Biomedical subjects

I Cechová

Publications and source records attributed to I Cechová.

9 recordsLinked to original sources

PubMed2005

[Surgical therapy of osteolysis around stable cementless hip arthroplasty].

PURPOSE OF THE STUDY: The article presents results of surgical treatment of osteolysis around stable cementless THA. MATERIAL AND METHODS: The authors evaluated 18 operated on cases of osteolysis around stable THA of ABG 1 type with a minimal follow-up of 4 years (49-70 months). The group included 6 men and 12 women who were at the time of revision 47 years old (36-56, SD 6.52). The average period between the primary and revision surgery was 45 months (23-66, SD 13.84), the average size of the original cup was 49.6 mm (44-54, SD 3.03), the median thickness of polyethylene was 7.5 mm (4.9-8.9). The average HHS prior to reoperation was 68.5 points (10-98, SD 18.3) and only three hips were completely asymptomatic (3/18, 17%). Polyethylene inlay was replaced twice, both acetabular components in twelve cases, the acetabular and femoral components in four cases. In 16 cases radical debridement and treatment of defects by bone grafting was an important part of surgery. OUTCOMES: By the time of the latest check, in total three revision surgeries were performed (3/18, 17%). Neither of them was necessitated by loosening of the revision cup or use of bone grafts. Revised were both hips after the replacement of polyethylene cup inlay. Stable bone fixation and healing of bone defect was achieved in 15 hips in which the implant replacement was combined with bone grafting (15/16, 94%). The revision cup was on average by 3.16 mm bigger than the original cup (p = 0.001). The average HHS during the latest check was 79 points (p = 0.056). DISCUSSION: In osteolysis around a stable implant, many North-American authors prefer the replacement of polyethylene cup inlay in case of an undamaged well-oriented metal cup with a functional lock. By contrast, the authors of this study in such indication replace the whole acetabular component. This discrepancy may be explained by the ABG 1 THA which often triggers an extensive osteolysis and fails relatively soon. CONCLUSION: Despite a small number of cases the study has proved that the bone bed damaged by osteolysis is able to accommodate a new cementless implant. A necessary part of the surgery is radical debridement and in more extensive defects also bone grafting.

Adult↗

PubMed2004

[Is osteolysis associated with a stable total hip replacement asymptomatic?].

PURPOSE OF THE STUDY: It has been reported that periprosthetic osteolysis in a stable cementless total hip prosthesis is often free from symptoms. The aim of this study is to check this assumption and provide details on the clinical presentation of this troublesome and worrying complication of hip arthroplasty. MATERIAL: Between March 1999 and June 2002, 76 hips in 72 patients underwent revision arthroplasty for periprosthetic osteolysis associated with stable ABG I prostheses. This patient group included 53 females and 19 males. The average age at the time of revision was 49 years (range, 32 to 63). The average time between the primary and revision surgery was 54.6 months (range, 23 to 85). The average cup size was 49.7 mm (range, 44 to 60), the modular 28-mm CoCr head was used in 69 hips, 28-mm ceramic head in six hips, and 22-mm CoCr head in one patient. METHODS: The following characteristics were recorded: gender, age, type of patient, height, weight, symptoms, diagnosis, ERS, CRP, Harris hip score, cup size, abduction angle and extent of bony defects. The data of symptomatic and asymptomatic patients were compared by parametric or non-parametric tests. RESULTS: Before revision, 61 hips (80%) were symptomatic. The patients complained of pain or signs of instability or both, and these complaints were taken as indications for revision surgery. The remaining 15 hips (20%) were asymptomatic. The average period from the primary surgery to the appearance of the first symptoms was 43 months (range, 5 to 80). The average Harris hip score before revision was 68 points (range, 37 to 90) and 82 points (range, 10 to 98) in the symptomatic and asymptomatic patients, respectively (p = 0.002). There were no other significant differences between these patients. DISCUSSION: The results of our study are in agreement with the findings of Hozack et al., but not with those of Maloney et al. and others who have reported that the progression of osteolysis developing in association with hip arthroplasty can be without symptoms. CONCLUSIONS: Osteolysis developing around a stable cementless hip prosthesis is generally symptomatic, with pain being the most frequent symptom. Even without a periprosthetic fracture, osteolysis may seriously impair the function of a joint and comfort of the patient. Since symptomatic patients are likely to see their attending physicians, it is emphasized that attention should also be paid to asymptomatic patients who have prostheses with unsuitable designs or pairings.

Adult↗

PubMed2003

[Early failure of the polyethylene liner in the ABG I total hip prosthesis].

PURPOSE OF THE STUDY: The polyethylene liner has appeared to be a weak point in total hip arthroplasty. An early wear-through or a fracture of the polyethylene liner have been referred to as a catastrophic failure. The aim of the present study is to report our experience with this rare complication in ABG I hip prostheses. MATERIAL: Between September 1994 and January 2000 a total of 506 ABG I prostheses were implanted at our clinic. Due to wear-related complications, revision arthroplasty had to be performed in 90 hips in 23 male and 63 female patients by January 2002. Extensive titanium metallosis associated with polyethylene failure was found in 11 hips of 11 female patients. The remaining 56 hips of 52 female patients served as a control group. METHODS: The characteristics recorded in every patient's included age, type of patient, sex, height, weight, ESR, CRP, diagnosis, Harris hip score before revision, cup size, abduction angle of the cup, time between the primary and revision surgery and implant stability. Student's t-test, the Mann-Whitney U-test and Pearson's chi 2 test were used to evaluate the results. RESULTS: The complete failure of ABG I prostheses occurred in 2.17% of the replaced hips (11/506). A fracture or complete wear-through were the causes of failure in three (3/11, 27%) and eight (8/11, 73%) hips, respectively. The average cup size in hips without metallosis was 48.9 mm (range, 44-58; SD, 3.1) and that in hips with metallosis was 46.5 mm (range, 46-48; SD, 0.9). This difference was highly significant (t-test, p = 0.00002; U-test, p = 0.014). In the hips with metallosis, the average thickness of the polyethylene liner was 5.17 mm (range, 4.9-5.9; SD, 0.45) and the Harris hip scores before revision were significantly lower than in the hips without metallosis (59 versus 70.3 points; t-test, p = 0.023; U-test, p = 0.044). There were no other significant differences between the hips with early catastrophic failure of the polyethylene liner and those without it. DISCUSSION: Several studies have shown an indirect relationship between polyethylene thickness and its wear. Berry et al. reported catastrophic failure in hip prostheses with a polyethylene thickness of less than 5 mm; in our study, the three failed polyethylene liners were 5.9 mm in thickness. CONCLUSIONS: This is the first report on a wear-through of the polyethylene liner in ABG I cups. It is suggested that a thin polyethylene liner, design characteristics and probably also poor polyethylene quality are crucial factors responsible for rapid wear in ABG I cup. The highest risk is associated with the combination of a 46 mm cup and a 28 mm head. Patients who have prostheses of this size should be checked up more frequently.

Adult↗

PubMed1997

[Monitoring of selected biochemical markers of tissue ischemia, particularly of the digestive tract, in experiments and clinical practice].

The increase of organ transposition ill tile reconstruction of digestive tract, particularly transposition of the stomach and colon, is essential ill gullet surgery. The transposition is always accompanied by certain bigger or less degree of ischemia. In this study the authors followed the biochemical markers of tissue ischaemia, capable to lay down both pre- and postoperative vitality of the tucked organ an the anastomosis. Disclosing of the initial and later stadium of intestine ischemia is tile aim. Monitoring of the lactate in the serum is very useful. Its using was proved in the rich experimental group and it was certified in clinical practice.

Acidosis↗

PubMed1994

[An instrument for hepatic artery compression in palliative treatment of liver metastases using repeated ischemia. A model and experimental study].

Method of interrupted ischaemization of the liver afflicted with metastases from colorectal cancer is not definitively evaluated yet. Using the literary reports the authors proposed (in cooperation with MEDIN) a instrument for compression of the liver artery, economically easy available. The reability of this instrument was tested in model conditions and his safety to the tested artery was proved on the experimental animal.

Animals↗

PubMed1993

[Serum fatty acids in premature neonates].

In the past we have published several papers concerning the evolution of large spectrum of fatty acids in the brain or in the blood-serum in rats or in human newborns (and their mothers just after the delivery). Therefore we realized this study: the blood-serum spectrum of fatty acids in the healthy human newborns (n = 32) was compared with the spectrum of fatty acids detected in the blood-serum of human premature neonates (n = 22). The birth-weight in the control group was 3,882, in the premature neonates 2,137 g only. Fatty acids were measured as methylesters (FAME) using the method of gas chromatography and absolutely the same methodological approach as in our previous studies (33, 22, 23). The results were computed by biocybernet. dep. of Physiological institute and the statistics were evaluated by Mann-Whitney U test. It was established that the premature neonates show a distinct greater content (expressed in percentage) of saturated fatty acids and a smaller share of polyenoic FA (PUFA). A further marked difference consists in a significant lower of the n-3 FA and consequently a higher n-6/n-3 index. In premature neonates a significant increase of caprylic acid and arachidonic acid in the blood-serum was detected. The significance of described changes in the participation of single fatty acids in the premature neonates for their maturation, structural evolution especially of the brain cells and for therapy, is discussed.

Fatty Acids↗

PubMed1993

[Results of surgical repositioning of congenital hip dislocation].

The authors submit an analysis of the results of surgical treatment of inborn dislocation of the hip joint in children from the age of one year to completed growth. Decisive for inclusion into this group was surgical reposition. The operated patients were divided into the following three groups by age at the time of operation: 1. first year up to 17 months; 2. 18 to 48 months; 3. patients older than 4 years up to 15 years. Between 1978 and 1992 96 children with inborn dislocation of the hip joint were operated (103 hip joints). Complete documentation was available for 59 hip joints of 54 patients. The follow up period varies between 1 and 14 years after operation. In the first group 24 hip joints of 21 patients were checked, the average age at the time of operation being 8 months. In 17 hip joints at the same time subtrochanteric osteotomy with abbreviation was performed. In these operated hip joints surgical reposition was preceded by distraction either using the "overhead" system or the Pavlanský's method. All hip joints in this group were operated from an anterolateral approach according to Scaglietti's principles. In the second group 19 hip joints of 16 patients were checked, the mean age at the time of operation being 28 months. A standard component of the operation was in addition to surgical reposition also pelvic osteotomy according to Salter's method, in 16 cases at the same time derotation varus osteotomy was performed. The third group comprises 16 hip joints of 15 patients operated at an average age of 9 years and 8 months. Fourteen of the hip joints had been operated previously at least once by different methods. In acetabular dysplasia different techniques were used, most frequently Chiari's osteotomy. The surgical reposition proper was preceded in four instances of high iliac dislocation by preoperative distraction by external fixation. For evaluation of the results clinical and radiological parameters were used, essentially identical with Severin's classification. X-ray evaluation was supplemented y values of the distance between the head and Köhler's protrusion. The best clinical and X-ray results were achieved in the first group; wih the number of previous operations and advancing age the perspective of excellent results declines. In the group as a whole five, i. e. 8.5%, avascular necroses were recorded. From the total number of operated patients good radiological results were achieved in 83%, 17% of the results are considered satisfactory.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗

PubMed1990

Proportion of individual fatty acids in the non-esterified (free) fatty acid (FFA) fraction in the serum of laboratory rats of different ages.

In experiments on Wistar strain rats of both sexes, aged 5, 10 and 14 days and adult (90-120 days), of their own breed, the authors determined the quantitative proportion of individual fatty acids in the serum free non-esterified fatty acid (FFA) fraction, using mixed blood (obtained by decapitation) and the titration method of Trout et al. (1960). The proportion of the individual fatty acids was then determined in this fraction by gas chromatography (Base 1978) and their concentration (in mumol.1-1) was determined by simple calculation from the relative chromatogram data. Animals in the first three age groups were killed in the morning, directly from the nest; in adult rats the FFA fraction was measured after a 20 h fast. It was demonstrated that the increase in the proportion of monoenoic acids was highly statistically significant (about fivefold) during ontogenesis and that there was also a marked increase in the quantitative expression of polyenic acids, especially in group (n-6). The n-6/n-3 acid index in the FFA fraction altered during maturation (despite some fluctuation it basically rose from 4.3 in 5-day-old young to 10.0 in adult rats). It was further demonstrated that the concentration of fatty acids with a very short chain fell significantly during development, so that C 8:0, for example, could be detected only in the first two age groups, but not in 14-day-old and adult rats. The concentration of the saturated fatty acids C 15:0 to C 18:0 in the serum FFA fraction showed a statistically significant increase, while the index expressing the ratio of saturated to unsaturated fatty acids displayed a downward trend during development.

Aging↗

PubMed1989

[Determination of hepatotoxicity using the texture analysis method].

To determine the hepatotoxic effects of hydrazine sulphate by means of a complex of methods of morphological examinations, ten sheep were used as a model of acute liver lesions induced by this compound. The hepatotoxic effects were demonstrated by a general histological examination of liver tissue and by a quantitative evaluation of percent proportions of intact liver parenchyma. Among quantitative indicators, the areas of histochemically detectable neutral lipids and of glycogen in liver tissue were also evaluated. Quantitative evaluation was performed by means of an automatic texture analysis using a texture analyzer T.A.S. plus (Leitz Texture Analyzer System) and a programme devised by the authors in the TASIC language. Similar steatotic changes in liver tissue were found in sheep which were treated with a dose of 0.4 mmol of hydrazine sulphate per 1 kg of live weight, as earlier reported for laboratory animals, carnivores, and monkeys. The above methods of morphological examination can be used for a basal determination of hepatotoxic effects of substances tested in pharmacological research.

Animals↗