IntroductionAnterior cervical discectomy and fusion (ACDF) in the subaxial cervical spine as originally suggested by Badgley in 1939 and described by Robinson and Smith in 1955 [28] and Cloward in 1958 [8] has established itself as a method of treatment for patients with neural compression by disc material or osteophytes.Although the interbody location of applied bone graft is a favourable healing environment, because of the relatively large surface area of subchondral cancellous bone Abstract Background. The purpose of this prospective semi-randomised comparative study was to compare fusion rates, course of fusion, and occurrence of collapse and subsidence of autologous and allogenic bone grafts in instrumented anterior cervical fusion. The number of fused levels and the smoking status were investigated as potential factors influencing the bone-healing process. No similar prospective study on instrumented anterior cervical discectomy and fusion was found in the literature. Methods. Seventy-nine consecutive patients were operated on using the Smith-Robinson technique with a single instrumentation system at one or two levels. Seventy-six cadaverous fibular bone grafts and 37 autologous iliac-crest bone grafts were inserted. All patients were followed up for at least 2 years. Results.The radiographs obtained during the follow-up were analysed, and showed no statistical difference in fusion and collapse rate between autografts and allografts. Allografts showed significantly longer time to union. No case of graft migration was observed. No difference was found between fusion and collapse rate with respect to the number of fused levels in general, but greater time to union was seen in two-level fusions. When one-and two-level subgroups were compared, there was no evidence of any significant difference in fusion or collapse rates between autografts and allografts, and the healing process took longer in allogenic grafts. Smoking status did not alter any of the fusion or collapse rates, or the course of bone fusion.Conclusions.This study demonstrates that allografts are suitable substitutes for autografts in instrumented ACDF. Prolonged time to union observed in allogenic bone grafts does not seem to be an important factor in instrumented procedures. Two-level grafting does not imply a significantly lower fusion rate, but longer time to union can be expected than with single-level instrumented procedures in both allograft and autograft subgroups. Our relatively small number of patients may not have been sufficient to decipher significant differences between smokers and nonsmokers in the rate or course of fusion as previously reported.

In IFNbeta-naïve patients with early active RRMS, combination treatment did not show superiority over IFNbeta-1a monotherapy.

Summary Common variable immunodeficiency (CVID) islymphocytes, showed age dependency to be more significant than in the control group. Our study demonstrates that T and B lymphocyte abnormalities in CVID are partially related to each other. Some of those abnormalities are not definite, but may evolve with age of the patient.

The original Gail model is not an accurate breast cancer risk assessment tool for the Czech female population.

Summary:Autologous stem cell transplantation (ASCT) has an established role in the treatment of symptomatic multiple myeloma (MM). Our aim was to analyse the impact of selected prognostic parameters on the survival of patients with MM after ASCT. The new International Staging System (ISS) was also evaluated. A total of 133 MM patients were transplanted in our centre between 1995 and 2002. Following ASCT, 35% of patients were in complete remission (CR) and 60% were in partial remission (PR). The median progression-free (PFS) and overall (OS) survival from transplantation were 29.5 and 68.8 months, respectively. Transplant-related mortality (TRM) was 3%. On multivariate analysis, factors associated with significantly shorter OS were lack of CR after transplant (P ¼ 0.002, hazard ratio (HR): 3.1), stage 3 according to ISS (P ¼ 0.001, HR: 3.0) and age at transplant over 60 years (P ¼ 0.035, HR: 2.0). The status of disease before ASCT did not significantly affect PFS and OS after transplantation. We conclude that ASCT is a safe and effective procedure in MM patients, associated with low TRM. The survival after ASCT was dependent on response after ASCT, stage according to ISS and age. Reliable and simple staging of MM is important for accurate prognostic evaluation and for the comparison of data from different clinical trials. Attempts to improve the widely accepted Durie-Salmon (DS) staging system 2 have led to the development of numerous new prognostic systems, 3-5 which have not been universally accepted. Recently, Greipp et al 6,7 presented a new International Staging System (ISS) for MM. It has shown promise in patients treated by conventional as well as high-dose chemotherapy and is based on a simple combination of serum b 2 -microglobulin and albumin values (stage 1 ¼ b 2 -microglobulin o3.5 mg/l and albumin X3.5 g/dl; stage 2 ¼ b 2 -microglobulin o3.5 mg/l and albumin o3.5 g/dl, or b 2 -microglobulin X3.5 mg/l to o5.5 mg/l; stage 3 ¼ b 2 -microglobulin X5.5 mg/l).When compared with standard-dose chemotherapy for MM, high-dose chemotherapy with autologous stem cell transplantation (ASCT) has been found to be significantly superior in terms of complete remission (CR), CR duration, progression-free survival (PFS) and overall survival (OS). [8][9][10][11][12] We have retrospectively analysed 133 patients with MM undergoing ASCT in our centre. The aims of our analysis were (1) to evaluate both ISS and DS systems in our set of patients; (2) to ascertain the feasibility and toxicity of the transplant procedure; (3) to evaluate the influence of some clinically important parameters (age, gender, type of MM, stage of MM, responses before and after ASCT, selected laboratory values at transplant) on PFS and OS after transplant in order to define the subgroups of patients with different prognosis. Patients and methods Patients and treatmentFrom January 1995 to December 2002, 133 patients with newly diagnosed symptomatic MM with stages I-III according to DS underwent ASCT at the Department of Internal Medicine -Haematooncol...