Needle biopsy of joints--its contribution to the diagnosis of ochronotic arthropathy (alcaptonuria).

The authors present the case history of a 48-year-old man with ochronosis. They discuss the possibilities of articular needle biopsy in the diagnosis of this disease. The histology of the synovial membrane may help establish the diagnosis of ochronotic arthropathy.

[Osteoarthritis--a major rheumatologic problem in internal medicine]. / Osteoartróza--prvoradý revmatologický problém ve vnitrním lékarství.

Degenerative affection of the locomotor apparatus is one of the major problems of rheumatology concerning above all internal medicine. The locomotor apparatus in particular its functionally important components, joints and the spine, undergo in the course of aging and due to endogenous and exogenous factors degenerative changes of a varying extent. From the pathogenetic aspect the condition is multifactorial. Attention is devoted in particular to the articular milieu and its constituents which are responsible for the development of degenerative changes. The problem of osteoarthritis is urgent because of the ever rising incidence and its economic and social sequelae. The authors discuss therapeutic difficulties and emphasize comprehensive care of patients suffering from osteoarthritis. The problem of osteoarthritis is of world-wide importance.

[The importance of benziodarone in the treatment of gout and hyperuricemic syndrome]. / Význam benziodaronu v lécbe dny a hyperurikemického syndromu.

The authors pay attention to benziodarone, a representative of the category of benzofurans. They test its effect on the uric acid serum level in normouraemic subjects as well as in hyperuricaemic syndrome and gouty arthritis. The hypouricaemic action of benziodarone (Amplivex-Labaz) is prompt. The maximum drop of uricaemia after Amplivex administration (2 tablets/day) occurs during the first three days. The uric acid level declines by as much as 80% of the baseline value. For long-term treatment 1 tablet per day is sufficient, in some instances even 1 tablet twice a week. The tolerance of the preparation is satisfactory. The authors deal also with the mechanism of action of benziodarone. Amplivex is not only a uricostatic but also a uricosuric agent.

[Puncture biopsy of the joint--contribution to research on the joint milieu]. / Punkcní biopsie kloubní--príspevek k výzkumu kloubního prostredí.

The authors deal with articular needle biopsy with regard to the extension of knowledge and research of the articular environment. Articular biopsy is indicated in diseases associated with an articular exudate. It is made most frequently on the knee joint. In some diseases the histological picture of the articular lining is typical for the diagnosis, in some it is at least characteristic. In some instances an unequivocal interpretation of the histological finding is rather dubious from the diagnostic aspect. Needle biopsy of the joint is confronted with other findings and the clinical picture. Articular needle biopsy can be used for detection of therapeutic preparations administered systemically and in particular by the intraarticular route. Articular needle biopsy extends moreover the criteria used to evaluate the therapeutic effect.

Injury to gastric mucosa due to cortisonoid therapy.

Drawing on their own experience and reports in literature the present authors analyze the problem of the incidence and origin of alterations on the gastric mucosa (steroid ulcer) in the course of cortisonoid therapy. Over the period of 5 years, 576 patients were studied, 29 (5.03%) of which were found to have developed a lesion of the gastric mucosa. Patients with rheumatoid arthritis and collagenoses were the most frequent of these. This is followed by an analysis of the mechanism of origin and the peculiarities of this lesion as compared with the picture of the classical ulcer. Apart from medicamentous therapeutic procedures in the treatment of steroid ulcers, local application of a HeNe laser radiation has come to be used recently in the healing of a chronic gastroduodenal ulcer. Despite all the vast experience and more accurate knowledge of the drawbacks cortisonoid therapy brings along, the steroid ulcer still represents a feared and not quite rare complication of glucocorticoid therapy.

Principles of managing chronic rheumatic diseases.

The principles of treating chronic rheumatic diseases are to be conceived as a complex care of the patient. Medication is just one part of the treatment, be it a very important one. Its possibilities are, however, restricted. In spite of the explosive appearance of new antirheumatic drugs we are sticking to the classical forms of treatment (salicylates, gold, antimalaric drugs). Pyrazolone derivatives and corticoids are still holding their place in the therapeutic design. They should be administered, however, wisely and one must be aware of what is to be expected of their effect. A special therapeutic problem appears to be osteoarthrosis, which has recently become more actual among the other rheumatic diseases. The therapeutic effort must be completed by social care of the patient suffering from a chronic rheumatic disease, at least in cases when the patient depends on the help of another person.

Non-surgical synovectomy (basic principles).

Non-surgical synovectomy is an important therapeutical method, the spreading of which is due to intensive research in the ways of treatment, particularly in rheumatoid arthritis. Various procedures have been worked out to settle pathological changes first on the synovial membrane (synoviorthesis) by intraarticular administration of pharmacological substances. From this point of view, we report on cortisonoids, chloroquine, cytostatic drugs, pyrazolone derivates and antiproteolytic substances. Special attention is paid to osmic acid and radioactive colloids as possible. It is a matter of the physician's skill and further research to find the optimal drug for synoviorthesis so as to introduce it into the long-term and systematic therapeutical programme necessarily required by rheumatoid arthritis.

[Osteoarthrosis]. / Osteoartroz.

The locomotor system, especially its functional important areas, joints and spinal column, undergo degenerative changes of various range during the age and owing to endo- and exogenous factors. Osteoarthrosis affects peripheral joints, spondylosis and spondylo-arthrosis affect axial skeletal joints. The problem of osteoarthrosis becomes actual both owing to the increasing incidence of this illness and in the connection with the prolongation of human life. The problem of osteo-arthrosis is significant all over the world. That's why the attention is devoted to this illness from the point of view of etiology, pathogenetic mechanisms and pathologic morphology. A special attention is devoted to joint's medium. We deal with clinical signs, diagnostic possibilities and therapeutic principles. We emphasize the necessity of complex treatment and we report its single parts. In this connection we emphasize psychological and sociological aspects of the access to the patient with this serious chronic illness. Last but not least we deal with osteoarthrosis as the economic and social problems.

[Development of a moral consciousness in medical schools]. / Formirovanie nravstvennogo soznaniia v usloviiakh meditsinskogo fakul'teta.

In the conditions of developed socialism, changes in social consciousness are also reflected in one of its forms - the morals. The problems of moral education as an inseparable part of communist education is coming to the foreground. It plays its role in all the stages of the education system, having its unsubstitutable place also in the conditions of universities and technical colleges, the faculties of medicine not excluding. It is its task to form the personality of the student and graduate, to make them, among others, acquire the moral codex of a builder of communism (habits of moral behaviour in professional activities - medical ethics). Such crucial situations must be found that are of cardinal importance for the formation of the medical student's moral profile (transition from the secondary school to university, entering the clinic, meeting the patient, running health institutions, positive and negative influences in the health service). The student must live the moral situation, obtain the experience from moral acting on his own self and be an active participant in the events creating his moral qualities, primarily in collective conditions. We stress the necessity of engagement - mobilisation of students to all-round social activities, connection of the theoretical findings of marxist ethics with their particular problems and actual activities. A special accent is laid on the method of personal example, the moral example of the university teacher himself, in the first place his authority based on all the progressive components of his personality.(ABSTRACT TRUNCATED AT 250 WORDS)