Posterior fixation of thoracolumbar burst fractures: Is it possible to protect one segment in the lumbar region?

Background

The treatment for thoracolumbar burst fractures is controversial. The aim of this retrospective study was to compare intermediate-segment (IS) and long-segment (LS) instrumentation in the treatment for these fractures.

Methods

IS instrumentation was considered as pedicle fixation two levels above and one level below the fractured vertebra (infra-laminar hooks attached to lower vertebra with pedicle screws). LS instrumentation was done two levels above and two levels below the fractured vertebra. Among a total of 25 consecutive patients, Group 1 included ten patients treated by IS pedicle fixation, whereas Group 2 included fifteen patients treated by LS instrumentation.

Results

The measurements of local kyphosis (p = 0.955), sagittal index (p = 0.128), anterior vertebral height compression (p = 0.230) and canal diameter expansion (p = 0.839) demonstrated similar improvement at the final follow-up between the two groups. However, there was a significant difference (p < 0.05) between Group 1 and Group 2 regarding clinical outcome [Hannover scoring system, Oswestry disability questionnaire and the range of motion of the lumbar region compared to neutral (0°)].

Conclusions

The radiographic parameters were the same between the two groups. However, the clinical parameters demonstrated that IS instrumentation is a more effective management of thoracolumbar burst fractures.     

The value of the serum I-FABP level for diagnosing acute mesenteric ischemia

Purpose

This study examined the feasibility of using the serum intestinal fatty acid binding protein (I-FABP) level for the early diagnosis of acute mesenteric ischemia, and investigated whether it contributes to the clinical decision-making process.

Method

Thirty patients diagnosed with acute mesenteric ischemia, 27 patients with other types of acute abdomen who presented with acute abdomen symptoms but were not diagnosed with acute mesenteric ischemia, and 20 healthy people were included in the study. Mesenteric ischemia was confirmed by a pathological evaluation in patients who underwent intestinal resection due to detection of mesenteric ischemia during surgery.

Results

There was no significant difference in the leukocyte counts and d-dimer levels between subjects with mesenteric ischemia and acute abdomen due to other causes (p > 0.05). There was a significant difference in the serum I-FABP level between these groups (p < 0.001).

Conclusion

The I-FABP level is a more reliable parameter for diagnosing acute mesenteric ischemia compared to leukocytosis and d-dimer elevation.     

The relationship between the S-wave in lead 1 and recurrence of RVOT PVC ablation

Background

Radiofrequency catheter ablation (CA) is a common non-pharmacological treatment option for ventricular premature contractions (PVCs) originating from right ventricular outflow tract (RVOT). In this study, we aimed to investigate the relationship between recurrence after CA for RVOT-PVC and S-wave in lead 1 that was shown to be associated with RVOT depolarization.

The attic of the femoral tunnel in anterior cruciate ligament reconstruction: a comparison of outcomes of two suspensory femoral fixation systems

Purpose

This study aimed to find answers to the following questions: (1) Is it possible to determine and measure the space between the top of the graft and entrance of implant tunnel by magnetic resonance imaging (MRI)? (2) Is there any correlation between the hole above the graft in femoral tunnel and the femoral tunnel widening? (3) Does the tunnel widening affect clinical outcomes? (4) Are clinical and radiological outcomes of Toggle Loc with Zip Loop implant-loop design better than Endobutton CL?

Methods

The operative data of two surgeons were analysed. One surgeon used Endobutton CL femoral fixation (E-CL group, n = 46); the other used Toggle Loc with Zip Loop femoral fixation (TL-ZL group, n = 32). At the last follow-up, clinical evaluation was performed with International Knee Documentation Committee Subjective Knee Form (IKDC), Tegner activity scale, Lysholm score, active and passive ROM, Lachman and pivot shift tests, and KT-1000 arthrometer. Radiological evaluation including measurement of tunnel widening on X-ray and MRI and the height of attic of femoral tunnel (space above the graft in femoral tunnel) on MRI was performed.

Results

No difference was found in patient demographics, concomitant meniscal surgery and clinical outcomes. The femoral tunnel widening was evaluated significantly low in TL-ZL group on the PA X-ray and MRI. No difference was observed in the tibial tunnel widening on X-ray and MRI. A correlation between the height of attic of femoral tunnel and the femoral tunnel widening was determined. Thus, the greater the height of attic of femoral tunnel, the greater the femoral tunnel widening. No correlation was established between the tunnel widening and IKDC and Lysholm scores.

Conclusions

The results of this study demonstrate that a positive correlation exists between the height of the attic of the femoral tunnel and femoral tunnel widening. Therefore, increasing the height of the attic of the femoral tunnel may contribute to graft motion, which would then enhance femoral tunnel widening.

Level of evidence

III.     

Variation of alkaloid contents and antimicrobial activities of Papaver rhoeas L. growing in Turkey and northern Cyprus

Context: Papaver rhoeas L. (Papaveraceae) corn poppy, widely distributed in Turkey, is used to make a cough syrup for children, as a tea for disturbed sleep, for pain relief and as a sedative in folk medicine.

Objective: Samples of P. rhoeas collected from eight different locations in Turkey and three from northern Cyprus were investigated for their alkaloid content and screened for their antimicrobial activities.

Materials and methods: From the aerial parts of P. rhoeas samples, alkaloids were isolated by column and preparative thin-layer chromatography. The alkaloids were identified by comparing their spectral data (UV, IR and ¹H-NMR) and TLC Rf values with those of authentic samples. The antimicrobial study was carried out by microbroth dilution technique against six strains of bacteria and three strains of fungi.

Results: Twelve different alkaloids belonging to proaporphine (mecambrine), aporphine (roemerine), promorphinan (salutaridine), protopine (coulteropine and protopine) and rhoeadine (epiglaucamine, glaucamine, glaudine, isorhoeadine, isorhoeagenine, rhoeadine and rhoeagenine) groups were isolated. The most significant activity was observed with the alkaloid extract of P8 against Staphylococcus aureus with a MIC value of 1.22?μg/mL and against Candida albicans with a MIC value of 2.4?μg/mL.

Discussion: The results indicate that P. rhoeas samples (P8 and P9), which contain roemerine as their major alkaloid, were the most active extracts.     

The effect of prostate cancer and antianrogenic therapy on lipid peroxidation and antioxidant systems

In living organism, excessive free radicals oroxidative damage which occur as a result of deficient antioxidant defensive mechanisms by the effect of endogenous and exogenous factors, influences especially developmental steps of chemically induced cancers [1, 2]. In our study, plasma malondialdehyde level (MDA) as an indicator of lipid peroxidation, erythrocyte glutathione (GSH) level as an indicator of antioxidant state, glutathione reductase (GSH-Red), glutathione peroxidase (GSH-Px), glutathione-S-transferase (GST) as an antioxidant enzymes and plasma vitamin E level were detected in patients with prostate cancer (21 males; age, 69.4 ± 4.8 years) before and after three months of antiandrogenic therapy with goserelin acetate as luteinizing hormone releasing hormone (LHRH) analogue. Healthy people evaluated as a control group (20 males; age, 63.7 ± 3.9). Erythrocyte GSH levels, the activities of GSH-Red and GSH-Px and plasma vitamin E levels were found significantly low in patients with prostate cancer when compared with the healthy subjects (p < 0.01, p < 0.05, p ≤ 0.001 and p ≤ 0.001 respectively). Plasma MDA level and erythrocyte GST activity of patient group were significantly higher than the levels of control group (p ≤ 0.001 and p ≤ 0.001 respectively). After antiandrogenic therapy erythrocyte GSH level, GSH-Red, GSH-Px activity and plasma vitamin E level were found unchanged. Significant decrease in plasma MDA level and significant increase in erythrocyte GST activity were detected in patient group (p < 0.05 and p ≤ 0.01 respectively). The study has revealed the shift in the oxidant-antioxidant balance towards oxidative state in patients with metastatic prostate cancer. Our results showed that antiandrogenic therapy increased in GST activity, decreased in lipid peroxidation. This revised version was published online in August 2006 with corrections to the Cover Date.