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Interference of thapsigargin (TG), an inhibitor of endoplasmic reticulum Ca²⁺ ATPase, with immune reactivity of murine macrophages was investigated under conditions in vitro. The activation of cells with lipopolysaccharide (LPS), interferon-_γ (IFN-_γ), and with acyclic nucleoside phosphonate N⁶-isobutyl-9-[2-(phosphonomethoxy)ethyl]- 2,6-diaminopurine (N⁶-isobutyl-PMEDAP) resulted in enhanced production of cytokines TNF-α, IL-10, chemokines RANTES/CCL5 and MIP-1α/CCL3, as well as in substantially augmented production of nitric oxide (NO) triggered by IFN-_γ. The effects were in a dual mode of action influenced by TG (1 μM). While TG upregulated secretion of TNF-α, it inhibited secretion of IL-10 and RANTES. The immune-stimulated secretion of MIP-1α remained virtually unaffected, though TG on its own activated expression of MIP-1α in macrophages. The high-output NO production induced by IFN-_γ, high concentrations of LPS, or by combination of IFN-_γ plus LPS or N⁶-isobutyl-PMEDAP was inhibited by TG. On the other hand, production of NO which was marginally activated by low concentration of LPS was upregulated by TG.

Peroxisome proliferator-activated receptors (PPARs) are subgroups of nuclear hormonal receptors of transcripting factors mostly found in adipose tissue. They are described as important regulators of lipid and saccharide metabolism including insulin sensitivity; therefore they are taken as marker of metabolic syndrome. Their synthetic ligands could be used as drugs for insulin resistance and type 2 diabetes mellitus.

The metabolic syndrome mostly represented by obesity and hyperinsulinaemia connected with insulin resistance, presents the main mechanism in the pathogenesis of cardiovascular disease. The aim of this study was to analyze the interrelations between several metabolic variables (including leptin) and factors related to insulin resistance in groups of both normal and non-diabetic hyperlipemic postmenopausal women and men of appropriate age, and to attempt to elucidate the gender differences. Two groups of patients (20 men, 20 women) with hypertriglyceridemia were compared with 30 individuals (10 men, 20 women) with normal serum triacylglycerols. Fasting serum leptin concentration, lipid parameters (triacylglycerols, HDL cholesterol, LDL cholesterol) and BMI were measured and compared with changes in insulin parameters influencing insulin resistance (HOMA IR, insulin, intact proinsulin, C-peptide). Statistical analysis was performed using SAS/STAT software including unpaired Student's t-test, Kolmogorov-Smirnov's test, Spearman's rank-order correlation and multiple regression analysis. In men, the insulin sensitivity correlates with leptin only. In women insulin sensitivity is markedly influenced by a complex of factors: leptin and lipid parameters. Increased insulin resistance in men is followed mainly by the increased correlations between leptin, HOMA IR and insulin parameters. In women correlations between leptin, HOMA IR and insulin parameters were smaller, but the inverse correlation with HDL cholesterol was stronger. In postmenopausal women and also in men, serum leptin concentration contributes to insulin resistance. However in women the effect of increase in serum triacylglycerols in contribution of insulin resistance seems to be more dominant.

In this report, we present the case of a 64-year-old woman who sustained a Burch-Schneider cage fracture. Prior to this event, she underwent repeated acetabular reconstructions, but in the end prosthesis removal was performed as a salvage procedure. We believe that the primary cause of the fracture was metal fatigue facilitated by intraoperative re-contouring of the flange, as well as reuse of the cage. Based on this case we caution against repetitive or excessive flange bending during implantation of Burch-Schneider cages and do not recommend their reuse.

The aim of this prospective clinical study was to compare the results of B-glucose estimations performed simultaneously on glucometer Advance (with Micro-draw strips) and Optium (G3 strips) by lay healthy volunteers under non-standardized conditions of everyday life, to assess the difficulties dealing with lay - handling of these systems and to demonstrate the possibilities of the software Glucobalance (Hypoguard) and PC-Link (Medisense/Abbott) for the analysis of selfmonitoring. In the course of 5 days, a total of 721 pairs of measurements were carried out on 10 pairs of glucometer Advance and Optium by 10 healthy volunteers aged 16-40 years. The data transfer of all values into computer from glucometer Advance using the Glucobalance software and from glucometer Optium using the PC-Link was carried out to determine the results. The correlation of B-glucose measured on the glucometer Advance and Optium was strong (r = 0.73). Glucometer Advance brings values about 0.21 ± 0.06 mmol/l lower than glucometer Optium. The average difference found within each pairs of glucometers Advance - Optium varied. Nevertheless, these differences are acceptable for routine selfmonitoring. The handling of glucometer Advance is not difficult for lay persons. The Glucobalance software simplifies the result evaluation by each tested person. Even though there are some advantages in comparison with the PC-Link, it should be further developed.

A double-blind, placebo-controlled clinical trial was performed to investigate the effectiveness of a herbal-based dentifrice in the control of gingivitis. Forty volunteers completed the 84-day study. All subjects were balanced for parameters measured - plaque index (PI), community periodontal index of treatment needs (CPITN) and papillary bleeding index (PBI). The dentifrice was effective in reducing symptoms of gingivitis as evaluated by the CPITN and PBI indexes.

The aim of our work was the detection of c- and N- myc proteins in the developing kidney of human fetuses especially in the neogenous zone. These proteins being localized in nucleus and encoded by the cellullar oncogene myc function as transcriptional factors. Myc gene represents the key control gene in the course of cellular proliferation and differentiation. It also participates in the regulation of apoptosis and the origin of some cancers. Both proteins have been proved to be inevitable for proper nephrogenesis in mice. Considering the dearth of studies dealing with human embryonic tissues, we attempted to map the localization and spatiotemporal relations of the expression of these proteins during human nephrogenesis. In addition, issuing from our previous observations, we tried to compare their ways of expression with those of Bcl-2 (antiapoptotic effect) and Bax (proapoptotic function) proteins. Histologically normal kidneys were collected from eight human fetuses ranging from the 10^th- 30^th week of IUD. Tissue samples were fixed in methacarn and processed by routine paraffin technique. Standard indirect three-step immunohistochemical method was applied for the detection of N- and c-myc proteins. In the neogenous zone both proteins are markedly present in metanephrogenic blastema with declining intensity with the increasing age of fetus. Branches of ureteral bud are almost negative. Such localization is also typical for Bcl-2 protein whereas Bax positive cells are present mostly in branches of the ureteral bud. It is not clear if all these proteins collaborate in the course of regulation of apoptosis in human metanephros.

The glycaemic index (GI) is a measure of the food power to raise blood glucose (B-glucose) concentration after a meal. For healthy eating, foods with low GI are recommended. However, for many foods in the European Union the GI has not been defined yet. The aims of this prospective open-label study were: (1) to determine the GI of white bread and juicy cereal bars FIT (Úsovsko, Czech Republic) by means of the glucometer Optium (Abbott/Medisense); (2) to compare the GI of tested foods determined in the morning and in the evening hours; (3) to compare the GI of tested foods in men and women and (4) to assess the variability of the GI. Methods: To determine the GI, measured portions of food containing 50 g of carbohydrates were eaten by 11 healthy volunteers. B-glucose curves were constructed from B-glucose values at time 0, 15, 30, 45, 60, 60, 120 min after the meal. The GI was calculated by dividing the incremental area under the curve (IAUC) for the tested food by that for the standard food (IAUCS). In each volunteer each food was tested 5 times so that 5 GI's was obtained and the average was calculated. The GI for each tested food was calculated as the mean from the respective average GI's of the 11 volunteers. MS Excel and the statistical program SPSS v. 10.1 were used to analyze the data. Results: (1) The mean values of the GI for white bread was 70.3 % and for juicy cereal bars was 101.0 %, as determined in a total of 139 tests in the whole group of 11 volunteers. There was a difference when comparing white bread vs. glucose (p = 0.012) and white bread vs. cereal bars (p = 0.026) but no difference between glucose and cereal bars. (2) There was no significant difference between the GI determined in the morning and in the evening hours either for the total of 139 tests or for the individual tested foods. (3) No significant difference could be seen between the GI in men and women when comparing glucose, cereal bars and white bread. (4) There was a wide variability of GI in all tested foods: the standard deviation of GI for white bread was 30.7 %, for juicy cereal bars 38.0 %. Conclusions: The GI's for white bread and juicy cereal bars were determined. There was no difference either between the GI values determined in the morning vs. the evening hours or between the values in men vs. women. The results show wide variability. An accurate standard method for the determination of GI needs to be defined, carefully used and re-evaluated to enable a comparison of the results with various methods of other working groups.

The aim of our study was to assess the accuracy and limitations of ultrasound guided fine-needle aspiration cytology (FNAC) of thyroid nodules. Methods: The usg-FNAC results of 245 patients with thyroid nodules, who afterwards underwent thyroid surgery or who died, and autopsies were carried out, and compared retrospectively with cytologic results. Patients with malignant cytologic conclusion without histological confirmation after surgery or autopsy were excluded from the study (9 persons). The usg-FNAC results were divided as follows: group 1: diagnosis of malignancy (n = 30), group 2: suspicion of malignancy (n = 28), group 3: benign (n = 126), group 4: inconclusive (n = 29). Results: Assuming the cytologic results of group 1 and group 2 were interpreted as being malignant and those of group 3 as being benign, the sensitivity, specificity and accuracy of usg-FNAC were 90 %, 85 % and 86 % respectively. Comparing the cytologic conclusions between a group of patients with follicular lesions and a subgroup of other lesions a statistically significant difference (p < 0,01) between both subgroups using Fisher's test was found. Sensitivity, specificity and diagnostic accuracy in subgroup of follicular lesions were low (71 %, 63 %, 67 %), while in the subgroup of other lesions were high (94 %, 86 %, 88 %). FNAC can specify the nature of focal lesion with high sensitivity, specificity and diagnostic accuracy in the cases of non-follicular lesions. Histological evaluation is required to specification of the nature in cases in which cytology is indicative of follicular proliferation.

This case report demonstrates successful cardiopulmonary and cerebral resuscitation (CPCR) of a young male explored 15 hours following a suicide attempt (carbamazepine intoxication) in deep hypothermia (19°C) with circulatory arrest. An extracorporeal circuit was used to rewarm the patient's blood. Weaning from extracorporeal circulation (ECC) was successful and without complications as was recovery from multiorgan dysfunction, severe rhabdomyolysis and carbamazepine intoxication. An excellent outcome was achieved without any neurological deficit at the time of discharge from the hospital.

The aim of this paper is to prove the possible reproducibility of measurement with a new developed device for artery elasticity monitoring and determining the standard of major pulse wave parameters. As a measurement sensor, a conic probe with thin convex membrane was used. This technique allows setting an arbitrary pressure to a measured surface artery. We measured pulse waves on the radial arteries of 108 individuals. We expected similar features in arterial wall elasticity. We concentrated primarily on the amount of subcutaneous fat. For the measured waves we evaluated five following pulse wave parameters: relative crest time, elasticity index, dicrotic wave attenuation, dicrotic wave time and interwave distance. There were no significant differences in measured pulse wave parameters among the tested groups of subjects.

From 1995 to 2002 we monitored a group of 127 patients who had undergone kidney transplantations in the Olomouc transplantation centre. The aim of our study was to assess the function of the kidneys after the transplantation, which were rinsed during the removal from cadaverous donors and afterwards were treated by different preservative dilutions. We divided the patients into three groups of approximate similar size, according to the used dilution - EC (Eurocollins), HTK (Custodiol) and UW (Viaspan). In the first three weeks we assessed in each group, the immediate function of the kidneys as primary, belated and afunction. The EC group showed the primary function in 51.2 % of cases, belated in 46.8 % of cases and afunction in 2.1 % of cases. In the HTK group, primary function was found in 73.7 %, belated 23.6 % and afunction 2.7 %. The results of the UW group came to primary function 71.5 %, belated 26.2 % and afunction 2.3 %. The criteria of the immediate but also the long-term function (five year investigation) was a serum creatinine figure. The lowest decline of creatinine in three weeks after the transplantation was noticed in the EC group (the average figure = 429 µmol/l). In contrast the HTK group (the average figure 279 µmol/l) and the UW group (the average figure 288 µmol/l) had comparable figures and there was no significant difference between them from the statistical point of view. It means later in the first, the third and the fifth year after the transplantation the figures levelled out: EC 154 µm/l, HTK 182 µm/l, and UW 133 µm/l. There was statistically a minimum significant difference between the HTK group and the UW group. Another criteria was to determine the amount of functional grafts in alive donees. The Assessment was carried out always in each year after the transplantation, altogether five years. The amount of the functional renal grafts in EC and HTK group was 100 %, in the UW group 76.9 %. Conclusion: HTK and UW gave better immediate functionality results, but there were no differences found among EC, HTK and the UW group from the long-term point of view.

This issue of Biomedical Papers (Vol. 146, No 1) contains abstracts of the scientific papers to be presented at the 1st Central European Congress on Intensive Care Medicine.1 The abstracts appear in order of presentation from Thursday 13 through Saturday 15 June 2002. This abstract book would have been impossible to produce without the help of several people from organizing and scientific committee, special thanks must be given to the Editorial Board of Biomed. Papers, which provided immense help toward successful completion of accepted papers. Our thanks also must go to people from Publishing Centre of Palacky University. On behalf of Organizing and Scientific Committee of 1st Central European Congress on Intensive Care Medicine we wish you a pleasant stay at Olomouc.

In epidemiological studies there exists the evidence of relationship between socio-economic status (SES) and health. The suspicious cause of these differences is life-style. The aim of the presented study was to identify the relationship between SES, demographic characteristics and the life-style in an industrial region. A structured questionnaire was distributed to a random sample of some 3,000 aged 25-70 and collected by postal delivery. The SES and demographic factors being analysed were sex, age, education, marital status and economic situation of the family in the relationship with a wide range of information on life style. The data was analysed using the chi-square test and logistic regression. The total number of analysed questionnaires was 634. The lowest response-rate was in the group with the basic education. Significant differences were found by sex in education (less women with university degree) and household income (more women in the lowest income category, men in the highest one). A detail analysis of the aggregated variables (adjusted for all SES variables) found: passivity and contentment were in adverse correlation with the level of education and economic situation; psychical well-being was correlated with family status and economic situation, risk behaviour was correlated with all SES factors except sex and education. Among the analysed factors economical situation of respondents, family and education were the most significant determinants of the differences in life-style.

OLOMOUC, 2 – 4 OCTOBER 2003

Smallanthus sonchifolius (yacon) and Lepidium meyenii (maca) were the traditional crops of the original population of Peru where they are also still used in folk medicine. These plants are little known in Europe and Northern America although at least yacon can be cultivated in the climatic conditions of these regions. This article deals with the botany and the composition, the structure of main constituents, biological activity of these plants and the cultivation of yacon in the Czech Republic. The potential of yacon tubers to treat hyperglycemia, kidney problems and for skin rejuvenation and the antihyperglycemic and cytoprotective activity of its leaves seems to be related mostly to its oligofructan and phenolic content, respectively. Maca alkaloids, steroids, glucosinolates, isothicyanates and macamides are probably responsible for its aptitude to act as a fertility enhancer, aphrodisiac, adaptogen, immunostimulant, anabolic and to influence hormonal balance. Yacon and maca are already on the European market as prospective functional foods and dietary supplements, mainly for use in certain risk groups of the population, e.g. seniors, diabetics, postmenopausal women etc.

At present surgery in comparison with other medical fields does not fulfil our ambitions and we are not happy with this state. Surgery is not developing as fast as oncology, haematology, immunology and other branches, which are based on rapidly developing molecular biology. Surgeons are aware of this situation and they do not want to lose. We want to play a part in this new development without losing our position and distinctive surgical goals. To seek these new ways is a goal of the Petřivalský – Rapant Day and we are proud that in our country we are one of the first who want to make this historical change. Therefore in this conference we include topics that should increase our knowledge of malignancies and influence their therapy according to the newest molecular-biological findings.

Leptin is a circulating pleiotropic hormone that play an important role in appetite control, fat metabolism, regulationof body weight, fetus growth, growth and aging of adults and hematopoiesis. It is expressed abundantly and specificallyin the adipose tissue. A liver cell with developed steatosis represents a cell metabolism similar to metabolism of cells ofadipose tissue. Analyses of serum leptin and free leptin receptor in the serum of patients with steatosis showed significantvariations from reference limits of normal values. However in liver tissue with verified steatosis detection of mRNAgene for leptin was not proven. Such expression of ob gene for leptin was not found even in the liver tissue without steatosis.With respect to the absence of ob gene expression, the direct effect of ob gene expression on other parameters ofleptin metabolism could not be evaluated. The RT-PCR method with verified specificity and satisfying sensitivity was developed.The results obtained from analysis of serum leptin and free leptin receptor in the serum are presented and evaluated.The used methods were verified and reference limits for Czech population were defined in dependence on age andother clinical parameters.

The paper presents a simplified (but not trivial) mathematical model of the interaction between the urine flowand the male urethra and bladder, respectively. Urine is assumed to be a Newtonian fluid. The flow is considered tobe non-stationary, isothermal and turbulent. The urethra and bladder wall, featuring elastic properties, experiencelarge displacements and strains. The dynamic forces are included in the urethra wall motion. When fully extendedthe urethra attains the shape of an axisymetric tube. An iterative method based on the uncoupled approach isdeveloped.

In vitro subcellular and cellular systems have important and irreplaceable roles in the metabolic investigationsthat precede the development of new potential drugs. Of these model systems, tissue slices are probably the nearestto in vivo conditions. From the experimental and complexity points of view, perfused organs lie midway betweentisssue slices and whole organism. Preparation and working with liver slices is quick and easy, and, excess materialcan be cryopreserved and stored untill the next experiment. Slices can be prepared from a wide variety of organsand it is possible to co-incubate them. Another important feature is the possibility of interspecies comparison ofslices. Different experiments can be run both in the short-term as well as long-term incubations. Each in vitro systemhas an important place for example, in the development of new medicaments. It is therefore important to compareand supplement experimental results from different in vitro systems when extrapolating to in vivo situations is done.

Aim of study was determine if a correlation exists between bone mass density and concentration of osteoprotegerin.We examined the group of 199 patients of mean age of 63 years. Of the group under study, 31 patients hadnormal bone density (T score >–1 and <1) and 168 probands had osteopenia or osteoporosis (T < –1).Persons with normal BMD values had median values of OPG 60.8 ng/l, while patients with reduced bone densityhad median values of 73 ng/l OPG. Cut-off for reduction of bone density was 128 ng/l OPG.We demonstrated that OPG concentrations vary inversely with bone density values (correlation coefficient –0.31).These results suggest that determination of OPG could allow discrimination of individuals with normal bonedensity and those with reduced bone density.

Olomouc, 7 June 2000