exercise-induced heart failure with normal ejection fraction?

Jaroslav Meluzin, Zdenka Gregorova, Monika Spinarova, Roman Panovsky

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):513-518 | 10.5507/bp.2014.066

The prevalence of isolated, exercise-induced HFNEF has not been systematically studied to date. We evaluated current data on the prevalence, clinical significance and specifically, the establishment of the diagnosis of isolated, exercise-induced HFNEF. There are conflicting results and significant problems associated with this diagnosis .This review will hopefully encourage further research in this difficult but clinically important area of heart failure.

A minireview on NHE1 inhibitors. A rediscovered hope in oncohematology

Romeo Gabriel Mihaila

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):519-526 | 10.5507/bp.2015.060

Na+/H+ exchanger-1 (NHE-1) is involved in pH regulation and is up-regulated in different malignancies. Inhibitors of NHE-1 are able to decrease intracellular pH and induce apoptosis. This review presents progress in understanding the mechanisms of action of these inhibitors, connections with certain genetic mutations and acquired treatment resistance, as well as new patents on them. NHE-1 inhibitors are promising adjuvant drugs for overcoming acquired resistance to treatment in various malignant hemopathies.

Original contributions

Glucose concentrations in blood and tissue - a pilot study on variable time lag

Rudolf Chlup, Jan Krejci, Mark O'Connell, Blanka Sebestova, Robert Plicka, Lucie Jezova, Tereza Brozova, Blanka Doubravova, Hana Zalesakova, Emilia Durajkova, Jiri Vojtek, Josef Bartek

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):527-534 | 10.5507/bp.2015.007

The lag phase between glucose concentrations in plasma and tissue in the course of increase/decrease appears to be longer in people with diabetes than in healthy persons. The decrease always lasts longer than the increase. The maximum glucose increase/decrease rate in HP was < 0.1 mmol/L/min. In diabetes, the maximum glucose increase rate was 0.25 mmol/L/min/ and the maximum decrease rate was mostly 0.15 mmol/L/min. The glucose increase/decrease rates appear to be more sensitive than oral GTT alone.

Association of polymorphisms in the endocannabinoid system genes with myocardial infarction and plasma cholesterol levels

Monika Chmelikova, Lukas Pacal, Lenka Spinarova, Anna Vasku

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):535-539 | 10.5507/bp.2014.043

This study provided preliminary evidence for several cardiovascular risk factors associated with genetic variation in the endocannabinoid system gene. Common functional single nucleotide polymorphisms in the endocannabinoid system gene (G1359A in CNR1,C385A in FAAH) are associated with increased total cholesterol level and increased risk of myocardial infaction in patients with a history of heart failure.

CT-1 induces angiogenesis by regulating the ADMA/DDAH Pathway

Zhen Zhong Zheng, Xiao Tian Fu, Jin Liang, Zhi Bing Guo

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):540-546 | 10.5507/bp.2015.009

This article showed that overexpression of CT-1(Cardiotrophin-1) increases endothelial cell proliferation, migration and formation of blood vessels, upregulates the expression of eNOSmRNA, DDAH I, DDAHII and VEGF, elevates the activity of DDAH and NOS, decreases the level of ADMA and promotes NO synthesis. In contrast, ADMA can partially inhibit the effects induced by CT-1. The results indicate that CT-1 induced endothelial cell angiogenesis and ADMA (Asymmetric Dimethylarginine) / DDAH (Dimethylarginine Dimethylaminohydrolase) pathway activation may play an important role in the process.

The effects of novel 7-MEOTA-donepezil like hybrids and N-alkylated tacrine analogues in the treatment of quinuclidinyl benzilate-induced behavioural deficits in rats performing the multiple T-maze test

Jan Misik, Jan Korabecny, Eugenie Nepovimova, Pavla Cabelova, Jiri Kassa

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):547-553 | 10.5507/bp.2015.006

Four newly synthetized tacrine-related cholinesterase inhibitors were preliminarily evaluated as possible candidates for the treatment of Alzheimer's disease. The pro-cognitive effect of novel compounds was tested in rats, using an animal model of pharmacologically induced amnesia. Novel inhibitors were compared with the standards, tacrine and donepezil. The effect of all novel compounds was comparable to that of the standards but further detailed investigation is advocated.

Detection of tumor-specific marker for minimal residual disease in multiple myeloma patients

Lenka Sedlarikova, Lena Kubiczkova, Fedor Kryukov, Jana Pelcova, Zdenek Adam, Ludek Pour, Roman Hajek, Sabina Sevcikova

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):554-561 | 10.5507/bp.2014.035

This the first report in the Czech Republic on qualitative and quantitative allele-specific detection of VDJ rearrangement. A restrospective study of multiple myeloma patients.

Elevated serum prolactin levels as a marker of inflammatory arthritis in psoriasis vulgaris

Marketa Husakova, Jan Lippert, Jiri Stolfa, Liliana Sedova, Petr Arenberger, Zdenka Lacinova, Karel Pavelka

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):562-568 | 10.5507/bp.2015.033

Psoriatic arthritis (PsA) accompanies psoriasis vulgaris (PV) in up to 40% cases. This study demonstrated that serum prolactin (PRL) levels reflect joint involvement in PV. PsA patients with active disease had elevated serum PRL levels. There was no correlation between serum PRL levels and activity of skin involvement. Elevated serum PRL levels may be a potential marker of active joint involvement in PsA patients.

Serum levels of valproic acid during delivery in mothers and in umbilical cord - correlation with birth length and weight

Ivana Kacirova, Milan Grundmann, Hana Brozmanova

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):569-575 | 10.5507/bp.2015.055

Maternal and umbilical cord serum levels of valproic acid were analyzed at delivery in a cohort of 58 women, between the years 1991-2013. A significant inverse correlation between birth length and weight and maternal and umbilical cord valproic acid concentrations but not dose were found. Therapeutic drug monitoring in mothers is more valuable than the given dose for predicting and obviating the risk of valproic acid effects on the fetus.

New biomarkers in the selection of patients for talcage of pleural cavity in the palliative therapy of malign pleural exudate

Petr Habal, Nedal Omran, James Chek, Jan Krejsek, Jiri Mandak

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):576-581 | 10.5507/bp.2015.005

This work assessed the development of selected local inflammatory markers in pleural effusion after talcage. Using these markers, could enable the selection of patients who will benefit from pleurodesis in the treatment of malignant pleural effusion.

Untargeted metabolomic analysis of urine samples in the diagnosis of some inherited metabolic disorders

Hana Janeckova, Alzbeta Kalivodova, Lukas Najdekr, David Friedecky, Karel Hron, Per Bruheim, Tomas Adam

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):582-585 | 10.5507/bp.2014.048

This study tested the method of untargeted metabolomics in conjunction with unsupervised (PCA) and supervised (PCA-DFA) data processing for detecting patients with specific inherited metabolic disorders. Four mild diseases with unclear biochemical profiles (cystinuria, maple syrup urine disease, adenylosuccinate lyase deficiency, and galactosemia) were selected. The approach was successful: patient samples were discriminated from controls by appropriate metabolites.

Increased levels of MMP-3, MMP-9 and MPO represent predictors of in-stent restenosis, while increased levels of ADMA, LCAT, ApoE and ApoD predict bare metal stent patency

Leos Pleva, Pavlina Kusnierova, Pavlina Plevova, Jana Zapletalova, Michal Karpisek, Lucie Faldynova, Petra Kovarova, Pavel Kukla

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):586-594 | 10.5507/bp.2015.037

This research showed that increased levels of MMP-3, MMP-9 and MPO may be predictors of ISR after bare-metal stent implantation. Increased ADMA, LCAT, and Apo E and D on the other hand, indicate decreased in-stent restenosis occurrence.

Comparison of brain vessel imaging from transtemporal and transcondylar approaches using contrast-enhanced transcranial color-coded duplex sonography and Virtual Navigator

David Skoloudik, Martin Kuliha, Martin Roubec, Jaroslav Havelka, Katerina Langova, Roman Herzig

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):595-600 | 10.5507/bp.2014.064

The transcondylar approach is new in transcranial color-coded duplex sonography which is used for detection of chronic cerebro-spinal venous insufficiency and intracranial venous reflux in patients with multiple sclerosis. The aim of this study was to compare the ability to detect blood flow in cerebral arteries, veins and intracranial venous sinuses of the new transcondylar approach and the conventional transtemporal approach. The results reveal that the transcondylar approach is seriously limited compared to the standard detection of intracranial blood flow and potential venous reflux.

Decrease in longitudinal strain in heart transplant recipients is associated with rejection

Helena Podrouzkova, Helena Bedanova, Martin Tretina, Josef Korinek, Radka Stepanova, Jana Hruskova, Petr Nemec, Tomas Konecny, Marek Orban

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):601-606 | 10.5507/bp.2015.020

A non-invasive diagnostic tool for uncovering heart transplant rejection is lacking. Strain is a sensitive measure of left ventricular function. Patients scheduled for endomyocardial biopsy within 2 hours underwent echocardiography. Worsening of longitudinal systolic strain compared to baseline measurement in heart transplant patients may be associated with acute cellular rejection.

Optic nerve head segmentation using fundus images and optical coherence tomography images for glaucoma detection

T. R. Ganesh Babu, S. Shenbaga Devi, R. Venkatesh

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):607-615 | 10.5507/bp.2015.053

In this study, a novel method was used to detect glaucoma by combining two imaging techniques namely fundus image and optical coherence tomography image. In the fundus image, the features, CDR and ISNT ratio are determined for detection of glaucoma. In the OCT image the features, cup depth and retinal thickness values are calculated for detection. The features from both fundus image and OCT are considered for glaucoma detection irrespective of the condition of the subject. By combining both features the diagnosic accuracy increased to 96.92%.

Contribution of sVEP visual acuity testing in comparison with subjective visual acuity

Petr Vesely

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):616-621 | 10.5507/bp.2015.002

The results of this study showed significant differences in average values for visual acuity obtained from the two methods used (sVEP and Snellen) in both samples. The authors confirmed significant correlations between repeated sVEP measurements. Objective measurement of visual acuity using sVEP is valid and reliable. They recommend using it only when it is not possible to use a subjective method for measuring visual acuity, e.g. children, mentally retarded or in cases of simulation/dissimulation.

Comparison of clinical outcomes and safety of catheter ablation for atrial fibrillation supported by data from CT scan or three-dimensional rotational angiogram of left atrium and pulmonary veins

Frantisek Lehar, Zdenek Starek, Jiri Jez, Miroslav Novak, Jiri Wolf, Radka Stepanova, Peter Kruzliak, Tomas Kulik, Alena Zbankova, Radek Jancar, Jiri Vitovec

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):622-628 | 10.5507/bp.2014.040

This study relates to the current topic of imaging methods in supporting ablation of atrial fibrillation. From the literature, no prior study has compared the clinical outcomes of ablation procedures using 3D rotational angiography as a substitute for cardiac CT. The clinical results of this study demonstrate the utility of 3D rotation angiography as an adequate alternative to a commonly performed CT scan.

Various forms of 18F-FDG PET and PET/CT findings in patients with polymyalgia rheumatica

Zdenek Rehak, Jiri Vasina, Petr Nemec, Zdenek Fojtik, Renata Koukalova, Zbynek Bortlicek, Dorota Rehakova, Jan Adam, Alena Vavrusova, Zdenek Adam

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):629-636 | 10.5507/bp.2015.026

Polymyalgia rheumatica (PMR) has no clear, specific laboratory marker or finding and is difficult to diagnose. In contrast to other imaging modalities (ultrasound and magnetic resonance imaging), PET and PET/CT require no targeting to a limited body part and as "one stop shops" can provide whole body examination. It can also visualize the involvement of diverse regions and their combinations.

The effects of separating inferior alveolar neurovascular bundles on osteogenesis of tissue-engineered bone and vascularization

Lin Feng, Lingling E, Hongchen Liu

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):637-641 | 10.5507/bp.2014.050

This study analyzed the role of inferior alveolar neurovascular bundles in osteogenesis and vascularization of tissue-engineered bone. In particular, the model was established by separating inferior alveolar neurovascular bundles, which has rarely been reported. The findings are of great significance to future studies on the repair of large maxillary defects using tissue-engineered bones.

Lung cancer, pulmonary emphysema and pleural effusion: An autopsy study

Miloslav Marel, Leona Koubkova, Zuzana Kovarikova, Alzbeta Grandcourtova, Frantisek Petrik, Hana Hroudova, Linda Capkova, Roman Kodet, Libor Fila

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):642-647 | 10.5507/bp.2015.024

This was an autopsy study carried out over two years, to determine the exact incidence of lung cancer, pulmonary emphysema and pleural effusion. The results showed that the above conditions occurred in more cases than are officially reported.

Significantly higher incidence of skin cancer than other malignancies in patients after heart transplantation. A retrospective cohort study in the Czech Republic

Zuzana Secnikova, Dana Gopfertova, Lenka Hoskova, Jana Hercogova, Martina Dzambova, Anna Jirakova, Lucie Rajska, Filip Rob, Zdenek Smerhovsky

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):648-651 | 10.5507/bp.2015.011

Skin cancer is the most frequent type of cancer in heart transplant recipients (HTRs). The authors report the results of the first study in the Czech Republic on HTRs. They compared the risks for different types of cancer. The study provides comprehensive analysis of skin cancer and other types of cancer from which they may be able to derive an evidence-based skin cancer surveillance program.

Incidence of intravenous drug incompatibilities in intensive care units

Ondrej Machotka, Jan Manak, Ales Kubena, Jiri Vlcek

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):652-656 | 10.5507/bp.2014.057

This is the first study conducted in the Czech Republic on intravenous incompatibility. Physicochemical incompatibility is a typical medication error in the administration of parenteral drugs and may lead to therapeutic failure, catheter occlusion or embolism. The authors aimed to identify the actual incidence of the medication error in a 12 month study in two ICUs. The results show that the incidence of drug incompatibilities could be reduced by adhering to a few simple rules for medication administration and following a set of recommendations for multiple lumen catheter use.

Kinematic analysis of preterm newborns' spontaneous movements for postural activity assessment

Jan Halek, Anita Muckova, Zdenek Svoboda, Miroslav Janura, Jana Marikova, Katerina Horakova, Lumir Kantor, Nina Nemcova

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):657-660 | 10.5507/bp.2014.053

This article describes the use of kinematic analysis of movement in newborns. By determining the center of mass (COM) and its motion in time, neonatal postural activity may be indirectly assessed. Significant differences in certain characteristics of motion of the COM in the group of preterm infants were found.

Predictors of hepatorenal syndrome in alcoholic liver cirrhosis

Martin Janicko, Eduard Veseliny, Gabriela Senajova, Peter Jarcuska

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):661-665 | 10.5507/bp.2015.010

Hepatorenal syndrome is relatively common and potentially fatal complication of advanced cirrhosis. Identification of patients at risk is key as there are effective but costly, means of prevention and treatment. Serum sodium is an accessible, reliable and cheap test that could, in conjunction with liver function, provide very important information on the hepatorenal syndrome.

Fluctuations in serum ethanol concentration in the treatment of acute methanol poisoning: a prospective study of 21 patients

Sergey Zakharov, Tomas Navratil, Tomas Salek, Ivana Kurcova, Daniela Pelclova

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):666-676 | 10.5507/bp.2015.008

Ethanol and fomepizole are both used as antidotes in the treatment of acute methanol poisonings; ethanol administration is considered to have a less safe side-effect profile and associated with higher risk of medication errors and adverse reactions due to difficult to predict pharmacokinetics and variations in serum concentrations. Despite significant variation in serum ethanol concentrations during the treatment this had no impact on the outcome of acute methanol poisoning. No adverse reactions directly related to ethanol administration were observed apart from fluctuations in serum ethanol concentrations during treatment. Given the general principle that an antidote should be administered as soon as possible after methanol ingestion, and the widespread availability of ethanol, both antidotes, fomepizole and ethanol, may be considered for ADH blockade during mass outbreaks of this highly toxic alcohol without limitations.

Effect of combination therapy of arthrocentesis and occlusal splint on nonreducing temporomandibular joint disk displacement

Peter Tvrdy, Petr Heinz, Jana Zapletalova, Richard Pink, Petr Michl

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):677-680 | 10.5507/bp.2014.044

Characteristics of publication: Temporomandibular joint disk displacement without reduction. The authors e statistically analysed the efficacy of arthrocentesis of the upper joint space in combination with splint therapy.

Case reports

Refractory cardiogenic shock due to extensive anterior STEMI with covered left ventricular free wall rupture treated with awake VA-ECMO and LVAD as a double bridge to heart transplantation - collaboration of three cardiac centres

Jan Kacer, Michaela Lindovska, Roman Surovcik, Ivan Netuka, Frantisek Mlejnsky, Tomas Grus, Jan Belohlavek

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):681-687 | 10.5507/bp.2015.044

The use of the awake ECMO approach in refractory cardiogenic shock in acute myocardial infarction enables safe interhospital transport and early indication for further definitive mechanical circulatory support in failed weaning. This case illustrates the importance of close interhospital collaboration in the context of refractory cardiogenic shock management.

Acute pancreatitis as the first manifestation of duodenal MALT lymphoma

Ivona Simkova, Karel Urbanek, Vlastimil Prochazka, Michal Konecny, Jan Gregar, Marie Geierova, Vit Prochazka, Eva Buriankova

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):688-694 | 10.5507/bp.2015.047

A case report of a patient with rare duodenal localization of MALT lymphoma. The extremely rare manifestation of this neoplasm is described.

Rapid and clinically significant response to masitinib in the treatment of mucosal primary esophageal melanoma with somatic KIT exon 11 mutation involving brain metastases: A case report

Jarmila Prosvicova, Sarka Lukesova, Jindrich Kopecky, Jiri Grim, Zdenek Papik, Renata Kolarova, Blanka Navratilova, Patrice Dubreuil, Julie Agopian, Colin Mansfield, Alan Moussy, Olivier Hermine

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015, 159(4):695-697 | 10.5507/bp.2015.061

We report the first patient with c-kit exon 11 mutated primary esophageal melanoma treated with oral tyrosine kinase inhibitor masitinib in the Czech Republic. The patient showed objective and clinical significant therapeutic response to masitinib within the first week of treatment, even regression in the number and size of brain metastatic lesions. There is strong medical plausibility that masitinib will have therapeutic benefit in advanced melanoma patients harboring a mutation in the juxtamembrane domain of KIT and results of trial AB08026 will therefore be of a great interest. To the authors' knowledge, this is the first report of brain metastases responding to masitinib.