Acute ophthalmology clinic in the new system of organized health care

PURPOSE: To analyse possibilities, needs, expenses and perspectives of the emergency service in ophthalmology clinic. MATERIAL AND METHODS: The number of patients were treated and diagnosis profile set. It has been analysed in emergency service in ophthalmology clinic. The calculation of patient's need and hospital operating costs has been performed. RESULTS: Only a few patients needed high specialist rescue of ophthalmology department. CONCLUSION: The system in which every patient has a possibility to go to the emergency service in ophthalmology department of hospital requires urgent changes. This system is too expensive for hospital and does not solve the problem who should take care of the patient: a general practitioner, out-patients ophthalmologist or other physicians.     

Decreased proliferative capability of CD4(+) cells of elderly people is associated with faster loss of activation-related antigens and accumulation of regulatory T cells

Decreased proliferation of CD4(+) lymphocytes of elderly people is at least in part due to lowered proportion of cells that are capable of dividing and producing viable progeny (effective precursors). We show that age-dependent reduction in effective precursor numbers depends on the one hand, extensive, activation-dependent apoptosis occurring from the very onset of stimulation and, on the other, the accumulation of non-dividing, regulatory (suppressor) CD4(lo)CD25(+)CD28(lo) T cells. In addition, analysis of changes in surface expression of activation-related antigens, including CD25, CD69, and PCNA in consecutive generations of dividing CD4(+) cells traced by carboxyfluorescein diacetate succinimidyl ester staining showed variable patterns of these changes that may relate to various aspect of impaired division of these cells in elderly.     

Sonographic assessment of the liver in children with psoriasis

PURPOSE: The aim of this study was to compare the size and echotexture of the liver in psoriatic and healthy children. METHODS: In 70 psoriatic and 43 healthy children, longitudinal sonograms of the liver were obtained along standardized section planes defined by the anterior axillary line, medioclavicular line, and midline. The livers' size and echotexture were examined and compared between the study groups. RESULTS: The measurements of the liver along the 3 section planes were not significantly different between psoriatic and healthy children. Parenchymal liver echogenicity in psoriatic children was neither decreased nor increased. CONCLUSIONS: No abnormality in size or echotexture of the liver was found in the psoriatic children.     

Multiple brain metastases from malignant peripheral nerve sheath tumour (MPNST)

Malignant peripheral nerve sheath tumours (MPNSTs) are rare soft tissue neoplasms arising from elements of the nerve sheath that often occur in the context of neurofibromatosis (NF) type 1. Their poor prognosis results from high local recurrence rate and distant dissemination. Nevertheless, the brain metastases are exceptional. We are presenting an unusual case of intrathoracic MPNST in a 33-year-old man with a five-year clinical course characterised by multiple times local recurrences of primary tumour and multiple remote metastases into the brain structures, thyroid and suprarenal gland. Moreover, the cerebellar metastasis regrew in spite of its total excision. Histologically, brain metastatic tumours were composed of spindle cells closely arranged in interlacing and woven fascicles. This highly cellular nerve tissue exhibited an advanced nuclear hyperchromasia and a high mitotic activity. The tumour exhibited rich delicate reticulin network. The schwannian nature of brain metastases has been confirmed by immunohistochemical findings showing S-100 protein and GFAP expression and ultrastructural evidences of the pericellular basal lamina.     

Errors in body temperature assessment related to individual variation, measuring technique and equipment

Errors in body temperature measurement might seriously influence the evaluation of an individual's health condition. We studied individual variation, measurement technique and the equipment used when assessing body temperature. In the first part of the study, three volunteers performed repeated measurements for five mornings. In the second part, the morning rectal, oral, ear and axillary temperatures were measured once in 84 men and women (19-59 years). The repeated measurements showed a daily temperature difference of 0.1-0.4 degrees C in rectal and oral temperatures, 0.2 degrees C-1.7 degrees C in the ear and 0.1-0.9 degrees C in the axillary temperatures. In the sample of 84 subjects, men and postmenopausal women had a lower mean body temperature compared to premenopausal women. The mean deviation between rectal temperature, and oral, ear and axillary temperatures, respectively, was > 0.5 degrees C, with a large individual variation. In conclusion, in order to improve the evaluation of body temperature, the assessment should be based on the individual variation, the same site of measurement and no adjustment of oral, ear or axillary temperatures to the rectal site.