RESUMEN
INTRODUCTION: Measurement of an- hippocampal area or volume is useful in clinical practice as a supportive aid for diagnosis of Alzheimer's disease. Since it is time-consuming and not simple, it is not being used very often. We present a simplified protocol for hippocampal atrophy evaluation based on a single optimal slice in Alzheimer's disease. METHODS: We defined a single optimal slice for hippocampal measurement on brain magnetic resonance imaging (MRI) at the plane where the amygdala disappears and only the hippocampus is present. We compared an absolute area and volume of the hippocampus on this optimal slice between 40 patients with Alzheimer disease and 40 age-, education- and gender-mateched elderly controls. Furthermore, we compared these results with those relative to the size of the brain or the skull: the area of the optimal slice normalized to the area of the brain at anterior commissure and the volume of the hippocampus normalized to the total intracranial volume. RESULTS: Hippocampal areas on the single optimal slice and hippocampal volumes on the left and right in the control group were significantly higher than those in the AD group. Normalized hippocampal areas and volumes on the left and right in the control group were significantly higher compared to the AD group. Absolute hippocampal areas and volumes did not significantly differ from corresponding normalized hippocampal areas as well as normalized hippocampal volumes using comparisons of areas under the receiver operating characteristic curves. CONCLUSION: The hippocampal area on the well-defined optimal slice of brain MRI can reliably substitute a complicated measurement of the hippocampal volume. Surprisingly, brain or skull normalization of these variables does not add any incremental differentiation between Alzheimer disease patients and controls or give better results.
Asunto(s)
Enfermedad de Alzheimer/diagnóstico por imagen , Hipocampo/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: There are several cortical areas related to the limbic system that form the output from the hippocampal formation whose cellular and morphological features are important for the onset and progression of AD. We hypothesized that there would be a significant difference in the size of cortical pyramidal neurons and that there would also be a hemispheric asymmetry between Alzheimer disease patients and controls. These differences would potentially be accompanied by an increase in the numbers of Fluoro-Jade B-positive degenerating cortical neurons and a corresponding decrease in the numbers of DAPI-stained cortical neuronal nuclei in subjects with AD compared to controls. Such changes could potentially be used as another marker in postmortem neuropathological diagnosis of AD. METHODS: We measured absolute numbers of DAPI and Fluoro-Jade B stained cells in five cortical areas of the limbic system and four subareas of planum temporale in the post-mortem brains of subjects with Alzheimer disease. We also measured the size of pyramidal neurons in layer III in the five cortical areas of the limbic system in these subjects. All measurements were performed separately for the left and right hemisphere in order to identify asymmetries between the two hemispheres. RESULTS: We observed a significant decrease in numbers of DAPI stained cells in layers IV-VI of the anterior cingulate gyrus on the right side, in layers I-III of the posterior cingulate gyrus on the left side, in layers IV-VI in the transition region from superior temporal gyrus into planum temporale on the right and in layers IV-VI in the transition from planum temporale to insular cortex on the left. We also observed a significant increase in the numbers of Fluoro-Jade stained cells in layers I-III of the anterior cingulate gyrus and in layers I-III on the left and layers IV-VI of the right gyrus of Heschl. Shortening of the size of layer III pyramidal neurons in subjects with Alzheimer´s disease was found in the anterior cingulate gyrus on the right, in the posterior cingulate gyrus and entorhinal cortex on the left and on the right in the parahippocampal gyrus. CONCLUSION: Our study demonstrates asymmetries in different cortical regions of the temporal lobe that can be used as another marker in the postmortem diagnosis of AD.
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Enfermedad de Alzheimer/patología , Mapeo Encefálico , Giro del Cíngulo/patología , Lóbulo Temporal/patología , Anciano , Anciano de 80 o más Años , Recuento de Células , Femenino , Fluoresceínas/metabolismo , Lateralidad Funcional/fisiología , Humanos , Masculino , Persona de Mediana Edad , Células Piramidales/patologíaRESUMEN
The objective of this paper was an evaluation of change in prevalence of overweight and obesity in Czech children, and a comparison of cut-off points for body mass index references from the Czech Republic (CzR), International Obesity Task Force and WHO. The authors conducted a survey in 7-year-old children, and compared data from 1951, 1981, 1991, 2001 and 2008 (WHO cut-offs). 2008 data were evaluated according to different cut-offs. Results showed that since 1951 in boys, overweight prevalence increased from 13.0% in 1951 to 26.8% in 2001, in girls from 10.9% to 22.9%. Obesity increased in boys from 1.7% to 8.3%, in girls from 1.7% to 6.9%. From 2001 to 2008 obesity in boys increased; obesity in girls and overweight in both genders decreased. In 2008 cohort the following values were found: overweight and obesity: CzR criteria, percentage was lowest (14.8% boys and 11.1% girls); WHO criteria, highest prevalence (23.5% boys and 19.5% girls); obesity: lowest ratio International Obesity Task Force criteria (4.4% boys, 3.3% girls), highest ratio boys WHO criteria (10.0%), girls CzR criteria (5.0%). Overweight and obesity prevalence increased in 7-year-old Czech children since 1951; since 2001 prevalence is plateauing with exception of boys. Using different body mass index references resulted in marked differences in overweight and obesity prevalence.
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Encuestas Epidemiológicas/normas , Obesidad/epidemiología , Sobrepeso/epidemiología , Índice de Masa Corporal , Niño , República Checa/epidemiología , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Prevalencia , Estándares de Referencia , Valores de Referencia , Organización Mundial de la Salud/organización & administraciónRESUMEN
Possibilities of conducting longitudinal human growth studies are very limited, since it is necessary to monitor the probands for a long time. Another problem can be a loss of data currency, and the small size of the final sample. The solution can be a follow-up semi-longitudinal observation. This research is drawn up as a short longitudinal monitoring of 1925 children (990 boys, 935 girls), aged 6-15 years, at 20 elementary schools in four regions of the Czech Republic, which has been conducted at the same time. Data of repeatedly examined probands of a wide age range were acquired in a short time period. With the help of a linear regression model with mixed effect, the growth velocity curves of 12 somatic traits have been obtained. The timing, intensity and duration of separate growth spurts have been observed, as well as the mutual location of both points of growth velocity, local maxima and minima, and points of the maximal acceleration and deceleration. The results demonstrate that the velocity of characters with variable growth dynamics (skin-fold thicknesses, circumferences of limbs) - contrary to characters with regular growth velocity - have a higher number of partial growth spurts and an opposite course. In the period of separate growth velocity, peaks of somatic characters with regular growth dynamics reach points of partial local minima. In comparison to previous longitudinal studies of body height growth dynamics, the shift of both the beginning and the peak of boys' and girls' pubertal spurt, to a lower age can be found.
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Desarrollo Infantil , Crecimiento , Adolescente , Antropometría , Estatura , Peso Corporal , Niño , República Checa , Extremidades , Femenino , Humanos , Estudios Longitudinales , Masculino , Factores Sexuales , Grosor de los Pliegues CutáneosRESUMEN
This comprehensive article notifies on the latest information concerning the morphology of the lower extremity veins, including their anatomical terminology. As a consequence of vehement development of the diagnostic and therapeutic techniques, the more detailed knowledge of anatomy, terminology, venous system variants and venous wall structure is necessary both for the phlebologists, sonographists and for the surgeons and cardiosurgeons. The histological part brings information about the content of collagen and elastin fibers in all layers of the superficial veins wall and about the arrangement of the vasa vasorum in both normal and varicose vena saphena magna. The anatomical-terminological part enlightens the variability of the superficial venous system of the lower extremity and the completion of the terminology of some superficial and deep veins, veins of the pelvis and perforating veins. The simple and clear anatomical terminology is the base for easy and non-problematic communication and discussion between inland and foreign specialists.
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Extremidad Inferior/irrigación sanguínea , Venas/anatomía & histología , Humanos , Terminología como AsuntoRESUMEN
The Czech Republic has undergone rapid political, social, and economic transformation since the late 1980s. While obesity rates among children and adolescents in the Czech Republic have been previously relatively low, this has changed in recent years. Across the past 50 years, body weight, body mass index (BMI)-for-age, and adiposity rebound (AR) (the time when a child reaches the lowest BMI before their BMI gradually begins to increase until adulthood) occurs earlier. The most dramatic changes have been observed among school-aged children, where BMI values have increased at the 50th, 90th, and 97th percentiles. In contrast, adolescent girls appear to be thinner than in the past. The analyses of weight-for-height percentiles indicated that the 50th percentile of the body weight among boys and girls remained similar in nearly all age categories across the past 50 years. Although the growth pattern of children at the 50th percentile has not changed, the 10th and 90th percentiles have expanded. Our findings suggest that the secular trend of increased height, accelerated growth, and earlier maturation is responsible for Czech children experiencing adiposity rebound at earlier ages compared to the past.
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Adiposidad , Estatura , Índice de Masa Corporal , Peso Corporal , Estado Nutricional , Obesidad/epidemiología , Sobrepeso/epidemiología , Adolescente , Imagen Corporal , Niño , Preescolar , República Checa , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Recién Nacido , Masculino , Actividad Motora , Apoyo Nutricional , Percepción , Prevalencia , Factores de TiempoRESUMEN
The 6th nationwide anthropological survey (NAS) of children and adolescents was carried out in the Czech Republic in 2001 to continue the series of surveys repeated at 10-year intervals since 1951 (with the participation of the Slovak Republic up to 1991). The major objective was to find out the following body measurements of children and adolescents: body height and weight, and head, arm, waist and hip circumferences. Questionnaires were used to find out the body measurements of parents (body height and weight) and some socio-economic characteristics of the child's family (number of siblings, education of parents, breast feeding duration, birth weight and length, child's physical activities, TV watching time, computer gaming time, etc.). A school children questionnaire focused on eating habits was also part of the survey in 2001. A total of 59,000 children aged 0.00 to 18.99 years, i.e. about 3% of the population of the same age range, were enrolled in the survey in 2001. The results obtained presented in diagrammatic and tabular forms are reference standards for monitoring growth of the Czech children and adolescents from birth to the age of 19 years. The survey revealed a substantial slowdown in the long-term trend in body height increase for both boys and girls. The most marked increase in the mean body height is currently recorded in boys at the prepubescent age while the pubescent girls show a practically zero increase for this parameter. A more marked increase in body height at the adult age is not expected any more, but the increase in body height and weight at the prepubescent age is likely to continue for some time. The 6th NAS showed a marked slow down to a stop in the trend in the mean body weight increase. No increase in the mean body weight has been recorded in pubescent girls since the 1970's and in pubescent and postpubescent boys since 1991. Nevertheless, the younger age groups, namely those of preschool and primary school children, continue to show increase in the mean body weight. The secular trend in body weight has been less pronounced compared to that in body height. The rates of overweight and obese children (as assessed by body mass index, BMI) have risen in most age groups of school children compared to those reported in 1991. In contrast, a slight decrease in the rate of overweight children can be seen in boys starting from the age of 16 years and in girls starting from the age of 13 years. The obesity prevalence rate is significantly higher in boys than girls. Statistical analysis confirmed a correlation between the BMI values in children and education of parents (the higher the education, the lower the rate of overweight children) and between the BMI values and the population size of the community where the child lives (the higher the population, the lower the prevalence rates of overweight and obesity). Single children suffer more frequently from overweight and obesity than those with siblings.
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Desarrollo del Adolescente/fisiología , Antropometría , Pesos y Medidas Corporales/estadística & datos numéricos , Desarrollo Infantil/fisiología , Adolescente , Distribución por Edad , Factores de Edad , Pesos y Medidas Corporales/tendencias , Niño , Preescolar , República Checa , Conducta Alimentaria , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Recién Nacido , Masculino , Obesidad , Instituciones Académicas , Distribución por Sexo , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
The submitted investigation describes long-term changes of 3 main cephalic dimensions (head circumference, maximal length and maximal width of the head) and analyses the possible influence of positioning of infants after birth (prone, supine and side sleeping position) on these changes. Information about children aged 6 months to 3.99 years, where the need of up-to-date data is greatest, were collected as part of an extensive anthropological survey implemented in 1995 to 1997 in the entire Czech Republic. The authors confirmed the trend of debrachycephalization, which is manifested by a statistically significant increase of the maximal length of the head and a statistically significant decrease of the maximal width of the head, as compared with children examined in the anthropological survey in 1956 to 1962 (1). These changes were established in the group of boys (200 boys) as well as in the group of girls (167 girls). The differences of the magnitude of long-term changes between boys and girls were not significant. Evaluation of the long-term changes of the head circumference in the entire group of 366 children aged 0.5-3.99 years (the head circumference of one girl was not measured) revealed a statistically significant increase of this dimension. During the period from 1956/62 till 1996, the influence of positioning on the magnitude of long-term changes of head circumference was not proved. We can say the same about the maximal length of the head of boys and girls and about the maximal width of the head of girls. Only between three differently positioned groups of boys (prone, side, supine) statistically significant differences in the magnitude of long-term changes of the maximal width of the head were found (p < 0.05). Highly significant changes of the maximum width and maximum length of the head occurred as compared with a reference group in all three groups of positioning of infants and in both sexes. The trend of debrachycephalization seems to be thus a more potent factor, which affects long-term changes in the shape of the head, then the predominating sleeping position during the first months after birth. This conclusion is supported by the persisting trend of debrachycephalization, although the supine position is now preferred.
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Cuidado del Lactante/métodos , Postura , Cráneo/anatomía & histología , Cráneo/crecimiento & desarrollo , Sueño , Análisis de Varianza , Cefalometría , Preescolar , Estudios Transversales , República Checa , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Valores de Referencia , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
With the support of the Internal Grant Agency of the Ministry of Health of the Czech Republic in 1997-1999 work proceeded on the grant "Semi-longitudinal study of the somatic growth of school children in the Czech Republic". The objective of this project is to assess the growth rate of the basic bodily characteristics in children and youth aged 6 to 14 years, to confirm the positive secular trend in height and body weight or its slowing or stagnation, and also to evaluate the growth and development of children under the new socio-economic conditions. In addition to thirty somatic characteristics which are assessed repeatedly every six months, in 1,925 children some supplementary data were obtained from parents. From hitherto assembled data ensues that there was no significant change of the mean length at birth nor of the birth weight as compared with 1989. The increase in height up to adolescence continues, in the higher age groups probably stagnation occurs. Despite a slight increase of mean body weight values since 1981, a gradual decline of the BMI values was observed. In boys this tendency is less marked than in girls, in particular in the oldest age groups. This trend was confirmed also by the results of the present investigation. As compared with the results of the 5th Nationwide Anthropological Survey in 1991 the group of overweight children, i.e. those above the 90th percentile of BMI comprises 6.9% boys and 8.9% girls from a total of almost 2,000 children, as compared with the expected 10%.