Long-term changes of Th17 and regulatory T cells in peripheral blood of dogs with spinal cord injury after intervertebral disc herniation.

BACKGROUND: Intervertebral disc herniation (IVDH) is one of the most common causes of spinal cord injury (SCI) in dogs. As a result of acute SCI, a complex inflammatory response occurs in the spinal cord. Th17 cells (Th17) produce pro-inflammatory cytokines, while regulatory T cells (Treg) have opposite effects producing anti-inflammatory cytokines. Therefore, the aim of this study was to determine whether Th17- and Treg cells are involved in the pathogenesis of SCI or whether cellular changes occur due to coexisting inflammatory diseases. We hypothesized that chronic alterations in the Th17/Treg ratio are associated with a worse outcome after SCI. METHODS: Twenty-six paretic or plegic dogs with IVDH with and without coexisting inflammatory disease were investigated in the acute stage of the disease and after recovery of SCI. In addition, a healthy control group was included (n = 14). Quantification of Th17 and Treg cells, from peripheral blood samples, was performed by multicolor flow cytometry and IL17 was measured using an enzyme-linked immunosorbent assay (ELISA). RESULTS: After recovery significantly higher levels of Th17 (p = 0.0265) and Treg cells (p = 0.00025) were detected compared to acute IVDH but Th17/Treg ratio did not differ significantly. Recovered dogs and the control group did not differ significantly from each other. No association between an imbalance in the ratio and neurologic severity or underlying inflammatory diseases was found. CONCLUSION: This study demonstrated that altered Th17 and Treg levels in peripheral blood are altered in the acute stage of IVDH, preexisting inflammatory diseases seem not to influence these cell populations. Th17 and Treg cells could be considered when evaluating new treatment strategies for SCI.

Spider silk nerve graft promotes axonal regeneration on long distance nerve defect in a sheep model.

Peripheral nerve injuries with substantial tissue loss require autologous nerve transplantation or alternatively reconstruction with nerve conduits. Axonal elongation after nerve transection is about 1 mm/day. The precise time course of axonal regeneration on an ultrastructural level in nerve gap repair using either autologous or artificial implants has not been described. As peripheral nerve regeneration is a highly time critical process due to deterioration of the neuromuscular junction, this in vivo examination in a large animal model was performed in order to investigate axonal elongation rates and spider silk material degradation in a narrowly delimited time series (20, 30, 40, 50, 90, 120, 150 and 180 days) by using a novel spider silk based artificial nerve graft as a critical prerequisite for clinical translation. Autologous nerves or artificial nerve conduits based on spider silk of the spider species Trichonephila edulis were transplanted in a 6.0 cm nerve defect model in the black headed mutton. At each of the post-implant time point, electrophysiology recordings were performed to assess functional reinnervation of axonal fibers into the implants. Samples were analyzed by histology and immunofluorescence in order to verify the timeline of axonal regeneration including axonal regeneration rates of the spider silk implant and the autologous transplant groups. Spider silk was degraded within 3 month by a light immune response mainly mediated by Langhans Giant cells. In conjunction with behavioral analysis and electrophysiological measurements, the results indicate that the spider silk nerve implant supported an axonal regeneration comparable to an autologous nerve graft which is the current gold standard in nerve repair surgery. These findings indicate that a biomaterial based spider silk nerve conduit is as effective as autologous nerve implants and may be an important approach for long nerve defects.

Vestibular disease in dogs: association between neurological examination, MRI lesion localisation and outcome.

OBJECTIVES: To determine whether the neurological examination correctly distinguishes between central and peripheral vestibular lesions in dogs. MATERIALS AND METHODS: Retrospective study on dogs with vestibular disease presenting to two referral clinics in Germany. RESULTS: Ninety-three dogs were included; neurological examination suggested central vestibular disease in 62 and a peripheral lesion in 31. MRI diagnosis was central vestibular disease in 68 dogs and peripheral in 25. Of the 62 dogs with a lesion localisation diagnosed as central vestibular by neurological exam, 61 were correctly identified (98.4%). Twenty-four of the 31 dogs diagnosed with a peripheral lesion by neurological exam had a consistent lesion on MRI (77.4%). CLINICAL SIGNIFICANCE: The neurological examination is efficient at identifying lesions in the central vestibular system but less so for peripheral lesions. Therefore it is prudent to recommend imaging in dogs that show signs of peripheral vestibular syndrome but do not rapidly respond to treatment.

Cervical myelopathy due to complex Atlanto-axial malformation including partial atlantal dorsal arch aplasia in a domestic rabbit.

A 1-year-old dwarf rabbit was presented with sub-acute progressive tetraparesis. Radiography, CT and MRI revealed compressive cervical myelopathy secondary to a complex atlanto-axial malformation including partial aplasia of the atlantal dorsal arch, dens malformation, malarticulation and lateral atlanto-occipital displacement. Owners decided against surgical treatment and elected conservative treatment including analgesia with non-steroidal anti-inflammatory drugs, cage rest and physiotherapy. Within 2 months clinical signs deteriorated and the owner elected euthanasia. Subsequent necropsy confirmed imaging findings. Similar cases described in humans and dogs suggest that partial aplasia of the dorsal arch of the atlas might often be an asymptomatic radiologic finding in these species. In contrast, this first description of a similarly affected rabbit demonstrates that complex atlanto-axial malformations can cause severe clinical signs.

Absence Seizures as a Feature of Juvenile Myoclonic Epilepsy in Rhodesian Ridgeback Dogs.

Myoclonic epilepsy in Rhodesian Ridgeback (RR) dogs is characterized by myoclonic seizures occurring mainly during relaxation periods, a juvenile age of onset and generalized tonic-clonic seizures in one-third of patients. An 8-month-old female intact RR was presented for myoclonic seizures and staring episodes that both started at 10 weeks of age. Testing for the DIRAS1 variant indicated a homozygous mutant genotype. Unsedated wireless video-electroencephalography (EEG) identified frequent, bilaterally synchronous, generalized 4 Hz spike-and-wave complexes (SWC) during the staring episodes in addition to the characteristic myoclonic seizures with generalized 4-5 Hz SWC or 4-5 Hz slowing. Photic stimulation did not evoke a photoparoxysmal response. Repeat video-EEG 2 months after initiation of levetiracetam treatment disclosed a >95% decrease in frequency of myoclonic seizures, and absence seizures were no longer evident. Absence seizures represent another seizure type in juvenile myoclonic epilepsy (JME) in RR dogs, which reinforces its parallels to JME in humans.

Wearing a Wetsuit Alters Upper Extremity Motion during Simulated Surfboard Paddling.

Surfers often wear wetsuits while paddling in the ocean. This neoprene covering may be beneficial to upper extremity movement by helping to improve proprioceptive acuity, or it may be detrimental by providing increased resistance. The purpose of this study was to evaluate the effects of wearing a wetsuit on muscle activation, upper extremity motion, heart rate, and oxygen consumption during simulated surfboard paddling in the laboratory. Twelve male, recreational surfers performed two paddling trials at a constant workload on a swim bench ergometer both with and without a wetsuit. Kinematic data and EMG were acquired from the right arm via motion capture, and oxygen consumption and heart rate were recorded with a metabolic cart and heart rate monitor. Wearing a wetsuit had no significant effect on oxygen consumption or heart rate. A significant increase in EMG activation was observed for the middle deltoid but not for any of the other shoulder muscle evaluated. Finally, approximate entropy and estimates of the maximum Lyapunov exponent increased significantly for vertical trajectory of the right wrist (i.e. stroke height) when a wetsuit was worn. These results suggest that a 2mm wetsuit has little effect on the energy cost of paddling at lower workloads but does affect arm motion. These changes may be the result of enhanced proprioceptive acuity due to mechanical compression from the wetsuit.

Elevated serum osteoprotegerin is associated with decreased osteoclastic differentiation in stenotic aortic valves.

Calcific aortic valve stenosis (CAVS) is an actively regulated process that involves mechanisms of bone development, including the receptor activator of nuclear factor κB, its ligand, and osteoprotegerin (RANK/RANKL/OPG) regulatory system. The aim of this study was to investigate whether the levels of circulating OPG and RANKL can be correlated with some histopathological features of the stenotic valves. Serum levels of osteoprotegerin (OPG) and soluble RANKL (sRANKL) were assessed in 27 patients with CAVS prior to valve replacement surgery and in 12 control subjects. The removed valves were examined macroscopically and microscopically. Valve sections were stained with hematoxylin and eosin for general morphology, with Oil Red O for lipids and immunostained with antibodies against markers visualizing osteoclastic cells (tartrate-resistant acid phosphatase, TRAP), macrophages (CD68) and blood vessels (CD34). Patients with CAVS had elevated levels of OPG as compared to the control group (p=0.005). Within the CAVS group, patients with osteoclastic TRAP-positive cells in their valves had significantly lower serum levels of OPG (p=0.009) and lipid content (p=0.03) than those without such cells. Moreover, osteogenic metaplasia was observed exclusively in the valves containing TRAP-positive cells. Results of this study suggest that the circulating OPG can influence the processes occurring in the calcifying valves by inhibiting osteoclastic differentiation of cells involved in calcification and by preventing osteogenic metaplasia.

[Soft tissue balanced navigation of total knee arthroplasties]. / Navigierte Implantation weichteilbalancierter Knieendoprothesen.

OBJECTIVE: Implantation of a total knee arthroplasty with a correct mechanical axis, a rectangular joint gap and a reconstructed joint line by use of an imageless computer navigation device INDICATIONS: Symptomatic gonarthrosis if non operative treatment or joint preserving operations remains ineffective CONTRAINDICATIONS: Infections; soft tissue damage in the approach area; massive instability of the collateral ligaments SURGICAL TECHNIQUE: Medial parapatellar approach to the knee joint; diminution of the patella; fixation of the reference arrays in tibia and femur; registration of leg axis, ligament balance and surface of the knee joint by use of the navigation system; tibial resection perpendicular to the mechanical axis; ligament balancing to achieve a rectangular extension gap; femoral implant planning to maintain the original joint line and reconstruct an equal joint gap in extension and flexion; femora resection perpendicular to the mechanical axis; reconstruction of the rectangular flexion gap by rotation of the femoral resection; two stage cementing technique for fixation of the original implants; check of the final mechanical axis and symmetry of the joint gap over the whole range of motion; wound closure. POSTOPERATIVE MANAGEMENT: Physiotherapy; continuous passive motion treatment; mobilization with 20 kg weight bearing with 2 crutches for 2 weeks, thereafter with 2 crutches and incremental full weight bearing for 4 weeks. RESULTS: The analysis of 582 consecutive navigated total knee arthroplasties showed one case of extension gap instability > 3 mm (0.2%) and 8 patients with flexion gap instability > 3 mm (1.4%). A too tight flexion gap was registered in 23 patients (4.4%), a too wide flexion gap in 13 cases (2.5%). The joint line was reconstructed with an average inaccuracy of 0 mm, in 17 patients the joint line was elevated > 3 mm (2.9%).

The influence of obesity on progression of coronary arteriosclerosis and clinical course after ST elevation acute myocardial infarction treated with primary coronary interventions.

PURPOSE: Evaluation of influence of obesity on the coronary atherosclerosis development and clinical outcome in patients with STEMI treated by PCI with BMS implantation. MATERIAL AND METHOD: 82 patients (64 men) treated with PCI within 6 hours from 1st STEMI. Three groups of pts were formed according to BMI. Based on coronary angiography number of significant stenoses (NSS), number of stenosed coronary arteries (NSA), and sum of significant stenoses (SSS) were calculated. Echocardiography examination was performed 3 days and 6 months after STEMI. Serial evaluation of TnI, CK, CKMB was performed after admission, and serum BNP was assessed after 2 days, 1 and 6 months after STEMI. RESULTS: Obese patients revealed higher values of NSA, NSS and SSS than patients with normal BMI and overweight. There were no differences of BNP, maximal values and AUC of CK, CKMB, TnI and echocardiographic parameters between all groups whereas decrease of BNP during follow-up correlated with BMI. CONCLUSIONS: Results of our prospective study indicate that in obese patients, there is a significantly greater number of atherosclerotic lesions in coronary arteries found during PCI, as compared to those with normal body weight or overweight. We proved that overweight and obesity did not result in significantly greater damage to the myocardium and left ventricular dysfunction, both in the acute phase and 6 months after myocardial infarction treated with primary coronary intervention, as compared to those with normal body weight. In addition correlation was found between BNP concentration profile and body mass index in the 6-month follow-up after STEMI treated with PCI and bare metal stent implantation.

How accurate is image-free computer navigation for hip resurfacing arthroplasty? An anatomical investigation.

BACKGROUND: The existing studies concerning image-free navigated implantation of hip resurfacing arthroplasty are based on analysis of the accuracy of conventional biplane radiography. Studies have shown that these measurements in biplane radiography are imprecise and that precision is improved by use of three-dimensional (3D) computer tomography (CT) scans. To date, the accuracy of image-free navigation devices for hip resurfacing has not been investigated using CT scans, and anteversion accuracy has not been assessed at all. Furthermore, no study has tested the reliability of the navigation software concerning the automatically calculated implant position. The purpose of our study was to analyze the accuracy of varus-valgus and anteversion using an image-free hip resurfacing navigation device. The reliability of the software-calculated implant position was also determined. METHODS: A total of 32 femoral hip resurfacing components were implanted on embalmed human femors using an image-free navigation device. In all, 16 prostheses were implanted with the proposed position generated by the navigation software; the 16 prostheses were inserted in an optimized valgus position. A 3D CT scan was undertaken before and after operation. RESULTS: The difference between the measured and planned varus-valgus angle averaged 1 degrees (mean +/- SD: group I, 1 degrees +/- 2 degrees ; group II, 1 degrees +/- 1 degrees ). The mean +/- SD difference between femoral neck anteversion and anteversion of the implant was 4 degrees (group I, 4 degrees +/- 4 degrees ; group II, 4 degrees +/- 3 degrees ). The software-calculated implant position differed 7 degrees +/- 8 degrees from the measured neck-shaft angle. These measured accuracies did not differ significantly between the two groups. CONCLUSIONS: Our study proved the high accuracy of the navigation device concerning the most important biomechanical factor: the varus-valgus angle. The software calculation of the proposed implant position has been shown to be inaccurate and needs improvement. Hence, manual adjustment of the implant position in the software-planning step is frequently required.

Is a valgus position of the femoral component in hip resurfacing protective against spontaneous fracture of the femoral neck?: a biomechanical study.

The aim of our study was to investigate whether placing of the femoral component of a hip resurfacing in valgus protected against spontaneous fracture of the femoral neck. We performed a hip resurfacing in 20 pairs of embalmed femora. The femoral component was implanted at the natural neck-shaft angle in the left femur and with a 10 degrees valgus angle on the right. The bone mineral density of each femur was measured and CT was performed. Each femur was evaluated in a materials testing machine using increasing cyclical loads. In specimens with good bone quality, the 10 degrees valgus placement of the femoral component had a protective effect against fractures of the femoral neck. An adverse effect was detected in osteoporotic specimens. When resurfacing the hip a valgus position of the femoral component should be achieved in order to prevent fracture of the femoral neck. Patient selection remains absolutely imperative. In borderline cases, measurement of bone mineral density may be indicated.

Robotic assessment of locomotor recovery in spinal contused rats.

The purpose of this study was to investigate the ability of a robotic device, "the rat stepper", to assess intrinsic locomotor recovery following spinal cord contusion injury in adult rats. The device consists of a motorized body weight support mechanism that precisely controls the load to the hindlimbs during stepping, and two small robotic arms that measure and manipulate hindlimb movement. Sixteen rats received a contusion injury to the mid thoracic spinal cord with different severity levels (mild, moderate, severe, and sham). The animals were then evaluated weekly using the rat stepper, beginning one week after injury and continuing for a period of twelve weeks, across a range of body weight support levels. The contused animals demonstrated recovery in a standard locomotor assessment score (the BBB score), with most of the recovery occurring by four weeks post injury. We analyzed fourteen robotic measures of stepping and found that the measures that were most sensitive to intrinsic recovery were step velocity and inter limb coordination. These measures were also significantly correlated with the BBB score. The number of steps taken during testing was not sensitive to intrinsic recovery, nor correlated to the BBB score. These results suggest that step quality, rather than quantity, best reflects recovery after contusion injury in adult, untrained rats. Thus, robotic motion capture of only a few steps can provide a sensitive, valid measure of locomotor recovery after contusion.

Robotic gait training: toward more natural movements and optimal training algorithms.

This paper overviews our recent efforts to develop robotic devices to help people relearn how to walk after spinal cord injury. Our efforts are focused on two goals. The first is to develop robotic devices that allow natural gait movements and good force control. We have developed a five degrees-of-freedom robot (PAM) that accommodates natural pelvic movement during walking. PAM uses pneumatic actuators and a nonlinear control algorithm to achieve good force control. We have also developed a novel leg robot, ARTHuR, which makes use of a linear motor to precisely apply forces to the leg during stepping. Our second goal is to develop optimal training algorithms for robotic gait training. Toward this goal, we have developed a small-scale robotic device that allows us to test locomotor training techniques in rodent models. We have also developed an instrumentation system that allows us to measure how experienced therapists manually assist limb movement. Finally, we are developing computational models of motor rehabilitation. These models suggest that assisting in stepping only as needed with a force-controlled robotic device may be an effective method for improving locomotor recovery.

[Evaluation of magnesium cation levels in serum of patients with mitral valve prolapse syndrome]. / Ocena stezenia kationów magnezowych w surowicy krwi u chorych z zespolem wypadania platka zastawki dwudzielnej.

Magnesium deficiency has been suggested to be related to the mitral valve prolapse syndrome (MVPS). The aim of the present study was to analyse the concentration of magnesium in blood plasma of patients (pts) with MVPS. In the group of 80 subjects, including 50 pts with MVPS and 30 healthy people matched for age and gender, who comprised the control group (CG), concentration of magnesium in blood plasma was estimated. Magnesium levels were measured by atomic absorption spectrophotometry. Mean concentration of magnesium cation in plasma in pts with MVPS was 0.74 +/- 0.12 mmol/l (range 0.47-1.02 mmol/l). It was only 1.02% lower than in the CG (x = 0.76 +/- 0.07 mmol/l; range 0.67-0.97 mmol/l). However evaluation of the magnesium concentration in blood plasma did not prove magnesium deficiency in the mitral valve prolapse syndrome. Moreover the study revealed that histograms of magnesium concentration values in both investigated groups were divergent.

[Variability of heart auscultation in patients with mitral valve prolapse]. / Zmiennosc zmian osluchowych serca u pacjentów z zespolem wypadania platka zastawki dwudzielnej.

The aim of the study was to analyze the auscultatory findings and its variability in 84 patients (pts) with mitral valve prolapse syndrome (MVPS) who were examined in the different body positions. All the pts underwent the echocardiographical examination and in 32 subjects (38%) prolapse of the anterior mitral leaflet was found, in 40 pts (48%) prolapse of the posterior mitral leaflet and in 12 (14%) pts prolapse of the both mitral leaflets. The auscultation of the heart was done in the supine position, in the lying position on the left side and in the upright position of the patient's body. Characteristic for the mitral valve prolapse (MVP) auscultatory findings (midsystolic murmur, late-systolic murmur and/or mid-systolic "non ejection" click) were demonstrated by 43 pts (51%) in the supine position. During the auscultation in the lying position of the pts on the left side, the auscultatory findings were found in 57 pts (68%) while in the upright position in 64 pts with MVPS (76%). The study showed that the auscultatory findings in pts with MVPS were demonstrated more frequently in the lying position of the body on the left side or in the upright position compared with the supine position. Moreover we found that 20 pts with MVPS (24%) did not demonstrate the characteristic auscultatory findings of MVP.

[The clinical course of end stage heart disease in 152 patients qualified for heart transplantation in a four year observation]. / Przebieg krancowej choroby serca u 152 chorych zakwalifikowanych do transplantacji serca w obserwacji czteroletniej.

UNLABELLED: The aim of the study was to analyse the clinical course of pts with end stage disease (ESD) in the period of four years. The study population consisted of 152 pts (132 males, 20 females) at the age of 17-66 years (mean = 48.8 year SD = 9.1) primarily qualified to the heart transplantation (HTX). We analysed the ethiology of cardiac failure, the NYHA class of circulation insufficiency, frequency of occurrence of cardiac arrhythmias and conduction system disturbances in 24-hour ecg monitoring, and the pharmacotherapy efficacy. An ischemic ethiology of cardiac failure we found in 102 pts, cardiomyopathy (idiopathic, hypertrophic or postinfectious) in 46 and unoperable valvular disease--in 4. Ten pts were in II NYHA class, 112 in III, and 30 in IV. Left ventricular ejection fraction (echo assessed) ranged from 11% to 40%(mean = 24.9%), LVEDd = 46-111 mm (mean = 80.9 mm), LVESd = 34-83.5 mm(mean = 63 mm). We found IVa class by Lown ventricular arrhythmias (in Holter monitoring) in 38 pts and IVb in 78. Fifty six pts were treated with amiodarone, 10--with beta-blockers and 11 with sotalol. 19 pts were treated by permanent cardiac pacing during the waiting period, 2 ones--by PTCA, 2--by CABG, three ones--by dynamic cardiomyoplasty, and one--by partial aneurysmectomy. One pt was treated by CABG and automatic cardioverter-defibrilator implantation. In 5 cases HTX was delayed because of the positive effect of pharmacotherapy. In assessed period HTX were performed in 64 cases, 31 pts died and 43 are still waiting for the procedure. CONCLUSIONS: During the 4-year period HTX were performed in 42% of waiting pts. Mortality in this group was 38.2%. In 9 pts (5.9%) the alternative methods of surgical treatment were applicable. In 5 pts (3.9) the decision about HTX was delayed because of the positive change of the clinical status. This fact confirms the necessity of the waiting list verification.

[Hypolipemic treatment in prevention of secondary ischemic heart disease]. / Leczenie hipolipemiczne w prewencji wtórnej choroby niedokrwiennej serca.

Available evidence indicating a possibility to inhibit the development of atherosclerosis and to reduce the mortality rate due to associated diseases in humans forms the rationale behind prevention of cardiovascular diseases. It consists of simultaneous modification of all concomitant risk factors including treatment of lipid disorders. Reduction of increased LDL cholesterol and TG levels is associated with a number of clinical benefits. It improves arterial endothelial function and stabilizes atheromatous plaque, which is reflected in the improved clinical, angiographic and hemostatic picture. Multiple studies have revealed a decreased rate of cardiac events and cardiovascular mortality in patients treated for lipid disorders. Furthermore, progression of atherosclerotic lesions has been shown to be inhibited. Before initiation of the therapy for lipid disorders taget LDL cholesterol level should be determined depending on the patient's risk group. In patients with known coronary artery disease or peripheral atherosclerosis (high risk group) it is desirable to reach LDL cholesterol level below 100 mg/dl and TG below 200 mg/dl. Basic approach to the therapy of lipid disorders both in primary and secondary prevention includes, modifications in the life style, especially dietary habits which may result in a mean of 10 to 20% decrease of LDL cholesterol and TG. When dietary modifications are ineffective it is recommended to use combined therapy but with a high degree of caution.

Changes in cell, matrix compartment, and fibrillar collagen volumes between growth-plate zones.

To define the contributions of changes in cell, matrix compartment, and fibrillar collagen volumes to longitudinal bone growth, we measured the differences in cell, pericellular/territorial matrix and interterritorial matrix volumes, and fibrillar collagen concentrations between the upper proliferative and lower hypertrophic zones of the proximal tibial physes of six miniature pigs. The mean numerical density of cells decreased from 110,000 cells/mm3 in the upper proliferative zone to 59,900 cells/mm3 in the lower hypertrophic zone. The mean cell volume increased nearly 5-fold (from 1,174 to 5,530 microm3), and the total matrix volume per cell increased 46% (from 8,040 to 11,760 microm3/cell) between the upper proliferative and lower hypertrophic zones. Both the pericellular/territorial matrix volume per cell and the interterritorial matrix volume per cell increased between the upper proliferative and lower hypertrophic zones; the pericellular/territorial matrix volume per cell increased 61% (from 4,580 to 7,390 microm3/cell), whereas the interterritorial matrix volume per cell increased 26% (from 3,460 to 4,370 microm3/cell). The total increase in mean cell volume of 4,356 microm3 exceeded the total increase in mean matrix volume per cell of 3,720 microm3; the total mean pericellular/territorial matrix volume per cell increased more than the total mean interterritorial matrix volume per cell (2,810 compared with 910 microm3/cell). Fibrillar collagen concentration was greater in the interterritorial matrix than in the pericellular/territorial matrix in both zones and increased in both matrix compartments between the upper proliferative and lower hypertrophic zones. The amount of fibrillar collagen per cell also increased in both matrix compartments between the upper proliferative and lower hypertrophic zones (from 1,720 to 3,100 microm3/cell in the pericellular/territorial matrix and from 1,490 to 2,230 microm3/cell in the interterritorial matrix; thus, the total amount of fibrillar collagen per cell increased from 3,210 to 5,530 microm3/cell). Growth rate was inversely related to the cell numerical density in the upper proliferative and lower hypertrophic zones and was directly related to interterritorial matrix volume per cell in the upper proliferative zone and to pericellular/territorial matrix volume per cell in the lower hypertrophic zone. These results show that cell enlargement contributes more to longitudinal bone growth than does increased matrix volume, that increased pericellular/territorial matrix volume makes a greater contribution to growth than does increased interterritorial matrix volume, and that the total amount of fibrillar collagen per cell increases between the upper proliferative and lower hypertrophic zones. The differences between the two matrix compartments in increase in volume, fibrillar collagen concentration, and amount of fibrillar collagen per cell strongly suggest that they differ not only in matrix organization but in rate of matrix accumulation and assembly and that these differences give the two compartments different roles in skeletal growth.

[Present day opinion about beta block treatment of congestive heart failure]. / Wspólczesne poglädy na tematzastosowania beta-blokerów w niewydolnosci serca.

The congestive heart failure is an important clinical problem because of its frequency of appearance and poor prognosis. A new groups of drugs are to be found to change the negative natural course of this disease. Beta adrenolytic agents are on focus now because of promising results of small and great clinical trials and wider knowledge about the pathophysiology of congestive heart failure. This paper presents the present day knowledge about the role of the beta blockers therapy in the congestive heart failure treatment.