Computerized tomography imaging in adolescent idiopathic scoliosis: prone versus supine

Background

The aim of the present study was to assess the degree of apical vertebral rotation values in Adolescent Idiopathic Scoliosis (AIS) that were obtained on CT scans, and to analyze the influence of patient position (supine versus prone) on the degree of rotation.

Methods

The study included 50 apical vertebra rotation measurements of 34 patients with Type 1A and Type 3C curvature according to the Lenke classification. CT imaging was applied to the patients in supine and prone positions to measure the apical vertebral rotation (AVR). The average AVR angles were measured using the Aaro–Dahlborn method and the results were compared.

Results

No significant differences were found between the vertebral rotation measured in the prone and supine positions for the Lenke 1A subgroup and the Lenke 3C thoracic group (p = 0.848; p = 0.659, respectively). In the Lenke 3C lumbar group, however, the vertebral rotation in the supine position was found to be significantly lesser than that in the prone position (difference ?1.40° ± 1.79°, p = 0.007).

Conclusion

The assessment of the apical vertebra rotation is crucial in AIS. Even though the vertebral rotation in the supine position was found to be significantly lesser than that in the prone position, CT imaging in a prone position could not be considered clinically more relevant than the CT images in a supine position as there was less than 3° difference.

     

Poly-ADP-ribose polymerase inhibition provides protection against lung injury in a rat paraquat toxicity model

Objectives

Paraquat (PQ) is a widely used herbicide. Exposure to PQ at toxic doses can result in fatal acute lung injury. Inhibition of the poly-(ADP-ribose) polymerase (PARP) enzyme alleviates inflammation and necrosis in various pathologies. Here we aimed to evaluate the effects of PARP inhibition on PQ-induced lung damage in a rat experimental model.

Methods

Female Sprague-Dawley rats (n = 24) were allocated into three groups: sham, PQ and PQ + 3-aminobenzamide (3-AB) that is a PARP inhibitor, groups. Experimental lung injury was induced by administration of 15 mg/kg PQ intraperitoneally in PQ and PQ + 3-AB groups. 3-AB (10 mg/kg twice per day) was administered to the PQ + 3-AB group for four consecutive days. The animals were killed on the fifth day following PQ administration. Lung tissue and blood samples were collected and stored until analysis.

Results

Serum lactate dehydrogenase (LDH) and neopterin levels, tissue oxidative stress parameters, transforming growth factor-beta1 (TGF-β) levels and histological injury scores in the PQ + 3-AB group were significantly lower than in the PQ group (P < 0.05, PQ vs. PQ + 3-AB). Total antioxidant capacity in the PQ + 3-AB group was significantly higher than in the PQ group (P < 0.05, PQ + 3-AB vs. PQ).

Conclusion

Our results suggested that the use of PARP inhibitors following PQ toxicity might be useful for minimizing lung injury due to paraquat toxicity.

     

Factors Influencing Chemotherapy Goal Perception in Newly Diagnosed Cancer Patients

Cancer patients who start receiving chemotherapy have difficulty in understanding the state of their disease, the prognosis, and the purpose of treatment. We used a survey to evaluate the extent of perception of chemotherapy goal among cancer patients. Two hundred sixteen cancer patients who received chemotherapy for the first time participated in the study. The presence of depression and anxiety was assessed using the “Hospital Anxiety and Depression Scale” (HAD). The consistency between the patients’ perception of the chemotherapy goal and the physician’s perception was described as “right,” and the inconsistency was described as “wrong.” Among the patients who participated in the survey, 53.2 % (n?=?115) were receiving adjuvant treatment and 46.8 % (n?=?101) were receiving palliative treatment for metastatic disease. The rate of right and wrong perception of the chemotherapy goal was 51.9 % (n?=?108) and 32.2 % (n?=?67), respectively, and the rate of confused patients was 18.9 % (n?=?41). The level of education was shown to be the only parameter involved in accurate perception of the treatment purpose (hazard ratio (HR)?=?0.444, p?=?0.025, 95 % confidence interval (CI) 0.219–0.903). In this study, there was a 51.9 % consistency between the physician’s perception and that of the patient regarding the purpose of treatment. We demonstrated that the level of education was the unique factor in accurate perception of chemotherapy goal among cancer patients.     

Evaluation of the anti-inflammatory effect of erythromycin on aseptic inflammation of temporomandibular joint in rabbit: a scintigraphic and histopathologic study

Abstract – This article investigates the anti‐inflammatory effects of erythromycin (EM) on aseptic inflammation of temporomandibular joint (TMJ) space using by Tc‐99 m HIG scintigraphy and histopathology. In this experimental study, 33 adult male New Zealand White rabbits were divided into three groups. The animals in the first group were treated with EM 25 mg kg^?1; the animals in the second group were treated with methylprednisolone (MP) 2 mg kg^?1 and the animals in the third group were given saline solution (control group). Each drug was given by intraperitoneal injection twice a day for 7 days. Two hours after the last injection, carrageenan was injected into right TMJ of rabbits for aseptic inflammation. After carrageenan injection, each rabbit was given an intravenous injection of 111 Mbq (3 mCi) Tc‐99 m human HIG, and scanning was performed 4 h later. Later, all animals were killed and TMJ and periarticular tissues were resected. Histopathologically, the distance between synovial surface epithelium (SSE) and muscle layer (ML) in each section was measured by using SAMBA 200 Cell image processor with software. Scintigraphically, when lesion activity/adjacent region activity (L/N) was evaluated there was a significant difference between the control group and the other two groups (P < 0.05 for EM and MP). However, no significant difference was found between the EM and MP groups. Histopathologically, the mean distance between SSE and ML in the sections was found longer in the control group (78.6 ± 10.7 μm) than in the EM (44.38 ± 18.26 μm) and MP (44.05. ± 18.25 μm) groups. We think that administration of EM, which is a well‐known macrolid antibiotic, might be very effective in the treatment of aseptic inflammation of TMJ space. Because corticosteroid administration has many side effects, EM may be a preferable drug in the treatment of inflammation of TMJ.     

The impact of joint line restoration on functional results after hinged knee prosthesis

Background:

Hinged knee prosthesis is an effective treatment method as a salvage procedure in marked ligamentous insufficiency and severe bone defects. Joint line determination and restoration are difficult due to large bone defects and distorted anatomy. We evaluated the impact of joint line alteration on the outcome in rotating hinge knee arthroplasty (RHKA).

Materials and Methods:

35 patients who had rotating hinged knee prosthesis applied between 2008 and 2013 were evaluated in this retrospective study. The patients were studied radiologically and clinically. Five patients were lost to followup and two patients died, leaving a total of 28 (7 male, 21 female) patients for final evaluation. The average age of the patients was 66.19 ± 8.35 years (range 52–83 years). The patients were evaluated clinically with Knee Society knee and functional score and patellar score. The joint line positions were evaluated radiographically with femoral epicondylar ratio method. The outcomes were also evaluated according to age, body weight and gender. Student''s t-test, independent t-test, and the Wilcoxon signed rank test were used in the statistical analysis.

Results:

The mean Knee Society knee and functional score significantly improved from preoperative 19.52 ± 11.77 and 12.5 ± 15.66 respectively to 72.46 ± 14.01 and 70.36 ± 9.22 respectively postoperatively (P < 0.001). The mean range of motion of the knee improved from 55.95° ± 25.08° preoperatively to 92.14° ± 13.47° postoperatively (P < 0.001). Joint line position was restored in 20 patients (71.4%). Joint line alteration did not affect Knee Society Scores (KSSs) in contrast to patellar scores. Additionally, KSS was better in the patients with body mass index ≤30 at followup (P = 0.022 and P = 0.045).

Conclusion:

RHKA is an effective salvage procedure for serious instability and large bone defects. Restoration of the joint line improves the patellar score although it had no effect on the clinical outcome.     

The association of job strain with coronary heart disease and metabolic syndrome in municipal workers in Turkey

To explore the association of job strain with CHD and metabolic syndrome in municipal workers. A cross-sectional study was completed of 450 male workers. Coronary heart disease was defined as: physician diagnosed ischemic heart disease; and/or, ischemic findings in the ECG. Metabolic syndrome was defined according to the criterion set by the National Cholesterol Education Panel. The demand-control model was used to assess job strain. Self administered questionnaires were completed after a face to face interview. Logistic regression models were constructed to assess the association of job strain with CHD and metabolic syndrome. The prevalence of metabolic syndrome and CHD were 17.8% and 8.0% respectively. Both CHD and metabolic syndrome were found to be significantly higher in higher income groups. Job demand and job control were not found to be associated with either CHD or metabolic syndrome. Metabolic syndrome was significantly more prevalent among the high job strain workers, but the significance was lost when controlled for age. The findings suggest that there is no significant association between job strain and metabolic syndrome and CHD in this sample of Turkish workers. Job strain may possibly be perceived differently in different cultures and occupations. Future studies may benefit from using a combination of different stress models and more diverse study populations.     

Factors Affecting the Survival of Patients Treated by Standard Nephroureterectomy for Transitional Cell Carcinoma of the Upper Urinary Tract

Purpose:In this study we tried to evaluate the predictive factors for survival in patients with upper urinary tract tumors. Materials and methods: From 1993 to 2003, 46 patients were treated by standard nephroureterectomy for upper urinary tract tumor, but only 24 patients (52%) who had regular follow-up were included in the study. Age, sex, presenting symptoms of the patients, tumor localization, tumor stage and grade were analyzed with respect to survival. Univariate and multivariate analyses were done using Kaplan–Meier method with log-rank test and Cox proportional hazards regression model, respectively. Results: The median of patient age was 61 years (34–74). Of the 24 patients, 9 (37.5%) were disease-free and alive at a mean time of 54 (26–97) months, 8 (33.3%) died of disease at a mean period of 23.4 months (2 because of bladder tumor, 2 had liver metastases, 1 had lung metastasis and 3 had lung and liver metastases) and 7 (29.2%) died disease-free at a mean period of 30.3 months. Metastases were detected in a mean period of 11.8 (6–24) months. Survival according to tumor stage Ta, T1-2, and invasive tumors were 87.5, 43.9, 15.7 months (p = 0.0001), respectively. Survival of the patients with low-grade tumors was significantly longer than those with high-grade tumors (77.3 and 31.4 months, respectively, p = 0.01). Patients with pelvis tumors when compared to ureter tumors (28.5 and 61.6 months, respectively, p = 0.038) and those presenting with flank pain when compared to those presenting with macroscopic hematuria and bladder cancer (17.7, 45.7, and 57.9 months, respectively, p = 0.046) had shorter survival rates. When multivariate analyses were done using Cox regression test, the only factor that affected survival was the stage of the tumor. Age and gender had no impact on survival. Conclusions: In univariate analysis, the stage, grade, localization of the tumor and presenting symptoms were found important predictors that affect the prognosis of the transitional carcinoma of the upper tract. However, tumor stage was the only independent predictor of survival in multivariate analysis. For high grade and high stage tumors, really effective adjuvant treatments along with aggressive surgery may be considered.