How biomass growth mode affects ammonium oxidation start-up and NOB inhibition in the partial nitritation of cold and diluted reject water.

The inhibition of undesirable nitrite oxidizing bacteria (NOB) and desirable ammonium oxidizing bacteria (AOB) by free ammonia (FA) and free nitrous acid (FNA) in partial nitritation (PN) is crucially affected by the biomass growth mode (suspended sludge, biofilm, encapsulation). But, the limitations of these modes towards less concentrated reject waters (≤600 mg-N L-1) are unclear. Therefore, this work compares the start-up and stability of three PN sequencing batch reactors (SBRs) with biomass grown in one of the three modes: suspended sludge, biofilm and biomass encapsulated in polyvinyl alcohol (PVA) pellets. The SBRs were operated at 15°C with influent total ammonium nitrogen (TAN) concentrations of 75-600 mg-TAN L-1. PN start-up was twice as fast in the biofilm and encapsulated biomass SBRs than in the suspended sludge SBR. After start-up, PN in the biofilm and suspended sludge SBRs was stable at 150-600 mg-TAN L-1. But, at 75 mg-TAN L-1, full nitrification gradually developed. In the encapsulated biomass SBR, full nitrification occurred even at 600 mg-TAN L-1, showing that NOB in this set-up can adapt even to 4.3 mg-FA L-1 and 0.27 mg-FNA L-1. Thus, PN in the biofilm was best for the treatment of an influent containing 150-600 mg-TAN L-1.

Cholesterol level correlate with disability score in patients with relapsing-remitting form of multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is an autoimmune disease characterised by demyelination. There are many environmental factors that can affect the progression of this disease. It is necessary to better understand the impact of these factors in MS pathogenesis and progression. OBJECTIVE: Present study investigates the relationship of total cholesterol serum levels and other parameters contributing to cardiovascular risk - homocysteine and serum lipid parameters (triglycerides, HDL, LDL) - with the progression of MS (EDSS score). METHODS: The study involved 169 patients diagnosed with MS. Total homocysteine levels were measured by high-performance liquid chromatography. Serum lipid parameters were measured with enzymatic kits. RESULTS: There was no difference observed between homocysteine levels in MS patients and controls. Dyslipidaemia seems to be associated with MS progression, particularly in women with relapsing-remitting form of MS. CONCLUSION: Positive correlation of total and LDL cholesterol with disability score in patients with relapsing-remitting form of MS suggests that lipid parameters could have a negative effect on the disease progression.

Effects of aging on T1, T2*, and QSM MRI values in the subcortex.

The aging brain undergoes several anatomical changes that can be measured with Magnetic Resonance Imaging (MRI). Early studies using lower field strengths have assessed changes in tissue properties mainly qualitatively, using [Formula: see text]- or [Formula: see text]- weighted images to provide image contrast. With the development of higher field strengths (7 T and above) and more advanced MRI contrasts, quantitative measures can be acquired even of small subcortical structures. This study investigates volumetric, spatial, and quantitative MRI parameter changes associated with healthy aging in a range of subcortical nuclei, including the basal ganglia, red nucleus, and the periaqueductal grey. The results show that aging has a heterogenous effects across regions. Across the subcortical areas an increase of [Formula: see text] values is observed, most likely indicating a loss of myelin. Only for a number of areas, a decrease of [Formula: see text] and increase of QSM is found, indicating an increase of iron. Aging also results in a location shift for a number of structures indicating the need for visualization of the anatomy of individual brains.

Phytoplankton community responses in a shallow lake following lanthanum-bentonite application.

The release of phosphorus (P) from bed sediments to the overlying water can delay the recovery of lakes for decades following reductions in catchment contributions, preventing water quality targets being met within timeframes set out by environmental legislation (e.g. EU Water Framework Directive: WFD). Therefore supplementary solutions for restoring lakes have been explored, including the capping of sediment P sources using a lanthanum (La)-modified bentonite clay to reduce internal P loading and enhance the recovery process. Here we present results from Loch Flemington where the first long-term field trial documenting responses of phytoplankton community structure and abundance, and the UK WFD phytoplankton metric to a La-bentonite application was performed. A Before-After-Control-Impact (BACI) analysis was used to distinguish natural variability from treatment effect and confirmed significant reductions in the magnitude of summer cyanobacterial blooms in Loch Flemington, relative to the control site, following La-bentonite application. However this initial cyanobacterial response was not sustained beyond two years after application, which implied that the reduction in internal P loading was short-lived; several possible explanations for this are discussed. One reason is that this ecological quality indicator is sensitive to inter-annual variability in weather patterns, particularly summer rainfall and water temperature. Over the monitoring period, the phytoplankton community structure of Loch Flemington became less dominated by cyanobacteria and more functionally diverse. This resulted in continual improvements in the phytoplankton compositional and abundance metrics, which were not observed at the control site, and may suggest an ecological response to the sustained reduction in filterable reactive phosphorus (FRP) concentration following La-bentonite application. Overall, phytoplankton classification indicated that the lake moved from poor to moderate ecological status but did not reach the proxy water quality target (i.e. WFD Good Ecological Status) within four years of the application. As for many other shallow lakes, the effective control of internal P loading in Loch Flemington will require further implementation of both in-lake and catchment-based measures. Our work emphasizes the need for appropriate experimental design and long-term monitoring programmes, to ascertain the efficacy of intervention measures in delivering environmental improvements at the field scale.

[Treating Diabetic Macular Edema by a Micropulse Laser - First Findings]. / Lécba diabetického makulárního edému mikropulsním laserem - první zkusenosti.

INTRODUCTION: Diabetic macular edema (DME) is the most common cause of a visus dicrease in patients suffering type 2 diabetes. DME originates in abnormal macula capillars permeability. This study presents the findings of observing patients with DME after by micropulse laser therapy with the wavelength of 577 nm. METHODS: The study covers 23 eyes of 15 patients with focal or difuse DME. In all patients we performed a 577 nm micropulse laser therapy of the macula, proceeding by a technique of placing spots next to each other in the shape of EDTRS optotype letters. In average we performed 3 treatments per eye. RESULTS: Best-corrected visual acuity (BCVA) was 61,8 of a letter at the beginning, 62,5 of a letter after 3 months, 59,5 of a letter after 6 months, 57,6 of a letter after 9 months and 59,2 of a letter after 12 months. The average difference between BVAC at the beginning and after a year was -2.7 of a letter. A T-test does shows statistically insignificant difference.The average central retinal thickness (CRT) was 380,4 µm at the beginning, 368,1 µm after 3 months, 327,5 µm after 6 months, 329,2 µm after 9 months and 301,0 µm after 12 months. The difference between the average CRT at the beginning and after 12 months was -79,5 µm. A T-test shows statistically significant difference. DISCUSSION: Our studied group reported visus improvement or stabilization in 61% of eyes and decrease or stabilization of DME in 83% of eyes. Without treatment a deterioration would occur due to the progressive nature of the disorder. Taking into account these results and relevant literature we resolved to change our treatment methods in favour of placing laser spots as close as possible. An evaluative study of this method will follow. CONCLUSION: In the studied group the average CRT improved and the average BCVA remained virtually equal. Treating DME by means of a micropulse laser has proven to be an effective method. It does not leave scars on retina and thus prevents creating scotoms. If the edema is higher or a resistent cyst occurs in the macula, it is recommended to combine laser and anti-VEGF therapies. In case of insufficient effects of a laser therapy there is a possibility of combining it with an anti-VEGF treatment.

[Spondyloarthritides: current perspective on diagnosis and classification]. / Spondyloartritidy: aktuální pohled na diagnostiku a klasifikaci.

Spondyloarthritides (SpA) are a heterogeneous group of chronic inflammatory diseases with common clinical features and genetic basis. They primarily affect the axial skeleton, especially the sacroiliac joint, other localizations of the affection being peripheral joints and entheses -  typical of the group of spondyloarthritides. On the basis of the predominant affection of the axial or peripheral skeleton, they can be divided, according to the current classification criteria, into axial SpA and peripheral SpA. Apart from axial and peripheral articular manifestations, many patients also display extra articular manifestations, which can thus become an important diagnostic clue and also the first symptom of the disease. The most frequent of them are anterior uveitis, inflammatory bowel diseases, and psoriasis. Also the strong binding of spondyloarthritides to the positivity of HLA B27 antigen or a family history of the disease is important information which helps in the diagnosis. Comorbidities, the most common and important of which are cardiovascular diseases or osteoporosis and its consequences in the form of fractures, are an integral part of the issue of spondyloarthritides.

[Recommendations of Czech Rheumatological Society for the treatment of rheumatoid arthritis. Efficacy and treatment strategies]. / Doporucení Ceské revmatologické spolecnosti pro lécbu revmatoidní artritidy. Ucinnost a strategie lécby.

Rheumatoid arthritis (RA) is an autoimmune disease of unknown aetiology characterized by presence of chronic symmetric synovitis, which leads to the formation of joint erosions. Generally recommended method for activity assessment of RA is so called Disease Activity Score (DAS). In early RA when low disease activity is present with oligo- or monoarthritis antimalarials are drugs of choice, while sulfasalazine (SAS) is recommended in cases with medium activity without erosions. Initial treatment with methotrexate (MTX) or leflunomide (LEF) should be applied in a very active polyarthritis with a rapid development of erosions. MTX is often combined with other disease modifying drugs (DMARD) and the blockers of tumour necrosis factor alpha (TNF-alpha). LEF is to be administered to the patients in whom the other DMARD are contraindicated or not tolerated. In established RA with oligo- or monoarthritis with permanent low activity SAS is DMARD of choice. In cases with insufficient response and medium activity MTX is used and if it is inefficient LEF or combination of DMARD should be considered. In a very active disease with a rapid evolution of erosions high doses of MTX or LEF are recommended. When extraarticular symptoms of RA are present azathioprine is to be applied and in case of involvement of vital organs cyclophosphamide should be used. When DMARD are failing or contraindicated TNF-alpha blockers are to be applied. When one TNF-alpha blocker is inefficient it should by replaced by another one from the same group or another biological should be used. For indication of biologicals the activity limit is DAS28 5.1 and the decrease of DAS28 more than 1.2 is an efficacy criterion. Nonsteroidal antirheumatic drugs are an important part in the management of RA, and also corticosteroids are often of used in oral or parenteral form. To the complex therapy of RA nonpharmacological means are usually implemented--different physical procedures and various surgeries.

Comparison of injection site pain and injection site reactions in relapsing-remitting multiple sclerosis patients treated with interferon beta-1a or 1b.

This prospective, multicentre, international, observational, cohort study compared injection site pain (ISP) and injection site reactions (ISRS) between interferon beta-1b (IFNB-1b; Betaferon) 250 microg subcutaneously every other day and interferon beta-1a (IFNB-1a; Rebif) 44 microg subcutaneously three times weekly in patients with relapsing-remitting MS. Patients started treatment within 3 months before recruitment and were on full dose of therapy at inclusion. Patients self-injected IFNB and self-assessed ISP for 15 consecutive injections immediately, 30 and 60 min after injection, using a visual analogue scale diary. Study staff assessed ISRS. Of 445 patients (valid cases), approximately 90% used autoinjectors. More patients were pain-free at all timepoints with IFNB-1b than with IFNB-1a (eg, 30 min: 42.6% versus 19.7%; P<0.0001). The mean proportion of pain-free injections was greater for IFNB-1b (eg, 30 min: 79.0%) than for IFNB-1a (53.3%; P<0.0001). The proportion of patients without ISRS was greater for IFNB-1b (second visit 51.8% versus 33.8%; P<0.0001). Compared with IFNB-1a, more IFNB-1b patients either had no pain or their ISP had no influence on treatment satisfaction (76.9% versus 64.1%; P=0.006). The impact on tolerability and patient acceptability of any new IFNB product formulations would, however, have to be evaluated in comparative studies.

[Biological treatment of rheumatic diseases]. / Biologická terapie revmatických onemocnení.

During recent two decades the progress in the understanding of the pathogenesis of the autoimmune diseases have led to new treatment targets, whose achievement claims new therapeutic advancings. Biological drugs complete or replace conventional immunosuppressive therapies in the treatment of autoimmune diseases. In the treatment of rheumatic diseases are currently used TNFalpha inhibitors and blockade of the IL-1, in phase of clinical trials or actual registration are agents blocking IL-6, the antibodies against B cell and inhibition of activation of T-cells by costimulating blockade with CTLA4Ig. In the Czech Republic are for treating of rheumatic diseases approved TNF blocking drugs. Treatment with this drugs is centred in biological therapy centres and patients are enroled into Registry of patients treated with anti TNFalpha drugs (ATTRA), which enable longterm observation of efficacy and toxicity.

Epithelioid hemangioendothelioma of the mandible.

The authors describe a locally recurrent tumor of the mandible whose microscopic structure and immunohistochemical findings corresponded to an epithelioid hemangioendothelioma. The tumorous cells had an epithelioid character, they created rudimentary vascular lumina, and they focally expressed vascular markers CD 34, CD 31, and F VIII. Locally the tumor grew aggressively. During the last recurrence, the tumor even affected the already healed and rebuilt bone graft, which was incorporated after the primary resection of the mandibular body. From the histological point of view, the tumor approximated an angiosarcoma. No metastases occurred.

[Intralenticular metal foreign bodies]. / Intralentikulární cizí kovová telíska.

OBJECTIVE: The paper is concerned with the problem of extraction of foreign metal bodies, which remained after a perforating injury in the patient's lens. The authors discuss early and late extraction of the opacifying lens. MATERIAL AND METHODS: In three successive accidents of young men (22-34 years) the authors compare the fate of intralenticular metal bodies and the lens. RESULTS: All three metal bodies were extracted, at the same time also surgery of the opacifying lens was performed with implantation of a posterior chamber intraocular lens into the sac after continual curvilinear capsulorrhexy. The postoperative visual acuity was 6/6. CONCLUSION: With regard to contemporary possibilities of careful solution of lenticular surgery, using high standard viscoelastic materials, it is advisable to remove primarily the foreign body from the lens along with the damaged opacified lens and replacement of the latter by a posterior chamber intraocular lens as the quickest possible solution of the posttraumatic state.

Arteriovenous malformations of the orofacial area.

Vascular lesions are pathological residues of the embryonic vascular system and can be divided into two main groups. The first group comprises haemangiomas, which are typical of childhood and involute spontaneously. The second group is formed by lesions without active proliferation, which include, among others, arteriovenous malformations that are congenital and grow proportionately with the subject. The authors present two cases of arteriovenous malformations of the orofacial area and discuss possibilities for modern diagnosis and treatment. Precise diagnosis and effective treatment of vascular lesions should be ensured by a diagnostic and therapeutic team of specialists from several disciplines (maxillofacial, ENT, plastic and general surgeon, paediatrician, haematologist, anaesthesiologist and possibly a neurosurgeon), headed by an intervention radiologist.

[Cerebrospinal fluid proteins in the diagnosis of disorders of the blood-cerebrospinal fluid barrier in central nervous system diseases]. / Bielkoviny likvoru v diagnostike porúch hematolikvorovej bariéry pri niektorých ochoreniach CNS.

BACKGROUND: Many neurological diseases are connected with the dysfunction of blood-CSF barrier. The quantitative determination of CSF proteins has already been used in the diagnosis of barrier impairments and inflammatory diseases of the central nervous system. PATIENTS: Serum and CSF, totaling 264 samples, were obtained from 15 controls and 117 patients with various diseases of the nervous system. Laurell's electroimmunoassay was used for estimation of albumin and IgG levels in serum and CSF. CSF-protein profile was evaluated according to Reiber's graph for the evaluation of the CSF-protein profile. RESULTS: The graph for the protein profile can be divided into 5 functionally different parts (1--normal range, 2, 3, 4--different types of barrier dysfunctions and 5--local humoral response in CNS without any barrier impairment). There was a good correlation of CSF-protein profiles and neurological diseases in our group of patients. CONCLUSIONS: According to our results, Reiber's graph was helpful for the diagnosis of blood-CSF-barrier dysfunctions. The graph has the following advantages: a) possibility of simultaneous assessment of the functional state of blood-CSF-barrier and the inflammatory response of the CNS, b)sensitivity for the determination of pathological local IgG-production in CNS and c) minimal number of protein assays necessary.

[Cataract operations and implantation of intraocular lenses in children and adolescents]. / Operace katarakty a implantace nitroocní cocky u detí a mladistvých.

The authors are presenting the results of 60 cataract operations performed in 54 patients younger then 18 years. Traumatic cataract was operated in 33 patient (29 boys, 4 girls), congenital cataract in 19 eyes and complicated cataract in 8 eyes. The visual acuity 0.5 and better was gained in 40% of the eyes in which it was possible to find out the visual acuity. This visual acuity was achieved in 50% of 19 patients with IOL implantation (the youngest was 4 years old). The visual acuity was 0.5 and better in 75% of 12 patients regularly wearing contact lens. The worse results were in patients with congenital cataract-just one eye from 10, in which the visual acuity was possible to evaluate, had the visual acuity 0.5. In one case it was necessary to replace the luxated posterior chamber IOL. The IOL implantation in children, especially in those with traumatic cataract, is becoming more frequent.