In vitro simulation of intraoperative vertebroplasty applied for pedicle screw augmentation. A biomechanical evaluation

Background and purpose

The purpose of this study was to evaluate the effect of an in vitro simulation of intraoperative vertebroplasty on embedded pedicle screws resistance to pullout. This method involved an application of acrylic cement into the vertebral bodies only after pedicle screws implementation.

Luteinizing hormone (LH) in hypergonadotropic hypogonadism

The serum LH concentration was analyzed in 47 patients of reproductive age with diagnosed hypergonadotropic hypogonadism based on clinical status, pituitary hormone and sex steroids levels, karyotype, ultrasound scan, CT scan, laparoscopy and ovarian biopsy. The following groups were categorized: 46XY, 45X0, premature ovarian failure, WHO III group and iatrogenic symptoms after surgery. The mean serum FSH level was similar in each study group. The serum LH concentration was the lowest in 45X0 group compared to the highest values in 46XY and surgically treated groups. The LH/FSH ratio was close to normal in 46XY and surgically treated groups. We conclude the syndrome should be recognized mainly on basis of FSH level since the LH level shows heterogenic fluctuations. The serum LH concentration is close to normal for physiological conditions (postcastrated menopause, male genotype) but significantly lower in ovarian disorders and gonadal dysgenesis.     

Assessment of stretching techniques for neck and arms muscles in physiotherapy following total laryngectomy

After total laryngectomy and after complete treatment (radiotherapy) there are many functional disorders in the range of head and neck. These decrease muscle strength and flexibility of muscles of cervical spine. This causes disorders of physiological range of motions of this area. The introduction of the stretching techniques (postisometric relaxation) to the physiotherapy program allows to decrease negative effects of treatment, mentioned above. The therapy of main cervical muscles was carried out during a two week rehabilitation camp. Biomechanical-kinesiological tests were used to assess the effect of the physiotherapy program. The application of postisometrical relaxation and the massage of the cervical and arm muscles increased the average motor ranges and muscle strength. Cervical muscles disbalance was decreased at the same time.     

Interaction between phenytoin and diazepam in mutant Han-Wistar rats with progressive spastic paresis

Summary The muscle relaxant (antispastic) effect of diazepam, alone or in combination with phenytoin, was studied in mutant Han-Wistar rats with progressive spastic paresis. Alone, phenytoin did not alter the spontaneous activity in the electromyogram (EMG) of the gastrocnemius soleus (GS) muscle of mutant rats, but strongly enhanced the depressant action of diazepam on the spontaneous EMG activity. Picrotoxin reduced the antispastic effect of diazepam alone and partially reversed the antispastic effect of combined treatment. Therefore, the antagonistic effect of picrotoxin on the reduction of the spontaneous activity in the EMG produced by the combination of both drugs hardly suggests an interaction of picrotoxin with phenytoin, but rather indicates an interaction with the effect of diazepam. Phenytoin enhancement of the depressant action of diazepam on the spontaneous EMG activity of mutant rats strongly suggests the potential therapeutic usefulness of the combined treatment with both drugs.     

Homocysteine level in ovarian follicular fluid or serum as a predictor of successful fertilization

OBJECTIVES: There are some data concerning homocysteine influence on fertilization and early embryogenesis, especially in women experiencing recurrent pregnancy loss (RSA). However, limited data support hypothesis that the ovum might be exposed to high homocysteine concentration what may be important in egg-sperm interactions, for example during in vitro-fertilization (IVF) cycle. DESIGN: Therefore, the aim of our study was to determine fasting total homocysteine concentration in follicular fluid or serum of women experiencing reproductive failure after spontaneous or in-vitro fertilization. MATERIALS AND METHODS: Eight nonpregnant RSA women, 8 normal healthy women with previous successful pregnancy outcome and 15 women undergoing IVF (6 with unexplained infertility-UI, 6 with male factor-MF, 3 with tubal obstruction-TO). Total fasting homocysteine level concentrations were established by ELISA method (Axis Homocysteine EIA, Axis-Shield AS) in serum of RSA and normal healthy women or ovarian follicular fluid of women undergoing IVF. RESULTS: Mean fasting total homocysteine concentration in study group were as follows: RSA-18.63 mumol/L +/- 6.67, Normal-13.98 mumol/L +/- 6.62, UI-20.62 mumol/L +/- 8.19, MF-22.60 mumol/L +/- 7.87, TO-36.75 mumol/L +/- 13.26. We found that RSA women have had significantly higher serum homocysteine concentration when compared to normal healthy women (P < 0.05). Among women undergoing IVF, those with following IVF success had not significantly lower homocysteine level when compared to those with IVF failure (22.81 mumol/L +/- 11.27 vs. 24.54 mumol/L +/- 9.50, P > 0.05). CONCLUSIONS: Our preliminary data suggest that high homocysteine level may negatively influence pregnancy outcome following natural or in-vitro fertilization. It cannot be excluded that elevated homocysteine concentrations contribute to defective chorionic villous vascularization during early stages of gestation.     

Expression of tumor necrosis factor-alpha (TNF-alpha) on peritoneal fluid mononuclear cells in women with endometriosis

OBJECTIVES: Tumor necrosis factor-alpha (TNF-alpha) plays a key role in the processes underlying the development of pelvic endometriosis. TNF-alpha acts on target cells via two receptors: TNFR1(p55) and TNFR2(p75). Depending on cell type and its activation state, ligand binding to TNF-alpha may induce activation and proliferation of the cells or promote apoptosis. The aim of our study has been to evaluate the expression of TNFR1 and TNFR2 on peritoneal fluid macrophages and T lymphocytes derived from women with endometriosis. MATERIAL AND METHODS: The study group consisted of 22 patients with endometriosis (stage I and II rAFS). 14 patients with benign, non-inflammatory ovarian tumors composed the reference group. Mononuclear cells have been isolated from peritoneal fluid, obtained during laparoscopy. The expression of TNFR1 and TNFR2 proteins has been evaluated by means of flow cytometry, using monoclonal antibodies against CD120a, CD120b, CD3 and CD14. RESULTS: The percentage of peritoneal fluid macrophages revealing the expression of TNFR1 and TNFR2 proteins has been higher in patients with endometriosis, in comparison with control group (22.6+/-5.3% vs. 6.8+/-1,8%; p=0.03 and 29.3+/-2.3% vs. 8.8+/-1.8%; p=0.01, respectively). The percentage of T lymphocytes with the expression of TNFR1 and TNFR2 has been similar in endometriosis and control group. CONCLUSION: Higher percentage of peritoneal fluid macrophages expressing TNFR1 and TNFR2 proteins in endometriosis suggests dependence of these cells on TNF-alpha stimulation. Changes in TNF receptors distribution on PF macrophages, but not lymphocyte, may play its role in the pathogenesis of endometriosis.