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In total, 3,009 sera from a representative population sample of the Czech Republic, 1508 females and 1,501 males, were tested by EIA using a commercial kit ETI-RUBEK-G Plus manufactured by Dia Sorin, Italy. The vaccination strategy was as follows: vaccination of 12-year-old girls since 1982 and all 2-year-olds vaccinated since 1986. Currently, all women under 31 years of age and all men under 17 years of age have been vaccinated. The results of the serological survey confirmed lower seropositivity rates in young men compared to vaccinated women of the same age as expected. An epidemic outbreak of rubeola among young men is another evidence of that The seropositivity rate of 2- 9-year-old vaccinee children reaches almost 95%. The long-term morbidity trend in the Czech Republic is downward sloping, with a marked differentiation between the male and female populations.

Salmonelloses belong to the most important alimentary diseases. From 1989 the main source of infection is S. Enteritidis (95% and more). The ratio of S. Typhimurium in the etiology declined gradually since 1994 from 3% in 1993 to 1.9% in 2001. The number of detected multiresistant strains STM DT104 is so far low in the Czech Republic. In 2000 laboratory tests confirmed 53 and in 2001 a total of 63 strains. Analysis of these strains revealed: 1. the proportion of multiresistant strains STM DT104 of the total number of isolated STM strains increased from 7% in 2000 to 11.5% in 2001, 2. the territory in the CR where these multiresistant strains were found expanded, 3. the relationship of proportions of the most frequently detected STM phagotypes in the human population changes: in 2000 this ratio was balanced, in 2001 the ratio of phagotype DT104 is roughly three times higher than of DT 141, 4. analysis of all STM strains from the environment and animals indicates that the frequency of STM DT104 is 73%. Almost 90% of these strains are multiresistant (resistant to one or several antimicrobial substances). The highest number was found in calves, piglets but also in poultry. With regard to the results of the submitted work it is important to concentrate attention on detection and further laboratory examination of STM strains in the human and animal population.

The ratio of serovars of S. Typhimurium among notified cases of salmonelloses in 1999-2001 did not exceed 3% and so far has a slightly declining trend. On a long-term basis the highest morbidity rate caused by this agent is reported in the South Moravian region. The age distribution and specific morbidity is highest in 1-4-year-old children, the seasonal incidence is highest, in the summer months. The most frequently suspected vehicles are eggs, poultry and meat products, in 1999 for the first time as a vehicle a grilled piglet was reported, in a total of three epidemics. Epidemiological analysis of salmonelloses caused by S. Typhimurium revealed that in the CR individual characteristics do not differ from those caused by S. Enteritidis and that the epidemiological situation as regards this serovar is, so far quiescent.

Protein kinase C (PKC) delta becomes tyrosine phosphorylated in rat parotid acinar cells exposed to muscarinic and substance P receptor agonists, which initiate fluid secretion in this salivary cell. Here we examine the signaling components of PKCdelta tyrosine phosphorylation and effects of phosphorylation on PKCdelta activity. Carbachol- and substance P-promoted increases in PKCdelta tyrosine phosphorylation were blocked by inhibiting phospholipase C (PLC) but not by blocking intracellular Ca2+ concentration elevation, suggesting that diacylglycerol, rather than D-myo-inositol 1,4,5-trisphosphate production, positively modulated this phosphorylation. Stimuli-dependent increases in PKCdelta activity in parotid and PC-12 cells were blocked in vivo by inhibitors of Src tyrosine kinases. Dephosphorylation of tyrosine residues by PTP1B, a protein tyrosine phosphatase, reduced the enhanced PKCdelta activity. Lipid cofactors modified the tyrosine phosphorylation-dependent PKCdelta activation. Two PKCdelta regulatory sites (Thr-505 and Ser-662) were constitutively phosphorylated in unstimulated parotid cells, and these phosphorylations were not altered by stimuli that increased PKCdelta tyrosine phosphorylation. These results demonstrate that PKCdelta activity is positively modulated by tyrosine phosphorylation in parotid and PC-12 cells and suggest that PLC-dependent effects of secretagogues on salivary cells involve Src-related kinases.

A multicenter, multinational, blinded, randomized, parallel-group, phase II study was conducted to investigate the use of recombinant human tissue factor pathway inhibitor (rhTFPI; SC-59735) as an antithrombotic additive to the intraluminal irrigating solution during microvascular anastomosis in free flap reconstructive surgery. A total of 622 patients undergoing free flap reconstruction were randomly assigned to three groups. For each group, a different intraluminal irrigating solution was administered at completion of the microvascular arterial and venous anastomoses and before blood flow to the flap was reestablished: rhTFPI at a concentration of 0.05 or 0.15 mg/ml (low-dose or high-dose group, respectively) or heparin at a concentration of 100 U/ml (current-standard-of-practice group). There were no other differences in treatment among the groups. Patient characteristics, risk factors, and surgical techniques used were similar among all three groups. Flap failure was lower (2 percent) in the low-dose rhTFPI group than in the high-dose rhTFPI (6 percent) and heparin (5 percent) groups, but this difference was not statistically significant (p = 0.069). There were no significant differences in the rate of intraoperative revisions of vessel anastomoses (11 percent, 12 percent, and 13 percent) or postoperative thrombosis (8 percent, 8 percent, and 7 percent) among the low-dose rhTFPI, high-dose rhTFPI, and heparin groups, respectively. The rate of postoperative wound hematoma was significantly lower in the low-dose rhTFPI group (3 percent) than in the high-dose rhTFPI (8 percent) and heparin (9 percent) groups (p = 0.040). There were no differences in blood chemistry or coagulation values among the three study groups. Other than hematomas, there were no differences in the incidence or severity of adverse reactions among the three groups. It is concluded that use of rhTFPI as an intraluminal irrigant during free flap reconstruction is safe, well tolerated, and as efficacious as use of heparin for preventing thrombotic complications during and after the operation. Furthermore, the lower dose of rhTFPI (0.05 mg/ml) may reduce the occurrence of postoperative hematoma and help prevent flap failure.

Receptor- and nonreceptor-mediated stimuli produce increases in both PKCdelta tyrosine phosphorylation and activity in rat parotid acinar cells and other cells. In vivo and in vitro increases and decreases in tyrosine phosphorylation resulted in increases and decreases, respectively, of PKCdelta activity. These studies demonstrated that increases in PKCdelta activity by G protein-coupled receptors and other stimuli were controlled by alterations in tyrosine phosphorylation.

Occupational hepatitis B remains a threat to healthcare workers (HCWs) worldwide, even with availability of an effective vaccine. Despite limited resources for public health, the Czech Republic instituted a mandatory vaccination program for HCWs in 1983. Annual incidence rates of acute hepatitis B were followed prospectively through 1995. Despite giving vaccine intradermally from 1983 to 1989 and intramuscularly as half dose from 1990 to 1995, rates of occupational hepatitis B decreased dramatically, from 177 cases per 100,000 workers in 1982 (before program initiated) to 17 cases per 100,000 in 1995. Among high-risk workers, the effect was even more dramatic (from 587 to 23 per 100,000). We conclude that strong public-health leadership led to control of occupational hepatitis B among HCWs in the Czech Republic, despite limited resources that precluded administering full-dose intramuscular vaccine for much of the program. Application of a similar program should be considered for other countries in regions that currently do not have a hepatitis B vaccination program.

In the Czech Republic in 1989 a triple increase of the incidence of salmonelloses was recorded: 34,435 cases. Since that year the morbidity trend varies between 400 and 500 cases per 100,000 population. The dominating agent (95% and more) is Salmonella Enteritidis PT8. The epidemic incidence was recorded on the whole territory of the Czech Republic mainly in Moravia and in the East Bohemian region. The specific morbidity is highest in 0 and 1-4 year-old children. The seasonal incidence has two peaks with the exception of 1997. During the period between 1989 and 1996 there was a significant increase of epidemics of salmonellosis in conjunction with food production incl. private confectionery shops, restaurants and the sale of foods in the streets. The most important vehicle are eggs and egg products, in particular confectionery. Salmonella Typhimurium DT104 is found only rarely in the Czech Republic. The first epidemic (15 cases) developed in 1998.

In 1998 in 33 laboratories in the Czech Republic 1,223 rotavirus infections were revealed. The largest number of positive infections was recorded in children under the age of 3 years. The most frequent diagnostic procedure is latex agglutination which was used in 29 laboratories. In six departments the positive findings are reported directly to the appropriate epidemiological department. In the information system of the hygiene service, Epidat, in 1998 239 cases were reported, i.e. 19.5% of those confirmed by laboratory tests. The authors discuss the contemporary impact of rotavirus infections in the Czech Republic.

Physiological concentrations of glucose that lead to Ca2+ entry and insulin secretion activate extracellular signal-regulated protein kinases (ERK1 and ERK2) in the MIN6 pancreatic beta-cell line. Here we show that this activation is inhibited by the down-regulation of protein kinase C (PKC) and by genistein, an inhibitor of protein tyrosine kinases. In contrast with results obtained in other cell types, neither the epidermal growth factor activity nor the Src family protein tyrosine kinases seem to be involved in the Ca2+-dependent activation of ERKs. inhibition of tyrosine phosphatases by vanadate leads to the activation of ERKs. As observed in the response to glucose, this activation is dependent on Ca2+ entry through L-type voltage-dependent Ca2+ channels. Thus the activation of ERKs in response to glucose depends on PKC and possibly on a tyrosine kinase/tyrosine phosphatase couple. To define the role of ERK activation by glucose we studied the regulation of transcription of the insulin gene. We found that this transcription is regulated in the MIN6 cells in the same range of glucose concentration as in primary islets, and that specific inhibition of mitogen-activated protein kinase kinase, the direct activator of ERK, impaired the response of the insulin gene to glucose. This was observed by analysis of the transfected rat insulin I gene promoter activity and a Northern blot of endogenous insulin mRNA.

In routine systems investigating the morbidity according to diagnosis it is very useful to analyse the development in time (for example the development of weekly reports). This paper is concerned with the methodology of such analyses. In practice it appears that the number of cases depends on season. It stands to reason, that it is necessary to consider also long-term trends. In this paper two different approaches are discussed--the Box-Jenkins analysis, which describes the random error and the Method of Trend Decomposition which spread the number of cases into the systematic component (long term trend and seasonal effect) and random variability. The authors describe the method of smoothing the estimate of the time series by kernel estimate. In both approaches they use weekly reports from the whole Czech Republic of diagnoses viral hepatitis A, rubella and salmonellosis.

Over a 6-month period, 23 members of the International Microvascular Research Group participated in a prospective survey of their microvascular free-flap practice. Data were recorded with each case for 60 variables covering patient characteristics, surgical technique, pharmacologic treatment, and postoperative outcome. A total of 493 free flaps were reported with a representative demographic distribution for age, sex, indications for surgery, risk factors, flap type, surgical technique, and pharmacologic intervention. Mixed effects logistic regression modeling was used to determine predictors of flap failure and associated complications. The overall incidence of flap failure was 4.1 percent (20 of 493). Reconstruction of an irradiated recipient site and the use of a skin-grafted muscle flap were the only statistically significant predictors of flap failure, with increased odds of failure of 4.2 (p = 0.01) and 11.1 (p = 0.03), respectively. A postoperative thrombosis requiring re-exploration surgery occurred in 9.9 percent of the flaps. The incidence of this complication was significantly higher when the flap was transferred to a chronic wound and when vein grafts were needed, with increased odds of failure of 2.9 (p = 0.02) and 2.5 (p = 0.02), respectively. There was a lower incidence of postoperative thrombosis when rectus/transverse rectus abdominis muscle (TRAM) flaps were used, where odds of failure decreased by 0.36 (p = 0.04), and when subcutaneous heparin was administered in the postoperative period, where odds decreased by 0.27 (p = 0.04). There was an overall 69-percent salvage rate for flaps identified with a postoperative thrombosis. Intraoperative thrombosis occurred in 41 cases (8.3 percent) and was observed more frequently in myocutaneous flaps or when vein grafts were needed (5.5 and 5.0 greater odds, respectively; p < 0.001) but was not associated with higher flap failure (2 of 41 cases; 4.9-percent failure rate). The incidence of a hematoma and/or hemorrhage was increased in obese patients and when vein grafts were needed [2.7 (p = 0.02) and 2.6 (p = 0.03) greater odds, respectively], whereas this complication was significantly decreased in muscle flaps (myocutaneous or skin-grafted muscle), in tobacco users, when a heparinized solution was used for general wound irrigation, and when the attending surgeon performed the arterial anastomosis (in contrast to the resident or fellow on staff) (p < 0.05 for each factor). With the multivariable analysis, many factors were found not to have a significant effect on flap outcome, including the recipient site (e.g., head/neck, breast, lower limb, etc.); indications for surgery (trauma, cancer, etc.); flap transfer in extremes of age, smokers, or diabetics; arterial anastomosis with an end-to-end versus end-to-side technique; irrigation of the vessel without or with heparin added to the irrigation solution; and a wide spectrum of antithrombotic drug therapies. These results present a current baseline for free-flap surgery to which future advances and improvements in technique and practice may be compared.

Infection by Toxoplasma gondii is asymptomatic, leading to an immune response that controls the disease. In immune-compromised patients, however, quiescent cysts can reactivate, leading to toxoplasmic encephalitis. We studied the infection of cells of the central nervous system in an attempt to understand the process leading to this complication. Primary cultures of rat hippocampal glial cells and neurons were infected with the virulent strain RH and examined by immunofluorescent microscopy after fixation of cells and staining with antibodies specific to the different cell types. After 24 h of infection, glial cells were highly infected and showed active division of the parasite. Neurons, on the other hand, were much less efficiently infected than glial cells, but actual penetration of the parasites was demonstrated by confocal microscopy. Whereas glial cells contained vacuoles with several parasites, the vacuoles observed in neurons usually contained one parasite or, rarely, two, indicating that the parasites inside neurons did not undergo active division. This was corroborated by determination of the incorporation of [3H]-uracil. Little is known about the mechanism of neuronal infection by Toxoplasma. The experimental setup used in this study should help to improve our understanding of neuronal infection and bring insight into the physiopathology of toxoplasmic encephalitis.

The assumption that the amount of rainfall in the summer months influences the frequency of TBE is based on the fact that the determining factor for the existence, development and activity of Ixodes ricinus is relative air humidity (RH) and the finding that low RH negatively influences dynamics of infection and infection rate of I. ricinus with TBE virus. A higher incidence of TBE then develops due to the coincidence of increased activity of ticks and recreational activity of humans after an intense prolonged rainfall. This presumption was verified by comparing the dynamics of rainfall as an indicator of RH in the tick environment with concomitant seasonal fluctuations of TBE incidence in humans. The total monthly rainfall in two regions of the Czech Republic was compared with data on the incidence of TBE in each respective region and period. Furthermore, in the district of Ceské Budĕjovice, typical by high prevalence of this disease, a detailed follow-up was carried out by decades. The comparisons were made between April and October from 1993 to 1995. The values of both variables were related to their long-term averages estimated within each particular period and region. Monthly data were analyzed for the Central Bohemian Region and the South Bohemian Region, both with a high incidence of TBE. The July above-average incidence of TBE was preceded by an above-average rainfall in June. If there was a below-average rainfall, there was a below-average incidence of TBE afterwards. Whenever, there was an above-average rainfall in August then there was an above average incidence of TBE in September, in the opposite case, no September peak of TBE occurred. The follow-up at ten-day intervals shows that any above-average rainfall was followed by an increased incidence of TBE, in every other ten-day period or two. This time shift is due to the incubation period, and partly also to the scattered attacks by ticks during the period of increased RH. The relationship found could be useful for the short-term prognosis of TBE incidence as well as for individual prevention of this serious infection by taking special care when going outdoors after heavy rain.

The src family protein tyrosine kinases (PTKs) are nonreceptor kinases. Some PTKs of this family are ubiquitously expressed, whereas others have a more restricted expression, as in neurons. Lymphoid cell kinase (lck) p56lck is highly expressed in tissues of lymphoid origin and believed to be specific for hematopoietic cells. Reports suggesting that CD4 is expressed in neurons prompted us to analyze the possibility that p56lck is also expressed in these cells. By western blot and immunoprecipitations using anti-lck antibody, an lck-like protein was detected in lysates from primary cultures of rat cerebellar granular neurons. This 56-kDa phosphoprotein was autophosphorylated in vitro and also phosphorylated enolase, similarly to p56lck. It was shown to be located actually in the neurons by immunocytofluorescence. Partial proteolysis mapping showed that the 56-kDa phosphoprotein had a peptide pattern very similar to the p56lck protein. Retrotranscription-PCR allowed the detection of an lck RNA in the neurons. The lck kinase domain was completely identical to the lymphocyte lck kinase domain, but the 5' end was modified in the neurons. These results show that p56lck is not lymphoid specific as is widely believed; its expression in neurons might underlie the toxicity of the HIV glycoprotein gp120 to neurons.

Mitogen-activated protein (MAP) kinases have been implicated in multiple responses to extracellular stimuli. In this study we show that MAP kinase activity is enhanced after a KCl pulse. This activation correlates with an increased tyrosine phosphorylation of a 42-kDa protein as determined by antiphosphotyrosine immunoblot. The same band is found in an anti-MAP kinase immunoblot. Activity is enhanced within 1 min, reaches a maximum at 2 min, and returns to basal level after 10 min. A second peak of activity is observed between 12 and 30 min. The activation is completely blocked by 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), showing the involvement of the AMPA type of glutamate receptor. Partial inhibition of MAP kinase activation by 2-amino-5-phosphonovalerate (APV) also shows the involvement of the NMDA receptor. Because the KCl pulse used induces long-term potentiation (LTP) in rat hippocampal slice, we conclude that MAP kinase may be involved in neuronal transduction events leading to LTP.

The "repression phase" of paralytic poliomyelitis in the Czech Republic (and in the Slovak Republic as well) between 1957 and 1960 was characterized by controlled, short term, mass vaccination campaigns. In spring 1957, at the very beginning of a polio epidemic, about 87% of all children aged 1 to 7 years and about 40% of those aged 8 to 15 years were intradermally vaccinated with IPV. The protective effect in population given two IPV doses was 66% (in Slovakia 74%). The starting epidemic of 1957 was stopped. Morbidity and mortality from poliomyelitis markedly decreased in 1958. Nevertheless, about 39%, 13% and 41% of children aged under 8 years (given three IPV doses) had not specific virus-neutralizing antibodies against polioviruses types 1, 2 and 3 respectively. A field trial with OPV started in winter 1958-59. Over 110,000 children aged 2 to 6 years were vaccinated with Sabin OPV, which proved to be safe, highly immunogenic and protective. In spring 1960 about 93% of children were vaccinated in the former Czechoslovakia with OPV in a mass, countrywide campaign. No case of paralytic poliomyelitis was reported during the second half of 1960. The same was true for all year 1961, the first year of the historical period of poliomyelitis elimination in our country.

The first large epidemic of poliomyelitis in (previous) Czechoslovakia was recorded in 1939. It affected only the western part of the state, Bohemia, with a relatively high morbidity and mortality, 25.42 and 2.05 per 100,000, respectively, the death rate being 8.1%. In Prague, children aged between 5 and 9 years represented 41.5% and those up to 14 years 84% of all cases of poliomyelitis. Other epidemics followed in 1943, 1948 and 1953 affected Moravia and Slovakia as well. The highest death rates were in the interepidemic periods, the lowest ones were recorded in the epidemics. During the "epidemic phase" between 1939 and 1956, 12,868 cases of poliomyelitis and 1,159 deaths from poliomyelitis were reported, the mean death rate value being 9.0%. General hygiene measures, passive immunization with specific convalescent human sera and intranasal "chemoprophylaxis" tried then on a large scale, did not show any demonstrable antiepidemic effect.

1. The present study evaluated the safety and efficacy of two dosages of SC 48,274 (1mg and 25mg) as compared to placebo in subjects with Generalized Anxiety Disorder (GAD). 2. This was a randomized, double-blind, placebo-controlled, parallel-group study which was part of one of three large multicenter trials which evaluated a total of 5 doses of SC 48,274 (.25, 1, 5, 25, and 100mg bid). Following a 7-day placebo baseline period, patients entered 4 weeks of double-blind treatment and a 7-day placebo follow-up period. 3. Efficacy was assessed weekly throughout the study with the Hamilton Anxiety Rating Scale (HAM-A), and Clinical Global Impression (CGI), and at treatment endpoint with the Covi Anxiety Scale, Raskin Depression Scale and Hamilton Depression Rating Scale (HAM-D). A diagnosis of GAD according to DSM-III-R criteria (with the exception that a GAD minimum duration of 3 months was allowed), a HAM-A score > or = 20 (anxious mood and tension items > or = 2), HAM-D less than HAM-A, Covi Anxiety Score > or = 8, Raskin Depression Scale less than the Covi Anxiety, and age of 18 to 65 years were necessary for inclusion in the study. 4. Patients received one of two dosages of SC 48,274, either 1mg (n = 28), 25mg (n = 9), or placebo (n = 28) bid, during the 4-week randomized portion of the trial. 5. Mean changes from baseline in HAM-A scores for the 1mg, 25mg, and placebo groups after 4 weeks treatment were -5.1, -4.2, and -1.9, respectively. Changes were significant for the 1mg group vs. placebo (F = 8.93, p = 0.004), but not for the 25mg group (F = 2.26, p = 0.138). 6. CGI severity of illness scores were also significant for the 1mg group versus placebo at the end of treatment (X2 = 3.8, p = 0.05), but not for the 25mg group (X2 = 0.90, p = 0.343). Neither group showed significant CGI improvement scores by end of treatment. 7. The most frequent adverse events associated with the study drug (n = 37) were headache (n = 7), nausea (n = 3), palpitations (n = 4) and chest pains (n = 2). There was, however, no apparent pattern of adverse events distinguishing SC 48,274 from placebo.

The authors discuss the incidence of salmonelloses in the Czech Republic and analyze changes which developed during the period from 1989 to 1993. In 1989 a steep rise of cases of salmonellosis was recorded; 34,435 cases were notified which, as compared with the previous period, is a threefold rise of the incidence. This trend persists already for five years. So far the largest number of notified cases (43,558) was recorded in 1992. The death rate and case fatality rate from salmonellosis has been low for some years: the number of deaths is approximately 20-25 people per year. The salmonellosis epidemic in 1989-1993 spread to all regions of the Czech Republic. The most heavily affected regions are the South Moravian, North Moravian, East Bohemian and West Bohemian region. As to age distribution, it was revealed that the highest values of specific morbidity are in children in their first year of life and in 1-4-year-olds and that the greatest increment in 1989-1993 was notified in 1-4-year-old and in 5-9-year-old children. The dominating aetiological agent was Salmonella enteritidis, probably phagotype 8. Its ratio in the isolation of Salmonella strains is 87%. The largest number of epidemics in 1989-1991 was notified in communities with a communal catering type (workers canteens, catering for nursery schools and schools) and in communities where half the epidemics developed during family festivities (weddings, graduation, funerals, birthdays, pig-slaughtering feasts etc.). During the last two years the number of epidemics which develop in workshops producing foods and in private confectionaries is rising.(ABSTRACT TRUNCATED AT 250 WORDS)

The authors review the incidence of trachoma in the Czech Republic during the last 20 years. Trachoma has become almost exclusively an imported disease. In 1989-1990 the authors treated 34 foreign nationals with imported trachoma at the Infectious Diseases Clinic in Prague. Even after many years' stay in the Czech Republic foreigners may develop exacerbations of the trachomatous process.

In the first half of 1993 an increased incidence of invasive meningococcal disease was recorded in the Czech Republic. In the CR a total of 59 cases were revealed, incl. 10 fatal ones. This high lethality (16.9%) is markedly higher than that from 036 recorded in this country during previous years. The highest incidence and death rate was recorded in the North Moravian region and in the age group from 15-19 years. Based on active surveillance of the invasive meningococcal disease by epidemiologists, microbiologists and infectiologists of the entire Czech Republic, it may be concluded that the sulphonamide sensitive strain Neisseria meningitidis C:2a:P1.2 caused in the North Moravian region a local epidemic of invasive meningococcal disease in the army and civilian population. In other regions of the CR the epidemiological situation in the first half of 1993 did not differ from the previous period: sporadic incidence of meningococcal disease, prevalence of the serological group B, highest incidence in the youngest age groups. The meningococcus C:2a:P1.2 was not detected in the CR before 1993. This uncommon epidemiological situation was resolved by immunization, aimed from the antigenic aspect and with regard to age and locality.

The incidence of poliomyelitis in the Czech Republic shows four epidemiologically different phases recorded during a lifetime of one human generation: endemicity (until 1938), epidemicity (1939 to 1956), repression (1957 to 1960) and elimination (1961 till now). The phase of the endemic incidence of poliomyelitis studied in this paper finished in 1938. Since 1919 when poliomyelitis notification was started, three waves of increasing though low mortality were observed: in 1926, 1932 and 1936 (0.27, 0.43 and 0.38 per 100,000, respectively). Between 1919 and 1938 the mortality increased in children over one year but it remained relatively highest in infants under one year of age. The poliomyelitis death rates were high between 1928 and 1938, 23.6% on the average. Such high rates might be attributable to the underrated morbidity cases in comparison with a rather reliably notified polio mortality. The period between 1919 and 1938 represented the end of the endemic incidence of poliomyelitis in the Czech countries, and it could be considered as preepidemic.

The submitted paper analyzes the treble increase of the annual incidence of salmonelloses in the Czech Republic in 1989-1991. It deals with the seasonal distribution of notified morbidity (it is highest in August, September, October), the age distribution (it is highest in 0-4-year-old children) and the geographical distribution (the most affected areas are the eastern Bohemian, southern Moravian and northern Moravian regions). The authors emphasize the high ratio of S. enteritidis in this rise (the ratio of S. E. increased from 55% in 1988 to 84% in 1991). They analyze the notified mass incidence of salmonelloses, where one third is accounted for by catering establishments of the so-called closed type; in 1989-1991 the highest ratio of salmonelloses was in works canteens. The authors confirm that the epidemic rise of salmonelloses in 1989-1991 is associated with the consumption of contaminated eggs, similarly as in other parts of the world. The most frequent vehicle of infection revealed in the Czech Republic are eggs, their products, in 1991 in particular confectionery and fancy cakes.

During 1990 and partly also 1991, after a practically 10-year zero incidence of measles on the territory of the Czech Republic a measles epidemic broke out. The most severely affected group were adolescents aged 15-19 years who were immunized only by a single dose of vaccine. Conversely the lowest morbidity was recorded in 2-9-year-old children who were immunized already with two doses. The cause of the epidemic was primary failure of the vaccine leading to a low level of collective immunity in some population age brackets. The authors discuss and explain the strategy of immunization against measles involving two doses of vaccine after a 6-10-month interval. In the conclusion possibilities to achieve permanent elimination of measles on our territory are discussed.

In a group of 38 patients with the Guillain-Barré syndrome (SGB) and a group of 38 patients selected at random who suffered from meningoencephalitis the authors compared the characteristics by age, sex, onset of the disease (month of the year) and intervals between the onset of the disease and collection of serum samples. Using the neutralization microtest, the sera were examined for antibodies against 23 serotypes of enteroviruses incl. polioviruses. The groups differed significantly in the following indicators: the SGP group had a non-seasonal annual distribution, it included different age groups, there were longer intervals of sample collection. There were fewer cases with an assessed enteroviral aetiology, no case with a polioviral aetiology. More detailed analysis of serological results revealed, that the group does not differ fundamentally as regards the immunological experience of individuals with enteroviruses before the disease. The authors discuss the need of more detailed examinations of the enteroviral aetiology in all cases of SGB.

The authors analyze the epidemic incidence of alimentary infections of bacterial origin in two periods: 1979-1983 and 1984-1988 and 1989 resp., where in each period the number of notified epidemics of different infections equals 100%. During the period 1984-1988 as compared with 1979-1983, there was a decline in the number of epidemics of salmonelloses in health institutions from 42% to 14%, whereby almost half these epidemics were caused by Salmonella agona spread via dried milk. Conversely there was an increase in the number of epidemics of salmonelloses in communities from 14% to 23% and in works canteens from 9% to 14%. In 68% of the latter Salmonella enteritidis dominated. In 1989 there was a potent increase epidemics of salmonelloses. In 86% of the notified epidemics Salmonella enteritidis was the aetiological agent. A quarter of these epidemics developed in works canteens and half the affected subjects were ill. The transmission occurred via poultry meat and egg products. The annual incidence of bacillary dysentery after 1985 has a declining trend, the epidemics persist in nursery schools, summer camps for children and are increasing in institutes for social care. The number of alimentary intoxications is rising in recent years, in particular in school and works canteens. The number of 008 epidemics in 1984-1988 declined in health institutions from 52% to 20%. 17% of the epidemics developed in schools and camps for children.

In a retrospective study the authors analyzed 76 cases of botulism reported in 1961-1989 in the Czech Republic. The analysis of descriptive data pertained to the annual incidence of botulism with a maximum of cases in 1966, 1973 and 1984 (11, 7 and 6 cases); geographical distribution with a maximum incidence in the South and Central Bohemian region (100,000 population); age distribution with a predominance in subjects above 15 years. The dominating vehicle of botulism was in 61% of the notified cases a home-prepared food; usually a galantine, aspic, liver paste, pork with vegetables, and smoked pork. In 1966 and 1973 a processed food predominated as vehicle: pickled herring and tomato, red peppers and sausage. The results of the retrospective study were compared in the discussion with the problem of botulism in other countries. The authors discuss the danger of undetected botulism and the necessity of an anti-botulin serum (Bossea).

The authors give an account of the development of the definition and context of epidemiological surveillance during the past decades in Czechoslovakia and in the world. They analyze views of epidemiologists who contributed in a major way to the modern concept of surveillance. The concept of surveillance reflects social conditions in the widest sense of the word and its contents are and probably will also in future be the subject of lively discussions. The authors assume that in the near future a more important part will be played by an active approach to surveillance of infections, as no modern system of health care can do without its development. Contemporary social changes will play a decisive role.

Animal studies and the original study comparing buspirone with diazepam and placebo indicated that sedative-hypnotic side effects and impairment in psychomotor function would be less with buspirone than with diazepam. This was borne out by the present double-blind study in which almost 700 patients received buspirone. Mean daily doses were buspirone, 20 mg; diazepam, 20 mg; and clorazepate, 24 mg. Sedation, lethargy, and depression were significantly less with buspirone than with diazepam or clorazepate and were comparable to placebo. There was no indication that other types of side effects would differ significantly from those seen with the benzodiazepines. Nervousness, headache, and dizziness were experienced more frequently with buspirone than with placebo.

In result of 20 pregnancies complicated by varicella 11 healthy and 6 defective offspring were born, 2 pregnancies were aborted by the physician and one pregnancy terminated by stillbirth of 3 siblings. Laboratory investigation of 16 pregnancies has shown that transplacental transfer of varicella-zoster (VZ) virus did not occur in 13 cases (81.2%). In 3 cases transplacental transmission of VZ virus was not inconsistent with the laboratory results, clinical course, and epidemiological analysis. Intrauterine VZ virus infection was suggested in one typical case of congenital varicella syndrome and in one healthy newborn according to the presence of high serum antibody levels at the time of maternal antibody decline. In the third case, VZ virus antigen was detected by indirect immunofluorescence in the foetal skin tissue after medical abortion.

At present epidemiological informations are dispatched from epidemiological departments of regional hygiene stations in different forms to different departments. The separate follow up of partial information leads to the development of different isolated information systems. Individual information systems help to resolve information problems in epidemiology, they provide, however, only limited opportunities when causal relations are sought and applied in the control of diseases. Surveillance calls for a uniform information system which concentrates scattered information in a single epidemiological centre. The author formulates possible approaches to the solution of the information problem in epidemiology.

On the example of existing information systems of communicable diseases the authors analyze the possibilities of and draw attention to the obstacles of their wider use. The following information systems are involved: ARO (acute respiratory diseases), APO (acute diarrhoeal diseases), ISBT (information system of bacillary tuberculosis), ISPO (information system of communicable diseases), ISID (information system of child immunization). In the general evaluation the authors draw attention to the demand to do away with the scattered character of the system and the necessity of delimitation of the responsibility for the establishment and operation of the information systems. The authors indicate the future desirable development.