Development of an ultraprecision metal mirror on additively manufactured Ti-6Al-4V.

Metal mirrors for precise optical applications are commonly fabricated by coating of a metal base substrate with a nickel-phosphorus alloy (NiP). The NiP layer is then processed by precision diamond turning and polishing to obtain a high-quality mirror surface. In this work, Ti-6Al-4V samples that were made by additive manufacturing, also called 3D printing, were used as a base for the development of metal mirrors. The additively manufactured samples were electroplated with a NiP coating and machined using single-point diamond turning (SPDT) to obtain a flat mirror with optical quality and low form error surface. The periodic structure of the SPDT toolmark was then removed by polishing postprocessing. Polishing optimization was first performed on NiP-coated aluminum test samples to find an optimal polishing setup. Based on this optimization, postprocessing of titanium samples was carried out by pitch polishing in combination with 1, 0.25, and 0.1µm diamond slurries. Using this polishing processing, a scratch-free surface was attained with surface microroughness below 0.5 nm.

Endocrine changes after burns: the bone involvement.

Any major burn is followed by a pronounced endocrine and metabolic response, by an acute phase response. In 30 burn subjects whose bone status was studied after burn trauma with the densitometer HOLOGIC 2000, bone involvement was found 6 and 12 months postburn: the Bone Mineral Density (BMD) of their lumbar vertebrae L1-4 and of their left hip dropped significantly in most of them. Elevated levels of cortisol both in blood and in urine (free cortisol) were found, accompanied by very low testosterone, dihydrotestosterone (DHT) and free testosterone levels in blood of the burned males, but not of the females. Elevated 17beta-estradiol levels were found in many burned males; they were generally not low in the burned females. DHEA-S levels were generally low. Very low levels of the triiodothyronine (T3) and of the free thyroxine (FT4) were found. Increased, even very high, PTH values were occasionally present. hGH and IGF-1 were generally normal, with a few exceptions (low or increased levels). Total and ionized calcium levels were low after burn, 250H vitamin D (calcidiol) was usually low or low normal too. Prolonged and very high levels of CTX and of NTX (both are indicators of bone resorpcion, of collagen catabolism) were found, as well as of the ACP (acid phosphatases), but the latter were less manifest, if compared with the CTX and NTX. ALP (alkaline phosphatases) were elevated too, but their elevated levels were much less pronounced than the levels of CTX and NTX. Osteocalcin levels were initially low to low normal, to increase later to the normal levels. As for the cytokines that had been investigated, mostly the elevated levels of TNFalpha were found, as well as those of IL-2, IL-6 and IL-8. Finally, a few suggestions have been given regarding the additional possibilities how to treat the burned patients: the use of anabolics, of vitamin D, of calcium, eventually of calcitonin.

Evaluation of the effects of a new Water-Jel system on specific bacterial and yeast strains in laboratory conditions.

In three previous studies the Water-Jel (WJ) system was found to protect burn wounds from microbial contamination, to have excellent analgesic and cooling effects when used as a first-aid dressing and to be bactericidal to 15 microorganisms including yeasts tested from the Ostrava Burn Unit. Now a new WJ system has been introduced without povidone iodine. An extensive bacteriological laboratory evaluation of the new WJ system showed quite clearly its excellent antimicrobial and antimycotic properties for 13 of the 15 strains of microorganisms tested, the only exceptions being Clostridium difficile and partially Streptococcus faecalis. In a preliminary study, the new WJ system was used for 24-48 h in 74 burned patients with superficial partial and deep partial skin thickness burns. In 89 per cent of them there were no signs of infection on their burn wound after 48 h. The new WJ system was well tolerated and no allergic reactions appeared.

[Parenteral, depot and repeatable forms of Parlodel LAR bromocriptine in the treatment of hyperprolactinemia syndrome. Comparison with oral Parlodel]. / Parenterální, depotní, opakovatelný bromokriptin Parlodel LAR v lécbe hyperprolaktinemického syndromu. Porovnání s perorálním Parlodelem.

Parenteral, depot, repeatable bromocriptine Parlodel LARR (PLO LAR) was used in the treatment of 10 women with hyperprolactinaemia. Two of them had previously an operation of a prolactinoma, eight did not have adenomas. Twenty eight days following administration of 50 mg PLO LAR, the PRL levels ere significantly lower than before treatment; in patients without adenomas they were quite normal. The action of the mentioned 50 mg PLO LAR corresponded roughly to a daily dose of 7.5 mg ParlodelR (PLO) by the oral route, i.e. in 28 days a total of 185 mg bromocriptine. After administration of five PLO LAR injections (50 and later 100 mg), the mean PRL levels in patients without adenomas were normal after 6 months. There were no significant nor pathological changes 28 days following i.m. PLO LAR 50 mg as regards T3, T4 levels, the blood sugar, cholesterol, FSH, LH, STH, TSH, testosterone cortisol, progesterone, 17 beta-estradiol, androstendione, 11 beta-OH androstendione, DHEA-S, 17 alpha-OH progesterone, aldosterone, 17-ketosteroids and 17-ketogenic steroids (in urine). LHRH + TRH + insulin tolerance tests were made repeatedly. Significant changes were found only in PRL levels (decline). In three amenorrhoic patients the originally low progesterone level rose significantly to levels of postovulation progesterone. One of these three women became pregnant after 18 years of unsuccessful treatment of sterility, incl. various oral dopaminergic preparations. The patients tolerated the preparation well and various biochemical and haematological tests were normal. The effect on galactorrhoea was favourable, seven amenorrhoic women had normal menstruation.

Water-Jel in the treatment of burns. A bacteriologic study.

In a previous study the Water-Jel system (dressings) was found to protect the burn wound from microbial contamination and to have excellent analgesic and cooling effects when used as the first-aid dressing. In an extensive bacteriologic study in vitro, both semiquantitative and qualitative, Water-Jel was bactericidal in all 15 microorganisms tested, including yeasts. All 15 microorganisms were from the Ostrava Burn Unit. Water-Jel was used successfully in three surgical, nonburned patients with very contaminated, dilacerated wounds. It was superior to all the selective antibiotics used systemically. After its 3-day application, the wounds became sterile; the skin grafting was successful.

Endocrine changes after burn trauma--a review.

After burn trauma, a very marked endocrine response occurs. Almost all the known hormones take part in it. Their response influences very much the postburn metabolic changes and participates in the integration of the body's response with the nervous and immune systems. In this review, mainly the changes in various hormone levels are described, as well as the possible role of the acute phase response after burn trauma, and the communications between the endocrine and immune systems, the cells of the latter are able to respond to various hormonal stimuli and to secrete various hormones themselves. Some of the hormones are very sensitive indicators of the burn stress, e.g., the T3 levels (very low), testosterone in males (very low), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) (very low), ADH, catecholamines, renin and angiotensin II, cortisol (high), 17-beta-estradiol in males (usually elevated). Other hormones are usually elevated, but not always (ACTH, aldosterone, prolactin, glucagon, immunoreactive insulin, beta-endorphin, rT3, 11-beta-hydroxyandrostenedione), but there are hormones that are unually low (T4, FSH, androstenedione, progesterone--the latter especially in females). Calcitonin, parathyroid hormone, growth hormone are sometimes elevated, as well as LH (measured with RIA methods). TSH is usually normal, the biologically measured LH was reported to be low. The levels of the sensitive indicators of burn stress may be used to evaluate the effect of treatment: if the burn patient is properly treated, the indicators may become earlier normal.

Long-term effect of pizotifen treatment on growth hormone levels of underweight children, including those with anorexia nervosa.

Eight underweight children, 3 of them with anorexia nervosa, were treated for 3 months without interruption with 1.0 to 1.5 mg pizotifen per day. Their mean weight gain was 4.6 +/- 1.1 kg (range 2.5 to 11.5 kg) and their height increased by 1.4 +/- 0.5 cm (range 0 to 4 cm), as in normal controls. Before the start of and at the end of treatment with pizotifen, protracted insulin tolerance tests were performed, during which blood glucose and growth hormone (hGH) levels were measured (10 times over 2 hours). In the same patients, hGH levels were measured (6 times over 2 hours) in the late evening, during sleep. Treatment with pizotifen did not decrease the hGH response to insulin-caused hypoglycaemia. After pizotifen, some blood glucose levels were lower than before pizotifen. The mean hGH values during sleep did not change significantly after pizotifen. In 1 patient with anorexia nervosa the increased hGH levels decreased during treatment to very low levels (she gained 11.5 kg); in another patient they increased (she gained 2.5 kg). The possible mechanisms of pizotifen action are discussed briefly. There were no changes in serum prolactin levels during pizotifen administration.

Growth hormone plasma levels in children treated for 6 months with ketotifen.

Twelve children with pollinosis or bronchial asthma were treated continuously, without interruption, for 6 months with ketotifen (2 mg per day). In the first group of 6 children, growth hormone and blood glucose levels were measured during insulin tolerance tests (-15, 0, 30 and 60 min) and growth hormone levels during the late evening when the children were asleep, before and after 3 and 6 months of treatment. In the second group of 6 children, growth hormone and blood glucose levels were measured during protracted insulin tolerance tests (-15, 0, 15, 30, 45, 60, 75, 90, 105 and 120 min) at the same periods. The results showed that the growth hormone increases and blood glucose decreases were generally the same before and during ketotifen treatment. Growth rate and weight gain in the treated groups were similar to those in control groups of untreated children and were not lower than the average values for Czech children of the same age. Measurements of thyroid stimulating hormone and prolactin levels showed that these also wer not altered during long-term ketotifen administration.

Endorphin releasers: a new possible approach to the treatment of pain after burns--a preliminary report.

Decapeptide ceruletide (CRL), chemically related to cholecystokinin and gastrin, proved to have remarkable analgesic properties when administered to a group of 22 burned patients, 15 patients with acute myocardial infarction, and 8 patients suffering from pain caused by malignant tumours with metastases. Its effect was such, that many of the patients required no other analgesics (opiates) even after a prolonged administration (up to 10 days) of CRL. In some of the patients a marked euphoria developed. There were no substantial changes in EEG records during CRL administration in 15 controls, among them 4 epileptics. It is probable that CRL helps to activate the internal analgesic system. In the burned patients cortisol, testosterone, renin, prolactin and tri-iodothyronine (T3) levels in serum (plasma) were measured (radio-immunoassays). CRL did not block the stress response (no drop of increased cortisol levels, no increase in low T3 levels), but it modified (influenced) it (drop of the high renin levels, and a tendency to increase the very low testosterone levels). CRL appears to act as an endorphin releaser, as evidenced by the plasma levels of beta-endorphins (quotations). CRL and similar drugs may represent a new, more physiological and probably safer approach to the management of pain.

Very low serum testosterone levels and severe impairment of spermatogenesis in burned male patients. Correlations with basal levels and levels of FSH, LH and PRL after LHRH + TRH.

The level of testosterone, FSH, LH and, in some cases, of PRL in serum was estimated in 39 burned male patients (mean burn index and S. E. was 31.5 +/- 2.5). The level of testosterone was found markedly decreased to a value as low as 0.19 ng ml-1, and such low level persisted for several weeks after the burn injury. At the same time the mean LH level was normal, while that of FSH decreased. However, in few patients high LH and PRL values were found. The dramatic drop of the level of testosterone and FSH began usually after the second postburn day. The administration of chorionic gonadotropin resulted in a marked elevation of testosterone level in less severely burned patients, while it was negligible in those severely burned. After LHRH plus TRH administration, the mean rise of LH level was almost normal, but FSH responded poorly. The lowest LH, FSH and PRL response was found during the 2nd and 3rd postburn week. The testes from 9 of the eleven patients that died were examined histologically, and no major histological alterations were found in those who died during the first 3 days after burn, while later a severe damage of germinal cells occurred. The pituitary-testicular axis does not operate properly after burn injuries. The main features of the endocrine (metabolic) response after burn are: 1. increased catabolism; 2. decreased anabolism; 3. changed endocrine priorities. To enable the survival an exaggerated response occurs very often with a possible resulting damage to some vital structures. Testosterone (anabolics) may be indicated in the treatment of burned patients.

Bromocriptine and glucose tolerance in acromegalics.

Acromegaly is very often accompanied by impaired glucose tolerance or a manifest diabetes mellitus, with increased immunoreactive insulin (IRI) levels whose response during oral glucose tolerance tests (OGTT) is quite often exaggerated. When the dopaminergic drug bromocriptine is administered to acromegalics, their elevated growth hormone (GH) levels very often decrease, their impaired glucose tolerance (as manifested in OGTT) improves and their exaggerated IRI response becomes more normal. Eighteen patients were treated with bromocriptine. They were followed-up repeatedly during their treatment of varying duration for up to 6 years. These results indicate that raised GH levels are not the only factor that impairs glucose tolerance in acromegalics. During bromocriptine administration, impaired glucose tolerance improved and abnormal IRI levels (OGTT) became more normal even without any decrease in the high GH levels. In non-diabetic acromegalics, when bromocriptine was administered, there was not only an average decrease in the elevated GH values during OGTT, but a normalization of increased IRI values as well, without any major change in the corresponding blood glucose levels. During insulin tolerance tests (ITT), after i.v. insulin, the IRI levels after 30 and 60 min were markedly higher in acromegalics on bromocriptine than in the same patients before its administration, without any significant change in the corresponding blood glucose values. In 2 diabetic acromegalics, bromocriptine administration re-established their lost ability to increase IRI levels during OGTT. This was accompanied by a marked improvement in their glucose tolerance. It is probable that bromocriptine decreases glucagon levels in acromegalics, or at least in some of them. It is suggested that bromocriptine could protect the beta-cells of acromegalics from "exhaustion'.