THE NRPI MULTI-PURPOSE ON-LINE MONITORING STATION FOR MEASUREMENT OF NATURAL RADIOACTIVITY IN THE AMBIENT ATMOSPHERE AND IN THE SOIL.

During years 2010-12 an automated, on-line and wireless outdoor measurement station of atmospheric radon, gamma dose rate and meteorological parameters was realised at the National Radiation Protection Institute (NRPI) in Prague. At the turn of the year 2013 an expansion of the existing station was completed. Under the project funded by the Czech Technological Agency a new updated station was established, additionally equipped with modules for measurement of atmospheric radon/thoron short-lived decay products, radon in water and soil and radon exhalation rate from soil. After the introduction of the station updated key detection parameters and benefits, its use for atmospheric modelling and monitoring is demonstrated. There are summarised results from the 3-year measurement period in the NRPI outdoor area in Prague and from simultaneous annual measurement performed by another similar station located near uranium mud fields in DIAMO, state enterprise, Stráz pod Ralskem. Observed seasonal and diurnal variations of atmospheric radon concentrations and variability of the equilibrium factor, F, are illustrated and compared.

[European Association of Urology guidelines on urinary and male genital tract infections]. / Synoptische Leitlinie der sexuell übertragbaren Erkrankungen (STD) mit Primärsymptomen im männlichen Genitale (S1). Leitinien der Deutschen Gesellschaft für Urologie.

Today, the classical bacteria that cause venereal diseases, e.g. gonorrhea, syphilis, chancroid and inguinal granuloma, only account for a small proportion of all known sexually transmitted diseases (STDs). Other bacteria and viruses as well as yeasts, protozoa and epizoa must also be regarded as causative organisms of STD. Taken together, all sexually transmitted infections comprise more than 30 relevant STD pathogens. However, not all pathogens that can be sexually transmitted manifest diseases in the genitals and not all infections of the genitals are exclusively sexually transmitted. Concise information and tables summarising the diagnostic and therapeutic management of STDs in the field of urology allow a synoptic overview, and are in agreement with the recent international guidelines of other specialist areas. Special considerations (i.e. HIV infection, pregnancy, infants, allergy) and recommended regimens are presented.

[Oncocytoma of the kidney--morphologic variation in 102 cases]. / Onkocytom ledviny--morfologická variabilita 102 prípadu.

From the collection of 2500 cases of renal epithelial tumors in our files, 102 renal oncocytomas were analyzed for size, multifocality and a morphologic spectrum of the growth pattern. The size of the tumors ranged from 1.5 to 13 cm in diameter, with a mean of 6.3 cm. Three cases were multifocal, four cases were combined with another primary renal tumor (1x angiomyolipoma, 1x conventional renal carcinoma, 2x papillary renal cell carcinoma). A central fibrosis or a scar was noted in 13 cases, and there was a gross area of hemorrhage in 11 cases. In 4 cases extensive necroses were recognized. Histologically, an alveolar pattern was noted in 70 cases. A tubular pattern was revealed in 31 cases and an unusual tubopapillar ("glomeruloid") pattern was noted in one case. Foci of atypical nuclei were identified in 58 cases. In 4 oncocytomas broad areas of clearance of the oncocytes were found. Psammoma bodies were recognized in 9 tumors and foci of ossification were present in 4 cases. Intracellular and extracellular hyaline globules were noted in two cases. Renal oncocytoma has a variable morphologic spectrum, and its diagnosis should be based on an analysis of structural and cytologic features. Differential diagnosis of renal oncocytomas with various tumors of the kidney which contain granular cytoplasm is discussed. These tumors with granular cytoplasm include conventional renal cell carcinomas, chromophobe cell carcinomas, and rare examples of papillary renal carcinomas.

[Teleconsultation network for ophthalmology--experiences and results]. / Telekonsultationsnetzwerk für die Ophthalmologie--Erfahrungen und Ergebnisse.

MOTIVATION: Telemedical services for ophthalmology are developed within the OPHTEL project, which has been funded by the European Union and by the Bavarian government in the Bavaria-online initiative. METHODS: Seven private ophthalmologists, one university eye clinic, one clinical Diabetes center and an informatics research institute are connected within a teleconsultation network. Asynchronous (based on Internet E-Mail) and synchronous (based on ISDN-mediated videoconferencing tools) types of teleconsultations are realized. RESULTS: 86 teleconsultations (62 asynchronous, 23 synchronous) took place within the first 10 months. Complex and rare eye diseases as well as interdisciplinary questions (ophthalmology--diabetology) are the main area of medical communication interest. Legal and security problems are discussed. CONCLUSIONS: Telemedical services must be understood as a complete process of medical care on the basis of modern communication technologies, which influences also the management of this process.

Pitfalls in the diagnosis of ectopic hamartomatous thymoma.

We describe four cases of ectopic hamartomatous thymoma with unusual morphological features. In cases 1 and 2 we found a dysplastic glandular component which was often arranged in a cribriform pattern bridging several glandular spaces. In case 2 we found solid adenocarcinomatous areas with infiltrative edges. Case 3 showed widespread smooth muscle differentiation within the spindle epithelial cell component, the presence of multiple clear cell glands which contained a distinct myoepithelial layer and an overall picture which vaguely resembled a sclerosing adenosis of the breast. Case 4 contained frequent foci of multinucleated giant epithelial cells within the markedly cellular spindle cell component: it also showed multiple, hypocellular, myxoid areas containing eosinophilic cords and pearls of squamous cells, and resembled squamous cell carcinoma with a sarcomatoid spindle cell component. We could not find any evidence of a thymic origin or of thymic differentiation in our four cases or in any other reported cases of ectopic hamartomatous thymoma. We believe that ectopic hamartomatous thymomas manifest salivary gland differentiation.

Carcinoma arising in ectopic hamartomatous thymoma. An ultrastructural study.

We present the ultrastructural features of a case of adenocarcinoma arising in ectopic hamartomatous thymoma in a 31 year old man, in the supraclavicular location. The tumor had a cribriform adenomatous component with a granular cell quality and mimicked a metastatic carcinoma. Ultrastructurally, the spindle cell component revealed clusters of tonofilaments and the tumor cells were attached by well developed desmosomes. The cytoplasm of adenocarcinoma cells contained peculiar cup-shaped bodies derived from the endoplasmic reticulum wrapped around the mitochondria.

Severe congenital lagophthalmos with tarsal aplasia.

Congenital elongation of the palpebral fissure associated with large eyelids was named euryblepharon after Desmarres in 1854. In some cases the length of the lower lid margin exceeded that of the upper lid margin by more than 3 mm. The lids are lax and the elongated lid margin of the lower lid is only partially in contact with the globe. In marked cases of euryblepharon there may be an additional minor vertical shortening of the upper lid. However, the abnormalities described by Desmarres did not produce severe kerato-conjunctival xerosis. We speculate that euryblepharon as originally described is merely a mild manifestation of congenital lagophthalmos. More severe forms show additional malformations, leading to pronounced insufficiency of lid closure. We report on four patients with severe congenital lagophthalmos. The appearance differs from that of euryblepharon by the following details: (a) a symmetrical congenital retraction of both the lower and the upper lid margins; (b) a marked vertical shortening of the lids (case 1 was referred for bilateral descemetoceles); (c) tarsal aplasia; and (d) severe kerato-conjunctival xerosis after insufficient surgical treatment, leading to different degrees of disability. The surgical approach involved bilateral shortening of the lid margins and free transplantation of retroauricular skin. Stabilization of the lax lower lid margin was achieved by lyodura strips applied with medium tension and in contact with the lid margin. At 5 years after the first operation a petty horizontal shortening of the lower lids was necessary because of circumscribed trichiasis. The dura strip remained present. The long-term result as evaluated at more than 8 years following the first operation was very satisfactory.

Carcinoma arising in ectopic hamartomatous thymoma. A previously unpublished occurrence. Report of two cases.

We describe the first two ever reported cases of carcinomas arising within ectopic hamartomatous thymoma in 31- and 39-year old men. The carcinomatous change occurred within the adenomatous gland component showing a granular cell quality.

Intravitreal silicone oil injection: complications and treatment of 415 consecutive patients.

Silicone oil injection in conjunction with pars plana vitrectomy was carried out by five surgeons in 415 consecutive patients using the same surgical equipment, the same surgical techniques and the same highly purified silicone oil (viscosity, 5000 mPa.s). Indications for silicone oil injection after vitrectomy included advanced stages of proliferative vitreoretinopathy following rhegmatogenous retinal detachment (49%), severe proliferative diabetic retinopathy (38%), and proliferative vitreoretinopathy following retinal detachment due to ocular trauma (13%). Postoperative complications were noted in a 6- to 30-month follow-up period. Cataractous changes of varying degree were seen in all phakic eyes. Silicone oil entered the anterior chamber in 6% of all phakic and pseudophakic eyes. Subretinal silicone oil was noted in 4%. Other complications associated with the use of intravitreal silicone oil included biomicroscopically visible silicone oil emulsification (0.7%), keratopathy (5.5%), glaucoma (6%), closure of the inferior iridectomy (6%), and reproliferation of epiretinal and subretinal fibrous membranes (40%). We anticipate that the physico-chemical characteristics of the highly purified silicone oil (viscosity, 5000 mPa.s) and the routine performance of an inferior iridectomy in all aphakic eyes had a positive impact on the low incidence of silicone-oil-related complications such as emulsification, keratopathy and secondary glaucoma.

Silicone oil in the anterior chamber.

A total of 42 cases (42 eyes) with silicone oil in the anterior chamber after pars plana vitrectomy (PPV) and after silicone oil injection into the vitreous cavity (SIV) were analyzed. The main complications caused by silicone oil were corneal endothelial cell damage and secondary glaucoma. Specular microscopy showed decreased cell density, apparent pleomorphism of endothelial cells, and increased corneal thickness. In some cases, edematous and necrotic endothelial cells were found. The characteristic optical artifacts resulting from silicone oil coming into contact with the endothelium, such as a bright reflex, reversed pattern of illumination, and interference fringes, were also observed. There was a definite correlation between elevated intraocular pressure (IOP) and the presence of silicone oil in the anterior chamber; the IOP dropped significantly on removal of the oil. The treatment and prevention of conditions involving silicone oil in the anterior chamber are briefly discussed.

[Actinomycoses of the female genitalia in connection with IUD insertion]. / Antinomykóza zenských rodidel v souvislosti se zavedením IUD.

PIP: Abdominal actinomycoses with genital localization are relatively rare, but their occurrence has been increasing recently due to more extensive use of IUDs. After a brief review of the etiology, diagnosis, and treatment of this disease, 3 cases of IUD-induced genital actinomycosis are described. All 3 women were in their 40s. In 2 cases, the disease developed within a week after the IUD had been extracted. The patients were hospitalized with a diagnosis of adnexitis, which was confirmed by histological tests, anaerobic cultures, and microscopic examination. In all 3 cases, surgery was followed by antibiotic therapy with megadoses of crystalline PNC, Entisol, and subsequent long-term treatment with ampicillin. The treatment was successful; the women recovered to an almost normal gynecological condition.^ieng

Endothelial findings in cryopreserved corneal transplants.

Specular microscopy of the corneal endothelium was performed on 16 eyes that had undergone corneal transplantation using cryopreserved donor material seven months to nine years previously. The average cell count was 817 cells/mm2 with a range of 360 cells/mm2 to 1808 cells/mm2. Grafts from donors under 30 years of age which had a very short death to freezing time showed a higher endothelial cell density than grafts from older donors with a longer death to freezing time. The most prominent findings were very large, multinucleated endothelial cells that are thought to be the result of cell fusion.

Evidence for mitosis in the adult corneal endothelium.

Intracellular structures probably representative of mitotic figures were seen by specular microscopy in the endothelium of a corneal graft following a rejection reaction. Serial measurements over an eight month period initially showed grossly enlarged cells and apparent mitotic figures. Subsequently, clusters of cells smaller than any cells previously seen were observed. Measurements of endothelial cell area over this period demonstrated a highly significant (P less than 0.0001) decrease in cell area, or increase in cell density, with time. These observations indicate that at least under some circumstances mitosis occurs in the endothelium of the adult human cornea.

Coalescence of endothelial cells in the traumatized cornea. III. Correlation between specular and scanning electron microscopy.

Sequential specular microscopy has shown that coalescence of endothelial cells occurs after thawing in cryopreserved rabbit corneas. Scanning electron microscopy of corneas studied in vitro by specular microscopy showed the same large, fused endothelial cells. As observed in the electron micrographs, these cells showed no evidence of the cell borders that had disappeared during the specular microscopic examination. These data support the reliability of our specular microscopic observations and provide additional evidence for the occurrence of fusion or coalescence of corneal endothelial cells.

Specular microscopic appearance of damaged and dead endothelial cells in corneas following short-term storage.

Specular microscopic evaluation of rabbit, pig, and cat corneas was performed after storage in a moist chamber in McCarey-Kaufman (M-K) medium or in tissue culture medium 199. Irrespective of the storage method, cooling at 4 degrees C resulted in a deterioration of the specular microscopic image. Most of the changes proved to be reversible if the tissue was quickly rewarmed to 35 degrees C and maintained at that temperature for 20 minutes. One change, dark areas larger than a single cell, was not reversible and increased in prevalence with increased storage time. Trypan blue staining revealed that the dark areas seen with the specular microscope contained damaged endothelial cells. Deep corneal striae tended to increase as the storage interval increased, and considerable cell damage occurred in the endothelium covering these folds. Storage in M-K medium was the most effective of the three methods in preventing deep corneal folds and endothelial damage.