Periprosthetic fractures are the third most common reason for revision total hip arthroplasty. Surgical treatment of periprosthetic fractures belongs to the most difficult procedures due to the extensive surgery, elderly polymorbid patients and the high frequency of other complications. The aim of this study was to evaluate the results of operatively treated periprosthetic femoral fractures after total hip arthroplasty. We evaluated 47 periprosthetic fractures in 40 patients (18 men and 22 women) operated on between January 2004 and December 2010. The mean follow-up period was 27 months (within a range of 12-45 months). For the clinical evaluation, we used modified Merle d'Aubigné scoring system. In group of Vancouver A fractures, 3 patients were treated with a mean score of 15.7 points (good result). We recorded a mean score of 14.2 points (fair result) in 6 patients with Vancouver B1 fractures, 12.4 points (fair result) in 24 patients with Vancouver B2 fractures and 12.7 points (fair result) in 7 patients with Vancouver B3 fractures. In group of Vancouver C fractures, we found a mean score of 16.2 points (good result) in 7 patients. Therapeutic algorithm based on the Vancouver classification system is, in our opinion, satisfactory. Accurate differentiation of B1 and B2 type of fractures is essential. Preoperative radiographic images may not be reliable. If in doubt, checking the stability of the prosthesis fixation during surgery should be performed. and M. Korbel, P. Sponer, T. Kucera, E. Procházka, T. Procek
We present first results of the study of possible relations between the seismic activity and crustal fluids (groundwater an d carbon dioxide) in the area of the Hronov-Poříčí Fault Zone (HPFZ), situated on the NE margin of the Bohemian Massif. Local seismic monitoring and observations of groundwater levels in deep wells and concentrations of carbon-dioxide in the mineral spring at Třtice was started in 2005. Since then, more than 30 local seismic events were observed in the area of the HPFZ. The two strongest earthquakes with macroseismic effects were recorded on August 10, 2005 (M = 2.4) and October 25, 2005 (M = 3.3). Most of the epicentres were situated along the central part of the HPFZ. Only some weak events from February and March 2006 were concentrated along the SE termination of the HPFZ. Results of the hydrological monitoring show that water level fluctuations are affected mainly by the precipitation, snow-melt, air pressure changes, and tidal deformations of the Earth’s crust. The effects of seismo-tectonic activity were detected only in one out of five water wells, where we observed several step-like water level anomalies with amplitudes of 4 to 15 cm. Two of them preceded the August 10, 2005 and October 25, 2005 earthquakes. Three other anomalies seemed to originate independently of the seismic activity. We therefore suppose that they were induced by aseismic movements along the HPFZ. Contrary to the water level fluctuations, CO2 concentrations in the mineral spring seem to be dependent on water temperature; no evident seismic-induced changes have been observed yet., Vladimír Stejskal, Lumír Skalský and Ladislav Kašpárek., and Obsahuje bibliografické odkazy
Resveratrol is a polyphenol found in different plant species and having numerous health-promoting properties in animals and humans. However, its protective action against deleterious effects of ethanol is poo rly elucidated. In the present study, the influence of resveratrol (10 mg/kg/day) on some hormones and metabolic parameters was determined in rats ingesting 10 % ethanol solution for two weeks. Blood levels of insulin, glucagon and adiponectin were affecte d by ethanol, however, resveratrol partially ameliorated these changes. Moreover, in ethanol drinking rats, liver lipid accumulation was increased, whereas resveratrol was capable of reducing liver lipid content, probably due to decrease in fatty acid synt hesis. Resveratrol decreased also blood levels of triglycerides and free fatty acids and reduced γ-glutamyl transferase activity in animals ingesting ethanol. These results show that resveratrol, already at low dose, alleviates hormonal and metabolic changes induced by ethanol in the rat and may be useful in preventing and treating some consequences o f alcohol consumption., K. Szkudelska, M. Deniziak, P. Roś, K. Gwóźdź, T. Szkudelski., and Obsahuje bibliografii
Neonatal exposure to hyperoxia alters lung development in mice. We tested if retinoic acid (RA) treatment is capable to affect lung development after hyperoxic injury and to maintain structural integrity of lung. The gene of vascular endothelial growth factor A (VEGF-A) is one of the RA-responsive genes. Newborn BALB/c mice were exposed to room air, 40 % or 80 % hyperoxia for 7 days. One half of animals in each group received 500 mg/kg retinoic acid from day 3 to day 7 of the experiment. At the end of experiment we assessed body weight (BW), lung wet weight (LW), the wet-to-dry lung weight ratio (W/D) and the expression of mRNA for VEGF-A and G3PDH genes. On day 7 the hyperoxia-exposed sham-treated mice (group 80) weighed 20 % less than the room air-exposed group, whereas the 80 % hyperoxic group treated with RA weighed only 13 % less than the normoxic group. W/D values in 80 and 80A groups did not differ, although they both differed from the control group and from 40 groups. There was a significant difference between 40 and 40A groups, but the control group was different from 40 group but not from 40A groups. The 80 and 80A groups had mRNA VEGF-A expression lowered to 64 % and 41 % of the control group. RA treatment of normoxic and mild hyperoxic groups increased mRNA VEGF-A expression by about 50 %. We conclude that the retinoic acid treatment of newborn BALB/c mice exposed for 7 days to 80 % hyperoxia reduced the growth retardation in the 80 % hyperoxic group, reduced the W/D ratio in the 40 % but not in the 80 % hyperoxic group. Higher VEGF-A mRNA expression in the 80 % hyperoxic group treated with RA was not significant compared to the 80 % hyperoxic group., M. Zimová-Herknerová, J. Mysliveček, P. Potměšil., and Obsahuje bibliografii a bibliografické odkazy
Retinol binding protein 4 (RBP4) is a novel adipokine which might be involved in the development of insulin resistance. The aim of the study was to investigate the expression of RBP4 mRNA in subcutaneous and visceral fat depots and the relationship between RBP4 plasma and mRNA levels relative to indices of adiposity and insulin resistance. In 59 Caucasian women (BMI 20 to 49 kg/m2 ) paired samples of subcutaneous and visceral fat were obtained for RBP4, leptin and GLUT 4 mRNA analysis using reverse transcription-quantitative PCR. Euglycemic hyperinsulinemic clamp and computed tomography scans were performed. RBP4 mRNA levels as well as GLUT 4 mRNA and leptin mRNA levels were lower (P<0.001, P<0.01 and P<0.001, respectively) in visceral compared to subcutaneous fat. No differences were found in RBP4 mRNA expression in the two fat depots or in RBP4 plasma levels between subgroups of non-obese subjects (n=26), obese subjects without metabolic syndrome (n=17) and with metabolic syndrome (n=16). No correlations between RBP4 mRNA or plasma levels relative to adiposity, glucose disposal rate and GLUT 4 mRNA expression in adipose tissue were found. There was a weak positive correlation between plasma RBP4 and plasma triglycerides (r = 0.30, p<0.05) and between plasma RBP4 and blood glucose (r = 0.26, p<0.05). Regardless of the state of adiposity or insulin resistance, RBP4 expression in humans was lower in visceral than in subcutaneous fat. We found no direct relationship between either RBP4 mRNA or its plasma levels and the adiposity or insulin resistance. and Obsahuje bibliografii a bibliografické odkazy
Pojem „personalizovaná medicína“ sa v posledných rokoch spomína čoraz častejšie v súvislosti so snahami čo najlepšie prispôsobiť medikamentóznu, ale aj režimovú liečbu potrebám a požiadavkám jednotlivých pacientov. Personalizácia antidiabetickej liečby prekonala svoj vývoj v kontexte nárastu poznatkov týkajúcich sa cukrovky. Od úrovne empirickej sa posunula na úroveň fenotypickú, ktorá umožnila rozlišovanie medzi jednotlivými typmi diabetu. V rámci diabetu 2. typu sa od 60. rokov minulého storočia aplikovala patogenetická personalizácia, ktorá vychádzala z predpokladov, že u niektorých pacientov prevažuje inzulínová rezistencia a u iných deficit sekrécie inzulínu. Bioštatistická personalizácia (medicína dôkazov) viedla k dôkazom, na základe ktorých bol metformín zaradený do odporúčaní pre liečbu diabetu 2. typu ako liek prvej voľby. Randomizované štúdie v prvom desaťročí 21. storočia síce nedokázali superioritu žiadnej z iných liečebných modalít ako prídavnej liečby k metformínu, ale viedli k individualizácii cieľov glykemickej kompenzácie. V súčasnej dobe sa personalizácia posúva na úroveň farmakogenetickú, od ktorej môžeme v najbližších rokoch očakávať individualizáciu liečby v zmysle výberu liekov prvej, druhej a tretej voľby v závislosti od panelu kľúčových génových polymorfizmov charakterizujúcich citlivosť jedinca na konkrétne antidiabetiká. V konečnom dôsledku by mala byť „liečba ušitá na mieru“ vybratá na podklade syntézy patogenetických, bioštatistických a farmakogenetických poznatkov, čo bude reflektovať transláciu výsledkov základného biomedicinískeho výskumu do klinickej praxe. Kľúčové slová: diabetes 2. typu – farmakogenetika – medicína dôkazov – patogenéza – personalizovaná liečba, In recent years, the term “personalized medicine“ has been increasingly mentioned in relation to the endeavours to tailor the pharmaceutical as well as regimen therapy to the needs and requirements of individual patients. The personalization of antidiabetic treatment has undergone a dramatic advancement in relation to the expansion of knowledge about diabetes. From the empirical it moved forward to the phenotypic level which made it possible to differentiate between individual types of diabetes. The pathogenetic personalization which began to be used within Type 2 diabetes in the 1960s, was based on the assumption that while insulin resistance predominates in some patients, others are mainly affected by insulin secretion deficit. Biostatistics-personalized medicine (evidence based medicine) gathered evidence based on which metformin was included in recommendations on the therapy for Type 2 diabetes as a first-line drug. Although randomized studies during the first decade of the 21st century did not prove superiority of any other treatment modality as an adjunctive therapy used with metformin, they brought with them individualization of the goals of glycemic control. At present, personalization is heading towards the pharmacogenetic level that will enable in the near future individualized therapy in terms of choice of first-, second- and third-line drugs depending on the panel of key gene polymorphisms which characterize sensitivity of an individual to specific antidiabetics. Finally, the “tailor-maded therapy“ should be chosen based on a synthesis of pathogenetic, biostatistic and pharmacogenetic knowledge that will reflect the translation of results of the basic biomedical research into the clinical practice. Key words: evidence based medicine – pathogenesis – personalized therapy – pharmacogenetics – type 2 diabetes, and Ivan Tkáč