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Biomedical subjects

Irén Mikó

Publications and source records attributed to Irén Mikó.

At least 19 recordsLinked to original sources
PubMed2006

Cellular and serological changes in the peripheral blood of splenectomized and spleen autotransplanted mice.

BACKGROUND: Our department worked out a modified surgical form of spleen autotransplantation earlier, named "spleen apron method" introduced already into the clinical practice. Recently we tested the immunological changes in a group of patients autotransplanted with about 10-15% of their spleen, what was the at least always implantable amount after the severe splenic injuries. In the current work we aimed at measuring some cellular and serological changes in the peripheral blood of splenectomized and spleen autotransplanted inbred mice two and eight months after the operations in order to get more unambiguous results than that we could obtain in our patients with this technique. MATERIALS AND METHODS: We divided 96 two months old Balb/c female mice into eight groups (n = 12/group). The group of controls, sham operated, splenectomized and autotransplanted animals with two and eight months of survival time after the operations. During the autotransplantation we inserted the same amount of spleen, five slices, "chips," about 10-15% of total mass of spleen, into the greater omentum similarly as it was used in the patients. The concentration of serum proteins were measured by laser nephelometry. The lymphocyte subsets were analyzed by flow cytometry. RESULTS: We found that two months after the operations the number of CD 19+ B-cells increased in the splenectomized but decreased in the autotransplanted animals. Eight months after the operations the number of both CD3+ T and CD19+ B lymphocytes decreased both in the splenectomized and autotransplanted animals compared to the controls and sham operated mice. However, the numbers of T and B cells were slightly but not significantly higher in the autotransplanted than in the splenectomized mice. The serum level of IgM was also decreased in the splenectomized and autotransplanted mice at both time points, however, eight months after the operations the concentration of IgM was significantly higher in the autotransplanted group than in the splenectomized animals. CONCLUSION: The effects of autotransplanted "chips" were different at the various ages of the animals. Additionally, they showed some immunological benefit being quantitatively in accordance to the amount of the transplanted spleen. The elevated level of serum IgM what we found in the autotransplanted mice even with this amount of transplanted spleen eight months after the operations, however, might have the potentially greatest importance compared to splenectomy. These experiments can prove that the attempts for autotransplantation may have real perspectives but their efficacy depends on the amount of the successfully transplanted (saved) mass of spleen.

Animals↗
PubMed2006

[Conceptions about microsurgical education. What were 5,460 hours of microsurgical basic education enough for?].

Microsurgical education has an involuting role in the respects both of the effective clinical and successful research work. In Hungarian literature little number of paper can be found that deal with microsurgical educational methods, their results and efficacy. In our department for several decades we have taught the basics of microsurgery at different education levels (graduate and postgraduate), giving the possibility for practicing and developing as well. In this paper we summarize our educational objective and subjective experiences of more than 10 years and 5460 education hours in microsurgical basic courses. Besides the numeric summaries it became clear that the teacher's or tutor's and the candidates' experience and their ability to attain the basics of microsurgery are very important. According to our experience the most effective method is the education in small groups: one tutor and 2-3 candidates can reach the final goal, the basic microsurgical skill.

Clinical Competence↗
PubMed2005

Intrinsic laryngeal muscle reinnervation with nerve-muscle pedicle.

OBJECTIVE: To test the application of the nerve-muscle pedicle (NMP) technique for selective reinnervation of previously denervated posterior cricoarytenoid (PCA) muscle. METHODS: The left recurrent laryngeal nerve (RLN) was severed in 5 mongrel dogs, and an ansa cervicalis-sternohyoid muscle pedicle was sutured to the left PCA muscle. Three dogs underwent a sham operation. Videolaryngoscopy was performed, and electromyographic data were collected after 1 year on average. Finally, histologic analysis of the NMP was performed. RESULTS: The video records showed the return of mobility of the PCA muscle reinnervated by the NMP. EMG data as to show evoked polyphasic potentials showed also evidence of reinnervation of the PCA muscle. With immunohistochemical reaction (antineurofilament antibody+biotin) we could show neurofilaments and motor endplates in both sides in all 5 animals. CONCLUSIONS: The NMP technique could eliminate the need for arytenoidectomy and laterofixation in patients with unilateral or bilateral vocal fold paralysis. The quality of life and voice may be improved.

Animals↗
PubMed2005

[Can the injured spleen be preserved? Results of 20-year experiments].

Researches of different spleen salvaging techniques have begun in 1986 at our department. The early purpose was to develop new spleen preservation surgical techniques, such as spleen autotransplantation and spleen resection. Besides the morphological and radiological examinations we also performed different investigations including hemorheological, hemostaseological and immunological follow-up of the splenic function. From these parameters changes in red blood cell deformability and peripheral phagocyte activity could indicate the possible complications originated from the reduced splenic function. Recent paper takes a survey of these experiences.

Animals↗
PubMed2005

[Comparative hematologic and immunologic studies of patients with splenectomy and spleen autotransplantation].

We compared changes in haematological and immunological parameters of patients with splenectomy (n=24), splenectomy plus spleen autotransplantation (n=12) and healthy controls (n=23). In the autotransplantation group pieces of the removed spleen were placed into the omentum with good visible circulation. Significant alterations in the hematological status and in some immunological parameters were observed in both groups of patients who were operated on compared to those in the control group. There was no difference, however, between the results of the two groups of operated patients. Therefore, we emphasize the importance of vaccination in patients with spleen autotransplantation in order to prevent potential sepsis. In addition, we recommend the possible further use of spleen autotransplantation.

Adult↗
PubMed2005

[Early clinical experience with postoperative monitoring of a patient after laparoscopic splenectomy combined with spleen autotransplantation. A case report].

We performed splenectomy combined with spleen autotransplantation after blunt abdominal trauma by minimally invasive technique at the County Teaching Hospital in Kecskemét. In case of advanced post traumatic spleen injury, spleen autotransplantation (Furka's spleen chips) is a well-known method to try to avoid postsplenectomy syndrome. During the operation, when in situ preservation of the spleen is not possible, chips of spleen tissue are transplanted into the omentum. Function of the transplanted spleen tissue was monitored by scintigraphy. We describe two different types of spleen scintigraphy to check the viability of spleen chips.

Humans↗
PubMed2005

[Comparative investigation of the hematologic and immunologic effects of splenectomy and spleen autotransplantation in mice].

We have analysed the hematological and immunological effects of the Furka's spleen chip method of autotransplantation in Balb/c mice two and eight months after splenectomy and autotransplantation. Our results showed that the autotransplants had positive effect on the partial restoration of the damaged elements of both cellular and humoral immunity appearing after splenectomy. However, these beneficial effects may have some dependence of time and species.

Animals↗
PubMed2005

[The role of pneumoperitoneum and the "chimney effect" on the development of port site metastasis. A new experimental animal model using Furka's spleen tissue suspension].

Following the introduction of laparoscopic cholecystectomy, laparoscopic technology has been applied in many other fields of surgery, including surgery for malignancies, even before prospective, randomised trials were available. Many authors observed development of port site metastases following laparoscopic surgery in malignancies (1-2%). The studies report about the pathomechanism of the development of port site metastasis, some describe the role of pneumoperitoneum. We developed a new model to show the role of pneumoperitoneum and the "chimney effect" on the development of port site metastasis, using a large experimental animal with a suspension of its own spleen tissue. On follow up histology viable spleen tissue was found between the layers of the trocar incisions.

Abdominal Neoplasms↗
PubMed2005

[Autotransplantation of cryopreserved thyroid tissue in dogs].

According to literature data autotransplantation of thyroid tissue for postoperative hypothyroidism remain controversial in the clinical praxis. The aim of this study was to examine the possibility of autotransplantation of cryopreserved (196 degrees C) thyroid tissue pieces in the sternocleidomastoid muscles and in the "apron" formed by the flaps of the greater omentum, and to evaluate their function postoperatively in dogs. Twelve adult mongrel dogs were used in the study. Total thyroidectomy was carried out in all animals. The removed thyroid lobes were cut into 3-4 mm pieces and cryopreserved to -196 degrees C. The cryopreserved thyroid tissue pieces were inserted in the sternocleidomastoid muscle and into the greater omentum. Determination of T3 and T4 levels was carried out pre- and postoperatively. Before sacrificing the surviving animals, total body scans were performed using J131 isotope to assess the function and position of autotransplants. The isotope activity of transplants from the sacrificed animals was evaluated quantitatively and their structures studied histologically. The starting values of T3 and T4 levels of animals were between 0.5 and 0.62 mmol/l and between 10.4 and 14.3 mmol/l respectively. On the 4-6th postoperative days the T3 and T4 levels of all surviving animals decreased close to zero, but from the 7-8th days they gradually increased and in weeks 3-4 reached their starting values. Isotope scans of both the sternocleidomastoid region and the greater omentum showed a significant rise in activity, which was highly different from that of surrounding tissues. Quantitative data obtained by the ROI technique correlated with values obtained after removal of the labelled tissues. The presence of thyroid tissue in the labelled ones was histologically justified. The results show that is possible to preserve the function of cryopreserved thyroid segments from totally thyroidectomized dogs by autotransplanting the segments into the muscles of the neck or into the omentum.

Animals↗
PubMed2005

[Laparoscopic versus open cholecystectomy: reaction in the liver bed].

The aim of this study was to compare the incidence, size and localisation of adhesion formation following open and laparoscopic cholecystectomy and to determine immune and foreign body reactions in the liver bed. The experimental animals were divided into two groups: open (OC) versus laparoscopic (LC) cholecystectomy. In the 14th postoperative day the animals were reoperated, types and size of adhesion were measured and tissue samples were extracted from the liver bed for histology. Dense, curtain-like adhesions were formed in OC group. The adhesions developed not only in the operation area but also on other organs. The thread used to ligate the cystic duct and cystic artery caused foreign body reaction, which resulted in granuloma formation. Numerous macrophages, histiocyte giant cell reactions were also present in OC group. Considerable fibrosis was also observed in the majority of the animals. Slender adhesion formation formed after LC. It was mostly detected in the liver bed. Foreign body granulomas around the laparoscopic clips did not develop in the cases. Moderate inflammatory reactions were noticeable. Laparoscopic operative technique is less traumatic. Its advantage over the open technique is lower adhesion rate and better immune function and reaction. This operation technique is less immunosuppressive and development of adhesions is less compared to OC.

Abdomen↗
PubMed2005

[Teaching of microsurgery--in service of research and clinical practice].

We analyse the improving role of teaching microsurgery, the advantages of the microsurgical models in research and clinical practice. We summarize our experience in teaching basic microsurgery according to Furka's model in the last 15 years. The main characteristics of the principles are: activity, synchronism, video assistance, self-control, individualization, analysis. We show the curriculum of the courses for researchers and participants in graduate and postgraduate education, which consists dry-training on models followed by surgical interventions on rats. Summarizing of our practices: to learn the basic microsurgical techniques the participants need endurance, patience, and have to work hard. Effectiveness of the education is most successful if we organize small groups, if one teacher deals with a maximum of two or three candidates.

Biomedical Research↗
PubMed2005

[Intraoperative laser doppler flowmetry of the tissue microcirculation of extraperitoneal transplanted omental flaps on dogs].

The aim of this study was to develop a new method to check of the viability of an extraabdominally transplanted omental flap. We performed free omental transplantation to the left lateral neck region in the frame of a formerly published new esophageal resection series on 5 dogs. Intraoperative laser Doppler flowmetry was performed, before and after isolation, after transplantation, and 14 days after the operation. From the 5 transplanted flaps, 4 survived the transplantation. The flap microcirculation deteriorated immediately after the transplantation, but at the time of re-operation the measurements showed similar microcirculation as control tissues, which proves the viability of the transplanted flaps. In our opinion, in dogs for the intraoperative monitoring of viability and microcirculation of free transplanted omental flaps, laser Doppler flowmetry is a feasible method.

Animals↗
PubMed2005

[In vitro examination of the influence of lipase and amylase on dog's pancreas tissue incubated with endotoxins, phospholipase A2 or cytokines].

Proinflammatory cytokines are elevated during acute pancreatitis. The endotoxins and Phospholipase A2 (PLA2) also have important role in acute pancreatitis. The aim of this study was to determine, what factors are responsible for the tissue damage in acute pancreatitis. The examinations were performed on fixed and frozen sections of healthy dog's pancreas tissue. Direct effects of endotoxins, PLA2, and proinflammatory cytokines together with pancreas enzymes were examined on pancreatic tissue. Pancreas enzymes themselves did not cause any change in the structure of pancreas. The common influence of endotoxins, PLA2 and pancreas enzymes was examined, and finally the effect of proinflammatory cytokines and enzymes was examined on pancreas tissue. Our results show, that besides enzymes many other factors are necessary to inflict tissue damage in acute pancreatitis, but for necrosis the presence of TNF alfa is a must.

Amylases↗
PubMed2005

[Kidney neovascularization by the greater omentum after pretreatment with omental angiogenic factor].

BACKGROUND: Several diseases may affect the renal artery and the circulation of the kidney. In these cases alternative blood flow should be secured to preserve renal function. There are experimental methods for this, such as omentonephropexy. In this model the new vessels grow into the kidney from the omentum. METHODS: Thirty mongrel dogs were anaesthetized and operated on. The left kidney was exposed, partially decapsulated, then omental angiogenic factor extractum was placed on the renal surface and the greater omentum was fixed there. After 4 weeks the left renal artery was ligated, and further 4 weeks later the right kidney was removed. Hematology tests were performed, urea, creatinine levels were measured and urine samples were tested after each operations. For statistical analysis Mann-Whitney rank sum and Wilcoxon signed rank tests were used. RESULTS: The survival rate was 20%. Significant elevations were observed in serum creatinine and urea levels after each operation, mostly after the third one and in non-surviving animals. Moderate anaemia was also present. CONCLUSION: The efficacy of the neovascularization presented in this study and the survival rate indicate further investigations are necessary in order to explore the mechanism and the dynamics of the vascularization processes.

Angiogenesis Inducing Agents↗
PubMed2005

[Determination of urinary NAG to detect renal ischemia-reperfusion injury and the protective effect of Allopurinol].

We analysed the effect of ischemia-reperfusion injury to renal parenchyma after unilateral renal artery clamping using urinary N-acetyl-beta-D-glucosaminidase (NAG) that is a sensitive parameter of early renal tubular injury. In the study 60 mongrel dogs were divided into 3 groups: in the 1st group the left renal artery was clamped for 45 minutes, in the 2nd group Allopurinol was administered before the clamping, the 3rd was the control group, where only laparotomy and closure of the abdomen was performed. Urinary NAG activity referring to urinary creatinine (NAG index) was determined before the operation, at the beginning of the reperfusion, in the 60th and 120th minute of the reperfusion then 1, 2, 3 and 5 days after the operation. The highest NAG indices relating to injury of the proximal tubuli were found at the beginning of the reperfusion, in the 60th and 120th minutes of the reperfusion, then NAG returned to preoperative level in each group. Significantly higher NAG indices were found in the ischemia-reperfusion group compared to the group with Allopurinol pretreatment. Renal ischemia-reperfusion injury and the protective effect of Allopurinol could be detected by lysosomal NAG enzyme. The injury of the tubular function was reversible so it could be a change in tubular function.

Acetylglucosaminidase↗
PubMed2005

[Experimental "functional amputate model" in ischemia-reperfusion].

Limb amputation and ischemia-reperfusion (I/R) after trauma is a serious challenge, though there are few laboratory parameters that are available to predict the prognosis. It is even less so when possible adverse effects of preventive cooling may also influence the clinical outcome. We performed an experimental model earlier on mongrel dogs to investigate the local and systemic effects of cooled and non-cooled limb I/R. In this paper we describe the model and summarize the informative laboratory results. In the warm I/R group the femoral vessels were separately clamped for 3 hours, while steel-loop tourniquet for 7 hours was performed under the femoral vessels around the thigh. After ischemia releasing the clamps provided reperfusion for 4 hours then the steel-loop was removed. In the cooled I/R group similar procedure was performed but with cooling by ice bags. Cooled and non-cooled sham-operated groups also were used. Before operations, during the reperfusion and for 5 days blood samples were collected then haematology and chemistry parameters were determined. Blood rheology and certain coagulation factors were significantly different between the cool and non-cool ischemia-reperfusion groups, furthermore, the changes were also significant compared to sham-operated animals, suggesting that these parameters may be useful in the prognosis.

Amputation, Surgical↗
PubMed2005

[The importance of hemorheological examinations in experimental limb ischemia-reperfusion injuries].

Rheological properties of the blood are determined by several factors and if they change it may be diagnostic for many diseases. It is well-known that during ischemia and reperfusion different free-radical liberating pathways are inducted besides the local physical and metabolical changes. These processes may harm red blood cells by increasing their rigidity and impairing their deformability. In ischemia-reperfusion models measurements of erythrocyte deformability is important. Characteristic alterations were observed in both rat and dog hind limb ischemia-reperfusion with vascular clamping on femoral vessels for 1 or 3 hours. Erythrocyte deformability was significantly impaired on the postoperative 1st-3rd days. The acute limb ischemia-reperfusion experimental models seem suitable for further in vivo rheological studies.

Animals↗