[Evaluation of the Clinical Outcomes of Autologous Chondrocyte Implantation in the Management of Chondral Lesions of the Knee after 10+ Years]. / Vyhodnocení klinických výsledku metody implantace solidního chondrograftu v lécbe chondrálních lézí kolenního kloubu po více nez 10 letech.

PURPOSE OF THE STUDY: The authors present the outcomes of more than ten-year clinical follow-up of patients who underwent surgical treatment of deep chondral defect of the knee (medial or lateral condyle). The method of treatment was the implantation of autologous cultured chondrocytes in the form of a solid chondral graft. The aim was also to compare the mid-term and long-term outcomes and to evaluate how the knee condition affects the everyday life and sports activities more than 10 years after surgery. MATERIAL AND METHODS Thirty patients of the total of 56 patients (26 patients dropped out of the long-term follow-up) operated in the period between 2001 and 2012 were available for retrospective evaluation of the clinical condition before surgery, at 1, 2, 5 years after surgery and at 10+ years after surgery. The mean follow-up period of patients was 14.5 years (10 - 20.5 years) after surgery. The clinical evaluation was performed using the Lysholm Knee Scoring Scale and the Tegner Activity Scale. RESULTS The mean preoperative Lysholm score of the followed-up study population was 37.5. During the fi rst two years, improvement was achieved to the maximum value of 83.1. At 5 years and subsequently also at more than 10 years after surgery, a slight decline was reported to the mean value of 78.6. When comparing the outcomes at 5 years and at more than 10 years after surgery, the decline in the value was statistically non-signifi cant. The mean value of the Tegner Activity Scale at more than 10 years after surgery was 4.5 points out of 10 points. DISCUSSION Management of a chondral defect especially in younger patients constitutes a common challenge in everyday orthopaedic practice. There are multiple methods at hand, all of which have their pros and cons. The size of the chondral lesion appears to be the limiting and decisive factor. The greatest pitfall are large chondral lesions (>4cm2 ), where many methods fail to yield satisfactory outcomes. One of the suitable options is the autologous chondrocyte implantation method. CONCLUSIONS The clinical outcomes of patients followed-up for more than 10 years after surgery do not show a statistically signifi cant decline compared to the mid-term outcomes. Based on the data obtained, we continue to consider the autologous chondrocyte implantation as an effective method to manage deep chondral defects in the knee. The patients were mostly able to get back to normal life, including their sports activities, with a signifi cant improvement of its quality compared to that before surgery. KEY WORDS: knee joint, chondrocytes, autologous cartilage implantation, long-term.

[Comparison of the Outcomes of Revision Anterior Cruciate Ligament Reconstruction Using Cadaverous BTB Graft with the Outcomes of Primary ACL Reconstruction with Filtering out the Effects of Age and Sex]. / Srovnání výsledku revizní rekonstrukce predního zkrízeného vazu kolenního kloubu kadaverózním BTB stepem s výsledky po primární rekonstrukci LCA s odfiltrováním efektu veku a pohlaví.

PURPOSE OF THE STUDY Evaluation of the success rate of revision ACL reconstruction using the cadaverous BTB allogeneic graft and comparison of the outcomes achieved with the data of patients after the primary ACL reconstruction using the autologous BTB graft with filtering out the potential effect of diversity of the groups of patients as concerns sex and age. MATERIAL AND METHODS The evaluated outcomes of 34 patients operated in the period 2004-2017, i.e. with the minimum follow-up period of three years, were compared with the outcomes of 34 patients selected individually so that in pairs the age and sex are identical - 10 women and 24 men in the range of age from 20 to 44 years, with the median of 29 years at the time of surgery. The assessment and comparison of the outcomes achieved are done according to the Lysholm and Tegner scores. RESULTS The mean Lysholm score of the patients after the revision ACL reconstruction using the cadaverous BTB allograft achieved 54.7 points preoperatively, 72.3 points at the 1-year follow-up and 77.4 points at the 3-year follow-up. The Tegner score at the time of full performance before the injury was 7.7 points, whereas it was 5.8 points after the injury and 6.5 points three years after the surgery. In the group of patients after the primary ACL reconstruction using the autologous BTB graft, the Lysholm score was 64.4 points preoperatively, 85.1 points one year postoperatively and 88.2 points three years postoperatively. The results according to the Tegner score achieved by the primary control group at respective follow-up periods were 6.7 points, 5.1 points and 6.2 points respectively. DISCUSSION The increase in the number of performed ACL reconstructions leads also to an increase in the number of revision surgeries. This trend is also fuelled by the change in the lifestyle, the shift in age-related indication criteria for surgery, and other factors. The realistic expectations regarding the outcome of the revision ACL reconstruction shall take into account the effect of multiple insults that the knee must withstand. Even though subjective improvement of the knee condition is usually experienced postoperatively, the achieved outcomes tend to be less positive than in primary reconstructions. The return to the original pre-injury level of sports activities is achieved less frequently after revision surgeries. CONCLUSIONS The revision surgery of ACL rupture using the cadaverous BTB graft is a safe and reliable technique. It has a potential to improve the subjective satisfaction of the patient, nonetheless the mean postoperative Lysholm score is not so high as that achieved in patients after primary ACL reconstruction. Key words: anterior cruciate ligament, revision ACL reconstruction, cadaverous BTB graft, ACL graft rerupture.

Blastic plasmacytoid dendritic cell neoplasm: First retrospective study in the Czech Republic.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy with aggressive behavior and poor prognosis. We present the first retrospective analysis mapping its incidence and therapeutic outcomes in patients diagnosed and treated from 2000 to 2017 in the Czech Republic. The cohort comprised 14 patients (10 males, 4 females) with a median age at diagnosis of 39 years (range, 5-68 years). Initially, skin involvement was noted in 10 (71%) patients and bone marrow infiltration was present in 9 (64%). The first complete remission was achieved in 6/14 (43%) patients after acute lymphoblastic leukemia/lymphoma induction therapy and in 3/14 (21%) patients after acute myeloid leukemia regimen. Nine patients underwent allogeneic hematopoietic cell transplantation, with two patients achieving the first complete remission only after allogeneic transplantation. Patients undergoing allogeneic hematopoietic cell transplantation had longer overall survival than those treated without transplantation (the median survival over the period 16.4 vs. 8.1 months). Relapse of the disease was a significant predictor of mortality (p=0.05). Over the study period, patients' survival ranged from 3.3 to 44.2 months, with a median overall survival of 13 months. Our results revealed an effectivity of allogeneic hematopoietic cell transplantation on complete remission achievement in refractory/relapsed disease. The study aimed to present the actual data from the Czech Republic and thus contribute to a global understanding of BPDCN.

[Two-Year Results of Modified AMIC Technique for Treatment of Cartilage Defects of the Knee]. / Dvouleté výsledky modifikované AMIC techniky v lécbe chondrálních defektu kolenního kloubu.

PURPOSE OF THE STUDY Damage to hyaline cartilage represents a serious problem due to its limited capacity of regeneration. Currently, there are several treatment options available. The purpose of this study is to evaluate the success rate of treatment of chondral and osteochondral defects of the knee joint using the modified AMIC (Autologous Matrix-Induced Chondrogenesis) technique, combining microfractures of the base and the implantation of the type I collagen-based cell-free implant over a two-year period. MATERIAL AND METHODS The prospective study of the success rate of treatment by the modified AMIC technique included 15 patients (13 men and 2 women) with a defect confirmed by MRI and appropriate indication criteria. The mean age at the time of implantation was 33.4 years (range 19-47 years). The mean size of a treated defect was 3.66 ± 1.71 cm2 (range 2.00-7.05 cm2). The clinical outcomes were monitored through the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Lysholm score and the Tegner activity scale preoperatively and subsequently at 6, 12 and 24 months postoperatively. Control MRI was conducted at 6, 12 and 18 months postoperatively. The MRI finding was evaluated using the Magnetic Observation of Cartilage Repair Tissue (MOCART) score. RESULTS The total KOOS score was 44.69 ± 7.71 preoperatively, while postoperatively it gradually increased up to 80.45 ± 8.97 (p < 0.001) at 24 months. The Lysholm score significantly rise from 43.47 ± 11.87 preoperatively to the mean value of 81.60 ± 13.07 (p < 0.001) at 24 months postoperatively. The preoperative Tegner score was 3.53 ± 1.41. At 24 months, there was a statistically significant increase to 5.40 ± 1.70 (p = 0.003). The mean MOCART score at 18 months postoperatively was 74.67 ± 14.08. At the end of the monitored period, a complete filling of the defect site by tissue was achieved in 73.33% patients. A complete integration with adjacent cartilage was seen in 66.67% patients and homogenous structure of newly formed tissue was reported in 80% of patients. DISCUSSION In recent years, cell-free implants (the so-called scaffolds or carriers) have been used ever more frequently in treating localised cartilage defects. Their main effect should consist in helping the cells penetrate the defect site and support new cartilage tissue formation. In order to improve the efficacy of cell-free implants, a new therapeutic technique was developed, combining the microfractures of the base with the use of cell-free scaffold AMIC (Autologous Matrix-Induced Chondrogenesis). Our modification of the original AMIC technique consists in the use of a type I collagen-based scaffold instead of the original collagen membrane constituted by collagen type I and III. Based on the statistical processing of results, the modified AMIC technique has shown a statistically significant improvement compared to the preoperative values of the KOOS questionnaire and all its sub-groups, the Lysholm core and the Tegner activity scale. These good clinical outcomes correlate with the results obtained by other authors using both the original method and the modified AMIC technique. CONCLUSIONS The modified AMIC technique using the cell-free type I collagen-based implant appears to be a safe, accessible and onestage technique to treat localised chondral and osteochondral defects of the knee joint up to the size of 8 cm2. Key words: hyaline cartilage, chondral defect, AMIC, scaffold, knee.

Simulated Soil Organic Carbon Response to Tillage, Yield, and Climate Change in the Southeastern Coastal Plains.

Intensive tillage, low-residue crops, and a warm, humid climate have contributed to soil organic carbon (SOC) loss in the southeastern Coastal Plains region. Conservation (CnT) tillage and winter cover cropping are current management practices to rebuild SOC; however, there is sparse long-term field data showing how these management practices perform under variable climate conditions. The objectives of this study were to use CQESTR, a process-based C model, to simulate SOC in the top 15 cm of a loamy sand soil (fine-loamy, kaolinitic, thermic Typic Kandiudult) under conventional (CvT) or CnT tillage to elucidate the impact of projected climate change and crop yields on SOC relative to management and recommend the best agriculture management to increase SOC. Conservation tillage was predicted to increase SOC by 0.10 to 0.64 Mg C ha for six of eight crop rotations compared with CvT by 2033. The addition of a winter crop [rye ( L.) or winter wheat ( L.)] to a corn ( L.)-cotton ( L.) or corn-soybean [ (L.) Merr.] rotation increased SOC by 1.47 to 2.55 Mg C ha. A continued increase in crop yields following historical trends could increase SOC by 0.28 Mg C ha, whereas climate change is unlikely to have a significant impact on SOC except in the corn-cotton or corn-soybean rotations where SOC decreased up to 0.15 Mg C ha by 2033. The adoption of CnT and cover crop management with high-residue-producing corn will likely increase SOC accretion in loamy sand soils. Simulation results indicate that soil C saturation may be reached in high-residue rotations, and increasing SOC deeper in the soil profile will be required for long-term SOC accretion beyond 2030.

Mechanism of ultrafast non-reactive deactivation of the retinal chromophore in non-polar solvents.

The photoisomerization of the all-trans protonated Schiff base of retinal (SBR+) in solution is highly inefficient. The present theoretical and experimental investigation aims at disclosing the mechanisms of ultrafast, non-reactive relaxation of SBR+ that lead to the drastic decrease in the isomerization yield in non-polar solvents. Our pump-probe measurements demonstrate the sensitivity of the all-trans SBR+ excited-state dynamics on the electrostatic interaction with the surrounding counterions and the crucial importance of the chromophore microenvironment. Our computational study focuses for the first time on the retinal chromophore-counterion pairs that are formed in non-polar solvents. By employing TDDFT-based nonadiabatic dynamics simulations and ADC(2) reaction paths calculations we found that internal conversion from the initially excited state to an inter-molecular charge transfer state with excitation localized on the counterion, leads to dissociation of the chromophore-counterion pair and to the abortion of isomerization. Barriers to conical intersection with the inter-molecular charge transfer state were found in the range 0.42-0.67 eV at the ADC(2) level. The existence of a barrier along the non-reactive relaxation pathways explains the observation that in solution the excitation on the blue edge of the SBR+ absorption leads to decrease in the isomerization yield with respect to the excitation at the red edge.

Influence of C60 co-deposition on the growth kinetics of diindenoperylene-From rapid roughening to layer-by-layer growth in blended organic films.

We investigated the growth of the two phase-separating materials diindenoperylene (DIP) and buckminsterfullerene C60 with different mixing ratio in real-time and in situ by X-ray scattering experiments. We found that at room temperature, mixtures with an excess of DIP show a growth mode which is very close to the perfect layer-by-layer limit with DIP crystallites forming over the entire film thickness. An unexpected increase in the island size is observed for these mixtures as a function of film thickness. On the other hand, equimolar and C60 dominated mixtures grow with poor crystallinity but form very smooth films. Additionally, it is observed that higher substrate temperatures lead to an increase in the length scale of phase separation with film thickness.

Biochars Reduce Mine Land Soil Bioavailable Metals.

Biochar has been proposed as an amendment to remediate mine land soils; however, it could be advantageous and novel if feedstocks local to mine land sites were used for biochar production. Two different feedstocks (pine beetle-killed lodgepole pine [] and tamarisk [ spp.]), within close proximity to mine land-affected soils, were used to create biochars to determine if they have the potential to reduce metal bioavailability. Four different mine land soils, contaminated with various amounts of Cd, Cu, Pb, and Zn, received increasing amounts of biochar (0, 5, 10, and 15% by wt). Soil pH and metal bioavailability were determined, and the European Community Bureau of Reference (BCR) sequential extraction procedure was used to identify pools responsible for potential shifts in bioavailability. Increasing biochar application rates caused increases in soil pH (initial, 3.97; final, 7.49) and 55 to 100% (i.e., no longer detectable) decreases in metal bioavailability. The BCR procedure supported the association of Cd with carbonates, Cu and Zn with oxyhydroxides and carbonates, and Pb with oxyhydroxides; these phases were likely responsible for the reduction in heavy metal bioavailability. This study proved that both of these feedstocks local to abandoned mining operations could be used to create biochars and reduce heavy metal bioavailability in mine land soils.

Effect of biochars produced from solid organic municipal waste on soil quality parameters.

New value-added uses for solid municipal waste are needed for environmental and economic sustainability. Fortunately, value-added biochars can be produced from mixed solid waste, thereby addressing solid waste management issues, and enabling long-term carbon sequestration. We hypothesize that soil deficiencies can be remedied by the application of municipal waste-based biochars. Select municipal organic wastes (newspaper, cardboard, woodchips and landscaping residues) individually or in a 25% blend of all four waste streams were used as feedstocks of biochars. Three sets of pyrolysis temperatures (350, 500, and 750 °C) and 3 sets of pyrolysis residence time (2, 4 and 6 h) were used for biochar preparation. The biochar yield was in the range of 21-62% across all feedstocks and pyrolysis conditions. We observed variations in key biochar properties such as pH, electrical conductivity, bulk density and surface area depending on the feedstocks and production conditions. Biochar increased soil pH and improved its electrical conductivity, aggregate stability, water retention and micronutrient contents. Similarly, leachate from the soil amended with biochar showed increased pH and electrical conductivity. Some elements such as Ca and Mg decreased while NO3-N increased in the leachates of soils incubated with biochars. Overall, solid waste-based biochar produced significant improvements to soil fertility parameters indicating that solid municipal wastes hold promising potential as feedstocks for manufacturing value-added biochars with varied physicochemical characteristics, allowing them to not only serve the needs for solid waste management and greenhouse gas mitigation, but also as a resource for improving the quality of depleted soils.

Analysis of the Phenotype and Function of the Subpopulations of Mucosal-Associated Invariant T Cells.

Mucosal-associated invariant T (MAIT) cells contain two main subpopulations, CD8(+) and double-negative (DN) cells. The first reports suggested that subpopulations of MAIT cells have similar phenotype and function. Recent works, however, demonstrate that the subpopulations have different ontogenesis and are differentially affected by xenobiotic treatment. In this work, we re-examined the possible differences between subpopulations of MAIT cells. We demonstrate that the main subpopulations of MAIT cells (CD8 and DN) are relatively uniform in terms of both phenotype and function. Both populations are memory/activated, tissue-homing and pro-inflammatory. CD8(+) MAIT cells are better equipped for pro-inflammatory functions as they express higher levels of CD16 and NKG2D, produce more pro-inflammatory cytokines (TNF-α and IFN-γ) and have higher cytotoxic potential (contain more granzyme B and express higher levels of CD107A upon stimulation). Our study contributes to the understanding of the heterogeneity of MAIT cell population.

Magneto-Optical Signature of Massless Kane Electrons in Cd_{3}As_{2}.

We report on optical reflectivity experiments performed on Cd_{3}As_{2} over a broad range of photon energies and magnetic fields. The observed response clearly indicates the presence of 3D massless charge carriers. The specific cyclotron resonance absorption in the quantum limit implies that we are probing massless Kane electrons rather than symmetry-protected 3D Dirac particles. The latter may appear at a smaller energy scale and are not directly observed in our infrared experiments.

17ß-Estradiol influent and effluent concentrations in wastewater: demographic influences and the risk to environmental health.

The concentration of 17ß-estradiol (E2) was measured through stages of wastewater treatment at a central Illinois wastewater treatment plant (WWTP). E2 concentration was quantified using a competitive enzyme-linked immunosorbent assay (ELISA). The concentration of E2 was compared with demographic effects of a university; physical parameters of the wastewater (dissolved oxygen, pH, and temperature); and daily influent and effluent flow rates. Effluent concentrations ranged from 0 to 25.3 ng L(-1) with an average discharge of 3.6 ng L(-1). E2 concentration was shown to increase at the start of each university semester; however, this trend was not observed in the summer sessions. Low influent and effluent flow rates, which correspond to increased water retention time at the WWTP, were correlated to increased removal efficiency of E2, where low flow was linked to 91 % removal efficiency and high flow with 58 % removal efficiency. This study concludes that E2 was being discharged at concentrations known to cause ecological risk, and that the demographic changes in a university student body had a significant effect on E2 concentration throughout the treatment process.

[Management of Osteochondral Lesions of the Ankle Joint by Implantation of Autologous Chondrocytes]. / Lécba osteochondrálních lézí hlezenního kloubu metodou implantace autologních chondrocytu.

UNLABELLED: PUPOSE OF THE STUDY The treatment of osteochondral lesions of weight-bearing joints remains a serious therapeutic challenge, largely due to the minimal ability of articular hyaline cartilage to regenerate. The authors present the long-term clinical and MRI results of treating deep chondral and osteochondral defects of the ankle joint by the method of implantation of autologous chondrocytes in the form of a solid chondrograft. MATERIAL AND METHODS The method of solid chondrograft implantation in the ankle joint was used in our Department from the year 2003. Between 2003 and 2013, this method was used in 31 patients, 16 men and 15 women. Their average age at the time of implantation was 29 years (16 to 50 years). The follow-up period ranged from 16 to 145 months (average, 57 months). The clinical outcome was evaluated using the Mazur questionnaire. At follow-up all patients underwent regular MRI examinations and the results were assessed on the basis of Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scores. Twelve patients required a second-look arthroscopy. RESULTS A comparison of the Mazur pre-operative scores with those obtained at 1, 2 and 5 years post-operatively showed marked improvement of ankle joint function. The average pre-operative value of 30.0 (based on responses of 31 patients) increased to the average of 89.7 (based on results of 11 patients). At 1 year post-operatively, the average MOCART score for a group of 18 patients was 78.3; at 5 post-operative years, the average value for nine patients examined was 77.0. Complete filling of defects at 1 year of follow-up was found in 88.1% and , at 5 years, it was recorded in 83.3% of the patients examined. DISCUSSION The articular hyaline cartilage is a highly differentiated tissue and its ability of repair is very limited. Therefore every damage to the articular surface should be regarded as a pre-arthritic condition// disease. Currently, there are several options of treating a damaged articular cartilage, but none of them makes its complete healing certain. A lot of studies concerned with longterm results of implanting autologous chondrocytes in the knee are available in the literature, but only few authors present long-term clinical and radiographic outcomes of ankle joint treatment similar to ours. CONCLUSIONS Based on our clinical and MRI results, the method of autologous chondrocyte implantation can be recommended since it has good long-term results, provides repair of articular cartilage and allows for patients' return to activities of daily living. KEY WORDS: chondral defect, hyaline cartilage, autologous chondrocyte, ankle joint.

Association of the ACE rs4646994 and rs4341 polymorphisms with the progression of carotid atherosclerosis in slovenian patients with type 2 diabetes mellitus.

The current study was designed to reveal possible associations between the angiotensin-converting-enzyme (ACE) gene polymorphisms (rs4646994 and rs4341) with markers of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM) in a 4-year-long follow-up study. Five hundred and ninety-five T2DM subjects and 200 control subjects were enrolled. Genotyping of ACE polymorphisms was performed using KASPar assays, and ultrasound examinations were performed twice (at the enrollment and at follow-up). With regard to the progression of atherosclerosis in subjects with T2DM, statistically significant differences were demonstrated in the change of the sum of carotid plaques thickness for the rs4646994 polymorphism. We did not demonstrate an association between the tested polymorphisms (rs4646994 and rs4341) and either carotid intima media thickness (CIMT) or CIMT progression in a 3.8-year period. In our study, we demonstrated that subjects with T2DM with the DD genotype of the rs4646994 [ACE insertion/deletion (I/D)] polymorphism had faster progression of atherosclerosis in comparison to subjects with other genotypes.

The decrease in number and change in phenotype of mucosal-associated invariant T cells in the elderly and differences in men and women of reproductive age.

Mucosal-associated invariant T (MAIT) cells are innate-like T cells comprising up to 10% of the peripheral blood T cells in humans. During ontogeny, MAIT cells can first be detected in the cord blood in low amounts, but rise steadily after birth. In this population-based study, we show that their counts continue to increase, reaching maximal levels (4.5% of CD3(+) cells, 65 cells/µl) in the third and fourth decenniums. At this age, the amounts of MAIT cells exhibit the highest interindividual variability. The values then dramatically decline; subjects 80 years old and older have on average 10 times less MAIT cells, both absolutely and as a percentage among CD3(+) T cells, than subjects in fertile age. The senescence of MAIT cells is associated with decreased CD8/double negative (DN) ratio. Finally, we observed significantly higher amounts of MAIT cells in women of reproductive age than in men of the same age. Our data suggest that further studies aimed at elucidating a role of MAIT cells in human pathologies must recruit age- and gender-matched controls.

Elevation of antibiotic resistance genes at cold temperatures: implications for winter storage of sludge and biosolids.

UNLABELLED: Prior research suggests that cold temperatures may stimulate the proliferation of certain antibiotic resistance genes (ARGs) and gene transfer elements during storage of biosolids. This could have important implications on cold weather storage of biosolids, as often required in northern climates until a time suitable for land application. In this study, levels of an integron-associated gene (intI1) and an ARG (sul1) were monitored in biosolids subject to storage at 4, 10 and 20°C. Both intI1 and sul1 were observed to increase during short-term storage (<2 months), but the concentrations returned to background within 4 months. The increases in concentration were more pronounced at lower temperatures than ambient temperatures. Overall, the results suggest that cold stress may induce horizontal gene transfer of integron-associated ARGs and that biosolids storage conditions should be considered prior to land application. SIGNIFICANCE AND IMPACT OF THE STUDY: Wastewater treatment plants have been identified as the hot spots for the proliferation and dissemination of antibiotic resistance genes (ARGs) and antibiotic resistant bacteria (ARB) to the environment through discharge of treated effluent to water bodies as well as application of biosolids to land. Identifying critical control points within the treatment process may aid in the development of solutions for the reduction of ARGs and ARB and curbing the spread of antibiotic resistance. This study found increases in ARGs during biosolids storage and identifies changes in operational protocols that could help reduce ARG loading to the environment when biosolids are land-applied.

[Most frequent causes of autologous graft failure in anterior cruciate ligament replacement]. / Nejcastejsí príciny selhání autologních náhrad predního zkrízeného vazu kolenního kloubu.

PURPOSE OF THE STUDY: The aim of this retrospective study was to present a comprehensive overview of the causes of bone-tendon-bone (BTB) autograft failure after primary anterior cruciate ligament (ACL) reconstruction. MATERIAL AnD METHODS: Between 2003 and 2013, we performed revision ACL replacement in 47 patients who had undergone primary BTB autograft ACL reconstruction in other hospitals. The group consisted of 16 women (aged 25 to 48 years) and 31 men (25 to 46 years). Surgery was performed on the right knee in 26 and on the left knee in 21 patients. In each of the 47 patients, two different assessments were made: 1. Analysis of causes of failure based on surgical protocols and/or intra-operative video records taken during most of the procedures. 2. Evaluation of bone tunnel location on lateral knee radiograms, using the method described by Harner for femoral tunnels and that reported by Stäubli and Rauschning for tibial tunnels. RESULTS: The most frequent cause of knee instability, occurring in 51.1% of the patients, was new trauma to the knee. nontraumatic instability in the remaining 48.9% was due to insuffiiency of the graft, and resulted from an incorrect surgical technique (42.5%) or biological causes (6.4%). The most common surgical mistake found was incorrect bone tunnel placement in the tibia or femur, with a malpositioned femoral tunnel being most frequent. This was diagnosed in 32 patients (68.1% of all patients) and, in 17, was the main or major cause of BTB graft failure. DISCUSSION: Based on relevant literature data and our experience, principles for prevention of graft failure after ACL reconstruction can be summarised as follows: 1. harvest of a suffiiently strong BTB autograft 2. accurate anatomical bone tunnel placement 3. appropriate tension of the BTB autograft 4. preventing graft impingement 5. secure graft fiation 6. early functional rehabilitation with an accent on delaying full weight-bearing on the knee (6 to 9 months post-operatively) CONCLUSIONS: New trauma to the knee is the most frequent cause of BTB autograft failure after ACL reconstruction. This can be avoided by participating in a professionally guided rehabilitation programme and not returning to sports activities earlier than 9 months after ACL reconstruction. The most common technical error in ACL reconstruction is non-anatomical tunnel placement in the tibia and femur. Femoral tunnel malposition is most frequent while incorrect tibial tunnel placement, which does not inflence graft failure so much, is less common.

[The role of MicroRNAs in the pathophysiology of neuroblastoma and their possible use in diagnosis, prognosis and therapy]. / Role mikroRNA v patofyziologii neuroblastomu a moznosti jejich vyuzití pro dia-gnostiku, odhad prognózy a terapii.

Neuroblastoma (NBL) is a typical childhood tumor developing from the precursor cells of the sympathetic nervous tissue and accounting for approximately 7% of total malignancies in pediatrics and 15% of deaths associated with this malignancy. MicroRNAs (miRNAs) are small single-stranded RNA molecules that are involved in posttranscriptional regulation of gene expression, whereas the pathophysiology of neuroblastoma tumor growth involves both upregulation of the protooncogenic miRNAs as well as downregulation of the tumor-suppresor ones. Comparison of the expression profiles of miRNAs in specific subtypes of neuroblastoma seems to be a useful tool adding to the classification of the diseases, and the assessment of the levels of specific miRNAs may be useful for estimation of the individual treatment response as well as prognosis of the patient. This paper provides the basic review of the studies focused on the role of miRNAs in pathogenesis of neuroblastoma and provides a survey of current/ possible use of these miRNAs in diagnostics, therapy or prognosis estimation in the neuroblastoma patients.

Comparison of the level of physical activity after the COVID-19 pandemic in Poland, Slovakia and the Czech Republic.

BACKGROUND: The COVID-19 pandemic was associated with limited physical activity (PA) of most of the world's population. This cross-sectional prospective study aimed to assess the levels of PA of university students in Poland, Czech Republic and Slovakia after COVID-19 using the International Physical Activity Questionnaire Short Form (IPAQ-SF). METHODS: A total of 2635 students completed questionnaires regarding their PA levels using the IPAQ-SF between September and December 2022. RESULTS: PA measured by metabolic equivalent of task (MET) scores, varied between the three countries: Slovakia median MET-minutes/week score 4459.9; Czech Republic 3838.8 Poland 3567.1. The results of the post hoc analysis revealed there were significant differences in MET-minutes/week values between the Czech Republic and Poland (p < 0.035) as well as between the Czech Republic and Slovakia (p < 0.037). The analysis of energetic expenditure during walking revealed that students from the Czech Republic and Slovakia had higher median MET-min/weeks values (Czech 2284.1; Slovak 2467.1) compared to their Polish (1536.1) peers (p < 0.001). Polish cohort presented with significantly higher body mass index (BMI) (p < 0.001) than Czech and Slovak groups (BMI Czech: 22.3; Slovak 22.8; Polish 23.8). CONCLUSIONS: Significant differences in PA levels between the Czech Republic, Poland, and Slovakia university students were identified. Slovakia showed the highest median PA measured as a MET score, and Poland showed the lowest. Compared to available pre-COVID studies it seems the total level of PA in the observed cohorts has not returned to the pre-COVID levels and students remain less active.

Evidence for kinetically limited thickness dependent phase separation in organic thin film blends.

We present depth-resolved grazing incidence x-ray diffraction, grazing incidence small angle scattering and x-ray reflectivity studies on the structure of mixed C(60) and diindinoperylene (DIP) films as a function of the mixing ratio. We observe enhanced out-of-plane order and smoothing of the mixed films compared to pure films upon coevaporation of DIP:C(60) thin films (in different mixing ratio) which otherwise phase separate. The mixing ratio of molecules can be tuned to alter the in-plane crystallite size as well as the interisland distances of the mixing molecules. Real-time in situ grazing incidence x-ray diffraction measurements show the kinetics and thickness dependence of phase separation, which appears to proceed only after a certain thickness. The crystallite grain size of the individual phase separated components is significantly larger at the top of the film than at the bottom with implications for the understanding of devices.