Trunk rotation and hip joint range of rotation in adolescent girls with idiopathic scoliosis: does the "dinner plate" turn asymmetrically ?

<p>Abstract</p> <p>Background</p> <p>In patients with structural idiopathic scoliosis the body asymmetries involve the pelvis and the lower limbs; they are included in many theories debating the pathogenesis of idiopathic scoliosis.</p> <p>Methods</p> <p>Hip joint range of motion was studied in 158 adolescent girls, aged 10–18 years (mean 14.2 ± 2.0) with structural idiopathic scoliosis of 20–83° of Cobb angle (mean 43.0° ± 14.5°) and compared to 57 controls, sex and age matched. Hip range of rotation was examined in prone position, the pelvis level controlled with an inclinometer; hip adduction was tested in five different positions.</p> <p>Results</p> <p>In girls with structural scoliosis the symmetry of hip rotation was less frequent (p = 0.0047), the difference between left and right hip range of internal rotation was significantly higher (p = 0.0013), and the static rotational offset of the pelvis, calculated from the mid-points of rotation, revealed significantly greater (p = 0.0092) than in healthy controls. The detected asymmetries comprised no limitation of hip range of motion, but a transposition of the sector of motion, mainly towards internal rotation in one hip and external rotation in the opposite hip. The data failed to demonstrate the curve type, the Cobb angle, the angle of trunk rotation or the curve progression factor to be related to the hip joint asymmetrical range of motion.</p> <p>Conclusion</p> <p>Numerous asymmetries around the hip were detected, most of them were expressed equally in scoliotics and in controls. Pathogenic implications concern producing a "torsional offset" of muscles patterns of activation around the spine in adolescent girls with structural idiopathic scoliosis during gait.</p

Corrective Bracing for Severe Idiopathic Scoliosis in Adolescence: Influence of Brace on Trunk Morphology

Aim. The aim of the work was to study whether wearing a corrective brace by adolescent girls with severe idiopathic scoliosis can influence external shape of the trunk. Methods. Comparison of clinical deformity of two groups of girls matched for age and Cobb angle: group (1) of 23 girls, aged 14.9 ± 1.3 years, Cobb angle 55.0° ± 6.8°, who refused surgical treatment and have been wearing Chêneau brace for more than 6 months, compared with group (2) of 22 girls, aged 14.1 ± 1.8 years, Cobb angle 59.7° ± 14.6° never treated with corrective bracing. Clinical deformity was assessed with the Bunnell scoliometer (angle of trunk rotation ATR) and surface topography (posterior trunk symmetry index POTSI and Hump Sum HS). Results. The ATR in the primary curvature was 11.9° ± 3.4° (5°–18°) in group 1 versus 15.1° ± 5.6° (6°–25°) in group 2 (P = 0.027). The HS was 16.8° ± 3.8 versus 19.2° ± 4.6, respectively, P = 0.07. The POTSI value did not differ between groups. Conclusion. Girls with Cobb angle above 45 degrees, who have been subjected to brace treatment, revealed smaller clinical deformity of their back comparing to nontreated girls having similar radiological curvatures

TOLERANCE OF PHYSICAL EFFORT IN PATIENTS WITH SURGICALLY TREATED SCOLIOSIS

Fourty-eight patients were treated operatively for idiopathic scoliosis by means of CotrelDubousset technique heaving pre-operative angle values of 50°_70°. Exercise test was performed using cycle ergometer both in pre-and postoperative period. Cardiorespiratory parameters were constantly measured throughout the test to estimate ventilation threshold. Following parameters were included: heart rate, oxygen intake, lung ventilation per minute, rate and volume of ventilation, as well as power and work performed. Test was terminated when ventilation threshold was achieved. This is considered noninvasive method to calculate threshold of anaerobic metabolism. Maximal oxygen intake was indicated by means of Astrand-Ryhming nomogram. Body weight and height were also measured. Operative treatment of scoliosis using Cotrel-Dubousset method enhances physical efficiency moderately most probably due to improvement of respiratory mechanics, increase in ventilation per minute during exercise test through deepening of breaths rather than increase in ventilation rate

All-arthroscopic AMIC procedure for repair of cartilage defects of the knee

PURPOSE: Bone marrow mesenchymal stem cells were introduced into clinical practice due to their ability to differentiate into many types of cells. Autologous matrix-induced chondrogenesis (AMIC) combines the microfracture method with matrix-based techniques that utilizes a collagen membrane to serve as a scaffold for new bone marrow mesenchymal stem cells, allowing effective reconstruction of even large fragments of a damaged cartilage surface. METHODS: All-arthroscopic technique to repair knee cartilage defects using the AMIC technique, which includes the use of a collagen matrix (porcine collagen type I and III) and fibrin glue—technique presentation. CONCLUSION: This technical note introduces an all-arthroscopic AMIC technique to reconstruct extensive cartilage defects (without bone defects). The technique may be used for treatment of all location of knee cartilage lesions. LEVEL OF EVIDENCE: V

Correlation between metallothionein (MT) expression and selected prognostic factors in ductal breast cancers.

Our study aimed at examining significance of metallothionein (MT) expression in ductal breast cancers by determination of a relationship between expression of MT protein (MT-1/2) and selected prognostic factors, including grade of histological differentiation (G), expression of Ki-67 proliferative antigen, expression of estrogen receptors (ER) and progesterone receptors (PgR) and expression of HER-2 receptor. Material for the studies involved 54 samples of invasive ductal breast cancer, manifesting malignancy grades of G1-G3. In paraffin sections of examined tumours immunohistochemical reactions were performed using specific antibodies directed to MT, Ki-67, ER, PgR or HER-2. Intensity of MT-specific immunohistochemical reactions was measured using the semiquantitative IRS scale of Remmele. Intensity of colour reactions targeted at Ki-67, ER, PgR was evaluated scoring proportions of positive cells, while HER-2-specific reactions were evaluated in the scale of 0-3 points. The lowest level of MT expression was detected in breast cancer cases of G1 malignancy grade (G1 vs G3 p=0.020). A positive correlation between MT and Ki-67 antigen expression (r=0.32, p=0.019) was disclosed. Moreover, MT expression exhibited negative correlations with expression of ER (r=-0.35, p=0.008) and PgR (r=-0.27, p=0.046). No relationships could be detected between expression of MT and expression of HER-2 (r=0.12, p=0.37). The obtained results suggest that MT expression might be helpful in prognostic evaluation of ductal breast cancers