[Changes in the quality of life after cataract surgery]

The questionnaire VF-14 is one of the most frequently used methods for exploration of patients' subjective evaluation of cataract surgery outcomes. In this study, the answers of 349 patients' were evaluated. These respondents completed the questionnaires before cataract surgery and again after 6 months. When the postoperative questionnaires were filled-in, 196 respondents had one eye operated on (group A), and 153 had both eyes operated on (group B). All cataract surgeries were performed by phacoemulsification. The complication--rupture of the posterior capsula--occured in 0.8%. In 26.7% patients an accompanying secondary eye disease was found. The average VF-14 index was 63.5 (SD 21.32) in group A and 59.4 (SD 22.62) in group B. After the surgery the VF-14 index increased significantly--in group A was the average 80.6 (SD 20.47) and in group B even higher 87.2 (SD 16.14). The change of VF-14 index prior to and after the operation was proven to be statistically significant both in group A and in group B (p < 0.001). The improvement of the VF-14 index was found in group A in 80.6% and in group B in 88.9% of respondents. The patients' satisfaction with their vision after cataract surgery was highly increased. The outcomes of the questionnaire study document the high success rate of cataract surgery for patients.

[Lyme borreliosis--incidence of serum anti-myelin antibodies]

The method of enzyme immunoassay (ELISA) was used for detection of antibodies against the basic protein myelin (antimyelin antibodies) for a group of serum samples (n 36) with positive anti-borrelia immunoglobulins IgG and IgM (ELISA-Borrelia afzelii) and their immune complexes (ELISA-PEG). Antimyelin antibodies (ELISA-Doxa Kit-Myelin Basic Protein Antibodies) were assessed in 31% (n 11) of examined serum samples of patients with the working diagnosis of Lyme borreliosis. Statistical analysis (p 0.07) confirmed a more frequent incidence of antimyelin antibodies in younger female subjects (age 31 years) as compared with a group of sera (n 25) where the authors did not record the formation of immunoglobulins against the basic myelin protein (age 51 years). Neither the value of titres nor the frequency of detected anti-borrelia IgG and IgM and immune complexes did not differ significantly in the two groups. From the assembled results ensues that in the course of Lyme borreliosis, in chronic affection of organs an autoimmune reaction may develop where the basic myelin protein is damaged (demyelinizatio) and subsequently antimyelin antibodies are formed.

Conformal radiotherapy for prostate cancer--longer duration of acute genitourinary toxicity in patients with prior history of invasive urological procedure

The incidence and predictors of acute toxicity were evaluated in patients treated with three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer. Between December 1997 and November 1999, 116 patients with T1-T3 prostatic carcinoma were enrolled in the study. Ninety patients were treated with 70 Gy and 26 patients with T3 tumors received 74 Gy. Of the 116 patients 42 (36.2%) had a prior history of invasive urological procedure (IUP) (transurethral resection of the prostate or transvesical prostatectomy for benign prostatic hyperplasia). Acute gastrointestinal (GI) and genitourinary (GU) symptoms were graded according to the EORTC/RTOG scoring system. Toxicity duration after the completion of 3D-CRT was recorded. The majority of patients experienced only mild or no (Grade 1) acute toxicities. Medications for GI and GU symptoms (Grade 2) were required by 28.4% and 12.9% of patients, respectively. Only one case of Grade 3 GI toxicity (0.9%) was observed. Seven patients (6.1%) experienced severe GU toxicity (Grade 3 or 4). No correlation was found between acute toxicity and age, stage, dose (70 Gy vs. 74 Gy), IUP and pelvic lymphadenectomy. A significant relationship was observed between the duration of acute GU toxicity and prior IUP. Symptoms persisted for more than 4 weeks in 51.9% and 26.0% of patients with and without a prior history of IUP, respectively (p = 0.02). The incidence of acute complications, associated with 3D-CRT for prostate cancer, was acceptable in our cohort of patients. A prior history of IUP resulted in a significantly longer duration of acute GU toxicity.

[Criteria for evaluation of immunoblots using Borrelia afzelii, Borrelia garinii and Borrelia burgdorferi sensu stricto for diagnosis of Lyme borreliosis]

The immunoblot was prepared from genotypes Borrelia afzelii (KC 90), Borrelia garinii (M 192) and Borrelia burgdorferi sensu stricto (B 31). Sera of 63 patients with different forms of Lyme borreliosis were examined and 40 healthy donors in the endemic area of the disease. In class IgM in the group of patients significantly more frequently antibodies against OspC, p39, p41 B. afzelii, p39, p41, p66, p83 B. garinii and OspC1, OspA, B. burgdorferi sensu stricto were found. In class IgG there were antibodies against p39, p41, p93 B. afzelii, p14, p41, p93 B. garinii and OspA, OspC p93 B. burgdorferi sensu lato. Based on the assembled results by means of discrimination analysis and logistic regression the most suitable combinations of antigens for evaluation of immunoblots in different genotypes were determined. Furthermore evaluation was suggested using a combination of antigens of several genotypes which led to an increased sensitivity and specificity of the immunoblot. Tables were prepared for easier evaluation of newly examined sera samples.

[Angiogenesis in breast carcinoma. Immunohistochemical study of 142 cases]

Due to the fact that capillary vessels provide not only supply of nutrients to the tumor but also represent a gate for lymphogenous and hematogenous metastatic spreading of the tumor, angiogenesis has gained increasing attention in recent years. The aim of the project was: 1. to study number of capillaries in the tumor and its relationship to the metastatic potency and prognosis and 2. to analyse the differences in the quantity of the capillaries between the groups of tumors with or without previously performed aspiration biopsy. 142 cases of breast carcinoma diagnosed at the Fingerland's Department of Pathology in the years 1997-98 were examined. Endothelial cells were visualized immunohistochemically using an antibody against factor VIII (von Willebrand factor). Capillary vessels were counted at 200x magnification (using eyepiece graticule) in the areas of highest angiogenic activity (hot spots), usually at the periphery of the tumor. The highest microvessel counts (HMC) were correlated with other factors (age, tumor size, grade, nodal status, expression of hormonal receptors, proliferative activity, p53, HER-2/neu). The differences between the tumors with and without previous aspiration biopsy were analyzed. All patients were women aged 31-86 years (median 59). The size of tumors was 4-70 mm (median 20 mm). Sixty cases have been previously examined by fine needle aspiration cytology; 72 cases were node-positive. HMC values varied from 26 to 185 (average 63.9, median 60) per microscopic field (area 0.24 mm2). The HMC was significantly higher in node-positive tumors (median 57.5 versus 66; p = 0.036). The capillary vessel counts did not correlate with other parameters examined. Fine needle aspiration cytology does seem to increase the number of intratumoral capillary vessels only for a transitory period. We have also compared HMC/mm2 in normal breast tissue with counts in carcinoma. Interestingly, the values in normal lobules, were significantly higher (median 565 versus 243; p < 0.0000001).