Institute for Care of Mother and Child

Prague, Czech Republic

Institute for Care of Mother and Child

Prague, Czech Republic
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Dankovcik R.,University of P.J. Šafarik | Dankovcik R.,R.Ø.S.A. | Muranska S.,R.Ø.S.A. | Kucera E.,Charles University | And 7 more authors.
Fetal Diagnosis and Therapy | Year: 2012

Encephalocystocele is a developmental malformation characterized by brain herniation accompanied with extracranial cystic protrusion of the ventricular system. This nosological unit is often overlooked and insufficiently classified merely as encephalocele. Herein, two exceptionally clear cases of the parieto-occipital cranioschisis with encephalocystocele and congenital hydrocephalus of the lateral ventricles are documented with 2-dimensional/3- dimensional sonographic images and the corresponding MRI findings. In both cases, prenatal diagnosis was confirmed by autopsy. © 2012 S. Karger AG, Basel.

Feola A.,The Surgical Center | Feola A.,Catholic University of Leuven | Endo M.,The Surgical Center | Endo M.,Catholic University of Leuven | And 12 more authors.
American Journal of Obstetrics and Gynecology | Year: 2015

Objective We aimed to characterize the effect of vaginal or abdominal mesh insertion and of different collagen augmentation of polypropylene mesh in a sheep model. Outcome measures were passive and active biomechanical properties and semiquantitative morphometry. Study Design Forty-two Texel sheep were used: 6 were nonimplanted controls (n = 6), the rest were implanted with polypropylene mesh (n = 12; Avaulta Solo; Bard Medical, Covington, GA) or collagen-coated meshes: Avaulta Plus (n = 12; Bard Medical) and Ugytex (n = 12; Sofradim International, Trevoux, France). Through a single incision, the rectovaginal septum was dissected and a 35 × 35-mm mesh was sutured to the underlying tissues. Abdominally, a 50 × 50-mm mesh was laid over a primarily sutured full thickness 40-mm longitudinal incisional defect. Animals were explanted after 60 or 180 days (n = 6 per group). Outcome measures were passive biomechanics by biaxial tensiometry, active contractility of vaginal explants, and histologic evidence. Results Vaginal explants were 2.4 times stiffer compared with native vaginal tissue (P <.001), but without differences in comfort zone stiffness or slope of the load-elongation in the physiologic range between the products that were tested. Collagen coating was associated with a 16-fold reduction in contractile force at 180 days, compared with native vaginal tissue, both for Avaulta Plus (P =.032) and Ugytex (P =.015). Abdominal explants were 1.3-times stiffer compared with native abdominal wall tissue (P <.001) and were 1.9-times stiffer compared with vaginal explants. Conclusion Vaginal mesh implantation yields less stiff explants compared with abdominal explants. Vaginal mesh implantation also alters the passive and active biomechanical properties compared with native vaginal tissues. Collagen matrices did not reduce the number of graft-related complications. © 2015 Elsevier Inc.

Turyna R.,Institute for Care of Mother and Child | Turyna R.,Charles University | Kachlik D.,Charles University | Kucera E.,Institute for Care of Mother and Child | And 3 more authors.
Journal of Anatomy | Year: 2013

The purpose of this study was to describe the distribution and structure of ventral tributaries leading into the inferior vena cava where right-sided paraaortic lymphadenectomy is performed. The study examined 21 retroperitoneal specimens by graphic reconstruction, statistical evaluation, and histological examination of ventral tributaries (VTs). Seventy VTs were identified. The average number per specimen was 3.33. There were 20, 40, and 40% of VTs found in Levels I, II, and III, respectively. During the preparation, we observed an unusual arrangement of the IVC wall, into which VTs were led through a preformed sleeve-like channel and anchored near the lumen. This finding is a key mechanism that explains the ease with which VTs are extracted during surgery. Knowledge of the distribution and histological structure of VTs allows proper orientation of the retroperitoneal area of the front wall of inferior vena cava, which is essential for uncomplicated right-sided paraaortic lymphadenectomy. The histological structure of the VT ostium within the wall of the inferior vena cava explains why injury is easy during the procedure. © 2013 Anatomical Society.

Janota J.,Thomayer Hospital Prague | Janota J.,Charles University | Sebkova S.,Thomayer Hospital Prague | Sebkova S.,Institute for Care of Mother and Child | And 4 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2014

Aim: To assess the impact of a hand hygiene protocol, using hand washing, alcohol hand rub and gloves when caring for preterm infants born after 31 weeks of gestation, on the incidence of neonatal late onset sepsis (LOS). Methods: All babies delivered between 32 + 0 and 36 + 6 weeks gestation and admitted to the neonatal intensive care unit during a 14-month period were included. We followed a hand hygiene protocol with hand washing and alcohol hand rub (hand rub period) for the first 7 months and a protocol of hand washing, alcohol hand rub and gloves (gloves period) for the second 7 months. The hand rub and gloves groups consisted of 111 and 89 patients, respectively. Results: Five patients were diagnosed with a total of six episodes of LOS in the hand rub group, and the incidence of LOS during the hand rub period was 2.99/1000 hospital days and 54.1/1000 admissions. There were no patients diagnosed with LOS during the gloves period (significant decrease, p = 0.028). Conclusion: Using a hand hygiene protocol with hand washing, hand rub and gloves significantly reduced the incidence of LOS in preterm newborns, and the results suggest that it may produce a sustained improvement in the infection rate. ©2014 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.

Turyna R.,Charles University | Turyna R.,Institute for Care of Mother and Child | Kachlik D.,Charles University | Feyreisl J.,Institute for Care of Mother and Child | And 2 more authors.
Clinical Anatomy | Year: 2014

The aim of the study was to gain a thorough knowledge of the topography and distribution of until now officially unnamed minute direct branches from abdominal aorta, stemming from its ventral and lateral aspects, supplying surrounding tissue, and to comprise it to the existing studies. The study was performed in fixed cadaverous material collected from India ink injections of abdominal aorta samples with large surrounding retroperitoneal tissue. The 25 samples were dissected under magnifying binocular glass, followed by graphic reconstruction; statistical analysis, and the study was preceded with detailed review of branches from abdominal aorta. For systematization of the segmental anatomy of the abdominal aorta and infrarenal segment of inferior vena cava, we defined three levels in this area. The retroperitoneal branches were most frequently situated simultaneously within all three predefined levels according to renal and inferior mesenteric arteries origin. There were 18% of retroperitoneal branches within Level 1, 39% within Level 2 and 43% within Level 3. They were branches not only from the abdominal aorta, but also from the testicular/ovarian artery, common iliac artery and in one case from the right accessory renal artery. Paired arrangement was recorded mainly cranially to the origin of inferior mesenteric artery, unpaired branches were more frequently found caudally. In conclusion, due to the terminological disunity of these arteries in the clinical literature and total absence in the anatomical literature, we propose to denominate them as anterior retroperitoneal branches of abdominal aorta (rami retroperitoneales anteriores aortae abdominalis). © 2014 Wiley Periodicals, Inc.

Lodinova-Zadnikova R.,Institute for Care of Mother and Child | Prokesova L.,Charles University | Kocourkova I.,Institute for Care of Mother and Child | Hrdy J.,Charles University | Zizka J.,Charles University
International Archives of Allergy and Immunology | Year: 2010

Background: The objective is to study the effect of after-birth oral colonization by a probiotic Escherichia coli strain in infants of allergic mothers to reduce occurrence of allergy later in life. Methods: In a controlled clinical trial, 158 infants were randomly divided into groups of (i) 56 colonized infants of allergic mothers, (ii) 57 control infants of allergic mothers, and (iii) 45 control infants of healthy mothers. Incidence rates of bacterial pathogens in stool and levels of anti-E. coli immunoglobulins and some cytokines in serum were determined, and secretory IgA was monitored in stool filtrates and maternal milk. Clinical check-ups of infants aged 4 days, 3 and 6 months, 2, 3 and 5 years were carried out and clinical symptoms of allergy were monitored. One milliliter of the probiotic E. coli strain was administered to infants of allergic mothers at first within 48 h after birth and subsequently 3 times a week over a period of 4 weeks. Control infants of allergic and healthy mothers were monitored in these intervals as well. Results: Presence of the E. coli strain was monitored in stool samples throughout the study. At the conclusion of the study, allergy symptoms were found in 14 infants of control allergic mothers, 7 infants of healthy mothers, and in 2 colonized infants of allergic mothers. Colonization affected levels of several cytokines and specific anti-E. coli antibodies. Conclusions: After birth, targeted colonization of the intestine by a probiotic E. coli strain can be an effective means of allergy prevention in infants of allergic mothers. Copyright © 2010 S. Karger AG, Basel.

Endo M.,The Surgical Center | Endo M.,Catholic University of Leuven | Urbankova I.,The Surgical Center | Urbankova I.,Catholic University of Leuven | And 11 more authors.
Gynecological Surgery | Year: 2015

The properties of meshes used in reconstructive surgery affect the host response and biomechanical characteristics of the grafted tissue. Whereas durable synthetics induce a chronic inflammation, biological grafts are usually considered as more biocompatible. The location of implantation is another determinant of the host response: the vagina is a different environment with specific function and anatomy. Herein, we evaluated a cross-linked acellular collagen matrix (ACM), pretreated by the anti-calcification procedure ADAPT® in a sheep model for vaginal surgery. Ten sheep were implanted with a cross-linked ACM, and six controls were implanted with a polypropylene (PP; 56 g/m2) control. One implant was inserted in the lower rectovaginal septum, and one was used for abdominal wall defect reconstruction. Grafts were removed after 180 days; all graft-related complications were recorded, and explants underwent bi-axial tensiometry and contractility testing. Half of ACM-implanted animals had palpable induration in the vaginal implantation area, two of these also on the abdominal implant. One animal had a vaginal exposure. Vaginal ACMs were 63 % less stiff compared to abdominal ACM explants (p = 0.01) but comparable to vaginal PP explants. Seven anterior vaginal ACM explants showed areas of graft degradation on histology. There was no overall difference in vaginal contractility. Considering histologic degradation in the anterior vaginal implant as representative for the host, posterior ACM explants of animals with degradation had a 60 % reduced contractility as compared to PP (p = 0.048). Three abdominal implants showed histologic degradation; those were more compliant than non-degraded implants. Vaginal implantation with ACM was associated with graft-related complications (GRCs) and biomechanical properties comparable to PP. Partially degraded ACM had a decreased vaginal contractility. © 2015, The Author(s).

Hlinka D.,Prague Fertility Center | Kalatova B.,University of P.J. Šafarik | Uhrinova I.,University of P.J. Šafarik | Dolinska S.,University of P.J. Šafarik | And 4 more authors.
Physiological Research | Year: 2012

Chronology of three consecutive mitotic events in human preimplantation embryos was examined by time-lapse imaging. In zygotes producing well-formed and pregnancy-yielding expanded blastocysts, uniform time-patterning of cleavage clusters (c) and interphases (i) was revealed: i2=11±1, i3=15±1, i4=23±1 h/c2=15±5, c3=40±10, c4=55±15 min. Oppositely, shortened or prolonged durations of one or more cell cycles were strongly predictive of poor implantation and development. Furthermore, trichotomic mitosis was discovered in 17 % of cases - zygotes cleaved into 3 blastomeres and 2-cell embryos into 5-6 cells (instead of normal 2 and 4). During conventional clinical assessment, such embryos are indistinguishable from normal, often considered just-in-course of the next cell cycle. Only detailed time-lapse monitoring paced at 10-minute intervals had proven all these embryos to be absolutely unviable, even in rare cases when they reduced their hypercellularity to normal cell counts via cell-cell fusion. Overall, we demonstrate that timelapse embryo cleavage rating (ECR) as a standalone diagnostic procedure allows for effective identification of viable early embryos with 90 % specificity, while elimination of good-looking but unviable embryos can be assumed with a specificity of 100 %. Thus, making this non-invasive and contactless approach worth of addition to routine embryo screening in clinical IVF programs. © 2012 Institute of Physiology v.v.i.

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