Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia (Biomed Paper)

Publications in this journal

• Article: A new program for highly reproducible automatic evaluation of the substantia nigra from transcranial sonographic images.

  Jiri Blahuta, Tomas Soukup, Monika Jelinkova, Petra Bartova, Petr Cermak, Roman Herzig, David Skoloudik
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  ABSTRACT: AIMS: Recent studies report increased echogenicity of the substantia nigra (SN) in patients with Parkinson's disease (PD) using transcranial sonography (TCS). However, the main limitation to TCS is its dependence on the sonographer's experience. Experimental software for quantitative evaluation of the echogenic SN area was thus developed by us. The aim of this study was to test the reliability of the data using developed B-Mode Assist software in patients with parkinsonism and in healthy volunteers. METHODS: The SN was imaged from the right temporal bone window in mesencephalic plane using TCS. DICOM images of SN were saved, converted into JPEG format, encoded and processed. Two observers performed 3 automatic evaluations of the SN area (measurements of SN area in each gray scale intensity inside the region of interest) by counting the standard deviation of all 6 measurements using developed software. The average value of all 3 measurements of each observer was used for computing Cohen's kappa coefficient to determine inter-observer correlations. Cohen's kappa coefficients as an intra-observer correlation for observer 1 and observer 2 were counted from the first 2 measurements of both observers. RESULTS: In total, 92 images were evaluated using this software. The mean of the standard deviations was 3.87; Cohen's kappa for intra-observer agreement of two observers were 0.947, and 0.943, resp.; Cohen's kappa for inter-observers agreement was 0.880. The agreement between visual and automatic detection of SN pathology was in 97.8% images. The sensitivity, specificity, positive and negative predictive values of automatic measurement were 100, 96.2, 95.1, 100%, resp. CONCLUSIONS: The results show very reliable measurement of SN features using designed application with "almost perfect" inter-observer and intra-observer agreements.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 04/2013;
• Article: Arthrocentesis of the temporomandibular joint: A review.

  Peter Tvrdy, Petr Heinz, Richard Pink
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  ABSTRACT: BACKGROUND: Arthrocentesis is a very gentle method for lavage of the joint space. The principle consists in the introduction of a pair of needles into the upper joint space and subsequent lavage using physiological saline or Ringer's solution. Arthrocentesis of the temporomandibular joint is used in both cases of acute closed lock and treatment of various temporomandibular disorders. METHODS: A literature search in Pubmed database, using key words: Temporomandibular joint (TMJ), Arthrocentesis, indications, technique, results. CONCLUSION: Arthrocentesis of the temporomandibular joint is a minimally invasive treatment method at the boundary between conservative and surgical therapy. It is usually performed on an out-patient basis under local anaesthesia. It is used both in cases of acute block caused by displacement of the articular disc and also to treat degenerative inflammatory diseases of the joints. The main objective of arthrocentesis is to wash out inflammatory mediators, release the disc, break adhesions, eliminate pain and improve joint mobility. It is a method with a minimum number of complications, it is simple and not demanding in terms of instruments, and it can be performed repeatedly. For this reason, it has become widespread and very popular in the treatment of internal disorders of the temporomandibular joint.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 04/2013;
• Article: Evaluation of a novel vascular graft with a distal bifurcation designed to reduce the development of intimal hyperplasia. Experimental study in a porcine aorta model.

  Robert Vlachovsky, Robert Staffa, Martin Dvorak, Michal Vlasin, Marketa Hermanova, Thomas O'Brien, Timothy McGloughlin
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  ABSTRACT: OBJECTIVE: Abnormal haemodynamics is commonly agreed to be a major contributor to the development of distal anastomotic intimal hyperplasia. A new vascular graft design proposed by computational studies was used to demonstrate its surgical feasibility and to compare it with the conventional graft in a porcine model. METHOD: The device was used in 12 eight-month-old pigs, six received the new graft and six had a conventional graft. The proximal graft end was implanted into the aorta, the distal graft end was implanted into the iliac artery. The host artery was ligated in order to simulate occlusion. At 20 weeks after surgery the pigs were killed and the device was excised for histological and morphometric analysis. RESULTS: In five experimental grafts the reconstruction was occluded due to thrombosis; only one prosthesis was patent showing a minimum of neointimal hyperplasia. In the control group too only three of the six grafts were patent. A histological analysis revealed, as the cause of occlusion, fibrous tissue overgrowth corresponding in structure to neointimal hyperplasia. Differences in the number of obliterations and in occlusion rates between the profiles of the two groups were evaluated using the median test (P<0.05). The results were not statistically significant. CONCLUSION: Although mathematical modelling had shown significant haemodynamic benefits of a naturally bifurcated graft, our study did not confirm its superiority over conventionally used prostheses.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 04/2013;
• Article: Reduced relative dose intensity of primary chemotherapy does not influence prognosis of patients with Hodgkin lymphoma.

  Ludek Raida, Tomas Papajik, Zuzana Rusinakova, Vit Prochazka, Edgar Faber, Dana Cahova, Pavel Tucek, Karel Indrak
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  ABSTRACT: AIMS: A retrospective analysis of patients with Hodgkin lymphoma (HL) was performed to assess their outcome regarding relative dose intensity (RDI) of chemotherapy administered in primary treatment. METHODS: A total of 194 patients were divided into three groups with different RDI of primary chemotherapy (100%, 90-99% and < 90%). Reduced RDI in two groups (90-99% and < 90%) was caused by the delay of the interval between the administration of some chemotherapeutic courses. The probability of complete remission (CR), disease relapse, event-free survival (EFS) and overall survival (OS) as the basic parameters of patient outcome were statistically compared. RESULTS: Multivariate analysis showed here were no significant differences in probability of CR (HR 0.9, 95% CI [0.75-1.08], P=0.5), risk of relapse (HR 1.34, 95% CI [0.92-1.94], P=0.11) or death (HR 1.52, 95% CI [0.94-2.5], P=0.13). There were also no significant differences in probability of EFS (mean 13 vs. 10 vs. 12 years, P=0.17; HR 1.54, 95% CI [0.91-2.6], P=0.22) or OS (mean 15 vs. 13 vs. 14 years, P=0.13; HR 1.52, 95% CI [0.93-2.5], P=0.13). CONCLUSION: We found no significant impact of primary chemotherapy delay resulting in reduced RDI on outcome in HL patients.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 04/2013;
• Article: Detection of minimal residual disease in lung cancer.

  Josef Chudacek, Tomas Bohanes, Jiri Klein, Andrea Benedikova, Josef Srovnal, Marek Szkorupa, Pavel Skalicky, Jozef Skarda, Marian Hajduch, Cestmir Neoral
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  ABSTRACT: BACKGROUND: Even after successful radical treatment of lung cancer, patients in stages I and II of the TNM system very frequently suffer recurrence, which end lethally. Detection of subclinical residual disease after surgery is thus one of the most important emerging diagnostic methods. Minimal residual disease (MRD) is defined as the presence of isolated tumor cells or circulating cells in a patient after curative primary tumor removal and at the same time, no clinical signs of cancer. Conventional methods cannot detect minimal residual disease and hence there is a need for detection using new molecular biological methods. METHODS: We searched the PubMed database for original and review articles on minimal residual disease in lung cancer. Search words were "lung cancer", "minimal residual disease" and "detection of minimal residual disease". The publications we found were compared with the results of our own studies on the detection of minimal residual disease in lung cancer and the personal experiences are described. Examination of blood samples from 98 healthy volunteers and bone marrow from 12 patients with non inflammatory and non tumour illness, were used to determine cut-off values for specific markers in the compartments. Subsequently, expression of selected markers in tumor tissue was analysed in a pilot sample of 50 patients with lung cancer and the presence of MRD was measured as expression of values of the tested markers correlated with clinico-pathological characteristics. CONCLUSIONS: Recent studies on other malignancies apart from lung cancer have shown the importance of MRD detection in the determination of disease progression and prognosis. The methods of MRD diagnostics are based on detection of specific tumor markers. Of these, the most specific for lung cancer, appears to be the LunX protein. The best method for determining MRD is probably RT-PCR. Further studies should expand knowledge in this area: to refine understanding of the importance of tumor markers for prognosis, as well as to confirm the significance of these findings in clinical practice.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 04/2013;
• Article: Current treatment methods for long occlusions of the femoropopliteal segment in patients with intermittent claudication. Minireview.

  Jana Fialova, Petr Utikal, Petr Bachleda, Martin Kocher, Marie Cerna, Katherine Vomackova
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  ABSTRACT: Backround: Intermittent claudication is a classic symptom of peripheral arterial disease. It is mainly treated conservatively but if this fails, a form of revascularization is indicated. The revascularization in chronic occlusion of femoropopliteal region is currently performed by two basic methods: the standard method of surgical bypass and the newer miniinvasive alternative represented by the endovascular method. The treatment of patients with solely claudication and long occlusion of femoropopliteal region remains controversial. The aim of this minireview was to determine whether surgical bypass is still the best method of choice in a time of endovascular techniques.Methods: A MEDLINE search for original and review articles using key terms, intermittent claudication and long femoropopliteal oclusion.Results and Conclusion: No ideal treatment for long occlusions of the femoropopliteal segment has been established to date. It is clear that the role of endovascular techniques in the treatment of SFA occlusions is increasing. It remains that, lower risk patients with claudication should be examined to assess the quality of veins suitable for revascularization and bypass should be selected as the first method of choice.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Long term visual outcome after arteriolar constriction in patients with branch retinal vein occlusion.

  Jiri Rehak, Ladislav Dusek, Martin Sin, Barbora Babkova, Zuzana Pracharova, Matus Rehak
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  ABSTRACT: AIM: To evaluate the final best corrected visual acuity (BCVA) in patients with branch retinal vein occlusion (BRVO) treated with either (1) laser arteriolar constriction (ACo) or (2) the standard treatment recommended by the Branch Vein Occlusion Study Group (grid laser photocoagulation (GLP) or only observation (if indication criteria for GLP were not met). METHODS: 358 BRVOs were treated in three different ways: early ACo (n=133) performed ≤ 9 weeks after onset of BRVO, late ACo (n=62) performed > 9 weeks after onset and controls which included GLP and observation (n=163). The groups were further divided according to initial BCVA into: ≤ 0.1; 0.16-0.3 and ≥ 0.4. RESULTS: Based on the proportion of 1 year BCVA ≤ 0.1 as a risk category, the results of early ACo (3.8%) were significantly better than for the controls (22.7%, P<0.001) and late ACo (16.1%, P=0.006). The greatest difference in final BCVA was in patients with the worst initial VA (≤ 0.1). In the intermediate initial BCVA group 0.16-0.3, a significant difference was only found between the early ACo group and controls (P=0.007). There was no significant difference between any treatment group and prevalence of a final BCVA ≤ 0.1 for patients with an initial BCVA ≥ 0.4. CONCLUSIONS: Early ACo significantly reduces the prevalence of a final BCVA ≤ 0.1 in patients with BRVO and an initial BCVA ≤ 0.3 compared to controls (standard treatment treated with GLP or observed).
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: The effect of nano-scale topography on osteogenic differentiation of mesenchymal stem cells.

  Faezeh Faghihi, Mohamadreza Baghaban Eslaminejad
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  ABSTRACT: BACKGROUND: Large bone defects resulting from trauma or disease pose a threat to humans. Thus far, tissue engineering as an important clinical approach uses cells, growth factors and scaffolds to regenerate large areas of damaged bone tissue. Since bone is a nanocomposite structure, it is assumed that nanomaterial scaffolds can induce or promote osteogenesis by mimicking the cell niche at nano level. METHODS AND RESULTS: In this review we highlighted the effect of nano-scale topography on osteogenic differentiation of Mesenchymal Stem Cells (MSCs) as potent cell candidates in bone engineered constructs. The key point in the induction of differentiation by nanomaterials is the discontinuity in their topography. This leads to alteration in protein adsorption and restriction of extracellular matrix deposition by the cells and consequently leads to changes in cell morphology and the frequency of accessible sites for cell adhesion. Here, we have reviewed the literature on the role of different types of nanomateial scaffolds in osteogenic differentiation of these cells. Since little is known about the underlying molecular networks induced by nanomaterials, we also reviewed possible underlying mechanisms of nanotopographical effects on the osteogenic differentiation of MSCs. CONCLUSIONS: Nano-scale materials provide a niche which is very similar to native bone in geometry and stiffness. Such nano-scale topographies improve the function of MSC-based engineered constructs in regeneration of bone defects.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Organs of BALB/c mice can be injured in course of tularemia.

  Oto Pavlis, Eva Kusakova, Ladislav Novotny, Miroslav Pohanka
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  ABSTRACT: BACKGROUND: Francisella tularensis is a biological agent exploitable for bioterrorism and biological warfare purposes due to serious pathogenic progression and easy dissemination. Despite intensive research in the past, some adverse consequences remain unclear. One consequence of this pathogen is oxidative stress. AIMS: The aim of this study was to undertake ex vivo assays for monitoring the disease in mice and increase our knowledge of the oxidative stress induced by tularemia. METHODS: The mouse BALB/c model was chosen and the animals were infected by a dose 10(4) CFU of F. tularensis. After five days, the animals were euthanized. Blood immediately processed in plasma, spleen and liver were sampled from the cadavers. Oxidative stress markers, cytokines and histopathological were undertaken. RESULTS: There was a significant link between oxidative stress and tularemia. Particularly elevated levels of malondialdehyde and decreased levels of low molecular weight antioxidants were found in the liver and spleen of tularemia-infected animals. The histopathological findings correlated well with the oxidative stress markers. The liver and spleen were proven to be significantly at risk from the disease and an association between stress and neutrophils in the affected organs was found. The histopathology excluded risk to other organs such as the kidney and or heart. CONCLUSIONS: Oxidative stress plays a significant role in tularemia infection in mice and this was confirmed by the histology.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: An unusual reason for severe bradycardia leading to cardiac arrest during general anaesthesia: A case report.

  Klara Struzkova, Petr Stourac, Jan Kanovsky, Ivo Krikava, Michaela Toukalkova, Pavel Sevcik
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  ABSTRACT: BACKGROUND: Takotsubo cardiomyopathy also known as transient balooning syndrome is an increasingly reported phenomenon characterized by acute reversible apical or midventricular dysfunction. This stress- induced cardiomyopathy mimics myocardial infarction, but without significant coronary artery disease, and rarely presents in perioperative period. METHODS AND RESULTS: We report a case of postmenopausal woman scheduled to undergo elective cholecystectomy, with no history of coronary artery disease. She presented perioperatively with Takotsubo cardiomyopathy by unique manifestation- asystoly. This uncommon cause of cardiac arrest during anaesthesia was possibly induced by preoperative emotional stress. There was full recovery thanks to intensive management. In Takotsubo cardiomyopathy related cardiogenic shock we used the calcium sensitiser levosimendan successfully. CONCLUSION: Takotsubo cardiomyopathy has an excellent long-term prognosis and nearly all patients have full recovery of left ventricular function. We emphasize the importance of heavy premedication by stress compromised patients and the need of sufficiently deep anaesthesia and analgesia during surgeries.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Self-care behaviour, treatment satisfaction and quality of life in people on intensive insulin treatment.

  Elena Gurkova, Katarina Ziakova
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  ABSTRACT: AIM: The aim of this cross-sectional study was to identify self-care behaviours and their relationships with treatment satisfaction and quality of life in people attending a structured educational programme for patients on intensive insulin therapy. METHODS: A sample of 104 people with diabetes (62 with type-1; 42 with type 2) was recruited from the National Institute of Endocrinology and Diabetology in Ľubochňa over six months. The majority of respondents were women (62.5%); had multiple daily injections of insulin (73%); diabetic late complications (68%) and had not previously participated in the structured educational programmes in the specialized diabetes centre (64.4%). Self-management behaviour data were collected by means of structured interviews with patients as well as during clinic visits. For measuring quality of life, the Audit Diabetes Dependent Quality of Life questionnaire and for measuring satisfaction with their treatment regimen, the Diabetes Treatment Satisfaction Questionnaire status version was used. RESULTS: General satisfaction with the treatment was significantly higher in people with diabetes, who implemented regular self-monitoring of the concentration of glucose in plasma (SMPG). We also demonstrated low adherence in the frequency of SMPG. 17% of respondents in our study performed daily SMPG. However, 52% respondents reported adaptation of insulin dosage in relation to factors such as carbohydrate intake, glycaemia values or degree of physical activity. Differences in quality of life due to performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations as well as carbohydrate counting were not significant. CONCLUSION: Performing the regular self-monitoring of glycaemia was associated only with higher treatment satisfaction. No significant improvement in quality of life was seen in people performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations or carbohydrate counting.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: (13)C-methacetin breath test in the evaluation of disease severity in patients with liver cirrhosis.

  Jana Vranova, Miluse Hendrichova, Hana Kolarova, Karolina Kratka, Jozef Rosina, Jiri Horak
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  ABSTRACT: AIMS: The non-invasive (13)C-methacetin ((13)C-MBT) breath test has been proposed as a measure of metabolic liver function that improves the diagnostic efficacy of serologic and biochemical tests in assessing hepatic functional capacity and liver disease severity, The goal of this study was to establish the clinical utility of this test in quantifying hepatic metabolic function in patients with liver cirrhosis of varying severity and to compare (13)C-MBT measurements with the AST/ALT ratio, APRI score, and other routine liver tests. METHODS: Routine liver function tests including serum bilirubin, aspartate aminotransferase activity (AST), alanine aminotransferase (ALT), AST/ALT ratio, the APRI score, the percentage of dose rate (PDR) and cumulative percentage of dose rate (CPDR) of the (13)C-MBT were evaluated in 52 cirrhotic patients of alcohol etiology (Child-Pugh A/B/C 10/28/14) and 37 healthy controls. RESULTS: The (13)C-MBT differed significantly between healthy controls and cirrhotic patients at all time intervals measured. It also proved the ability to differentiate patients with liver cirrhosis based on severity of hepatic impairment corresponding to the Child-Pugh classification A vs. B vs. C. The ROC curve analysis suggested that the best prediction is provided by time intervals between the 10(th) - 20(th) or 10(th) - 40(th) minute of PDR. CONCLUSIONS: The (13)C-MBT offers a reliable means for quantification of hepatic metabolic function over the complete range of functional liver impairment. It is non-invasive, easy to perform and completely safe.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: X-linked agammaglobulinemia caused by new mutation in BTK gene: A case report.

  Zuzana Havlicekova, Milos Jesenak, Tomas Freiberger, Peter Banovcin
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  ABSTRACT: AIM: Primary immunodeficiencies (PID) are becoming a recognized public health problem worldwide. The most important subgroup of these disorders are the antibody deficiencies. X-linked agammaglobulinaemia was the first described entity of this group and is characterised by early onset of recurrent bacterial infections, profound deficiency of all immunoglobulin isotypes and markedly reduced number of peripheral B-lymphocytes. CASE REPORT: We report the case of a 10-year old boy with X-linked agammaglobulinaemia caused by a previously non-described mutation in BTK gene with typical clinical presentation but delayed diagnosis. Following diagnosis, substitution therapy with intravenous immunoglobulins was started and the clinical status of the patient improved. CONCLUSION: We reported a case of X-linked agammaglobulinaemia with delayed diagnosis despite the typical anamnestic signs for primary humoral immunodeficiency. The disease was caused by a previously non-reported mutation in the BTK gene. Measurement of serum immunoglobulins should be performed in all children with recurrent, complicated respiratory infections as a screening test for humoral immunodeficiencies.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Variability of post-exercise pulmonary capillary wedge pressure recovery. Implications for noninvasive echocardiographic diagnostics.

  Jaroslav Meluzin, Petr Hude, Jan Krejci, Lenka Spinarova, Pavel Leinveber, Radka Stepanova, Petr Nemec
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  ABSTRACT: AIM: The aim of our study was to assess the course of immediate post-exercise pulmonary capillary wedge pressure (PCWP) changes to identify the optimal time window for the noninvasive diagnostics of exercise-induced PCWP elevation. METHODS AND RESULTS: Seventy-one patients at risk of heart failure with normal left ventricular ejection fraction underwent simultaneous exercise echocardiography and right heart catheterization. The ratio of early left ventricular filling velocity (E) to early diastolic mitral annular velocity (e') was used to predict noninvasively exercise-induced PCWP elevation. Fifty-one patients had exercise-induced PCWP elevation ≥ 8 mmHg and reached peak exercise PCWP ≥ 20 mmHg. Rapid post-exercise recovery of PCWP within 2 min was achieved in 18 (35.3%) patients. Intermediate post-exercise PCWP recovery at 3 and 4 min was found in 16 (31.4%) patients while late post-exercise PCWP recovery (≥ 5 min) was achieved in 17 (33.3%) patients. CONCLUSION: The course of post-exercise PCWP recovery is highly variable, and a significant proportion of patients have only a brief period (≤ 2 min) of exercise-induced PCWP elevation. This fact should be taken into account in noninvasive assessment of exercise-induced PCWP.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Impact of retransfusion of blood processed in cell-saver on coagulation versus cardiopulmonary bypass: a prospective observational study using thromboelastography.

  Tomas Vymazal, Martin Filaun, Michal Horacek
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  ABSTRACT: AIMS: To compare an impact of retransfusion of blood processed in cell-saver (CS) with that of cardiopulmonary bypass (CPB) on blood coagulation in patients undergoing cardiac surgery. METHODS: Prospective observational study using thromboelastography (TEG). RESULTS: TEG samples from 170 patients were analyzed. Cardiopulmonary bypass was used in 100 patients while 70 patients were operated off-pump. In 20 off-pump patients collected blood was processed by cell-saver and returned. In all patients clot formation after heparin neutralization by protamine was unimpaired. However, there was a significant increase in fibrinolysis defined by the TEG parameter Lysis time 30 min after the maximum amplitude of the clot was reached (Ly30) in groups with CPB or CS but this increase still did not exceed the threshold for clinical fibrinolysis (Ly30 > 7.5%). In the group without CPB there was no significant impact on coagulation. CONCLUSION: Surgery that avoids CPB and/or CS is the gentlest method for inducing blood coagulation.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Therapeutic monitoring of psychoactive drugs - antidepressants: A review.

  Milan Grundmann, Ivana Kacirova, Romana Urinovska
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  ABSTRACT: BACKGROUND: Major depression, is one of the most prevalent mental disorders in Europe and the USA. The dramatic rise in pharmacological antidepressants is mainly due to increase in use of selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors and other new generation antidepressants. In clinical practice, optimum individual doses are often guided by trial-and-error. This article reviews the available literature on therapeutic monitoring of antidepressant drugs. METHODS: A search using MEDLINE (english-language reports, 1983 - August 2012) with the key words for antidepressant drugs and therapeutic drug monitoring. RESULTS: There is a need for monitoring antidepressants due to wide interindividual pharmacokinetic variability. At the same drug dose, a more than 20-fold variation in steady state concentration of drug in the body may result: people differ in their ability to absorb, distribute, metabolise and excrete drugs for reasons of concurrent disease, age, gender, smoking and eating habits, concomitant medication and genetics. CONCLUSIONS: Monitoring of antidepressant drugs enables us to individualise drug doses based on rational therapy, minimalise side effects, reduce morbidity and mortality and cut the cost of health care. Phenotyping and genotyping could increase therapeutic drug monitoring furthere.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Treatment of central serous chorioretinopathy with beta-blocker metipranolol.

  Oldrich Chrapek, Barbora Jirkova, Vit Kandrnal, Jiri Rehak, Martin Sin
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  ABSTRACT: AIM: The purpose of this study was to evaluate the effect of the systemically administered betablocker metipranolol on the course of central serous chorioretinopathy (CSC). METHODS: A prospective double-blind study involving 48 patients with a first attack of CSC not exceeding two weeks and who agreed to the follow-up ophthalmology examinations every week. The group was divided into a metipranolol group (n=23), receiving 10 mg of drug twice per day and a placebo group (n=25). The outcome measure was time in weeks from drug intervention (metipranolol vs. placebo) to reattachment of macula neuroepithelium. RESULTS: There was no statistically significant difference in duration of CSC in patients who used metipranolol and those who used placebo (P=0.341). CONCLUSIONS: In a prospective double-blind study, we found no effect of the betablocker metipranolol on the duration of central serous chorioretinopathy.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;
• Article: Optical coherence tomography in progressive cone dystrophy.

  Jiri Zahlava, Jan Lestak, Ivan Karel
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  ABSTRACT: AIM: The aim of the study was to analyse different clinical pictures in patients with progressive cone dystrophy (PCD), to compare these with the results of optical coherence tomography (OCT) and to evaluate the benefits of this method for diagnosis. METHODS: The group consisted of 16 patients (32 eyes) with PCD. All patients were examined for visual acuity, colour sense and visual field. We performed biomicroscopic examination, photo-documentation, fluorescein angiography, electrophysiological tests and OCT. RESULTS: Using biomicroscopy and fluorescein angiography, we found changes in the retinal pigment epithelium ranging from barely detectable changes up to the typical bull's eye appearance. In all the eyes, OCT established statistically significant reduction in the thickness and structural changes in the neuroretina of the macula. Atrophy was evident especially in the outer nuclear layer, in the photoreceptor inner segment/outer segment junction and in the retinal pigment epithelium. Visual acuity was mainly dependent on the degree to which the continuity of the photoreceptor inner segment/outer segment junction layer was maintained. Eyes with better preserved neuroretinal structure in the fovea centralis had generally less reduced thickness of the retina and a better visual acuity. CONCLUSION: OCT specifies the quantitative and qualitative changes in the macula and may contribute significantly to the diagnosis of the progressive cone dystrophy, particularly in the early stages of the disease which is difficult to diagnose.
  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 03/2013;