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Biomedical subjects

M Samánek

Publications and source records attributed to M Samánek.

At least 37 records · Page 2Linked to original sources

Effect of prostaglandin E2 on the ductus arteriosus in the newborn rat. An ultrastructural study.

A patent ductus arteriosus (DA) was maintained in newborn rats (Wistar strain) by administering prostaglandin E2 (PG E2) in doses of 15 micrograms.kg-1 at 30 min intervals up to 300 min after birth. In the control animals, the DA was functionally closed 300 min after birth. The lumen was blocked by clustered endothelial cells at various stages of degeneration. Elastic membranes of the media had disintegrated into irregular fragments and the smooth muscle cells were contracted. Cytoplasm excrescences formed on their surface as a result of contraction protruded as hernias into adjacent muscle cells and into endothelial cells. The smooth muscle cells degenerated. The administration of PG E2 inhibited contraction of the smooth muscle cells and so also the development of degenerative changes; 300 min after birth the DA was fully patent, the elastic membranes were structurally intact, regularly organized and continuous. The smooth muscle cells had the character of synthesizing cells with richly developed granular endoplasmic reticulum. The intima and its endothelial lining were likewise free from structural changes. The ultrastructural image of the wall of the DA correspondent to the state 10 min after birth, when the DA was fully patent. The administration of PG E2 did not induce any ultrastructural changes indicative of injury to the wall of the DA.

Animals↗

[The effect of a high-altitude climate on the function of the respiratory system in children with asthma].

In 108 asthmatic children (age 6-15 years) an effect of the 6-8 weeks stay in the High Tatra mountains (Children's Lung Institute, Dolný Smokovec) on lung function was studied in the years of 1985-1988. The patients consisted of groups followed-up in different periods of the latter years. Indications for the stay was airway obstruction (a.o.) in symptom-free period or bronchial hyperreactivity (b.h.) before starting the stay. The effect of climate on a.o. and b.h. was assessed from the parameters, measured from maximum expiratory flow-volume (MEFV) curves. Mean MEFV curves and their areas were considered as indices of the climate effect on a.o. and b.h. in the studied groups of asthmatics during the stay in the Institute. B.h. was assessed according to the induced a.o. after 5 min. free running outdoors. Mean MEFV curves and their areas did not differ significantly at the start and end of the stay in this high mountains climate. However, the MEFV curves significantly differed after the induced a.o. by 5 min. free running at the start and end of this climate therapy. The descendent parts and areas under the curves were reduced much less after the induced a.o. during and the end of stay than at the start of stay. They proved a decrease of bronchial hyperreactivity in all studied groups of asthmatics in the climate of High Tatra. The degree of bronchial hyperreactivity, tested as a magnitude of a.o. following 5 min. free running outdoors, on the basis of parameters from MEFV curves, appeared as an objective measure of climate therapy effect on lung function in our asthmatic children.

Adolescent↗

[Seasonal differences in the occurrence of congenital heart defects].

Incidence of congenital heart defects was studied prospectively in all 664,218 children born in 1977 to 1984. Those suspected of having a heart disease were examined at the center specialized in pediatric cardiology. All children who died were autopsied and those in whom a heart defect was proved were included in our series. In total, 4409 infants (6.64/1000 live births) were born with a heart defect in Bohemia. Differences from one year to another were not statistically significant. The incidence of infants with a heart defect was highest in October, lowest in December, June and July (p less than 0.05). Seasonal incidence of individual forms of heart defects differed as well. The seasonal variation was not influenced by the total number of live births. High incidence of congenital heart defects in infants born in October and November coincides with the epidemics of influenza in early pregnancy.

Czechoslovakia↗

[Regional differences in the prevalence of congenital heart defects].

Prevalence of congenital heart diseases was studied prospectively in all 664,218 infants live born in Bohemia from 1977 to 1984. All children who died were autopsied and those suspected of having a heart disease were examined at the specialized center. In total, 664/100,000 infants were born with a heart defect, most of them in Prague (957,9/100,000) and in Central Bohemia (739.4) and in Northern Bohemia (619.3). The lowest prevalence was found in West Bohemia (515.1/100000 live births). The relative frequency of congenital heart defect categories differed significantly among regions. Evidence of regional differences in prevalence of congenital heart diseases and their forms suggests that environmental factors can play an important role in the etiology of congenital heart defects.

Czechoslovakia↗

Seasonal differences in the incidence of congenital heart defects.

The incidence of congenital heart defects was studied prospectively in all 664 218 children born in 1977 to 1984. Those suspected of having a heart disease were examined at the centre specialized in pediatric cardiology. All children who died were autopsied and those where a heart defect was proved were included in our series. In total, 4409 infants (6,64/1000 live births) were born with a heart defect in Bohemia. Differences from one year to another were not statistically significant. The incidence of infants with a heart defect was highest in October, lowest in December, June and July (p less than 0.05). Seasonal incidence of individual forms of heart defects differed also. The seasonal variation was not influenced by the total number of live births. The high incidence of congenital heart defects in infants born in October and November coincides with the epidemics of influenza in early pregnancy.

Czechoslovakia↗

[Evaluation of free walking as a provocation method for detection of nonspecific bronchial hyperreactivity in children].

The bronchial hyperreactivity alone does not stand for illness but it is typical of asthma. Nonspecific tests are on a low level of standardization and the results of various research groups are difficult to compare. We used the free running provocation test compared with the inhalation test of acetylcholine in a routine lung function laboratory. Using the flow-volume curve both methods were of a comparable value although not absolute equal. Running-provocation seems to be especially qualified for the ascertainment of exercise-induced bronchospasm. A preexisting obstruction more often led to a positive result with increased reaction. The MEF values on low level of FVC proved to be especially sensitive. Free-running using the flow-volume curve for evaluation of ventilation is a cheap, noninvasive, natural, and in our opinion qualified method for the estimation of nonspecific bronchial hyperreactivity.

Acetylcholine↗

Different activities of energy metabolism enzymes in children's cardiac atria and ventricles.

Tissue samples from the right atrium and ventricle of the same heart were obtained during surgery on 45 children operated on for congenital heart disease (tetralogy of Fallot, ventricular septal defect). Significant enzyme activity differences were found between atrial and ventricular muscle. Aerobic metabolism enzymes (citrate synthase, malate dehydrogenase), with lactate metabolism (lactate dehydrogenase) and fatty acid oxidation (hydroxyacyl-SoA dehydrogenase) showed significantly higher activities in ventricular muscle tissue. In contrast, hexokinase, the enzyme responsible for glucose phosphorylation was significantly higher in the atria. Hence, the right ventricle can utilize and oxidize to the full all the main nutrients (fatty acids, glucose and lactate) while the right atrium utilizes primarily glucose. These atrio-ventricular differences are independent of the type of congenital heart disease and their existence can be presumed in healthy persons, too.

3-Hydroxyacyl CoA Dehydrogenases↗

[Differences in the incidence of congenital heart defects in boys and girls].

4,409 children born in Bohemia (1974-1983) with heart defect were distributed almost between 2,296 (52.1%) boys and 2,213 (47.9%) girls: The boy:girl ratio was 1.09:1. Boys prevailed in double outlet right ventricle (2.68:1), hypoplastic left heart (2.25:1), transposition of the great arteries (2.11:1), aortic stenosis (1.95:1), pulmonary atresia (1.55:1), tricuspid atresia (1.45:1), coarctation of the aorta (1.30:1) and the corrected transposition (1.25:1). Girls prevailed significantly in patent ductus arterious (1.66:1), Ebstein's anomaly of the tricuspid valve (1.57:1), truncus arterious (1.22:1), atrioventricular septal defect (1.17:1) and tetralogy of Fallot (1.12:1). The difference in the remaining heart defects was less than 10%.

Child↗

[Adaptation of cardiac energy metabolism in children with congenital heart defects].

Metabolic differences of the cardiac muscle in children with normoxaemic and hypoxaemic congenital heart disease were analyzed by means of representative enzymes of the energy metabolism in 95 specimens in 80 children with congenital heart disease. Tissue specimens from the right atria and ventricles were obtained during surgical operations. It was revealed that the myocardial metabolism of patients with congenital heart disease was markedly influenced by hypoxaemia: the aerobic capacity was significantly reduced in the atria as well as in the ventricles. Changes in the atrial musculature were, however, more marked: in addition to citrate synthase - similarly as in the ventricles - in the atria also activities of enzymes associated with lactate metabolism (LDH) and with glycolysis (TPDH, GPDH) were reduced. Patients with an atrial septal defect had a significantly lower activity of the enzyme involved in the fatty acid breakdown (HOADH) than patients with a ventricular septal defect. The described new adaptive mechanism is of practical importance for the treatment of congenital heart disease and other conditions associated with prolonged hypoxaemia.

Adaptation, Physiological↗

[Differences in the activity of enzymes associated with energy metabolism in the heart atria and ventricles in children].

Tissue specimens from the right atrium and ventricle of the same heart were obtained during surgery in 45 children operated on account of congenital heart disease (tetralogy of Fallot and ventricular septal defect). Significant differences were found in the enzyme activities between the atrial and ventricular musculature. The activities of enzymes associated with aerobic metabolism (citrate synthase, malate dehydrogenase, with lactate metabolism) lactate dehydrogenase (and the fatty acid oxidation) hydroxyacyl-SoA-dehydrogenase) were significantly higher in the ventricular musculature. Hexokinase, the enzyme responsible for glucose phosphorylation was on the other hand, significantly higher in the atria. From this ensues that the right ventricle can utilize and oxidize to a full extent all main nutrients (fatty acids, glucose and lactate), while the right atrium utilizes above all glucose. These atrio-ventricular differences do not depend on the type of the congenital heart disease and it may be assumed that they exist also in healthy subjects.

Adolescent↗

[Cardiac arrhythmia following total correction of tetralogy of Fallot].

41 patients after surgical correction of the tetralogy of Fall of aged 2-24 years (mean 11.2 y.) were followed for 12-65 months (mean 39.5 m.) for known or suspected dysrhythmias. 24-hour ambulatory ECG and exercise testing demonstrated nonsignificant ventricular ectopy (grade 0-1 according to a modified Lown classification) in 28 patients (group I) and significant (grade 2-5) ventricular dysrhythmias in the remaining 13 patients (group II). There were 2 cases of sudden late death in group II, whereas all patients in group I are alive. The victims of sudden death had no, other serious dysrhythmias and received no antiarrhythmic treatment. Ejection fraction of the functional part of the right ventricle estimated by radionuclide angiocardiography was not different in both groups whereas, global right ventricular ejection fraction differed nearly significantly (group I: 39.6 +/- 8.3%, group II: 31.9 +/- 10.4%, p = 0.052). Thus, a diminished global right ventricular ejection fraction caused by an extensive resection and large patch in the right ventricular outflow tract may be connected with the occurrence of higher grades of ventricular ectopy. These may lead to sudden late death.

Adolescent↗

[The incidence of heart defects in children].

By examining all of 91,823 children born in 1980 in Bohemia, congenital heart disease was proved in 589 (6.415/1000 liveborns) and cardiomyopathy in 24 (0.261/1000 liveborns). Further 166 (1.808/1000 liveborns) were follow-up with a diagnosis of congenital heart disease by pediatric cardiologists in the field, but at the age of 4 years we didn't prove the defect any more. Prevalence of heart defects: ventricular septal defect (31.4%), atrial septal defect (11.4%), aortic stenosis (7.6%), pulmonary stenosis (7.1%), coarctation of the aorta (5.8%), transposition of the great arteries (5.4%), patent ductus arteriosus (4.8%), atrioventricular canal and hypoplastic left heart (4.1%), tetralogy of Fallot (3.6%). Other defects occurred less frequently than in 2.5% of all congenital heart disease.

Child, Preschool↗

[Energy-supplying metabolism of the volume overloaded and hypoxia stressed heart in children].

This study summarizes results obtained with regard to atrial and ventricular enzymes of energy supplying metabolism in children with different types of congenital heart disease. In all groups of patients - normoxemic as well as hypoxemic - significant atrio - ventricular differences were observed: the right ventricle is amply equipped for utilization and oxidation of all major nutrients, while the right atrium utilizes glucose predominantly. Myocardial metabolism in children with congenital heart disease was significantly influenced by hypoxemia: the capacity of aerobic enzymes in cyanotic patients was significantly lower, both in atrial and ventricular tissue, whereby the atrial changes were even more striking. No marked differences were found between atrial and ventricular septal defects in normoxemic patients; the only difference was a lower capacity of fatty acid catabolism in children with atrial septal defect.

Adolescent↗

The physiological closure of ductus arteriosus in the rat. An ultrastructural study.

The evolution of morphological changes in the wall of the ductus arteriosus during its physiological closure in newborn rats was examined by electron microscopy. The contraction of smooth muscle cells in the tunica media seems to be the primary mechanism which leads to the physiological closure of the ductus arteriosus. For this reason our attention was centred mainly on the morphology of the tunica media. No important changes in the ultrastructure of smooth muscle cells can be observed in the early phases of the closure. Most of them exhibit ultrastructural features of cells with enhanced synthetic activity during all phases of the closure. The permanent contraction of smooth muscle cells results in their morphological changes. The most striking is the herniation of smooth muscle cell cytoplasm into the endothelial and later into adjoining muscle cells. These changes together with signs of degeneration of the smooth muscle cells are already clearly discernible 120 min after birth. The elastic component of the tunica media exhibits surprisingly fast changes. As soon as 60 min after birth, the fragmentation of elastic membranes and their structural changes provided evidence about the degradation of elastic material. The matrix vesicles, probably derived from the lysosomal apparatus of the muscle cells, may play an essential role in this process.

Animals↗

Prevalence, treatment, and outcome of heart disease in live-born children: a prospective analysis of 91,823 live-born children.

All 91,823 children born in 1980 in Bohemia (population 6.314 million; area 52,478 square kilometers) were examined at least four times during infancy and at the age of three and four years. All children who died were autopsied and those with heart disease were selected. A total of 779 children (8.223/1000 live births) were suspected by provincial pediatric cardiologists of having a heart disease. All of these were examined at the age of four years at our Center of Pediatric Cardiology. At this age heart disease was proved in 613 alive or deceased children (6.676/1000 live births), congenital cardiac malformations in 589 (6.415/1000 live births), and cardiomyopathies in 24. The most frequent congenital heart defects (CHD) were ventricular septal defect (VSD) (31.41%), atrial septal defect (ASD) (11.37%), aortic stenosis (AS) (7.64%), pulmonary stenosis (PS) (7.13%), coarctation of the aorta (CoA) (5.77%), and transposition of the great arteries (TGA) (5.43%), followed by persistent ductus arteriosus (PDA) (4.75%), atrioventricular septal defect (AVSD) and hypoplastic left heart syndrome (HLHS) (4.07% each), tetralogy of Fallot (TF) (3.56%), and pulmonary atresia (PA) (2.38%). A prevalence of less than 0.1/1000 live births was found for the remaining cardiovascular defects. One hundred fifty-nine (25.9%) patients were admitted to our highly specialized center, 116 (19.7%) catheterized and 85 (13.9%) treated surgically, during the first four years of life. A total of 440 (71.8%) patients survived the fourth year of life. The percentage of deaths was 25.6% among those with congenital heart diseases and 71% with cardiomyopathies. The overall mortality rate was 27% in surgically and 26% in medically treated patients.

Aortic Coarctation↗

Correction of aortico-left ventricular tunnel during the first day of life.

Two critically ill newborns with aortico-left ventricular tunnel and severe heart failure were operated on at six and 14 hours after birth. The diagnosis was established clinically by the auscultatory finding of systolic and diastolic murmurs and by two-dimensional and Doppler echocardiography. In the first newborn, the left aortic sinus was connected with the left ventricle below the aortic valve by an aneurysmatically dilated tunnel. In the second patient, the tunnel connected the right aortic sinus and the left ventricle. The repair was performed under deep hypothermia, total hemodilution, and cardiopulmonary bypass. The tunnel was closed with two patches of Gore-Tex on the aortic and ventricular orifices. Both children are free from symptoms and are developing normally 10 and 8 months after repair.

Aorta↗

Lung function in simple complete transposition after intracardiac repair.

Pulmonary function was measured in 35 patients (mean age 11.6 years) with simple complete transposition 4.4 years after intracardiac repair. A disturbance in the lung function (greater than 2 SD from the normal value) was found in 88% of the patients. A marked increase in static recoil pressure (P less than 0.001) was most frequent (in 66%). Static lung compliance was only 75.1% of the predicted values. Values of mean vital and total lung capacity were decreased (P less than 0.01 and 0.001). Residual volume, the ratios of functional residual versus total lung capacity and residual volume versus total capacity were all increased. The signs of decreased patency of the airways were found in only 4 patients. A negative correlation was detected between the indices of lung stiffness and the age of assessment of lung function. A positive correlation was found between the ratios between functional residual and total capacity and pulmonary blood flow. No other correlation between lung function data and pulmonary arterial pressure or flow was proved. Increased lung stiffness, restriction of lung volume and hyperinflation could influence unfavorably the long-term results in successfully treated patients with simple complete transposition.

Adolescent↗

Effect of hypoxaemia on enzymes supplying myocardial energy in children with congenital heart disease.

The differences in energy metabolism of the myocardium in children with congenital cardiac malformations producing hypoxaemia (arterial oxygen saturation 77 +/- 2%) or normoxaemia (arterial oxygen saturation 94 +/- 2%) were analysed by measuring the activity of the representative energy-supplying enzymes. Right atrial and ventricular tissue samples were obtained during surgical interventions. We demonstrated that myocardial metabolism was significantly influenced by hypoxaemia: the aerobic capacity of the energetic metabolism was reduced both in the atriums and ventricles. Atrial myocardium was more affected: in addition to citrate synthase, the activity of enzymes connected with lactate uptake and carbohydrate catabolism was also significantly decreased. These results demonstrate that the human heart is able to adapt to hypoxaemia by changing its energetic metabolism.

Adolescent↗