Polish heart surgeons excel at cardiac operations
27.1.2006 - Michal Zajac

Poland's heart surgeons are among the best in the world. Just a decade ago waiting lists of patients in need of heart surgery were far longer than in most European countries, but now that reputation has been turned round. There are Polish doctors who specialize in certain rare operations, Polish medical universities are teaching students from around the world, and patients from different countries are also opting for Polish hospitals.

Michal Zajac traveled to southern Poland, where he visited the 2nd Cardiac Surgery Clinic in Katowice to find out what lies behind this remarkable evolution.

Doctor Marek Jasinski specializes in heart valve repair operations. He and his colleagues at the Medical Centre in Katowice, share their expertise and knowledge in courses attended by fellow cardiologists and heart surgeons from all over the world.

"For the last five years, we have been organizing international meetings and during those courses new developments in cardiac techniques are presented and discussed."

Professor Robert Jones of Duke University in the United States agrees that Polish cardiology and cardiac surgery centers, like the one in Katowice, are among the world's leading institutions in the field:

"They are certainly comparable and some kind of lead the other centers. I've been very impressed with what I have seen in Poland. We have recruited eight Polish centers and each one of them has performed admirably, not only in the number of patients that they have entered but in the high quality work that they have done and the data that they have provided. In fact, they are the leading enrolling center into this world-wide study, which randomizes patients between a medical and a surgical strategy and if they get surgery there is a special way of doing it as well. We have 26 countries and 110 sites around the world. Poland is leading this group."

Doctor Marek Jasinski explains where the progress of Polish cardiology and cardiac surgery lies:

"The most important achievement of Polish cardiology or cardiac surgery is actually the opportunity to use all new developments for our patients. The introduction of all modern technologies has been the biggest achievement of the last decade to the extent that we have acquired our own experience, allowing us to share it with other for example during international congresses and courses."

Progress in Polish cardiology and cardiac surgery has been remarkable in the last decade. The number of operations carried out is comparable with that in Western Europe. Specialists have developed their own techniques for dealing with certain heart problems. They treat arrhythmia with electro magnetic waves or low temperature, thanks to which 80% of patients can be cured. Equipment has been developed, which assesses the condition of vessels in and around the heart with 90% accuracy and helps to anticipate the heart attacks. The rate of successful post heart attack operations has more than tripled in the last five years. While in the early 1990s 30% of patients treated for narrowing of the arteries had the same problems six months after undergoing surgery, today this is the case with just 4% of patients. More progress in Polish cardiology is imminent with efforts to create an artificial heart developing fast.

Jacek's grandfather died following a bypass operation 10 years ago. Now his chances of surviving would be much higher.

"I am visiting a cousin. He's had successful bypass surgery in this hospital. Before the operation we were terrified because our grandfather had died after such a surgery. But my cousin will live."

Unfortunately, these reassuring developments have not motivated Poles to take better care of their own hearts. Doctor Marek Dejna explains what we can do to prevent serious cardio-vascular disease and reduce our likelihood of becoming patients of cardiology wards:

"Definitely the number of procedures and the number of patients being served is growing in Poland but still we have waiting lists. The most important thing is to stop smoking, if you do. Generally we cannot do much about the fact that we are growing older. But we may modify the so-called risk factors that may cause to atherosclerosis to progress faster. So a degree of daily physical activity is important. The proper diet and watching your own hypertension is also important. For example one glass of wine daily. But everything in moderation."

Hungary's "tensio arteriograph" - a simple way of examining our veins
27.1.2006 - Sandor Laczko

Cardio-vascular disease is the leading cause of death in Hungary and much of the rest of the world. Problems are often detected too late because many people do not suffer obvious symptoms. Even suspect cases can be difficult to confirm. But that may soon be history thanks to a new device invented by Hungarian doctor Miklos Illyes.

The "tensio arteriograph" is the first and so far only device that provides us with a fast and easy way of obtaining cardiac data that in the past could only be obtained through complicated and sometimes painful screenings.

"The medical profession was lacking a proper method to determine these data, called 'arterial stiffness parameters', namely, the augmentation index and the pulse rate velocity of the human aorta. So, this method before was determined by very specific procedures, very difficult methods, which needed a lot of time and a lot of expert knowledge of how to perform the examination."

Says, doctor Miklos Illyes, the inventor of the tensio arteriograph. So how does it work? It's much simpler than one might expect. The arteriograph detects the condition of our veins in a procedure that's just as easy as taking our blood pressure.

"We discovered a new method how to assess the so-called arterial stiffness non-invasively with a very fast method, which needs only two minutes to determine the arterial age of the patient. This novelty consists of the fact that we use a simple cough to determine important central human dynamical parameters. This makes it possible for us to use this method for everyday practice and to screen the patient for arteriosclerosis. We do feel that in a few years, this kind of method will be used generally not only to check blood pressure but to have much more information about arterial stiffness beyond blood pressure measurement."

Dr. Laszlo Tisler of the St. Imre Hospital in Budapest was one of the first physicians to use it:

"My experience over all is very positive. It uses a very new way of assessing the compliance of large blood vessels. This information is substantial because it is associated with the survival of our patients - in particular, with patients of higher cardiovascular risk. The information this device provides is extremely helpful in those with high risk, and this may add new information, information on compliance of the vessel, or stiffness of the vessel, may provide information on those who have no other risk factors and this may be a very early sign of cardiovascular risk."

In Hungary, over a dozen arteriographs are already in use and Dr. Miklos Illyes believes the device will soon become popular all over the world:

"I'm invited very often by international societies like the Hypertension Society of Austria, or of the Czech Republic and many other countries. And also, my presentation was done in San Francisco in the United States. So, it seems that the world starts to understand that this method indeed provides much more information much more easily than formerly used methods."

Austria's search for a cure for AIDS
27.1.2006 - Kerry Skyring, Genie Johnson

A new born baby at Vienna's general hospital. The parents are relieved - it's apparently healthy. And its chances of a long life are good as it's been born into a wealthy society where even feared diseases like Aids can be treated. But if it was born in almost any country in sub-Saharan Africa its prospects would be far less hopeful. In fact there's a good chance it would contract the HIV virus which causes aids from its mother.

Tony Barnet from the London School of Economics studies the social impact of the AIDS epidemic:

"It makes people die prematurely and they leave orphans behind. And those orphans also contract aids and die prematurely. And I guess that now in the 25th or 30th year of the epidemic - for it's that long that it has been going on - in Africa certainly - we're seeing orphans of orphans of orphans. And at each stage of the orphan process we are breaking the bonds of human society."

This laboratory at Vienna's Institute of Applied Microbiology is leading the fight against the spread of HIV - AIDS. Of the world's four known Anti-bodies against AIDS - three of them were discovered here. They have show great promise in preventing the transmission of the HIV virus from mother to baby during and after birth. So far tests have only been carried out on monkeys but scientists like Herman Katinger want to take the next step.

"First passive immunisation of babies and what from a purely scientific point of view is extremely interesting - if we can show that these anti-bodies are protective in humans then lots of research based on using these anti-bodies as tools for the design of new vaccine immunogens make lots of sense."

Professor Katinger and his colleagues believe that what they call "passive immunisation" - giving these antibodies to mothers during delivery and birth can prevent the transfer of the HIV Virus from mother to child across mucous membranes.

"We think a baby is most endangered in the first weeks. A baby is not responsive to vaccines and therefore a combination of passive immunisation with anti-bodies on the one hand with a follow up, probably with a vaccine, and active vaccine against HIV, if such a vaccine is existing, which is not the case now, would be a situation where we would have a real hope to save babies."

Dr Norbert Vetter is one of Austria's top AIDS experts. He's alarmed by the fact that in the countries of Central Europe - the greatest number of new infections is among women.

"There are only women who will give birth to children so we have to be aware of this situation and build strategies to reduce transmission from mother to child. There are other situations, how to get a child if you are discordant - one is infected and one is not infected. So there are a lot of issues coming out of this progression of the disease particularly in women."

This is a frustrating time for Herman Katinger. He believes that passive immunisation will save many lives. But the funds for human clinical trials are lacking.

"For babies in Africa or somewhere else in the developing world this is not really a market - it's just a demand and where you have no market - just a demand - the interest of the capitalistic world is not very big."

Though he's short of funds, Herman Katinger and his colleagues are planning a new study in Africa in which they hope to show how the anti-bodies will reduce the transmission of the HIV Virus from mother to child. He says a ten percent reduction would be would be a great success.

New liver resection technique saves lives in Slovenia
27.1.2006 - Ksenija Samardzija-Matul

Slovenia has gone a long way in the field of liver surgery, especially in liver resection - the removal of part of the organ by surgery. Only half a century ago, doctors almost always lost the battle with cancerous lesions and tumours of the liver. But now, as we report from Maribor, there is fresh hope for liver patients:

"Liver surgery has mainly developed in the last 50-60 years. It used to be very dangerous surgery because there are three vascular systems that fill the liver with blood, so operations and all procedures on the liver were very dangerous, because of the enormous blood loss."

Dr. Eldar Gadzijev heads the department of Abdominal and General Surgery at Maribor hospital. He spent years trying to find a way of operating on the liver without risking the patient's life. His efforts seem to have paid off. So, how is this "safe surgery" actually performed? The most crucial step is locating and controlling all the important vessels that enter and leave the liver. This ensures that there is practically no bleeding during the operation. Then an ultrasound examination is performed. After that the resection is done and the good news is: another part of the organ can be removed safely should the disease spread or a tumour reappear:

"Years ago many patients with liver tumours were practically left to die without any help. We have now experienced that we can re-operate on the liver again and again, even remove tumours several times just because of the capacity of the liver to regenerate."

In the hospital in Maribor, surgeons also operate on patients from abroad:

"Considering all the possibilities of after care, our patients can easily be sent home 5 to 7 days after the operation, which formerly was not the case. Also the rate of complications is diminished very much and so there is no such danger after the operation as there used to be."

Mrs. Jez is 75. Eight years ago, she was diagnosed with cancer. She went through treatment and seemed to have won her battle until doctors discovered that the disease had spread to her liver. In a desperate attempt to win this battle too, she decided to undergo liver resection:

"When you lose your partner, all you have is your family. My son has three children, who mean the world to me and I would love to share beautiful moments with them. I live for them and it means so much to me to stay healthy and be there for them. They give my life meaning."

Two weeks after the operation Mrs Jez feels good. Doctors are confident that she will be able to live a normal life.

"It was a good decision, very positive and definitely at the right time and the operation was successful, the doctors told me."

Thanks to the new surgery and postoperative care, 30-40% of the liver patients who have undergone resection can expect to remain healthy for at least five years.

Milan Zaviacic - the Slovak scientist who discovered the female prostate
27.1.2006 - Katarina Richterova

In recent years Slovakia has not offered many major achievements in the field of medical innovation. Many doctors say that a lack of money is the core of the problem. But Radio Slovakia International's Katarina Richterova did find one Slovak who has made an important discovery that could have important implications for women.

I'm at Bratislava's faculty of medicine, the department of pathology, in search for an outstanding Slovak medical achievement. I see nervous students standing around in the hallway. May I ask what you are waiting for?

"We are waiting to take the pathology exam."

Is it hard? How much did you have to learn for it?

"Yes, it is quite hard. We have been studying for five weeks."

What is the basic thing you need to know, for which they would throw you out if you didn't know it?

"Actually, we have to know everything."

"The favourite theme of Professor Zaviacic is the female prostate."

"We should know a lot about that, for example the histology of the female prostate, how it was discovered, because it is the research of Professor Zaviacic."

Is that one of the most important researches here at the faculty?

"Yes, actually I think it is."

"I think the female prostate is something new in the field of pathology, because many authors claimed that the female prostate doesn't exist. Mr. Zaviacic defined the term female prostate. In the future we will see how important it is for practice."

Prof. Milan Zaviacic has been researching female anatomy since 1980. Surprising though it may sound, he came to the conclusion that women, just like men, have their own prostate.

"The female prostate has the same functions as the male prostate, especially concerning the uroendocrine equipment and production of the secretion."

But the female prostate does vary slightly from its male counterpart. It is approximately a quarter of the size. Another difference is that the...

"The female prostate is located in the wall of the female urethra and the male prostate is around the urethra."

The tissues that lie on the border between the urethra and the neck of the bladder were only known as glands without a special function until Prof. Zaviacic proved this theory wrong:

"It is a very important functioning organ of the urogenital system. This prostatic tissue is a new erogenic zone for females. It participates in the female ejaculation phenomenon, in which the female prostate is stimulated indirectly."

The organ is mainly significant in terms of sexual pleasure for women; however it has a health relevance to it too. The female prostate can be susceptible to all the illnesses known in the male prostate, although they are less frequent. Until Prof. Zaviacic's discovery, many illnesses were mistakenly diagnosed and treated as diseases of the urethra.

"For the treatment of the female prostatic disease I recommend the same kind of drugs as for the prostate in the male."

As Prof. Zaviacic says, in practice the right treatment of the female prostate is still rather rare in Slovakia, especially in smaller towns, because of the lack of information. It seems that Prof. Zaviacic's work is more recognized by the international community than at home. He agrees that it is almost impossible to conduct research or attain outstanding achievements in Slovakia with the current lack of finances:

"The financial aspect is very important in using new methods in investigations, but according to my opinion hard work is much more important."

25 years of research have meant for Zaviacic weekends at work and sacrificing time with his family for the study of the female prostate.

In 2001 the Federative International Committee on Anatomical Terminology officially accepted the term female prostate and started to use it in specialist publications. There are many structures and functions in the human body still waiting to be found, says professor Milan Zaviavic, and maybe one of the many young medical students who successfully passed their exam today will be among the lucky and talented few who actually make such a discovery.

Czech team invents simple and fast device to make computers work for the disabled
27.1.2006 - Dita Asiedu

Over the past decade, the personal computer has become an essential instrument in our everyday lives. Add an internet connection to your computer and you don't even need to leave your home. But what about those with a physical disability who can't use a PC? Scientists around the world have been straining their little grey cells to find a simple way of helping them - but it was a small team in Prague who came up with a very clever little system.

This is what it usually sounds like when I'm writing on my computer...[sound of keyboard]...and this is what it sounds like with a system tailor-made for the physically disabled who cannot use a mouse or write on the keyboard... [silence]...can you guess what I'm using to control my PC? Believe it or not - I'm using my eyes.

The memory recorder or the I4Control system was developed by a small group of people at the Czech Technical University's Cybernetics department. Lenka Lhotska was one of them:

"The original idea came from a colleague who works with disabled children. When she saw how difficult it is for them to control a computer, we started to discuss ways to enable these children and, of course, adults with similar disabilities to use computers."

So how exactly does it work? Well, it's easy, light, and all you need is a pair of glasses - or actually just the frame. Prof. Vladimir Marik explains:

"You have a small micro-camera attached to your glasses, which watches your eye movement and you can learn to control the cursor on the computer by your eye-movement. So the camera processes the information and detects the motions of the eye. What you need is to train yourself, which means you have to spend between five to fifteen minutes by adjusting the device to your eye movements. That's the only constrain. What's interesting is that people with disabilities are able to finish the training exercise much faster. This means that they are done in five minutes and can use it quite efficiently."

To select icons, folders, or documents, just close your eyes a little longer than when you blink. There's an integrated keyboard with special characters that you can use to write texts. Prague's well-known Jedlicka Institute is dedicated to making the lives of the disabled as pleasant as possible and integrating them into society. The institute's Tomas Susicky tested out the I4Control system:

"It's good for web browsing, chatting with other people, and listening to internet radio. What benefits us is that it is a Czech programme so it should be cheaper [than foreign inventions]. It also replaces the system and we do not need any special software for it. So, this is very important for our country because we have a difficult language. So, if we can operate with normal windows, it's very good."

So it's goodbye to uncomfortable electrodes, special contact lenses, and complicated software. But the I4Control system has yet to be mass produced. Its inventors are awaiting authorization from the Czech health care authorities because tests have shown it can also be used as a medical device:

"Of course there may be other ways of using this system. For instance you can use it for the automatic follow-up of moving targets and objects in the camera. You can also use it to evaluate the mental or physical state of patients because you can evaluate the motions. So there are other potential applications in the medical field and others as well."

The Czech Technical University's invention is one of Europe's best Information Society Technologies. Every year independent experts from 16 European countries nominate the most attractive and innovative products for the prestigious IST Grand Prize. The I4Control system is the only invention from the ten newest EU member states and from a university team that is an IST prize winner this year.