Kniegelenksmeniskusverletzungen im Kindesalter mit Berücksichtigung der Nachuntersuchungen

Zusammenfassung Es wurden 30 Fälle der Kniegelenksmeniskusverletzung im Kindesalter vorgestellt, die operativ behandelt waren. 20 der Behandelten wurden nach 1–12 Jahren nach dem operativen Eingriff nachuntersucht. Es wurden n die Ätiologie, der Verletzungsmechanismus und der klinische Befund besprochen. Die klinische und radiologische Nachuntersuchung ermöglichte die morphologische und funktionelle Auswertung des Kniegelenks nach der Meniskusverletzung.

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Injury of the semilunar cartilages of the knee-joint in childhood

Summary In the paper, 30 patients at the age of 5 till 14 with injuries of the semilunar cartilages of the knee-joint, are presented. All the children were subjected to surgery, and 20 of them underwent same examinations performed in a delay of 1 to 12 years after they had been operated. Both etiology and the injury mechanism subjects are hadled together with the clinical pictures, specific to the age of the young patients. Basing on the clinical and X-ray examinations, the state of the morphological and functional condition of the knee of a child after semilunar cartilage had been removed, was considered and estimated.

     

Evaluation of a risk of a cross-reactivity with Echinococcus multilocularis-specific Em2plus antigen in patients with liver cancer

The incidence of non-specific reactions with E. multilocularis antigen in patients with liver malignancies, and the risk of a supradiagnosis of alveolar echinococcosis (AE) in space-occupying lesions in the liver due to neoplastic proliferative diseases were studied. Analysis of specific IgG serum antibody against Em2plus antigenic complex was performed in 11 AE patients in comparison to 76 individuals with malignant neoplasms of abdominal or extra-hepatic location, including some patients with primary hepatocellular cancer or distant metastases to liver, and 42 patients with benign hepatic lesions. Only one false borderline result was reported in a case with colorectal cancer, and dissemination to liver. Low risk of false positive results with E. multilocularis-specific Em2plus antigen in patients with liver malignancies makes the test valuable for practical reasons in a differential diagnosis of irregular tumor masses visualized by imaging techniques.     

Reversed blood flow during internal carotid artery stenting using Parodi Anti-Emboli System--progress in protection against cerebral stroke

Carotid artery stenosis is one of the main causes of stroke. Nowadays two techniques for treating carotid stenosis are available - surgical endarterectomy and percutaneous angioplasty combined with stent implantation at the site of stenosis. Cerebral protection devices during internal carotid stenting significantly decrease the incidence of periprocedural complications, however, during the introduction of protective devices the cerebral blood flow remains unprotected. Therefore, the quest for a system specifically protecting cerebral flow during the whole procedure is still underway. Temporary reversal of carotid flow during the procedure using the Parodi Anti-Emboli System seems a viable solution. The present study describes the first two patients who underwent internal carotid artery stenting using this technique in our institution.     

Reduced clot permeability and susceptibility to lysis in patients with acute coronary syndrome: effects of inflammation and oxidative stress

BackgroundStable angina is associated with unfavorable fibrin structure/function. It is not known how acute coronary syndromes (ACS) affect fibrin architecture.ObjectiveWe investigated fibrin clot properties and their determinants in ACS patients.Patients and methodsClot permeability, turbidity and fibrinolysis were assessed in 40 patients with ACS versus 40 controls with stable angina matched for age, sex, and risk factors.ResultsPatients with ACS had lower clot permeability (p = 0.001), faster fibrin polymerization (p = 0.008), and prolonged fibrinolysis time (p < 0.0001) than controls. C-reactive protein (CRP) and 8-epi-prostaglandin F_2α, a marker of oxidative stress, were the only independent predictors of clot permeability (R² = ?0.74; p < 0.0001 and R² = ?0.65; p < 0.0001, respectively) and fibrinolysis time in ACS patients (R² = 0.60; p < 0.0001 and R² = 0.59; p = 0.0002, respectively). In angina patients, fibrinogen and CRP predicted permeability (R² = ?0.71; p < 0.0001 and R² = ?0.62; p < 0.0001), and D-dimer predicted lysis time (R² = 0.54; p = 0.0005). In regression analysis models incorporating all patients, the only independent predictor of all clot variables was being an ACS patient (R² 0.51 to 0.85; p < 0.001).ConclusionsThis first study of clot properties in patients during an ACS demonstrated that compared with stable angina patients, their clots are composed of dense networks that are more resistant to lysis and these features are correlated with raised CRP and oxidative stress.     

Factors associated with preservation of C-peptide levels at the diagnosis of type 1 diabetes

Aims

The level of C-peptide can identify individuals most likely to respond to immune interventions carried out to prevent pancreatic β-cell damage.The aim of the study was to evaluate factors associated with C-peptide levels at type 1 diabetes (T1D) diagnosis.

The Role of the Epiglottis in the Swallow Process after a Partial or Total Glossectomy Due to a Neoplasm

Repeatable epiglottic movement patterns were recorded during a videofluoroscopic swallow evaluation of 95 patients who had undergone a total or partial glossectomy due to a neoplasm. Because no epiglottic function assessment was performed preoperatively, for the purpose of this study it was assumed that epiglottic mobility was “normal” during this time and that all abnormalities found afterward resulted from the growth of the neoplasm and the glossectomy. It was noted that in the early postoperative period, absence of epiglottic movement was accompanied by aspiration and made swallowing incompetent in a majority of cases (9 of 10). A correlation of movement between the epiglottis and the extent of oral tissue excision was found. Epiglottic mobility was evaluated as “normal” in 72% of the patients, i.e., in 67 of 91 (74%) patients after a partial or nearly total glossectomy and in 1 of 4 people who underwent a total glossectomy. In the subgroup (16%) of patients who underwent a total or nearly total glossectomy and then had videofluoroscopic examinations, 60% of the cases had normal epiglottic movements and 40% had an immobile epiglottis. Compensatory mechanisms implemented by the patients on their own initiative, such as additional swallows and prolonged apnea during deglutition, enabled them to avoid aspiration. However, upward head movement and downward chin tilting during deglutition as compensatory mechanisms used by patients with no epiglottic movement did not reduce the aspiration risk in the early postoperative period and were found to accompany incompetent swallowing attempts.     

Even low levels of ambient air pollutants are associated with increased emergency department visits for hypertension

Background

Numerous studies have reported associations between air pollution and cardiovascular diseases. While several studies illustrate that exposures to air pollutants can elevate blood pressure, few have evaluated the clinical relevance of this relationship. Hence, we aimed to explore the associations between daily concentrations of several air pollutants and emergency department visits for hypertension.

Methods

Odds ratios (ORs) for emergency department visits for hypertension in Edmonton, Canada, from April 1992 to March 2002 were associated with pollutant levels (CO, NO₂, SO₂, O₃, and particulate matter [PM] < 10 microns [PM₁₀] and < 2.5 microns [PM_2.5] in aerodynamic diameter, respectively) by means of a case-crossover technique with time-stratified strategy to define controls. The analysis was performed for all (N = 5365), male (N = 2069), and female (N = 3296) patients and for six air pollutants lagged by 0 to 9 days. ORs and their 95% confidence intervals (CIs) were reported for an increase in an interquartile range (IQR) for each pollutant.

Results

We observed associations for all patients and levels of NO₂ (IQR = 12.8 parts per billion; OR, 1.06; 95% CI, 1.00-1.12), SO₂ (IQR = 2.3 parts per billion; OR, 1.04; 95% CI, 1.00-1.08), and PM₁₀ (IQR = 15.0 μg/m³; OR, 1.06; 95% CI, 1.01-1.11) for lag day 3, as well as for PM₁₀ (IQR = 15.0 μg/m³; OR, 1.06; 95% CI, 1.01-1.11) and PM_2.5 (IQR = 6.2 μg/m³; OR, 1.07; 95% CI, 1.01-1.11) for lag day 6.

Conclusions

These findings support the contention that ambient pollution can produce clinically meaningful increases in blood pressure.     

Ocena zależności między stosowaniem inhibitorów pompy protonowej a występowaniem uczulenia na wybrane alergeny pokarmowe

Proton pump inhibitors are considered to be highly selective and effective drugs, which have few side effects. They are used in both adults and children (including infants) as well as in pregnant women. By increasing the gastric fluid pH, they impair the activation process and reduce the secretion of pepsin, secretin and pancreatic proteases, thereby impairing protein degradation. The remaining peptides are immunoreactive and lead to the development of an allergic response, while the increased permeability of the gastrointestinal tract mucosa may also induce sensitization. Observational studies conducted in patients with gastroenterological disorders, children with allergy diseases and experimental studies in animals have demonstrated that the use of anti-ulcer drugs favours sensitization to selected food allergens.     

Tubulointerstitial nephritis with uveitis: clinico-pathological and immunological study

A 10-year-old boy was evaluated for fever, weight loss, uveitis, normocytic, normochromic anemia, renal insufficiency, and hypergammaglobulinemia of 8 weeks' duration. Infectious and neoplastic causes of fever were excluded. A renal biopsy performed in the 4th week of disease revealed diffuse plasmocytic interstitial nephritis. No treatment was prescribed and the patient was transferred to another hospital. Because clinical symptoms and renal insufficiency were still present, in the 8th week of disease a second biopsy was performed, which showed lympho-monocytic interstitial nephritis. At the same time, phenotypic analysis of peripheral blood mononuclear cells was carried out, revealing a significantly decreased number of CD3(+), CD4(+), and CD3(+)/CD8(+) cells, increased non-T CD3(-)/CD8(+) and CD56(+) NK cells, and decreased "na?ve" (CD45RA(+)/CD4(+)) and memory (CD45RO(+)/CD8(+)) T lymphocytes. A 6-month course of oral prednisone was prescribed. Clinical symptoms and laboratory findings quickly returned to normal values. After 13 days of corticosteroid therapy, a second phenotypic analysis of peripheral blood mononuclear cells was performed, which revealed normalization of CD3(+), CD4(+), and CD3(+)/CD8(+) cells as well as proportions of non-T CD8(+) and CD56(+) NK lymphocytes, "na?ve" and memory cells. This case shows spontaneous evolution of tubulointerstitial infiltrates from plasmacytic to lympho-monocytic, profound disturbances of the immunological system, and the beneficial effect of corticosteroids on both the clinical course and immunological disturbances.