Comparative study of the substantia nigra echogenicity and 123I-Ioflupane SPECT in patients with synucleinopathies with and without REM sleep behavior disorder.

OBJECTIVES: Hyperechogenicity of the substantia nigra (SN) and abnormal dopamine transporter-single-photon emission computed tomography (DAT-SPECT) are biomarkers commonly used in the assessment of prodromal synucleinopathy. Our goals were as follows: (1) to compare echogenicity of SN in idiopathic rapid eye movement (REM) behavior disorder (iRBD), Parkinson's disease (PD) without RBD (PD-noRBD), PD with RBD (PD + RBD), and control subjects; and (2) to examine association between SN degeneration assessed by DAT-SPECT and SN echogenicity. PATIENTS/METHODS: A total of 61 subjects with confirmed iRBD were examined using Movement Disorders Society-unified PD rating scale (MDS-UPDRS), TCS (transcranial sonography) and DAT-SPECT. The results were compared with 44 patients with PD (25% PD + RBD) and with 120 age-matched healthy subjects. RESULTS AND CONCLUSION: The abnormal SN area was found in 75.5% PD, 23% iRBD and 7.3% controls. Median SN echogenicity area in PD (0.27 ± 0.22 cm2) was higher compared to iRBD (0.07 ± 0.07 cm2; p < 0.0001) and controls (0.05 ± 0.03 cm2; p < 0.0001). SN echogenicity in PD + RBD was not significantly different from PD-noRBD (0.30 vs. 0.22, p = 0.15). Abnormal DAT-SPECT was found in 16 iRBD (25.4%) and 44 PD subjects (100%). No correlation between the larger SN area and corresponding putaminal binding index was found in iRBD (r = -0.13, p = 0.29), nor in PD (r = -0.19, p = 0.22). The results of our study showed that: (1) SN echogenicity area in iRBD was higher compared to controls, but the hyperechogenicity was present only in a minority of iRBD patients; (2) SN echogenicity and DAT-SPECT binding index did not correlate in either group; and (3) SN echogenicity does not differ between PD with/without RBD.

Transcranial Sonography of the Insula: Digitized Image Analysis of Fusion Images with Magnetic Resonance.

Purpose: Transcranial B-mode sonography (TCS) of brain parenchyma is increasingly used as a diagnostic tool for movement disorders. Accordingly, experimental B-Mode Assist software was developed to enable digitized analysis of the echogenicity of predefined brain regions. The aim of the study was to assess the reproducibility of digitized TCS image analysis of the insula. Materials and Methods: A total of 130 patients with an indication for neurosonological examination were screened for participation in the study. The insula was imaged from the right temporal bone window using Virtual Navigator and TCS-MRI (magnetic resonance imaging) fusion imaging. All subjects were examined three times by two experienced sonographers. Corresponding images of the insula in the axial thalamic plane were encoded and digitally analyzed. Interclass correlation coefficient (ICC) and Spearman's rank correlation coefficient were used for the assessment of intra- and inter-reader as well as intra- and inter-investigator reliabilities. Results: TCS images of 114 patients were evaluated (21 patients with TIA, 53 patients with headache, 18 patients with essential tremor, 22 patients with neurodegerative disease). 16 patients were excluded from analysis due to insufficient bone window. The intra-reader, inter-reader, intra-investigator and inter-investigator ICCs/Spearman's rank correlation coefficients were 0.995/0.993, 0.937/0.921, 0.969/0.961 and 0.875/0.858, resp. Conclusion: The present study demonstrates a high reliability to reproduce echogenicity values of the insula using digitized image analysis and TCS-MRI fusion images with almost perfect intra-reader, inter-reader, intra-investigator and inter-investigator agreement.

Experimental oral and ocular Encephalitozoon cuniculi infection in rabbits.

Encephalitozoon cuniculi is an obligate intracellular pathogen that has a wide host distribution, but primarily affects rabbits. The aim of this study was to characterize both the cell-mediated and the antibody response in rabbits after experimental infection using 2 different infection routes: oral and ocular. SPF rabbits were infected with low (10³ spores) and high (107 spores) infection doses. Monitored parameters included clinical signs, detection of spores in urine, antibody response detected with ELISA, and cell-mediated immunity detected by antigen-driven lymphocyte proliferation. At week 13 post-infection, half of the rabbits in each group were suppressed by intramuscular administration of dexamethasone. At week 18 post-infection, animals were euthanized. Clinical signs were mild with exacerbation after immunosuppression. Spores in urine and antigen-specific cell-mediated immunity were detected from weeks 5 and 4 post-infection, respectively. Specific IgM was detected 1 week after infection, and IgG antibodies followed 1 week later in rabbits infected with the high dose. Immunological responses were dose dependent. The authors can conclude that both oral and ocular experimental infection with E. cuniculi resulted in an immune response of the infected animals. Rabbits could be used as an experimental model for the study of ocular microsporidiosis.

[News and perspectives in uterine fibroids radiotherapy]. / Novinky a perspektivy v radiologické lécbe delozních myomu.

Uterine artery embolization (UAE) represents radiological treatment of uterine fibroids. It is highly effective and safe mainly in premenopausal patients with symptomatic fibroids and represents an alternative to hysterectomy in a group of women not suitable for minimally invasive surgical treatment (LAVH) and women desiring uterus sparing therapy. The future of UAE lies in optimal selection of patients based on volume-shrinkage prediction and fertility outcome. The second group is represented by methods based on direct fibroid tissue destruction using specific energy under MRI or UZ guidance. The common aim of these two groups is the volume shrinkage as well as the symptomatic relief. The second group is represented by radiofrequency ablation, focused ultrasound surgery, interstitial laser ablation and cryotherapy. Based on their non-surgical, percutaneous approach these can be classified as minimally-invasive methods. The second group of methods is suitable only for patients with the absence of any desire for child bearing due to the absence of their long-term outcome data.

[Multidisciplinary cooperation in the management of serious bleedings complicating necrotizing pancreatitis--a case review]. / Multioborová spolupráce pri osetrení závazného krvácení komplikující prubeh nekrotizující pankreatitidy--kazuistika.

Acute necrotising pancreatitis is connected with a high complication rate. The most serious ones are hemorrhagic complications with bleeding from vascular structures erosions. Authors report a case of endovascular treatment of surgically untreatable lesion of portal vein. In this case stentgraft was successfully implanted to cover the erosion and stop the bleeding. Percutaneous transhepatic route was used.

Commercially available rabbit anti-human polyclonal antisera as a useful tool for immune system studies in veterinary species.

We have used selected rabbit anti-human polyclonal antibodies as an example of useful and easily available tools for studies on immune system structure and development in important veterinary species, many of which also represent animal models in biomedicine. The cocktail of anti-human Igkappa-FITC/anti-Iglambda-RPE F(ab')(2) fragments was used for two-colour and, in combination with the cross-reactive anti-CD79alpha monoclonal antibody HM-57, for three-colour flow cytometry of canine, feline, bovine and porcine peripheral B-cells. A possible application of such immunoreagents in studies on primary B-cell differentiation has been suggested in pigs; the same approach can be used in other species of interest. Rabbit anti-human lactoferrin-FITC F(ab')(2) fragment was used for visualizing neutrophils in dogs, pigs and cattle and an application for two-colour immunophenotyping of canine granulocyte subsets has been designed. Affinity isolated rabbit anti-human CD3 and anti-human TdT have been shown to represent a ready-to-use tool for in situ studies on primary T-lymphopoiesis in pigs with possible extensions both to the B-lineage development in pigs and other animal models. Altogether, our study show that carefully selected polyclonal antibodies available on the market may possess broad cross-reactivity with important applications in veterinary research.

[Remarks on embolization of uterine fibroids]. / Praktické poznámky k embolizaci delozních myomú.

OBJECTIVE: To give a systematic comment on uterine artery embolization for the treatment of uterine fibroids. DESIGN: Expert comment. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and General Faculty Hospital, Charles University, Prague. METHODS: The analysis of results of the group of patients treated with uterine fibroid embolization in our facility in the years 2001-2005. RESULTS: Opinions of the multidisciplinary team, specialized in complex therapy of uterine fibroids were summarized. On the base of experience with more than 110 patients treated with uterine fibroid embolization we worked up practical comments on indications, cover and implementation of the procedure, and on suggested studies pre and post-procedurally with regard to expected effect and possible complications. CONCLUSION: Uterine artery embolization is a minimally invasive procedure with large symptomatic potential in therapy of post-fertile females with leiomyomas. The indication of such therapy for pregnancy planning women is controversial and needs thorough individual consideration about benefits and risks of embolization and its comparison with standard therapy (myomectomy). Organizing of the whole procedure (preoperative studies, equipment and experience of interventional radiologist, pain management, handling with complications) is challenging and should be performed by specialized teams and centers.

[Combined treatment of uterine myoma (uterine arteries embolization followed by laparoscopic myomectomy)]. / Kombinovaná lécba delozního myomu (embolizace uterinních arterií s následnou laparoskopickou myomektomii).

OBJECTIVE: The treatment of uterine myoma with pretreatment of uterine arteries embolization followed by laparoscopic myomectomy is presented. DESIGN: Case report. SETTING: Department of Obstetrics and Gynaecology 1st Medical Faculty of Charles University and General Faculty Hospital in Prague. SUBJECT AND METHOD: Forty two years old woman with uterine myoma was "pretreated" with uterine arteries embolization followed by laparoscopic myomectomy next day. The reason for this procedure was to improve in short period conditions for surgery and definitively solve uterine pathology. CONCLUSION: The "pretreatment" with uterine arteries embolization improves basically conditions and effect of uterine myoma surgery. This "two step procedure" could be recommended mainly for cases of large and vascularizated myomas.

[Management of uterine myomas in women of fertile age]. / Management delozních myomu u zen ve fertilním veku.

OBJECTIVE: Review of current knowledge about uterine fibroids management in young women. Analysis of possible diagnostic and therapeutic algorithms regarding fertility preserving. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. METHODS: Analysis of the facts in literature (texts in medical journals, monographies, textbooks, internet database Medline and Ovid) and authors' clinical experience. CONCLUSIONS: Alternatives of treatment of infertility in women with uterine fibroids have significantly enlarged in past 10 years. However none of the indicated methods is perfect. Expectation does not exclude the risk of growth of fibroids and abortion. The effect of pharmacological therapy is only temporary. Myomectomy is associated with the risk of surgical complications, fibroids' recurrence and uterine rupture in subsequent gestation. Although uterine artery embolisation (on an average) halves the fibroids volume, the long-term effect of the method on female fertility is still unknown. Nevertheless it seems convenient to advise the active approach to all women planning pregnancy and having significant (submucous or intramural) fibroid even before spontaneous or assisted conception. Most recent studies indicate significant improvement of reproduction outcomes after myomectomy, especially in young women with the absence of other factors of infertility. Only the results of randomized, controlled trials (that are still awaited) will inform us about comparison of the effects and risks of myomectomy and uterine artery embolization in management of infertility.

Endovascular brachytherapy of transjugular intrahepatic portosystemic shunt.

Purpose: To evaluate the technical feasibility and efficacy of endovascular brachytherapy with Iridium-192 in the prevention of restenosis caused by neointimal hyperplasia of transjugular intrahepatic portosystemic shunt (TIPS).Materials and Methods: The endovascular brachytherapy with high dose rate automatic afterloading system was performed in six patients with recurrent of stenosis of TIPS. We used a single dose fraction of 12 Gy delivered at 3 millimeter (mm) from the source axis to the stenotic vessel segment in five patients with spiral Z-stent, and 15 Gy at 5 mm in one patient with Wallstent.Results: Follow-up time ranged from 148 to 639 days. In one patient, restenosis occurred in the treated vessel segment, diagnosed 71 days after endovascular brachytherapy by doppler ultrasound. All other patients were, during the follow-up time, without restenosis in the irradiated vessel segment. Radiation-associated side effects were not observed.Conclusions: Endovascular brachytherapy of TIPS is technically feasible and may be done as a part of the percutaneous revision of the shunt. This pilot study may be the largest experience of treating TIPS restenosis in humans to date. For definitive conclusions, a lot of studies are needed.

Endovascular brachytherapy in the prevention of vascular restenosis.

PURPOSE: To evaluate the technical feasibility and efficacy of endovascular brachytherapy for prophylaxis of restenosis after femoropopliteal percutaneous transluminal angioplasty (PTA). MATERIALS AND METHODS: Ten patients with recurrence of stenosis in the femoropopliteal region underwent PTA followed by endovascular irradiation with Iridium-192 a high-dose rate after-loading technique. We used a single fraction of dose 12 Gy given in 3 mm from the source axis in the stenotic vessel segment. RESULTS: During follow-up of 59-580 days restenosis occurred in four patients 111, 460, 472 and 580 days after irradiation. All other patients are without restenosis. No radiation-associated side effects were observed. CONCLUSIONS: Endovascular brachytherapy of restenosis in the femoropopliteal region is technically feasible, and may be done as a part of the PTA. These encouraging results open the possibility of reduction of restenosis by the present method.

Value of Doppler sonography in revealing transjugular intrahepatic portosystemic shunt malfunction: a 5-year experience in 216 patients.

OBJECTIVE: The purpose of the study was to evaluate the long-term clinical efficacy of Doppler sonography in revealing failure of transjugular intrahepatic portosystemic shunts (TIPS). SUBJECTS AND METHODS: During a 5-year period, 1192 Doppler examinations were performed in 216 patients with TIPS. No regular follow-up shunt venography was performed. Doppler examinations were retrospectively compared with the results of shunt revisions. Sonograms with negative findings were compared with the patients' clinical status so that the number of false-negative sonographic findings leading to an episode of shunt failure (recurrence of gastrointestinal bleeding or ascites) could be ascertained. Sonographic parameters assessed included diameter, velocity, flow volume, and congestion index of the portal vein; and shunt velocities. RESULTS: Doppler sonography revealed shunt occlusion in 25 of 26 angiographically proven cases (sensitivity, 96%). The combination of velocity criteria (peak intrashunt velocity > or =250 cm/sec, maximum velocity in the portal third of the shunt < or =50 cm/sec, or maximum portal vein velocity less than or equal to two thirds of the baseline value) revealed shunt stenosis in 103 of 110 cases (sensitivity, 94%). Doppler sonography missed a significant shunt stenosis that led to an episode of gastrointestinal bleeding or ascites recurrence in only seven cases. The congestion index of the portal vein showed significant differences between patent and malfunctioning shunts (p < 0.001). CONCLUSION: Doppler sonography is an effective primary imaging method for long-term follow-up of patients with TIPS.

[Percutaneous aspiration thrombectomy in the popliteal and calf area--a 4-year experience]. / Perkutánní aspiracní trombektomie v popliteálním a bércovém recisti--4leté zkusenosti.

PURPOSE: Retrospective analysis of results of percutaneous aspiration thrombectomy (PAT) in the popliteal and tibioperoneal arteries in patients with primary and iatrogenic peripheral embolization and during intraarterial thrombolysis. MATERIAL AND METHOD: Percutaneous aspiration thrombectomy was used in 41 patients (42 arteries). In 12 cases this method was used as the first choice in treatment of the peripheral artery disease, in 14 cases during intraarterial thrombolysis and 16 times after iatrogenic embolization secondary to balloon angioplasty. An antegrade approach to the common femoral artery was performed in all cases. In 40 patients the aspiration thrombectomy was performed from the popliteal region and proximal parts of tibioperoneal arteries. RESULTS: Overall success (n = 42) was achieved in 67%, partial success in 23%. Aspiration thrombectomy was unsuccessful in. 10%. PAT was successful in 88% after iatrogenic peripheral embolization (n = 16), in patients during thrombolysis (n = 14) a good result was achieved in 40%, partial success in 50% and this method failed in 10%. Primarily performed aspiration thrombectomy (n = 12) in occlusion of peripheral arteries was successful in 50%. No major complications were recorded. CONCLUSION: PAT is a highly effective method in treatment of iatrogenic peripheral embolizations after endovascular procedures and effective accessory method in combination with intraarterial thrombolysis. This method can be used primarily in acute occlusion of distal popliteal artery.

Endovascular brachytherapy of transjugular intrahepatic portosystemic shunt.

PURPOSE: To evaluate the technical feasibility and efficacy of endovascular brachytherapy with Iridium-192 in the prevention of restenosis caused by neointimal hyperplasia of transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: The endovascular brachytherapy with high dose rate automatic afterloading system was performed in six patients with recurrent of stenosis of TIPS. We used a single dose fraction of 12 Gy delivered at 3 millimeter (mm) from the source axis to the stenotic vessel segment in five patients with spiral Z-stent, and 15 Gy at 5 mm in one patient with Wallstent. RESULTS: Follow-up time ranged from 148 to 639 days. In one patient, restenosis occurred in the treated vessel segment, diagnosed 71 days after endovascular brachytherapy by doppler ultrasound. All other patients were, during the follow-up time, without restenosis in the irradiated vessel segment. Radiation-associated side effects were not observed. CONCLUSIONS: Endovascular brachytherapy of TIPS is technically feasible and may be done as a part of the percutaneous revision of the shunt. This pilot study may be the largest experience of treating TIPS restenosis in humans to date. For definitive conclusions, a lot of studies are needed.

[Percutaneous therapy of obliterative disease of the femoropopliteal arteries using stents--2 years' experience]. / Perkutánní lécba obliterujících onemocnení femoropopliteálních tepen pomocí stentu--2leté zkusenosti.

PURPOSE: To evaluate the clinical results and short and mid-term stent patency in patients with femoropopliteal stent placement. MATERIAL AND METHODS: Forty-one patients (42 limbs) underwent stent placement--27x into superficial femoral artery, 15x into popliteal artery. There were inserted 44 self-expandable stents. In 3 cases PTA of stents and in 2 cases local endovascular brachytherapy were performed because of restenosis. The mean follow-up is 12.9 months (1-24 months). RESULTS: Stents were successfully inserted in all cases. Clinical improvement at the time of latest follow-up occurred in 77% of patients, no improvement in 13% and clinical worsement in 10% of patients. Primary patency rates at 6 months, 12 an 24 months were 83.8%, 67.7% and 67.7%, respectively. Primary assisted patency were 90.3% at 6 months, 77.4% at 12 months and 77.4% at 24 months. CONCLUSION: Stents implantation in femoropopliteal arteries is a method of choice after suboptimal angioplasty results in patients with critical limb ischemia for whom no reasonable surgical alternative exists.

[Surgical interventions in dialysis fistulae]. / Intervencní výkony na dialyzacních pístelích.

PURPOSE: To evaluate the efficacy, feasibility and safety of interventional procedures in patients with hemodialysis shunts in retrospective analysis. We report the technical success rate and the midterm primary and secondary patency rate in our patients. MATERIAL AND METHODS: Between April 1996 and May 1999 (35 months) we performed 129 interventional procedures on hemodialysis shunts in 87 patients (40 women and 47 men in age 22-88 years, mean age 67 years). We treated 46 occlusions and 83 stenoses. There were native fistulas--63 radiocephalic fistulas, 7 brachiocephalis fistulas, 1 brachiobasilic fistula, and hemodialysis grafts--14 vein allografts and 2 synthetic PTFE grafts. Indication for fistulography and intervention was decreasing efficacy of hemodialysis (in case of stenosis) or shunt occlusion. Patients were treated by means of percutaneous transluminal angioplasty, thrombolysis and percutaneous mechanical thrombectomy with hydrolyser or with thrombectomy basket. Stents were placed twice. Once in suboptimal result of local thrombolysis, second time in case of central venous stenosis. Follow up ranged from 0.3 to 35 months (mean 11 months). Nine patients were lost for follow up, 15 patients died during follow up. RESULTS: Overall technical success rate was 84% (108 procedures, n = 129), technical success in cases of occlusion was 57% (27 procedures, n = 46), in stenoses treatment was 98% (81 procedures, n = 83). Overall primary patency rate in 6 months is 40% (n = 59), in 12 months 24% (n = 59) and in 2 years 5% (n = 59). The primary assisted patency rate and secondary patency rate is 95% (n = 59) in 6 months, 88% (n = 59) in one year and 73% (n = 59) in two years. CONCLUSION: Repeated percutaneous interventional procedures in patient with hemodialysis shunts can extent shunt patency. Despite relatively low primary patency rate we can achieved good primary assisted or secondary patency rate in patients with stenoses of shunt.

[Revascularization of the aortoiliac arteries using stents]. / Revaskularizace v aortoilických tepnách pomocí stentu.

The authors summarised their three year experience with endovascular treatment of the aortoiliac artery obstructive lesions using stents and transluminal angioplasty. Fifty-seven patients (61 limbs) underwent stent implantation to treat claudications (n = 50 limbs), rest pain (n = 6), non-healing defects (n = 4) and one patient was asymptomatic (n = 1). After stent placement patients were followed-up using clinical and duplex ultrasound examinations at 3 months and 6 months thereafter. Immediate angiographic success was achieved in all cases. Three serious complications were observed. Percutaneous reinterventions because of stenosis inside the stent were performed in 7 patients (7 limbs). The primary patency rates were 92% at 1 year, 88% at 2 years and 86% at 3 years. Cumulative primary assisted patency were 98% (mean follow-up 15.8 months, range 3-47 months). Regular clinical and ultrasound follow-up examinations can reveal the asymptomatic instent stenosis and percutaneous reinterventions can improve long-term stent patency.

[Interventional procedures in patients after vascular reconstructive surgery of the lower extremities]. / Intervencní výkony u nemocných po cévních rekonstrukcních operacích na dolních koncetinách.

This study reports the results and complications of local thrombolysis therapy of recently occluded grafts manifested by acute ischemia in comparison with transluminal angioplasty of graft stenoses. Stenoses were diagnosed by means of ultrasound (asymptomatic patients) or manifested by claudications. The aim of our study is to emphasize the difference between efficacy of these two kinds of treatment and their difficulties. Fourty three patients were treated in the period of 39 months (March 1994-June 1997). Sixty seven interventional procedures were done, including 32 local thrombolysis in 20 patients and 35 angioplasties in 23 patients. Types of grafts were: aortofemoral (n = 8), ilicofemoral (n = 4) and one aortotibioposterior, femoropopliteal vein (n = 18) and synthetic (n = 9) and two distal tibioposterior bypasses. Fourty one bypasses were created due to arteriosclerotic occlusion, one for traumatic amputation and one due to stenosis after perinatal catheterization. The period between surgery and intervention varied from 1 month to 11 years (mean 33 months), the mean follow up period was 13 months. Technical success rate in patients treated by local thrombolysis was 69% (n = 22). Midterm graft patency in the this group is 40% (n = 8) with 95% (n = 19) limb salvage. In patients treated by transluminal angioplasty was technical success rate 97% (n = 34). In this group is patent 96% (n = 20) bypasses with 31% (n = 4) restenoses. All patients with patent grafts have a good run-off with at least 2 patent calf arteries. Six complications occurred during local thrombolytic therapy. Our results indicate that despite of the high initial success rate are the late results poor in the group treated by thrombolysis because of the high rate of rethromboses. The result depends on number of patent calf arteries. Results in patients treated by angioplasty only are much better with lower risk of complications during procedure. Our results prove that it is better to follow patients after lower limb bypass surgery by ultrasonography and perform angioplasty when stenoses occur.

Stimulation of cell defense mechanism of bovine endometrium by temporal colonization with selected strains of lactobacilli.

The aim of the experiments was to assess the response to topical administration of selected live strains of lactobacilli of the cells responsible for the resistance of bovine endometrium. Experimental cows (n = 8) at 8 to 12 days of the estrous received one intrauterine dose of 20 ml of a suspension of lactobacilli in 1% glucose solution. Group I (n = 4) was treated with the strain Lactobacillus spp. G 013 (5.5 x 10(8) CFU/ml) and Group II (n = 4) with the strain Lactobacillus casei CCM 1753 (1.2 x 10(8) CFU/ml). Control cows (n = 4) received 20 ml of 1% glucose solution. Samples of endometrial tissue were obtained by biopsy or from slaughtered cows on post-treatment days 5 or 6 and/or 10 or 12. Colonization of the uterine cavity with lactobacilli for up to 12 days was confirmed by bacteriological examination and scanning electron microscopy. Highly significant increases (P < 0.01) were found in numbers of all cell types under study. The pronounced cellular infiltration of endometrium was mostly due to the accumulation of mononuclear cells, particularly lymphocytes forming often indistinctly demarcated lymphoid nodules. Also marked was the infiltration of mast cells and macrophages. The cellular infiltration of endometrium persisted still on post-treatment day 12. No signs of alteration of epithelial cells were observed. No principal differences in the effects on endometrium were found between the two lactobacilli strains. The proved stimulatory effect of lactobacilli on endometrial cell defense mechanisms demonstrated in our experiments and inhibitory effects of the former on the growth of pathogenic microorganisms are promising for practical application in the prevention and alternative therapy of bovine endometritis.

[Endovascular treatment of abdominal aortic aneurysms. Morphology of aneurysms as one of the deciding indicating factors]. / Endovaskulární lécba aneuryzmat abdominální aorty. Morfologie aneuryzmatu jeden z rozhodujících momentu v indikaci.

Endovascular treatment of aneurysms of the abdominal aorta is based on intravascular bridging of the aneurysm using of an endovascular prosthesis. The prosthesis must be safely anchored above and below the sac of the aneurysm in the non-dilated artery. Therefore the indication of endovascular treatment depends on the morphology of the aneurysm. The objective of the work was to analyse the morphology of the aneurysm with regard to the possibility of endovascular treatment. The morphology of the aneurysm was evaluated with regard to the angiographic examination and examination by computed tomography. The following parameters were investigated: diameter and length of the proximal and distal neck, diameter of the sac in two planes, diameter and tortousity of the iliac arteries, tortousity of the infrarenal aorta. A total of 70 patients with aneurysms of the abdominal aorta were examined. The patients were divided into three groups according to the morphology of the aneurysm. I. infrarenal aneurysms not affecting common iliac artery (n = 20) 28.5%, II. infrarenal aneurysms affecting common iliac artery (n = 38) 54.2%, III. juxtarenal aneurysms regardless of the affection of common iliac arteries (n = 12) 17.1%. Of the total of 70 examined patients 24 (34.2%) with infrarenal aneurysm and 6 (8.57%) with juxtarenal aneurysm were suitable for endovascular treatment.