In vitro culture Muller cell model to study the role of inverted internal limiting membrane flap technique in macular hole closure.

Inverted internal limiting membrane (ILM) flap may constitute a scaffold for Muller cells whose migration and proliferation on its surface begin the process of macular hole closure. The goal of the study was to establish an in vitro model of the interaction between ILM and the Muller cells. Vitrectomy with inverted ILM flap was performed in 23 patients due to a full-thickness macular hole (FTMH). After dissection of the inverted flap, the area of ILM peeling was extended and material was collected for cell culture experiments. Muller cells cultured on adherent cell plates showed significantly better growth than on suspension plates. Our results reveal that the presence of the ILM can overcome the growth inhibitory effect of the non-adhesive surface. Moreover, the ILM appears to be the optimal growth surface under normoxia conditions mimicking the microenvironment after vitrectomy and hypoxia which is natural state for Muller cells. The closure rate of FTMH was 100%. Our study revealed that in non-adhesive culture conditions patient derived ILM constitutes an optimal growth surface for Muller cells. We have demonstrated that the ILM effectively stimulates attachment, proliferation, and survival of Müller cells in conditions of normoxia which is the case after vitrectomy. The results strongly advocate for the use of inverted ILM flap method in macular hole closure surgeries.

Effects of silage type and inclusion level on ruminal characteristics and feeding behavior of steers fed finishing diets.

Crossbred beef steers fitted with a ruminal cannula were used to study the effects of silage type (BH 8895 corn or AF7401 sorghum) and level of inclusion (10 or 20%) in beef cattle finishing diets on digestibility of nutrients, ruminal kinetics, in vitro methane production, and feeding behavior. A 4 × 6 unbalanced Latin square design was used (6 steers; 363 ± 23 kg; 4 diets: corn silage [CS] or sorghum silage [SS], both at 10 or 20% inclusion, DM basis). Each period consisted of 14 d of adaptation and 7 d of collection. Steers were fed once daily at 1000 h. An additional study evaluated the ruminal degradability of intact ensiled sorghum grain ruminally incubated in 3 steers (547 ± 56 kg BW), using the same hybrids from the main study from 10 laboratory experimental silos. The GLIMMIX procedures of SAS were used for statistical analyses. Steers fed SS had greater NDF intake ( < 0.01) compared with the ones fed CS. The magnitude of the NDF intake change depended on the level of inclusion ( < 0.01), which was 6 and 16% for 10 and 20% inclusion, respectively. Regardless the level of inclusion, CS diets promoted greater ( ≤ 0.01) apparent total tract digestibility of nutrients evaluated (DM, OM, NDF, ADF, hemicellulose, and starch) compared with SS diets. Steers fed SS diets tended to chew 1.1 h/d more ( = 0.07) than steers fed CS diets. The level of inclusion increased ( = 0.02) the chewing time per day by 1.3 h. No major differences were observed in any of the ruminal pH and in vitro gas production variables evaluated for silage type and inclusion level ( ≥ 0.09). The CS-fed steers had 12% greater total VFA concentration and an 18.5% lower ( < 0.01) acetate-to-propionate ratio compared with SS-fed steers. The acetate-to-propionate ratio was 16% greater ( < 0.01) when steers were fed SS compared with when steers were fed CS. The CS samples were more extensively ruminally degraded ( < 0.01) than the SS samples. Greater ( < 0.01) NDF ruminal disappearance was observed in ruminal environments containing 20% silage compared with those containing 10% silage. After 96 h inside the rumen, intact ensiled sorghum grain degradability of DM reached only 51.7%. Replacing CS with SS in beef finishing diets (low roughage inclusion) requires adjustments to balance dietary energy. Sorghum material induced a desirable roughage effect in feeding behavior but also offered the potential for improved regarding fiber digestibility and intact grain ruminal degradability.

Effects of tannic acid on growth performance, carcass characteristics, digestibility, nitrogen volatilization, and meat lipid oxidation of steers fed steam-flaked corn-based finishing diets.

Effects of a tannic acid blend (ByPro; Silvateam USA, Ontario, CA) added to steam-flaked corn-based fishing diets on beef cattle growth performance, carcass characteristics, nutrient digestibility, fecal N volatilization, and meat lipid oxidation were evaluated. Steers ( = 144; 349 ± 25 kg initial BW) were blocked by initial BW and assigned randomly to 1 of 3 treatments with 12 pens/treatment and 4 steers/pen and fed ad libitum. Treatments included a control (CON; no ByPro) and ByPro fed at 30 or 60 g DM/steer daily (30-ByPro and 60-ByPro, respectively). Pen fecal samples were collected 7 d after cattle were shipped to slaughter for estimation of N volatilization. Strip loins were aged for 21 d for evaluation of color and antioxidant activity. Intake quadratically increased ( = 0.05) from d 0 to 35, whereas linear trends were observed for increased DMI from d 0 to 105 and d 0 to slaughter ( = 0.07 and = 0.06, respectively), resulting in a 3.7% greater overall DMI for 60-ByPro than for CON. No differences were detected for carcass-adjusted ADG ( = 0.65) or G:F ( = 0.17). Carcass characteristics including HCW ( = 0.52), fat thickness ( = 0.32), LM area ( = 0.57), quality grade ( = 0.44), yield grade ( = 0.29), and percentage of condemned livers ( = 0.13) were not affected by treatments. Apparent total tract digestibility of starch linearly decreased tendency ( = 0.03) with increasing ByPro dose, whereas tends for a linear decrease ( = 0.09) in CP and a quadratic increase ( = 0.09) in OM digestibility were observed. No effects of treatment ( ≥ 0.39) were noted for fecal N volatilization. An increase ( < 0.01) in metmyoglobin in strip loin steaks was observed with ByPro inclusion. Oxymyoglobin decreased ( < 0.01) as display day progressed, except on d 5, at which time CON and 30-ByPro steaks had lower proportions than 60-ByPro steaks. Only subtle changes in discoloration ratio and deoxymyoglobin were observed, whereas no effects ( ≥ 0.43) for pH or thiobarbituric acid reactive substances were noted. Feeding ByPro increased DMI during the first half of the feeding period without negatively affecting gain efficiency; however, fecal N retention was not altered by ByPro. ByPro did not negatively affect meat quality or carcass characteristics, and it did not seem to affect retail meat antioxidant activity.

[Left ventricular projectile migration after an accidental close-range gunshot wound]. / Linksventrikuläre Projektilmigration nach akzidentiellem Schrotschuss aus nächster Nähe.

We report the case of a 24-year-old female after sustaining a shotgun wound in the left upper extremity and chest. Initial emergency diagnostics revealed numerous shotgun pellets scattered throughout the left-side soft tissue, chest and upper lung lobe with one pellet having migrated into the left ventricle of the heart.Due to the devastating injury pattern, gunshot wounds are interdisciplinarily challenging and should include extended initial diagnostics, such as contrast agent CT. The potential toxicity of elevated lead blood levels have to be taken into further account.

Biofuel feedstock and blended coproducts compared with deoiled corn distillers grains in feedlot diets: Effects on cattle growth performance, apparent total tract nutrient digestibility, and carcass characteristics.

Crossbred steers (British × Continental; = 192; initial BW 391 ± 28 kg) were used to evaluate the effects of feeding ethanol coproducts on feedlot cattle growth performance, apparent nutrient digestibility, and carcass characteristics. Steers were blocked by initial BW and assigned randomly to 1 of 6 dietary treatments within block. Treatments (replicated in 8 pens with 4 steers/pen) included 1) control, steam-flaked corn-based diet (CTL), 2) corn dried distillers grains with solubles (DGS; DRY-C), 3) deoiled corn dried DGS (DRY-CLF), 4) blended 50/50 corn/sorghum dried DGS (DRY-C/S), 5) sorghum dried DGS (DRY-S), and 6) sorghum wet DGS (WET-S). Inclusion of DGS was 25% (DM basis). The DGS diets were isonitrogenous, CTL was formulated for 13.5% CP, and all diets were balanced for ether extract. Final shrunk BW, ADG, and DMI did not differ among CTL and DGS treatments ( ≥ 0.19). Overall G:F did not differ from CTL for DRY-C, DRY-CLF, or WET-S ( ≥ 0.12); however, G:F was 9.6% less for DRY-S compared with CTL ( < 0.01) and tended ( = 0.09) to be less for DRY-C/S than CTL. For grain source, ADG and G:F were less for DRY-S vs. DRY-C ( < 0.05), but blending DRY-C/S tended ( = 0.07) to increase ADG and increased ( = 0.05) carcass-adjusted G:F vs. DRY-S. For WET-S, final BW and ADG were greater ( < 0.05), and G:F tended ( = 0.06) to be greater than for DRY-S. There was no difference in ADG, DMI, or G:F of steers fed DRY-C vs. DRY-CLF ( ≥ 0.35). Apparent DM and OM digestibility did not differ for CTL, DRY-C, DRY-CLF, and WET-S ( ≥ 0.30) but were lower for DRY-C/S and DRY-S ( < 0.05). Nutrient digestibility was lower for DRY-S vs. DRY-C ( < 0.01), but apparent digestibility of OM, DM, NDF, ADF, CP, ether extract, and starch were increased ( < 0.01) for DRY-C/S vs. DRY-S. Although starch digestibility did not differ between DRY-S and WET-S ( 0.18), digestibility of other measured nutrients was greater for WET-S vs. DRY-S ( < 0.01). Ether extract digestibility was greater for DRY-CLF vs. DRY-C ( < 0.05). Carcass weight, dressing percent, and marbling score did not differ between CTL and DGS diets ( ≥ 0.23). For DRY-S, HCW was lower than for DRY-C ( = 0.02); however, compared with DRY-S, HCW tended to be greater for DRY-C/S ( = 0.10) and WET-S ( = 0.07). At a moderately high (25% DM) inclusion, blending C/S or feeding WET-S resulted in cattle growth performance and carcass characteristics similar to those of CTL and corn-based coproducts.

[Penetrating neck injury of a blacksmith by splitter projectile]. / Penetrierende Halsverletzung durch ein Splitterprojektil bei Schmiedearbeiten.

Laryngeal injuries are rare but potentially life-threatening injuries. Due to the topography of the neck, accompanying injuries of the greater blood vessels, cervical nerves, thoracic organs and spinal cord are common. Therefore in initial diagnostics, these must be excluded from injuries which determine the prognosis. A patient presented with ventral perforation of the larynx, initial dyspnea, hematemesis and left-sided emphysema of the neck. Cause of the findings, we treated the patient non-operatively in interdisciplinary consensus.

Severe sepsis caused by a linezolid-resistant Enterococcus faecium in a 10-year-old girl after multiple trauma.

While infections caused by Enterococcus faecium resistant to vancomycin (VRE) are increasing, linezolid-resistant strains are still rare. We present the case of a 10-year-old girl with severe sepsis caused by a linezolid-resistant E. faecium (Van-B VRE) after multiple trauma and right-sided hemipelvectomy. The off-label use of a targeted antimicrobial therapy with daptomycin (350 mg/day; approximately 8 mg/kg) for 17 days resulted in rapid normalization of infection parameters and improved clinical status. No side effects were observed and the patient was successfully discharged from the intensive care unit.

[Quality management in acute pain therapy: results from a survey of certified hospitals]. / Qualitätsmanagement in der Akutschmerztherapie : Ergebnisse einer Befragung TÜV-zertifizierter Kliniken.

AIM: Systems for and methods of quality management are increasingly being implemented in public health services. The aim of our study was to analyze the current state of the integrated quality management concept "quality management acute pain therapy" of the TÜV Rheinland® (TÜV) after a 5-year project period. MATERIAL AND METHODS: General characteristics of the participating hospitals, number of departments certified by the TÜV and implementation of structures and processes according to the TÜV guidelines were evaluated by a mail questionnaire. Furthermore, positive and negative aspects concerning the effects of certification were evaluated by the hospitals' representatives of certification. RESULTS: A total of 36 questionnaires were returned. Since 2006 the number of certified hospitals (2011: n = 48) and surgical departments (2011: n = 202) has increased continuously. The number of certified medical departments is low (2011: n = 39); however, in the last 3 years, it has increased by about 200-300% annually. Standard operative procedures for pain therapy and measurement of pain intensity at regular intervals were implemented in all certified clinics (100%). Although 41% take part in the benchmarking project QUIPS (Quality Improvement in Postoperative Pain Therapy), 24% do not systematically check the quality of the outcome of pain management. Acceptance of the new pain therapy concepts among nursing staff was rated positively (ratio positive:negative 16:1); however, acceptance among physicians was rated negatively (1:15). CONCLUSION: Certification by the TÜV leads to sustainable implementation of quality management principles. Future efforts should focus on better integration of physicians in acute pain therapy and the development of an integrated tool to measure patients' outcome.

Development of a risk index for the prediction of chronic post-surgical pain.

The incidence of chronic post-surgical pain (CPSP) after various common operations is 10% to 50%. Identification of patients at risk of developing chronic pain, and the management and prevention of CPSP remains inadequate. The aim of this study was to develop an easily applicable risk index for the detection of high-risk patients that takes into account the multifactorial aetiology of CPSP. A comprehensive item pool was derived from a systematic literature search. Items that turned out significant in bivariate analyses were then analysed multivariately, using logistic regression analyses. The items that yielded significant predictors in the multivariate analyses were compiled into an index. The cut-off score for a high risk of developing CPSP with an optimal trade-off between sensitivity and specificity was identified. The data of 150 patients who underwent different types of surgery were included in the analyses. Six months after surgery, 43.3% of the patients reported CPSP. Five predictors multivariately contributed to the prediction of CPSP: capacity overload, preoperative pain in the operating field, other chronic preoperative pain, post-surgical acute pain and co-morbid stress symptoms. These results suggest that several easily assessable preoperative and perioperative patient characteristics can predict a patient's risk of developing CPSP. The risk index may help caregivers to tailor individual pain management and to assist high-risk patients with pain coping.

[Fulminant pulmonary artery embolism in the early postoperative phase. Use of transesophageal echocardiography in acute diagnostics]. / Fulminante Lungenarterienembolie in der frühen postoperativen Phase. Einsatz der transösophagealen Echokardiographie in der Akutdiagnostik.

Acute pulmonary embolism is a serious perioperative complication with a high mortality. A case of early onset pulmonary embolism with acute right heart failure and resuscitation after spinal surgery is reported. The diagnosis was rapidly and reliably confirmed by transesophageal echocardiography (TEE) and a right atrial thrombus was detected. Persistent life-threatening hemodynamic instability required thrombolysis with 100 mg recombinant tissue-type plasminogen activator (rt-PA). The patient survived this critical situation but sustained permanent paraparesis.

The comparison of methods for determination of humoral and cell-mediated immunity in patients with breast cancer.

We observed the immunological answer to antigens obtained from the human malignant breast tumor and from the blood of inbred mice strain C3H/H2K infected by LDH virus. We compared the modified ELISA method for humoral immunity with the leukocyte adherence inhibition (LAI) assay for cell-mediated immunity. The modified ELISA method is suitable for early diagnosing and monitoring antibodies in a malignant breast tumor simultaneously with senological examinations which include mammography and clinical examinations, because the antibodies are determined in a high number of samples by single application.

Cell-mediated immunity in cervical cancer evolution.

Cell-mediated immunity (CMI) response to different antigens was examined in healthy women, in patients with cervical precancerous lesions, and in patients with cervical cancer. Cervical lesions were diagnosed by cytological (PAP) smears, from examination by colposcopy, and from "punch" biopsy material by histology. CMI response is related to specific processes in healthy and cancer cells. CMI was investigated by leukocyte adherence inhibition (LAI) assay using specific antigen (prepared from cervical carcinoma tissue) and non specific antigen (prepared from blood of mice infected by LDH--lactate dehydrogenase--virus). The CMI responses of healthy women and cancer patients to the antigens used are different: the majority of T lymphocytes display adherence and non adherence, respectively (but the CMI responses elicited by the antigens are not equal and small quantitative differences are observed). Regardless of the CIN (cervical intraepithelial neoplasia) grades, CMI responses correspond either to healthy women or to cervical carcinoma patients (at about similar ratio of cases in all the CIN groups). Effect of non specific antigen suggests that cervical carcinoma transformation may be connected with reduction of mitochondrial activity similar to processes in LDH virus infection.

[Intra-articular ketamine after arthroscopic knee surgery. Optimisation of postoperative analgesia]. / Intraartikuläre Ketamingabe bei arthroskopischen Knieoperationen. Optimierung der postoperativen Analgesie.

BACKGROUND: Surgery of the knee can be very painful and sufficient postoperative pain treatment is often problematic. To optimize postoperative analgesia, application of local analgesics has been suggested. In the present study it was investigated whether intra-articular administration of ketamine reduces the level of pain after arthroscopic knee surgery. MATERIAL AND METHODS: A total of 68 patients undergoing arthroscopic knee surgery were randomized into 4 groups. At the end of surgery the following pharmaceuticals were administered: 10 ml 0.25% bupivacaine intra-articular (i.a.), 0.25 mg S-(+)-ketamine/kg body weight to 10 ml in 0.9% NaCl i.a., 0.25 mg S-(+)-ketamine/kg body weight intravenous (i.v.), and 10 ml 0.9% NaCl i.a. as placebo. Postoperative pain therapy was performed as i.v. patient controlled analgesia (PCA) with piritramide. Postoperative opioid consumption and pain intensity were assessed as the main criteria in the postoperative course. RESULTS: All 4 groups were comparable with respect to biometrical data. The scores of the visual analogue scale (VAS) showed a significantly (p<0.05) lower pain intensity in patients treated with ketamine i.a. or i.v. compared to the other groups. Shortly after surgery the highest reduction of pain was detected in the i.a. ketamine group compared to i.a. bupivacaine or placebo administration. The postoperative opioid consumption was always lowest in the i.a. ketamine group. A significant difference in piritramide consumption (p<0.05) was demonstrated in the first 20 min after operation in the i.a. ketamine group compared to the i.a. administration of placebo and bupivacaine. CONCLUSIONS: The i.a. application of ketamine after arthroscopic knee surgery leads to a significant decrease of postoperative analgesic demand and decreases patients' subjective level of pain compared to i.a. application of bupivacaine or placebo. Likewise, the i.v. application of ketamine is similarly effective but the effect is of shorter duration.

Early rehabilitation model shows positive effects on neural degeneration and recovery from neuromotor deficits following traumatic brain injury.

This study used an experimental early rehabilitation model combining an enriched environment, multisensory (visual, acoustic and olfactory) stimulation and motor training after traumatic brain injury (via fluid-percussion model) to simulate early multisensory rehabilitation. This therapy will be used by brain injured patients to improve neural plasticity and to restore brain integration functions. Motor dysfunction was evaluated using a composite neuroscore test. Direct structural effects of traumatic brain injury were examined using Fluoro-Jade staining, which allows identification of degenerating neural cell bodies and processes. Animals in the rehabilitation model group performed significantly better when tested for neuromotor function than the animals in standard housing in the 7-day and 15-day interval after injury (7d: p=0.005; 15d: p<0.05). Statistical analysis revealed significantly lower numbers of Fluoro-Jade positive cells (degenerating neurons) in the rehabilitation model group (n=5: mean 13.4) compared to the standard housing group (n=6: mean 123.8) (p<0.005). It appears that the housing of animals in the rehabilitation model led to a clear functional increase in neuromotor functions and to reduced neural loss compared with the animal group in standard housing.

Alcohol abuse in mothers during gravidity and breastfeeding brings changes of hippocampal neurons in their offspring.

Neurotoxic effect of ethanol on the CNS of laboratory rats in the prenatal and postnatal period was studied. Another aim of the experiment was to analyse structure of the hippocampus after the prenatal and postnatal exposure to alcohol and to identify the most vulnerable hippocampal regions. Pregnant Wistar rats of our own breed received 20% alcohol p.o. ad libitum every day since the conception to the 18th day of postnatal life of their offspring. Since the birth (the day 1) till the age of 18 days offspring were kept together with their mother and were exposed to postnatal alcohol effect (alcohol in the breast milk). At the age of 18 days animals were perfused under deep thiopental anaesthesia with buffered solution of paraformaldehyde. Serial sections were stained with Fluoro-Jade B and DNA specific dye bis-benzimide (Hoechst No 33258). Brains of young rats aged 18 days were analysed under the light microscope Olympus Provis AX-70 with epifluorescence. In CA1 and CA3 areas and in Gyrus dentatus of the hippocampus, groups of degenerating cells were observed. In all offspring some cells with fine granulated karyons were identified, which were accompanied with high numbers of glial cells. Our results demonstrate the neurotoxic effects of alcohol and the high vulnerability of the developing CNS. The identification of cells with segmented karyons indicates the role of apoptotic mechanism in the cell death.

Effect of magnesium pre-treatment on the hippocampal NOS activity during long-lasting intermittent hypoxia.

Influence of magnesium pre-treatment during repetitive hypoxia was studied in the hippocampus of rats by histochemical analysis (NADPH-diaphorase staining). NADPH-diaphorase occurs concurrently with NO-synthase that is responsible for NO synthesis. Rat pups were kept together with their mother for 8 hours a day in a hypobaric chamber at a simulated altitude of 7,000 m since the day of birth till the 17th day. The first group of animals was exposed to the repeated hypoxia; the second group under the same conditions was pre-treated by magnesium before the exposition to the hypoxia. Both groups were compared with intact control animals and intact animals treated with magnesium. The experimental and control animals were the transaortically perfused with 4% buffered neutral formaldehyde under thiopental anaesthesia at the age of 35 days. Brains were processed for NADPH-d staining. We estimated the density of NADPH-d positive neurons in CA1 and CA3 areas of the hippocampus and in the dentate gyrus. Intermittent hypoxia brings about higher numbers of NADPH-diaphorase positive neurons of CA1 and CA3 of the hippocampus and of the dorsal blade of dentate gyrus, in the comparison with either group of control animals. In the hilus and ventral blade of the dentate gyrus, on the contrary, the number of NADPH-d positive neurons was smaller. Magnesium pre-treatment during hypoxia decreased number of nitrergic neurons in all areas of the hippocampus except CA1 area, where the effect of magnesium was not significant. These results demonstrate that magnesium can probably have a neuroprotective effect.

Changes in the number of nitrergic neurons in rats hippocampus following nicotine administration.

Nicotine is a very widely used drug of abuse, which exerts a number of neurovegetative behavioural effects by interacting with the neuronal nicotinic acetylcholine receptor. Using histochemical analysis (NADPH-diaphorase and Fluoro-Jade B dye), the influence of intraperitoneal administration of nicotine on neurons of the hippocampus in 35-day-old male rats of the Wistar strain was studied. At the age of 37 days, the animals were transcardially perfused with 4% paraformaldehyde under deep thiopental anaesthesia. Cryostat sections were stained to identify NADPH-diaphorase positive neurons that were then quantified in CA1 and CA3 areas of the hippocampus, in the dorsal and ventral blade of the dentate gyrus and in the hilus of the dentate gyrus. In the same areas, using Fluoro-Jade B dye, signs of neurodegeneration were classified, using Fluoro-Jade B dye. Nicotine administration increased the number of NADPH-diaphorase positive neurons in the CA3 area of the hippocampus and in the hilus of the dentate gyrus with no effect in the remaining areas studied. Fluoro-Jade staining did not reveal any degenerating neurons in the hippocampus as an effect of nicotine administration.

[Respiratory sinus arrhythmia as predictor of blood pressure stability during anaesthetic induction in diabetics]. / Die respiratorische Sinusarrhythmie als Prädiktor der Blutdruckstabilität während der Anästhesieeinleitung beim Diabetiker.

OBJECTIVE: Diabetics with cardiovascular autonomous neuropathy (CAN) can show severe hypotension during the course of anaesthesia. To improve the safety of anaesthesia, pre-operative evaluation of this concomitant disorder is recommended. The conventional test battery described by Ewing and Clarke to diagnose CAN is relatively time-consuming and complex. The aim of this study was to evaluate whether patients at risk could be reliably identified with less diagnostic effort. METHODS: Fifty patients with diabetes mellitus undergoing an ophthalmosurgical procedure were investigated. To evaluate their cardiovascular reflex status, the following tests were performed one day before surgery: determination of heart rate variation (HRV) under deep respiration (6 breaths/min), and the response of heart rate (max/min 30:15 ratio) and blood pressure after getting up from a supine position. Anaesthesia was induced with thiopental and fentanyl and maintained with enflurane/N (2)0; vecuronium was administered for tracheal intubation. Patients whose systolic blood pressure fell below 90 mm Hg during the induction phase were assigned to Group H (hypotensive), the remaining patients to Group N (non-hypotensive). The groups were compared regarding the pre-operatively collected variables. RESULTS: The demographic data were comparable in the two groups with exception of the length of diabetes. Regarding blood pressure reaction during orthostatic load, there was no significant difference between the groups. In contrast, the parameters of HRV under deep respiration (with exception of the "mean circular resultant") and the max/min 30 : 15 ratio were significantly lower in patients of Group H than in Group N. The best differentiation between the groups offered the E/I ratio (= quotient resulting from the longest R-R interval during expiration (E) and the shortest R-R interval during inspiration (I) under deep breathing) as a measure of respiratory sinus arrhythmia. The incidence of hypotension during anaesthetic induction in patients with a normal E/I ratio was 8.7 %, but in patients with a pathologically reduced E/I ratio 51.9 % ( P = 0.0019). The sensitivity of this test concerning hypotension that occurred was 87.5 %, the specificity 61.7 %. CONCLUSION: The available results prove the close connection between the pre-operatively measured breadth of respiratory sinus arrhythmia and blood pressure response during anaesthetic induction. Patients at risk of hypotension can be identified reliably and quickly during pre-operative screening with the help of a single, simple test procedure.

Serum endostatin levels in patients with lung carcinoma.

UNLABELLED: The purpose of our study was to evaluate the clinical usefulness of serum endostatin levels during chemotherapy of lung cancer in relation to the histopathological type of the tumor, clinical stage and response to therapy. MATERIALS AND METHODS: Serum concentrations of endostatin were determined in 37 patients (24 with non-small cell lung cancer and 13 with small cell lung cancer), 10 healthy subjects constituted controls. To determine endostatin levels (ELISA), venous blood samples were collected from each patient before treatment and after 4-6 courses of chemotherapy. RESULTS: The serum concentrations of endostatin were found significantly higher in patients in comparison with controls (p=0.003). No statistically significant differences were established between the concentrations of endostatin with regard to such clinical features, as: performance status, clinical stage (III and IV) and histopathological type (non-small cell lung cancer and small cell lung cancer). The concentrations of endostatin did not change after chemotherapy. There was no change of endostatin concentration caused by the response to treatment. CONCLUSIONS: The serum endostatin concentrations were elevated in lung cancer patients.

[Purkinje's concept of a neuron]. / Purkynova koncepce nervové bunky.

With his experiments and findings J. Ev. Purkyne influenced 34 scientific disciplines; in some of them he is assumed to be their founder (embryophysiology, histology, pharmacological physiology, biophysics, comparative physiology). He was the pioneer in the field of neuroscience not only due to his neuroanatomical descriptions but namely due to his neurophysiological experiments. Beside the description of "Purkyne cells" and cells of other regions of the brain, Purkyne studied also the structure of neuronal processes and it is possible to attribute him the first description of dendrites. Existing material shows that Purkyne studied also the structure of hippocampus. Those and other papers prove that Purkyne recognised possible functional differences between various types of neurons and he speculated about their mutual relations. Only contemporary particularly detailed knowledge on the structure of hippocampal neuronal circuits, description of the mediator interaction and modulation together with the identification of neuroplastic processes in the hippocampus enable to accomplish the Purkyne's attempt to correlate the structure and function.