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Background Treatment by anti-TNFα antibodies (aTNFα) is known to change the dysbiotic faecal bacteriome in Crohn's disease (CD). However, whether the change is caused by aTNFα itself or by improving the gut inflammation status is unknown. Therefore, we aimed to identify and compare bacterial taxa and faecal metabolite changes upon aTNFα between children with CD and juvenile idiopathic arthritis (JIA), a disease very rarely affecting the gut. Methods Faecal samples were analysed for bacteriome by massively parallel sequencing of the V4 region of the 16S rRNA and for faecal metabolome by 1H nuclear magnetic resonance. Gut inflammation status was assessed by faecal calprotectin levels. Results In total, 530 stool samples from 121 children (CD 54, JIA 18, healthy 49) from six different hospitals in Czechia were collected. In CD patients, 37 progressed to the need for aTNFα therapy, whereas 17 remained on other therapeutic modalities; in JIA, 14 received aTNFα, whereas four remained on other treatments. In JIA, calprotectin levels were not different from controls (P=0.16), and lower than in CD (~50 fold, P Conclusion Our findings suggest that aTNFα therapy changes the dysbiotic microbiome in CD towards healthier composition. This is supported by relatively comprehensive longitudinal stool sampling in a multicentric study. Most importantly, the observed bacteriome changes upon treatment with TNFα blockers are of secondary origin, as they occur only in CD patients, whose gut inflammation status improves after the treatment, and no effects are observed in the control group of JIA.

Axial flux electric motors have received a lot of attention in recent years due to successful implementations in industrial or traction applications. Particularly, axial flux permanent magnet synchronous motors (AFPMSM) can be an attractive choice in case of high torque-density requirements or when the drive environment (packaging) is geometrically limited to a disc-shaped motor. However, compared to radial flux motors, axial flux machine modeling possibilities are much less documented. In the present study, different electromagnetic modeling approaches have been compared through an example AFPMSM design. The motor parameters were determined by analytical and finite element methods. A 2D equivalent model (2D Linear Motor Modeling Approach – 2D-LMMA) and a 3D model results have been compared. The calculated values were used to carry out a drive control analysis of the axial flux motor.

Finite element modelling is a modern and efficient way to perform stress-strain analyses on both simple components and complex structures. If the material properties are properly set, the software can also model the deformation of parts. A very important criterion of accurate finite element calculations is an appropriate material model. The stress–strain function recorded during the tensile testing of standard specimens shows that stress is not constant during deformation and so it can be specified with a function in finite element software. Often, in finite element modelling, a bilinear model is used to simplify this function. The aim of this paper is to show the difference between the bilinear model, the multilinear model (the model split into several sections the stress-strain curve) and the real function in the analysis of deformation in hardness testing. We also analyse the minimum density of meshing which still provides acceptable accuracy in hardness testing calculations.

In this study, the effect of the magnitude of inherent strain is examined for the simulated deformations of printed specimens, where the material grade is either of MS1 or 316L steel powders. While both material qualities are steel grades, and the same sets of inherent strain values with different magnitude and directional variations are defined in the simulations, allowing isotropic and orthotropic behaviour too, the resulting deformation in the printed part may also be strongly influenced by the mechanical properties of the different steel grades.

In this paper, the results of computed tomography and destructive testing of a die cast, gas tight aluminium part are compared and analysed with the aim of refining the porosity map. The mapping of the continuity defects detected by the two methods makes it possible to estimate the number, shape and distribution of continuity defects on and in the immediate vicinity of the machined surface, and to compare the characteristics of continuity defects detected by non-destructive and sequential fine machining. Based on the results of the CT scan of a given casting, we also performed destructive testing to find defects in a selected part of the casting by sequential fine machining. The basic criterion for the choice of the cutting parameters was to minimize the plastic deformation (smearing) on the machined surface, i.e. to clearly identify porosity. We then investigated the position, shape and other characteristics of porosity on the surfaces. The results and differences resulting from the two different methods are also analysed.

Background Psoriatic arthritis (PsA) is a chronic and debilitating disease that can be managed by different clinical specialists. Objectives The objective of theLOOPstudy was to evaluate the impact of clinical specialty setting on the time to diagnosis and treatment of patients with PsA. Clinical disease activity and disease burden were also compared between clinical settings. Methods LOOPwas a cross-sectional, multicentre, observational study conducted in 17 countries in Western and Eastern Europe, the Middle East, Latin America and Asia. Adult patients (>= 18 years) with a suspected or established diagnosis of PsA who were routinely visiting a rheumatologist, dermatologist or non-rheumatology/non-dermatology physician were enrolled. All patients were assessed by both a rheumatologist and a dermatologist. Results Of 1483 enrolled patients, a total of 1273 had a confirmed diagnosis of PsA. There was no significant difference in the median time from onset of inflammatory musculoskeletal symptoms to PsA diagnosis between patients enrolled by rheumatologists and dermatologists (6.0 vs. 3.9 months). However, the median time from diagnosis to first treatment with a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) was significantly shorter in the rheumatology setting compared with the dermatology setting (0 vs. 2.0 months;P < 0.001). In addition, disease activity was significantly higher in the dermatology setting compared with the rheumatology setting. Conclusions Differences in the management and clinical status of patients with PsA were observed between the rheumatology and dermatology settings. Importantly, median time from diagnosis to first csDMARDwas significantly shorter in the rheumatology setting, and patients in the dermatology setting had higher disease activity. These data show the importance of improved collaboration between rheumatologists and dermatologists. AbbVie

The variational principle, which allows the deduction of the basic equation system of continuum mechanics from the local form of Gyarmati’s integral principle is presented in this paper. Following the approach of irreversible thermodynamics, the principle the kinetic energy is described like the fundamental equation of thermodynamics as the internal energy change, namely intensive quantity multiplied by the changing of extensive quantity. As the internal energy is objective so that is an independent quantity from the coordinate system, this description to the internal energy can be done. However, the kinetic energy is coordinate-dependent quantity. To resolve this contradiction the stress tensor can be divided into elastic and dissipative stress components by using the laws of thermodynamics.

Background Evidence suggests that timely and effective management can improve long-term outcomes in patients (pts) with psoriatic arthritis (PsA); however factors influencing treatment management decisions are not well understood. Objectives To evaluate the association between the clinical specialty setting and time from inflammatory musculoskeletal symptom onset to PsA diagnosis and to different management steps in pts with a diagnosis of PsA. Methods LOOP is a large cross-sectional, multi-centre, observational study conducted in 17 countries across Western and Eastern Europe, Latin America, and Asia. Adult pts (≥18 years) with a suspected or an established diagnosis of PsA routinely visiting a rheumatologist (rheum), dermatologist (derm) or non-rheum/non-derm site were eligible to participate in this study. Each enrolled patient in the study was assessed by both rheum and derm. Main endpoints assessed were time from inflammatory musculoskeletal symptom onset to PsA diagnosis, time from PsA diagnosis to first csDMARD and to first bDMARD, and time from first csDMARD to first bDMARD. Results Of the 1483 pts enrolled in this study, 1273 pts with a confirmed diagnosis of PsA were included in this analysis. A majority of pts were recruited by rheums (671, 52.7%), followed by derms (541, 42.5%), physiatrists (36, 2.8%), and other specialties (25, 2.0%). PsA was first suspected by a rheum in 726 (57.0%) pts and by a derm in 541 pts (42.5%). Pt demographics and disease characteristics were mostly comparable between rheum and derm settings. Current disease activity and disease burden of patients with PsA categorised by clinical specialty are shown in table 1. Disease activity was higher in PsA pts in derm setting compared with rheum setting. The timing of different disease management steps by clinical specialty is reported in table 2. The mean time from symptom onset to PsA diagnosis was 24 months (mo) in rheum setting and 1 mo longer for derms. In rheum and derm settings, the mean time from PsA diagnosis to first csDMARD were 11 and 25 mo, respectively; whereas the mean time to first bDMARD were 52 and 55 mo, respectively. The mean time from first csDMARD to first bDMARD was 42 mo for rheums; while it was 3 months shorter for derms. Conclusions Although the duration from symptom onset to PsA diagnosis was similar between rheum and derm setting, there were differences in the timing of introduction of different DMARD classes. Notably, mean time to first csDMARD was significantly shorter in rheum setting. PsA pts in derm setting had significantly higher disease activity. These data lend further support to the need for rheum-derm collaborative approach to optimise management of pts with PsA. Acknowledgements AbbVie funded the LOOP study, contributed to its design, and participated in data collection, analysis and interpretation of the data, and in writing, review, and approval of the publication. AbbVie and the authors thank all study investigators for their contributions and the patients who participated in this study. Medical writing was provided by Deepa Venkitaramani, PhD, of AbbVie. Disclosure of Interest W.-H. Boehncke Grant/research support from: Abbvie, Biogen Idec, Celgene, Covagen, Galderma, Janssen, Leo, Lilly, MSD, Novartis, Pantec Biosolutions, Pfizer, and UCB, Consultant for: Abbvie, Biogen Idec, Celgene, Covagen, Galderma, Janssen, Leo, Lilly, MSD, Novartis, Pantec Biosolutions, Pfizer, and UCB, Speakers bureau: Abbvie, Biogen Idec, Celgene, Covagen, Galderma, Janssen, Leo, Lilly, MSD, Novartis, Pantec Biosolutions, Pfizer, and UCB, R. Horvath Grant/research support from: AbbVie, MSD, Novartis, Pfizer, and UCB, Consultant for: AbbVie, MSD, Novartis, Pfizer, and UCB, Speakers bureau: AbbVie, MSD, Novartis, Pfizer, and UCB, E. Dalkilic Grant/research support from: AbbVie, Speakers bureau: AbbVie, MSD, Roche, Pfizer, and UCB, S. Lima Consultant for: Abbive, BMS, and Janssen, Speakers bureau: Abbive, BMS, and Janssen, M. Okada Grant/research support from: AbbVie Japan, Ayumi Pharmaceutical, Eli Lilly and Company, Mitsubishi Tanabe Pharma, and Ono Pharmaceutical, Consultant for: AbbVie Japan, Ayumi Pharmaceutical, Eli Lilly and Company, Mitsubishi Tanabe Pharma, and Ono Pharmaceutical, Speakers bureau: AbbVie Japan, Ayumi Pharmaceutical, Eli Lilly and Company, Mitsubishi Tanabe Pharma, and Ono Pharmaceutical, M. Hojnik Shareholder of: AbbVie, Employee of: AbbVie, F. Ganz Shareholder of: AbbVie, Employee of: AbbVie, E. Lubrano Grant/research support from: AbbVie, Celgene, Janssen, MSD, Novartis, and Pfizer, Consultant for: AbbVie, Celgene, Janssen, MSD, Novartis, and Pfizer, Speakers bureau: AbbVie, Celgene, Janssen, MSD, Novartis, and Pfizer

The identification of property changes and damage in various structures is one of the major points in the engineering society. This work contains the method and results of a long-term aging process implemented by an experimental system. We applied a chemical and heat artificial aging test on metal and plastic pipes to indicate the degradation levels and results with suitable measuring instruments. During our measurements of aged pipes vibration tests were performed to get information about the changing of the vibration spreading properties of different materials. We were searching for information about the property changing of widely used pipe materials to estimate the rate of degradation and the service life of these instruments more accurately.

Das fragile X-assoziierte Tremor-/Ataxie-Syndrom (FXTAS) ist eine kurzlich erstmals beschriebene neurodegenerative Erkrankung, die sowohl Manner als auch Frauen (Manner >Frauen) mit einer Pramutation des FMR1-Gens betrifft. Der Erkrankungsbeginn liegt typischerweise nach dem 50 Lebensjahr, wobei das Lebenszeitrisiko, an FXTAS zu erkranken, fur Manner bei 1:3000 bis 1:6000 liegt. Klinisch stehen eine progrediente Gangataxie und ein zerebellarer Tremor im Vordergrund, die mit kognitiven Defiziten, Polyneuropathie und autonomer Dysfunktion assoziiert sind. Die Diagnose wird in der Zusammenschau des klinischen Bildes, der zerebralen Bildgebung und der genetischen Diagnostik gestellt. Aufgrund des noch geringen Bekanntheitsgrades und des variablen klinischen Erscheinungsbildes ist das FXTAS derzeit noch unterdiagnostiziert. Die Sicherung der Diagnose ist dennoch von herausragender Bedeutung fur die genetische Beratung der Patienten, da deren Nachkommen ein hohes Risiko fur die Erkrankung an einem fragilen X-Syndrom, einer vorzeitigen Ovarialinsuffizienz oder einem FXTAS tragen. Daruber hinaus sind zahlreiche Symptome des FXTAS einer symptomatischen Therapie zuganglich.

A gunshot residue sample that was collected from an object or a suspected person is automatically searched for gunshot residue relevant particles. Particle data (such as size, morphology, position on the sample for manual relocation, etc.) as well as the corresponding X-ray spectra and images are stored. According to these data, particles are classified by the analysis-software into different groups: ‘gunshot residue characteristic’, ‘consistent with gunshot residue’ and environmental particles, respectively. Potential gunshot residue particles are manually checked and – if necessary – confirmed by the operating forensic scientist. As there are continuing developments on the ammunition market worldwide, it becomes more and more difficult to assign a detected particle to a particular ammunition brand. As well, the differentiation towards environmental particles similar to gunshot residue is getting more complex. To keep external conditions unchanged, gunshot residue particles were collected using a specially designed shooting device for the test shots revealing defined shooting distances between the weapon's muzzle and the target. The data obtained as X-ray spectra of a number of particles (3000 per ammunition brand) were reduced by Fast Fourier Transformation and subjected to a chemometric evaluation by means of regularized discriminant analysis. In addition to the scanning electron microscopy in combination with energy dispersive X-ray microanalysis results, isotope ratio measurements based on inductively coupled plasma analysis with mass-spectrometric detection were carried out to provide a supplementary feature for an even lower risk of misclassification.

Objective: To assess the clinical validity of polymerase chain reaction (PCR) based molecular methods in the microbiological diagnosis of culture negative infective endocarditis in a group of surgically treated patients. Design: Retrospective case–control study. Setting: Reference cardiovascular surgical centre. Patients and samples: 15 culture negative patients with infective endocarditis classified according to Duke criteria, with 17 heart valve samples; 13 age and sex matched control patients without infective endocarditis, with 13 valve samples. Interventions: Medical records were reviewed and clinical, demographic, and microbiological data collected, including results of molecular detection of bacteria and fungi from valve samples. The clinical validity of molecular diagnosis was assessed, along with the sensitivity and speed of the systems. Results: In the study group, 14 patients were PCR positive (93%). Organisms detected were streptococci (3), staphylococci (2), enterobacter (1), Tropheryma whippelii (1), Borrelia burgdorferi (1), Candida albicans (1), and Aspergillus species (2). Three cases were positive on universal bacterial detection but the pathogen could not be identified because of contaminating background. One case was negative. All but two positive cases showed clinical correlations. These two cases had no symptoms of infective endocarditis but there was agreement with the surgical findings. All control cases were PCR negative. Results were available within eight hours, and if sequencing was necessary, within 48 hours. Conclusions: PCR based molecular detection of pathogens in valve samples from surgically treated culture negative infective endocarditis patients is fast, sensitive, and reliable. The technology, combined with thorough validation and clinical interpretation, may be a promising tool for routine testing of infective endocarditis.

A new method has been developed for detecting genes determining the extended-spectrum beta-lactamase (ESBL) phenotype directly from patients' clinical material. The method enables detection of the bla(CTX-M) gene encoding CTX-M beta-lactamases and the bla(SHV) gene variants with real-time PCR technology using locked nucleic acid oligonucleotides.In this pilot study, tracheal aspirates obtained from patients with mechanical ventilation hospitalized at Department of Anaesthesiology and Resuscitation of the University Hospital in Olomouc between 1st March and 30th December 2010 period were tested. Each sample was identified with standard microbiological procedures including phenotypic determination of ESBL-positive enterobacteria. At the same time, each sample was analyzed for the presence of nucleic acids (DNA) which encode CTX-M and SHV ESBL using real-time PCR.150 samples of tracheal aspirates from 71 patients were included into testing. In the set, 13 (8.7%) ESBL-positive samples were identified by culture methods while 27 (18 %) positive samples were identified by the real-time PCR method. Of the 27 PCR-positive samples, 24 were positive for the bla(CTX) gene; in 2 samples, the ESBL bla(SHV) gene was detected, and both genes were present in 1 sample. All culture-positive samples were also PCR-positive for the presence of bla(CTX) and/or bla(SHV) sequences.The new real-time PCR assay is likely to shorten the time for detection of enterobacteria producing SHV and CTX-M beta-lactamases from 48 to 6 hours. It enables ESBL-positive enterobacteria determination in tracheal aspirates of patients suffered from life-threatening nosocomial pneumonia where the early introduction of adequate antimicrobial treatment plays the important role.

Familial Mediterranean fever (FMF) is a well-described monogenic autosomal recessive disorder with highest occurrence in the Mediterranean region. In this article, we describe the experience of a center in the Czech Republic that follows four families with members bearing mutations in MEFV gene without provable ancestry from the Mediterranean region. We also discuss the clinical picture of the heterozygous variants that were present in our cohort. The typical clinical presentation in heterozygotes corresponds to data described in the international literature. The possibility of combination of mutations and/or polymorphisms in different genes and epigenetic or environmental influences on the clinical symptoms are taken into account.

In the last decade, there has been a rapid development in the use of molecular genetics methods in clinical microbiology. Novel technologies bring new knowledge and approaches to various disciplines of microbiology--taxonomy, identification of microbes, clinical diagnosis, epidemiology of infectious diseases and antibiotic resistance. This article summarizes the conclusions from the workshop of the Molecular Microbiology Working Group TIDE held during the Second Annual Meeting of the Society for Medical Microbiology of the J. E. Purkyne Czech Medical Association.

Introduction: Leigh syndrome caused by dysfunction of the mitochondrial metabolism is an inherited, heterogeneous and progressive, neurodegenerative disorder of infancy and early childhood, typically presenting with developmental regression, ataxia and muscular hypotonia. Case report:: We report on a 2½ year old boy presenting with developmental delay, behavioural disorder, weakness and ataxia. Cerebral MRI showed hyperdensity in the basal ganglia. Laboratory investigations revealed elevated lactate in cerebrospinal fluid, urine and blood (lactate/pyruvate in blood >20µmol/l). Biopsy of the muscle did not reveal any structural or biochemical abnormalities, respiratory chain analysis of complex I-IV was normal. Fibroblast examination detected heteroplasmy compared to wild type of nearly 100% of the mitochondrially encoded ATP Synthase 8 (MT-ATP8), a subunit of the ATP-Synthase-Complex V. Western Blot of the blue native electrophoresis showed an atypical elevation of the F1 subunit as previously described in patients with pathogenic ATP6 mutation. Molecular genetic analysis of the mitochondrial DNA revealed a T>C-mutation at nt. 8430 in the MT-ATP8 leading to a base replacement of leucine to proline and an A>G-mutation at nt. 8623. MT-ATP6 leading to a base replacement of threonine to alanine. The patient showed nearly 100% heteroplasmy for both mutations, compared to 50% heteroplasmy of MT-ATP8 mutation and an 80% heteroplasmy of MT-ATP6 mutation in the healthy mother. Thus, based on the high heteroplasmy and validated according to Polyphen, the MT-ATP8 mutation is considered to be pathogenic, whereas the MT-ATP6 mutation is classified benign. Whether the MT-ATP8 mutation alone or the combination of both mutations is responsible for the phenotype of our patient is to be seen. Conclusions: Our findings show that dysfunctional MT-ATP8 can cause Leigh Syndrome as already shown for MT-ATP6-mutation. The phenotypic characteristic of the MT-ATP8 mutation has to be further delineated. It is worthwhile to pursue extensive mitochondrial examination even when respiratory chain analysis does not reveal any quantitative defect.

Introduction: The Barth syndrome (MIM#302060) is a rare X-linked recessive inherited disorder, which is based on a mutation in the tafazzin gene (TAZ). The classical clinical presentation consists of a (severe) cardiomyopathy/myopathy, prepubertal growth retardation and cyclic neutropenia. Seen from a pathobiochemical point of view there is a disturbance in mitochondrial energy supply. Laboratory findings show a reduction in cardiolipin and elevated monolysocardiolipin in the mitochondria. Case report: An eight year old boy, who was seen in our department at the age of 3 ½ years with gros motor delay and dystrophy (length, weight, head circumference

Polymerase chain reaction allows a direct detection of DNA of bacterial pathogens in synovial fluid. With the help of artificially synthetized nucleotides, the so called primers, and in the presence of DNA polymerase enzyme it is possible to produce a great number of copies of the DNA being investigated and subsequently detect them. Authors used this method in 32 symptomatic knees after TKR (P.F.C. cemented type - Johnson and Johnson). Group I (pyogenic infection) comprised 14 patients. Their clinical condition required operation - extraction of TKR, debridement, spacer, lavage. All of them were PCR positive. Only 6 patients had a positive bacteriological cultivation, 8 of them were bacteriologically negative. Group II (synovialitis) included 18 patients. All of them had a negative bacteriological cultivation. Group II.a showed a slightly positive PCR reaction (mitigated infection, detection of DNA microbes incapable of reproduction). After the treatment by antibiotics the patients were without complaints. Group IIb included patients who were all PCR negative. Their case was non-bacterial irritation of synovial membrane. They had a good response to non-steroid antiflogistics. The sensitivity of PCR method is 100%, it can detect also microbes in patients treated by antibiotics. PCR method is fast providing results within 24 hours. It reliably detects the presence of bacteria in the punctate, it specifies diagnosis and contributes to the distinguishing between pyogenic infection from non-bacterial synovialitis. Key words: total knee replacement, infection.

Fragile X-associated tremor/ataxia syndrome (FXTAS) is a recently characterized adult onset neurodegenerative disorder affecting both male and female (malefemale) carriers of premutation CGG repeat expansions of the FMR1 gene. Onset typically occurs after the age of 50 years with a lifetime risk of FXTAS in males of about 1 in 3,000-6,000. Core features include progressive gait ataxia and cerebellar tremor with associated features of cognitive deficits, peripheral neuropathy and dysautonomia. The diagnosis of FXTAS is established based on clinical presentation, cerebral imaging and genetic testing. Due to the still low level of awareness of FXTAS and its variable clinical picture FXTAS is substantially underdiagnosed. However, confirming the diagnosis is essential for genetic counseling of the patients as the offspring are at risk for fragile X syndrome, premature ovarian insufficiency (POI) or FXTAS. Furthermore, many features of FXTAS can be treated symptomatically.

The original method for molecular typing of E. coli strains was developed using the polymorphism in chromosomal sequences of bacterial interspersed mosaic elements (BIMEs) detected by multiplex PCR and analysed by AFLP assay. The applicability of the method in the epidemiology of E. coli was tested on a group of 524 strains of human and veterinary origin. In the studied group 18 different genotypes were detected. Significant differences were found in the frequencies of the genotypes among various groups of strains, suggesting the method could be a promising tool in the epidemiology of E. coli.

Molecular diagnostics (detection of nucleic acids by molecular genetics techniques) become more valuable in clinical diagnosis of disease. Apart from the already long-time used genetic techniques for detection of congenital anomalies, current use of molecular techniques includes detection of microbial pathogens. The character of these techniques increases the possibility of achieving diagnosis in cases where classical cultivation is not possible, is not reliable or is not fast enough. As with every new approach, molecular diagnostics have faced encountered reactions from the scientific community. Some scientists tend to overestimate the value of molecular diagnostic techniques, while sceptics, sometimes influenced by a biased or incomplete knowledge of the technology, think it is of little value. In this work, on the basis of literature and our own data from more than 5 years of experience with these methods, we have assessed the pros and cons of the use of molecular diagnostics of infectious diseases in the light of their potential use in clinical practice.

Meat contaminating bacteria may be the direct cause of foodborne diseases and represent a potential cause for the drug resistance of human pathogenic agents. The prevalence and resistance to 17 antimicrobial drugs of isolates of selected bacterial species were investigated in 70 swabs of beef carcasses and 70 subsequent samples of beef meat. Molecular techniques (coagulase gene typing Staphylococcus aureus and original gene typing Escherichia coli) were used in the differentiation of isolates. Carcasses were already contaminated after evisceration, least frequently with S. aureus strains (7.5% of samples), most frequently with coagulase-negative staphylococci strains (52.2% of samples). During carcass processing, contamination with resistant or polyresistant strains of S. aureus and E. coli significantly increased (P

The possible causative role of novel TT virus in liver diseases has been intensively studied in regarding its hepatotrophy, ability to cause persistent infection and worldwide prevalence. The aim of this study was to estimate the prevalence as well as the clinical importance of TTV in a normal healthy population group in the Czech Republic and in a group of liver transplant recipients diagnosed with cryptogenic cirrhosis. Polymerase chain reaction (PCR) detected the DNA of TT virus in 68% (13/19) of samples isolated from peripheral blood leukocytes and in 21% (4/19) of plasma samples in the liver transplant group. The viral DNA was detected only in 11.8% (4/34) of leukocytes and in no plasma sample from the healthy population control group. All patients included in this study had good liver function and had no complications during the postoperative period. The prevalence of TTV DNA detection in healthy control group in Czech republic is similar to the rates reported in European and North American countries. Significant difference was proved between the prevalences of TTV in the groups of healthy controls and liver transplant recipients with cryptogenic cirrhosis. However, no association of TTV infection with possible postoperative complications could be found.

The method of the polymerase chain reaction (PCR) is used in the detection of septic conditions and monitoring of infectious agents in asymptomatic patients after organ transplantations and extensive cardiosurgical operations. The method allows semiquantitative and quantitative detection of bacteria, micromycetes and viruses and from the systematic quantitative follow-up of pathogen levels it is possible to draw conclusions on the prognosis of the patients condition or the success of the therapeutic procedure. The author demonstrates on practical examples of examined patients the possibilities of the method as compared with hitherto used ones. As examples two patients are quoted after surgery of a valve on account of bacterial endocarditis and three patients after transplantation of life important organs where the presence if cytomegalovirus was detected.

This paper provides an introduction to stochastic calculus and stochastic differential equations, in both theory and applications, emphasizing the numerical methods needed to solve such equations.

Up to now the exstirpation of thymus gland stands in the central position of the immuno-therapeutic strategy of myasthenia gravis promising alone the chance of total and definitive recovery in some cases. FIGURE 1. The current antigen-specific therapeutical approaches inducing autoimmune unresponsiveness to acetylcholin receptor are still in experimental phase.(ref. 1) They certainly need a rather long period until one or more of them will be applied in humans. This is the reason why the therapeutic centers elaborated new management for the therapy-resistant patients.(ref. 2, 3, 4, 5). FIGURE 2. In some dubious cases the diagnosis of myasthenia gravis and the indication of thymectomy are difficult and need a long-lasting observation. The benefit from maintaining anticholinesterase therapy, the significant respond to plasma-exchange in crisis, the secondary generalization of ocular symptoms and the electrodiagnostic tests becoming positive after some years all strengthen the indication for thymectomy. FIGURE 3. As you can see on the third figure the indication of immunotherapies other than thymectomy has pro- and contra-arguments. We used to apply these methods at thymectomy unresponders, elderly X-ray unresponders, pregnants in crisis-prone state and in anticholinesterase resistance or intolerance. The crisis tendency is the major reason for applying these expensive therapies, but decreasing the drug doses and making rare the myasthenic relapses in the interest of improving life-quality are not negligible standpoints, either. FIGURE 4. In some severe cases both the plasma-exchange and the high-dose intravenous methylprednisolon infusion as well as the repeated high-dose intravenous immunoglobulin therapy may unfortunately fail.(ref. 6, 7, 8) All these observations induced us preparing new effectual therapeutic pattern.

New immunoactive therapies, plasmapheresis, intravenous steroid pulse infusion and intravenous immunoglobulins were examined for efficacy on the basis of large casuistics of myasthenia gravis. The best results were achieved with combination of these procedures. Indications of the new methods: (i) respiratory crisis of any character (myasthenic, cholinergic or mixed oscillating crisis); (ii) the patients' preparation for thymectomy; (iii) post-thymectomy therapy aimed at improving the patients condition, at avoiding relapses, at shortening the time of steroid therapy and at repressing cholinergic drug therapy; (iv) patients of old age in crisis-prone state. The new methods, together with thymectomy, steroid therapy and immunosuppression, represent a very efficient and promising new way toward modern therapy of myasthenia gravis.

Evaluation of the results of plasmapheresis therapy is reviewed on 160 patients suffering from myasthenia gravis. This new therapeutical procedure is considered very valuable: improvement can be achieved in 63% of the patients during the therapy, a further improvement in 30% after it. Plasmapheresis is especially effective for patients in respiratory crisis-prone state, for drug-resistant cases and for preparation patients for surgery. Plasma exchange therapy may be combined with other forms of immunosuppression with benefit. Thymectomy and plasma exchange are considered to be the main therapeutical procedures in myasthenia gravis.

The authors report on experiences of treatment for superficial bladder cancer with BCG have achieved during three years. To achieve a permanent recidive prophylaxis the 6 weeks long course was repeated yearly. During the 37-12 months follow up a tumor recurrence have been observed in 10 of 49 patients (20.4%). There have not been seen any serious side-effects requering the interruption of the course or requering any antituberculotica. On the basis of their results and the torelable side-effects they recommend the local BCG treatment as a favourable possibility in prevention of bladder tumor recurrence.