mó rek szpi ku. Material i metody. Ma te riał kli nicz ny sta no wi ło 46 pa cjen tów z ubyt ka mi chrzęst no -kost ny mi o ró żnej etiolo gii, po twier dzo ny mi w MRI, w dwóch gru pach: 21 cho rych za opa trzo nych z uży ciem kon cen tra tu ko mó rek szpiku i 25 cho rych le czo nych za po mo cą ko mó rek me zen chy mal nych uzy ska nych z krwi ob wo do wej. Oce nę przepro wa dzo no po 6 mie sią cach, 1 ro ku i 5 lat po re kon struk cji ubyt ku na pod sta wie skal: KO OS, Ly shol ma i VAS.Wy ni ki. Au to rzy uzy ska li istot ną po pra wę we wszyst kich ska lach ocen u 40 ope ro wa nych pa cjen tów (86%). U 6 cho rych od no to wa no wy nik zły. Wy ka za no istot ną sta ty stycz nie ró żni cę w gru pach po rów ny wanych na ko rzyść cho rych le czo nych ko mór ka mi ma cie rzy sty mi po zy ska ny mi z krwi. Oce na ob ra zów MRI, u cho rych z wy ni ka mi do bry mi i bar dzo do bry mi, wy ka za ła za do wa la ją cą od bu do wę po wierzch ni chrzęst nej oraz do brą in te gra cję re ge ne ra tu. Po 5-ciu la tach od no to wa no nie wiel ki spa dek śred niej ocen kli nicz nych w obu gru pach cho rych.Wnio ski. 1. Re kon struk cja z uży ciem zmo dy fi ko wa nej tech ni ki ka nap ko wej jest sku tecz ną me to dą le czenia głę bo kich ubyt ków chrzęst no -kost nych sta wu ko la no we go. 2. Nie co gor sze wy ni ki w gru pie le czo nej koncen tra tem ko mó rek szpi ku mo że mieć swą przy czy nę w licz bie po da nych ko mó rek ma cie rzy stych.Sło wa klu czo we: cho ro by chrząst ki, mar twi ca chrzęst no -kost na, ko mór ki ma cie rzy ste, chi rur gia re kon struk cyj na SUM MA RY Background. We pre sent the re sults of the tre at ment of oste ochon dral le sions with the mo di fied san dwich tech ni que with a col la gen mem bra ne. The aim of the stu dy was to as sess and com pa re cli ni cal out co mes fol lowing the re con struc tion of oste ochon dral le sions in two gro ups of pa tients tre ated with stem cells ob ta ined from blo od and with bo ne mar row con cen tra te.Material and methods. The stu dy gro up com pri sed 46 pa tients with MRI -con fir med oste ochon dral le sions of va rio us aetio lo gy. A gro up of 21 pa tients was tre ated with bo ne mar row con cen tra te and 25 pa tients we re treated with me sen chy mal cells ob ta ined from pe ri phe ral blo od. Pa tients we re as ses sed with the use of KO OS, Lysholm and VAS sca les at 6 mon ths, and at 1 and 5 years fol lo wing the re con struc tion.Re sults. We no ted a si gni fi cant im pro ve ment across all sca les in 40 pa tients (86%). A po or out co me was no ted in 6 pa tients. The re was a sta ti sti cal ly si gni fi cant su pe rio ri ty of the gro up tre ated with stem cells ob ta ined from blo od. The ana ly sis of MRI evi den ce in pa tients with go od and excel lent re sults sho wed sa tis fac to ry recon struc tion of the car ti la gi no us sur fa ce and go od re ge ne ra te in te gra tion. At 5 years, a sli ght de cre ase in me an cli ni cal as ses sment sco res was se en in both gro ups of pa tients.Conc lu sions. 1. The mo di fied san dwich...

The morphological appearance of rheumatoid synovitis and the serum MMP and TIMP-1 profile were correlated with the clinical activity of the disease, confirming the heterogeneity of RA. These associations also suggest that patients with different histological forms of RA might require different treatment regimens.

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1. One-stage reconstruction of large cartilage lesions with bone marrow concentrate is an effective treatment modality. 2. Due to its lower cost it is a valuable alternative to autologous chondrocyte transplantation. 3. The study group requires 2-3 years of further monitoring to clinically verify this treatment modality.

1. The reconstruction of large cartilage lesions with peripheral blood stem cells is an effective treatment modality. 2. This method is a valuable alternative to autologous chondrocyte transplantation.

Widespread vasculopathy and profound fibrosis are key features of the pathogenesis of systemic sclerosis (SSc). We hypothesized that the TNF-like weak inducer of apoptosis (TWEAK), a recently recognized multifunctional cytokine which regulates angiogenesis and tissue remodeling, may play a role in the development of SSc. The production of TWEAK by the peripheral blood mononuclear cells (PBMC) was investigated, by means of ELISA, in 24 SSc patients and 14 healthy subjects. Moreover, production of TWEAK was correlated with clinical features of SSc. PBMC were isolated using density gradient centrifugation on Histopaque and were cultured in FCS supplemented RPMI medium at 37°C under 5% CO 2 . Production of TWEAK by PBMC was significantly diminished in patients with more severe microvascular damage, as indicated by the presence of "active" capillaroscopic pattern, compared with SSc patients with less pronounced microangiopathy ("slow" pattern), and healthy subjects. Moreover production of TWEAK correlated inversely with duration of Raynaud's phenomenon. PBMC from patients with scleroderma-related interstitial lung disease tended to produce lower amounts of TWEAK compared with SSc patients without lung involvement but the difference was not significant. The results of our study suggest that diminished production of TWEAK might play a role in the pathogenesis of vascular injury in SSc patients. Whether TWEAK may represent a new therapeutic target in SSc requires further studies.

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