[Bilateral Macular Edema Caused by Optic Disc Drusen - a Case Report]. / Bilaterální makulární edém na podklade drúzových papil.

UNLABELLED: In the case report, bilateral cystoid macular edema with optic disc edema on the left side in young man is described. As etiology out of the systemic diseases, we considered the hypertension. The results of the neurological examination, including the brain CT examination were physiological. The patient was examined by the internal specialist, the hypertension was treated - and it was the presumed etiology of the ophthalmologic findings. Due to the repeated worsening of the ophthalmologic findings, we searched for other etiology. Bilateral buried optic disc drusen were found by means of ultrasound. Bilateral cystoid macular edema and optic disc edema were evaluated as signs of circulatory disturbance of the posterior ciliary arteries and macular choroid caused by optic disc drusen. The antiglaucomatic treatment was started with - alpha 2 adrenergic receptors agonist - brimonidine - which increases the blood supply of the optic nerve and decreases the intraocular pressure with presumed delay of axons dysfunction. KEY WORDS: macular edema, optic disc drusen, intraocular pressure, visual field, ultrasound.

[Optic Disc Drusen and their Complications]. / Drúzy papily zrakového nervu a jejich komplikace.

UNLABELLED: The aim of the study was to analyze the group of patients with optic disc drusen focusing on possible complications of this disease. MATERIAL AND METHODS: In our group of patients, we examined 46 eyes of 23 patients with the suspicion of optic disc drusen during the period from May 2013 until January 2014. In all adult patients, we examined the anterior and posterior segment of the eye biomicroscopically, established the visual acuity, measured the intraocular pressure, examined the visual field, performed the ultrasound examination of the eye (A and B-scan), analyzed the retinal nerve fiber layer (RNFL) by means of optic coherence tomography (OCT), and color and red-free photography. According to the biomicroscopical findings, the drusen were divided into invisible drusen (buried drusen) (verified by ultrasound only) - grade 0, visible delicate drusen - grade I, and multiple drusen (conglomerates) - grade II. RESULTS: Out of 23 patients, 14 were women and 9 were men. The age of the patients ranged from 8 to 82 years, the mean age was 44.4 years. In the group, there were 3 children (8, 11, and 13 years). In twenty-two patients, the drusen were present bilaterally, and one female patient had drusen on the right eye only. The grade of the drusen was set from 0 to II in all 45 eyes according to their amount, location, and visibility. As grade 0 were evaluated drusen in 11 patients; out of them, 10 patients had drusen bilaterally, and one female patient unilaterally. Out of these 11 patients, three were children. Grade I optic disc drusen bilaterally had nine patients, and three patients had drusen grade II bilaterally. In grade 0 drusen, no defect of the visual field was noticed. In drusen grade I, it was noticed the defect of the visual field in two patients (four eyes) out of nine patients, and in grade II the defect was present in two out of three patients (three eyes). The evaluation of the RNFL, by means of OCT, was performed among all three groups according to their grade 0 - II. In higher grades, the thickness of the RNFL was lower. Comparing to drusen grade 0, the drusen grade I, and II presented serious thinning of the RNFL superiorly. In three patients (drusen grade 0 and I) other complications of the optic disc drusen were observed. In one female patient with drusen grade I, there was decrease of the visual acuity due to the partial intravitreal hemorrhage in her left eye and parapapillary located retinal hemorrhages. In one male patient with drusen grade 0 was bilateral decrease of the VA due to cystoid macular edema caused by drusen. This patient had also retinal hemorrhages located near the papilla and partial intravitreal hemorrhage in his worse left eye. In one female patient with the drusen grade 0, the tortuous veins were noticed. CONCLUSION: Drusen of the optic disc are present in 0.3 - 1.0 % of the population, and are bilateral in approximately 75 - 91 % of the cases. It is important to distinguish optic nerve disc drusen from the papiledema. Drusen of the optic nerve can cause severe defects of the visual field, decrease of the retinal nerve fiber layer, and may be accompanied by vessels complications. Patients with the optic disc drusen should regularly undergo ophthalmologic examinations focused on the intraocular pressure, visual field testing, and retinal fiber layer analysis. In patients with visual field defect and borderline values of intraocular pressure, the antiglaucomatic therapy is recommended. KEY WORDS: optic disc drusen, intraocular pressure, visual field, ultrasound, retinal nerve fiber layer analysis, complications of the optic disc drusen.

Meat quality characteristics of lambs of three organically raised breeds.

Carcass and meat (muscullus quadriceps femoris [MQF]) quality characteristics were evaluated in ten lambs per each of Zwartbles (ZW), Suffolk (SF) and Oxford Down (OD) breeds, raised organically and slaughtered at a mean live weight of 38 kg. Meat of ZW lambs had lower (P<0.05) collagen, myoglobin and intramuscular fat content than OD lambs, and lower (P<0.05) tenderness and juiciness scores in comparison with OD and SF lambs. Despite a low polyunsaturated/saturated fatty acid ratio (0.13 in all three breeds; P>0.05), meat of the pasture-fattened lambs can be considered a dietetically superior food with very favourable (0.85-0.88; P>0.05) polyunsaturated fatty acid n - 6/n - 3 ratio, and containing per 100g of muscle on average 62 mg of EPA+DHA (differences between breeds not significant, P>0.05) and no more than 20mg of dietetically unfavourable arachidonic acid.

Effects of environmental pollutants on the porcine and bovine immune systems.

Immunological examinations were done in 30 fattening pigs from three swine farms (D., M., T.) and 20 dairy cows from one cattle farm (N.) in the district of Hodonín in 1994. At the same time, samples of stable dust deposits collected in the four farms were analysed for the contents of mercury, cadmium, lead, gamma-HCH (lindane), and total DDT and polychlorinated biphenyls (PCB). Decreased blood level of lysozyme (0.92 mg/l) was found in the swine herd D. Ten percent of the pigs in the herd were affected with purulent skin lesions. The concentrations of the pollutants under study in the dust deposits collected in the herd D. were low. An increased concentration of PCB (0.263 mg/kg) in stable dust but no adverse effects on the immune system were found in the swine herd M. Eosinophilia (6.2%), increased extensity of Ascaris suum infection (25%) and a high content of lead in stable dust (11.2 mg/kg) were typical of the swine herd T. A high content of lindane (0.139 mg/kg) and an extremely high content of lead (214 mg/kg), which can participate in the immunosuppression of lymphocytes, were found in the cattle herd N. The activity of lymphocytes was depressed in 35% of the cows and the mean value was at the lower limit of the physiological range. Hazardous pollutants can affect the immune system of farm animals and their penetration into the stable environment should be prevented.

[Occurrence of harmful pollutants in fattened pigs]. / Zhodnocení výskytu rizikových polutantu u výkrmových prasat.

Fourteen fattened pigs (age of 240-250 days, live weight 110-120 kg) were examined on three farms (D., M. and T.) in Hodonin district in 1994 for the content of some harmful pollutants (mercury, cadmium, lead, lindane, DDT sum, DDT isomers, lower and higher chlorinated biphenyls, PCB congeners) in the muscle, liver, kidneys and subcutaneous fat. Maximum allowable quantities (MAQ) of extraneous matters were slightly exceeded in mercury only, in 5 samples of the muscle (0.012-0.022 mg/kg). In comparison with the average contents of extraneous matters in pigs in the Czech Republic in 1994, higher concentrations of mercury (0.009 mg/kg), lead (0.124 mg/kg), lindane (0.060 mg/kg fat) and DDT sum (0.083 mg/kg) were observed in the muscle of pigs from Hodonín district. The liver of the pigs contained the highest average concentrations of lead (0.141 mg/kg), lindane (0.280 mg/kg fat), DDT sum (0.323 mg/kg fat), p,p'-DDE (0.106 mg/kg fat), p,p'-DDT (0.057 mg/kg fat). PCB-Delor 103 (0.415 mg/kg fat), PCB-Delor 106 (0.561 mg/kg fat) and PCB 118 congener (0.029 mg/kg fat). The highest average values of mercury (0.014 mg/kg) and cadmium (0.147 mg/kg) were determined in the kidneys of pigs. The ratio of lower-chlorinated biphenyls (Delor 103) to higher-chlorinated biphenyls (Delor 106) was approximately 1 : 3 in the muscle, 1 : 1 in the liver and 1 : 2 in subcutaneous fat. The per cent share of three PCB congeners, 101, 138 and 153, was highest in the muscle, liver and subcutaneous fat of pigs. The pigs from Hodonín district exhibited in 1994 the greater load of mercury, lead, lindane and DDT than in other regions of the Czech Republic, but these values did not mostly exceed the hygienic limits in force. It is desirable to observe the spectrum of indicator PCB congeners for objective evaluation of PCB load in pigs, as they indicate the contamination level with lower- and higher-chlorinated biphenyls (Delor 103 to Delor 106). Greater attention should be paid to the congener PCB 118, which is the most toxic out of the indicator congeners concerned.

[Clinical use of infusion pumps with rotors in occlusive tracts]. / Klinické pouzití infuzní pumpy s rotorem v okluzní dráze.

The authors used in clinical practice an infusion pump driven by a rotation system with an occlusive pathway whereby the movement of the rotor is ensured by a stepper with reduction of the steps to 12,800 microsteps per revolution. As regards the degree of mechanical damage of the inserted tube of the infusion set this system did not differ from the keyboard system which is used by the majority of manufacturers as the driving unit of infusion pumps. Mechanical damage of the infusion set made from PVC was evaluated by the authors with regard to the amount of phthalic acid extracts which are added to PVC as softening agents and are not chemically linked. The authors recorded an increase of the temperature of the infusion solution during the flow through the driving unit in both investigated systems, however, the increase was smaller in the keyboard system. The increase of temperature was, however, in both instances small and has no impact on clinical practice. Contrary to the infusion pump with the keyboard system, the infusion pump with a rotor in an occlusive pathway and a microstep motor (12,800 microsteps per revolution) was significantly more accurate as regards dosage (evaluated as the difference between the required and actually achieved value of flow). The revealed difference was statistically significant at the 1% level. This greater precision of dosage can be ascribed to the point compression of the inserted and to the microvibrations transmitted from the rotor to the inserted tube of the infusion set which helps to recover after every compression the original volume (circular shape of section) of the inserted tube.

[Phthalic acid esters in the peritoneal cavity of patients treated with continuous ambulatory peritoneal dialysis]. / Estery kyseliny ftalové v peritoneální dutine nemocných lécených kontinuální ambulantní peritoneální dialýzou.

A solution for peritoneal dialysis stored in bags made from material which does not contain diethylhexyl phthalate is significantly less contaminated with this plasticizer, as compared with a solution stored in bags made from PVC with diethylhexyl phthalate. The afferent tube which contains diethylhexyl phthalate in all sets investigated by the authors is not an important source of this plasticizer for the peritoneal solution. Contamination of the peritoneal solution with dibutyl phthalate added to colours used for print on the bags (inscription on the outside of the bag) was found in both types of bags (no significant differences were found). It may be thus assumed that dibutyl phthalate penetrates through the wall of both types of bags with the same intensity. This applies only, provided that the peritoneal solution is not contaminated with dibutyl phthatate during preparation, before it is filled into bags. After six hours instillation in the peritoneal cavity diethylhexyl phthalate and dibutyl phthalate was not detectable in the peritoneal solution (detection limit 0.5 microgram/l). They are completely retained and metabolized resp. in the patient's peritoneal cavity.

[Occurrence of chlorinated pesticides and polychlorinated biphenyls in the stalls and outdoor environment in pig-fattening farms]. / Výskyt chlorovaných pesticidu a polychlorovaných bifenylu ve stáajovém a mimostájovém prostredí farem pro výkrm prasat.

Contents of some pesticides (lindane, DDT sum, o,p'-DDE, p,p'-DDE, o,p'-DDD, p,p'-DDD, o,p'-DDT, p,p'-DDT) and polychlorinated biphenyls (Delor 103, Delor 106, PCB congeners: 28, 52, 101, 118, 138, 153, 180) were investigated on three farms of fattened pigs (D., M. and T) in Hodonín district in 1994, as occurring in feed mixtures (n= 15), drinking water (n = 10), stable sedimented dust (n = 14), slurry (n = 10) and pavement dust (n = 5). Maximum permissible contents (MPC) of extraneous matters in feed mixtures were exceeded in lindane (two samples) and polychlorinated biphenyls (PCB). MPC of extraneous matters were not exceeded in drinking waters in any of the samples examined. Feed mixtures were found to have the highest average lindane content (0.054 mg/kg) and PCB sum (0.24 mg/kg); the ratio of lower chlorinated biphenyls (Delor 103) to higher chlorinated biphenyls (Delor 106) was 12:1; out of the PCB congeners, the highest amounts were determined for congeners 28 (0.067 mg/kg) and 52 (0.022 mg/kg); among the DDT isomers, isomer p,p'-DDT was prevailing (0.008 mg/kg). Drinking water had the 1:1 ratio of lower chlorinated to higher chlorinated biphenyls; out of the PCB congeners, the highest amounts were found out for congeners 28 (2.574 ng/l) and 101 (2.066 ng/l); among the DDT isomers, isomer p,p'-DDE was prevailing (1.887 ng/l). Stable dust was found to have the highest average level of DDT sum (0.026 mg/kg); the ratio of lower chlorinated to higher chlorinated biphenyls was 1:7; out of the PCB congeners, the highest amounts were determined for congeners 138 (0.036 mg/kg) and 153 (0.030 mg/kg); among the DDT isomers, isomer p,p'-DDE was prevailing (0.012 mg/kg). Slurry showed the 1:6 ratio of lower chlorinated to higher chlorinated biphenyls; out of the PCB congeners, the highest amounts were found out for congeners 138 (0.016 mg/kg dry matter) and 153 (0.014 mg/kg dry matter); among the DDT isomers, isomer p,p'-DDT was prevailing (0.005 mg/kg dry matter). Pavement dust had the 1:5 ratio of lower chlorinated to higher chlorinated biphenyls; out of the PCB congeners, the highest amounts were found out for congeners 138 (0.016 mg/kg) and 153 (0.012 mg/kg); among the DDT isomers, isomer p,p'-DDE was prevailing (0.005 mg/kg). Examination of feed mixtures and drinking waters will provide basic data on pollutant inputs to the stable environment. Stable sedimented dust is considered as an outstanding indicator of pollutant contamination of stable environment, regardless whether it comes from feed or other sources. Slurry examination will provide additional information on the total pollutant load of pig farms, informing us about outputs of extraneous matters residues from pig farms. Pavement dust examination indicates the level of pollutant load of outside stable environment as the pollutants can occasionally penetrate to the internal stable environment.

Mutagenicity of stable dust and drinking water on swine and cattle farms.

Single pilot examinations of mutagenicity of stable dust and drinking water were made on three swine farms (D., M., T.) and one cattle farm (N.) in the district of Hodonín in summer 1994. The mutagenicity was examined by the Ames test using the indicator strains Salmonella typhimurium TA 98 and TA 100 with (+S9) or without (-S9) metabolic activation. At the same time the contents of selected pesticides (PES) and polychlorinated biphenyls (PCB) in stable dust and drinking water and that of polycyclic aromatic hydrocarbons in stable dust were determined. Increased mutagenicity was demonstrated in drinking water (strain TA 98 with metabolic activation; index Rt/Rk 3.6-7.7) and stable dust (strain TA 100 with metabolic activation; index Rt/Rk 2.2) collected on the swine farm M. High contents of PAH (8.246 mg/kg) and PCB (0.263 mg/kg) were also found in the dust samples collected on this farm. Only drinking water showed mutagenic activity (strain TA 98 without metabolic activation; index Rt/Rk 2.6) on the swine farm D. On both the farms, the number of revertants was dose-dependent. Increased content of PAH (2.553 mg/kg) was also demonstrated on the dust samples collected on the farm D. No significant increase (twofold or higher when compared with negative controls) of mutagenic activity of stable dust or drinking water was demonstrable on the swine farm T. and the cattle farm N. Substances responsible for the mutagenicity of drinking water on the farms D. and M. have not yet been identified. Anyway, the increase of mutagenicity of stable dust and drinking water should be taken as a warning that mutagens that can jeopardise animal and human health have penetrated into the stable environment.

[Circulating heparin-like anticoagulant--2 cases of successful therapy]. / Cirkulující antikoagulans heparinové povahy--dva prípady úspesné lécby.

In the circulation of patients with severe haemorrhagic conditions in rare instances an anticoagulant of heparin nature can be detected, the exact origin of which has not been elucidated so far. These patients can be treated by protamine sulphate. The authors present their own observations in two women where the circulating anticoagulant of heparin nature was detected during a haemorrhagic condition after spontaneous rupture of an enlarged spleen and in scleroderma with organ affection. In both instances treatment was successful.

[Determination of quantitative proteinuria from a single urine sample based on the protein:creatinine ratio]. / Stanovení kvantitativní proteinurie z jednorázove odebraného vzorku moci na podklade pomeru bílkovina:kreatinin.

Assessment of quantitative proteinuria is associated with collection of urine over several hours. This is, however, not always possible, in particular in ambulatory patients. Therefore efforts are made to assess the urinary protein per 24 hours on the basis of the proteinuria index, i.e. the ratio protein:creatinine in a single urine specimen. In a group of forty patients the authors demonstrated the closest correlation (correlation coefficient = 0.910374) between quantitative proteinuria and the index of proteinuria in urine specimens which were collected during daily activity. The closeness of this correlation depends on renal function. Assessment of quantitative proteinuria from a single urine sample on the basis of the protein:creatinine ratio is therefore useful in subjects with a preserved or not very restricted renal function.