[Iodine deficiency in the world and in the Czech Republic--current status and perspectives]. / Jodový deficit ve svete i v Ceské Republice--soucasný stav a perspektivy.

Iodopenia is importance world-wide problem--the cause of spectrum of iodine deficiency disorders (IDD). The "simple" way for its compensation is iodine supplementation--preferably by iodinization of salt: in the Czech Republic prevalence of IDD was very high in the past. The complex program for compensation of iodine deficiency realized in the CR includes improvement of salt iodization, supplementation of pregnant and lactating women, fortification of products for babies' nutrition and increasing use of iodinized salt in general population incl. food industry. Thus CR is country with compensated iodine deficiency according to criteria WHO, UNICEF, ICCIDD. In future, however, systematic interest should be focused on optimalization of iodine saturation, esp. in pregnant women and evaluation of possible risk of supranormal iodine intake (impairment of thyroid function, activation of thyroid autoimmunity). Taking in account, the changes of nutrition and life style systematic monitoring of quality of iodine supplementation seems to be essential.

[Evaluation of results of iodine prophylaxis in Czech Republic]. / Hodnocení výsledku jodové profylaxe v ceské republice.

BACKGROUND: Improvement of system of iodine prophylaxis in Czech Republic resulted in compensation of iodine deficiency. Effects of increased iodine intake on the status of thyroid gland (volume, function, autoimmune disorders) should be determined. The aim of the study was to evaluate those effects in an epidemiological survey. METHODS AND RESULTS: A randomly selected sample of adult population (18-65 years old) from 3 regions was investigated using the same methods at the interval of 5 years. A significant increase of ioduria was proved with the marked increase of prevalence of high category (over 300 ug of I per 100 mL of urine). Volume of the thyroid gland decreased significantly in women, not in men. No significant changes of TSH were observed, however FT4 level slightly, but significantly increased. CONCLUSIONS: Repeated epidemiological survey of the randomly selected sample of adult population in 3 regions verified the effectiveness of improved iodine prophylaxis with not unequivocally positive increase of high (supraphysiological) category of ioduria. Decrease of thyroid volume was proved in women only, a tendency of mild (clinically not important) increase of thyroid function was also observed.

[Selenium deficiency of west Bohemia population]. / Deficit selenu v populaci západních Cech.

To estimate status and intake of selenium in inhabitants of the most Western region of the Czech Republic (Cheb region) 241 serum, 404 urine and 30 hair samples from randomly selected persons in the age between 6 and 65 years is performed. Serum and hair samples were analysed by means of instrumental neutron activation analysis (INAA), while Se in urines was detected by means of fluorimetry. Urine iodine was determined in the same group by Sandell-Kolthoff method for the possibility to detect concomitant Se and I deficiency and/or correlations between these two essential trace elements necessary for metabolism of thyroid hormones. Average values of Se indexes are low (55.4 +/- 13.8 microg Se/L serum; 15.4 +/- 5.7 microg Se/L urine; 13.6 +/- 6.0 microg Se/g creatinine; 0.268 +/- 0.051 microg Se/g hair) and prove Se deficiency in the searched population. Statistical evaluation of Se in subgroups of boys, girls, men and women proved significant differences as far as age is concerned, gender differences were found only between boys and girls. Some significant and highly significant differences were found also in subgroups according age and gender (males and females in the age of 6, 10, 13, 18-35, 36-49 and 50-65 years). On the other hand, urine iodine average value (126 +/- 65 microg/L) is on the lower optimum level. By the use of correlation analysis, slight but significant correlations were found between Se and I in urine and some of thyroid hormone parameters and their influence on the organism.

International study in premedical education.

This study surveyed medical school admission deans about the desirability of international study. Most agreed that an international study program in the premedical years was beneficial, but most were neutral concerning science courses taken in international programs.

Advances in total phalloplasty and urethroplasty with microvascular free flaps.

This article focuses on the lateral arm free flap as the option that comes closest to meeting the diverse aesthetic and functional goals of phalloplasty. The authors introduce a new technique for incorporating a prefabricated neourethra within the lateral arm to permit the coexistence of an erectile prosthesis alongside a fully vascularized urethra that extends to the distal tip. The unrecognized value of the radial forearm free flap for urethroplasty is also discussed and a case of reconstruction following urethral loss is presented. Also described is how the prefabricated urethra technique may be useful for repairing severe hypospadias defects.

The efficacy of breast augmentation: breast size increase, patient satisfaction, and psychological effects.

In this study designed to quantify the degree of breast enlargement produced by augmentation mammaplasty, 112 women who underwent breast augmentation were interviewed. The size increase that typically resulted from various implant volumes was measured by comparing preoperative and postoperative bra sizes. For the study group as a whole, the average increase was two bra sizes (either increased cup size or a combination of increased cup size and chest circumference), regardless of the implant volume inserted. Patients also were asked a series of questions to evaluate the impact of the surgery on various psychological parameters, including body image, feelings of self-confidence, and interpersonal relationships. Along with having a very positive body image, the group reported decreased self-consciousness (86 percent) and heightened self-confidence (88 percent); in addition, 95 percent said they felt better about themselves after surgery. The women's satisfaction with the results of augmentation and the success of surgery in meeting their expectations also were measured. Eighty-six percent reported being completely or mostly satisfied with the postoperative results, 86 percent felt the operation was a complete success, and 95 percent said that augmentation met their expectations.

HLA typing in women with breast implants.

Since the 1970s, anecdotal reports have described a relatively small number of women who received silicone gel breast implants and later developed either a recognized rheumatologic disease or unexplained symptoms suggestive of an autoimmune disorder. The study reported here examined whether there is any association between the symptoms seen in implant patients and HLA molecules. One-hundred and ninety-nine subjects were evaluated by HLA typing: symptomatic patients with implants (group I, n = 77), asymptomatic women with implants (group II, n = 37), healthy female volunteers without implants (group III, n = 54), and fibromyalgia patients without implants (group IV, n = 31). A statistically significant 68 percent of group I were positive for HLA-DR53, compared with 35 percent of group II and 52 percent of group III. The fibromyalgia patients were strikingly similar to group I women in terms of HLA-DR molecules, with 65 percent of group IV being positive for DR53. Group I also had a statistically significant increased frequency of HLA-DQ2. Asymptomatic women with implants (group II) had an increased frequency of DR1 and DQ1. In addition, 42 percent of symptomatic patients with implants formed autoantibodies to their own B cells; of these, 81 percent were DR53-positive. Although frequencies of capsular contracture and implant rupture were not significantly different in the two groups with implants, there were statistically significant associations in group I between contractures and ruptures and the presence of DR53 and B-cell autoantibodies. These data suggest that symptomatic patients with implants share important genetic characteristics (primarily HLA-DR53 positivity) that differentiate them from their asymptomatic counterparts. DR53 may be a marker of women who are predisposed by their HLA genotype to develop symptoms following exposure to silicone gel breast implants.

Preparative high-performance liquid chromatography of minor products of Streptomyces cinnamonensis.

Analytical and preparative high-performance liquid chromatography of 3 phenazines and furonaphthoquinone derivative on reversed-phase column are described. The mobile phase was methanol and water. The injected amount of the mixture was about 30 mg for a preparative chromatographic run requiring 80 min. Substances were detected directly in the column effluent by UV detection.

[Contribution of ergonomy in the prevention of accidents]. / Beitrag der Ergonomie zur Unfallverhütung.

The present article reports on the interrelation between the working man and his work conditions. The knowledge of ergonomics can be used in the field of working security. Connections between working security on one hand and fatigue and its causes on the other have been presented. Furthermore environmental factors at the work place and interrelations between man and machine have been pointed out.

[Occupational health-related organization of work in large laundry facilities]. / Untersuchung zur gesundheitsgerechten Gestaltung der Arbeit in Grosswäschereien.

In the ergonomic assessment of work in 14 large laundries, it is primarily constrained posture due to working conditions and uniform overstrain that are highlighted objectively. Accordingly common are complaints about back problems, leg pain, severe fatigue, headache and nervousness (42-70%). The added work difficulties most objected to include heat (rate of mention in flatwork operations 80%), dust, dirt, odors (in sorting operations 75%), constant standing and walking (in several areas of work 70-80%), too great exertion of the arms (in sorting and folding operations 50-67%), and noise (depending on area of work 33-73%). On the basis of these results, attempts at resolving these problems to improve the organization of work in large laundries were developed. These include for example, an adequate capacity to adjust the working surfaces, suitable seats and aids for standing, installation of platforms, and further measures to reduce overstrain.

[Ergonomic studies in a spinning mill--case study]. / Ergonomische Untersuchungen in einer Spinnerei -- Fallstudie.

The effects of unfavorably assembled machinery on the workers was analyzed in a spinning-mill. Simple ergonomical methods were used such as: evaluation of the working process, of the movements, measurement of working heights, grasping space, dislocated weights, resistance to operating elements, length of lifting way. The workers were interrogated on their subjective feelings of tiredness and pains, their heart rate was measured. The physical strain and the ailments seem to be in connection with the cervicobrachial syndrome. Possibilities to introduce the proposed improvements were examined.

[Conclusions from traffic noise studies: suggestions for noise thresholds]. / Schlussfolgerungen aus Verkehrslärmuntersuchungen: Vorschläge für Lärmgrenzwerte.

Based on 4 surveys, threshold limit values for noise are proposed; beside noise immissions, the quality of living has also been considered.

[Occupational medicine insight into the problem of occupational stress in the construction industry]. / Arbeitsmedizinischer Einblick in die Problematik der beruflichen Belastung im Baugewerbe.

According to the present study, in addition to the high accident rate, work in the building trade is characterized by intense muscle strain and constrained physical posture. In bricklaying, for example, a worker moves by hand up to seven tons of stone per shift. Consequently, various health complaints occur far more frequently in this occupation than in the other occupational groups, for instance, back complaints (71%), severe fatigue (58%), pain in the arms and hands (42%), headache (40%) and leg pain (34%). The most complained of factors include effects of the weather (74%), draft (50%), noise (55%), air pollution via dust (53%), skin contact with dirt and harmful substances (47%), moving heavy objects by hand (53%), adverse posture during work (47%), and a high risk of accidents (47%). Besides technical and organizational measures, the prevention of health impairments in employees in the building trade should be promoted by purposive care by works services of occupational medicine.

[Disturbances caused by noise in offices]. / Lärmstörungen in Büros

Noise measurements were carried out in 57 offices. At the same time 228 employees were asked about their opinion on the noise situation. Relations between objective and subjective criteria, noise values and complaints about disturbance caused by different types of noise were analyzed. Noise parameters comprising noise peaks are more adequate to assess disturbing noise than parameters based on a mean noise level. Statements on extent and frequency of disturbance in general and of communication depend on noise. Statements on disturbances of concentration and on impairment of performance do not depend on noise. Outdoor noise and "subjectively worst noise" are measurable in dB values; indoor noise, however, is independent from the measured values.

[Ergonomic problems in cash register jobs at self-service stores]. / Ergonomische Probleme der Kassenarbeit in Selbstbedienungsläden.

By means of inquiry and work place inspection health and ergonomic problems of jobs on diverse cash register systems were investigated, taking into account larger shopping centers as well as smaller self-service shops in various parts of Switzerland. A lot of work place inconveniences, e.g. current of air = 62%, tiresome goods handling = 31%, limited scope for movement = 30%, unsuitable seat = 23%, etc., as also construction and arrangement short comings related to definite types of cash register boxes, obviously resulting in an increased incidence of bodily ailments (back pain = 55%, arm pain = 43% visual troubles = 42%, etc.) were identified. Based on this investigation and on ergonomic analysis of different types of work place arrangements, recommendations were made on the planning and construction of cash register set-ups and on the organisation of work.

[Ergonomic analysis of heavy work carried out by female workers in the textile industry]. / Analyse ergonomique d'un travail pénible chez des ouvrières de l'industrie textile

Work and recovery pulse were measured with 22 female workers doing heavy work. The proposed limit of capacity under continuous operating conditions of 25 work pulses was surpassed by 10 of the 22 workers. Recovery pulse made it possible to detect illness in two cases and correlates significantly with the total duration of relaxing operation. Similar results could not be obtained with work pulse. As the recovery pulse is quickly and easily measurable, it was in the frame of this study a more interesting value than the work pulse.

[Air and noise pollution caused by traffic in a small Swiss town]. / Schadstoff- und Lärmbelastung durch Strassenverkehr in einer Schweizer Kleinstadt.

In order to evaluate the extent of annoyance caused by air pollution and noise immissions, we measured the values in the small town of Uznach, which is crossed by a narrow and sloped street with a heavy traffic. The results revealed that noise immissions exceed the "alarm-value" of 70 dB(A) and that pollution of the air is situated in the range of limit values.

[Disturbance due to traffic noise at night]. / Belästigung durch Strassenverkehrslärm in der Nacht.

In order to obtain bases for the establishment of threshold values in the new environmental law, a random sample survey with 1600 persons in urban and rural areas has been made on the degree of disturbance by street traffic noice in the night.

[Noise protection at the Autobahn N 3--case study]. / Lärmschutz an der Autobahn N3--Fallstudie.

This study deals with the actual and the future noise situation along a highway over a distance of 3,5 km. Three alternatives for noise protection measures, their efficiency and their costs are proposed.

[Burdens due to noise and air pollution in residents of areas near streets with heavy traffic]. / Die Belästigung der Anwohner verkehrsreicher Strassen durch Lärm und Luftverunreinigungen.

The residents of different streets with varying traffic density and building density were questioned about annoyance due to traffic noise and air pollution. Frequency and extent of annoyance felt, effects of immissions on such living aspects as recreation, or communication, and also the reactions to the disturbance felt (such as closing windows and taking sleeping pills) were investigated. Noise levels as well as particulate matter and gaseous air pollutant concentrations were measured along the streets under investigation. The evaluation of 1300 questionaires showed that reactions to noise were different in different quarters although noise levels were the same. In general, about 40% of residents were heavily disturbed during daytime when the noise level Leq was around 65 dB(A); while for the same noise level at night about 55% reported to be heavily disturbed. Strong correlations were also obtained between annoyance due to noise and that due to air pollution. The results show that annoyance felt is dependent not only on the measured noise levels and/or air pollution concentrations, but that there do exist interactions between the residential quarters and annoyance. These interactions should be considered while fixing the limits and standards.