[Polycystic ovary syndrome as a multisystemic endocrinopathy]. / Nemoc polycystických ovarií jako multisystémová endokrinopatie.

OBJECTIVE: To review the recent progress in the diagnosis, pathophysiology and treatment of polycystic ovary disease (PCOD). DESIGN: A review describing the progress in understanding of the dysregulation of ovarian androgen biosynthesis in polycystic ovary disease (PCOD). SETTING: The Institute for the Care of Mother and Child, Podolské nábr. 157, 147 10 Prague 4, Sanatorium Pronatal, Na Dlouhé mezi 4/12, 147 00 Praha 4-Hodkovicky. CONCLUSION: It is proposed, that although this syndrome is very heterogeneous, the final common pathway involves a dysregulation of enzymes responsible for ovarian androgen biosynthesis, possibly induced/influenced by extraovarian factors--especially insulin resistance, hyperinsulinaemie, growth factors, luteinizing hormone and their biochemical sequelae. It's probably extraovarian factors that determine endocrinological and clinical expression of the disease.

Human recombinant erythropoietin in the treatment of anaemia in chronic haemodialysis patients.

Five women aged 50-64 years with chronic renal failure caused by interstitial nephritis, maintained by chronic haemodialysis, were treated for three months with human recombinant erythropoietin. The blood haemoglobin level roce from 78.0 +/- 6.9 g/l to 108.4 +/- 15.5 g/l, haematocrit from 21.8 +/- 1.8% to 33.6 +/- 4.8%, and the rate of reticulocytes 1.8% to 4.9%. Serum ferritin concentration declined from 2213 +/- 1982 micrograms/l to 850 +/- 953 micrograms/l. Unlike the pre-treatment period, no blood transfusion had to be given during the administration of erythropoietin. The patients' general condition improved. There were no serious complications. The action of erythropoietin persisted for two months. Human recombinant erythropoietin is a significant help in the treatment of patients with chronic renal failure.

[The importance of screening for hepatitis B surface antigens in pregnancy]. / Význam skríninku povrchového antigenu viru hepatitidy B u tehotných.

Transmission of hepatitis B virus (HBV) from mother to infant during the perinatal period represents very efficient mode of HBV infection and often leads to severe long-term sequelae. Perinatal transmission can occur when an infant is born to mother positive for hepatitis B surface antigen (HBsAg), frequency of transmission is high if the mother is also HBeAg positive. Prevention of perinatal transmission of HBV is important since the majority of these infants who are infected at birth become chronic carriers and can subsequently develop chronic hepatitis, cirrhosis or primary hepatocellular carcinoma. Routine screening for HBsAg of all pregnant women attending prenatal clinic at the Institute for the Care of Mother and Child, Prague in the third trimester of pregnancy by Sevatest ELISA HBsAg Micro I. method (Sevac, Prague) began in June 1986. HBsAg positive patients were subsequently tested for HBeAg and anti-HBe hepatitis markers. Of the 2744 women examined 22 were found HBsAg positive, of these mostly asymptomatic carrier mothers 2 were positive for HBeAg, 14 for anti HBe and 6 were negative for both HBeAg and anti-HBe. All infants were given passive HBIG prophylaxis in conjunction with HB vaccine after birth regardless of HBeAg status of mother. At present no infant were found HBsAg positive at 6 month of age, observation of this risk group infants continues.

[Treatment of anemia in patients on a regular dialysis program using human recombinant erythropoietin]. / Lécba anemie pacientu v pravidelném dialyzacním programu lidským rekombinantním erytropoetinem.

Five women aged 50-64 years with chronic renal failure, due to interstitial nephritis, enlisted in a regular dialyzation programme were treated for three months with human recombinant erythropoietin. The blood haemoglobin level rose from 78.0 +/- 6.9 g/l to 108.4 +/- 15.5 g/l, the haematocrit from 21.8 +/- 1.8% to 33.6 +/- 4.9%. The serum ferritin concentration declined from 2213 +/- 1892 micrograms/l to 850 +/- 953 micrograms/l. Contrary to the period before treatment, during erythropoietin administration no blood transfusion had to be administered. The general condition of the patients improved. There were no serious complications. The action of erythropoietin persisted for two months. Human recombinant erythropoietin is significant help in the treatment of patients with chronic renal failure.

[Routine screening for serological markers of viral hepatitis B in pregnancy]. / Rutinní screening sérologických markeru viru hepatitidy B u tehotných.

Transmission of hepatitis B virus (HBV) from mother to infant during the perinatal period represents very efficient mode of HBV infection and often leads to severe longterm sequelae. Perinatal transmission can occur when an infant is born to mother positive for hepatitis B surface antigen (HBsAg), frequency of transmission is high if the mother is also HBeAg positive. Prevention of perinatal transmission of HBV is important since the majority of these infants who are infected at birth become chronic carriers and can subsequently develop chronic hepatitis, cirrhosis or primary hepatocellular carcinoma. Routine screening for HBsAg of all pregnant women attending prenatal clinic at the Institute for the Care of Mother and Child, Prague in the third trimester of pregnancy by Sevatest ELISA HBsAg Micro I. method (Sevac, Prague) began in June 1986. HBsAg positive patients were subsequently tested for HBeAg and anti-HBe hepatitis markers. Of the 2744 women examined 22 were found HBsAg positive, of these mostly asymptomatic carrier mothers 2 were positive for HBeAg, 14 for anti-HBe and 6 were negative for both HbeAg and anti-HBe. All infants were given passive HBIg prophylaxis in conjunction with HB vaccine after birth regardless of HBeAg status of mother. At present no infant were found HBsAg positive at 6 month of age, observation of this risk group infants continues.

The development and evaluation of Sevatest ELISA hCG Micro I. kit as a test for pregnancy.

The enzyme-linked immunosorbent assay (ELISA) method of sandwich type for determination of human chorionic gonadotropin (hCG) in serum or urine using horseradish peroxidase as an enzyme label and microtiter ELISA plates (or polystyrene microtubes respectively) as a solid phase support for antibody was developed. Test sensitivity of 200 mIU hCG per milliliter is approximately sixfold greater than the available hemo- or latex agglutination tests; quantitative hCG ELISA method has sensitivity of 6 mIU hCG per milliliter. In order to evaluate the usefulness of the method for early pregnancy detection 5,000 urine samples were prospectively collected and results correlated with outcome of pregnancy. Reliability of the test performed on routine basis at the Institute for the Care of Mother and Child in Prague proved to be 97.2% for intrauterine pregnancy detection, in 2.52% the test result was "+ -", and only in 0.28% the results were erroneous. For samples sent with the diagnosis of suspected extrauterine pregnancy 93.5% of correct results, 4.35% of "+ -" and 2.17% of erroneous results was found.

PIP: The enzyme-linked immunosorbent assay (ELISA) method of sandwich type for determination of human chorionic gonadotropin (hCG) in serum or urine using horseradish peroxidase as an enzyme label and microtiter ELISA plates (or polystyrene microtubes respectively) as a solid phase support for antibody was developed. Test sensitivity of 200 mIU hCG/milliliter is approximately 6 times greater than the available hemo- or latex agglutination tests; quantitative hCG ELISA method has sensitivity of 6 mIU hCG/milliliter. In order to evaluate the usefulness of the method for early pregnancy detection, 5000 urine samples were prospectively collected and results correlated with outcome of pregnancy. Reliability of the test performed on a routine basis at the Institute for the Care of Mother and Child in Prague proved to be 97.2% for intrauterine pregnancy detection, in 2.52% of the test result was "+ -", and only in 0.28% were the test results in error. For samples sent with the diagnosis of suspected extrauterine pregnancy, 93.5% were correct results, 4.35% were "+ -", and 2.17% were results in error.