Automated assessment of cervical dystonia.

We developed an automated and objective method to measure posture and voluntary movements in patients with cervical dystonia using Fastrack, an electromagnetic system consisting of a stationary transmitter station and four sensors. The junction lines between the sensors attached to the head produced geometrical figures on which the corresponding aspects of the head were superimposed. The head position in the space was reconstructed and observed from axial, sagittal, and coronal planes. Four patients with cervical dystonia and 6 healthy subjects were studied. Each patient was representative of one of the typical patterns of cervical dystonia. The study allowed the authors to collect quantitative data on posture and range of motion of the head. This pilot study demonstrates the efficacy of the Fastrack system to objectively measure the head position in cervical dystonia patients.     

Response of bone marrow stroma cells to demineralized cortical bone matrix in experimental spinal fusion in rabbits

The effect of autogeneic bone marrow (BM) cells and allogeneic demineralized bone matrix (DBM), alone or combined, as transplantation materials was studied in an experimental posterior thoracic spinal fusion model in rabbits. Transplantation of composite grafts composed of BM and DBM showed the first signs of fusion between two spinal segments after four weeks, reaching 86% after 20 weeks. Late fusion results achieved with DBM alone were similar. The capacity of BM per se to build up a spinal fusion was insignificant. Calcified tissue, documented roentgenographically, was shown to develop locally with time, and the earliest bridging of an interspace was noted after four weeks. Histologically, formation of new bone and cartilage was observed after two weeks, showing mature lamellar bone formation between thoracic segments after 20 weeks. Furthermore, increased 45Ca activity was still observed in the fused tissues after 20 weeks. Although, with grafting materials used, this model for experimental spinal fusion gave promising results, further investigations with other fusion techniques could give still better effects.     

Histologic evaluation of radiofrequency ablation in renal cancer.

AIM: To report on the histologic evaluation of renal tumors after intraoperative radiofrequency ablation (RFA) performed immediately before surgical nephrectomy. MATERIALS AND METHODS: Ten patients with renal tumors were studied. All tumors were confirmed to be renal cell carcinoma before radio frequency ablation treatment. All specimens were stained with hematoxylin and eosin and nicotinamide adenine dinucleotide (NADH). RESULTS: Mean tumor size was 29 mm (range 14 to 48 mm). Of the 10 tumors 5 were completely devitalized with a treatment margin ranged from 1 to 20mm. One tumor needed two treatment sessions. No complication related to radiofrequency treatment was recorded. CONCLUSIONS: Our data indicate that RFA can completely destroy renal tumors. However, in our study, complete tumor cell death was obtained only in 50% of cases. More studies are needed to ensure that is technique is an effective and reproducible treatment.     

Stability of skeletal Class III malocclusion after combined maxillary and mandibular procedures: titanium versus resorbable plates and screws for maxillary fixation.

PURPOSE: The aim of this study was to evaluate skeletal stability after double jaw surgery for correction of skeletal Class III malocclusion to assess if there were any differences between resorbable plate and screws and titanium rigid fixation of the maxilla. PATIENTS AND METHODS: Twenty-two Class III patients had bilateral sagittal split osteotomy for mandibular setback stabilized with rigid internal fixation. Low level Le Fort I osteotomy for maxillary advancement was stabilized with conventional titanium plate and screws in 12 patients (group 1) and with resorbable plate and screws in 10 patients (group 2). Lateral cephalograms were taken before surgery, immediately postoperatively, 8 weeks after surgery, and 1 year postoperatively. RESULTS: Before surgery both groups were balanced with respect to linear and angular measurements of craniofacial morphology. One year after surgery, maxillary stability was excellent in both groups. In group 1 no significant correlations were found between maxillary advancement and relapse. In group 2, significant correlations were found between maxillary advancement and relapse at A point and posterior nasal spine. No significant differences in postoperative skeletal and dental stability between groups were observed. CONCLUSION: Surgical correction of Class III malocclusion after combined maxillary and mandibular procedures appears to be a fairly stable procedure for maxillary advancements up to 5 mm independently from the type of fixation used to stabilize the maxilla. Resorbable devices should be used with caution for bony movements of greater magnitude until their usefulness is evaluated in studies with large maxillary advancements.     

Malignant Myoepithelioma of the Rhinopharynx: Case Report

Malignant myoepitheliomas are rare tumors of salivary glands. Most occur in the parotid gland; few other sites of origin are described. Malignant myoepithelioma of the rhinopharynx has only been reported twice. Because the lesion is so rare, there are no specific indications for its treatment. We present a third case of malignant myoepithelioma in the rhinopharynx and discuss its diagnostic and therapeutic aspects.     

Effects of atorvastatin on arterial endothelial function in coronary bypass surgery

Objective: Endothelial dysfunction represents a critical early component of organ injury following cardiopulmonary bypass. Recent studies demonstrate that the treatment with atorvastatin is associated with a significant improvement of endothelial function independently of its efficacy on cholesterol levels. Therefore, we investigated the effects of preoperative atorvastatin treatment on endothelium function after coronary surgery. Methods: Forty patients undergoing coronary surgery were randomized to treatment with atorvastatin (20 mg/die; N = 20) or placebo (N = 20) 3 weeks before surgery. Twenty normal patients served as control group. The flow-mediated dilations (FMD) of the brachial artery after both reactive hyperemia (endothelium dependent) and nitroglycerin administration (endothelium independent) were evaluated at baseline, at 48 h, and 5 days postoperatively. Results: At baseline, the endothelium-dependent FMD was significantly attenuated in coronary versus normal patients (normal 10.3 ± 1.8% vs coronary 4.1 ± 1.6%, p < 0.01). At 48 h postoperatively all patients exhibited a reduced FMD compared with baseline values: the endothelium-dependent dilatation showed a drop of 60.1 + 15% in the patients of the placebo group compared with 45.8 + 16.6% (p < 0.05) those in the atorvastatin group. At the univariate analysis, no significant correlation was found between serum levels of either total cholesterol or HDL cholesterol and FMD. The nitroglycerin-induced dilation was not significantly influenced by extracorporeal circulation as well as by atorvastatin treatment. Conclusions: The endothelial dysfunction following cardiopulmonary bypass is improved by the treatment with atorvastatin, by a mechanism unrelated to the drug efficacy of controlling serum cholesterol levels.