Background and Aims Negative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi-d) in the treatment of DSWI. Methods We retrospectively evaluated the patients who were treated at our institution between March 2018 and November 2021 for DSWI after radical sternectomy using NPWT or NPWTi-d. The NPWTi-d was applied to start the first postoperative day using 75 mmHg negative pressure for 3 h, followed by instillation of sodium hypochlorite <0.08% with a 3-min dwell time. Results The NPWTi-d group showed a shorter length of stay (29.39 ± 12.09 vs. 39.54 ± 17.07 days; p = 0.049), a shorter elapsed time between the debridement and the flap coverage (7.18 ± 4.27 vs. 11.86 ± 7.7 days; p = 0.003) and less operative or nonoperative dressing changes (1.73 ± 1.14 vs. 2.68 ± 56; p < 0.001). The in-hospital mortality was 8.2%, with no significant differences between the two groups (p = 1). Conclusion NPWTi-d can be safely employed in the treatment of DSWI. Further prospective randomized studies need to establish the role of NPWTi-d in the control of infection and biofilm as well as in wound healing.

<p>Ventriculo-peritoneal shunting is the most commonly used method for the treatment of paediatric hydrocephalus. Despite improved shunts and surgical techniques there are still complications. This retrospective study focuses on diagnoses and treatment of shunt malfunction and infections. Cost/benefit of using an adjustable shunt was assessed. Two adjustable cerebrospinal fluid shunts and their compatible antisiphon devices were compared in-vitro.</p><p>In 21 of 46 children the standard shunt was changed to an adjustable one due to over-drainage. Adjustment of the shunt was performed in 73% of the children thereby avoiding surgery in several cases. This was a financial advantage.</p><p>Ascites or an abdominal pseudocyst without infection was detected in eight children due to resorption difficulties. A ventriculo-atrial shunt was inserted for a period of time. In three children it could successfully be reverted to a ventriculo-peritoneal.</p><p>In six children papilloedema was the only sign of shunt dysfunction. At revision the intracranial pressure ranged from 25 to 52 cm H₂O. Fundoscopic examination in children older than 8 years may detect symptomless shunt malfunction.</p><p>During a 13-year period 39 shunt infections were diagnosed. Skin bacteria were found in 80%. Prolonged and anaerobic cultures increased the detection rate by more than one third. The intraventricular infections were treated with intraventricular and systemic antibiotics resulting in quick sterilisation. No relapses were encountered. In five older children with distal catheter infection <i>Propionibacterium acne</i> was found. These were treated with intravenous antibiotics and exchanging of the shunt system.</p><p>Strata NSC^TM and Codman Hakim^TM worked according to the manufacturers except at the lowest setting. The resistance was below and in the lower range of the physiological one respectively. The antisiphon device of Strata shunt had to be placed in line with shunt to function properly. </p>

Ventriculo-peritoneal shunting is the most commonly used method for the treatment of paediatric hydrocephalus. Despite improved shunts and surgical techniques there are still complications. This retrospective study focuses on diagnoses and treatment of shunt malfunction and infections. Cost/benefit of using an adjustable shunt was assessed. Two adjustable cerebrospinal fluid shunts and their compatible antisiphon devices were compared in-vitro. In 21 of 46 children the standard shunt was changed to an adjustable one due to over-drainage. Adjustment of the shunt was performed in 73% of the children thereby avoiding surgery in several cases. This was a financial advantage. Ascites or an abdominal pseudocyst without infection was detected in eight children due to resorption difficulties. A ventriculo-atrial shunt was inserted for a period of time. In three children it could successfully be reverted to a ventriculo-peritoneal. In six children papilloedema was the only sign of shunt dysfunction. At revision the intracranial pressure ranged from 25 to 52 cm H2O. Fundoscopic examination in children older than 8 years may detect symptomless shunt malfunction. During a 13-year period 39 shunt infections were diagnosed. Skin bacteria were found in 80%. Prolonged and anaerobic cultures increased the detection rate by more than one third. The intraventricular infections were treated with intraventricular and systemic antibiotics resulting in quick sterilisation. No relapses were encountered. In five older children with distal catheter infection Propionibacterium acne was found. These were treated with intravenous antibiotics and exchanging of the shunt system. Strata NSCTM and Codman HakimTM worked according to the manufacturers except at the lowest setting. The resistance was below and in the lower range of the physiological one respectively. The antisiphon device of Strata shunt had to be placed in line with shunt to function properly.

Submitted by Cristhiane Guerra (cristhiane.guerra@gmail.com) on 2017-02-03T15:37:52Z No. of bitstreams: 1 arquivototal.pdf: 4718514 bytes, checksum: 73b76bdede325ded91073c36318f98f2 (MD5) / Made available in DSpace on 2017-02-03T15:37:52Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 4718514 bytes, checksum: 73b76bdede325ded91073c36318f98f2 (MD5) Previous issue date: 2016-02-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / The synthetic alkaloid 2-methoxy-4-(7-methoxy-1,2,3,4- tetrahydroisoquinolin-1-yl) phenol encoded as MHTP, has a 93.45% yield and it had no genotoxic effect with low acute toxicity in preclinical analyses, with LD50 higher than 1000 mg / kg. The MHTP presented vasorelaxant and anti-inflammatory effects in acute inflammation models by orally administration. The aim of this study was to evaluate the immunomodulatory effect of MHTP, administered intranasally (in) in experimental allergic pulmonary inflammation induced by ovalbumin (OVA) by means of allergic (measurement of serum IgE) and inflammatory parameters (cell migration and production of cytokines, the fluid broncoalveolar- washed BAL, mucus production and histopathological pulmonary remodeling). Female BALB / c mice were sensitized with OVA at days 0 and 12 of the experimental protocol and on days 19 and 22 were treated via i.n. MHTP with the doses of 2.5 and 5 mg / kg or dexamethasone (2 mg/kg). After each treatment was aerosol challenged with OVA for 30 minutes daily; 24 hours after the last challenge, it was collected biological material for evaluation of allergic lung inflammation characteristic on allergic asthma. Treatment with MHTP at dose of 2.5 mg/kg decreased (p<0,05) the migration of total lymphocytes, (p<0,0001) the lymphocytes CD4+ and production of the cytokines IL-13, IL-4, IL-17 and IL-10. The dose of 5 mg/kg, in turn, decreased (p <0,05) the production of OVA-specific IgE and migration of lymphocytes CD3+; (p<0,0001) migration of leukocytes, total lymphocytes CD4+, macrophages and (p<0,001) eosinophils; (p<0,0001) the percentage of granulocytes; the production of the cytokines IL-13, IL-4, IL-17 and IL- 10. In addition, MHTP reduced inflammatory histopathological parameters such as hyperplasia and hypertrophy of goblet cells and mucus overproduction. The results infer that the immunomodulatory mechanism of MHTP is related to regulation of Th2 profile that is responsible for generating and maintaining allergic pulmonary inflammation process characteristic of allergic asthma. / O alcaloide sintético 2-methoxy-4-(7-methoxy-1,2,3,4- tetrahydroisoquinolin-1-yl) phenol, codificado como MHTP, possui rendimento de 93,45%, não apresentou efeito genotóxico com baixa toxicidade aguda pré clínica e DL50 maior que 1.000 mg/kg. O MHTP apresentou efeito vasorelaxante e antiinflamatorio em modelo de inflamação aguda, administrado por via oral. O objetivo do presente trabalho foi avaliar o efeito imunomodulador do MHTP, administrado por instilação nasal (i.n.), na inflamação pulmonar alérgica experimental induzida por ovalbumina (OVA), por meio dos parâmetros alérgico (quantificação de IgE sérica), inflamatório (migração celular, produção de citocinas, no fluido do lavado broncoalveolar- BAL) e morfológico (produção de muco e histologia pulmonar geral). Camundongos fêmeas BALB/c foram sensibilizados com OVA nos dias 0 e 12 do protocolo experimental e nos dias 19 a 22 foram tratados por via i.n. com MHTP nas doses 2,5 ou 5 mg/kg ou Dexametasona (2 mg/kg). Após cada tratamento, foi realizado os desafios por aerossol com OVA, durante 30 minutos diários; 24 horas após o último desafio, foi coletado o material biológico necessário para avaliação da inflamação pulmonar alérgica, característica da asma alérgica. O tratamento com MHTP na dose de 2,5 mg/kg diminuiu (p<0,05) a migração de linfócitos totais, (p<0,0001) linfócitos CD4+ e a produção das citocinas IL-13, IL-4, IL-17 e IL-10. A dose de 5 mg/kg, por sua vez, diminuiu (p<0,05) a produção de IgE-OVA específica e migração de linfócitos CD3+; (p<0,0001) migração de leucócitos totais, linfócitos CD4+, macrófagos e (p<0,001) eosinófilos; (p<0,0001) o percentual de granulócitos e a produção das citocinas IL-13, IL-4, IL-17 e IL-10. Além disso, MHTP reduziu os parâmetros inflamatórios histopatológicos e morfológicos e a hiperprodução de muco. Os resultados obtidos inferem que o mecanismo imunomodulador do MHTP está relacionado à regulação do perfil Th2, que é responsável por gerar e manter o processo inflamatório alérgico pulmonar, característico da asma alérgica.

Background Novel theranostic options for high-risk non-muscle invasive bladder cancer are urgently needed. This requires a thorough evaluation of experimental approaches in animal models best possibly reflecting human disease before entering clinical studies. Although several bladder cancer xenograft models were used in the literature, the establishment of an orthotopic bladder cancer model in mice remains challenging. Methods Luciferase-transduced UM-UC-3LUCK1 bladder cancer cells were instilled transurethrally via 24G permanent venous catheters into athymic NMRI and BALB/c nude mice as well as into SCID-beige mice. Besides the mouse strain, the pretreatment of the bladder wall (trypsin or poly-L-lysine), tumor cell count (0.5 × 106–5.0 × 106) and tumor cell dwell time in the murine bladder (30 min – 2 h) were varied. Tumors were morphologically and functionally visualized using bioluminescence imaging (BLI), magnetic resonance imaging (MRI), and positron emission tomography (PET). Results Immunodeficiency of the mouse strains was the most important factor influencing cancer cell engraftment, whereas modifying cell count and instillation time allowed fine-tuning of the BLI signal start and duration – both representing the possible treatment period for the evaluation of new therapeutics. Best orthotopic tumor growth was achieved by transurethral instillation of 1.0 × 106 UM-UC-3LUCK1 bladder cancer cells into SCID-beige mice for 2 h after bladder pretreatment with poly-L-lysine. A pilot PET experiment using 68Ga-cetuximab as transurethrally administered radiotracer revealed functional expression of epidermal growth factor receptor as representative molecular characteristic of engrafted cancer cells in the bladder. Conclusions With the optimized protocol in SCID-beige mice an applicable and reliable model of high-risk non-muscle invasive bladder cancer for the development of novel theranostic approaches was established.

Background Novel theranostic options for high-risk non-muscle invasive bladder cancer are urgently needed. This requires a thorough evaluation of experimental approaches in animal models best possibly reflecting human disease before entering clinical studies. Although several bladder cancer xenograft models were used in the literature, the establishment of an orthotopic bladder cancer model in mice remains challenging. Methods Luciferase-transduced UM-UC-3LUCK1 bladder cancer cells were instilled transurethrally via 24G permanent venous catheters into athymic NMRI and BALB/c nude mice as well as into SCID-beige mice. Besides the mouse strain, the pretreatment of the bladder wall (trypsin or poly-L-lysine), tumor cell count (0.5 × 106–5.0 × 106) and tumor cell dwell time in the murine bladder (30 min – 2 h) were varied. Tumors were morphologically and functionally visualized using bioluminescence imaging (BLI), magnetic resonance imaging (MRI), and positron emission tomography (PET). Results Immunodeficiency of the mouse strains was the most important factor influencing cancer cell engraftment, whereas modifying cell count and instillation time allowed fine-tuning of the BLI signal start and duration – both representing the possible treatment period for the evaluation of new therapeutics. Best orthotopic tumor growth was achieved by transurethral instillation of 1.0 × 106 UM-UC-3LUCK1 bladder cancer cells into SCID-beige mice for 2 h after bladder pretreatment with poly-L-lysine. A pilot PET experiment using 68Ga-cetuximab as transurethrally administered radiotracer revealed functional expression of epidermal growth factor receptor as representative molecular characteristic of engrafted cancer cells in the bladder. Conclusions With the optimized protocol in SCID-beige mice an applicable and reliable model of high-risk non-muscle invasive bladder cancer for the development of novel theranostic approaches was established.

<p>A diagnosis of coeliac disease (CD) in adults relies on the presence of a structurally abnormal intestinal mucosa, followed by a clear clinical remission on a gluten-free diet. There is a clear need for a rapid, simple, safe and sensitive method to determine the type and intensity of inflammation in the gut mucosa in clinical practice. The overall aims of our studies were to develop and evaluate a new technique, “the mucosal patch technique”, to characterize rectal local inflammatory process after rectal food challenge in patients with CD<b>. In study 1</b> we evaluated the potential of the new technique. The technique was well tolerated and easily applied. Pronounced neutrophil and eosinophil involvement in ulcerative colitis (UC) was demonstrated. With the high sensitivity of the technique, low-degree mucosal neutrophil activation could also be quantified in patients with collagen colitis,UC in clinical remission and in patients with irritable bowel syndrome. <b>In study 2 and 3</b> the aim was to elucidate the dynamics of the rectal inflammatory response and nitric oxide (NO) production after rectal gluten challenge. We found a pronounced neutrophil activation in coeliac patients after rectal gluten challenge. This activation was apparent 4 hours after challenge and remains for at least 48 hours. A more modest eosinophil activation started 1-2 hours later and remained at least for 48 hours. The biphasic pattern of neutrophil and eosinonphil activation after challenge suggests a biphasic inflammatory reaction. The activation of neutrophils and eosinophils precedes a pronounced enhancement of mucosal NO production. Some of our coeliac patients displayed signs of an inflammatory reaction after rectal corn gluten challenge. <b>In study 4</b> the aim was to investigate the local inflammatory reaction to gluten and cow’s milk protein in CD patients in remission. The findings indicate that not only gluten sensitivity but also cow’s milk (CM) protein sensitivity is common in CD. The data support the hypothesis that CM sensitivity may contribute to persistent symptoms in coeliac patients on gluten-free diet.</p>

A diagnosis of coeliac disease (CD) in adults relies on the presence of a structurally abnormal intestinal mucosa, followed by a clear clinical remission on a gluten-free diet. There is a clear need for a rapid, simple, safe and sensitive method to determine the type and intensity of inflammation in the gut mucosa in clinical practice. The overall aims of our studies were to develop and evaluate a new technique, “the mucosal patch technique”, to characterize rectal local inflammatory process after rectal food challenge in patients with CD<b>. In study 1</b> we evaluated the potential of the new technique. The technique was well tolerated and easily applied. Pronounced neutrophil and eosinophil involvement in ulcerative colitis (UC) was demonstrated. With the high sensitivity of the technique, low-degree mucosal neutrophil activation could also be quantified in patients with collagen colitis,UC in clinical remission and in patients with irritable bowel syndrome. <b>In study 2 and 3</b> the aim was to elucidate the dynamics of the rectal inflammatory response and nitric oxide (NO) production after rectal gluten challenge. We found a pronounced neutrophil activation in coeliac patients after rectal gluten challenge. This activation was apparent 4 hours after challenge and remains for at least 48 hours. A more modest eosinophil activation started 1-2 hours later and remained at least for 48 hours. The biphasic pattern of neutrophil and eosinonphil activation after challenge suggests a biphasic inflammatory reaction. The activation of neutrophils and eosinophils precedes a pronounced enhancement of mucosal NO production. Some of our coeliac patients displayed signs of an inflammatory reaction after rectal corn gluten challenge. <b>In study 4</b> the aim was to investigate the local inflammatory reaction to gluten and cow’s milk protein in CD patients in remission. The findings indicate that not only gluten sensitivity but also cow’s milk (CM) protein sensitivity is common in CD. The data support the hypothesis that CM sensitivity may contribute to persistent symptoms in coeliac patients on gluten-free diet.

No description available.

Tato diplomová práce byla psána při studentské zahraniční stáži, pod záštitou Evropské Unie – program „ERASMUS Student Mobility for Placement“. Stáž byla absolvována mezi prosincem 2010 a květnem 2011 ve společnosti a.d.Tramontana, mající sídlo v Palau de Santa Eulália, Španělsko. Pro kompletní návrh podvozku a odpružení jakéhokoli vozidla je nezbytná znalost mnoha technických disciplín. Tato diplomová práce se zabývá dvěma z nich – odpružení a řízení. Nejprve je rozebrána teorie, na kterou se může navázat v praktické části práce. Velká pozornost byla věnována srozumitelnosti textu a názornosti obrázků, bez zbytečných detailů, avšak bez vynechání důležitého. Tuto práci je tedy možné užít jako prvního kroku před návrhem podvozku. V další části je popsáno, jak byla probraná teorie využita při návrhu řízení u skutečného vozu, přičemž největší pozornost je věnována Ackermannově teorii řízení a geometrii zabraňující samořízení při propružení. V závěrečných částech je pozornost věnována ukázce některých z každodenních činností v malosériové výrobě automobilů – jde o zjištění maximálně možného pohybu kola při propružení a proces výroby příčných trojúhelníkových ramen včetně návrhu jejich připevnění k šasi.