[Evaluation of operative treatment of subcutaneous rupture of the achilles tendon--correlation between clinical presentation and ultrasound examination]. / Ocena wyników leczenia operacyjnego podskórnego zerwania sciegna Achillesa--korelacja obrazu klinicznego i USG.

OBJECTIVE: To improve of the effectiveness of surgical procedures in the repair of rupture of the Achilles tendon, some surgeons use various augmented techniques. The purpose of this study was to evaluate the value of the use of graft from the fascia lata to add strength to the Bunnell suture in the treatment of subcutaneous tear of the Achilles tendon on the base of clinical and ultrasonographic results. MATERIALS AND METHODS: 44 cases of the Achilles tendon lesion in 43 patients were included to the study. The patients were placed quasi-randomly into one of the two groups--group A of 26 tendons, repaired using the Bunnell suture with the reinforcement by a graft of the fascia lata, and group B of 18 tendons, repaired with simple end-to-end Bunnell suture. Results of the treatment were evaluated by the objective 100-point Hannover scale and subjectively by the modified Rupp scale. Results of the static and dynamic ultrasound examination were also analysed. RESULTS: There was no statistically significant difference due to Hannover and Rupp scales in results between the two repair methods. The analysis of results of ultrasound examinations demonstrated that the decreased visibility of internal structures was statistically greater in the patients whose tendon was sutured using a graft from the fascia lata. The treatment method did not, however, influence the presence of inflammatory changes or the quality of sliding ability, as seen in ultrasound. CONCLUSIONS: Open reconstruction of the subcutaneous rupture of the Achilles tendon, regardless fascia lata was used or not, gives a high percent of positive results, both in subjective and objective evaluations. Use of the fascia lata in repair of the Achilles tendon increases the probability of ultrasonographically visible structural changes in the tendon without clinical consequences.

Parenteral ambroxol treatment causes xanthine and calcium oxalate stones in rats.

INTRODUCTION: Ambroxol (ABX) is known to promote bronchial secretion and is used as an expectorant. This study was undertaken to document the connection between ambroxol parenteral treatment and bladder stones in rats. MATERIAL AND METHODS: Forty-five wild rats (Rattus sp.) were divided into three equal groups. Rats from the first and second groups received ABX s.c. during 2 weeks in total doses of 30 mg/kg per 24 h and 60 mg/kg per 24 h, respectively. Rats from the control group received 1 mL of injection solution s.c. One month after the treatment termination, animals were sacrificed and urinary tracts without urethra were dissected. Stones found in the bladders were measured, weighed and chemically analysed. Voiding cystography was performed to exclude pathology of the lower urinary tract. Photo documentation was produced. RESULTS: From the first and second groups, 33% and 47% of rats, respectively, had solitary stones in the bladder. In one case from the second group, there was a huge stone in the bladder and urethra. There were no stones in rats from the control group. The mean length of stones was 1.38 +/- 0.23 mm and 1.41 +/- 0.60 mm in the first and second groups, respectively. Mean stone weight was 1.2 +/- 0.2 x 10(-3) g and 1.44 +/- 0.54 x 10(-3) g. Stones were composed of 67% of xanthine and 33% of calcium oxalate. CONCLUSIONS: Ambroxol parenteral treatment caused xanthine and oxalate stone formation. Attention should be paid to the possibility of urinary stone formation after long-term ABX treatment.

Ozone therapy and the activity of selected lysosomal enzymes in blood serum of patients with lower limb ischaemia associated with obliterative atheromatosis.

BACKGROUND: The paper compares the effects of ozone therapy and conventional balneological methods on health condition of patients with obliterative atheromatosis and on serum activity of three lysosomal enzymes. MATERIAL/METHODS: Sixty-four patients with lower limb ischaemia in the course of obliterative atheromatosis (without diabetes) were enrolled in the study. Thirty-two patients were treated with ozone administered by intravenous infusions and 30-minute aerosol oxygen-ozone baths. A comparative group was formed of 32 patients treated with traditional balneology. There was also a control group made up of 30 healthy subjects. Ozone therapy as well as traditional balneology were administered daily for the period of 10 days, excluding Saturdays and Sundays. Blood for biochemical analysis was collected from elbow vein in the following time intervals: 24 hours before ozone therapy or classical balneology, one hour after therapy and on the 10th day of treatment. The activity of cathepsin D, acid phosphatase and arylsulphatase as well as the levels of a-1-antitrypsin (protease inhibitor) were determined in blood serum of patients with obliterative atheromatosis. RESULTS: In patients who received ozone therapy the activity of analysed lysosomal hydrolases returned to the values typical for healthy subjects. Patients' general condition also improved. The use of traditional balneological methods did not result in any significant change either in the activity of lysosomal hydrolases, the level of a-1-antitrypsin or general condition of patients. CONCLUSIONS: Ozone therapy administered by intravenous infusions and aerosol oxygen-ozone baths of lower extremities yields much better therapeutic results in comparison with classical balneology.