LATERAL TARSAL STRIP TECHNIQUE IN CORRECTION OF EYELID ECTROPION AND ENTROPION.

BACKGROUND: Ectropion and entropion are eyelid malpositions associated with a number of unpleasant symptoms. One of several surgical methods that can correct these problems is referred to as the lateral tarsal strip technique. In this paper, we evaluate the postoperative results and quality of this technique. We also examine the complications associated with this surgical method. METHODS: The study took place from April 2018 to April 2020 at the Military University Hospital in Prague. The operation was performed by two surgeons. The study included 43 eyes of 33 patients (17 women and 16 men), average age was 79 years. Before the operation, 23 eyes were affected by ectropion and 20 eyes affected by entropion, 35 of the 43 were cases of involutional origin. The study does not include patients who underwent other surgical techniques. RESULTS: There were no perioperative or postoperative complications in the entropion surgery group. Successful correction was achieved, and adverse symptoms disappeared in 91.3% of cases. Correct position of the eyelid was not achieved in two cases. For patients with ectropion, surgical correction was successful in 95% of cases. Ectropion persisted after surgery only in one patient. CONCLUSION:   The lateral tarsal strip technique is a safe, reliable and highly effective surgical technique. Correction of eyelid malposition was achieved in more than 90% of cases. The vast majority of patients were satisfied and reported relief from preoperative symptoms.

DIAGNOSIS THAT MIMIC PACHYCHOROID DISEASES OF MACULA - CASE REPORTS.

Pachychoroid disease of retina is a spectrum of diseases manifested by thickening and hyperperfusion of the choroid with changes in the sensory part of the retina. The main unit of this group is central serous chorioretinopathy (CSC). In practice, we often encounter other conditions, which are manifested by thickening of the choroid and changes in the retina, but they cannot be classified as pachychoroid diseases. The aim of this study is to point out on a series of 3 case reports the difficulties in the differential diagnosis of retinal diseases in which we find thickening of the choroid. Case report 1: 42-year-old patient treated for central serous chorioretinopathy. After optical coherence tomography (OCT), fluorescence angiography (FAG) and indocyanine green angiography (ICG) the diagnosis was changed to choroidal hemangioma and he was treated with photodynamic therapy (PDT) which led to a reduction of the hemangioma. Case report 2: A 30-year-old patient treated for ankylosing spondylitis comes for visual impairment in the left eye. On OCT the condition resembled chronic CSC. The patient suffered from a febrile exanthema a few days ago. Serological testing for coxsackievirus was positive and the diagnosis was changed to acute chorioretinitis in coxsackievirus infection. Oral treatment with prednisone was successful. Case report 3: A 46-year-old patient was treated conservatively for CSC. After FAG and ICG, a solitary dilated choroidal vessel was found in the area of the papillomacular bundle with leakage under the sensory epithelium which was diagnosed as choroidal macrovessel. We performed PDT with a very good anatomical effect. Conclusion: Precise differentiation of these mentioned diseases from pachychoroid retinal diseases was essential in choosing the appropriate therapy. The use of all modern imaging methods of the retina and choroid plays a key role in determining the diagnosis. Key words: pachychoroid disease, central serous chorioretinopathy, choroidal hemangioma, chorioretinitis, coxsackievirus, choroidal macrovessel.

Analysis of short wavelength infrared radiation during laser welding of plastics.

In this paper, a new measurement system and a new approach in calculation for infrared (IR) radiation investigation in quasi-simultaneous transmission laser welding of plastics are presented. The measurement system is based on a MW/SWIR (medium-wave/short-wave IR) camera and optical filters narrowing the spectral region to SWIR. The measured signals contain radiation from the melted zone in between the semitransparent and absorbing polymers, as well as radiation from the surface and interior of the semitransparent polymer. The new calculation approach was developed to distinguish between these signals. It is based on simplification of the process to two places with two temperatures (surface and molten interface) and knowledge of the spectral optical properties of the material, filters, and camera response. The results of measurement and calculation for three different optical filters and polyoxymethylene samples with two thicknesses are shown and discussed. Good agreement is obtained for the calculation variant using normal transmissivity of the semitransparent polymer.

Active thermography inspection of protective glass contamination on laser scanning heads.

Industrial lasers are an expanding technology of welding and other materials processing. Lasers with optical scanning heads are often used, as these provide more versatility, accuracy, and speed. The output part of the scanning head is covered by a protective glass, which might get contaminated by various particles from the laser processing. This decreases the transmissivity of the glass, and it can affect the production quality. The contamination needs to be checked regularly, but a visual inspection might not always be effective. This paper proposes two alternative methods of inspecting the protective glass: flash-pulse active thermography, and laser active thermography. They are based on the thermal excitation of the glass and measuring the response with an infrared camera. The experimental setup and practical results are described and the advantages and disadvantages are discussed. The presented methods are proven to be effective in detecting the contamination of the glass.

[Gastric carcinoma and current situation]. / Karcinom zaludku a soucasnost.

INTRODUCTION: Gastric carcinoma is a serious malignant disease, manifesting often in advanced stages and with a presence of metastatic dissemination into lymph nodes. AIM: The aim of the study was to asses own results with a reference on modern trends in surgery of gastric carcinoma and research of dependence of the age and stage of the disease on survival. METHODS: In the Ist Surgical Clinic of Abdominal, Thoracal and Trauma Surgery of General Teaching Hospital in Prague a total of 191 patients with gastric carcinoma were operated during a period of 10 years, from October 1998 to October 2008. To the closing date of the study 130 patients deceased, 40 patients lived on. Every patient underwent an endoscopical examination of gastroduodenum once a year. A data from 21 patients couldn't be collected because of a bad compliance. There were 88 patients older than 65 years, 82 patients were younger. In prospective-retrospective study we examined survival of patients and dependence on age and stage of the disease. RESULTS AND CONCLUSION: Total survival rate 24% corresponds with data in literature, quoted from 10 to 30%. An age isn't an independent factor of survival. A dependence on the stage of the disease is noticeable.

Analyses of gas composition in vacuum systems by mass spectrometry.

Analyses of the composition of residual gases for diagnostic purposes, analyses of the atmosphere enforced by the introduction of gases for technological purposes and analyses of gases released from analyte materials in numerous analytical methods (e.g. TSD, SIMS) are frequently carried out in vacuum systems. There is only a small amount of gas available, in the vacuum system so the most important property of a mass spectrometer is high sensitivity. As a consequence, the mass resolution is usually low. Moreover, a low outgassing rate of the mass spectrometer itself and all parts connecting it to the vacuum system is required. Dynamic mass spectrometry satisfies these demands best. Quadrupole mass spectrometers are almost solely utilized in applications, although the time-of-flight mass spectrometer has come into use recently. The main disadvantage of the quadrupole mass spectrometer is a strong dependence of the sensitivity and the mass discrimination factor on the stability of the supply voltages. Together with the necessity to use multipliers for detection of the ion current, this leads to a requirement for frequent recalibration. Another serious problem, that is met in such applications is the estimation of the gas composition from the measured mass spectra. Usually, the analyte gas mixtures consist of various individual gases, or at least are measured on a background of such mixtures. This implies a requirement for the exact knowledge of the fragmentation pattern of the gases, and again the necessity for frequent calibration over a satisfactorily wide range of mass numbers. Some theoretical considerations and some experimental results obtained by the authors are presented.

Increased frequency of in vivo hprt gene-mutated T cells in the peripheral blood of patients with systemic sclerosis.

OBJECTIVE: Activated T lymphocytes are involved in the pathogenesis of scleroderma (systemic sclerosis, SSc); such cells rapidly divide in vivo and are thus theoretically subject to random mutation more frequently than resting cells. To study whether SSc is associated with rapidly expanding T cell clones the frequency was determined of in vivo mutated T cells (MF) at the hypoxanthine guanine phosphoribosyl transferase (hprt) gene in the peripheral blood from patients with SSc. Specific clinical or serological associations were also investigated. METHODS: Peripheral blood lymphocytes from 16 healthy individuals and 20 patients with SSc were cultured using an hprt clonal assay; mutated and wild T cell clones were established to assess individual values of T cell MF. T cell clones were further expanded in vitro and their phenotype was determined by standard immunofluorescence technique. Enzyme-linked immunosorbent assays were used for simultaneous measurements of plasma levels of soluble Interleukin-2 receptors (s-IL-2R) and Intercellular adhesion molecule-1 (s-ICAM-1). RESULT: Mean (SD) value of T cell MF in patients with SSc was 2.5-fold higher than the normal mean (SD) value [10.6 (6.6) x 10(-6) v [4.4 (2.8) x 10(-6), p = 0.0007]. Eleven of 20 patients with SSc (55%) had T cell MF values greater than two SD above the normal mean value. The majority (84%) of mutated T cells had a helper/inducer, memory phenotype while 12% were cytotoxic/suppressor T cells. There was no association between T cell MF and the extent of skin involvement or the duration of Raynaud's phenomenon. High individual T cell MF values were not related to a possible concurrent immune overactivity as assessed by plasma levels of s-IL-2R and s-ICAM-1. Patients with long standing skin disease, however, had almost double T cell MF values than patients with early skin disease [(13.6 (7.4)) x 10(-6) v (7.5 (4.3)) x 10(-6), p = 0.03], suggesting that increased T cell MF in SSc may reflect an ongoing process of chronic in vivo T cell proliferation and/or prolonged survival. CONCLUSION: Increased in vivo T cell mutation in patients with SSc suggests that excessive division and/or survival of T cell clones contribute to the pathology in SSc; this approach can be used in further investigations to identify the stimulus that is triggering T cell activation in this disease.

Circulating intercellular adhesion molecule-1 in patients with systemic sclerosis.

In view of recent data demonstrating increased expression of intercellular adhesion molecule-1 (ICAM-1) in the skin of patients with systemic sclerosis (SSc) we studied whether levels of soluble ICAM-1 (s-ICAM-1) shed into the circulation are increased in patients with this disorder. We also compared blood levels of s-ICAM-1 in SSc with those in systemic lupus erythematosus (SLE) and we investigated any possible association of s-ICAM-1 with soluble IL-2 receptor (s-IL 2R) levels, the latter being considered as a marker of lymphocyte activation. Patients with SSc had increased levels of sICAM-1 compared with healthy control subjects (mean +/- SEM, 587 +/- 34 versus 373 +/- 27 ng/ml, P < 0.0001). Patients with diffuse rapidly progressive disease had the highest s-ICAM-1 levels. No association was observed between the extent of skin or internal organ involvement and s-ICAM-1 levels. Patients with digital ulcers had significantly elevated s-ICAM-1, but not s-IL 2R, levels. No correlation was detected between individual s-ICAM-1 and S-IL 2R levels in SSc patients. These novel findings suggest that circulating s-ICAM-1 levels may be a useful marker of endothelial activation in SSc; however, further studies are needed to determine the role of ICAM-1 in the pathogenesis of this disorder.

Optic neuropathy and central nervous system disease associated with primary Sjögren's syndrome.

Three cases of optic neuropathy associated with primary Sjögren's syndrome are reported. All three patients had clinical manifestations of primary Sjögren's syndrome, although two of the patients did not report sicca symptoms at initial examination. Two patients had focal neurologic signs in addition to optic neuropathy. The differentiation of this syndrome of optic neuropathy, focal neurologic signs, and Sjögren's syndrome from multiple sclerosis and antiphospholipid antibody syndrome is important for reasons of treatment and prognosis. This diagnostic differentiation was facilitated by positive tests for xerophthalmia and findings of positive minor salivary gland biopsy. High titers of antinuclear antibody, anti-SSA(Ro), and anti-SSB(La), and the absence of antiphospholipid antibodies provided additional help in the differential diagnosis. In 5 years of observation, none of the patients developed symptoms of multiple sclerosis or additional connective tissue disorders.

The frequency of sicca syndrome in an elderly female population.

In a population of 103 elderly Caucasian women, 39% had sicca symptoms and 24% had abnormal Schirmer's tear tests. Two (2%) satisfied criteria for Sjögren's syndrome and 12 (12%) were felt to have possible Sjögren's syndrome. Fifty percent of those with sicca were taking medications that might induce mucosal dryness. Fibrosis was noted on all 23 labial minor salivary gland biopsy specimens obtained. Mucosal drying medications and senile salivary gland atrophy seemed to contribute to the high frequency of sicca in this population with a lesser proportion of the subjects demonstrating previously undiagnosed Sjögren's and possible Sjögren's syndrome.

[Identification of vernix caseosa]. / Indentifikace mazu sýrového (vernix caseosa).

Identification of vernix caseosa is relatively rare. As a rule it is examined only by morphological methods. The authors proved also the species and group. The authors draw attention to the possible erroneous assessment of the group (if the vernix is mixed with amniotic fluid, maternal blood).

Imperforate hymen with hematocolpos.

Presented are two cases of imperforate hymen with hematocolpos seen in a pediatric emergency department (ED) during a seven-month period. The first case presented with abdominal pain, urinary obstruction, and constipation on initial visit. The diagnosis was not made on the initial presentation. The patient was seen a second time, and final diagnosis was not made until a third visit to the pediatric outpatient clinic. The second case presented with syncope and bilateral lower abdominal pain. Ultrasound and subsequent surgery confirmed the physical findings in the ED of imperforate hymen and hematocolpos. Both patients underwent hymenectomy, and they have experienced no further symptoms.

[Possibilities and pitfalls in the determination of group characteristics in the remains of historical persons]. / Moznosti a nezdary pri vysetrováni skupinové príslusnosti z pozustatku historických osob.

The authors give an account of their experience with the assessment of group substances from skeletal remnants of historical persons and Egyptian mummies. They also draw attention to possible pitfalls of examinations and the interpretation of results.

Pulmonary vascular response during Raynaud's phenomenon in progressive systemic sclerosis.

Progressive systemic sclerosis and Raynaud's phenomenon are associated with a distinctly vascular form of pulmonary involvement and pulmonary hypertension. To investigate a possible underlying vasospastic predisposition in these patients, the pulmonary vascular response to Raynaud's phenomenon induced by cold-water hand immersion was examined in nine patients. Four patients had pulmonary fibrosis and four patients had the CREST syndrome; no patient had pre-existing pulmonary hypertension. During Raynaud's phenomenon, there was no significant rise in mean pulmonary artery pressure (15 +/- 3 versus 15 +/- 2 mm Hg, p = NS) or pulmonary vascular resistance (112 +/- 38 versus 118 +/- 50 dynes X second X cm-5, p = NS) over baseline, despite a significant rise in mean aortic pressure (104 +/- 14 versus 92 +/- 11 mm Hg, p less than 0.01) and systemic vascular resistance (1,700 +/- 450 versus 1,500 +/- 470 dynes X second X cm-5, p less than 0.01). It is concluded that pulmonary vasospasm with transient pulmonary hypertension does not occur in patients with progressive systemic sclerosis and Raynaud's phenomenon during episodes of Raynaud's phenomenon. Abnormal pulmonary vasospasm in these patients in response to other stimuli, however, is not excluded.