Criteria to Screen for Traumatic Cervical Spine Instability: A Consensus of Chiropractic Radiologists

Objective

The purpose of this study was to establish consensus on a radiographic definition for cervical instability for routine use in chiropractic patients who sustain trauma to the cervical spine.

A pre‐clinical functional assessment of an acellular scaffold intended for the treatment of hard‐to‐heal wounds

The majority of the population experience successful wound‐healing outcomes; however, 1–3% of those aged over 65 years experience delayed wound healing and wound perpetuation. These hard‐to‐heal wounds contain degraded and dysfunctional extracellular matrix (ECM); yet, the integrity of this structure is critical in the processes of normal wound healing. Here, we evaluated a novel synthetic matrix protein for its ability to act as an acellular scaffold that could replace dysfunctional ECM. In this regard, the synthetic protein was subjected to adsorption and diffusion assays using collagen and human dermal tissues; evaluated for its ability to influence keratinocyte and fibroblast attachment, migration and proliferation and assessed for its ability to influence in vivo wound healing in a porcine model. Critically, these experiments demonstrate that the matrix protein adsorbed to collagen and human dermal tissue but did not diffuse through human dermal tissue within a 24‐hour observation period, and facilitated cell attachment, migration and proliferation. In a porcine wound‐healing model, significantly smaller wound areas were observed in the test group compared with the control group following the third treatment. These data provide evidence that the synthetic matrix protein has the ability to function as an acellular scaffold for wound‐healing purposes.     

Lower extremity lipedema,upper extremity lipodystrophy and severe calcinosis complicating juvenile dermatomyositis

Juvenile dermatomyositis (JDM) is a rare but complex and potentially life-threatening autoimmune disease of childhood. Significant proportions of patients have residual weakness, muscle atrophy, joint contractures, and calcinosis. Recently, new clinical findings, such as lipodystrophy accompanied with increased fat deposition in certain areas, have been reported. So far, it is not known whether the redistribution of body fat may be the type of lipedema of lower extremity. We describe a 39-year-old woman who was diagnosed with JDM at the age of 7. Later she developed symmetrical lipodystrophy of upper extremities and symmetrical lipedema of lower extremities (making 2 and 58.3 % of total body fat mass, respectively), with multiple calcified nodules in the subcutaneous tissues. These nodules gradually increased in size despite therapy. Capillaroscopy findings showed scleroderma-like abnormalities. ANA and anti-U1RNP antibodies were positive. Similar cases with simultaneous occurrence of the lipedema of lower extremities, lipodystrophy of upper extremities, and severe calcinosis complicating JDM have not been published so far. We showed that the calcinosis and lipodystrophy were associated with short duration of active disease. Also, we display case that raises the question whether it is possible overlapping autoimmune diseases revealed during follow-up.     

Histopathologic and immunocytochemical changes in the liver in patients with chronic hepatitis C

BACKGROUND: The presence of lymphocytes within the liver parenchyma is related to immunologically mediated liver damage in chronic hepatitis C. The aim of the study was to make histological, histochemical, and immunocytochemical assessment of liver biopsy specimens in patients with chronic hepatitis C virus (HCV) infection. METHODS: Biopsy specimens of 20 patients with chronic HCV disease were analyzed, using standard staining procedures to verify histologic liver lesions, as well as immunoenzymatic staining with monoclonal antibodies to detect CD4+ T-lymphocytes, B-lymphocytes, and macrophages. RESULTS: Micromorphologic characteristics of chronic active viral hepatitis C were present in all the patients, differing, however, by the level of their activity. Dominant changes were found within the portal space, consisting of mononuclear lympho-plasmocytic infiltration and macrophages. Immunocytochemical investigation of mononuclear and macrophageal infiltration showed the correlation between micromorphological findings and the degree of the activity. CONCLUSION: The presence of lymphocytic and macrophageal infiltration within the hepatic tissue directly correlated with the intensity of the liver damage. Analysis of the population of cellular infiltrate in the liver together with the monitoring of viremia level and the level of hepatocyte necrosis, could be useful tools for elucidation of the pathogenesis of chronic hepatitis C.     

Manifestations of hemorrhagic fever with renal syndrome in a military unit stationed in a combat zone

Since it has been recognized as a separate disease during the Korean war, hemorrhagic fever with renal syndrome (HFRS) has often been discovered among the members of different armies in various countries, military personnel being the highest risk group for the disease. In the period from March to May 1999 we treated 6 soldiers coming from the military formation stationed at Kosovo and Metohia. The reaction of indirect hemagglutination test proved the presence of antibodies against Hantavira in each of them. They were infected during the stay in a dugout in the area with great population of field rodents. Only one patient was slightly ill, on the admission to the hospital. The others had severe clinical and laboratory findings: several days lasting fever, strong abdominal pain, as well as the pain in the loins, dyspeptical discomfort, manifold increased blood urea nitrogen and serum creatinine values, thrombocytopenia, etc. Oliguria occurred in 4 patients. Hemorrhagic manifestations were slight (epistaxis, petechial rash, conjunctival injection), or absent. Because of the aggravation of the acute renal failure, hemodialysis was performed in 3 patients, while other 3 underwent conservative treatment. Two of the patients had severe anemia because of which transfusions of erythrocytes and plasma were performed. Complications occurred in 2 patients (convulsive crises and lung infections). All patients recovered completely.