THE INSTITUTE OF PREVENTIVE AND CLINICAL MEDICINE

Limbova 14, 833 01 Bratislava, Slovak Republic,
Phone (Secretariat): (+42-7) 374 980 Fax: (+42-7) 373 906, (+42-7) 371 094
email : trnovec@upkm.sanet.sk
 

Ladies and Gentlemen,

It is our pleasure to introduce to you the Institute of Preventive and Clinical Medicine (IPCM), Bratislava.

Assoc. Prof. Tomas Trnovec, MD, DrSc

CONTENTS

  • MISSION
  • STRUCTURE
  • PROJECTS
  • US
  • EU
  • WHO
    •
  • RESEARCH AREAS
  • Interaction of the Human Organism with Non-biological Components of the Environment
  • Interaction of the Human Organism with Biological Components of the Environment
  • Clinical Disciplines
  • Clinical Immunology and Allergology
  • Interdisciplinary
    •
  • HISTORY
    •

    MISSION

    As compared to developed democratic countries, the health status of the population in post-communist countries (including Slovakia) is substantially worse. Therefore, environmentally related diseases (both communicable and non-communicable), their prevention and therapy, represent the main focus of research efforts. Research on the health effects of environmental exposure to chemical, physical and biological agents calls for new scientific initiatives and approaches. Knowledge of mechanisms of exposure and biological response provides the means for developing intervention strategies that may be expected to reduce excessive exposures and/or prevent early biological processes that result in damage and disease.

    Since major objectives of environmental health science include identification, investigation, and mitigation of risks to human health, the understanding of the causal mechanisms of disease enhances our ability to evaluate risk and to identify effective strategies. Tools that create new research opportunities include molecular biology, genetics, human exposure assessment, and biomarkers.

    Clinical research is oriented towards primary and secondary prevention of environmentally related diseases (cardiovascular, oncological, etc.) and towards the understanding of the fate and action of drugs in human body with a view to find rational treatment of diseases that have particularly worrying health and social consequences.

    In addition to main research projects in preventive and clinical medicine the Institute is also active in the following areas:

    a/ Expert opinions on biological, physical, chemical and psycho-social factors of the environment/working environment;

    b/ Establishment and maintenance of a registry and an information system on chemical substances;

    c/ Design and evaluation of guidelines, standards and legislative measures related to protection of the environment/working environment;

    d/ National reference laboratories for AIDS, viral hepatitis, disinfection and sterilization, enteral virus identification, Salmonella phage typing;

    e/ Bank of collection microbial strains;

    f/ National reference center for organ transplantation;

    g/ Center of radiation monitoring network;

    h/ Clinical pharmacokinetics, pharmacodynamics, clinical trials with new drugs phases I-IV;

    i/ Assessment of toxic profiles of xenobiotics;

    j/ Tests, analyses, expertises for contractual customers.
     

    STRUCTURE

    To meet the objectives of its mission, the IPCM has been organized into 12 departments:

    * Department of Clinical Pharmacology

    * Department of Clinical Immunology

    * Department of Virology

    * Department of Xenobiotics in the Environment

    * Department of General Microbiology

    * Department of Radiation Hygiene

    * Department of Environmental Microbiology

    * Department of Toxicology

    * Department of Molecular and Cellular Toxicology

    * Department of Ergonomics

    * Department of Genetics

    * Department of Epidemiology and Biometry.

    The structure of the research departments is flexible and depends on the current research projects. The Institute operates its own Quality Assurance Unit so that all activities are conducted in compliance with the respective guidelines, recommedations and legislation.
     

    JOINT INTERNATIONAL PROJECTS

    WITH US COUNTERPARTS

    Project: Polychlorinated Dibenzo-p-dioxins (PCDDs), Dibenzofurans (PCDFs), Biphenyls (PCBs) and Dioxin-like PCBs in the human populations of the Slovak Republic P.I.: Anton Kocan, Ph.D.

    Cooperating Institution: Dr. Donald Patterson, Chief Dioxin Laboratory CDC, Toxicology Branch, 1600 Clifton Road, Atlanta, Ga. 30333, U.S.A.

    Project: Stability and Immunogenicity Studies of Vibrio Antigens in Oral Vaccines, P.I.: Ivan Ciznár, Ph.D., D.Sc.,

    Cooperating Institution: Dr. David A. Sack, The Johns Hopkins University, Division of International Health, Baltimore, Md., U.S.A.

    Project: Lead Exposure and Cognitive Development of Children in the Slovak Republic - PENDING, P.I.: Eva Sovcikova, Ph.D.,

    Cooperating Institution: Dr. Venkat Rao, Senior Toxicologist, Science Application International, Cooperation Quantitative Analytical Division, 7600 A Leesburg Pike , Falls Church, Va. 22043, U.S.A.

    Project: Epidemic Investigation of Allergic Diseases Among Children in the Slovak Republic, P.I.: Eva Reichrtova, M.D., D.Sc.,

    Cooperating Institution: Scott J.N. McNabb, Ph.D., CDC, 1600 Clifton Road, Atlanta, Ga. 30333, U.S.A.

    Project: Minority International Research Training Grant, Fogarty International Center,P.I.: Tomas Trnovec, Assoc. Prof., M.D., D.Sc.

    Cooperating Institution: John Hamilton, M.D., Div. Infect. Dis., Duke Univ. Med. Center, Durham, N.C., U.S.A.

    Project: International Training for Rural and Environmental Health, P.I.: Tomas Trnovec, Assoc. Prof., M.D., D.Sc.,

    Cooperating Institution: Burton C. Kross, Ph.D., The University of Iowa, Iowa City, Ia. 522 42, U.S.A.

    Project: Down Syndrome: Superoxide Dismutase and Antioxidants as Important Biological Variables Effecting Intracellular Mechanisms at Various Ages - PENDING P.I.: Maria Sustrova, M.D., Ph.D.

    Cooperating Institution: Dr. Siegfried M. Pueschel, M.D., Ph.D., MPH, Professor of Pediatrics, Brown University School of Medicine, Rhode Island Hospital., 593 Eddy Street, Providence, RI 02903, U.S.A.

    Project: Development of a strategy to improve the quality of health in the communities of both U.S. and Slovak Republic Partners P.I.: Tomas Trnovec, Assoc. Prof., M.D., D.Sc.

    Cooperating Institution:

    Slovak Republic Jana Sturova, Ph.D., President Aid to Children at Risk Foundation U.S.A. Daniel M. Couch Truman Medical Center, Inc. The American International Health Alliance ("AIHA")
     

    WITH EUROPEAN COUNTERPARTS

    COPERNICUS (European Union grant)

    Project: Comet Assay (SCGE) - Application in Genotoxicity and Screening Methods for Exposure Assessment of Human Population to Genotoxic Substances, P.I.: Maria Dusinska, Ph.D.

    Cooperating Institutions:

    Slovak Republic Darina Slamesová, Ph.D., Cancer Research Institute of Slovak, Academy of Sciences,

    Czech Republic Rudolf Stetina, Ph.D., Czech Academy of Sciences, Prague

    Poland Marcin Kruszewski, Ph.D., Institute of Nuclear Chemistry, Warsaw

    Germany Beatrice Pool-Zobel, Ph.D, BFE Institut für Hygiene und Toxikologie, Karlsruhe

    Coordinator: Andrew R. Collins, M.D., Ph.D., Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen AB2 9RD, Scotland, The United Kingdom

    PECO

    Project: Assessment of Early Signs of Biological Action Following Human Exposure to Polychlorinated Dibenzo-p-dioxins and Related Substances P.I. : Anton Kocan, Ph.D.

    Cooperating Institution: Dr. A. G. Smith (coordinator) Medical Research Council University of Leicaster, Leicaster LE1 9HN, The United Kingdom

    PECO

    Project: Standardization and Validation of the Use of Pulmonary Epithelial Cells for Toxicity Assessment of Occupational Agents and Drugs, P.I.: Zuzana Kovacikova, Ph.D.

    Cooperating Institution: Dr. Benoit Nemery, Ph.D., Katholieke Universiteit, Leuven, Belgium

    (The Collaborative Project involves 11 other European Institutes)

    EUROCAT - Concerted Action of the E. E. C. Brussels

    Project: Occupational Exposures and Congenital Malformations, P.I.: Elena Szabova, Ph.D.

    Cooperating Institution: Dr. Sylvaine Cordier, INSERM - U 170, Unité de Recherches Epidémiologiques et Statistiques sur l' Environnement et la Santé, Villejuif Cedex, France

    SWEDISH INSTITUTE, Stockholm, Sweden

    Project: Genotoxic Effects and DNA Repair in Mammalian Cells Induced by Carcinogenic Epoxides, P.I.: Maria Dusinska, Ph.D.

    Cooperating Institution: Dr. Ada Kolman, Department of Radiology, Arrhenius Laboratory, University of Stockholm, Sweden
     

    EU - COOPERATION IN SCIENCE AND TECHNOLOGY WITH CENTRAL AND EASTERN EUROPE

    ,

    Project: Creutzfeldt - Jakob Disease in Slovak Republic, P.I.: Eva Mitrova, M.D., D.Sc.

    Cooperating Institution: Dr. Roger G. Will, Department of Pathology, Western General Hospital, Edinburgh, Scotland, EH 4 2 XU, The United Kingdom

    EU - PHARE - Project No. EU/AIR/22

    Title: National Needs Assessment of Air Pollution P.I.: Eva Reichrtova, M.D., D.Sc.

    Cooperating Institution: Dr. B. Griepink, European Commission, Brussels, Belgium

    EU - PHARE - Project EU/AR/206/91

    Title: Danube Regional Pesticide Study, P.I.: Jana Kovacicova, Ph.D.

    Cooperating Institutions:

    Dr. Maria Tasheva, Center of Hygiene, Sofia, Bulgaria

    Dr. Jeno Molnar, National Institute, of Public Health, Budapest, Hungary

    Dr. Magda Kurucova, VUCHT, Bratislava, Slovak Republic

    Project: Collaboration between the Free State Bavaria and the Slovak Republic in the field of the Health Care: Immunologic Investigations for Kidney and Bone Marrow Transplantation, P.I.: Stefan Nyulassy, Assoc. Prof., M.D., D.Sc.,

    Cooperating Institution: Prof. Eckehart Albert, M.D., Immunogenetic Laboratory, Children Policlinic of the Ludwig Maximilian University, Munich, Germany

    Project: European Union Informatics for Kidney and Bone Marrow Transplantations, P.I.: Stefan Nyulassy, Assoc. Prof., M.D., D.Sc.

    Cooperating Institution: Prof. Pavol Ivanyi, M.D., D.Sc., Red Cross Blood Transfusion Center, Immunogenetic Laboratory, Amsterdam The Netherlands
     

    WHO

    Project: European Longitudinal Study of Pregnancy and Childhood (ELSPAC), P.I.: Ida Valkyova, Dr.

    Cooperating Institution: Prof. Jean Golding, Institute of Child Health, Royal Hospital for Sick Children, Bristol BS 2 8 BJ, The United Kingdom
     

    MAIN RESEARCH AREAS

    In considering research needs and opportunities with respect to environmentally related diseases it is important that insights into their nature and mechanisms contribute to prevention and treatment strategies and thus reduce serious impacts of toxic environmental components (of both non-biological and biological origin). The most effective approach to environmentally related diseases is to develop appropriate preventive measures.
     

    I. Interaction of the Human Organism with Non-biological Components of the Environment

    Contributions to the prevention and/or treatment of environmentally related diseases cover the whole range of hazard evaluations for environmental pollutants, the assessment of exposure (biomonitoring), development and use of biological markers and the detection of damages on organism, organ, cellular and subcellular levels as well as epidemiological approaches.

    * Environmental pollution and human exposure.

    Exact measurements or model estimates of human exposure to environmental pollutants are of crucial importance for the assessment of public health risks. Research projects dealing with environmental pollutants are based on their monitoring in environmental compartments, biota, food and human organism (particularly body fluids, placenta).

    Particular attention is being paid to:

    * metals - Pb, Cd, Hg, Ni, As, Cu, Zn, Mg, Se;

    * polychlorinated biphenyls, dibenzodioxins, dibenzofurans, phenols, benzenes, hydrocarbons, pesticides, etc.;

    * dusts (asbestos fibres and their substitutes and other selected dusts).

    * Protection against ionizing radiation

    The main purpose is to control ionizing radiation sources in the working and general environment, with special attention to nuclear industry safety. After the Chernobyl accident a wide monitoring programme was developed in the territory of the Slovak Republic. The Institute serves as a Center of Radiation Monitoring Network which continuosly collects data on the radiation situation in Slovakia. New legislation was introduced to protect the population in events of radiation accidents.

    The internal contamination with radionuclides is evaluated by whole body counting and radiochemical procedures. The study of effects of ionizing radiation on humans includes development and implementation of biophysical methods and biological dosimetry. The Department of Radiation Hygiene serves as Secondary Reference Center for the Metrology of Radon and Radon Products Measuring Devices. Indoor radon concentrations are screened and radiation burden from radon to the Slovak population are determined.

    Also of concern are the estimation and optimization of the radiation dose to patients in diagnostic radiology including the application of the quality assurance programme in radiology.

    * The role of nutrition and antioxidants in the detoxification of xenobiotics

    The relatively short life expectancy and the high incidence of cardiovascular and oncological diseases in the Slovak Republic and other post-communist countries is a multifactorial phenomenon in which pollution and nutritional disorders (mainly deficiency of antioxidants) play an important role. Detoxification of xenobiotics in the membrane-bound cytochrome P-450 cycle is accompanied by the release of free oxygen radicals. Chronic deficiency of antioxidants therefore potentiates negative effects of xenobiotics on membrane phospholipids, membrane-bound enzymes and membrane-bound receptors. Some of these changes are preventable by the administration of free radical scavengers and antioxidants. The aim of the research projects in this field is to find an optimum combination of water- and lipid-soluble natural antioxidants (ascorbic acid, tocopherols, selenium) in subjects exposed to foreign substances (cadmium, chlorinated phenols, etc.).

    The research on the potential synergism of protective effects of selected antioxidants is of great importance for designing a rational diet or efficient pharmacological prevention of "free-radical diseases" (atherosclerosis, cancer).

    * Mechanisms of the toxic effects of xenobiotics

    The descriptive and static approach is being completed with toxicokinetic parameters of xenobiotics and interactions of xenobiotics with organ and tissue structures (determination of glucocorticoid receptor concentration in liver cytosol, determination of estrogenic receptor in rat uterine cells).

    Besides standard tests for toxicological evaluation (acute, short-term and long-term studies incl. carcinogenicity,immunoto- xicity and teratogenicity studies) new alternative methods have been introduced for studying toxic, teratogenic and carcinogenic effects of xenobiotics.

    Alternative methods comprise: cytotoxicity in vitro (plating efficiency, proliferative activity of cells, Bradford method determination of proteins), teratogenicity in vitro (chick embryo culture), toxicity and carcinogenicity in the fish model.

    * Genotoxicology

    Research in this field is aimed at elucidating the mutagenic and genotoxic effects of chemical substances on various biological models. An integral part is biological monitoring of population groups exposed in industry, health service, etc. The objective of epidemiological studies is to investigate the effects of environmental factors on genetic health and on reproduction quality of the population.

    * Molecular and cellular toxicology

    Research includes:

    * Study of DNA damage and DNA repair in mammalian cells in vitro, particularly oxidative DNA damage, gene mutations in locus HPRT, DNA adducts, single and double strand breaks;

    * Molecular toxicology studies at the level of genes, DNA, chromosomes and DNA products, and genetic epidemiological studies, such as DNA polymorphism and gene mutations;

    * Neoplastic transformation in vitro (clonal morphology in Syrian hamster embryo cells, focus assay in mouse fibroblasts C3H10T1/2, immunodetection of selected cytoskeletal proteins);

    * Modulation of mutagenesis and carcinogenesis in vitro, e.g. by DNA repair inhibitors, tumor promoters and other factors;

    * Molecular toxicology evaluation of xenobiotics using mutagenicity and carcinogenicity tests in vitro.

    * In vitro study of the role of cytoskeletal components, especially proteins associated with actin microfilaments in manifestation of cytotoxicity caused by selected xenobiotics in mammalian cells.

    * Pharmaco- and toxicokinetics

    Biological effects of drugs and other chemicals are determined by their pharmacokinetics (absorption, distribution, metabolism and excretion processes). Owing to this, the investigation of the interactions of xenobiotics with the organism include as an essential part pharmacokinetic studies which proceed in several directions. Genetically determined differences (genetic polymorphism) in biotransformation of xenobiotics are also assessed.

    Experimental investigations of new drugs are undertaken on laboratory animals, with subsequent human studies as a part of phase I of drug investigations.

    Biocompatibilty studies of constituents of bone replacement materials remain an important part of research.

    Concentrations of drugs and their metabolites in biological matrices are measured using gas and liquid chromatographic equipment in compliance with GLP requirements. An air conditioned animal house and an operation theatre with the possibility of inhalation anesthesia, of monitoring cardiovascular and respiratory functions, using extracorporeal circulation and surgical microscopes enable to carry out a range of experiments.

    Bioavailability and bioequivalence studies are run as a part of clinical pharmacological investigations. These studies allow the selection of formulations with optimal rate and extent of absorption. Up-to-date statistical approaches are used to compare different formulations.

    Among the most important problems in pharmaco- and toxicokinetics is that of interspecies differences. In order to extrapolate experimental data from laboratory animals to humans physiologically-based pharmacokinetic modelling is in progress. Modelling is a well-established approach which not only enables obtaining of pharmacokinetic parameters in man but also to predict human toxicity on the basis of animal data. Physiologically-based models are also applied for cancer risk assessment. In addition to in vivo studies in laboratory animals, in situ studies in isolated perfused animal organs are conducted. Data of therapeutic drug monitoring from Slovakia are used to compile a pharmacokinetic database on the population level.
     

    II. Interaction of the Human Organism with Biological Components of the Environment

    Policy implications in the field of communicable diseases, transmission associated with environmental factors and international migration all point to the importance of programmes and strategies in this field. Surveillance calls for new highlights in research.

    Research activities:

    * Mechanisms of interaction between microorganisms and host structures;

    * Genetic determination and regulation of pathogenic potential of microorganisms;

    * Interactions between potential and obligatory pathogens in the ecosystems in vitro and in vivo with regard to factors influencing environmental contamination;

    * Antigens stimulating human immune system:

    Studies conducted at molecular, cellular and organ levels;

    * Bacterial resistance to antibiotics and its consequences for the prevention and treatment of diseases and for ecology.

    * Bacteria

    Primary mechanisms of pathogenicity and antibiotic resistance of intestinal bacteria belonging to Salmonella, Shigella, Escherichia coli and Vibrio species, and of potential pathogens such as Pseudomonas, Yersinia and Mycoplasma species. Bacterial cell surface structures and the mechanisms responsible for the interaction with host cell receptors are studied at the molecular and cellular level. Genetic determinants of pathogenicity factors are investigated by hybridization and cloning methods utilizing the latest knowledge of bacterial genetics and genetic engineering.

    Special attention is paid to factors determining bacterial adherence, invasiveness and production of bacterial toxins, and to finding ways of modifying their production with biologically active substances. Bacteriologic studies are designed to elucidate specific problems of relationships between microorganisms, the human body and the environment, mainly with regard to trends in urbanization.

    * Viruses

    Biological and genetic properties of selected viruses with the aim of defining and understanding the early and long-term changes that develop as a result of viral infection. The results obtained are utilized to design new therapeutic and preventive measures.

    * Enteral viruses

    The relationship between viral nucleic acids and the protein composition, and the pathogenetic role of enteroviral infection in acute and chronic clinical syndromes (e.g. myocarditis, diabetes mellitus, enteritis, etc.) including the mechanisms of autoimmunity induction. Evaluation of highly-pecific methods of enteral virus diagnostics.

    * Hepatotropic viruses

    Etio-immunopathogenesis of chronic viral hepatitis B and C. Strategy planning and monitoring of immunomodulation therapy.

    Interferon and other regulatory molecules are studied at the cellular level and during their therapeutic administration to patients. Methods of molecular biology are increasingly applied in studying viral hepatitis.

    * "Slow viruses"

    The consequences of infectious amyloidosis as well as those associated with the persistence of the measles virus in the CNS. Transmission of "unconventional" infections is being investigated together with the identification of sources in regions with higher incidences (in the Slovak Republic, the rates are rather high). Explanation is sought of why the breaking of the interspecies barrier occurs allowing an infection to spread. Methods of molecular biology are applied, especially for the detection of specific mutation PrP gene on codon 200, 178, and polymorfism 129.

    * Human Immune Deficiency Virus

    Investigation of the activity of natural immunity factors and of autoimmune processes in HIV infected patients. Confirmations of HIV reactive samples are provided and data on HIV infection incidence are assembled for both the local and the WHO authorities.

    * Micromycetes

    Prevention of diseases caused by microscopic fungi in man: allergic disorders in genetically determined subjects, mycoses in sensitive individuals and mycotoxicoses caused by toxic metabolites of micromycetes.
     

    III. Clinical Disciplines

    Clinical Pharmacology

    Scientific studies are directed to:

    * The clinical pharmacological evaluation of new drugs;

    * The evaluation of treatment schedules for various diseases, particularly in internal medicine;

    * Pharmacological prevention and treatment of kidney diseases with special emphasis on new drugs slowing down their progression;

    * Cardiovascular diseases. Particular attention is paid to new drugs in the treatment of hypertension;

    * Metabolic alterations and diseases such as atherosclerosis and diabetes;

    * Treatment of kidney diseases with cyclosporin A and prevention of the progression of kidney diseases through diet, angiotensin converting enzyme inhibitors and antithromboxane therapy;

    * The effect of drugs for the treatment of kidney and cardiovascular diseases on carbohydrate and lipid metabo- lism, functional performance of the kidney, liver, and striated muscle;

    * Platelet aspects of antihypertensive treatment from the point of view of cardiovascular risk (which is not adequately decreased by simple antihypertensive treatment);

    * The relationship between oxidative status and hemocoagulation: identification and explanation of the risk associated with factors such as lipoprotein(a), fibrinogen, ß-thromboglobulin and means of their pharmacologic modification;

    * The value of antioxidative, antiaggregatory and lipid modulating therapy for the inhibition of progression, or even regression, of atherosclerosis and coronary sclerosis;

    * Postmenopausal osteoporosis;

    * The effects of nootropic and other drugs on the mental state of gerontological patients.

    * Lipid and Glucose Metabolism and Genetics of Atherosclerosis

    Main research orientation on:

    * Clinical and laboratory evaluation of hypolipemic drugs;

    * Evaluation of the silent ischaemia in patients with premature myocardial infarction before and during hypolipidemic therapy;

    * Effect of the hypolipidemic therapy on the prevalence of premature atherosclerosis;

    * Evaluation of the effect of genetic and environmental factors on the occurrence of premature myocardial infarction in families;

    * Prevalence of primary dyslipoproteinemias in families with premature myocardial infarction;

    * Association of different apolipoprotein DNA polymorphisms with the occurrene of premature myocardial infarction in families;

    * Analysis of the role of reversed cholesterol transport disturbances in the high prevalence of hypoalphalipoproteinemia in myocardial infarction families;

    * Evaluation of the oxidative damage on the DNA level and its reparation and its relationship with lipid peroxidation in patients with premature myocardial infarction and control;
     

    IV. Clinical Immunology and Allergology

    The main research areas include:

    * The effect of xenobiotics on the immune system

    The two main topics are studied using immunopharmacological and immunotoxicological approaches:
    Immunopharmacology:
    Modulation of the immune response to achieve the desired therapeutic effect on immune reactivity.
    Immunotoxicology :
    Estimation of undesired side effects of drugs and environmental factors on the immune system.

    * Immunopharmacologic clinical trials

    in volunteers, in patients with diseases with the involvement of the immunopathogenetic mechanism and in patients undergoing therapy for non-immunological diseases, to investigate the influence of non-immunological therapy on the immune system;

    * Immunopharmacologic and immunotoxicologic studies

    in vitro, ex vivo and in vivo in experimental animals.

    * Immunopathology

    The Institute provides differential diagnosis and treatment of immunopathologic conditions (allergic and immunodeficiency-associated) for both in- and out-patients. Evaluation of new drugs according to their respective immunotherapeutic potential.

    * Transplantation and clinical immunogenetics

    Research activities are concerned with immunogenetics of organ (particularly kidney) and tissue allotransplants, incl. the influence of the major histocompatibilty complex (MHC) with respect to the development of diseases. The immunological responsiveness to drugs and environmental factors is correlated with major histocompatibility complex (MHC) characteristics of individuals. The genetic influence of MHC on a certain type of immunologic response is then studied.

    Department of Clinical Immunology serves as the National Center for Organ Transplantation, and is responsible for running the National Transplant Register, for quality assurance and for reference work in tissue typing in Slovakia as well as for the coordination of Organ Transplantation Programme from the immunogenetic aspect. Research activities are concerned with the role of MHC in the outcome of cadaveric kidney transplantation.

    Further activities from the point of view of clinical immunogenetics are concerned with certain virus-induced diseases - subacute (de Quervain's) thyroiditis and chronic active hepatitis.

    Child development and immune disorders

    * Diagnosis,treatment and special medical care of children and adolescents with primary immune deficiency and with genetic disorders, particularly Down syndrome;

    * Guidelines for optimum medical care and intervention in Down syndrome;

    * Prevention of secondary metabolic disorders due to phenotypic expression of 21 trisomy;

    * Early recognition of signs of immunity changes (e.g. thyroid dysfunction and its consequences);

    * Analysis of immunologic examinations in individuals with Down syndrome ( determination of phagocytic function of PMNs, evaluation of serum immunoglobulins and IgG subclasses, etc.) and other parameters ( e.g. serum Zn, Cu and Se, antioxidant enzyme activities, etc.).
     

    V. Interdisciplinary Fields

    * Ergonomics

    Ergonomic research deals with various forms of work load resulting from the influence of environmental factors, work and their combinations. Diseases of the locomotor system of occupational origin, particularly those which represent causes of working inability, remain an important health-related and economic problem.

    Basic task:

    * Setting up guidelines and development of methods

    to prevent excessive load, strain or health damage, and creation of a comfortable working environment.

    * Epidemiology and Biometrics

    Epidemiological studies are used for significant advancement of the understanding of environmental problems, distribution of diseases and health in the population. The Department of Biometrics participates in the formulation of problems of biological nature, in the evaluation of data, and in the interpretation of research results. Mathematical modeling plays an integrating role both in clinical and experimental research.

    * The WHO coordinated European Longitudinal Study of Pregnancy and Childhood (ELSPAC)

    is conducted to improve the health status of children. Data on factors within the most intimate environment (family) are collected with the aim to elucidate their influence on the development of the fetus and on the formation of biologic, mental and social components of pre-school children's health.

    FROM THE HISTORY OF I P C M

    The predecessor of the Institute, the Regional Institute of Hygiene, was established in 1948. In 1977, the Institute of Hygiene, the Institute of Industrial Hygiene and Occupational Diseases, and the Institute of Microbiology and Epidemiology merged to form Research Institute of Preventive Medicine. The present Institute of Preventive and Clinical Medicine was formed in 1990, after a merger of the Research Institute of Preventive Medicine with the Centers of Clinical Pharmacology and Immunology of the Medical Bionics Research Institute.

    The period from 1990 has been full of principally positive turbulence. Investments were made into sophisticated new research equipment, there has been a considerable growth in output (publications and invited lectures at international conferences). The advancement of scientific knowledge has been strongly related to creativity of young researchers working under the guidance of experienced and highly qualified leading scientists of the Institute. Research activities integrate both experimental and clinical approaches.

    The Institute of Preventive and Clinical Medicine is located in the western district of Bratislava on the rolling foothills of the Carpathian mountain range. With its nearly 400 employees, the Institute is the largest scientific and research institution in the health sector of Slovakia. It is funded and supported by the Ministry of Health of the Slovak Republic and by private sponsors.

    SHORT HISTORY of BRATISLAVA

    Bratislava, the capital of the Slovak Republic, is situated on both banks of the Danube on the foothills of the Little Carpathians, just a few kilometers from the Austrian and Hungarian borders and close to the geographical center of Europe.

    Bratislava has a colourful history. In 1291 the town had been granted full royal urban privileges. After 1526, when the Turks occupied a major part of Hungary, the town prestige grew, and Bratislava became the capital and coronation town and the town where Hungarian Assembly would held its sessions for three centuries. Eleven Habsburg kings and 8 royal spouses were crowned in St. Martin's Gothic Cathedral. In 1991, Bratislava celebrated the 250th anniversary of the coronation of the Empress - Queen Maria Theresa. In 1465, King Matthias Corvinus founded Academia Istropolitana, the first university in Slovakia on the territory of Bratislava. In 1805, Peace of Bratislava was signed between Napoleon's France and Austria at the Mirror Hall of the Primate's Palace.

    Today's Bratislava is characterized by strong promotion of science, culture, education (Comenius University, the Slovak Academy of Sciences, Slovak Technical University, research centers).

    Bratislava can be accessed by rail, road, waterway or air. The city has its own airport, and can also be easily reached from the Vienna airport Schwechat (40 km).