Interannual adjustments in stomatal and leaf morphological traits of European beech (Fagus sylvatica L.) demonstrate its climate change acclimation potential.

The current projections of climate change might exceed the ability of European forest trees to adapt to upcoming environmental conditions. However, stomatal and leaf morphological traits could greatly influence the acclimation potential of forest tree species subjected to global warming, including the single most important forestry species in Europe, European beech. We analysed stomatal (guard cell length, stomatal density and potential conductance index) and leaf (leaf area, leaf dry weight and leaf mass per area) morphological traits of ten provenances from two provenance trials with contrasting climates between 2016 and 2020. The impact of meteorological conditions of the current and preceding year on stomatal and leaf traits was tested by linear and quadratic regressions. Ecodistance was used to capture the impact of adaptation after the transfer of provenances to new environments. Interactions of trial-provenance and trial-year factors were significant for all measured traits. Guard cell length was lowest and stomatal density was highest across beech provenances in the driest year, 2018. Adaptation was also reflected in a significant relationship between aridity ecodistance and measured traits. Moreover, the meteorological conditions of the preceding year affected the interannual variability of stomatal and leaf traits more than the meteorological conditions of the spring of the current year, suggesting the existence of plant stress memory. High intraspecific variability of stomatal and leaf traits controlled by the interaction of adaptation, acclimation and plant memory suggests a high acclimation potential of European beech provenances under future conditions of global climate change.

[Mid-Term to Long-Term Results of Revision Total Hip Arthroplasty Using the Oval-Shaped Acetabular Cup - TC Type]. / Strednedobé az dlouhodobé výsledky reimplantací totální náhrady kycelního kloubu pri pouzití oválné revizní jamky ­ typ TC.

INTRODUCTION The purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODS Altogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010. The mean follow-up was 8.2 years (5.1-11.6 years after the reimplantation, more than 10 years in 16 patients who underwent surgery). The position and osseointegration of the implant were assessed by digital radiography, the remodelling of transplanted bone tissues in the area of defects and between the implant ribs by computed tomography with reducing artefacts around the metal implant (Aquilion 64 - Toshiba Medical Systems), and for the clinical outcomes the Harris Hip Score was used. RESULTS Preoperatively, the condition of the hip joint based on the Harris Hip Score was in 30 cases evaluated as poor, in 8 patients as satisfactory. At the time of final evaluation, 8 patients achieved excellent results, in 19 patients the condition of the joint was very good (in 2 patients bilaterally), in 6 patients it was considered satisfactory and in 3 patients poor. The mean value for HHS increased from 39.5 to 84.5. Based on the radiography evaluation, in 27 patients (in 2 patients bilaterally) the osseointegration of the revision cup was good, in 8 cases with a radiolucent line of 2-4 mm in width in DeLee zone III, in one case proximal migration of the cup occurred caused by deep infection. The informed consent form for pelvic CT was signed by 25 patients of our cohort. Remodelling of bone tissue in the space between the ribs of the implant was always detected, the presence of bone cysts was not reported, the bone defects following the application of autologous spongioplasty in the monitored patients were healed. In 6 patients, an ingrowth of fibrous tissue of 2-4 mm in width in the convexity of the cup was detected. The mean survival of the revision oval-shaped cup - TC type with a follow-up of 8.2 years after the reimplantation based on Kaplan-Meier analysis was 91.4 %. DISCUSSION The number of revision total hip arthroplasties due to a younger age of patients who undergo alloplasty keeps growing. The choice of a revision implant should always match the intraoperative finding and the bone tissue quality. The standard uncemented implants with osteoactive surface can be opted for when anterior and posterior column of the acetabulum are intact (IIA and IIB according to Paprosky). Starting from type IIC, also the proximal part of acetabulum shall be considered. At our department, preference is given to the revision cup - TC type. The oval shape facilitates a lower degree of bone resection and easier restoration of the anatomical centre of rotation. Careful debridement of granulating and necrotic tissue, thorough treatment of bone defects and osteoactive surface of implants in case of adequate primary fixation of the cup substantially contribute to the quality of its osseointegration. Greater rigidity of fixation verified by pull-out tests enables to insert angular stable screws into the gaps in the proximal part of the cup. There is still room for improvement in treating the bone defect. The application of allogenic bone grafts into the defects and spaces between the ribs of the TC cup is more challenging than the use of augmentation in the systems with trabecular titanium. Based on the evaluation of CT scans, remodelling of the transplanted bone occurs, therefore the defect zone is reduced. CONCLUSIONS The oval-shaped uncemented cup - type TC meets the requirements placed on a state-of the art revision implant, moreover its specific construction helps improve the conditions where another re-operation of acetabulum is necessary. By evaluating mid-term to long-term results of non-homogenous group of 36 patients (38 cups) we have obtained data on joint function comparable to similar groups with revision uncemented implants presented in our and foreign literature. Key words: revision oval-shaped cup, bone remodelling, pull-out tests, angular stable screws, computed tomography.

Heat shock protein gene expression profile may differentiate between rheumatoid arthritis, osteoarthritis, and healthy controls.

OBJECTIVE: Heat shock proteins (Hsps) have been repeatedly implicated in the pathogenesis of rheumatoid arthritis (RA). The aim of this work was to study Hsp mRNA and protein levels to determine whether they can be used to differentiate between RA, osteoarthritis (OA), and healthy controls. METHODS: Hsp27, Hsp60, Hsp70, Hsp90α, and HspBP1 mRNA expression was analysed using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) in 24 RA, 11 OA, and 21 healthy controls. Hsp70 and HspBP1 protein levels were measured in serum using an enzyme-linked immunosorbent assay (ELISA). RESULTS: Hsp gene expression profiles differ significantly between inflammatory (RA) and non-inflammatory (OA) joint diseases, showing significantly increased Hsp27 and Hsp90α mRNA levels in RA synovial tissues. Up-regulated Hsp60 and Hsp90α together with down-regulated Hsp70 and elevated HspBP1/Hsp70 mRNA ratios can be used to differentiate between RA patients and healthy individuals through analysis of peripheral blood samples. Despite increased HspBP1 levels in RA sera, Hsp70 levels and the HspBP1/Hsp70 protein ratio remained identical in the RA patients and healthy individuals, which may contribute to the inhibition of Hsp70 anti-apoptotic activity. CONCLUSION: Hsp gene expression analysis can be implemented as a new diagnostic approach to facilitate differentiation between RA, OA, and healthy controls.

[Cementless total hip replacement type S.F.: mid-term results]. / Strednedobé výsledky a nase zkusenosti s necementovanou endoprotézou kycelního kloubu typu S.F.

PURPOSE OF THE STUDY: The authors evaluate the mid-term results and their experience with the cementless total hip replacement Beznoska type S.F. "Slavík, Fencl" in a group of 40 patients. MATERIAL: During 2002, a total of 46 patients underwent implantation of a cementless total hip replacement (THR) type S.F. Six patients failed to come to the final follow-up at 5 years after surgery. Coxarthritis was the indication for primary surgery in the majority of the patients. The average age of the group, which comprised 20 men and 20 women, was 63 (50-75) years. METHODS: At the end of 2007, 40 patients were evaluated at an average follow-up of 62.5 months. The patients' age, gender, body mass index, physical activity, diagnosis on which indication for surgery was based, size of each cementless component and intra- and post-operative complications were recorded. The objective outcome was assessed using the Harris Hip Score (HHS), signs of secondary stability were evaluated on radiographs at 3, 6 and 12 months, then at 3 and 5 years after the primary THR. RESULTS: The primary fixation of all components was always good. In the post-operative period there was no THR dislocation and no loosening of the polyethylene acetabular liner from the titanium shell. One patient suffered a periprosthetic fracture following a fall. At 5-year follow-up, no evidence of acetabular loosening was found one patient required polyethylene liner exchange for excessive wear. Thirty-eight stems were evaluated as stable, with three stems showing ingrowth of a fibrous intermediate layer. Only one femoral component was assessed as unstable with a suspected late haematogenous infection. The mean HHS value was 45.6 before THR and 90.3 at 5 years after the primary surgery. The results were excellent in 24, very good in 12, fair in two and poor in two patients. DISCUSSION: If the correct surgical procedure is observed, a perfect press-fit fixation of both components can always be achieved. The S.F. type implant can also be used for a dysplastic acetabulum in this case a deeper reaming of the acetabular bed in preferred to acetabular augmentation (acetabuloplasty). The excessive polyethylene wear in one patient can be accounted for by the patient's overdone daily exercise the imperfect secondary osteointegration of three stems was probably due to the selection of a smaller femoral component than it was appropriate. When an undersized stem is used, insufficient implant osteointegration and a higher incidence of pain symptoms should be expected. The findings of signs of stress shielding were in accordance with those reported in the literature. CONCLUSIONS The mid-term clinical results and evidence of good osteointegration of both components five years after primary implantation of the THR type S.F. in 40 patients are very satisfactory. This group of patients will be followed up for another 5 years and evaluated.

[Allogenic transplantation of bone marrow in childhood]. / Alogenní transplantace kostní drene v detském veku.

BACKGROUND: Bone marrow transplantation has become the therapeutic method in some forms of malignant haemotopoietic diseases, malignant tumours, inborn errors of metabolism and immunodeficiency states. The objective of the presented work is the analysis of 40 allogenic bone marrow transplantations in children made in 1989-1994. METHODS AND RESULTS: Bone marrow transplantation was made in 40 children (26 boys and 14 girls), mean age 10.5 years (range 1.5-17.5 years). Indications were acute lymphoblastic leukaemia in 11, acute myeloid leukaemia in 10, chronic myeloid leukaemia in 6, myelodysplastic syndrome in 2, aplastic anaemia and Fanconi's anaemia in 7, non-Hodgkin lymphoma in 2 and inborn errors in 2 children. The donor was in 33 patients in HLA identical sibling and in seven instances a monozygotic twin, HLA non-identical sibling or relative or unrelated matched donor. Bone marrow engraftment was achieved in 35 (87.5%) patients, in one instance the bone marrow was rejected (2.5%) and in four patients (10%) early death occurred before the bone marrow engraftment. On Aug. 15, 1995 20 patients (50%) survived, a relapse developed in 7 (17.5%) and 13 patients died in conjunction with the transplantation (32.5%). The most frequent cause of death were infectious complications (9 children) either in conjunction with the development of graft versus host reaction (6x) or without signs of this reaction (3x). As a prophylaxis of graft versus host disease 24x Cyclosporine A with corticosteroids was used, 16x with methotrexate. A chronic graft versus host disease developed in 6 of 28 children surviving 100 days after transplantation. The greatest problem are infectious (bacterial and mycotic) complications in the phase of bone marrow aplasia before engraftment of the transplanted bone marrow or in conjunction with a graft versus host reaction which cannot be completely avoided by preventive measures. CONCLUSIONS: Bone marrow transplantation is also in children an effective therapeutic method of some forms of malignant haematopoietic diseases, malignant tumours and immunodeficiency states. The correct indication, suitable donor, preventive measures against the graft versus host reaction and protection against infectious complications are essential for the success of this pretentious treatment.

[Surgical treatment of patients with juvenile cerebral palsy at the orthopedic clinic of the Charles University Medical School in Prague-Motol]. / Operacní lécení pacientu s detskou mozkovou obrnou na ortopedické kliníce FDL UK Praha-Motol.

In the period of 1976-1987 there were in total 181 patients operated on with the diagnosis of infantile cerebral palsy at the Orthopaedic Clinic of the Faculty of Pediatrics of Charles University in Prague-Motol. 412 operations were performed in total in these patients. The indication was mainly the improvement of the statics and gait, therefore operations on lower extremities prevailed. Within the preoperative preparation it is essential to precisely classify the type of affection of the patient from the neurological viewpoint and mainly estimate the future physical and psychical abilities of the child which is of substantial importance in the postoperative treatment. The surgical solution is always individual and respects the specificity which need not be symmetric on both extremities. Therefore the range of orthopaedic operations is wide. The surgeon has to treat the equinus position of the foot, the valgus position, flexion contractures of knees, adduction position in hip joints. In case it is necessary to operate the affection of the entire lower extremity the specialists at the above mentioned Orthopaedic Clinic prefer a single solution to the stepwise one. Recently the surgical treatment of patients suffering from spasm has achieved a certain progress. Substantial is the contribution for patients who on the basis of the operation regain the ability to walk. Therefore the authors emphasize the importance of the cooperation of the neurologist and the rehabilitation worker with the orthopaedic surgeon when considering comprehensive therapeutical possibilities.