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Aims: Stuttering is a serious health and social problem that can distinctively affect not only the mental development of an individual but also his life possibilities, including social fulfilment and his general life prospects. The etiology of stuttering is however unknown and that is why it is not possible to treat it causally. This pilot study takes into account the hypothesis of bronchial constriction as a negative factor in stuttering and investigates the effect of the long-acting bronchodilator formoterol fumarate on stuttering in 42 patients. Methods: Patients were divided in 2 groups - A (school children and juveniles) and B (adults 18-25 resistant to other treatment). The medicine was administered once a day in the morning in a dose of 12 µg for the total period of 6 months. The prime outcome parameter - severity of stuttering - was evaluated using the ordinary scale (McGill Pain Questionnaire). The evaluation was done by an examining physician during visits to the centres and by the patients themselves (in cases of the youngest with the assistance of a parent) in a daily diary. Results: A non-parametric pair test (Wilcoxon signed rank test) was used to compare the average marks in the whole set of patients. During the six moth period of administration of Foradil® the speech fluency improved. The average number of dysfluent words decreased from 10.5 ± 1.3 to 6.6 ±0.97. Conclusion: The average mark of speech fluency evaluated by the physicians between the period of non use of Foradil® and the six month period after the use of Foradil® improved from 2.95 ± 0.76 to 1.95 ± 0.56 (as proved by the chi-square test, p<0.0001). The evaluation of speech fluency of balbuties uses the logopedic practices. Other clinical evaluations of speech fluency are not known.

Aims: There is no standardized protocol for measuring glycemic index (GI) that takes time-of-day effects into account. The software DegifXL2 and Medtronic-Minimed's CGMS and Solutions, makes the GI calculation at breakfast and dinner time possible. The aim of this study was to assess the enhanced data processing software (DegifXL4) enabling the GI calculation at breakfast, lunch, afternoon snack and dinner times. Methods: The glucose levels of 20 healthy volunteers were monitored after they consumed either 50 g of glucose or one of ten alternative foodstuffs either for breakfast and dinner or for lunch or snack. Within the 9-day test period, 10 such meals were monitored in 3 replicates for each volunteer. Specifically, CGMS was used to monitor plasma glucose levels at 5-minute intervals for a period of 120 min following the foodstuff ingestion. Results: Using the enhanced spreadsheed DegifXL 4, a total of 640 profiles were obtained and 491 (77 %) accomplished the criteria for further processing. The percentage of successful tests in each foodstuff varied from 57 to 87 %. Conclusions: The use of the new software DegifXL4 offers accurate GI estimates for foodstuffs eaten for breakfast, lunch, snacks and dinners in three replicates. In combination with the CGMS Solutions Software is DegifXL4 an enhanced efficient and comfortable way to routinely measure GI values.

Aims: Bone structure around basal implants shows a dual healing mode: direct contact areas manifest primary osteonal remodeling, in the void osteotomy-induced spaces, the repair begins with woven bone formation. This woven bone is later converted into osteonal bone. The purpose of this study was to develop a model to accurately represent the interface between bone and basal implant throughout the healing process. The model was applied to the biological scenario of changing load distribution in a basal implant system over time. Methods: Computations were made through finite element analysis using multiple models with changing boneimplant contact definitions which reflected the dynamic nature of the interface throughout the bony healing process. Five stages of bony healing were calculated taking into account the changes in mineral content of bone in the vicinity of the load transmitting implant surfaces. Results: As the bony integration of basal implants proceeds during healing, peak stresses within the metal structure shift geographically. While bony repair may still weaken osteonal bone, woven bone has already matured. This leads to changes in the load distribution between and within the direct contact areas, and bone areas which make later contact with implant. Conclusions: This study shows that basal implants undergo an intrinsic shift of maximum stress regions during osseointegration. Fatigue testing methods in the case of basal implants must therefore take into account this gradual shift from early healing phase until full osseointegration is achieved.

AIMS: The aim of this study was to assess the correlation between IgG index values and the number of the oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS). MATERIAL AND METHODS: The set of 150 patients consisted of 41 males and 109 females (aged 18-68, mean 36.6 ± 10.1 years). The CSF collected by a lumbar puncture was examined evaluating intrathecal synthesis using the IgG index and determining OCB. The number of alkaline OCB in the CSF was assessed using the method of isoelectric focusing. Pearson's correlation analysis, and homogeneity χ² test, Mann-Whitney test, paired-sample t-test (parametric) and Wilcoxon signed-ranks test (nonparametric) were used to evaluate the statistical significance of the results. RESULTS: No positive correlation between the IgG index and the number of OCB was found. Mann-Whitney test also failed to demonstrate any significant difference of the IgG index values in patients both with the OCB number ≥ 2 and < 2. CONCLUSION: This study did not confirm any correlation between the IgG index values and the OCB number in the CSF of MS patients.

AIM: Bendable and angulated single-piece implants are used alternatively to screwable abutments in two-piece dental implant designs. Though used frequently, data on the stress distribution within such implants are not available and the question whether the bending contributes to fracture resistance has not been addressed. METHODS: We used the method of finite element to identify von Mises stresses and maximum stresses in bent and non-bent but angulated implants. Implants with one (e.g. applicable to screw designs) or two (applicable to basal implants) bending areas were the variables under investigation. RESULTS: For bends up to 13 degrees we discovered that if there is only one bend, the maximum stress is in the bent area. If two bends are made in two different bending areas, the maximum stresses are distributed between the two and, if either one of the bent areas is machined, there are no residual stresses within the implant body in this area. The maximum stresses are always located near the base-plates. The absolute value of the maximum stress is higher because no residual stresses are available to compensate stresses that stem from loading. CONCLUSION: Assuming that all other parameters are equal, bendable (basal) implants show a more even stress distribution along the vertical implant region than identically shaped implants with a machine-angulated area. Bendable basal implants therefore probably resist masticatory forces better than pre-angulated, machined implants, and unbent implants which provide a thin region in the vertical implant area.

Background: Dental materials, oral hygiene products and food additives may cause contact allergic reactions in the mouth with varied clinical presentation. Oral lichenoid lesions (lichen planus-like lesions) can be induced by hypersensitivity to dental restorative metals, acrylates, flavorings and other substances. Aim: The aim of this study was to demonstrate contact allergy to dental materials in patients with oral lichenoid lesions using patch tests. Patients and methods: Routine patch tests with two sets of allergens - "European Standard" and "Dental Screening" (Chemotechnique Diagnostics, Sweden) supplemented with pulverized amalgam, iridium, indium, menthol, sorbic acid and platinum were done on a set of 25 patients with lichenoid lesions located on the buccal mucosa, tongue and lips. Application and interpretation of the tests were conducted according to ICDRG (International Contact Dermatitis Research Group). Results: 15 (60 %) patients showed sensitization to 1 or more allergens, with a total of 31 positive reactions. The greatest frequency of positive reactions was to dental metals, with a total of 27 positive reactions. The order of tested metals according to frequency of positive reactions was mercury (6/25/24 %), amalgam (6/25/24 %), nickel (4/25/16 %), palladium (4/25/16 %), cobalt (3/25/12 %), gold (2/25/8 %), chrome (1/25/4 %), indium (1/25/4 %). The clinical relevance of the results with regard to the material's presence in the mouth was demonstrated in 11 (44 %) patients. In 9 patients, replacement of the positively tested materials led to healing or to significant regression of mucosal changes. Conclusions: The results of the patch tests showed the possible contribution of contact sensitization in the pathogenesis of lichenoid manifestations in the oral cavity. Due to the premalignant character of these lesions, replacement of positively tested materials and follow up of these patients is advised.

Aims: Annual evaluation of blood transfusion preparation administration at the University Hospital Olomouc, Czech Republic as a contribution to the European Union haemovigilance system. Methods: Analysis of blood transfusion preparations released from the Department of Blood Transfusion of the above university hospital and laboratory examination results in receivers of these products for the year 2006. Total hospital consumption and usage in particular medical disciplines in the hospital were assessed. Results: Red cell concentrates: in total 14 347 TU (deleucotised in 20.4 %). Departments according to usage: surgery, haematooncology, anaesthesiology and surgery intensive care department, and internal medicine department. Haemoglobin levels were above 100 g/L before blood transfusion administration in 24 % of cases. Platelets: in total 1 712 TU (100 % manufactured by apheresis, 56 % deleucotised). Platelet counts below 20 x 10⁹/L were found in all cases before platelet concentrate administration. Plasma: in total 5 959 TU to 1 297 of patients. Departments according to usage: surgery, anaesthesiology and surgery intensive care department, internal medicine and haematooncology. Two hundred and forty nine cases without coagulation parameter monitoring and 333 (25.67 %) patients with only 1 TU of administered plasma were found. Conclusions: The incorrect indications for red cell transfusion preparations were found in eleven patients with haemoglobin levels above 130 g/L. Underdosing in 25.67 % of plasma administrations signifies dubious indications in these cases. Implementation of the haemovigilance system in practice is now mandatory for the Czech Republic after joining the European Union. Therefore more precise data and analysis of questionable cases with further education of staff in clinical departments are essential for the haemovigilance principle to be applied on a hospital basis in the Czech Republic.

Background: Benign biliary strictures are usually treated surgically or endoscopically. When these strictures are not accessible by endoscope or when open repair is not possible, percutaneous dilatation treatment is indicated. The efficacy of treatment is usually evaluated by clinical trial which includes leaving a small non-functional catheter in situ and following liver function tests. The evaluation may be effectively done by the biliary manometric perfusion test. Aim: The aim of this paper is to emphasize the importance of percutaneous dilatation treatment of benign biliary strictures with focus on the role of the biliary manometric perfusion test and its future prospects. Methods and Results: Based on the literature and our own experience, this article gives a short overview of percutaneous treatment of benign biliary strictures, indications, techniques, complications and results. The treatment of these strictures has an overall success rate between 60 to 90 %. This article also explains the biliary manometric test, the technique and its importance in evaluation of treatment success. Conclusion: Benign biliary strictures of the hepatic duct junction or bilio-enteric anastomosis are difficult to treat surgically and are endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long term externalinternal drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective. The evaluation of the treatment success may be more effectively done by the manometric perfusion test. It is easy, reliable, less time-consuming giving immediate results, and relatively safe.

Abstract: A philosopher and teacher, F. M. (Ladimir) Klacel (1808-1882), educated in what is now the Czech Republic, developed his own explanation for the origin and interaction of living organisms. Klácel, a member of the Augustinian Monastery in Brno, infl uenced his younger colleague, Friar Gregor Mendel, who went on to formulate concepts in heredity that are still recognized for their profound insight. A mutual interest in the natural sciences of these two friends provided a basis for their discussions of the relationship between religion, evolution, and society. Klacel's outspoken defense of his proposals caused him to lose favor with both the Church and the authorities, and he immigrated to America in 1869. His failing health and inability to communicate with the English-speaking populace, unfortunately, limited his infl uence in his new environs. In this paper we trace the roots of Klacel's philosophy and elucidate his incorporation of ideas from Hegel, Darwin, and others. An investigation of Klacel's recipe for a successful society reveals his belief in the universality of life and his optimistic hope for human achievement.

Aims: To study the pathological changes in neurophysiological examination of lower-limb peripheral nerves in patients with long-term statin treatment. Methods: Forty-two patients (23 males, 19 females, mean age 51.9 and 52.3 years) with a definitive diagnosis of combined hyperlipidemia were studied. Other metabolic disorders or chronic ethanol abuse were excluded. Initial examinations included laboratory and neurophysiological measures (peroneal and tibial nerves: MNCV, CMAP, Fwave mean latency; superficial peroneal and sural nerve: SNCV, SNAP). Subsequently, treatment with simvastatin 20mg daily was initiated. Patients were followed for 24 months with examinations at 1, 6, 12 and 24 months after statin treatment initiation. Results: None of the patients reported subjective symptoms typical for polyneuropathy. In laboratory findings, there was no elevation of muscle enzymes. Nevertheless, electrophysiological examination of lower-limb peripheral nerves demonstrated statistically significant prolongation of F-wave mean latency on peroneal and tibial nerves (p < 0.0001, paired t-test). A control group of 50 patients with combined hyperlipidemia but no statin treatment showed no changes over the same time interval. The study demonstrated that long-term Conclusions: The study demonstrated that long-term treatment with statins might cause a clinically silent but still electrophysiologically definite damage to peripheral nerves.

Non-alcoholic fatty liver disease (NAFLD) is emerging as one of the most common liver disorders claiming the urgent attention of both medical professionals and the public sphere because of the imminent epidemic of advanced liver injury that appendages epidemic of obesity. Recent research reveals simple triglyceride accumulation in hepatocytes (i.e., liver steatosis) frequently becoming complicated by inflammation (i.e., non-alcoholic steatohepatitis, or NASH) that may progress into more advanced stages of the disease including cirrhosis or, eventually, hepatocellular carcinoma. The exact mechanisms of the progression of NAFLD into overt NASH and advanced disease stages are largely unknown. There is urgent need in terms of both intensive research pursuits and effective practical measures to deal with this common threat.

Background: Crohn's disease (CD) is a chronic relapsing disease. Especially acute period may be associated with metabolic disturbances. Alteration of lipid metabolism has been described in critically ill patients and hypocholesterolemia is associated with poor prognosis. The human organism acquires cholesterol by two principal processes - synthesis de novo, and absorption from the diet. It is possible to assess, using cholesterol synthesis markers (lathosterol) and cholesterol absorption markers (sitosterol, campesterol) the leading form of cholesterol acquisition. Aim: The aim of this study is assess the association between the lipid profile in plasma and the plasma concentration of sterols in active CD patients and in control subjects. Method: Routine laboratory tests, CDAI, lipid and non-cholesterol sterols plasma levels were performed on days 3, 14 and 28. The metabolic parameters have been compared with a control cohort of 100 healthy blood donors. Results: Presently, complete data for 8 patients are available The serum total cholesterol, LDL and HDL cholesterol, and triglyceride concentrations were lower in patients with acute Crohn's disease than in the control group. Moreover lathosterol, campesterol and sitosterol concentrations were lower, whereas squalene concentration was higher than in controls. As mentioned above, complete data are not currently available. Therefore statistical analysis has not been finished. Conclusion: Our pre-results show substantial abnormalities in the concentrations of plasma lipids and non-cholesterol sterols, which are presented as markers of cholesterol requirement, in patients with acute CD.

Background: About 20 percent of the population in developing countries is composed of women of reproductive age. These women face one of the catastrophic risks of pregnancy "uterine rupture". Studies conducted in the developing world give strong evidence that uterine rupture is a major health problem in these countries with the rate being high in rural areas. Aim: The purpose of the study was to estimate the incidence and determine the risk factors and outcome of uterine rupture among women using the referral hospital Al-thawra in Sana'a City, Yemen republic and to extrapolate the data to the whole of Yemen. Methods: The data was collected retrospectively; by interviewing, examining and following up all the cases of uterine rupture coming to the hospital during a period of 9 months between September 1996 and May 1997. A descriptive analysis and distribution frequency of the commonest causes of uterine rupture in 37 cases are presented taking into account medical, reproductive, health services provided and sociodemographic factors. Results: Incidence of uterine rupture in Yemen was found to be (0.63), obstructed labor 83 %, contracted pelvis 19 %, previous surgery in 48 %, Oxytocine infusion in 42 %. Grand-multiparty was in 65 % and maternal age over 35 years in 50 %. Antenatal care was only in 34 %. Conclusion: The high percentage of malpresentation, cephalopelvic disproportion, previous uterine surgery accompanied by the high percentage of use of Oxytocin in this study highlights very clearly the role of this medication in increasing the risk of uterine rupture in Yemen.

Periprosthetic osteolysis is associated with accelerated wear rates. The goal of this study was to investigate the influence of demographic and technical variables on wear rates and size of osteolytic lesions. Eighty retrieved ABG I prostheses were analyzed according to prospectively established criteria. There were 22 men and 58 women with an average age of 52 years (34-65) at the time of revision. The average time from index surgery to revision was 67 months (26 to 106). Polyethylene wear measurements were performed using a Universal-type measuring microscope. The average linear wear and volumetric wear rate was 0.363 mm per year (0-0.939, SD 0.241) and 161 mm³ per year (0-467, SD 118.2), respectively. The wear rates were significantly higher (a) in patients with primary osteoarthritis in comparison with postdysplastic hips, (b) in hips where zirconia prosthetic heads articulated against the polyethylene liner, and (c) in cups placed laterally to Kohler's line. Risk that linear wear rate could be more than 0.2 mm per year was three times higher in patients who were operated in 1997 and later (OR 3.0, 95 % CI 1.126-7.993, p = 0.03). A strong association was revealed between magnitude of wear and size of femoral osteolysis.

Background: Brain natriuretic peptides are relevant markers of heart impairment. Aim: We investigated the relevance of investiging brain natriuretic peptides (NT-proBNP, BNP) in monitoring different types of cardiovascular disease (chronic heart failure due to coronary artery disease, cardiomyopathy, acquired valve disease, congenital heart diseases). Methods: The NT-proBNP assay (Roche) was performed on 280 patients (mean age 49 years; range 20-89 years) and 48 healthy controls (mean age 43 years; range 13-65 years) and BNP assay (Bayer Shionoria) was performed in a subgroup of 42 patients (mean age 50 years; range 20-79 years). Patients were divided into four groups characterized by severity of heart failure according to the New York Heart Association classification. Results: NT-proBNP concentrations differed in patients with cardiovascular diseases from controls (median 371 ng/l versus 41.5 ng/l, p < 0.0001). The cut off value of NT-proBNP determined in 280 patients with cardiovascular diseases was at 130 ng/l (AUC-area under curve = 0.93; sensitivity 98 %; specificity 79 %). Comparison of NT-proBNP and BNP values in patients showed significant correlation (r = 0.93; p < 0.0001). NT-proBNP showed significant differences between groups. Conclusions: Measurement of brain natriuretic peptides is useful and relevant in various types of heart diseases including congenital.

Background: Pulse wave analysis permits non-invasive assessment of indices of arterial elasticity. Decreased arterial elasticity results in higher pulse wave velocity and therefore earlier wave reflection. Aim: The aim of this study was to evaluate the short-term variability for measurement of surface arteries. Method: For detection of artery wall movement, a plethysmography method was used. The changes in artery volume, affecting the fluid behind the scanning membrane, transfer themselves into pressure changes and move towards the positive input of a sensitive differential pressure transducer. The output is carried to a notebook computer and analysed within the frequency and time domain. To correlate arterial pulse waves, the following parameters were used: relative crest time RCT, interwave distance IWD, dicrotic wave amplitude DWA and dicrotic wave time DWT. These parameters were analysed using Bland-Altman plots. Results: Two data points (5.6 %) fall outside the 2*SD range for both IWD and DWA parameters on posterior tibial artery and one data point (2.8 %) for DWT. Three data points (8.3 %) fall outside the 2*SD range for IWD and two data points for both DWA and DWT on the radial artery. Two data points fall outside the RCT measured on the ulnar artery, and all but one for IWD, DWA and DWT lie within the 2*SD range. Conclusions: Pulse wave analysis showed reproducibility in a short-term study of all three measured distal arteries and is therefore suitable for use in patients for observing the progression of artery-wall-involving diseases.

Background: The need for a laboratory marker of myocardial ischemia has been alluded to for at least the last decade. Aim: The aim of this study was to evaluate the diagnostic importance of the myosin light chain-1 (MLC-1), clusterin and Reg-I7α in patients with suspected myocardial ischemia. Methods: A group of 176 at high-risk for myocardial ischemia subjects was evaluated and divided into two subgroups using myocardial SPECT (Single Photon Emission Computed Tomography) - individuals with and without signs of myocardial ischemia. Laboratory markers in venous blood were repeatedly examined in all subjects: a) immediately prior to SPECT: C-reactive protein, Haemoglobin, Hematocrite, Lactate, MLC-1, Clusterin, Reg-Iα b) at subjective maximum: Hb, Htc, lactate, MLC-1, Clusterin, Reg-Iα c) 30 min after stress levels reached their peak: MLC-1, Clusterin, Reg-Iα and d) 60 min after peak stress levels: MLC-1, Clusterin, Reg-Iα. Results: Patients were divided into subgroups according to their positive and negative SPECT results (positive: n = 37; negative: n = 139). MLC-1 values were different for all 4 blood collections. An increase in MLC-1 > 2.2 mg/l showed 64 % sensitivity and 88 % specificity for the diagnosed presence of myocardial ischemia (AUC 0.81; LR+ 5.9; PPV+ 68 % and NPV- 87 %). There was no significant difference between the groups in terms of Clusterin and Reg-Iα for any of the sampling periods. Conclusions: High diagnostic efficacy of detectable MLC-1 was shown for the diagnosis of latent myocardial ischemia. Measurement of serum Clusterin or Reg-Iα did not sufficient for the diagnosis of latent myocardial ischemia.

Objectives: The aim is to define conditions for exact measurement of urethral pressure profile, to prepare an aparatus and fabricate an artificial urethra for testing measuring catethers. To examine it's qualities by experiment. Methods: We designed a measuring appliance and a specialized software for measuring and evaluating. An experimental phantom of urethra, made from a part of bull's urethra, was used for testing of measurement's validity with use of different measuring catethers. Measurements were 10x repeated within the same position of the catether. Reproducibility of the measurement and stability of the experimental model was tested. Results: Measuring urethra and experimental phantom of urethra succeeded, it was possible to make well reproducible measurements with different measuring catethers and to evaluate their metrologic abilities and limits. Results of our measurements confirmed appointed theoretical conditions of the measurement. Conclusion: Measurements proved that it is possible to simulate the conditions that are similar to physiological conditions and that it is possible to test metrological qualities of compressive profilometry of urethra.

Objective: The aim of this study was to investigate risk factors for placental abruption and to determine if anamnestic variables such as inherited thrombosis or recurrent fetal loss might be used as a predictor for placental abruption. Methods: A retrospective case-control study at the University Hospital, Palacky University, Olomouc, Czech Republic. One hundred and eighty women with placental abruptio out of 20,175 deliveries (0.79 %) who were compared to 196 unselected pregnant women. A detailed anamnesis was taken. Results: Compared to controls, women with placental abruptio had a 12-fold increased prevalence of prior recurrent fetal loss and a 6-fold increased prevalence of inherited thrombosis. Conclusions: We found that recurrent fetal loss, and inherited thrombosis may be significant risk factors for placental abruptio.

The present 15 days study was undertaken to evaluate the cardioprotective potential of the prenylated isoflavones osajin and pomiferin isolated from the infructences of Maclura pomifera, Moraceae, against ischemia-reperfusion induced injury in rat hearts as a model of antioxidant-based composite therapy. The study was performed on isolated, modified Langendorff-perfused rat hearts and the ischemia of heart was induced by stopping coronary flow for 30 min followed by 60 min of reperfusion (14 ml min^-1). The Wistar rats were divided into four groups. The first treatment group received osajin (5 mg/kg/day in 0.5% Avicel); the second treatment group received pomiferin (5 mg/kg/day in 0.5% Avicel); the placebo group received only 0.5 Avicel; the last was an untreated control group. Biochemical indicator of oxidative damage-lipid peroxidation product malondialdehyde, antioxidant enzymes - superoxide dismutase, glutathione peroxidase, total antioxidant activity in serum and myocardium were evaluated. The effect of osajin and pomiferin on cardiac function, left ventricular end-diastolic pressure, left ventricular pressure and peak positive +dP/dt ischemia and reperfusion, also was examined. The results demonstrate that osajin and pomiferin attenuates the myocardial dysfunction provoked by ischemiareperfusion. This was confirmed by an increase in both antioxidant enzyme values and total antioxidant activity. The cardioprotection provided by osajin and pomiferin treatment results from the suppression of oxidative stress and this correlates with improved ventricular function.

There is no doubt, that the medical staff has often to face aggressive patients, their threats and event their violent physical attacks today. More frequently than ever they are faced with the necessity to think over and consider very carefully the way to defend against imminent or persistent attack on them. First, I would attempt to qualify patients' aggressive behaviour - from lesser acts, when the violent attack is not imminent, through threatening with killing, inflicting aggravated bodily harm or causing exceptionally serious damage or enforcement by violence, the threat of violence or the threat of causing another serious damage, to do something, to desist from doing something or tolerate something. to the imminent or persistent attack. Then I would try to describe the best ones of possible ways of self-defence against various levels of aggressive behaviour.

Background: The increase in maternal age in recent years has intensified the effort to develop early non-invasive methods for screening for trisomy 21 and other chromosomal abnormalities in prenatal diagnosis. In the first trimester of pregnancy, maternal age, fetal nuchal translucency (NT), maternal levels of free β- human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) are used as screening markers. We evaluated the introduction of this method of screening for the first time in the Czech Republic. Methods: it is a prospective study for one-year from the beginning of 2004. The risk of trisomy 21(Down's syndrome) was estimated for 686 singleton pregnancies. The specific risk was calculated using the Fetal Medicine Foundation software (FMF) by accredited sonographers. Karyotyping was offered to women with risk ≥ 1 in 250. Results: In the population screened 18 % of women were aged 35 and more. We found 2 cases of trisomy 21 and 1 case of trisomy 18 (Edward syndrome) resulting in a detection rate of 100 % for trisomy 21 for a 5 % false positive rate (33 of 683). The maternal age of the detected cases was 30, 38 and 42 years. Conclusion: Introduction of the first trimester screening to our clinic, reduced the number of invasive genetic testing from 18 % to 5 %. First trimester screening for trisomy 21 and other aneuploidies has a high sensitivity with a low false positive rate and can be delivered in an efficient manner in a university hospital.

The diagnosis of low grade prosthetic joint infection is difficult and time consuming. Nested-PCR for universal bacterial DNA segments detection of "orthopaedic" bacteria was tested in a laboratory setting. This method is based on amplification of the 16S bacterial ribosomal RNA coding sequences. 11 species of the most frequent bacterial pathogens (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus agalactiae, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Serratia marcescens) involved in prosthetic joint infections were studied. All could be detected rapidly and sensitively by this method.

The most significant precancerosis in the esophageal cancer is Barrett's esophagus. The risk of malignant transformation is determined primarily in accordance with the degree of dysplastic alterations of the mucosa. Indication of "preventive" extirpation of the esophagus should be supported by other factors, for example by detection of p53 mutation or expression. The study reports on the evaluation of a group of 20 patients with Barrett's esophagus treated at the 1^st Department of Surgery, the p53 level and its correlation with histological findings evaluated in these patients. A good correlation was found between the grade of Barrett's esophagus dysplasia and high p53 positivity. This correlation was also confirmed by detection of early carcinoma in patients with "preventive" extirpation of the esophagus due to a high-grade dysplasia. Preliminary results show that examination of p53 level in specimens taken from the esophageal mucosa may be helpful for the estimation of malignant potential of the dysplastic mucosa.

The aim of the study was to determine the prevalence of risk factors for cardiovascular diseases among physicians at a teaching hospital. In total, 203 men and 167 women were included in the study. The participants filled in a questionnaire; their height, weight, blood pressure, serum cholesterol and glucose levels were added. 19.2 % males and 13.8 % females were smokers, hypertension was diagnosed in 10 % of males and in 6.6 % of females, 52.2 % males and 17.4 % females were overweight, 37 % males and 43.1 % females had hypercholesterolemia. The above findings suggest that Czech physicians have more favourable values of all the studied cardiovascular diseases risk factors than the general Czech population. However, Czech physicians smoke more than those in other countries and their level of cardiovascular diseases risk factors is unsatisfactory and calls for further intensive prevention. Preliminary outcomes of the study repeated after two years show no positive trends as well as physicians' low willingness to actively participate in lowering cardiovascular diseases risk factors.

This review article describes the scientific evidence for the relationship between birth weight and insulin resistance. Most studies demonstrate that low birth weight is closely connected to insulin resistance and later development of diabetes type II in adulthood. For this reason it is important for clinicians to focus on the personal history of the patient's birth weight. In patients with low birth weight, primary measures should be taken to prevent the development or progress of insulin resistance, and late consequences like diabetes and atherosclerotic complications.

Myrrh and opopanax has been used throughout history in incense and as a perfume. Since Bible times it has been used for the treatment of wounds. The first attempts to identify content compounds were almost 100 years ago. In this review we discuss the present state of knowledge in the chemistry of substances of Commiphora spp.

Cyclosporine A (CyA) is a standard component of immunosuppressive regimens. It is a critical-dose drug for which a minor change in absorption can have important clinical consequences. The aim of the study was to compare the pharmacokinetics and safety of the new generic CyA formulation, Equoral® capsules, after a switch from original formulation, Neoral® capsules, in seventy stable adult renal transplant recipients. The extent and rate of pharmacokinetic parameters for bioequivalence were compared in a non-randomized, steady-state clinical study with fixed non-replicate study design. Pharmacokinetic analysis of CyA have shown that both the rate and extent of absorption of Equoral® does not differ significantly from that of Neoral®. At identical dosing, the new formulation was found to have geometric means of C_max 717 ng/ml and AUCτ 3108 ng/ml.h, while corresponding results of comparator were 725 ng/ml and AUCτ 3039 ng/ml.h, respectively. The 90 % confidence intervals of C_max and AUCτ were within 80- 125 % interval of the mean values. The results suggest that Equoral® capsules can be used as an alternative treatment to Neoral® capsules in CyA regimen.

Over more than 20 years hair analysis for drugs has been gaining increasing attention and recognition in various toxicological fields as preemployment and employment screening, forensic sciences, doping control of banned substances, clinical diagnostics in health problems. Hair analysis for drugs can expand the toxicological examination of conventional materials and thus contribute with additional important information to the complex evaluation of a certain case. Hair is a unique material for the retrospective investigation of chronic drug consumption, intentional or unintentional chronic poisoning in criminal cases, gestational drug exposure or environmental exposure to pollutants and adulterants and with specific ultrasensitive procedures allow to demonstrate even a previous single dose administration in a very low amount. Assuming the ideal hair steady and uniform growth, segmental hair analysis can provide the information about the time course of the substance use or exposure. However, the physiological background of hair growth, mechanisms of drug incorporation are not simple, not yet understood in full details and need not be evaluated exactly in all cases. The hair sampling, storage, sample preparation, analytical performance themselves are also very important for final results. Different laboratory attitudes can produce different results. The full information on circumstances of the case examined must be taken into account during interpretation. The pitfalls in hair analysis should be known and avoided to assure the responsible and correct interpretation of laboratory results adequate to an individual case.

Myosin light chains-1 (MLC-1) have been recently associated with the markers of heart function (NYHA, LVEF, NT-proBNP). Verification of the relationship between markers of heart function (New York Heart Association classification (NYHA), left ventricle ejection fraction determination (LVEF), N terminal prohormone of natriuretic peptide B type BNP (NT-proBNP) and concentrations of myosin light chains-1 (MLC-1) was assesed. Patients examined for dyspnea without signs of acute coronary syndrome. All patients underwent echocardiography (calculation of left ventricle ejection fraction - LVEF) and in the serum of all subjects NT-proBNP (ELEIA) and MLC-1 (ELISA) were determined. In the 38 patients (21 men, 17 women), mean age of 58 years (±12 years as 1 SD), a significant negative correlation was found between NT-proBNP and LVEF (r = - 0.47; p = 0.02, Spearman). The median levels of NT pro-BNP were closely associated with NYHA classification (type II - 584 ng/l, type III - 2792 ng/l, type IV - 6400 ng/l; p < 0.05). Individuals with clinical NYHA IV differed significantly in median MLC-1 concentrations from persons with clinical NYHA classification II and III (type II - 5.7 ng/l, type III - 8.9 ng/l, type IV - 17 ng/l; p < 0.05). A significant negative correlation between MLC-1 and LVEF (- 0.35; p < 0.03) and significant positive correlations between MLC-1 and NT-proBNP (- 0.42; p < 0.012) were found. In conclusion MLC-1 cannot be used as a diagnostic marker in differential diagnosis of dyspnea.