Neonatal pneumonia caused by Trichomonas vaginalis.

Neonatal pneumonia is mostly bacterial and other etiology is considered less frequently. We report a case of newborn whose neonatal pneumonia has not improved, despite the aggressive ventilation regime and empiric antibiotic therapy. A special sample from the respiratory tract was collected for PCR examination. The test confirmed the presence of Trichomonas vaginalis. Antibiotic therapy was extended to include metronidazole. Targeted antibiotic therapy, which lasted for 28 days, improved the condition and the patient was discharged in a stabilized condition to home care on the 44th day of life. We demonstrate the need to consider atypical pathogens in the case of infections that do not respond to conventional therapy. The multiplex real-time PCR technique was used to detect the DNA of the pathogen. Targeted antibiotic therapy is the result of pathogen identification.

Echogenic foci in fetal heart from a pediatric cardiologists point of view.

OBJECTIVES: To evaluate the occurrence and the significance of echogenic foci in the fetal heart and to assess the prognosis of the fetus and child. SETTING: Department of Pediatrics and Prenatal Cardiology, Department of Pediatrics, University Hospital, Faculty of Medicine, Ostrava. DESIGN: Original article. METHODS: A retrospective study was conducted between 2008-2017. Fetal echocardiography was performed in the second trimester of pregnancy in the study population. The identification of echogenic heart foci, and their follow up during and after the pregnancy were performed by a pediatric cardiologist. RESULTS: In the monitored period, a total of 27,633 fetuses were examined. Isolated cardiac hyperechogenic foci were detected in 3% (829/27,633) of the fetuses. The foci was found in 93%, 5%, and 2% in the left ventricle, mainly in valvular apparatus of the mitral valve, in the both ventricles, and in the right ventricle, respectively. In 1% (11/829) of the fetuses with cardiac echogenic foci, the others concomitant pathologies (tricuspid regurgitation, extrasystoles, renal pathology) were found. No genetic abnormalities were detected in the fetuses with cardiac hyperechogenic foci. CONCLUSION: The echogenic focus in fetal heart is a relatively common, mostly insignificant finding, with any serious consequences for the fetus and the child.

[Development of prenatal diagnostics of congenital heart defects, profit of standardized scanning planes]. / Vývoj prenatální diagnostiky vrozených srdecních vad, zisk z jednotlivých ultrazvukových projekcí.

OBJECTIVE: To audit the development and success rate of prenatal detection of congenital heart defects (CHDs), and to evaluate the effectiveness of diagnostics performed in standardized scanning planes. SETTING: Department of Pediatrics, University Hospital Ostrava. DESIGN: Retrospective study. METHODS: Ultrasound examination of fetal heart (fetal echocardiography) was performed in the second trimester pregnancy. The observed region was the Moravian-Silesian region; the assessment was performed in the retrospective study performed between 2000- 2016. The knowledge of all significant heart defects in the region, processing of data from genetic reporting, further examination of all prenatal pathologies by a pediatric cardiologist, presence of a pediatric cardiologist at all autopsies, with a precise description of the defect, birth of a pathological new-born at a specialized centre. Analysis of detected CHDs was performed in relation to the ultrasound scans used. RESULTS: During the monitored 17-year period, a total of 748 (3.8 cases per 1,000 foetuses) of prenatally identified and postnatally significant CHDs were observed in the total population of 198,300 foetuses. There were 53% (393/748) CHDs detected prenatally and 47% (355/748) of cases were not prenatally recognized. The effectiveness of CHD screening has improved progressively, from the initial 10% up to the current 74%. The best results were obtained using the basic four-chamber (4CH) scan; the results in practice gradually decreased, from the basic 4CH projection to the aortic arch. CONCLUSION: The effectiveness of prenatal detection of congenital heart defects gradually improves, namely in cases of hypoplasia and significant ventricular anomalies, with up to 100% prenatally detected cases in the past three years. The level of detection statistically decreases, from the four-chamber projection to out-flow tracts, great arteries and the aortic arch. Congenital heart defect is generally well detectable prenatally, and is usually observed as an isolated anomaly. The most important factors include a precise diagnosis, overall examination of the pregnancy and correct counselling provided for the affected family.

The effects of within stand disturbance in plantation forests indicate complex and contrasting responses among and within beetle families.

Plantation forests with timber production as the major function are highly fragmented and disturbed regarding the tree species composition and stand area. Their closed canopies also have different microclimatic conditions compared with better studied conservation areas. We studied three beetle families (click, longhorn, and rove beetles) with different ecological demands in lowland plantation forests dominated by Sessile oak and Norway spruce in the Czech Republic. Our main interest was how their species richness, abundance, diversity, body length, rarity, red-list status, species composition and individual species were driven by the main tree species, stand area and canopy openness. We analyzed 3466 individuals from 198 beetle species and the results revealed complex and contrasting responses of the studied beetle families - click beetles mostly preferred sun-exposure and spruce as the dominant tree species, longhorn beetles mainly preferred large stands, whereas rove beetles were mostly influenced by oak as the dominant tree species and increasing area. We also observed that some species had different preferences in plantation forests than is known from the literature. The main conclusions of our results are that the dominance of non-natural spruce plantations and a large stand area (both originating from artificially replanted large clear-cuts) did not affect the majority of the studied taxa as we expected. On the other hand, our results might have been influenced by other factor, such as the current small total area of the former vegetation, which in the past might have led to extinction debt; or a large area of other conifers in the surroundings that might have promoted conifer-associated fauna.

[Ectopia cordis - case report]. / Ektopie srdce - kazuistika.

OBJECT: Case report of ectopia cordis in a fetus at 23 weeks gestation. DESIGN: Case repor. SETTING: Obstetrics and Gynecology Clinic, University of Ostrava and University Hospital in Ostrava. METHODS AND RESULTS: We report a case of pentalogy of Cantrell variant in a 23-week fetus with an ultrasound finding of ectopia cordis, associated intracardial defects and omphalocele containing liver and guts. The patient opted for termination of pregnancy by using prostaglandins. Autopsy of the fetus revealed a cleft sternum and thoracic wall defect with nude ectopic heart-thoracic type and omphalocele containing liver and guts. Detailed examination of the heart revealed a double outlet right ventricle with a complete atrioventricular septal defect. Our study describes typical ultrasound findings in a correlation with autopsy findings. CONCLUSION: Ectopia cordis is a rare congenital malformation with an estimated incidence of 1:100 000 live births in developed countries. It is characterized by abnormal heart placement outside the thorax, mostly on the thoracoabdominal side. This form is often associated with pentalogy of Cantrell.

Glutamate carboxypeptidase II: an overview of structural studies and their importance for structure-based drug design and deciphering the reaction mechanism of the enzyme.

Recent years witnessed rapid expansion of our knowledge about structural features of human glutamate carboxypeptidase II (GCPII). There are over thirty X-ray structures of human GCPII (and of its close ortholog GCPIII) publicly available at present. They include structures of ligand-free wild-type enzymes, complexes of wild-type GCPII/GCPIII with structurally diversified inhibitors as well as complexes of the GCPII(E424A) inactive mutant with several substrates. Combined structural data were instrumental for elucidating the catalytic mechanism of the enzyme. Furthermore the detailed knowledge of the GCPII architecture and protein-inhibitor interactions offers mechanistic insight into structure-activity relationship studies and can be exploited for the rational design of novel GCPII-specific compounds. This review presents a summary of structural information that has been gleaned since 2005, when the first GCPII structures were solved.

[Risk factors in the medical history of pregnant women undergoing congenital heart defect prenatal screening]. / Rizikové faktory v anamnéze tehotných zen pri prenatálním screeningu vrozených srdecních vad.

AIMS: Evaluation of the congenital heart defects (CHDs) incidence and their prenatal detection rate in the Moravian-Silesian region. Presentation of fetal echocardiography as a screening method. Investigation of the relationship between risk factor and congenital heart defects. METHODOLOGY: Long-term study between 1999-2009. Overall evaluation of CHDs incidence and their follow-up and analysis of their link to possible risk factors. The data were collected from medical notes of the gynecologist and pediatric cardiologist in the region. Fetal echocardiography was performed as a primary screening during the second term of pregnancy. A number of 22 743 pregnant women were included in the study. When any pregnancy pathology detected, more detailed examination followed (extracardial diseases, chromosomal aberrations). RESULTS: In the observed period, there were a total of 453 significant CHD (3.55/1000 births). In prenatal phase 208 CHDs (45.9%) were diagnosed. At least one risk factor was mentioned in 15.9 % of the screened families. When compared with the group without and with any risk factor, the difference is significant (chi=7.28, p<0.0001). Mothers younger than 35 were compared with those aged 35 and older and the difference in values was not significant. However, generally, the probability of CHDs grow with age (GLM, z=2.468, p=0.013). CONCLUSIONS: Prenatal detection of CHDs has the highest success rate as a rutine screening method during the second trimester of pregnancy. We confirmed the existence of a higher occurrence of the CHD in the group of pregnant women with a history of risk factors in comparison with the group without such a history. The risk families should be offered a detailed examination by paediatric cardiologist skilled in fetal echocardiography. Heart defects are the most common morphology anomalies, mostly occuring as an isolated issue.

[Fetal tricuspid regurgitation]. / Trikuspidální regurgitace u plodu.

AIMS: To study the incidence and significance of fetal tricuspid insufficiency (TI). Evaluation of this incidence of physiological fetuses and of fetuses with congenital heart defects (CHDs). Possibility of prediction the other significant heart pathology or pathology of fetal circulation of fetuses with tricuspid regurgitation (TR). METHODOLOGY: The study was undertaken between June 2006 and 2010. Fetal echocardiography in the Moravian-Silesian region was mostly performed as a primary screening in the second term of pregnancy. The diameters of the right side of the heart (tricuspid valve annulus, pulmonary valve annulus, surface of the right atrium and diastolic size of the right ventricle) of fetuses with and without TI were evaluated. The pathology of the pregnancy was generally examined and delivery of the newborn was planned. The fetuses with TI were monitored and examined after delivery. RESULTS: In the observed period, 8 896 pregnancies were examined and we diagnosed 90 significant CHDs. TR occurred in 178 (2%) fetuses. Out of them 20 (11%) fetuses had a defined CHD or significant heart arrhythmia. The most critical CHD with TR was hypoplastic left heart syndrome. TI was insignificant in 158 (89%) fetuses. Progression of the significance of TR with the color Doppler mapping correlated with increased speed of flow. The parameters of the right side of the heart of fetuses with TI do not significantly differ from that of fetuses with a normal tricuspid valve. After the delivery of fetuses with TI, no CHD or chromosomal aberrations were confirmed. CONCLUSIONS: The detection of fetal TI during pregnancy is possible. In some fetuses, there is TI connected with some other CHDs which might be detected by fetal echocardiography what provides us detailed description and diagnosis. TI was always insignificant after a CHD had been eliminated and this TR in the fetus did not significantly affect haemodynamics and did not predict any pathology.

Peculiar clusters of daughter cells observed in Cryptococcus neoformans grown in sealed microtiter plates.

Cryptococcus neoformans was grown in 96-well microtiter plates sealed by foil which is less than 0.01 % permeable to oxygen. On day 14 of the cultivation, we observed peculiar clusters of small droplike daughter cells arranged around < or = 4 % of mother cells. The fact that most of the other cells had died indicates that few cells had been able to survive hypoxic conditions and escape the cell-cycle arrest. However, their daughters were unable to separate from them and to continue their proliferation under such conditions.

Lymphocyte activation receptors: new structural paradigms in group V of C-type animal lectins.

The structure-function relationship in group V of C-type animal lectins remains incompletely understood despite the new structures of NK (natural killer) cell receptors that have been solved recently. Recombinant, soluble forms of rat and human NKR-P1 and CD69 that we obtained after in vitro refolding were analysed by Fourier transform-ion cyclotron resonance MS and heteronuclear NMR ((1)H-(15)N correlation). In NKR-P1, calcium may not be removed by chelating agents because of the very high affinity of binding. In CD69, incorporation of calcium causes a structural shift in several amino acids important for the interaction with carbohydrates. Structural studies have also allowed us to understand an interesting preference of these receptors for either linear (NKR-P1) or branched (CD69) carbohydrate sequences.

Toward an optimal oligosaccharide ligand for rat natural killer cell activation receptor NKR-P1.

Aminosugars have a good affinity for the NKR-P1A protein, the major activating receptor at the surface of rat natural killer cells. We have systematically investigated the structural requirements of the recombinant soluble dimeric form of the receptor for its optimal carbohydrate ligands. While N-acetylD-mannosamine was the best neutral monosaccharide ligand, its participation in the context of an extended oligosaccharide sequence was equally important. The IC(50) value for the GalNAcbeta1 --> ManNAc disaccharide was nearly 10(-10) M with a further possible increase depending on the type of the glycosidic linkage and the aglycon nature. From the point of view of its availability, stability, and affinity for the receptor and a potential in vivo use, these studies are pivotal for the design of an oligosaccharide or glycomimetics suitable for further clustering into the multivalent glycodendrimers.

Synthesis of chitooligomer-based glycoconjugates and their binding to the rat natural killer cell activation receptor NKR-P1.

NKR-P1 protein is an important activating receptor at the surface of the rat natural killer cells. GlcNAc and chitooligomers were identified as strong activation ligands in vitro and in vivo. Their clustering brings about increase of their affinity to the NKR-P1 by 3-6 orders. Here we describe novel methodology for preparation of neoglycoproteins based on BSA carrying the chitooligomers (n = 2-5). Further on we developed novel methodology of the coupling of glycosylamines via aromatic-SCN activated linker both to protein or synthetic cores. Inhibition studies of chitooligomer glycoconjugates with the NKR-P1 receptor show that our neoglycoproteins are very strong ligands with high binding affinity (-log IC(50) = 13-15). In analogy with our previous observations with GlcNAc clustered on protein or PAMAM backbones the synthetic chitooligomer clusters should provide considerably better ligands in the in vivo antitumor treatment.

[Tetramisol, piperazine, and metrifonate treatment of experimental invasion by Ascaridia galli in chickens of differents ages]. / Lécba umelé invaze Ascaridia galli u ruzne starých kurat tetramisolem, piperazinem a metrifonátem

The authors studied the anthelminthic effectiveness of a single peroral application of tetramisol (40 mg per 1 kg 1. w.), piperazine (500 mg per 1 kg 1. w.) and metriphonate (50 mg per 1 kg 1.w.) in the artificial invasion by Ascaridia galli. A set of 118 chickens of the White Leghorn breed were subjected to a single invasion by 3000 or 1500 invasive eggs at the age of 6, 36, and 48 days. The inteseffectiveness and extenseffectiveness of the treatment with the tested preparations were examined on the fifteenth day after invasion; the examination was based on the findings of ascarids in the helminthological dissection performed 48 hours on the findings of ascarids in the melminthological dissection performed 48 hours after therapy. The numbers of ascarids in the tested animals were compared with those in the controls. A histological examination was carried out to study the tissue reaction in the intestine, liver, spleen, kidneys, heart, and brain. Tetramisol showed the highest effectiveness. The intenseffectiveness of this substance reached 89-100% in young as well as older chickens. Piperazine had a good effectiveness in older chickens (61-83%); in young chickens it was entirely ineffective. The intenseffectiveness percentage of metriphonate was almost at a zero level. The extenseffectiveness of tetramisol ranged between 20 and 100% (the low values are characteristic of a severe course of invasion). Piperazine showed an extenseffectiveness ranging from 17 to 67% only in older chickens in cases of a mild invasion; otherwise it was equal to zero. Metriphonate was entirely ineffective. The reflection of ascaridiasis in the tissue reaction of the host manifested itself as granulomatous changes in intestinal mucous membrane, as multiplied histiocytic elements and plasma cells, and inflammatory lymphocytic infiltrates in the liver parenchyma.