Lunate resection and vascularized Os pisiform transfer in Kienböck's Disease: an average of 10 years of follow-up study after Saffar's procedure

PURPOSE: To investigate the long-term results of lunate replacement by vascularized bone transfer in advanced Kienb?ck's disease. METHODS: Twenty-one patients were reviewed (mean follow-up period +/- SD, 9.9 +/- 3.5 y) to analyze results after lunate replacement by vascularized pisiform transposition (Saffar's procedure) for Lichtman stages III and IV. RESULTS: Pain was improved in 16 of 21 patients but range of motion did not improve after surgery. Range of motion was reduced to 68% and grip power to 80% of that of the opposite hand. At follow-up evaluation the mean score on the Disabilities of the Arm, Shoulder, and Hand Questionnaire was 22.3 +/- 17.9 and the mean Cooney score was 75.4 +/- 13.2. Radiologically, Lichtman stage persisted in 8, improved in 1, progressed in 8, and could not be evaluated in 3 patients. Two patients had radiologic signs of arthritis before surgery. At follow-up examination osteoarthritis was found in 50% of patients. The majority of degenerative changes were associated with carpal collapse. CONCLUSIONS: The replacement of the lunate by vascularized pisiform transposition maintained preoperative ranges of motion. At follow-up examination both patient satisfaction and wrist function were high. In the long term, however, Saffar's procedure can restore alignment of the carpus only partly and also results in osteoarthritis in half of all patients.     

Vascularized os pisiform for reinforcement of the lunate in Kienböck's Disease: an average of 12 years of follow-up study

PURPOSE: Little is known about the long-term results of vascularized bone transplantation for Kienb?ck's disease. This retrospective study investigated the long-term results of vascularized pisiform transfer. METHODS: We reviewed 23 patients to analyze results after vascularized pisiform transposition to a cored-out lunate for Lichtman stages II and III. Patients with ulnar-minus variance received additional radial shortening. RESULTS: Pain improved in 20 of 23 patients. Range of motion increased significantly relative to preoperative values but was only 80% that of opposite side. Grip power was 84% of the contralateral hand. At follow-up evaluation the mean Disabilities of the Arm, Shoulder, and Hand questionnaire score was 15.3 +/- 17.9 and the mean Cooney score was 82.4 +/- 10.0. Radiologically, out of 20 patients with preoperative x-rays Lichtman stage was unchanged in 11, improved in 3, and progressed in 6 patients. No patient showed radiologic signs of arthritis before surgery. At follow-up evaluation osteoarthritis was found in 7 of 22 patients. The majority of degenerative changes were of low grade and were seen at the radiocarpal joint. CONCLUSIONS: The results show high patient satisfaction and good function after vascularized bone transplantation for Kienb?ck's disease. In the long term vascularized pisiform transfer prevented lunate collapse in 16 of 22 patients.     

Inhibition of plant and mammalian diamine oxidase by substrate analogues

Imidazoles, aliphatic substrate analogues and the natural dipeptides, carnosine and anserine, were investigated as inhibitors of diamine oxidase from the pig kidney, human pregnancy plasma and pea seedlings. Imidazole, methyli-midazoles,N-acetylimidazole, histamine andN -methyl-histamine are relatively potent inhibitors of mammalian diamine oxidase showing no influence on plant enzymes. Anserine and carnosine are inhibitors of pig kidney and pea seedling enzymes.K ₁ values are 2 M and 10 M respectively. Investigated natural derivatives of putrescine and cadaverine have no influence on diamine oxidase of different origin.In conclusion, we present some evidence to suggest that mammalian diamine oxidase, despite a high reaction rate with putrescine, is better adapted to histamine oxidation, whereas for plant enzymes the diamines are preferred substrates.     

The evolution of epidemiology and clinical characteristics of laryngeal and hypopharyngeal carcinoma in Poland from 1991 to 2001

On the base of retrospective analysis of 12,888 cases of carcinoma of larynx and hypopharynx, diagnosed in 19 ENT Departments in Poland from 1991 to 2001, the assessment of basic epidemiological data, including the localization of tumor and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 11 years the trends to change of the mentioned above parameters has been examined. The significant increase of female patients in this period was observed, with average proportion M:F = 8:1. The glottis localization of carcinoma dominated (47.6%), followed by supraglottis (40.8%) and pyriform fossa (7.8%), with significant increase of pyriform fossa tumors in the analyzed period of 11 years. In the majority of cases the carcinoma of larynx and hypopharynx was diagnosed in the advanced stage (T3 + T4) of local disease, with the highest percentage in localization within the pyriform fossa (81.0%), and the lowest percentage in glottis tumors (45.6%). The regional lymph nodes metastases has been diagnosed in 46.7% of the analyzed group, with the highest percentage in tumors localized in pyriform fossa (82.9%), and the lowest percentage in tumors of glottis localization (33.1%). In the 11 years time the significant drop down of N0 cases and tendency to increase of N2 and N3 in the supraglottis localization of tumor. The distant metastases in the analyzed group at the time of diagnosis has been registered in 2.0%, with the highest percentage in posterior pharyngeal wall (7.6%) and pyriform fossa (7.4%). The authors postulate the renewal of prospective study on epidemiology, clinical characteristics and treatment results of larynx and hypopharynx carcinoma in Poland.     

Simultaneous Ionic and Electronic Conductivity in Polymeric Materials

Summary: Pyrrole and 3‐(3,6‐dioxaheptyl)pyrrole were polymerized in the presence of an oligo(oxyethylene monomethylether) sulfonate (DP_PEO = 17) with ammonium peroxydisulfate as an oxidizing agent and dry chloroform as a solvent. The oligo(oxyethylene) sulfonate acted as a phase transfer agent and also became incorporated into the polymer as a counter ion. The polymers were obtained as gel‐like particles that could be easily dispersed in organic solvent and could be doped with lithium triflate to enhance the ionic conductivity of the electronically conductive materials. DSC and X‐ray measurements showed a glass transition (T_g) in all samples at around ?40 °C which is related to the dynamics of the EO segments. In addition, the system composed of polypyrrole with oligo(oxyethylene) sulfonate counter ions showed partial crystallinity and a melting transition at 34 °C. Conductivity was explored by impedance spectroscopy with regard to frequency and temperature dependence. The data could be evaluated in the coordinates of an Arrhenius plot as the sum of two Arrhenius functions in all cases. Although one Arrhenius‐type function was sufficient to describe the temperature profile of the conductivity below T_g, a second term needed to be added at T > T_g. The absolute values of conductivity were also dependent on the level of doping with lithium triflate. These phenomena were interpreted as a contribution of ionic conductivity by the lithium ions to the electronic conductivity, which comes about from the oxidation state of the polypyrrole backbone.

A good Li‐ion conducting polymer which also exhibits electronic conductivity.     

High-resolution whole-organ mapping with SNPs and its significance to early events of carcinogenesis

We attempted to identify deleted segments in two model tumor suppressor gene loci on chromosomes 13q14 and 17p13 that were associated with clonal expansion of in situ bladder preneoplasia using single nucleotide polymorphisms (SNPs)-based whole-organ histologic and genetic mapping. For mapping with SNPs, the sequence-based maps spanning approximately 27 and 5 Mb centered around RB1 and p53, respectively, were assembled. The integrated gene and SNP maps of the regions were used to select 661 and 960 SNPs, which were genotyped by pyrosequencing. Genotyping of SNPs was performed on DNA samples corresponding to histologic maps of the entire bladder mucosa in human cystectomy specimens with invasive urothelial carcinoma. By using this approach, we have identified deleted regions associated with clonal expansion of intraurothelial neoplasia; which ranged from 0.001 to 4.3 Mb (average 0.67 Mb) and formed clusters of discontinuous deleted segments. The high resolution of such maps is a prerequisite for future positional targeting of genes involved in early phases of bladder neoplasia. This approach also permits analysis of the overall genomic landscape of the involved region and discloses that a unique composition of noncoding DNA characterized by a high concentration of repetitive sequences may predispose to deletions.     

Immunomodulatory medicine use in the bi-symptomatic neuro-vertebral conflict

Background. The following study is an attempt to draw the readers' attention to the issue of the multifariousness of the intervertebral discs' destructive processes resulting in the neuro-vertebral syndrome. The professional literature mentioned here gives a prominence to the thread of immunological phenomena accompanying disc diseases and their treatment.
Material and methods. Selected groups of patients with a high probability of the coexistence of immunological processes were analyzed in terms of pain patterns and topographic cross-sections of the intervertebral discs. They were then treated transdermically with butapirazole and levamisole hydrochloride under the control of Lasegu's bioengineer test, electro-sensory tests and CIC level tests.
Results. A Lasegu's test, an electro-sensory (I) test and a survey showed that the groups of patients treated locally 15 times with Butapirazole showed an almost complete recovery of the symmetry with no effect on the CIC level and the localized pain intensity (II). The majority of the patients experienced a regression of ailments within 3 months. As far as the group of patients treated with Levamisole is concerned both root (I) and localized pains (II) subsided rapidly as confirmed by a survey and a Lasegu's test as well as the electro-sensory tests (I), (II). A high decrease of the level of immunological complexes was noticed after only 15 Levamisole infusions. This correct level was maintained 3 months later, which was shown by further tests.
Conclusions. This seems to be the premise confirming the effect of a localized inflammatory point on the level of immunological complexes present in blood (CIC).