Polymer-conjugated bovine pancreatic and seminal ribonucleases inhibit growth of human tumors in nude mice.

The hydrophilic poly[N-(2-hydroxypropyl)methacrylamide] (PHPMA) was used for RNase A or BS-RNase modification to prevent their degradation in bloodstream or fast elimination. Two PHPMA chains (classic and star-like) were synthesized and their conjugates with both enzymes were tested on the CD-1 nude mice bearing various human tumors. These RNase conjugates injected intravenously or intraperitoneally into the mice bearing melanoma, neuroblastoma or ovarian tumor caused significant reduction of transplanted tumors following ten daily doses of 2.5 and/or 1 mg/kg, respectively, while free RNase A or BS-RNase injected in doses of 10 mg/kg exerted only negligible antitumor activity. Histological examination confirmed potent cytotoxic effect of RNase A conjugates in ovarian tumor. Despite the antitumor activity observed in vivo, the in vitro cytotoxic activity of RNase A conjugates was not pronounced and did not differ from that caused by the free RNase A. The in vitro experiments with 125I-labeled preparations demonstrated that polymer conjugates were internalized by tumor cells very poorly in contrast to the dose-dependent internalization of the wild enzyme preparation. Surprisingly, mice injected with EL-4 leukemic cells, which were preincubated for 4 h with BS-RNase conjugates, exerted significantly prolonged survival compared with the control non-treated mice. It may be supposed that both BS-RNase and RNase A conjugates with PHPMA act after administration in vivo by a mechanism different from that or those occurring under in vitro conditions because in vivo they exert an antitumor action, whereas in vitro, they are ineffective. The experiments proved that RNase A, when conjugated to PHPMA, produced identical aspermatogenic and antitumor effects as BS-RNase conjugated to this polymer and that this preparation may be regarded as a potential anticancer drug.

[Surgical treatment of recurrent urethral strictures in males after unsuccessful operations]. / Nové moznosti chirurgické lécby muzu po neúspesných operacích recidivujících striktur mocové trubice.

BACKGROUND: Subvesical obstructions of any origin represent a frequent and serious disorder occurring predominantly in males. Often it brings incontinence and/or erectility dysfunction, infection of urinary tract. Relapses of the acute pyelonephritis can turn into chronic tubulointersticial one and terminate in the renal insufficiency. To treat strictures, dilation, intermittent catheterization and recently stent introduction were used. Most suitable appears a stent from composite polymers. The aim of our work was to test properties of stents developed in the Institute of Macromolecular Chemistry ASCR. METHODS AND RESULTS: Stents from composite polymers, which are non-toxic, not-irritable can swell in body fluids and have mechanical properties similar to that of silicone rubber. Properties of the material are functionally graded and the casting or repoussé from the material can subsequently change its shape. Ten patients (males, aged 25 to 78 years) with long urethral strictures in its bulbocavernous part (50%) were treated with this method. Strictures were caused by pelvical fractures (4 times), prostate hypertrophy surgery (4 times), prolonged catheterizations (2 times). All patients were followed for 16 to 26 month and had no severities. CONCLUSION: Our results indicate that stent from composite polymers and silicone may have long-acting effects without irritation or crust formation and beneficially effected healing of the spongio-fibrous process.

Clinical informatics in medical education: yesterday, today, tomorrow. Experiences at the first Faculty of Medicine, Charles University.

The subject known as clinical informatics started to develop in the 60's in medical education of clinical disciplines and was mainly concerned with structuring information for instruction and examinations. This application contributed substantially to the development of the discipline of medical education that started to be considered as a legitimate new field that could become a clinical sub-specialty in its own right. Due to uneven access to computer hardware the area developed differently in the West and East. We elaborated our projects for application of didactic games in internal medicine for the paper and pencil system. On turn of the 90's the use of PCs brought new possibilities for the application of computer programme support in the analysis of the effectiveness of the system of instruction in internal medicine we were concerned with. We carried out two longitudinal studies in clinical memory of the 4th and 6th year students of the same study cycle. In a non-anonymous questionnaire, more than 1000 respondents described their experience in observation/examination of 70 recommended disorders important for internal practice. We offer some unpublished results showing how the clinical memory of the students is formed during the four-year study and how few possibilities there are for some students to see some manifestations of various clinical disorders. Thinking about the future we are preparing a series of integrated medical and language programmes for the use of the multi-medial approach.

[Computer networks in hospital information systems]. / Pocítacové síte v nemocnicních informacních systémech.

The author explains the term computer network in health institutions, incl. links with the hospital information system. He describes basic technical principles necessary for the understanding of medical network applications in the framework of the information system. The author mentions the importance of connecting the hospital network to international computer networks.

Curriculum of medical informatics and medical technology in the medical faculty.

1. CURRICULUM DESCRIPTION. Twenty years ago, our faculty organized several lessons in a physiology course to inform students about computers. Recently, new courses in informatics were established. In their first year, students take a compulsory course (15 hours=h) of basic computer science (computers databases, networking, and basic non-medical computer software). A special elective course in medical informatics (30h) can be taken in the 4th year (about 20% of students pass tis course). This course includes the following lessons: computers in medicine (2h), scientific information (4h), classification in medicine (2h- including ICD, SNOMED etc.), computer support of clinical decision (2h-calculation principles with demonstration), artificial intelligence (2h), statistical software (2h), hospital information systems (2h), software for practitioners (2h), biosignal and image analysis (4th), computers in pharmacology (2h), computer simulation (2h), support of metabolic care (2h-consultations, risk calculations), and laboratory information systems (2h). The same course, though slightly differences, is used for paramedical students (occupational therapy, health education, and nursing). Medical technology was established in a three year curriculum courses in the 1st year include common courses in electronic devices (60 h), computers and programming (120 h), biophysics (90 h), biomechanics (30 h), and different medical courses (500 h). For the 2nd and 3rd year, 75% of the courses (700 h per year) are technical e.g., medical devices, information systems, signal and picture analysis, laboratory technique, and data protection. 2. CONCLUSION AND PERSPECTIVES. Students of medicine, and some paramedical studies, are able to use computer in their profession after having taken these courses. Bachelors of medical technology find application in biomedical research, hospitals, and medical technology firms.

[Informatics education in undergraduate study at the 1st Medical School of Charles University]. / Výuka informatiky v pregradualním studiu na 1. lékarske fakulte Univerzity Karlovy.

History of medical informatics at the 1st Medical Faculty goes to 25 years back. Currently curriculum is divided in two parts. In the first year of studies and obligatory course of computer technique is organized including: computer functions, communications with computers, database systems and text editors. In the 4th year of studies a course in clinical informatics is realized including: principles of computer science, statistical software, artificial intelligence, computer in pedagogy, scientific information, classification in medicine, biological signal and picture analysis, hospital information systems, computer in outpatient ward, clinical decision support, computer simulation in clinical medicine, computers in pharmacology, computer in metabolic care, computers in medical devices. In this way medical students are prepared to be able to use technical means in scientific information management.

[Computer-assisted analysis of the results of training in internal medicine]. / Analýza výsledku výuky vnitrního lékarství s vyuzitím výpocetní techniky.

Analysis of the results of teaching of clinical disciplines has in the long run an impact on the standard and value of medical care. It requires processing of quantitative and qualitative data. The selection of indicators which will be followed up and procedures used for their processing are of fundamental importance. The submitted investigation is an example how to use possibilities to process results of effectiveness analysis in teaching internal medicine by means of computer technique. As an indicator of effectiveness the authors selected the percentage of students who had an opportunity during the given period of their studies to observe a certain pathological condition, and as method of data collection a survey by means of questionnaires was used. The task permits to differentiate the students' experience (whether the student examined the patient himself or whether the patient was only demonstrated) and it makes it possible to differentiate the place of observation (at the university teaching hospital or regional non-teaching hospital attachment). The task permits also to form sub-groups of respondents to combine them as desired and to compare their results. The described computer programme support comprises primary processing of the output of the questionnaire survey. The questionnaires are transformed and stored by groups of respondents in data files of suitable format (programme SDFORM); the processing of results is described as well as their presentation as output listing or on the display in the interactive way (SDRESULT programme). Using the above programmes, the authors processed the results of a survey made among students during and after completion of the studies in a series of 70 recommended pathological conditions. As an example the authors compare results of observations in 20 selected pathological conditions important for the diagnosis and therapy in primary care in the final stage of the medical course in 1981 and 1985.