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Radiotherapy plays a key role in the treatment of squamous cell head and neck cancers (HNSCC). The effectivity of radiation therapy is often limited by radioresistance of these tumours. microRNAs (miRNAs) are endogenous, evolutionary conserved, small non-coding RNAs involved in regulation of cellular processes associated with radioresistance. The objective of this study was to identify miRNA profile enabling to predict the radiation treatment outcomes in HNSCC patients.The retrospective study included HNSCC patients who underwent a definitive radiotherapy. Patients were divided into two groups according to loco-regional control (LRC) as follows - short LRC (n = 22; median 5.1 months (min. 1.3, max, 18.6)) vs. long LRC (n = 21; 60.4 (min. 46.8, max. 98.8)) group. Global miRNA expression profiles were obtained by use of Affymetrix microarray technology (GeneChip miRNA 4.0 Array).We identified 24 miRNAs to be significantly associated with LRC (p0.05), all of these miRNAs were upregulated in patients with short LRC. Out of these miRNAs, 12 miRNAs with p0.025 and 4 miRNAs with p0.01 have been identified.miRNAs seems to be promising as potential biomarkers predicting radiotherapy treatment outcomes in patients with HNSCC.Key words: microRNAs - radiotherapy - head and neck cancer The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Supported by Ministry of Health of the Czech Republic, grant No. 15-31627A. All rights reserved.Submitted: 19. 3. 2018Accepted: 20. 3. 2018.

In 1986-1988 at the Orthopaedic clinic of the Institute for Postgraduate Medical Training 56 stems on non-cemented total endoprostheses of the hip joint type Schenker were implanted. The non-cemented stem was combined in all patients with a cemented socket Poldi. The endoprosthesis was indicated in particular in young patients in 59% in hip joints affected with secondary postdysplastic arthritis of the hip joint. The group was checked by Harris' method, the mean follow-up period in 1992 was 58 months. Of 36 followed up patients 21 operated patients reported pain in the area of the hip joint, 10 patients used analgetics. In nine patients reimplantation of the non-cemented Schenker stem was performed on account of aseptic loosening, in 11 patients the X-ray check revealed obvious signs of aspectic loosening associated with subjective complaints. The dependence of aseptic loosening on the quality of primary implantation is marked. In patients with perfect cortical contact of the stem aseptic loosening developed in 27% of the patients, in patients with inadequate cortical contact aseptic loosening was recorded in 80% of the operated patients. The general evaluation according to Harris comprised 42% excellent results, 30% good results, 14% satisfactory results and 14% poor results. This evaluation does not include patients who on account of pain and loosening of the femoral Schenker component were already re-operated. Because of the considerable number of complications implantation of this type of prosthesis was discontinued at the authors' department.

At the Orthopaedic Clinic of the Institute for Postgraduate Medical Training in the course of 10 years (1979-1989) 2340 primary implantations of total endoprostheses of the hip joint were performed. During the same period 168 total endoprostheses of the hip joint and 20 cervico-occipital prostheses were reoperated. The most frequent reason for reoperation was aseptic loosening of the acetabular component. The mean period between operation and reoperation in these patients was 98 months. In the group with loosening of the socket associated with mechanical destruction of the component the mean period which had elapsed since the primary operation was 43 months. In 87% small size sockets were involved. The most serious problem of reoperation of total endoprostheses of the hip joint is replacement of bone defects. During reoperation of acetabular components an isolated defect on the floor of the acetabulum was found in 26%, a defect of the margins in 38% and a combined defect of the margins in 26% of the patients. For treatment of the defects the authors used bone grafts in the majority allogenic grafts were involved which were used to reconstruct the margins and floor of the acetabulum. Metal implants should hold the bone grafts in the desired position and should not serve as a skeleton. Reoperation of the acetabular part of total endoprostheses of the hip joint is easier from the technical aspect; in defects of the upper portion of the femur it is essential to use a very careful procedure and to preserve the skeleton to a maximal extent.(ABSTRACT TRUNCATED AT 250 WORDS)

The frequency of venous thrombosis diagnosed by the fibrinogen uptake test and ultrasound in relation to HLA typing was examined in a prospective study of 154 patients undergoing total hip replacement. The results demonstrate an association between venous thrombosis and the presence of HLA Cw4 and B35 (being in a linkage disequilibrium with Cw4) (Cw4 34.4% and B35 27.3%, relative risk 2.531 and 1.935 respectively). These results suggest that the presence of HLA Cw4 can be regarded as one of laboratory risk factors of venous thrombosis.

Technological progress in the eighties achieved in the development and implementation of computer technology facilitates new approaches to information processing. Informatics becomes one of the key branches of economy of advanced countries. Under the conditions of the present growth of the volume of information also health care must change the classical form of information processing if it is to fulfil its function properly. The consideration is presented on the possibilities of the introduction of computer technology in our clinics and the problems resulting from it. The experience is described with developing a data base information system of the Orthopaedic clinic of the Institute for In-Service Training of Physicians and Pharmaceutists using ADT 4700 minicomputer.

In the years 1978-1986 the authors implanted 207 total prostheses in patients with the fracture of the femoral neck or after the fractures in the area of the hip joint. 50 patients were operated on for an acute fracture of the neck. The surgical technique in these indications does not differ on principle from the surgical technique of coxarthrosis. They point out a higher number of some peroperative complications. They checked 141 patients with and average follow-up of 47 months. In 4.2 per cent of late complications they reported roentgenological symptoms of loosening. Reoperation because of the loosening of the acetabular component was inevitable in 2.9 per cent of patients. All these cases fall into the group of patients in which the total hip arthroplasty was performed after the fractures of the acetabulum. In no patient it was necessary to reoperate the femoral component. Within the check up the patients underwent roentgenological examination and the result was assessed by the method according to Harris. In total, excellent result was reported in 43.2 per cent of patients, good result in 29.8 per cent, fair result in 14.2 per cent and poor result in 12.8 per cent of patients. With regard to a low number of complications and very good results of the evaluation according to Harris the authors consider total hip arthroplasty in the treatment of post-traumatic conditions for fully indicated. Total hip arthroplasty is indicated also in acute fractures of the femoral neck in which it brings in a short time interval good functional results with minimum complications. A group at risk is represented by patients operated on after the fractures of acetabulum.

The authors have made evaluation of the surgical treatment of luxation fractures of the ankle in the period 1979-1987 in 105 patients (60 female, 45 male patients) in the age range from seventeen to eighty-one years, with the most frequent representation of the age group ranging from thirty-five to forty-five years. The group comprised 2,70 percent of fractures of type Weber A, 31.53 percent of fractures of type Weber B and 65.77 percent of fractures of type Weber C. 53 percent of patients were operated on the day of injury, 24.8 percent of patients were transferred with a delay from other clinics and in the rest of the patients the timely operation was contraindicated because of the poor local or general condition. The results were processed according to a uniform worksheet by the computer. On the basis of the evaluation there were found out 87.62 percent of successful and 12.38 percent of poor results. 93.3 percent of patients resumed their original jobs and there was no patient eligible for a full disability pension. The main cause of failure was the osteoarthritis of the ankle joint found out in connection with the inaffestable factors (such as defects of cartilage, nature of the bone lesion, luxation of talus, age and sex of the patient) and affectable factors (infection, failure of osteosynthesis, pseudoarthrosis of medial malleolus, non-anatomical position in the area of tibiofibular syndesmosis). The incidence of these negative factors may be reduced by a timely operation, precise surgical strategy and technique and proper post-operative treatment.

After an inadequate conservative treatment of III-grade sprain of the ankle combined with the rupture of ligaments, these heal in prolongation which result in the chronic instability of the ankle joint. After the evaluation of the anamnesis and the objective examination the diagnosis is specified by comparative forced X-ray images in both projections. To substitute insufficient fibular ligaments we use a modification of the Weber method. We perform tenodesis of m. peronaeus brevis. The tendon is led through the bone channel above the apex of the lateral maleolus and its proximal end is fixed in the area of the origin of lig. fibulotalare anterius to talus. We checked up 29 patients on average 4 years and 7 months after the operation. From the subjective viewpoint almost 80 per cent patients had no or minimum complaints. In the examination of the range-of-motion; we found in 52 per cent of patients the range identical with the intact side, in 41 per cent there occurred functionally insignificant limitation of inversion. On the basis of longterm satisfactory results we can recommend our modification of the Weber method as a simple and efficient method of the treatment of chronical instability of the ankle joint.

Compartment syndrome represents the most serious complication in the treatment of the fractures of the shin. In the period 1979-1987 17 patients with variously developed form of the compartment syndrome were treated at the Orthopaedic clinic of the Institute for In-service Education of Physicians. 7 patients, i. e. 40 per cent were transported from other clinics. There were 8 open fractures in the group, i. e. 47 per cent, and they were classified according to Allgöwer. All patients were primarily operated on for the fracture of the shin and the compartment syndrome occurred in 11 cases after plate osteosynthesis and in 6 cases as a result of the implementation of an external fixation device. Early fasciotomy in the interval up to two hours after the manifestation of the syndrome was done only in two patients, in three cases fasciotomy was not done at all. From the viewpoint of the types of decompression bilateral incision was done in five cases and parafibular decompression in 7 cases. Restitutio ad integrum after the syndrome does not exist. Results of the treatment range from the healing with the defect of soft tissues to the amputation which was performed in two patients. In the evaluation of surgical errors resulting in the development of the syndrome primary closure of operational wound ranks the first place. In the evaluation of the general biological condition of the organism in 66 per cent polyglobulia and hypalbuminemy were found as an expression of a poor biological condition of the organism and chronic hypoxy. The necessity was stressed of the evaluation of the condition of soft tissues and their contamination and their adequate treatment. The possibility was pointed out of hyperbaric oxygenation as a still neglected component of the causal therapy.

The authors have made electromyographic examination of m. tensor fasciae latae and m. glutaeus medius and sometimes also minimus in patients after the implantation of total endoprosthesis of the hip joint by anterolateral Watson - Jones approach and transgluteal Bauer approach with the aim to find out if there occurs the anticipated transection of n. glutaeus usp. and dennervation of m. tensor fasciae latae and compare from this viewpoint both approaches. The examination was performed in 18 patients after the implantation of 20 total endoprostheses of the hip joint (out of which 10 hip joints were operated on by Watson - Jones approach and 10 by Bauer approach) in the period of 6-20 weeks after operation. In the examination concentric needle electrodes and NEUROMATIC 2000 C device (produced by DANTEC Co.) were applied. It was found out that the transection of n. glutaeus sup. is inevitable in neither approach. In patients operated on by Watson-Jones approach there occurred only twice complete transection of the nerve with the dennervation of m. tensor fasciae latae, six time incomplete interruption of the nerve and twice the finding in m. tensor fasciae latae was normal. In patients operated on by Bauer approach complete transection of n. glutaeus sup. was found out six times and incomplete interruption of this nerve four times. Thus from this viewpoint Watson-Jones approach is more considerate. Moreover, in Bauer approach eight times there occurred partial interruption of the innervation of the ventral portion of m. glutaeus medius. Consequently, the study has not proved the assumption that both approaches must necessarily result in complete transection of n. glutaeus sup.(ABSTRACT TRUNCATED AT 250 WORDS)

The authors deal with etiology, pathological anatomy and clinical finding in inborn high-riding scapula--the so-called Sprengel deformity. What is the best treatment tactics? Is the conservative treatment more suitable than the surgical one, or vice versa? By comparing their own experience with the data in the specialized literature the authors advocate a strictly individualized approach to each affected patient. After determining the diagnosis of Sprengel deformity it is necessary to evaluate the position of the scapula and the extent of the limitation of the range of motion of the respective shoulder-girdle. At the same time it is essential to consider the ability of the child and his parents to cooperate in the period of the postoperative rehabilitation. The rehabilitation carried out properly in the postoperative period is equally important as the perfect performance of the surgery. In more severe grades of affection combined with greater functional limitation of the ipsilateral shoulder the authors recommend the surgical treatment using the Green procedure with additional subperiosteal osteotomy of the ipsilateral clavicle (morcellation). The aim of the operation consists in the reduction of the scapula with simultaneous extraperiosteal release of most muscles inserted on the scapula. At the same time the os omovertebrale, if present, is always removed. The congruency of the anterior surface of the scapula and the thoracic wallis achieved by the resection of the supraspinatus part of the scapula. The proper position of the reduced scapula is ensured both by the reinsertion of muscle insertions to new, functionally more advantageous parts and by the fixation of the interior angle of the scapula in a newly created "pocket" in m. latissimus dorsi. Immediately after operation the proper position of the scapula is ensured by wire cerclage, distally anchored to the contralateral spica cast. The authors evaluate a group of 7 patients operated on at the Orthopaedic Clinic of the Institute for Further Education of Physicians, Teaching Hospital at Bulovka in Prague in the period of 1980-1987. Ensuing from the evaluation is the fact that in all deformities of III grade according to Cavendish the results achieved were satisfactory. On the other hand, the deformities of IV grade are difficult to treat even by operation. Only in one case the result was partially successful. In the conclusion the authors recommend a timely screening of the deformity, its timely operation (up to the age of 4 years) and indication carefulness in elder children.

Two intriguing tumours in the appendicular skeleton are coined by odontogenic terms: the "adamantinomas" and "cementomas" (or "cementifying fibromas"). Both are extremely rare, mainly the latter. Eight verified observations are presented here: five adamantinomas and three cementomas. Whereas in adamantinomas, the localization and radiographic picture was very typical in all cases, only one cementoma was found in the metaphysis of a long tubular bone in our survey. Diaphyseal tibial localization in one, and metacarpal in the another patient are the first two atypical localizations, described for this tumor in the world's medical literature. Angiography is characteristic for a benign expansive lesion and should be carried out in all cases. An "en bloc" resection is the intervention of choice for both these entities.