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Background: Lipoprotein apheresis (LA) is considered as an add-on therapy for patients with familial hypercholesterolemia (FH). We aimed to analyze the data collected in the last 15 years from FH patients treated with LA, to elucidate the benefit of this procedure with respect to plasma lipids, biomarkers of inflammation, and endothelial dysfunction and soluble endoglin.Results: 14 patients (10 heterozygous FH patients (HeFH), 4 homozygous FH patients (HoFH)) were treated by long-term lipoprotein apheresis. Lipid levels were examined, and ELISA detected biomarkers of inflammation and soluble endoglin. Paired tests were used for intergroup comparisons, and a linear regression model served to estimate the influence of the number of days patients were treated with LA on the studied parameters. LA treatment was associated with a significant decrease of total cholesterol (TC), LDL-C, HDL-C, and apoB, in both HeFH and HoFH patients, after single apheresis and in a long-term period during the monitored interval of 15 years. Biomarkers of inflammation and endothelial dysfunction were reduced for soluble endoglin, hsCRP, and MCP-1, and sP-selectin after each procedure in some HeFH and HoFH patients.Conclusions: LA treatment up to 15 years, reduced cholesterol levels, levels of biomarkers related to endothelial dysfunction, and inflammation not only after each procedure but also in the long-term evaluation in FH patients. We propose that long-term LA treatment improves lipid profile and endothelial dysfunction in familial hypercholesterolemia patients, suggesting a promising improvement in cardiovascular prognosis in most FH patients. [ABSTRACT FROM AUTHOR]

Aim: An overview of MRI in patients with implanted vagal nerve stimulator (VNS) and the method of surgical explantation of VNS, reflect--ing the MRI protocol al-low--ing the subsequent MRI examination without significant limitations. Patients and methods: MRI can also be safely performed in patients with the implanted VNS device. Head examination and body examination caudal-ly from Th8 can be performed, but only local radiofrequency coils must be used. Before the MRI, the VNS system must be reprogram-med. If the patient has an explanted generator and the larger part of the electrode, the MRI of the entire body can be performed with any com-mon MRI setting. This applies to a situation where after the explantation there is only a 2- cm part of the electrode left –  cor-respond--ing to the portion of the electrode on the vagal nerve with fixation anchors. Results: From June 2016 to June 2018, we explanted a VNS with this approach in six patients. Post-operative course of all patients was without complications. Post-operative control was performed using neck X-ray and CT 3D imaging. Imag--ing methods showed that the remainder of the electrode on the vagal nerve electrode was ≤ 2 cm. Post-operatively, patients did not have swallowing dif-ficulties, hoarseness or voice changes. Four patients have subsequently already undergone MRI without any dif-ficulties or complications. Conclusion: Surgical explantation of VNS accord--ing to the MRI protocol, leav--ing part of the electrode on the vagal nerve and omitt--ing the complete preparation of the entire electrode on the nerve, reduces the risk of complications and shortens the duration of the operation. The patient can afterwards safely undergo the MRI of the entire body without any limitations in normal technical settings. Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy. Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů. [ABSTRACT FROM AUTHOR]

Introduction. Familial hypercholesterolemia is a hereditary disorder with autosomal dominant heredity. The underlying cause involves the gene for the LDL-receptor leading to accelerated atherosclerosis. Extracorporeal elimination of cholesterol (CH) is indicated in 3-5% of patients not responding to conservative treatment or in homozygous FH. Two methods are used at our institution: immunoadsorption of LDL- cholesterol and rheohemapheresis. Patients and Methods. We currently have long term follow-up available for 14 patients with familial hypercholesterolemia (8 males, 6 females) aged 28-70 years (median 57 years). 10 patients are treated with immunoadsorption (5 homozygous and 5 heterozygous) and 4 patients are treated with rheohemapheresis (2 males, 2 females). Median follow-up is 8.5 years. During immunoadsorption, plasma is collected by continuous separation and flows through alternating pairs of adsorbers in an automatic adsorbing-desorbing device. In rheohemapheresis, plasma is collected similarly but goes through a "second step" - filter. Procedures are repeated every 2-4 weeks. Cholesterol and LDL- cholesterol values are measured before and after each procedure. Results. 1922 procedures have been performed (immunoadsorption 1590 times, rheohemapheresis 332 times). Average cholesterol and LDL- cholesterol values before the procedure were 5.34 and 3.12 mmol/l in immunoadsorption, 5.07 and 2.86 in rheohemapharesis; after the procedure: 1.73 and 0.72 (a fall of 72% and 85%), resp. 1.96 and 0.97 mmol/l (a drop of 61% and 66% drop). Fibrinogen fell by 22% (from 3.05 to 2.42 g/l) and 64% (from 3.48 to 1.2g/l). There were 3.1% of adverse reactions and no difference was observed between the two methods. Conclusion. Treatment of FH is very effective when indicated. There is a significant decrease in all observed parameters. No patient experienced worsening of atherosclerosis. Both methods are safe with minimum adverse reactions. Immunoadsorption is more effective in CH elimination. RHF can be used in patients with hyperfibrinogenemia as an additional risk factor of atherosclerosis. Care of these patients is costly and requires an experienced team and an interdisciplinary approach. [ABSTRACT FROM AUTHOR]

Higher biomass especially of some aquatic macrophyte species offered a higher density of phytophilous zoobenthos, but did not increase the proportion of non‐planktonic to planktonic prey in young‐of‐the‐year perch Perca fluviatilis. Both abundance and biomass of non‐planktonic prey dominated over planktonic prey in the pond with lower biomass of aquatic macrophytes and lower food. Survival of P. fluviatilis was lower (20%) in the pond with lower food than in the other pond (34%), however, specific growth rate (1·3% day−1) and final Fulton's condition factor of P. fluviatilis were similar in both ponds. [ABSTRACT FROM AUTHOR]

Sudden hearing loss (sudden idiopathic sensorineural hearing loss, SISHL) is a major medical, social and economic problem. The etiology is not fully understood; the problem is arising presumably by the action of heterogeneous factors (viral infections, immunologic or vascular disorders etc.). Treatment of SISHL is generally not satisfactory, both in terms of corticosteroids or other options. Rheohemapheresis (RHF) offers a possibility of a rescue treatment. It is based on a rapid improvement of rheologic properties of blood that can favorably affect the viscosity and thus the flow of the microcirculation, coagulation or activity of the endothelium. In the years 2012-2013, we treated 16 patients in the age 34-72 years by means of our own modification of RHF, after treatment failure with corticoid infusion therapy. Hearing improvement was achieved significantly in 11 patients according to WHO rating, respectively in 12 diseased according to Fowler counting. 5 patients did not improve significantly, at one patient the hearing worsened. Most patients achieved an improvement at a frequency of 0.5 kHz. Tinnitus disappeared in two patients, and average tinnitus reduction was achieved 15.25 dB. Unfavorable prognostic factor showed to be the severity of hearing loss and age of the patient and the time of the incident. RHF side effects were not significant (two short-term non-serious reactions). RHF in our study showed a beneficial therapeutic effect even after a failed conventional therapy and subsequent initiation of treatment and was not associated with significant adverse risks. Treatment results of our group support the hypothesis that RHF may be an alternative rescue therapy in SISHL, especially in case of a vascular etiology, even after a failure of a standard therapy. [ABSTRACT FROM AUTHOR]

Background. Using our statin analysis method, it was possible to uncover a significant drop in statin levels (atorvastatin, simvastatin, and metabolites) after extracorporeal LDL-cholesterol elimination (EE) in severe familial hypercholesterolemia (FH). The purpose of this work was to identify the mechanism underlying this drop and its clinical significance as well as to proposemeasures to optimize a pharmacotherapeutical regimen that can prevent the loss of statins. Methods. Ultra High Performance Liquid Chromatography (UHPLC) connected to the triple quadrupole MS/MS system was used. Patients. A group of long-term treated patients (3-12 years of treatment) with severe FH (12 patients) and treated regularly by LDL-apheresis (immunoadsorption) or haemorheopheresis (cascade filtration) were included in this study. Results. After EE, the level of statins and their metabolites decreased (atorvastatin before/after LDL-apheresis: 8.83/3.46 nmol/l; before/after haemorheopheresis: 37.02/18.94 nmol/l). A specific loss was found (concentration of atorvastatin for LDL-apheresis/haemorheopheresis: 0.28/3.04 nmol/l in washing fluids; 11.07 nmol/l in filters). To prevent substantial loss of statin concentrations, a pharmacotherapeutic regimen with a longer time interval between the dose of statins and EE is recommended (15 hours). Conclusions. A specific loss of statins was found in adsorbent columns and filters. The decrease can be prevented by the suggested dosage scheme. [ABSTRACT FROM AUTHOR]

Rheological conditions basically influence tissue perfusion, oxygen and nutrient supply, tissue regeneration and in its consequence the course of pathological processes, especially in microcirculation and partially even in macrocirculation. Haemorheotherapy has shown to be successful in several indications (critical disorders in microcirculation) when other methods of therapy have failed. In this study we describe the changes of effectivity indicators in haemorheopheresis treatment and their clinical importance in cases of eye microcirculation, statoacoustic apparatus and disorders of the lower extremities. We treated with haemorheopheresis (separator Cobe.Spetra + Evaflux filter) 24 patients (16 patients with age related macular degeneration, 5 with critical peripheral arterial foot disease, and 3 with acute hearing loss). After the procedures α2-macroglobulin decreases by about 58%, fibrinogen by about 69%, IgM by about 61%, LDL-cholesterol by about 77%, apolipoprotein B by about 76% and lipoprotein(a) by about 63%. It corresponds with a decrease in blood and plasma viscosity and clinical improvement in the observed patients, i.e. visual improvement, acceleration of tissue defect healing and improvement in hearing. We noticed 7.1% clinically insignificant side-effects. The method of haemorheopheresis was safe. It led to improvement in patients' clinical condition in the above mentioned indications when other methods of treatment failed. [ABSTRACT FROM AUTHOR]

Examines the advantages of large volume erythrocytapheresis (LVE) therapy in patients with erythrocytosis. Improvement in symptomatology; Causes of polyglobulia; Efficacy of LVE therapy.

BACKGROUND: Using our statin analysis method, it was possible to uncover a significant drop in statin levels (atorvastatin, simvastatin, and metabolites) after extracorporeal LDL-cholesterol elimination (EE) in severe familial hypercholesterolemia (FH). The purpose of this work was to identify the mechanism underlying this drop and its clinical significance as well as to propose measures to optimize a pharmacotherapeutical regimen that can prevent the loss of statins. METHODS: Ultra High Performance Liquid Chromatography (UHPLC) connected to the triple quadrupole MS/MS system was used. Patients. A group of long-term treated patients (3-12 years of treatment) with severe FH (12 patients) and treated regularly by LDL-apheresis (immunoadsorption) or haemorheopheresis (cascade filtration) were included in this study. RESULTS: After EE, the level of statins and their metabolites decreased (atorvastatin before/after LDL-apheresis: 8.83/3.46 nmol/l; before/after haemorheopheresis: 37.02/18.94 nmol/l). A specific loss was found (concentration of atorvastatin for LDL-apheresis/haemorheopheresis: 0.28/3.04 nmol/l in washing fluids; 11.07 nmol/l in filters). To prevent substantial loss of statin concentrations, a pharmacotherapeutic regimen with a longer time interval between the dose of statins and EE is recommended (15 hours). CONCLUSIONS: A specific loss of statins was found in adsorbent columns and filters. The decrease can be prevented by the suggested dosage scheme. [ABSTRACT FROM AUTHOR]

Úvod: Onemocnění zprostředkované IgE protilátkami postihují 25-30 % populace. Jednou z nejzávažnějších manifestací je astma bronchiale. Komplexní léčebnou strategií lze při adekvátní léčbě dostat pod kontrolu astma u 95 % pacientů, ale u zbytku dochází k opakovaným exacerbacím. Jednou z léčebních modalit je biologická léčba s anti-IgE protilátkou (omalizumab). Významného snížení hladiny IgE lze dosáhnout i pomocí specifické extrakorporální eliminace IgE protilátek. V našem souboru jsme pacienty léčili kombinací těchto modalit. Materiál a metodika: Od listopadu 2016 do listopadu 2019 jsme imunoadsorpcí (IA) léčili celkem 4 pacienty s těžkým perzistujícím astmatem (3 muži a 1 žena, věkový průměr 35,3 roku, rozmezí 17-46 let). Průměrná vstupní hladina IgE byla 6 003,5 IU/ml, rozmezí 1 145-19 744 IU/ml (norma 0-200 IU/ml). Primární separace plazmy probíhala na separátoru Spectra Optia (Terumo BCT, Lakewood, Co, USA), následně plazma protékala specifickým jednorázovým adsorbérem IgEnio (Fresenius Medical Care, Bad Homburg, Německo). Při každém výkonu byly zpracovány 2 objemy plazmy. Jako antikoagulans byla použita kombinace ACD-A a heparinu. Výsledky: Během 8 dnů byly u 3 pacientů provedeny 4 IA, u 1 pacienta 5 IA, tj. celkem jsme provedli 17 IA. U 3 pacientů proběhly IA zcela bez komplikací, u 1 pacienta došlo k rozvoji mírné kožní alergické reakce, zvládnuto podáním hydrokortizonu. Průměrná hladina IgE po posledním výkonu byla 7 432, rozmezí 135-29 145 IU/ml. U 3 pacientů došlo ke snížení IgE průměrně o 86,7 %. U jednoho nemocného byly protilátky před zahájením extrémně vysoké, došlo k poklesu o 24,6 %. U všech pacientů byla následně zahájena léčba omalizumabem. Závěr: Naše prvotní zkušenosti ukazují, že IgE imunoadsorpce je bezpečnou léčebnou metodou u nemocných s těžkým perzistujícím astmatem. Umožňuje významné snížení IgE (až o 86 %) a následné zahájení biologické léčby. Plánované klinické výzkumy na větší skupině nemocných by měly potvrdit výsledky pilotních studií. [ABSTRACT FROM AUTHOR]

Abstract Present research suggests that phenotypic variations and consequent potential differences in suitability for commercial culture are more likely to occur among genetically diverse populations. We investigated diversity in traits important to aquaculture and assessed genetic differentiation based on four mitochondrial markers in three European populations of Perca fluviatilis. Using a transplant approach to standardize conditions and minimize environmental effects on phenotype expression, we compared survival, cannibalism, growth rate, growth heterogeneity, and specific growth rate of the populations to assess whether difference in aquaculture performance (i.e. expression of phenotypical traits that facilitate the rearing of fish and impact the productivity of the farming) is more likely between genetically differentiated populations than between genetically similar populations. We found key traits of performance to differ among allopatric populations, suggesting value in considering geographic source of broodstock. The largest aquaculture performance disparities were observed among genetically differentiated populations. Some lesser differences were observed between allopatric genetically similar populations, possibly the consequence of pre-collection environment, or transgenerational effects. Highlights • Allopatric populations of European perch differ in suitability to commercial culture. • Evaluation of geographic differences in key traits is a potential way to overcome current issues in perch aquaculture. • The differences in traits affecting aquaculture performance was observed among genetically differentiated populations. [ABSTRACT FROM AUTHOR]

This 4-month study (10 May - 6 September 2012) evaluated the effects of supplementary feeding on common carp ( Cyprinus carpio Linnaeus, 1758) growth, water quality, natural food availability and nutrient balance under different pond treatment regimes (eight rectangular earthen ponds; 0.03 ha surface area; 3-year-old carp). The nitrogen and phosphorus budgets were calculated as the difference between input (food, fish stocked and influent water) and output (effluent water and fish harvested). Three types of supplementary feeds were used: wheat, thermally-treated wheat, and thermally-treated and pressed wheat. An additional test group was provided with naturally available forage only and served as a control. The type of supplementary feed did not influence the water quality, with the exception of dissolved oxygen. No significant differences among experimental ponds were observed in zooplankton abundance. The use of modified cereals (especially thermally-treated and pressed wheat) improved carp growth performance and resulted in lower nutrient concentrations in effluent water via improving their digestibility. Both thermally-treated and thermally-treated and pressed cereals improved the balance of phosphorus; hence these diets could be beneficial, not only from the fish production point of view but also as a tool to reduce the deterioration of pond water quality. [ABSTRACT FROM AUTHOR]

Abstract: A number of surprising observations have shown that stem cells, in suitable conditions, have the ability to produce a whole spectrum of cell types, regardless, whether these tissues are derived from the same germ layer or not. This phenomenon is called stem cell plasticity, which means that tissue-specific stem cells are mutually interchangeable. In our experiments, as a model, we used neural stem cells (NSCs) harvested from fetal (E14–15) neocortex and β-galactosidase positive. In the first experiment we found that on days 12 and 30 after sub-lethal irradiation (LD 8.5 Gy) and (β-galactosidase+) NSCs transplantation all mice survived, just as the group with bone marrow transplantation. Moreover, the bone marrow of mice transplanted NSCs contained the number of CFU-GM colonies with β-galactosidase+ cells which was as much as 50% higher. These differences were statistically significant, p <0.001. In the second experiment, we studied kinetics of (β-galactosidase+) NSCs after their transplantation to sub-lethally irradiated mice. Histochemistry of tissues was performed on days 12 and 30 post-transplantation, and β-galactosidase+ cells were detected with the help of histochemical examination of removed tissues (lung, liver, spleen, thymus, and skeletal muscle). In tissues removed on day 12 post-transplantation, we found a significantly higher number of β-galactosidase+ cells in the spleen and thymus on day 30. While we presumed the presence β-galactosidase+ cells in the spleen, as spleen and reticuloendothelial system represent an important retaining system for different cell types, the presence of β-galactosidase+ cells in the thymus was rather surprising but very interesting. This indicates a certain mutual and close interconnection of transplanted stem cells and immune system in an adult organism. In the third experiment, we verified the mutual interchange of Sca-1 surface antigen in the bone marrow cells and NSCs before transplantation. Analysis of this antigen showed 24.8% Sca-1 positive cells among the bone marrow cells, while NSCs were Sca-1 negative. Our experiments show that NSCs share hemopoietic identity and may significantly influence the recovery of damaged hematopoiesis but do not have typical superficial markers as HSCs. This result is important for the determination of predictive factors for hemopoiesis recovery, for stem cell plasticity and for their use in the cell therapy. [Copyright &y& Elsevier]

To support multicyclic, dose-intensive chemotherapy in breast cancer, we assessed the effects of reinfusing hematopoietic progenitors either as a leukapheresis product or as mobilized unprocessed whole blood. In this clinical study, 16 consecutive female breast cancer patients were given six cycles of chemotherapy regimen EC (epirubicin (150 mg/m2) and cyclophosphamide (1250 mg/m2) on day 1). In the first cycle, 24 h after chemotherapy, mobilization of the peripheral blood progenitor cells (PBPC) was started with growth factor G-CSF (Neupogen; Amgen-Roche) at a dose of 5 μg/kg/day for 13 days. In all other cycles G-CSF had been given at the same dose from day 7. On days 11, 12 and 13 the leukaphereses were performed and their products cryopreserved. On day 14 whole blood was collected. The median peak incidence of CFU-GM (granulocyte–macrophage colony-forming unit) in peripheral blood was approximately 50 times the baseline level. The leukapheresed PBPC were divided into portions and reinfused after the fourth, fifth and sixth chemotherapy courses. The support with mobilized whole blood was given after the second and third cycles. The effects of the support of whole blood vs leukapheresed PBPC on hematopoietic recovery were compared. The best yields of leukaphereses were achieved on day 13 after initiation of the chemotherapy. The mean number of CD34+ cells was 4.93 × 106/kg (s.d. 2.7; range 0.36–10.54 × 106/kg) the amount of CFU-GM was 2.18 × 105/kg (s.d. 1.3; range 0.07–4.2 × 105/kg). The yields of CFU-GM in 450 ml whole blood collected on day 14 reached 0.51 × 105/kg (s.d. 0.28; range 0.05–1.5 × 105/kg) and of CD34+ cells were 1.3 × 106/kg (s.d. 0.8, range 0.18–2.58 × 106/kg). PBPC yields in 450 ml of unprocessed whole blood were in some cases not... [ABSTRACT FROM AUTHOR]