Biomechanics of leg deformity treatment.

At pre-school age, there is a possibility to treat severe varosity and/or valgosity of legs by orthoses. The three points force effect of the orthosis partially corrects the pathologic defect of the leg. If the orthosis is intermittently used for a long time the correction is permanent. Step by step correction of bone deformities are based on remodelling of growth epiphyses and bones that are caused by orthotic bending pre-stressing. According to Hüter-Volkmann's law, the oblique loading regulates the growth of epiphyseal plates of long bone into the direction of the pressure result and the bone remodelling process is started: it means that the bone grows at the tensile part of growth epiphyses more quickly than at pressure one and gradually eliminates the varosity and/or valgosity defect. The knowledge of stress values for starting of the bone remodelling process is principal for clinical praxis. The values of pre-stressing cannot be increased by starting the remodelling process from the ethical point of view but it can be judged on its starting according to the success of the treatment. The aim of this article is to study the bone, ligament stress state and deformations of successful treatment. Method and calculation algorithm of stress state and deformation that are necessary for the starting of the remodelling process at the knee region were verified on a group of eight patients that were fitted by orthoses with bending pre-stressing. The space models of the knee, femur and tibia were composed with the help of X-ray, CT and MRI scan. The calculation algorithm was implemented on a PC and the program can be easily applied at clinical praxis.

Preclinical development of a vaccine 'against smoking'.

BACKGROUND: Nicotine is the main culprit for dependence on tobacco-containing products, which in turn are a major etiologic factor for cardiovascular diseases and cancer. This publication describes a vaccine, which elicits antibodies against nicotine. The antibodies in the blood stream intercept the nicotine molecule on its way to its receptors and greatly diminish the nicotine influx to the brain shortly after smoking. METHODS: The nicotine molecule is chemically linked to cholera toxin B as a carrier protein in order to induce antibodies. The potential to elicit antibodies after subcutaneous as well as intranasal immunization is evaluated. In order to simulate realistic conditions, nicotine pumps delivering the nicotine equivalent of 5 packages of cigarettes for 4 weeks are implanted into the mice 1 week prior to vaccination. The protective effect of the vaccine is measured 5 weeks after vaccination by comparing the influx of radiolabeled nicotine in the brains of vaccinated and non-vaccinated animals 5 min after challenge with the nicotine equivalent of 2 cigarettes. RESULTS: The polyclonal antibodies induced by the vaccine show a mean avidity of 1.8 x 10(7) l/Mol. Subcutaneous immunization elicits high antibody levels of the IgG class, and significant IgA antibody levels in the saliva of vaccinated mice can be found after intranasal vaccination. The protective effect also in the animals with implanted nicotine pumps is significant: less than 10% of radiolabeled nicotine found in the brains of non-vaccinated animals can be found in the brains of vaccinated animals. CONCLUSIONS: These data provide credible evidence that a vaccine can break the vicious circle between smoking and instant gratification by intercepting the nicotine molecule. Astonishingly, there is no sign of exhaustion of specific antibodies even under extreme conditions, which makes it highly unlikely that a smoker can overcome the protective effect of the vaccine by smoking more. Finally, the high titers of specific antibodies after 1 year let us hope that booster vaccinations are probably only necessary in intervals of years.

[Incidence of carcinomas in goiters and their combination with Hashimoto's thyroiditis]. / Incidence karcinomu ve strumách a jejich kombinace s Hashimotovou tyroiditidou.

In the investigated group 300 patients were operated for a thyropathy mostly struma nodosa, tumours were proved in 69 cases; 38 of them were carcinomas of various extent and 3 of them were combined with Hashinoto's lymphomatous goitre. The overwhelming majority of the carcinomas were papillary carcinomas (22 cases). The incidence of papillary carcinoma in Hashimoto's goitre was about 8%; this fact calls for more attention to autoaggressive thyroiditis both in examination of surgical material, and during autopsies in middle-aged women, where this thyroiditis is often clinically silent. Our results suggest an increase in the incidence of carcinoma in Hashimoto's goitre and the generally accepted rarity of this coincidence is questioned. We recorded also a lower incidence of medullary carcinoma than the worldwide average and a more frequent incidence of mixed-type carcinoma.

[Heterotopic chondro-osteoplastic metaplasia of the subclavian vein wall after long-term catheterization. Case report]. / Heterotopická chondroosteoplastická metaplazie steny vena subclavia po dlouhodobé kanylaci. Kazuistické sdelení.

A 59-year-old man admitted for i.m. had a 3-way cannula inserted into the right subclavian vein for 31 days. Autopsy revealed a circular firm thickening of the venous wall. Histology identified it as chondroid and osteoid tissue replacing adventitial connective tissue. Unusual chondroosteoplastic metaplasia not described up to now is discussed as about its causes.

The effect of biological media on the hydrolysis of mustard simulants.

A useful decontaminant for mustard would be one which is readily available in large quantities, inexpensive and potentially biodegradable. Currently one that is being investigated consists of a mixture containing bovine hemoglobin, gelatin and poi. Two of them, gelatin and poi, are common foodstuffs in the diet on the mainland of the United States and in the Hawaiian culture, respectively. Various combinations of these substances have unusual flow properties since the physical states change from a liquid to a gel form. The hydrolytic kinetics of the mustard simulants, 2-chloroethyl ethyl, 2-chloroethyl methyl and 2-bromoethyl phenyl sulfide are reported. The kinetic mechanisms and rate constants are dependent upon the mixtures' concentration and viscosity.

Effects of cadmium on osteoclast formation and activity in vitro.

Chronic exposure to cadmium has been linked to bone loss, low bone mass, and increased incidence of fracture. To determine if Cd could directly increase the formation of cells responsible for bone resorption, we cultured normal canine bone marrow cells containing the progenitor cells for osteoclasts. Cultures were evaluated for the number of multinucleate osteoclast-like cells (MNOCs) formed. Exposure to Cd (10-100 nM) increased the number of MNOCs formed over control values when cultured in the presence but not in the absence of a bone wafer. The MNOCs formed were functional, evidenced by pits excavated on the bone wafers included in the cultures. By 12 days, MNOCs formed in the presence of 50 nM Cd excavated significantly more pits and a greater pit area than did untreated MNOCs. By 14 days, the control values were similar to those of the Cd-exposed MNOCs, but pit formation was enhanced by Cd in that the ratio of pit complexes to single pits was increased twofold over that for untreated cultures. Mature osteoclasts, isolated from the long bones of rat neonates and cultured for 1-3 days on bone slices, provided a direct method to assess the effect of Cd on osteoclast activity. Exposure of osteoclast cultures to 100 nM Cd increased the number of osteoclasts present over that for untreated osteoclasts by a factor of 1.7 +/- 0.1, the number of pits excavated by 2.8 +/- 0.6, the area excavated by 3.2 +/- 0.8, and the area excavated per osteoclast by 1.8 +/- 0.4 (mean +/- SE; n = six experiments). These data suggest that Cd accelerates the differentiation of new osteoclasts from their progenitor cells and activates or increases the activity of mature osteoclasts.

A starch-hemoglobin resuscitative compound.

A resuscitative compound in freeze-dried form has been synthesized between a modified starch and a tetremerically stabilized hemoglobin. In order to complex the hemoglobin, the starch has been prepared in mono-, di-, tri-, and tetra-aldehyde moieties. The hemoglobin was stabilized with low molecular weight diacids. Electrophoretic densitometric patterns indicate compound formation. The resulting polymers were characterized with respect to oxygen transport (biotonometry), Hill constant and P50. The in vivo evaluation indicates that these compounds are effective in exchange-transfusion experiments with rats to a level of about 85% replacement of whole blood. The final product is a cost-effective acellular resuscitative compound which can be stored in freeze-dried form at room temperature for extended periods of time. This artificial blood substitute can be reconstituted upon the addition of water.

Mixtures of erythrocytes and acellular fluids: an in vitro evaluation.

To evaluate the biophysical properties of two acellular resuscitative fluids, experiments were performed using mixtures of these with suspensions of red blood cells. Two acellular resuscitative fluids were synthesized using a diacid to tetramerically stabilized hemoglobin and then complexing it with either a hydroxyethyl starch or a Tetronic Polyol. The new polymers were characterized with respect to the molecular weight, second virial coefficient and intrinsic viscosity. These fluids were then combined with red cells and the following measurements were made: non-Newtonian flow properties, malonamide induced hemolytic kinetics, sedimentation rates and oxygen transport. The in vitro evaluation indicates that these compounds are effective hemodiluents, offer protection to the red cell membrane and do not cause erythrocyte aggregation. The oxygen transport was satisfactory.

[The effect of creatine phosphate in patients after surgery in ischemic heart disease]. / Pusobení kreatinfosfátu u nemocných operovaných pro ischemickou chorobu srdecní.

The authors submit their experience with the use of creatine phosphate in patients operated on account of coronary heart disease. They divided 50 consecutive patients into three groups. Group A--controls, group B--creatine phosphate was added to the filling of the apparatus for extracorporeal circulation and group C--creatine phosphate was added to Bretschneider's cardioplegic solution. During operation and during the early postoperative period the CK and CK MB levels were evaluated as well as levels of free acid radicals, the haemodynamic state of the patients, the incidence of ventricular dysrhythmias, the need of defibrillation, histological and histochemical examinations. The authors found a lower CK and CK MB level, a lower percentage of ventricular dysrhythmias and the same haemodynamic results of the operation in patients with a more markedly impaired systolic function of the left ventricle when creatine phosphate was used. Creatine phosphate did not affect the morphology of the heart muscle nor the level of the assessed myocardial enzymes.

[Composite carcinoma-carcinoid of the large intestine]. / Kompozitní karcinom-karcinoid tlustého streva.

The authors give an account of a bioptically revealed adenocarcinoma of the large bowel which was combined with a carcinoid. The carcinoid constituent of the tumor had massive metastases as revealed by the postmortem examination.

[Tumor-related partial pseudocirrhosis of the liver]. / Tumorigenní parciální pseudocirhóza jater.

Unusual sort of breast carcinoma metastases to the liver, combined with pseudolobular transformation, was found in an autopsy of 68-year-old female after complete oncological treatment. Nodes of parenchyma in abundant connective tissue nearly consisted of tumour cells. Terminology and pathogenesis were discussed.

Purification of an inositol 1,4,5-trisphosphate-binding calreticulin-containing intracellular compartment of HL-60 cells.

To investigate the identity of Ins(1,4,5)P3-sensitive intracellular Ca2+ stores in myeloid cells, we have developed a method that yields subcellular fractions highly enriched in Ins(1,4,5)P3 binding. HL-60 cells were disrupted by nitrogen cavitation, and subcellular fractions were obtained by differential centrifugation, followed by Percoll- and sucrose-density-gradient separations. A subcellular fraction enriched 26-fold in Ins(1,4,5)P3-binding sites was obtained. This fraction showed no enrichment in plasma-membrane markers and only a comparatively moderate enrichment (7-fold) in endoplasmic-reticulum markers. The ratio between specific enrichment of Ins(1,4,5)P3 binding and endoplasmic-reticulum markers in the different fractions varied over 50-fold, from less than 0.1 to greater than 5. The purified Ins(1,4,5)P3-binding fraction was enriched to a similar extent (27-fold) in the putative intravesicular Ca(2+)-storage protein calreticulin. Our results favour the concept of a distinct Ins(1,4,5)P3-binding, calreticulin-containing compartment (i.e. the calciosome) in HL-60 cells.

A potential blood substitute from a tetronic polyol and a modified hemoglobin.

This investigation reports a new potential blood substitute. An acellular fluid is formed between a Tetronic polyol and a modified hemoglobin. It was possible to stabilize the hemoglobin with glutaric acid. The subsequent reaction with the alcohols of the Tetronic polyol resulted in a useful resuscitative fluid. Exchange transfusion experiments in rats was possible at the 75% replacement level with an excellent survival rate. This was apparently possible because of the effective transport properties of this material. Histological sections of the liver, kidney and lungs showed little or no permanent damage to the organs. The Tetronic polyol - modified hemoglobin complex was not excreted in the urine in contrast to the modified hemoglobin by itself and a solution of unmodified hemoglobin. These preliminary studies indicate that this combination of a polymer and modified hemoglobin has a potential use as a red cell substitute.

Stabilized hemoglobins as acellular resuscitative fluids.

This study reports some recent work dealing with the stabilization of the tetramers of hemoglobin. It is shown that by using a variety of diacids, it is possible to increase the P50 above that of stroma free hemoglobin. In order to lengthen the retention times in the circulatory system, the stabilized hemoglobins were complexed with both hydroxyethyl starch polymers and polyol tetronic polymers. The resulting hemoglobin-polymer compounds were then freeze-dried. It was possible to reconstitute the powder by the addition of physiological saline when needed. The methods presented here appear to be appear to be as effective as using pyridoxal phosphate but at a fraction of the cost.

[Use of the tissue glue, Tissucol, in experimental liver injuries]. / Pouzití tkánového lepidla Tissucol pri poranení jater v experimentu.

The authors investigated in experiments on rabbits the course of recovery of liver injuries after treatment with the fibrin glue Tissucol, as compared with a control group of animals where the injured liver was not treated. Healing was followed-up at several time intervals. Rupture of the liver left to spontaneous healing was at first unsatisfactory from the histological aspect (wide demarcation margin near the necrosis). Subsequently the margin disappeared however. The scar was minimal after two months and were no manifestations of inflamed parenchyma surrounding the scar. When Tissucol was used, as a rule favourable healing was achieved. Scarring was satisfactory although the connective tissue was somewhat wrinkled and the scar was not linear. On the whole the tissue glue Tissucol is favourable in the final stage despite the fact that during healing a granulomatous reaction to the glue developed and the proliferation of the minor biliary pathways persisted also in the final stage of the experiment.

Diagnosis and differentiation of HTLV-I and HTLV-II infection by enzyme immunoassays using synthetic peptides.

Synthetic peptides from the major envelope protein of HTLV-I (ENV-I, amino acid 177-213) and HTLV-II (ENV-II, amino acid 173-209) and a conserved region of the transmembrane protein (TM, amino acid 378-402) were used as antigens in microtiter plate enzyme immunoassays (EIA) to detect and discriminate antibodies to HTLV-I and II. The ENV-I and ENV-II peptide EIAs were able to correctly discriminate HTLV-I and II infections in 17 of 18 subjects whose infections were determined by a gene amplification method. Sera from 100 of 107 subjects with serologically confirmed infection with HTLV-I/II and 0 of 218 seronegative controls reacted with one or more of the peptides (sensitivity, 93.5%; specificity, 100%). Ninety-six of the 100 peptide positive sera reacted exclusively with either the ENV-I or the ENV-II peptide, thereby differentiating the two viral infections. The pattern of reactivity to the ENV peptides was distinct in different populations. Patients attending an Emergency Department, who had a history of drug abuse, and male inmate entering a correctional facility only had antibody reactivity to the ENV-II peptide. Subjects from Haiti and patients with HTLV-associated neurological disease only had antibody reactivity to the ENV-I peptide. Peptide-based enzyme immunoassays that distinguish antibodies to HTLV-I and HTLV-II will facilitate studies of the epidemiology of HTLV.

[Spatial positional orientation in deaf-mute individuals with bilateral vestibular areflexia]. / Prostorová polohová orientace u hluchonemých jedincu s oboustrannou vestibulární areflexií.

Ten deaf-mute subjects with total vestibular areflexia were subjected to positional tests, i.e. assessment of the postural subjective vertical and horizontal plane by deviations in the frontal and sagittal plane. The tests were performed in the author's modification of a Grahe table. Comparison with the results of 10 healthy subjects revealed that extinction of vestibular activity increases the inaccuracy of assessment of the body position in space. The conclusion is: the vestibular (otolith) apparatus supplements and makes the activity of all other gravireceptors more accurate but not hold a dominant place among them.

[Treatment of liver rupture in an experiment]. / Osetrení jaterních ruptur v experimentu.

The authors investigated in experiments on rabbits healing of liver incisions under various circumstances: spontaneous healing, liver incisions treated by suture by application of the tissue glue Tissucol, the collagenous haemostatic felt Collastypt combined with one stitch. Healing was followed up after several time intervals. From normal, i.e. the group of spontaneous healing, differed the groups treated by Tissucol and Collastypt where marked encapsulating fibrous tissue reactions round the necroses on the wound margins were found with numerous eosinophils as a transient phenomenon. The final result (with a maximum of cca two months) was adequate in all groups--as a rule a thin fibrous tissue scar with few remnants of atrophic hepatic trabeculae. In the treatment of small injuries it seems best to use the collagenous haemostatic Collastypt. In the treatment of sutures in rare instances a large number of leucocytes was found in the area of the necrosis and stitches, perhaps as result of contamination of the wound or sewing material.

[Effect of celiprolol on isoprenaline-induced myocardial necrosis]. / Ovlivnení izoprenalinových nekróz myokardu celiprololem.

The assessed elevated catecholamine levels in the organism during substantial physical or mental stress lead to changes in the heart rate and to intensification of contractions. The demands of the heart muscle as regards increased oxygen supplies and are not met. This may have serious consequences for the patient. The authors wanted to find out therefore whether the beta-blocker celiprolol will be able to reduce the negative effect of large amounts of catecholamine in the organism and thus play a part in the prevention of myocardial damage. When celiprolol was administered half an hour before isoprenaline, the extent of necrosis caused by catecholamine was reduced. When administered half an hour after isoprenaline administration, the marked protective effect was no longer observed. The necroses in the heart muscle were similar as in animals given catecholamine only.