BILATERAL EYE INJURY WITH BILATERAL BLOWOUT FRACTURE CAUSED BY A HIGH-PRESSURE WATER JET IN 16-YEARS-OLD FIREMAN GIRL. CASE REPORT.

PURPOSE: The aim is to present a report of a case of bilateral eye injury with bilateral blowout fracture caused by a high-pressure water jet from a fire hose in a 16-year-old girl during a competition for young firefighters. METHODS: We present a case report of a 16-year-old female patient with bilateral extensive eyelid contusion, oedema and lacerations of upper eyelids, lacerations of bulbar conjunctiva, contusion of both eyes, left optic nerve and bilateral blowout fractures of orbits.  Results: The initial ocular examination revealed "hand motion" in the right eye and no light perception in the left eye. Intraocular pressure was low in both eyes. Motility of both eyes was reduced, especially in the left eye. Lacerations of the eyelids and conjunctiva required a surgical procedure. No repair of the upper canaliculus of the left eye was attempted. Paralytic mydriasis and loss of lens accommodation in both eyes did not change throughout the follow-up period. A surgical procedure was applied to resolve the left blowout fracture, ocular motility of the right eye improved spontaneously. Traumatic cataract developed in the left eye within 1 year after injury, requiring cataract surgery and posterior capsule lens implantation, the right lens remained clear. Massive scarring of the retina and choroid in the lower parts of the eyes and in the macula reduced best corrected visual acuity in the right eye to 0.15 and in the left eye to 0.08. Intraocular pressure is within normal limits without any glaucoma therapy. The follow up period is three years. CONCLUSION: This is the first reported case of child with an eye injury caused by a high-pressure water jet during a sports activity.

Giant cell reparative granuloma in the mandible--case report and review of the literature.

OBJECTIVE: Central giant cell granuloma (GCG) is defined as an intraosseous lesion consisting of cellular fibrous tissue containing multiple foci of hemorrhage, aggregations of multinucleated giant cells. Peripheral GCG is a reactive exophytic lesion occurring on the gingiva and alveolar ridge originating from the periosteum or periodontal membrane, usually as a result of local irritating factors. STUDY DESIGN: The case report evaluated long-term therapy of giant cell granuloma. A 9-year-old boy generally healthy was admitted to our clinic with a swelling in the frontal area of mandible. Giant cell granuloma was detected. Surgical curettage was applied. After 3 years of the operation, the recurrence was seen during the physical examination. The new GCG was removed. The prosthetic rehabilitation including implants insertion (18-year-old adult patient) finished treatment. RESULTS: Three-year recall confirmed the stability of treatment. CONCLUSION: Esthetical and functional therapy is of great importance in the patient's rehabilitation.

Midface distraction in patients with cleft palate.

Cleft palate patients with a severe maxillary hypoplasia can pose a very challenging problem for the surgeon. Traditional orthodontic surgery methods frequently do not fulfil expectations from the point of view of achieving normal aesthetic proportions of the face. Therefore distraction is nowadays an important technique in the treatment of craniofacial skeletal dysplasias. To treat maxillary hypoplasia, either intraoral midface distractor IMD or rigid external distractor RED can be used. This study presents 16 patients. In five of them, we used the IMD and in 11 of them the RED. In all of the patients we achieved good functional as well as aesthetic results. While using this method, complications were minimal. In this study, we analyse surgical and orthodontic methods as well as the advantages and disadvantages of both surgical methods.

[Surgical treatment of sequelae of oncologic treatment in the orbital region]. / Chirurgické resení následku onkologické lécby v oblasti orbity.

Complications after surgical oncological treatment and irradiation such as impaired growth of the facial skeleton, orbitoethmoid fistulae and others are an important problem for the patient's further fate. For their elimination collaboration of the ophthalmologist and maxillofacial or plastic surgeon is essential as various reconstruction procedures must be used some of which are mentioned in the paper. Some procedures are demonstrated on three patients where osteotomies of the orbit and implantations of bone grafts were performed as well as transplantation of vascularized tissues and skin flaps. In all mentioned patients marked improvement was recorded.

[Frequency of occurrence of apolipoprotein E isoforms in patients with various types of hyperlipoproteinemias]. / Frekvence výskytu izoforem apolipoproteinu E u pacientu s ruznými typy hyperlipoproteinémií.

BACKGROUND: Apolipoprotein E is a polymorphic protein playing a crucial role in the metabolism of plasma lipoproteins. Three alleles referred to as epsilon 2, epsilon 3 and epsilon 4 code for three common isoforms of apoE. The most frequent allele in the population at large is epsilon 3 allele. epsilon 2 and epsilon 4 alleles are connected with lipoprotein disorders as well as with other diseases. The aim of our study was to establish frequencies of apoE coding alleles in patients with different types of hyperlipidaemia (HLP) and to reveal differences in their distribution in comparison with the general population. METHODS AND RESULTS: Therefore apoE genotype was assayed in 752 patients with primary HLP and 291 subjects randomly selected from the general Czech population. Allele frequencies were determined separately in a group of patients with familial hypercholesterolaemia (FH), polygenic hypercholesterolaemia (PHC), familial combined hyperlipidaemia (FCH) and in patients with type III. hyperlipidaemia (III). In patients with HLP a significantly higher frequency of epsilon 4 allele than in control subjects was found. In the group of FH patients frequency of the epsilon 2 allele was higher than in control subjects. In patients with PHC a significantly higher frequency of the epsilon 4 allele and lower frequency of the epsilon 2 allele were observed. In the group of FCH patients distribution of epsilon alleles did not differ from the control group. Frequency of the epsilon 2 allele in patients with type III. hyperlipidaemia was significantly higher than in controls. CONCLUSIONS: We conclude that there exist significant differences in frequencies of apoE coding alleles between patients with primary hyperlipidaemia and a randomly selected population sample. The revealed differences in allelic distribution suggest that the impact of apoE polymorphism is not uniform in all types of hyperlipidaemia.