[Arthroscopic Treatment of Chronic Retrocalcaneal Bursitis - Endoscopic Calcaneoplasty]. / Artroskopická terapie chronické retrokalkaneární burzitidy ­ endoskopická kalkaneoplastika.

INTRODUCTION The authors evaluate the results of endoscopic treatment and analyse the causes of persisting difficulties in retrocalcaneal bursitis unresponsive to conservative treatment. Stated as one of the causes is the possible chronic irritation of minor/partial tears of anterior parts of the distal portion of the Achilles tendon, which have no chance to heal due to continued overload and impingement syndrome of the superior prominence of the calcaneal tubercle. MATERIAL AND METHODS The authors evaluate the group of 24 patients (10 women and 14 men) diagnosed with retrocalcaneal bursitis, who reported more than 12 months of difficulties and in whom the conservative therapy options have already been exhausted. The decision to perform a revision arthroscopy was made by the authors based on chronic long-lasting difficulties, clinical examination, calcaneus radiograph, ultrasound examination and negative response to the performed conservative treatment. The MRI scan was obtained in 4 patients. In 11 patients during arthroscopy the Achilles tendon was intact, in 13 patients (54.2%) minor tears were detected on the anterior aspect of the distal Achilles tendon, not diagnosed preoperatively (by ultrasound examination). In all the patients, resection of the prominence of the calcaneal tubercle was performed, whereas in patients with affected Achilles tendon also the loose tendon fragments were resected. RESULTS A total of 23 patients reported an improvement of their condition, the pain subsided at 21-43 days. Altogether 21 patients returned to activities carried out before the onset of pain. The AOFAS score values measured preoperatively in patients with an intact tendon were 59.5 ± 15.0, in patients with an injured tendon it was 45.57 ± 9.6, while 6 months after the surgery the values were 95.7 ± 6.2, or 88.71 ± 7.8 respectively. In 1 female patient, with one prior surgery, diagnosed with a partial tear of the Achilles tendon, the effect of the surgery was unsatisfactory. After six months the patient underwent an open revision surgery and the Achilles tendon reinsertion. No intraoperative or postoperative complications were observed. DISCUSSION The endoscopic technique facilitates a more visible bone resection, with better control of resection, which is less invasive than the open technique. The source of irritation can be removed, which is not always only the prominence of the calcaneal tubercle, but another cause of persisting problems can also be a microtrauma affecting the anterior portion of the Achilles tendon, with a reactive hyperaemia in bursal tissue. Compared to literature and also based on the results of the authors of this retrospective study, the endoscopic calcaneoplasty is less invasive than the open surgery. It is always necessary to properly diagnose the causes of difficulties and to timely respond to persisting symptoms in patients, not responding satisfactorily to conservative therapy. CONCLUSIONS The findings presented by the authors provide a new perspective on the causes of chronic problems such as the "posterior heel pain" and tend to give preference to the active endoscopic approach in patients with persisting problems, not responding to conservative treatment, predisposed based on the radiological examination and with a positive finding on ultrasound or MRI scan. Key words:retrocalcaneal bursitis, endoscopic calcaneoplasty, arthroscopy.

[In vitro and in vivo physicochemical study of depot formation of cinchocaine in an atelocollagen matrix]. / Fyzikálne chemické in vitro a in vivo studium depotizace cinchokainu v atelokolagenové plsti.

The paper presents an introductory physicochemical study dealing with the preparation of atelocollagen felt saturated with local anesthetics, with the modelling of the release of the anesthetic from the collagen matrix in vitro, and with the checking of the corresponding analytical procedures (dc-polarography and UV-VIS spectrophotometry) for the determination of cinchocaine. The study is supplemented with experiments in vivo that confirm the usability of the new material for the depot formation of local anesthetics.

Toxicity of monomers HEMA, DEGMA and AEMA, used in synthesis of hydrogels for medical applications.

Acute toxicity parameters (lethal doses) were evaluated and calculated after i.m. and i.p. administration of 2-hydroxyethyl methacrylate (HEMA), 2-(hydroxyethoxy)ethyl methacrylate (DEGMA) and 2-(acetoxy)ethyl methacrylate (AEMA) to rats. Our previous findings were revisited and corrected. Based on preceding standardization and physiological values study, some clinical chemical and hematological markers of in vivo subacute i.m. toxicity were followed. Hematological parameters revealed to be of low sensitivity to the toxic influence. Clinical chemical tests suggest the prevalent muscle cell injury.

[Distribution of 3H-labeled acetyl-HEMA monomer in rats]. / Distribuce 3H znaceného monomeru acetyl-HEMA u potkanu.

Original method of tritiation of acetyl-HEMA and its hydrogenated product was developed. Distribution and excretion of both compounds was examined in rat for up to 70 hrs. While the distribution in the tissues examined (liver, spleen, kidney, lung, muscle, heart, and skin) was nearly uniform, the excretion of acetyl-HEMA and its hydrogenated form differed: acetyl-HEMA in the 24. hour is excreted preferably into urine, the hydrogenated form in faeces. In addition to it the later form was absorbed from the application point (muscle) more rapidly. Distinct cumulation of activity (original compound or/and its metabolites) was observed in all tissues.

Hormesis in effect of low uranium doses on organisms.

Uranium nitrate applied daily in small amounts per os (0.5-17 mg/l in drinking water) or per cuttim (0.2-0.8 g/kg) exerts positive effect on metabolism of phosphate ions by red blood cells in vitro. This positive effect changes to the negative one with increasing dose or exposure time. It may be assumed that most other cells in the organism are affected in the same way as erythrocytes and that similar effect might be observed with other harmful agents or substances.

Distribution of cesium in the organism and its effect on the nucleotide metabolism enzymes.

After the intraperitoneal administration of 0.5 mEq 134 CsCI . kg -1 to mice, the maximum cesium level in the kidney's, heart, lungs and liver was found in the first hour (T 1/2 13 h), in the muscles after 8 h (T 1/2 180 h), in the brain after 24 h (T 1/2 140 h) and in the blood after 24 h. Maximum cesium levels were found in the muscles. Rats excreted about 17% of the administered dose in 24 h and 38% in 144 h. Most of the cesium (about 90%) is excreted in the urine. In rats, equalization of the plasma and RBC cesium levels takes longer than 6h. Cesium transport is not entirely dependent on the ATPase system, as shown by the results given by the crude mitochondrial fraction with a reduced potassium content. Among the various univalent ions studied, the effect of cesium on creatine kinase, 5'-nucleotidase, phosphodiesterase and deaminase activity was the smallest.

Effect of rubidium, lithium and cesium on brain ATPase and protein kinases.

The authors studied the effect of rubidium, lithium and cesium on the ATPase system and c-AMP protein kinase in brain. They demonstrated that rubidium could replace potassium in the Na+K-ATPase system, whereas lithium and cesium had no effect on this enzyme activity in the absence of potassium. K+-dependent ATPase was activated by even low rubidium concentrations; lithium and cesium inhibited it. None of three (rubidium, lithium and cesium) affected c-AMP protein kinase.

[Effect of X-radiation on the metabolism of rat erythrocytes]. / Vliv X zárení na metabolismus erytrocytu krys

Rats and rabbits were whole-body irradiated with X-rays in the dose of 100 to 750 R. At daily intervals samples of blood were collected and kept in heparin. After addition 32P phosphate they were incubated for 35 minutes at 37 degrees C in vitro. Incorporation in the erythrocytes was decreased significantly from the dose of 250 to 500 R. The maximum response was obtained between the 6th and 14th day. The method can be applied for the examination of the state of the organism irradiated with the dose higher than 250 R of X-radiation. The specificity of the method is discussed.

[Effect of cyclophosphamide on themetabolism of erythrocytes]. / Vliv cyklofosamidu na metabolismus erytrocytu

Cyclophosphamide was applied i.p. in the dose of 100 mg kg-1 to rats. After one, two, three, and seven days the animals were killed and in the collected heparinized blood the incorporation of o-phosphate 32P in erythrocytes was determined in vitro at 37 degrees C and in 35 minutes. Decreased incorporation in animals with Cyclophosphamide indicated, compared with the control, disturbed metabolism of phosphate. The method can be applied as a criterion of secondary toxic effects in the treatment of cancerostatics of alkylation type.