An efficient approach for limited-data chemical species tomography and its error bounds.

We present a computationally efficient reconstruction method for the limited-data chemical species tomography problem that incorporates projection of the unknown gas concentration function onto a low-dimensional subspace, and regularization using prior information obtained from a simple flow model. In this context, the contribution of this work is on the analysis of the projection-induced data errors and the calculation of bounds for the overall image error incorporating the impact of projection and regularization errors as well as measurement noise. As an extension to this methodology, we present a variant algorithm that preserves the positivity of the concentration image.

[Precariousness, DRG's and health planning: pilot study at the Lariboisière hospital in Paris]. / Précarité, tarification à l'activité et planification sanitaire et sociale: étude pilote à l'hôpital Lariboisière de Paris.

OBJECTIVES: This paper considers the specific administrative procedures set up by managers of public healthcare establishments and those responsible for health and welfare policies to care for low-income pregnant women for whom 100% of the "price per act" (T2A) is refunded. What are the limitations and what improvements can be suggested? PATIENTS AND METHOD: The results are based on an analysis of data from semi-structured interviews, legislation and documents. RESULTS: The State, health insurance systems, public health establishments, local authorities, charities and outpatient services are involved in handling low-income parturients in different services and different establishments, both locally and regionally. A health and welfare policy comprising specific, coordinated actions and measures has been developed. The T2A "price per act" system may threaten its survival: the limited number of front-line facilities is often saturated and demand is increasing, treatment is often reduced to reactive management leading to unwanted readmissions, ethics are sometimes called into question and there is a risk of patient selection. DISCUSSION AND CONCLUSION: This pilot study provided some encouraging information but also indicated the limitations of the approach adopted. However, it was still of interest to see whether it was possible to use this approach, which did not require considerable resources, to reveal useful markers. This appeared to be the case. Regional Health Agencies (ARS) and local authorities could support the system. Additional funding is needed.

[Focal segmental glomerulosclerosis]. / Fokálne segmentární glomeruloskleróza.

Focal and segmental glomerulosclerosis accounted for 4.1% of all primary glomerulopathies. Typical signs of focal and segmental glomerulosclerosis were striking arteriolosclerosis on histological examination, the urinary syndrome of high proteinuria with mild haematuria and frequent nephrotic syndrome. The ten-year cumulative percentage of remissions was 30%. Patients with remission had at the time of biopsy a normal serum creatinine level and no or minimal regressive tubulointerstitial changes. The ten-year cumulative percentage of renal failure was 40%. Presence of nephrotic syndrome, extracapillary proliferation and advanced tubulointerstitial changes, tended to shorten a kidney survival. In one third of the patients the serum creatinine level rose by more than 50 mol/1/year.

[Clinical picture of 11 patients with sponge kidney]. / Klinický obraz 11 nemocných s houbovitými ledvinami.

The authors review clinical data assembled in 11 patients with sponge kidneys followed up for prolonged periods. The disease is manifested by colics, haematuria and symptoms of bacterial inflammation of the urinary pathways. The basis of the diagnosis is excretory urography with typical changes in the renal pyramids: cystic dilatation of the collecting tubules, calcifications and concrements. The main functional disorder is a decline of the concentrating capacity of the kidneys. In some patients renal tubular acidosis of the distal type can be proved.

[Lung infections after kidney transplantation. II. Diagnosis and therapy]. / Plicní infekce po transplantaci ledviny. II. Diagnóza a lécení.

In the diagnosis of pulmonary infections in patients after transplantations of the kidneys the main requirement is rapid assessment of the causal agent. This demand can be met only by collaboration of many specialists. Only when the diagnosis is established in time, the infectious process can be treated and the patient saved. An analysis of diagnostic and therapeutic procedures used in the examination of patients with pulmonary infections after transplantations of the kidneys is the subject of part II of the authors' paper.

Pharmacokinetics of roxithromycin in kidney grafted patients under cyclosporin A or azathioprine immunosuppression and in healthy volunteers.

The pharmacokinetics of roxithromycin was studied in 9 kidney grafted patients under cyclosporin A immunosuppression, in 10 transplanted patients with azathioprine, and in 6 healthy volunteers. The biological half-life (beta-phase) of roxithromycin in cyclosporin patients was 34.4 (+/- 12.25) h (mean +/- SD), in azathioprine patients 23.4 (+/- 8.18) h and in healthy volunteers 17.0 (+/- 3.8) h. The total elimination constant (k10) was 0.046 (+/- 0.014), 0.068 (+/- 0.019) and 0.084 (+/- 0.036) h, respectively. The total clearance was 0.79 (+/- 0.21), 1.45 (+/- 0.66) and 1.84 (+/- 0.56) l/h, respectively. The areas under the serum level curves were 407.6 (+/- 118.3), 251.0 (+/- 106.6) and 180.7 (+/- 73.2) mg.h/l, respectively. The differences in these parameters between healthy volunteers and cyclosporin patients were statistically significant, as well as those between cyclosporin and azathioprine patients. The differences between healthy volunteers and azathioprine patients were not statistically significant. The results cannot be interpreted unambiguously as an interaction between roxithromycin and cyclosporin; the effect of cyclosporin on the function of eliminating organs which causes the slowed-down elimination of roxithromycin could be taken into account.

[Type I and III membranoproliferative glomerulonephritis. Clinical picture and prognosis]. / Membranózne proliferativní glomerulonefritis I. a III. typu. Klinický obraz a prognóza.

Membranoproliferative glomerulonephritis (CN) of types I and III was diagnosed in 154 patients (15.5% out of primary CN). Out of this number 60% were men. During biopsy, one third of the patients were normotensive, 40% were slightly hypertensive and one third suffered from severe hypertension. Mean proteinuria was 6.5 +/- 5.5 g/24 h. In two thirds of the patients erythrocyturia was higher than 35 mil. in Addis' sediment and the findings in the urine were characterised by the proportion between proteinuria and erythrocyturia (p less than 0.001). During biopsy in one half of the patients, the serum creatinine level was already elevated. The presence of creatininemia was found to be directly linked to blood pressure, proteinuria, the degrees of extracapillary proliferation, tubulointerstitial regression and vascular arteriolosclerosis. The cumulative duration of the kidney function within the period of 10-20 years was 41 or 28%, the cumulative cure amounted to 14% 10 years after biopsy.

[Lung infection after kidney transplantation. I. Etiology, pathogenesis and clinical picture]. / Plicní infekce po transplantaci ledviny. I. Etiologie, patogeneze a klinický obraz.

Pulmonary infection is a frequent and serious complication following kidney transplantation. Increased susceptibility to infection is due to a decrease in the patient's immunological response caused by immunosuppression through drug administration, and by other influences. The majority of bacterial sources are gram-negative, often hospital strains. The most important gram-positive bacterium is Staphylococcus aureus. Lung tb occurs with a 10-25 times higher frequency than in the rest of the population. Nocardial and Legionella pneumonias are no exception. Candida and Aspergillus are the most common fungus infections. They affect patients weakened by previous bacterial or virus infections. Cytomegalovirus is the most serious among the latter. The disease is usually accompanied by fever, leukopenia, thrombocytopenia and hepatitis. Pneumocystic pneumonia is characterized by a rapid progression of hypoxemia without any marked skiagraphical changes. Disseminated toxoplasmosis affects also the central nervous system simultaneously with the lungs, and the clinical picture shows a combination of interstitial pneumonia and a focal neurological finding with consciousness impairment.

[Trimethoprim VUFB in the therapy of urinary infections]. / Trimethoprim VUFB pri terapii mocových infekcí.

Twenty women with asymptomatic significant bacteriuria took Trimethoprim (TMP) VUFB, 2 X 200 mg, for eight days. Twelve had morphological changes of the urinary pathways confirmed by intravenous pyelography. The test for the presence of bacteria with an antibody film in the urinary sediment suggested that the infection was in the upper urinary pathways in eight of the women. Immediately after termination of treatment the urine was negative in 16 women (80%), after another three weeks the negative finding persisted in the urine of nine women (45%). In one patient treatment was discontinued after five days on account of dyspeptic complaints, the remaining patients tolerated the drug well.

[Long-term effect of the administration of repeated single doses of netilmicin in urinary tract infections]. / Déletrvajcí úcinek opakovaného jednorázového podání netilmicinu pri infekcích mocových cest.

In 26 patients with different clinical forms of infections of the urinary pathways a 300 mg single dose of netilmicin was administered by the i.m. route and the bacteriological urinary finding was checked for as long as 10 weeks after administration of netilmicin. During this period the urine was bacteriologically negative in 42% of the subjects. In 8 subjects with relapses of the infection a second dose of 300 mg netilmicin was administered and the urine was bacteriologically negative for 10 weeks in four of the patients. On the whole it proved possible to eliminate the urinary infection for 42-112 days in 17 subjects (65%), even in so-called complicated infections. It may be stated that single dose treatment with netilmicin used once or repeatedly leads to prolonged elimination of the infection without affecting the sensitivity of the organisms, without side-effects and with a substantial reduction of the cost of treatment.

Comparison of three dosage regimens of ciprofloxacin in urinary tract infections.

Fifty-four patients with complicated UTI were administered ciprofloxacin in doses of 500 mg (30 subjects) and 250 mg (24 subjects) at 12-hour intervals. While a positive effect was noted in 96-100% upon termination of therapy, the effect was still present 3 weeks later in 90% of the high-dose, but only in 71% of the low-dose group. In 23 patients with uncomplicated UTI, a positive effect of the three-day therapy with 100 mg of ciprofloxacin at 12-hour intervals was observed in 91% of subjects. Intolerance to the agent was found in one case only. Development of resistance to ciprofloxacin was not observed.

Bile composition in patients with chronic renal insufficiency.

Very little is known about bile composition in the end stage of chronic renal sufficiency. Patients with this condition are either assigned to a dialysis-transplantation programme, or are treated temporarily with a low-protein diet. Our study was designed to determine bile composition both in a group of ten patients treated with a low-protein diet over a long period of time, and in 11 patients on regular haemodialysis. The patients on haemodialysis were found to have increased bile cholesterol and an increased saturation index in the bile, i.e. changes implying increased risk of cholecystolithiasis. These changes were further enhanced by the effect of a low-protein diet with subsequent increases in cholesterol values and the bile saturation index, as well as a decrease in primary and an increase in secondary bile acids in the bile, i.e. a change in the spectrum of bile acid characteristic for cholecystolithiasis.

[Idiopathic membranous glomerulonephritis. Clinico-morphologic relations and prognosis]. / Idiopatická membranózní glomerulonefritida. Klinicko-morfologické vztahy a prognóza.

Membranous glomerulonephritis (GN) was diagnosed in 61 of 993 patients with histologically confirmed primary GN. Two-thirds of the patients were men. High hypertension was recorded in 7.5% of the patients. A typical finding was marked proteinuria (6.15 +/- 4.88 g/24 h.) with mild erythrocyturia (median 8 million in Addis sediment). At the time of biopsy 86% of the patients had normal creatininaemia, the level of which was positively correlated with the blood pressure and degree of tubulointerstitial regression. The cumulative duration of renal function in 5, 10 and 20 years was 88, 80 and 57%; during the same time intervals 22, 48 and 52% of the patients were cured.

[Prevention of recurrent urinary infections using Solco Urovac, a polymicrobial vaccine]. / Profylaxe recidivujících mocových infekcí polymikrobiální vakcínou Solco Urovac.

The administration of Solco Urovac polymicrobial vaccine to 26 patients with recurrent episodes of urinary tract infection significantly reduced the number of episodes, in one third of the persons even prevented them for a period of one year. In case of persistent bacteriuria, accompanying, for example, nephrolithiasis, the vaccine had no effect. A better effect can be achieved in cases of uncomplicated infections of the lower urinary tract than in infections associated with structural abnormalities of the kidneys and urinary tract. In some patients, the administration of the vaccine is accompanied by mild side effects which, but only exceptionally, can lead to the discontinuation of the therapy.

[The effect of diphenylhydantoin on IgA nephropathy]. / Vliv difenylhydantoinu na IgA nefropatii.

Seventeen patients with verified diagnosis of IgA nephropathy (15 men and 2 women) were divided into two groups using random selection. The group receiving treatment consisted of 9 persons, the control group was made up of 8 persons. The former group were given diphenylhydantoin in doses of 2-3 mg/kg/day for a period of 6 months. After the termination of the course of treatment, the authors found a drop in the levels of serum immunoglobulins A, G, complement components C3, C4, circulating immunocomplexes, and decreased haematuria, and, in contrast, increased levels of serum creatinine. No undesirable effects of diphenylhydantoin were noted.