16S rRNA gene-based identification of cultured bacterial flora from host-seeking Ixodes ricinus, Dermacentor reticulatus and Haemaphysalis concinna ticks, vectors of vertebrate pathogens.

A total of 151 bacterial isolates were recovered from different developmental stages (larvae, nymphs and adults) of field-collected ticks (67 strains from Ixodes ricinus, 38 from Dermacentor reticulatus, 46 from Haemaphysalis concinna). Microorganisms were identified by means of 16S rRNA gene sequencing. Almost 87 % of the strains belonged to G(+) bacteria with predominantly occurring genera Bacillus and Paenibacillus. Other G(+) strains included Arthrobacter, Corynebacterium, Frigoribacterium, Kocuria, Microbacterium, Micrococcus, Plantibacter, Rhodococcus, Rothia, and Staphylococcus. G(-) strains occurred less frequently, comprising genera Advenella, Pseudomonas, Rahnella, Stenotrophomonas, and Xanthomonas. Several strains of medical importance were found, namely Advenella incenata, Corynebacterium aurimucosum, Microbacterium oxydans, M. schleiferi, Staphylococcus spp., and Stenotrophomonas maltophilia. Data on cultivable microbial diversity in Eurasian tick species D. reticulatus and H. concinna are given, along with the extension of present knowledge concerning bacterial flora of I. ricinus.

[The effect of preoperative administration of heparin on the heparin resistance development]. / Vliv predoperacního podání heparinu na vznik heparinové rezistence.

BACKGROUND: Heparin resistance is relatively frequent problem in cardio surgery. We were try to determine real occurrence heparin resistance before operation. AIM OF THE STUDY: Purpose of the project--to find the real frequency of heparin resistance in patients who will undergo a cardio surgical operation. To find out the dependence between the pre-operational application of heparin and the development of heparin resistance. METHODS: We recorded pre-operative administration heparin in patients. If the dose of heparin was 5 mg/kg and more then we insert patients to the group heparin resistant. RESULTS: In our collection was heparin resistance in 203 patients from 624, it was 32.5%. Test agreement relative frequency with 22% was throw out--p < 0.001--heparin resistance in our group statistically different from 22% heparin resistance was higher than hypothesis. Heparin before operation was administrate 181 patients, which make to 29%. For administration of heparin was hypothesis of independence thrown (p < 0.001). CONCLUSION: Results of our works confirmed statistically significant occurrence of heparin resistance in patients that was administration heparin pre-operative. Heparin resistance occurred against presumption 22% in 32.5% in our group. It is statistic significant difference.

Lactobacillus spp. associated with early childhood caries.

A group of 69 lactobacilli was isolated from caries lesions and root canals of early childhood caries (ECC) affected children treated in the Department of Pedodontics (Children's Teaching Hospital, Brno, Czech Republic). Biochemical and physiological properties of all strains were characterized by API 50 CH kit and conventional tube tests. The rep-PCR fingerprinting with the (GTG)(5) primer was used for genotypic grouping of the isolates. The (GTG)(5)-PCR fingerprinting grouped all analyzed strains into a few clusters in nearly full agreement with phenotype identification results and clarified the taxonomic position of 13 biochemically unidentified strains. In total, 20 strains of Lactobacillus fermentum, 17 L. rhamnosus, 14 L. casei/paracasei, 7 L. gasseri, 7 L. salivarius and 4 L. plantarum were identified. Mixtures of two or even three Lactobacillus spp. were isolated from a few root canal content samples. Results obtained by biotyping and (GTG)(5)-PCR were generally comparable except for L. gasseri strains that were not biochemically identified. The (GTG)(5)-PCR fingerprinting was shown to be quicker, easier to perform and more reliable than biotyping. Our results imply this molecular method as a good tool for screening and identification of Lactobacillus spp. inhabiting dental plaque.

Characterization of Aeromonas encheleia strains isolated from aquatic environments in the Czech Republic.

AIMS: Characterization and identification of Aeromonas strains isolated from surface and underground waters using phenotypic and genotyping methods. METHODS AND RESULTS: Biotyping using the ENTEROtest 24 kit and conventional biochemical and physiological tests assigned four strains to Aeromonas encheleia, whereas three isolates were identified as ambiguous Aeromonas bestiarum/Aeromonas caviae and one strain as Aeromonas eucrenophila/Aeromonas encheleia. Further characterization grouped the analysed strains together with Aer. encheleia CCM 4582(T) and assigned the analysed group as members of Aer. encheleia species using ribotyping, whole-cell protein analysis and ERIC-PCR fingerprinting. The results obtained were verified by DNA gyrase A subunit gene sequencing. All analysed isolates showed unique molecular patterns, except for isolates P 1769 and CCM 7407, which revealed the same EcoRI ribotype profile and proved to be identical strains. CONCLUSIONS: Our results imply that Aer. encheleia strains occur in unpolluted surface as well as in underground waters and demonstrate applied methods as suitable for their identification. SIGNIFICANCE AND IMPACT OF THE STUDY: To our best knowledge, this is the first report of the isolation and identification of Aer. encheleia in the Czech Republic.

HLA DRB1, DQB1 and insulin promoter VNTR polymorphisms: interactions and the association with adult-onset diabetes mellitus in Czech patients.

Both the human leucocyte antigen (HLA) DRB1 and the HLA DQB1 gene loci play a role in the development and progression of autoimmune diabetes mellitus (T1DM). Similarly, the insulin promoter variable number tandem repeats (INS-VNTR) polymorphism is also involved in the pathogenesis of diabetes mellitus (DM). We studied the association between each of these polymorphisms and DM diagnosed in patients older than age 35 years. Furthermore, we analysed possible interactions between HLA DRB1/DQB1 and INS-VNTR polymorphisms. Based on C-peptide and GADA levels we were able to distinguish three types of diabetes: T1DM, latent autoimmune diabetes in adults (LADA) and T2DM. INS-VNTR was genotyped indirectly by typing INS-23HphI A/T polymorphism. The genotype and allele frequencies of INS-23HphI did not differ between each of the diabetic groups and group of healthy subjects. We did, however, observe an association between the INS-23HphI alleles, genotypes and C-peptide secretion in all diabetic patients: A allele frequency was 86.2% in the C-peptide-negative group vs. 65.4% in the C-peptide-positive group (P(corr.) < 0.005); AA genotype was found to be 72.4% in the C-peptide-negative group vs. 42.6% in the C-peptide-positive groups (P(corr.) < 0.01). The HLA genotyping revealed a significantly higher frequency of HLA DRB1*03 allele in both T1DM and LADA groups when compared to healthy subjects: T1DM (25.7%) vs. control group (10.15%), odds ratio (OR) = 3.06, P < 0.05; LADA (27.6%) vs. control (10.15%), OR = 3.37, P < 0.01. The simultaneous presence of both HLA DRB1*04 and INS-23HphI AA genotype was detected in 37.5% of the T1DM group compared to only 9.2% of the healthy individuals group (OR = 5.9, P(corr.) < 0.007). We summarize that in the Central Bohemian population of the Czech Republic, the INS-23HphI A allele appears to be associated with a decrease in pancreatic beta cell secretory activity. HLA genotyping points to at least a partial difference in mechanism, which leads to T1DM and LADA development as well as a more diverse genetic predisposition in juvenile- and adult-onset diabetes. The simultaneous effect of HLA and INS-VNTR alleles/genotypes predispose individuals to an increased risk of diabetes development.

Ribotyping and biotyping of Staphylococcus epidermidis isolated from hospital environment.

The Staphylococcus strains acquired from scrapings from hospital environments were identified to the species level based on their biochemical properties. From the monitored sample the Staphylococcus epidermidis strains were selected for more accurate typing and tested on their virulence factor and ribotyped. The biotyping of S. epidermidis did not show any considerable intraspecific variation of these isolates and there were no atypical reactions, with the exception of three strains (out of 33). In contrast, the results of ribotyping showed greater heterogeneity of strains and unequivocally demonstrated the relation between the ribotype and the place of sample drawing. In addition to this fact, the found ribotypes repeat in the same environment in the long-term which suggests the occurrence and persistence of the same strains of conditionally pathogenic bacteria in hospital environment. We showed that ribotyping is a suitable method for precise and reliable detection of some coagulase-negative staphylococci.

KCNJ11 E23K polymorphism and diabetes mellitus with adult onset in Czech patients.

In this work, we studied the association of the E23K polymorphism of the Kir6.2 ATP-sensitive potassium channels in 212 Czech patients with diabetes mellitus who were diagnosed after the age of 35. Patients were classified into T1DM, LADA and T2DM groups based on C-peptide and GADA levels. Carriers of the predisposing Kir6.2 E23K K allele showed no increased risk of either type of diabetes mellitus development. On the other hand, we found a correlation between E23K SNP of the KCNJ11 gene and C-peptide levels, which may be considered a measure of pancreatic beta-cell activity, although this correlation was not statistically significant. In conclusion, we failed to confirm the Kir6.2 E23K as a genetic marker for T1DM, LADA and T2DM in the Central Bohemian population of the Czech Republic.

[Mechanisms influencing implantation of the embryo--the last-years' news]. / Mechanismy ovliviiující implantaci embrya--co je nového v posledních letech.

OBJECTIVE: To summarize recent knowledge concerning mechanisms which influence the implantation of embryo. DESIGN: Literature-based overview. SETTING: Institute for the Care of Mother and Child, Prague. SUBJECT OF THE STUDY: Factors influencing implantation of embryo in the uterus elicit increased interest due to study of unexplained failures of embryotransfer following the successful in vitro fertilization. Our article points to recent information about physiology and pathology of mechanisms controlling implantation, namely the factors of immunity (antibodies, cells, cytokines and other mediators) whose exact regulation on the feto-maternal interface is a crucial precondition of successful implantation. Also the genetics of early embryo, as well as the possibilities of modern endoscopic techniques offer new insight onto mechanisms of implantation. Recommendations for diagnostics and treatment of implantation failure are given in the end of the article.

[European Cataract Outcome Study--results of five years of participation]. / European Cataract Outcome Study--výsledky petileté úcasti.

GOAL: To inform about European Cataract Outcome Study and to publish results from the Department of Ophthalmology, Faculty Hospital in Hradec Králové achieved during the five years' participation. METHOD, GROUPS: European Cataract Outcome Study is an international multicentric study pursuing quality of cataract surgery in individual departments of European countries. Its goal is to monitor the development of new trends and to be helpful in setting standards using the collected data. The Study evaluates results of all surgeries performed during one month. Our department participated in it in the years 1998-2002. In the first part of the trial the basic demographic data as well as the course of the surgeries were followed, in the second part results of examination during the first six months after the surgery were collected. RESULTS: Operations are mostly performed by means of the facoemulsification method in local anesthesia (subconjunctival or parabulbar), the stay in hospital varies in individual years between 35.1% and 56%, the percentage of implanted foldable (soft) intraocular lenses rises every year, in 2002 up to 61.5% (average of the whole study was 78.2% in 2002), the percentage of posterior lens capsule rupture during the procedure during the five year period in our department descends (range 3.7% to 1.2%). In the referred groups, 40.4% to 50.5% of eyes suffered from still another disease. The best corrected visual acuity 0.6 or better after the surgery achieved in individual years 64% to 78%. The deviation from planed refraction is between 0.69 to 0.88 diopters. The induced postoperative astigmatism varied in followed periods from 0.49 to 0.69 cylindrical diopters. CONCLUSION: The results of the study shows that the quality of surgeries performed in the department is on the high level and is fully comparable with contemporary European standard.

[Evidence based medicine and cost-effectiveness analysis in ophthalmology]. / Evidence based medicine, cost-effectiveness analýza v oftalmologii.

GOAL: To make the reader familiar with the term evidence based medicine (EBM), to explain the principle of cost-effectiveness analysis (price-profit), and to show its usefulness to compare the effectiveness of different medical procedures. METHOD: Based on few examples, in this article the relevance and calculation of important parameters of cost-effectiveness analysis (CE), as utility value (UV), quality adjusted life years (QALY) is explained. In addition, calculation of UV and QALY for the cataract surgery, including its complications, is provided. RESULTS: According to this method, laser photocoagulation and cryocoagulation of the early stages of retinopathy of prematurity, treatment of amblyopia, cataract surgery of one or both eyes, from the vitreoretinal procedures the early vitrectomy in cases of hemophtalmus in proliferative diabetic retinopathy or grid laser photocoagulation in diabetic macular edema or worsening of the visual acuity due to the branch retinal vein occlusion belong to highly effective procedures. On the other hand, to the procedures with low cost effectiveness belongs the treating of the central retinal artery occlusion with anterior chamber paracentesis, as well as with CO2 inhalation, or photodynamic therapy in choroidal neovascularization in age-related macular degeneration with visual acuity of the better eye 20/200. CONCLUSION: Cost-effectiveness analysis is a new perspective method evaluating successfulness of medical procedure comparing the final effect with the financial costs. In evaluation of effectiveness of individual procedures, three main aspects are considered: subjective feeling of influence of the disease on the patient's life, objective results of clinical examination and financial costs of the procedure. According to this method, the cataract surgery, as well as procedures in the pediatric ophthalmology belong to the most effective surgical methods.

[Nodular faciitis--rare localization on the eye (a case report)]. / Fasciitis nodularis--vzácná lokalizace na oku (kazuistika).

GOAL: To contribute to differential diagnosis of changes of the outer segment of the eye. CASE REPORT: A 43-years old woman with three weeks long history of fast growing painless focus in the nasal part of the sclera of the left eye, which caused, except of visible tubercle and moderate feeling pressure, no problems. It is an unusual localization of non-malignant disease of unknown etiology originating from the Tenon's capsule. The literature quotes the same histological finding in different organs; the localization in the eye is rare. The author considers difficulties of the differential diagnosis in the unusual ocular diagnosis. CONCLUSION: The diagnosis was specified on the basis of the ocular and following histological findings. The treatment is surgical.

[Immunologically conditioned fertility disorders in men--experience of the immunobiological department of the Institute for Maternal and Child Care]. / Imunologicky podmínené poruchy plodnosti u muzu - zkusenosti imunobiologického pracoviste Ustavu pro péci o matku a díte.

OBJECTIVE: To provide an overview of the results obtained from the more than ten-year systematic monitoring of the contribution of immunopathological mechanisms to the ethiopathogenesis of fertility disorders in men. DESIGN: A summarising retrospective study. SETTING: Mother and Child Care Institute, Prague. METHODS: The data source is a selected group of a total of 3,800 couples, who were examined in the Immunobiological Department (ID) of the Mother and Child Care Institute (MCCI) in Prague- -Podolí for fertility disorders in the past. From among the laboratory quantities, the following ones were systematically monitored: a) sperm parameters; b) cell-mediated immunity against spermatozoa; c) the presence of anti-spermatozoa auto-antibodies attached to spermatozoa; d) in a part of the clinical group, the serum concentrations of FSH, testosterone, SHBG and the free androgen index (FAI) were monitored. RESULTS: After selection was made according to defined criteria, the group comprised of a total of 1,680 men, of whom 49.4% were normozoospermic and 50.6% suffered from some form of seminal pathology. Increased cell-mediated immunity against spermatozoa was identified in 10.2% of fertile men, in 18.5% of normozoospermic men and in 66.3% of azoospermic men. In asthenozoospermic and teratozoospermic men, the increased cell-mediated immunity against spermatozoa was identified in 48.3% and 53.1% of them, respectively. The auto-antibodies attached to spermatozoa were identified in 3 out of every 42 fertile men (7%), while in asthenozoospermic men, it was a total of 21% (IgA antibodies) and 22% (IgG antibodies). As concerns the concentration of free androgens (FAI) in the serum, there was no difference among the individual subgroups of men. In oligoasthenozoospermic men, FSH was significantly higher on the average in comparison with normospermic men. CONCLUSION: The significantly higher incidence of increased cell-mediated immunity against spermatozoa in men with a pathological spermiogram in comparison with the control group (fertile men and normozoospermic men) indicates that cell-mediated immunity participates in the pathogenesis of seminal pathologies.

HLA in Czech adult patients with autoimmune diabetes mellitus: comparison with Czech children with type 1 diabetes and patients with type 2 diabetes.

Type 1 diabetes results from an autoimmune insulitis, associated with HLA class II alleles. The evidence about HLA allele association is not clear in patients diagnosed after 35 years of age. In this study we have analyzed HLA alleles of DQB1 and DRB1 genes by sequence specific primer (SSP)-PCR technique in adult patients with disease onset after 35 years of age. Two hundred and eighty-one patients were divided into three groups according to the insulin therapy, the level of C peptide (CP), and GAD antibodies (anti-GAD). Group 1 (type 1 diabetes in adults) was characterized by CP less than 200 pmol/L and anti-GAD more or less than 50 ng/mL (n = 80). All of them had insulin therapy within 6 months after diagnosis. Group 2 latent autoimmune diabetes mellitus in adults (LADA) was defined by a minimum 6-month-long phase after diagnosis without insulin therapy, and was characterized by CP more than 200 pmol/L and anti-GAD more than 50 ng/mL (n = 70). Group 3 (type 2 diabetes) was characterized by CP more than 200 pmol/L and anti-GAD less than 50 ng/mL (n = 131). None ever had insulin therapy. In group 1, there was increased frequency of DRB1*04 (45.0% vs. controls 14.1%, OR = 5.0, P < 0.0005) and DQB1*0302 alleles (43.3% vs. controls 11.1%, OR = 6.1, P < 0.00005). There was increased frequency of DRB1*03 and DQB1*0201, and decreased frequency of DQB1*0602 (3.3% vs. controls 20.2%), but it was not significant. In group 2, there was a significantly increased frequency of DRB1*03 only (50.0% vs. controls 21.2%, OR = 3.7, P < 0.05). Compared with children with type 1 diabetes and adults with type 2 diabetes (group 3), we conclude that the presence of predisposing DQB1 alleles in adults with type 1 diabetes decreases with the age, probably due to environmental factors. Only the DRB1*03, but not the DQB1 gene, becomes the main predisposing allele in LADA patients. These findings suggest that the presence of HLA-DQB1*0302 identifies patients at high risk of requiring insulin treatment. Type 1 diabetes mellitus (DM) in children or adults may have partly different immunogenetic etiopathogenesis than LADA.

[Effect of strabismus on the quality of life in adults]. / Vliv strabismu na kvalitu zivota dospelých.

The aim of this paper was to prove by help of questionnaire the psychosocial problems in 26 adult patients operated for strabismus. We stated that the biggest difficulties of patients occurred by work and sport activities. The patients with diplopia also complained of difficulties with uncertain orientation, walking on steps and by locating the objects. The uncertainty by communication was also a great problem. The surgery fulfilled the expectations by 18 patients (69%), 8 patients (31%) were disappointed.

Gliadin, endomysial and thyroid antibodies in patients with latent autoimmune diabetes of adults (LADA).

Latent autoimmune diabetes of adults (LADA) manifested after the age of 35 is characterized by the presence of disease-specific autoantibodies (anti-glutamate decarboxylase GADAb, anti-IA2Ab). However, autoimmunity in Type 1 diabetes mellitus is not targeted only to pancreatic beta-cells. No data have so far been published concerning the antibodies associated with other autoimmune disease in LADA patients. The presence of anti-thyroglobulin (TGAb), anti-thyroid peroxidase (TPOAb), anti-gliadin IgA (AGAAb) and IgG (AGGAb) and endomysial antibodies (EMAb) in sera of 68 diabetics typed as LADA was compared with the antibody presence in sera of 85 patients with Type 2 diabetes. We found a significantly higher occurrence of gliadin antibodies in LADA patients: the rate of AGGAb was 19.1% in comparison with 3.5% in the T2DM group (P = 0.0026), the rate of AGAAb was 13.2% in comparison with 3.5% (P = 0.035). The prevalence of EMAb was very low in both groups (1.5% and 0). The two groups differed significantly in the TPOAb rate: 22.1% in LADA compared to 9.4% in T2DM (P = 0.04), whereas no significant difference was found in the presence of TGAb (8.8% and 3.5%, P = 0.187). In comparison with T2DM patients, LADA patients were found to express higher antibody activity against gluten-related antigens and against TPO.

[Immediate and late intraocular pressure levels after trabeculectomy with releasable sutures] ]. / Casná a pozdní hladina nitroocního tlaku po trabekulektomii s povolitelnými stehy.

PURPOSE: To evaluate the level of IOP and clinical status the first day after trabeculectomy (TE) with releasable sutures (RS), to follow up the extraction of RS in correlation with early and late postoperative level of IOP. METHODS: In a retrospective study, 40 patients with open angle glaucoma were followed. They underwent TE with two RS on both eyes. RESULTS: Hypotony (IOP less than 6 mmHg) was noted in 15 eyes (19%) the first day after the operation, shallow anterior chamber in 5 (6%). An IOP level higher than 20 mmHg was found in 11 eyes (13%) one day after surgery. No RS were extracted in the first group of 26 eyes. The early mean IOP was 10.15 +/- 7.1 mmHg the 1st day after surgery. IOP increased to a mean level of 15.3 +/- 3.8 mmHg two years after TE, 65% of eyes were without glaucoma therapy. One RS was extracted in the second group of 28 eyes. The early mean level of IOP was 10.7 +/- 6.5 mmHg, the late level 13.9 +/- 3.7 mmHg. The target pressure was maintained in 68% of the eyes without additional glaucoma therapy. The third group had 26 eyes and two RS were extracted after TE. The early mean level of IOP was 14.7 +/- 6.9 mmHg, the mean level of IOP was 15.8 +/- 3.9 mmHg two years after surgery, 39% of eyes were without glaucoma therapy. CONCLUSION: A level of IOP the first day after the operation, lower than 6 mmHg or higher than 20 mmHg, must not be an indicator for failure of the surgery. Observing the level of IOP 3-5 days after surgery determines whether the RS is to be removed or not. The use of RS prevents short-term complications and the extraction of RS during the postoperative period can positively influence the evaluation of filtration.

[Monitoring intraocular pressure and therapy after trabeculectomy in both eyes during a 2-year period]. / Sledování nitroocního tlaku a lécby po dobu dvou let po trabekulektomii na obou ocích.

PURPOSE: To evaluate the level of intraocular pressure (IOP) and glaucoma therapy during two years after trabeculectomy (TE) with two releasable sutures (RS) on the first and the second operated eye. METHODS: In a retrospective study, preoperative and postoperative IOP and glaucoma therapy in 40 patients with open angle glaucoma, were evaluated. Patients underwent standardized TE with two RS on both eyes performed by the same surgeon. The first (worse) eye was operated on an average of three years after the diagnosis of glaucoma, and after 8.2 +/- 6.9 months the second (better) eye was operated on. RESULTS: TE with RS significantly decreased the level of IOP (p < 0.0001) and therapy (p < 0.0001) during a two year follow up period. There was no significant difference in IOP (p = 0.226) and glaucoma therapy (p = 0.086) between the first and the second operated eye. IOP was stabilised within 2-3 months after surgery for most patients, however glaucoma therapy was added for some to keep the target pressure. After one year IOP and therapy were stable for all patients. CONCLUSION: There is no difference between the first-worse and the second-better operated eye regarding IOP and glaucoma therapy during a two year period.

[Frequency of removal of releasable sutures after trabeculectomy]. / Frekvence extrakce povolitelných stehu po trabekulektomii.

PURPOSE: To find out the frequency and time of extraction of releasable sutures (RS) in the first and second operated eye. METHODS: In a retrospective study, 40 patients with primary open glaucoma were followed. Patients underwent trabeculectomy with two RS on both eyes. The trabeculectomy was performed by the same surgeon and by the identical method. RESULTS: It was not necessary to remove RS postoperatively in 30% of the first operated eyes and in 35% of the second operated eyes. One RS was removed in 37.5% of the first and 32.5% of the second eyes. Two RS were removed equally in 32.5% of both eyes. The differences of RS extraction on the first and on the second eye were not significant (p = 0.76). The extraction time was similar in both eyes, too. CONCLUSION: There is no difference between the first and second operated eye regarding the frequency and time of extraction RS.

[Changes in the quality of life after cataract surgery]. / Zmena kvality zivota pacientu po operaci katarakty.

The questionnaire VF-14 is one of the most frequently used methods for exploration of patients' subjective evaluation of cataract surgery outcomes. In this study, the answers of 349 patients' were evaluated. These respondents completed the questionnaires before cataract surgery and again after 6 months. When the postoperative questionnaires were filled-in, 196 respondents had one eye operated on (group A), and 153 had both eyes operated on (group B). All cataract surgeries were performed by phacoemulsification. The complication--rupture of the posterior capsula--occured in 0.8%. In 26.7% patients an accompanying secondary eye disease was found. The average VF-14 index was 63.5 (SD 21.32) in group A and 59.4 (SD 22.62) in group B. After the surgery the VF-14 index increased significantly--in group A was the average 80.6 (SD 20.47) and in group B even higher 87.2 (SD 16.14). The change of VF-14 index prior to and after the operation was proven to be statistically significant both in group A and in group B (p < 0.001). The improvement of the VF-14 index was found in group A in 80.6% and in group B in 88.9% of respondents. The patients' satisfaction with their vision after cataract surgery was highly increased. The outcomes of the questionnaire study document the high success rate of cataract surgery for patients.

Development of multiple organ failure in critically ill newborns under AT III substitution.

Criteria for the AT III substitution were fulfilled by 33 infants. Mean birth weight was 1321 g (480 g up to 2860 g), and mean gestational age was 29 weeks (23-39 weeks). AT III substitution in dosing of 5 u/kg/hr was administered to all patients as well as standard heparin 10 u/kg/hr. Initial plasma level of AT III in the study group prior to start of the substitution was 45 +/- 17% activity of normal plasma of adult donor. The value increased up to 90 +/- 32% after 24 hours and up to 113 +/- 38% at the end of the therapy. Eight patients died (24%). Considerable decrease of the Neonatal Therapeutic Intervention Scoring System (NTISS), indicating a level of multiple organ dysfunction, was observed as early as after the first 48 hours of AT III therapy in the entire group (p < 0.01). Extensive increase of platelet count (p < 0.05) occurred after 48 hours of AT III therapy in survivors. Except for a severe sepsis in one case, no clinical signs of increased bleeding occurred during the AT III therapy, and the clinical signs of pre-existing bleeding even disappeared in 5 cases. Analysis of the group of 8 deceased patients revealed irreversible organ dysfunction in 7 cases present prior to the start of AT III substitution. In conclusion, during the AT III substitution, no bleeding, no clinical side effects but improvement in multiple organ dysfunction including increase in platelet count was recorded.