The effect of chronic alcohol administration on bone mineral content and bone strength in male rats.

Alcohol use has been identified as a risk factor for the development of osteoporosis. Eight male Wistar rats at two months of age were alcoho-fed (7.6 g 95 % ethanol/kg b.w. per day) to evaluate the effects of long-term administration (three months) of alcohol in drinking water. We have used a dose which is considered to be comparable to a dose of 1 liter of wine or 2.5 liters of 12(°) beer used in male adults daily. The bones were tested mechanically by a three-point bending test in a Mini Bionix (MTS) testing system. The bones from alcohol-fed rats were characterized by a reduction in bone density as well as in ash, calcium and phosphate content. In alcohol-fed rats the reduction in bone mineral density (10 %) was reflected by about 12 % reduction of mechanical strength of femur (158+/-5.5 vs. 178+/-3.2 N/mm(2)). Alcohol significantly altered femoral cortical thickness. In our experiment alcohol itself did not exert any antiandrogenic effect and it did not produce changes in the weight of seminal vesicles. Liver function test (GGT, ALP, AST) did not differ between alcohol-fed rats and control rats. Alcohol-induced bone loss is associated with increased bone resorption and decreased bone formation. These results document the efficacy of alcohol at the dose of 7.6 g 95 % ethanol/kg b.w. to cause bone loss and loss of bone mechanical strength in intact rats. The results of the present study may be interpreted as supporting the hypothesis of alcohol as a risk factor for osteoporosis.

The effect of chronic nicotine administration on bone mineral content and bone strength in normal and castrated male rats.

Tobacco, containing nicotine as the principal pharmacologically active chemical, has been identified as being a risk factor for the development of osteoporosis. Thirty-two male Wistar rats of two months of age were castrated or sham operated to evaluate the effects of long-term administration (four months) of nicotine in drinking water (9.0 mg/kg/day). The presence of cotinine in urine confirmed successful delivery of nicotine. The bones were tested mechanically by a three point bending test in a Mini Bionix (MTA) testing system. The bones from castrated rats were characterized by a reduction in bone density as well as ash, calcium and phosphate content. Castration significantly altered mechanical properties of bone (9%) and femoral cortical thickness. When intact rats were treated with a high dose of nicotine, nicotine had negative effect on tibial bone density as well as ash, calcium, phosphate content and significantly altered the mechanical properties of bone (12%) and femoral cortical thickness compared to intact animals. Nicotine itself does not exert any anti-androgenic effect and does not produce changes in the weight of seminal vesicles. Nicotine-induced bone loss is associated with high bone turnover in the male rats as expressed by increased TrACP and B-ALP. When castrated rats were treated with the high dose of nicotine the changes in bone density resulting from castration were not further potentiated. These results document the efficacy of nicotine at high doses to cause bone loss and loss of bone mechanical strength in intact rats. The results of the present study may be interpreted as supporting the hypothesis of nicotine as a risk factor for osteoporosis.

[Hydatic cysts--echinococcosis]. / Echinokoková nákaza--echinococcosis.

The case diagnosis and treatment of hydatic cyst in the right and left lobe of the liver in a 28 year old pregnant woman is described in the article.

[Duodenal stump closure--still a live problem. A case report]. / Uzáver duodenálního pahýlu-- stále zivý problem. Kazuistika.

Included is a case study of duodenal peptic ulcer bleeding. The patient was treated by Finsterer-Bancroft modification of II-type gastric resection. An early reoperation was indicated by reason of duodenal stump leak. The situation solved by means of duodenostomy. The authors discuss causes of duodenal stump insufficiency. Possibilities of prevention of this complication - which are cited in literature - are mentioned. Duodenostomy is a legitimate optimal solution of duodenal stump suture insufficiency.

Effect of alendronate administration on bone mineral density and bone strength in castrated rats.

Castration of male rats leads to increased bone turnover and osteopenia. This study was conducted to examine the effects of the aminobisphosphonate alendronate on castration-induced bone changes. Bisphosphonates are drugs that inhibit bone turnover by decreasing the resorption. Since they suppress bone remodeling, they may also prevent the repair of microdamage and decrease bone strength. Although the mechanical properties of bones are directly related to the determination of fracture risk, bisphosphonate effects on the related variables have scarcely been investigated. Twenty-four male Wistar rats at two months of age were castrated or sham-operated to evaluate the effects of long-term administration (six months) of sodium alendronate at a dose of 1 mg/kg/day. The bones were tested mechanically by a three-point bending test in a Mini Bionix (MTS) testing system. High bone remodeling seen in castrated rats expressed by increased TrACP and B-ALP was suppressed by alendronate administration. Bone from castrated rats was characterized by a reduction in bone density as well as ash, calcium and phosphate content. Castration significantly altered mechanical properties of bone and femoral cortical thickness. When castrated rats were treated with high dose of alendronate, the changes in bone density resulting from castration were entirely prevented, and mechanical analysis revealed preserved mechanical strength of femur and cortical thickness. We conclude that castration induces cortical bone loss associated with high bone turnover in the male rat, and this bone loss can be prevented by alendronate through the inhibition of osteoclastic activity, while preserving the mechanical properties of bone. These results document the efficacy of alendronate, even at high doses, in preventing bone loss, loss of bone mechanical strength, and the rise in biochemical bone turnover indicators due to castration in rats, and raises the possibility that a alendronate could be equally effective in humans.

Effects of triiodothyronine and estrogen administration on bone mass, mineral content and bone strength in male rats.

Experimental hyperthyroidism had a negative effect on bone mineral density, but did not significantly alter mechanical properties of femur and femoral bone thickness. Estradiol at a dose used in humans for the treatment of osteoporosis decreased seminal vesicle weight and concentration of testosterone but increased bone density in male rats compared to intact animals. In these rats, the mechanical analysis revealed an increased mechanical femur strength higher than the increase in bone density and femoral cortical thickness. When hyperthyroid male rats with low bone density were treated with estradiol in spite of a low plasma testosterone, the changes in bone density resulting from hyperthyroidism were entirely prevented. Estrogens protect the male skeleton against resorbing action of T (3). Treatment with estradiol in male rats with hyperthyroidism did not increase mechanical bone strength or femoral cortical thickness as it did with estradiol administration alone. Our results suggest that exogenously administered estrogens may have therapeutic value in preventing bone loss accompanying triiodothyronine administration, even in male rats with a low testosterone levels. At the concentration studied, estradiol increased in spite of low plasma testosterone, bone mineral density, mechanical strength of femur, and femoral cortical thickness.

[Experimental correction of irregular astigmatism in patients with keratoconus using diode laser thermal keratoplasty]. / Experimentální korekce nepravidelného astigmatismu u pacientu s keratokonem termokeratoplastikou diodovým laserem.

OBJECTIVE: To evaluate the potential of diode laser thermokeratoplasty (DTK) in the correction of irregular astigmatism in patients with keratoconus. GROUP AND METHODS: The coagulation of deep layers of cornea stroma was made on four eyes of four patients suffering from advanced keratoconus at the mean age of 31 years by means of the infrared contact cw laser Prolaser Rodenstock 1.9 DTK. The aim of the treatment was to increase the curvature of cornea in flat meridians and to compensate flattening of cornea in steep meridians by way of forming traction strips between the contracted tissue of individual coagulation points. The changes on the cornea topography and changes of visual functions were determined. RESULTS: The diode laser keratoplasty is capable to induce sector increase of cornea curvature and thereby improve symmetry pictures of irregular astigmatism in keratoconus. For a definitive inclusion of DLK into the spectrum of clinically applicable procedures, other therapeutic studies are needed as well as larger groups with relatively homogeneous pre-operation pictures.

Evaluation of the THINK FIRST For KIDS injury prevention curriculum for primary students.

THINK FIRST is a national non-profit organization whose mission is to educate young people about the prevention of brain and spinal cord injuries. This paper describes a study conducted by THINK FIRST of Oregon on one of its injury prevention curricula, THINK FIRST for KIDS.

[An unusual cause of intestinal obstruction in the puerperal period (case report)]. / Neobvyklá prícina strevní nepruchodnosti v puerperiu (kazuistika).

The authors present a case report of acute intestinal obstruction which manifested itself on the fourth day after the delivery of twins by Caesarian section. Compression of the rectosigmoid colon by the enlarged uterus--which was as big as a pregnant uterus in its fourth month--was established as the cause of ileus. Acute intestinal obstruction was obviously caused by sudden enormous enlargement of the antero-posterior dimension of the contracting uterus at the aditus pelvis level. The situation was successfully surgically resolved by the employment of temporary tube cecostomy.

Use of demineralized bone implants in orbital and craniofacial reconstruction and a review of the literature.

A retrospective study and review of the literature was performed on the use of demineralized bone implants for the correction of orbital and craniofacial defects. Demineralized bone implants heal by endochondral osteogenesis, inducing a transformation of local cells, as well as by osteoconduction, similar to autogenous grafts. They induce the chemotaxis and transformation of mesenchymal cells into chondroblasts, followed by ossification. They also act as a scaffold, with bone resorption taking place simultaneous with bone formation. This study reviewed 21 patients and 31 orbits, in which demineralized bone was used for orbitocranial reconstruction for congenital deformities (nine patients), after surgery for orbital fractures (seven patients: four floor, three roof), and orbital tumors (five patients). The surgical technique is described, and the results are discussed. The follow-up period averaged 15 months (6 months to 33 months). The overall resorption rate of the demineralized bone implants was estimated based on follow-up radiologic studies (facial films, computed tomography scans, and magnetic resonance imaging scans), as well as clinical examinations. All patients had a satisfactory to excellent result. The demineralized bone and Grafton (Osteotech, Shrewsbury, NJ, U.S.A.) was obtained from the Musculoskeletal Transplant Foundation of Holmdel, New Jersey, and it was all processed and reconstituted in a standard manner with Alloprep System. Surgical complications were cerebrospinal fluid leaks (one patient) with infection, transient chemosis, enophthalmos, and hypophthalmos. There were no complications related to demineralized bone alone. Properly prepared demineralized bone is a safe material for orbital reconstruction that eliminates the need for a second operative site to harvest a bone graft.

[Prospective randomized comparison of the effects of pefloxacin and clindamycin with cefoxitin after hepatobiliary and pancreatic operations]. / Prospektivní randomizované srovnání úcinku pefloxacinu a klindamycinu s cefoxitinem u nemocných po hepatobiliárních a pankreatických operacích.

The authors present their experience from a prospective randomized study of therapeutic effects of a combination of pefloxacine (Abaktal) and klindamycin with cefoxitine in patients after hepatobiliary and pancreatic surgery. The therapeutic results in both investigated groups were evaluated in more than 95% patients as excellent, without statistically significant differences. The authors provided evidence of a comparable effectiveness of a combination of pefloxacine with klindamycin and the effectiveness of cefoxitine in patients after the above mentioned types of surgery, while treatment was cheaper when a combination of pefloxacine and klindamycin was used and moreover there was the possibility of oral administration of these preparations, as soon as the patients' condition made it possible.

Myelomeningocele, spinal arteriovenous malformations and epidermal nevi syndrome: a possible rare association?

A 20-year-old woman with myelomeningocele presented with acute right-ear pain and right hemiplegia which improved, but then progressively deteriorated. Surgery, after MRI, revealed a large arteriovenous malformation (AVM) involving the right side of the upper cervical cord and brainstem. The woman also had two epidermal nevi at the same site as the spinal cord AVMs. There has been no previous report of an association of myelomeningocele, spinal cord AVMs and epidermal nevi syndrome. The same location of the nevus and spinal cord AVMs, with a proposed common pathogenesis, raise the possibility that the association may be more than chance occurrence. Spinal cord AVMs should be considered in patients with myelomeningocele and similar clinical features.

[Surgical treatment of afferent loop syndrome]. / Príspevek k chirurgickému lécení syndromu prívodné klicky.

Included is a case study of the afferent loop syndrome after subtotal gastric resection for a peptic ulcer. A 60 year old woman was successfully treated by the ligature of the afferent loop with the anastomosis between efferent loop and the duodenum. By means of this modification the following aims were achieved: 1 elimination of the antiperistaltic function of the afferent loop anastomosed "from the left", 2-replacement of resected stomach by means of anastomosis between the efferent loop and the duodenum.

[Chronic volvulus of the stomach]. / Chronický volvulus zaludku.

An acute gastric volvulus calls for an urgent operation, while a chronic volvulus can be indicated for operation only after a careful clinical and paraclinical examination which rules out other causes of the symptoms. The authors describe a case of secondary gastric volvulus successfully treated by a causal surgical operation involving elimination of adhesions without gastropexy.

Syndrome of intramedullary gunshot wound with incomplete neurologic deficit: case report.

A patient with a gunshot wound to the spinal cord with an incomplete neurologic deficit is presented. The neurologic examination revealed a combination of a central cord injury and the Brown-Séquard Syndrome. The authors suggest that the Brown-Séquard portion of the syndrome was caused by compression of tracts within the spinal cord caused by the mass of the bullet and the central cord injury was produced by the kinetic energy of the bullet during penetration into the spinal canal. They conclude that with incomplete neurologic lesions following gunshot wounds the bullet be removed.