Advantages of simultaneous radial nerve and tendon reconstruction - a case report.

Transection of the radial nerve is frequently associated with humeral shaft fractures that are part of a very complex upper extremity injury. In the presented case, a 19-year-old man with a 10-cm radial nerve defect with a need for nerve grafting to recover complete sensory and motor deficit of the radial nerve. In our case, at the same time we provided the tendon transfer of musculus (m.) pronator teres to m. extensor carpi radialis brevis, m. flexor carpi ulnaris to m. extensor digitorum communis, m. palmaris longus to m. extensor pollicis longus, and long sural nerve graft because of an extensive zone of the injury. The assumption was that if these two procedures are performed in one surgery, it will accelerate overall recovery, restore the functionality of the upper limb more quickly, and thus enable a faster recovery.

Influence of collateral ligament laxity on patient satisfaction after total knee arthroplasty: a comparative bilateral study.

INTRODUCTION: Correct ligamentous balancing is an important determinant of the clinical outcome in total knee arthroplasty (TKA). Many surgeons prefer a tight rather than a lax knee during implantation of a TKA. The hypothesis in this study was that patients with a slightly laxer knee joint might perform better than patients with a tight knee joint after implantation of a TKA. PATIENTS AND METHODS: Twenty-two patients with bilateral knee arthroplasties were clinically and radiologically evaluated at a mean follow-up of 4.5 years, ranging from 2 to 7 years. There were 12 women and 10 men with an average age of 68.9 years (range 32-82 years) at the time of surgery. A modified HSS score (excluding laxity), varus and valgus stress X-rays in 30 degrees of knee flexion, and the subjective outcome of both knees were compared. A knee was considered tight when it opened less than 4 degrees and lax if it opened 4 degrees or more on stress X-ray. RESULTS: There was a trend towards improved range of motion and HSS score for the laxer knee joints. However, the difference did not achieve statistical significance. Eleven of the 22 patients considered one side subjectively better than the other side. In 10 out of these 11 TKA, the slacker knee joint was the preferred side ( p<0.05). CONCLUSIONS: As the present study compared bilateral knee joints after TKA, the same patient could act as a control group, and subtle subjective differences were revealed which are not quantifiable. The results showed that patients with a preferred side felt significantly more comfortable on the laxer side, indicating that during intraoperative ligamentous tensioning, some varus and valgus laxity at 20-30 degrees of flexion might be preferable to an over-tight knee joint. Further biomechanical and prospective investigations will be necessary to establish the correct soft-tissue tensioning.

[Problems in the determination of immunocomplexes. VI. Changes in the levels of C4 complement and IgG in the precipitation of immunocomplexes using polyethylene glycol]. / Problematika stanovování imunokomlexu. VI. Zmeny koncentrace C4 komplementu a IgG pri precipitaci imunokomplexu polyetylénglykolem.

The authors modified the method for the assessment of circulating immunocomplexes by assessing changes in the concentration of IgG and C4 components of complement in the precipitate after adding polyethylene glycol. The method was tested on a series of samples, the scatter of values for the healthy population was assessed and the results were compared with the PEG method elaborated in the Institute for Clinical and Experimental Medicine.

[Determination of C-reactive protein using the solid-surface immunoenzyme assay (ELISA)]. / Stanovení C-reaktivního proteinu metodou enzymoimunostanovení na pevném povrchu (ELISA).

The authors elaborated the ELISA method for the assessment of the CRP concentration in body fluids. The method is accurate, sufficiently sensitive and can be made automatic. The authors assessed the CRP value in serum of healthy subjects and the method was compared with kits for assessment of CRP available on our market.

Hyperlipidemia, dyslipoproteinemia and apolipoproteinopathia--classification and risk of atherosclerosis. Part 2: Hypercholesterolemia.

This paper sums up recent intervention epidemiological studies of primary atherogeneous hypercholesterolemias. The authors include in this category familial hypercholesterolemia, familial combined hyperlipidemia, and polygenous hypercholesterolemia. Individual disorders are thoroughly analyzed in view of their early diagnostics, differential diagnostics and clinical state. The paper also deals with relatively harmless hypercholesterolemias and their clinical and biochemical criteria.

Hyperlipidemia, dyslipoproteinemia and apolipoproteinopathia--classification and risk of atherosclerosis. Part 3: Hypertriacylglycerolemia.

The authors classify hypertriacylglycerolemias according to their relationship with atherosclerosis as disorders with and without chylomicronemia, atherogenous disorders with an increased level of apolipoprotein B in the VLDL fraction, and relatively harmless (benign) cases. They single out the remarkable heterogeneity of hypertriacylglycerolemias and their epidemiological aspects. The analysis of the various disorders comes complete with their pathobiochemistry and the clinic-biochemical criteria of their classification. The paper also draws attention to a number of possible clinical complications accompanying hypertriacylglycerolemias and their frequency among the population.

Hyperlipidemia, dyslipoproteinemia and apolipoproteinopathia--classification and risk of atherosclerosis. Part 4: Apolipoproteinopathia.

The article defines apolipoprotein diseases as the structural defects of apolipoproteins or disorders in their synthesis or secretion. The survey covers a range of atherogenous defects, providing a detailed description of their clinical-biochemical and genetic aspects as well as diagnostic and differential diagnostic criteria. Attention is paid also to the significance of analytical isoelectric focusing.

Hyperlipidemia, dyslipoproteinemia and apolipoproteinopathia--classification and risk of atheroslcerosis. Part I: Principles of classification and methods of dyslipoproteinemia determination.

This paper sums up new findings in the field of pathogenetic relations between lipid and lipoprotein metabolical disorders on the one hand and the risk of early forms of atherosclerosis on the other hand. Detail classification of disorders proceeds from precise clinical and biochemical criteria, genetic considerations and therapeutical aspects. It provides definitions of hyperlipidemia, hyperlipoproteinemia, normolipidemic (latent) dyslipoproteinemia, secondary hyperlipidemia, apolipoproteinopathia and relatively harmless (benign) hyperlipidemia. The paper provides detail tables and systematic graphs.

[Determination of fibronectin using immunonephelometry]. / Imunoefelometrické stanovení fibronektinu.

The authors obtained by a simple isolation procedure pure fibronectin which served as an immunogen for the preparation of the antibody. The antibody was used in the immunonephelometric protein estimation. The authors assessed the reference range of fibronectin concentrations for the healthy population, using different anticoagulating agents.

Beta 2-microglobulin serum levels during dialysis: effect of cuprophan and serum osmolality changes.

New cuprophan dialysers were used in twenty, re-used dialysers in twelve dialyses and new dialysers in ten sequential ultrafiltrations. Serum beta 2-microglobulin (beta 2m) concentration was measured before and after all these procedures. Serum osmolality changes were compared with changes in serum beta 2m concentrations. These concentrations rose in dialyses with new and re-used dialysers, but remained unchanged during sequential ultrafiltration. beta 2m increased with serum hypo-osmolality, decreased with serum hyperosmolality and did not change during iso-osmolar dialysis. These results indicate that cuprophan membrane does not raise beta 2m concentration during dialysis. It is hypo-osmolality that is responsible for the increment of beta 2m in serum.

[Determination of secretory IgA in saliva]. / Stanovení sekrecního IgA ve slinách.

The authors elaborated a method of assessment of secretory IgA in saliva by the nephelometric technique. They used an antibody and standard for serum IgA. The authors discuss the advantages and limitations of the method.

Some immunological characteristics of subjects suffering from frequent herpes simplex virus recrudescences.

Some parameters of specific and non-specific immunity were tested in a group of 44 subjects suffering from frequent herpes simplex type 1 (HSV-1) or herpes simplex type 2 (HSV-2) recrudescences. The tests performed included determinations of (i) HSV complement-independent and complement-dependent neutralizing antibodies, (ii) antibodies to glycoprotein C of HSV-1 and glycoprotein G of HSV-2, (iii) antibodies to viral capsid and early antigens of Epstein-Barr virus, (iv) antibodies to tetanus toxoid, (v) serum levels of IgM, IgG, IgA, transferrin, prealbumin and C'3 and C'4 components of complement, (vi) active and total T lymphocytes, (vii) phagocyting activity of polymorphonuclear neutrophils, eosinophils and mononuclear cells, (viii) skin reactivity to tuberculin, toxoplasmin, candidin, tetanus and diphtheria toxoids. In the patients the following deviations from the control groups were noted: (i) Antibody levels to homotypic but not to heterotypic HSV were enhanced, (ii) serum IgM levels were elevated, (iii) percentages and numbers of active and total T lymphocytes were decreased, (iv) phagocyting activity of neutrophils was depressed but that of eosinophils was increased.

[Chromogens in systems for immunoenzyme determination using horseradish peroxidase-labeled antibodies]. / Problematika chromogenu v systémech enzymoimunostanovení s pouzitím protilátky znacené krenovou peroxidázou.

The author tested the suitability of various chromogens in ELISA systems with horseradish peroxidase. As a model he used assessment of human chorionic gonadotropin (HCG). The author evaluated the influence of substrate concentration on the resulting colour reaction and the influence of the presence of a detergent on the peroxidase activity. He investigated also the advantages of the used chromogens with regard to the accuracy and sensitivity of the estimation.

[What is the reason for the increase in beta-2-microglobulin levels in the blood when using cuprophane dialysis membranes?]. / Co je prícinou nárustu koncentrace beta-2-mikroglobulinu v krvi pri pouzití cuprofanové dialyzacni membrány?.

The authors discuss the question of whether the growing blood concentration of beta-2-microglobulin in the course of haemodialysis is due to the bioincompatibility of the cuprophane membrane or to changes in serum osmolality. x531p4cuprophane dialyzer was used for 20 acts of haemodialysis, a regenerated one for 12, a new one for 10 sequence ultrafiltrations. The serum concentration of beta-2-microglobulin was measured prior to and after haemodialysis, and so was serum osmolality. The changes in beta-2-microglobulin concentration during haemodialysis were compared with serum osmolality changes. The levels of beta-2-microglobulin rose during haemodialysis using a new as well as a regenerated dialyzer but remained unaltered during sequence ultrafiltration. They increased in the presence of serum hypoosmolality, remained unchanged in normal osmolality, and decreased in hyperosmolality. The results show that the cuprophane membrane is not the source of increased beta-2-microglobulin, but that serum hypoosmolality developing during haemodialysis is the factor responsible.

[Dialysis amyloidosis and beta-2-microglobulin]. / Dialyzacní amyloidóza a beta-2-mikroglobulin.

Basic facts are presented of the recently identified and yet clinically very significant complication of chronic artificial kidney treatment -- haemodialysis amyloidosis. The manifestations include the carpal tunnel syndrome, humeroscapular periarthritis, and other types of arthritis, destructive spondyloarthropathy, bone cysts as well as, very probably, visceral involvement. Fully developed, the disease may cause invalidism. The presence of amyloid with beta-2-microglobulin as the main component was proved in articular structures and other localizations. The precise mechanism of the build-up of this amyloid is not known, though a massive and chronic increase in beta-2-microglobulin in the blood of haemodialyzed patients is thought to be mainly responsible. Since beta-2-microglobulin is not normally removed in routine cuprophane haemodialysis, its blood values keep increasing. This phenomenon is reported to be connected with the biocompatibility of the dialysis membrane and, of late, with serum osmolality changes in the course of haemodialysis. While the highly previous membranes used for haemofiltration and haemodiafiltration do remove beta-2-microglobulin the serum levels are never completely normalized. Current research centers on the problem of whether the incidence of dialysis amyloidosis can be reduce by a wider use of on-line haemofiltration.

Placebo-controlled study with subunit herpes simplex virus vaccine in subjects suffering from frequent herpetic recurrences.

The safety and efficacy of a subunit herpes simplex virus (HSV) type 1 vaccine were tested in a small-scale double-blind trial carried out in a group of 42 volunteers suffering from frequent recurrences of herpetic lesions. The patients were paired according to sex, age, type of virus isolated, previous history of the disease and some non-specific immunological markers. One member of each pair received repeated doses of HSV vaccine, the other a placebo. Clinical reactions were mild. Antibody responses following the vaccination were generally low and were almost entirely limited to subjects suffering from HSV-2 lesions. A majority of the patients exhibited improvement of their condition during the postvaccination period. These improvements were, however, nearly equally distributed between the vaccine and placebo groups.