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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.

AIMS: The goal of this study was to investigate the effect of chronic smoking on arterial stiffness at a peripheral site using pulse wave analysis. METHODS: Forty two non-smokers (17 males, 25 females) of average age 20.2 ± 1.3 year and forty five smokers (19 males, 26 females) of average age 24.3 ± 2.4 year were included in the study. Four parameters, SI (stiffness index), RI (reflection index), CT (crest time) and IWD (interwave distance) were evaluated by means of an adapted device based on pletysmographic principles that transform volume changes to voltage changes. RESULTS: SI corresponding to pulse wave velocity was 0.64 m/s higher in smokers than in non-smokers (7.25 ± 0.53 m/s versus 7.89 ± 0.73 m/s, P < 0.001). RI was significantly higher in smokers (42.49 ± 6.71 %, versus 35.46 ± 0.06 %, P < 0.001) than in non-smokers. IWD for non-smokers was 8.01 ± 0.13 %, in smokers we found a 16 % increase to 9.21 ± 0.83 % (P < 0.001). We detected a small increase in CT in smokers compared to non-smokers (0.09 ± 0.01 s versus 0.10 ± 0.01 s, P < 0.005). CONCLUSIONS: Chronic tobacco smoking is associated with endothelial dysfunction. In smokers we found increased values for all assessed parameters. Our results suggest that the negative effect of cigarette smoking on the vascular system can be found even in young smokers who have been smoking for less than 10 years.

Background: Cardiotrophin-1 is newly discovered chemokin with a lot of functions. Aim of our work was to describe most important of them. Methods: systematically scan of available scientific resources. Results: Cardiotrophin-1 stimulates the proliferation of cardiomyocytes. Cardiotrophin-1 expression and plasma values are elevated in individuals with heart failure and have high diagnostic efficacy for the heart failure. Plasma values are also an independent prognostic factor. Preliminary findings suggest that the determination of plasma cardiotrophin-1 may be useful for the follow-up of hypertensive heart disease in routine clinical practice. Cardiotrophin-1 also plays an important cardioprotective effect on myocardial damage, is a potent regulator of signaling in adipocytes in vitro and in vivo and potentiates the elevation the acute-phase proteins. Cardiotrophin-1 may play also an important protective role in other organ systems (such as hematopoietic, neuronal, developmental). Conclusion: Cardiotrophin is a newly discovered chemokin with a lot of system effects and is stable in system circulation hence permitting its development in the routine clinical investigation.

Aim: Vacuum-assisted closure (VAC) was primarily designed for the treatment of pressure ulcers or chronic, debilitating wounds. Recently, VAC has become an encouraging treatment modality for sternal wound infection after cardiac surgery, providing superior results to conventional treatment strategies. Methods: From November 2004 to September 2006, 34 patients, undergoing VAC therapy for sternal wound infection following cardiac surgery, were prospectively evaluated. Ten patients (29 %) were treated for superficial sternal wound infection and 24 (71 %) for deep sternal wound infection. The median age was 69.9 years (range 48 to 82) and the median BMI was 33.4 kg/m² (range 28 to 41). Twenty patients (59 %) were women and 19 patients (59 %) were diabetics. Owing to sternal wound infection complications, 16 patients (47 %) were readmitted to the department. VAC was used following the previous failure of the conventional treatment strategy in 7 patients (21 %). Results: Thirty-three patients (97 %) were treated successfully. One patient (3 %) died of multiple organ failure. The overall length of hospitalization was 34.6 days (range 9 to 62). The median number of dressing changes was 4.6 (range 3 to 10). The median VAC treatment time until surgical closure was 9.2 days (range 6 to 21 days). VAC therapy was solely used as a bridge to definite wound closure. Three patients (9 %) with chronic fistula were re-admitted 1 to 6 months after VAC therapy. Conclusions: VAC therapy is a safe and reliable option in the treatment of sternal wound infection in cardiac surgery. VAC therapy should be considered an effective adjunct to conventional treatment modalities for the treatment of extensive and life-threatening wound infections following cardiac surgery, particularly in the presence of risk factors.

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.

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.

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.

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: 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: 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.

Aims: The aim of this study was to determine glycaemic index (GI) of 10 popular foodstuffs/mixed meals in healthy persons. Methods: Ten tested foodstuffs and glucose standard were consumed in three replicates in the course of a defined 9-day meal plan: puffed rice squares with chocolate, dark chocolate, white bread, honey and glucose for breakfast (at 7 a.m.) and dinner (at 8 p.m.); pasta with meat, fried fish with mashed potatoes, and buttered apricot dumplings for lunch (at 12 a.m.); wafers, puffed spelt squares with chocolate, and tomato soup for snack (at 4 p.m.). Each portion contained 50 g of carbohydrates and was consumed within 30 minutes. Glucose concentrations were measured by means of the Continous Glucose Monitoring System (CGMS™, Medtronic Minimed, Northridge, CA, USA). The results were processed by Solutions Software (Medtronic Minimed, Northridge, CA, USA) and DegifXL4 software, Palacký University, Olomouc, CZ. Twenty healthy persons aged 21.9 ± 1.39 y (mean ± SE), BMI 23.6 ± 0.63 kg/m² completed the study. Results: GI of tested foodstuffs ranged from 34.7 % (chocolate) to 105.3 % (puffed rice squares with chocolate). There were more than tenfold differences between minimal and maximal values of the GI for some foodstuffs. Significant interindividual differences were found between GIs of foodstuffs. Conclusions: In twenty healthy persons the glycaemic indexes of ten popular foodstuffs were determined, to be added to the nutritional labels in order to facilitate the optimum meal planning.

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.

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.

We investigated the performance of brain natriuretic peptides (BNP and NT-proBNP) in detecting various degrees of left ventricular systolic dysfunction. The NT-proBNP assay (Roche) and the BNP assay (Bayer Shionoria) were performed in 46 patients (mean age 50 years; range 20-79 years) with various types of heart disease (chronic heart failure due to coronary artery disease, cardiomyopathy, acquired valve disease, congenital heart diseases) and different impairment of left ventricular systolic dysfunction was assessed by echocardiography. Patients were divided into four groups according to the left ventricular ejection fraction (LVEF) correlated with clinical severity. Significant differences in medians of NT-proBNP and BNP values between all groups were determined (P= 0.0161 for NT-proBNP and P=0.0180 for BNP). For identifying patients with severe systolic dysfunction (LVEF<40%), receiver operating characteristic (ROC) analysis for both BNP and NT-proBNP was performed. The diagnostic performances expressed as areas under the curve were of 0.69 for NT-proBNP (cut off value 367 pg/ml) and 0.60 for BNP (cut off value 172 pg/ml). However, the BNP showed higher sensitivity (85 % vs. 63 %) and a higher positive predictive value (69 % vs 55 %) than the NT-proBNP. The negative predictive values of BNP and NT-proBNP were similar (70 % and 71 % respectively). Brain natriuretic peptides are promising markers for the diagnosis of severe left ventricular systolic dysfunction.

Heat shock proteins (hsp's) are among the most conserved proteins in evolution. They have been identified as important pathogen-related antigens as well as autoantigens suitable for construction of novel vaccines. The high evolutionary homology of hsp's has raised the question about the safety of such vaccines. Experimental and clinical observations have confirmed that hsp proteins are involved in the regulation of some autoimmune disease such as autoimmune arthritis, type 1 diabetes mellitus, atherosclerosis, multiple sclerosis, and other autoimmune reactions. It has been shown in experimental animals that some hsp proteins (especially hsp60, hsp70, and hsp10) can either induce or prevent autoimmune reactions depending on the circumstances. This article discusses the involvement of hsp proteins in the etiology of autoimmune diseases and it presents promising experimental data on the effects of immunization with hsp proteins in the prevention and therapy of autoimmune diseases.

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: 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.

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.

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: Bifocal pacing (BFP) has been proposed as a more feasible alternative of cardiac resynchronization therapy (CRT). Aim: To evaluate BFP in patients with severe congestive heart failure and significant intraventricular conduction delay and to compare it with biventricular pacing (BVP). Methods: Both echocardiographic examination including tissue Doppler imaging and invasive measurements of cardiac hemodynamics was performed under basal conditions and during BFP and BVP. Results: 50 patients were included: 29 patients with ischemic heart disease (IHD), 21 patients with idiopathic dilated cardiomyopathy (IDCM). Left ventricular (LV) pressure gradient (dp/dt_max) increased during BFP compared to the baseline (13.4 %, 95 % CI 9.2-17.6 %, p < 0.0001) and a further increase was achieved during BVP (29.5 %, 95 % CI 23.7-35.4 %, p < 0.0001). A significant correlation was found between the distance of the right ventricular apical and outflow tract leads and percentage of dp/dt_max increase in IDCM patients (r = 0.72, p < 0.001), but not in IHD patients. Interventricular mechanical delay (IVMD) decreased in BFP compared to baseline (43 ± 22 ms vs. 53 ± 31 ms, p = 0.006). BVP produced even shorter IVMD (22 ± 19 ms, p < 0.0001). In all patients, the regional systolic contraction times were significantly shortened, corresponding with prolongation of the respective regional diastolic filling times during both BFP (p < 0.05 for all segments) and BVP (p < 0.001 for all segments). The effect of BVP on regional systole shortening was more pronounced. Conclusions: BFP improves LV hemodynamics by decreasing the inter- and intraventricular conduction delays. The leads in the right ventricle should be placed at the longest achievable distance. BVP is superior to BFP.

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.

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.

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.

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.

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.

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 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.