[Novel approach to treatment of lagophthalmos-associated neuroparalytic keratitis]. / Novyi podkhod k lecheniyu neiroparaliticheskogo keratita v sochetanii s lagoftal'mom.

UNLABELLED: Aim - to develop effective treatment approaches to lagophthalmos-associated neuroparalytic keratitis. MATERIAL AND METHODS: A total of 34 patients (36 eyes) with neuroparalytic keratitis were enrolled. Group 1 consisted of 20 patients (21 eyes), in whom autoconjunctivoplasty was performed in combination with eyelid surgery. Group 2 consisted of 12 lagophthalmic patients (13 eyes) with purulent corneal ulcers, who additionally underwent corneal transplantation. Group 3 included 2 patients (2 eyes) with central corneal ulcer in the only seeing eye, who received, besides other things, upper sector iridectomy intended to serve as a pupil (RU 2299048 with priority date of 15.07.2005). RESULTS: In group 1, corneal re-epithelization and complete recovery was achieved in all patients within 3.00±0.69 weeks. Visual acuity (VA) has generally increased over the first year after treatment from 0.14±0.06 to 0.25±0.13 in group 1 and from 0.09±0.05 to 0.21±0.13 in group 2. In group 3, sector iridectomies also yielded an increase in VA - from 0.01 to 0.02 in one case and from 0.2 to 0.6 in the other. Autoconjunctivoplasty enabled rapid and stable re-epithelization of corneal defects in all cases. CONCLUSION: One-stage corneal and eyelid surgery has been shown to be more effective in treating lagophthalmos-associated neuroparalytic keratitis than previous methods. The novel approach ensures acute symptoms of keratitis resolve and the eye is saved, moreover, it allows to maintain visual acuity and prevent recurrences in 64% and 65% of patients, respectively.

[Early pregnancy loss and inherited thrombophilic states]. / Casné tehotenské ztráty a vrozené trombofilní stavy.

OBJECTIVE: Review the literature regarding inherited thrombophilic states and early pregnancy loss. DESIGN: Literary review. SETTING: Department of Gynekology and Obstetrics, 1st Faculty of Medicine, Charles University Prague. SUBJECT AND METHODS: Thrombotic risk is increased in normal pregnancy. This risk is further enhanced in women with congenital or aquired thrombophilia. As an adequate placental circulation is dependent on the normal balance procoagulant and anticoagulant mechanism, inherited thrombophilia may be associated with fetal loss. Literary review. CONCLUSIONS: Placental thrombosis may be final common pathophysiologic pathway in most women with habitus abortions and repeated pregnancy wastage. Preliminary nonrandomized studies suggest a benefit for prophylaxis with unfractioned and low-molecular-weight heparin (LMWH), and prospective randomized trials are in progress to define whether LMWH is effective in preventive pregnancy loss and other gestational vascular complications in women with thrombophilia and previus fetal wastage.

The effect of platinum derivatives on interfacial properties of DNA.

The interaction of DNA modified by the binding of various platinum compounds with an electrically charged mercury surface was studied by means of linear sweep voltammetry. It was found that DNA and its adducts with antitumour active cis-diammine-dichloroplatinum(II) (cis-DDP) on the one hand and antitumour inactive trans-diamminedichloroplatinum(II) (trans-DDP) and diethylenetriaminechloroplatinum(II) chloride (dien-Pt) on the other were unwound due to their adsorption on the negatively charged mercury surface polarized to the potentials of a narrow region around -1.2 V (vs. saturated calomel electrode). The modification of DNA by bifunctional platinum compounds (cis- and trans-DDP) resulted in a substantial lowering of the extent of this interfacial conformational rearrangement, the modification by trans-DDP being more effective. The modification of DNA by monofunctional dien-Pt influenced the unwinding of DNA on the mercury surface only negligibly. It has been concluded that in particular interstrand cross-links induced by platinum compounds in DNA are responsible for the effect of these drugs on the extent of the interfacial unwinding of DNA. This conclusion is in good agreement with the view that among the lesions induced in DNA by platinum compounds, the interstrand cross-links are of less significance from the point of view of the antitumour efficacy of these inorganic drugs.