Results of surgical treatment of carpal tunnel syndrome by mean of an open and semi - open method

The aim of this study was to compare outcome obtained using the two methods of surgical treatment of carpal tunnel syndrome (CTS) - the open method with the method of two incisions called ‘semi-open’. The material included 478 patients, with clinically diagnosed CTS, who were surgically treated in the Department of Orthopaedics and Traumatology CM in Bydgoszcz in years from 2001 to 2010. The minimum duration of the follow up was 6 months. We prepared for the study an observation card, which includes all data relating to the treatment and follow up. Analysis of the results of treatment was based on pre and postoperative assessment of pain, touch resolution, static hand grip, strength, postoperative subjective assessment of treatment as well as EMG. Results obtained were mostly good or very good comparable in both groups operating. In the subjective assessment, significantly better outcomes were obtained when using semiopen method. The surgical treatment of carpal tunnel syndrome confirmed by EMG test should be the method of choice.Celem pracy jest porównanie wyników leczenia, uzyskanych przy pomocy dwóch metod operacyjnego leczenia zespołu cieśni nadgarstka: metody otwartej z metodą dwóch cięć („półotwartą”). Materiał obejmuje 478 chorych, z rozpoznanym klinicznie ZCN, operowanych w Klinice Ortopedii i Traumatologii Narządu Ruchu CM w Bydgoszczy w latach 2001-2010. Okres obserwacji wynosił minimum 6 miesięcy. Dla potrzeb badania przygotowano kartę obserwacji chorego, zawierająca wszystkie niezbędne dane dotyczące leczenia i obserwacji. Analizy wyników leczenia dokonano na podstawie przed- i pooperacyjnej oceny bólu, dotyku, statycznej rozdzielczości, siły chwytu ręki, pooperacyjnej subiektywnej ocenie leczenia jak również badania EMG. Wnioski: 1. Uzyskane wyniki w zakresie danych obiektywnych w większości przypadków były dobre i bardzo dobre porównywalne w obu grupach operacyjnych. 2. W ocenie subiektywnej znacznie lepsze wyniki leczenia występowały w metodzie półotwartej. 3. Leczenie zespołu kanału nadgarstka potwierdzonego badaniem EMG powinno być z wyboru operacyjne Ze względu na złożony problem, ZCN i jego następstwa oraz częste trudności stojące przed chirurgiem w czasie wyboru metody leczenia, wyniki badań powinny być pomocne w wyborze metody otwartej lub „półotwartej”

FRACTURE OF THE HUMERUS DURING ARM WRESTLING: REPORT ON 9 CASES AND REVIEW OF THE LITERATURE

Arm wrestling has become a popular sport practiced by both professionals and amateurs. Its popularity comes from the fact that the rules are simple; it is spectacular and does not require use of complicated equipment. In the years 2001 to 2013 ten cases of humeral bone fractures resulting from arm wrestling were admitted to the Department of Orthopaedics and Traumatology of the dr Jurasz University Hospital in Bydgoszcz. The assessment of the limb condition included the examination of the fractured extremity and an interview. All the patients underwent surgical treatment, using the method of open reduction and internal fixation. The aim of this work was to perform a biomechanical analysis of forces which act during arm wrestling, as well as explain the mechanism of occurrence of humeral bone fractures of similar topology as observed on X-rays.Siłowanie się na rękę jest popularnym sportem uprawianym na całym świecie zarówno przez amatorów jak i przez profesjonalistów. O popularności dyscypliny decyduje: prostota zasad, minimalne wymagania sprzętowe oraz widowiskowość. W latach 2001-2013 w Katedrze i Klinice Ortopedii Szpitala Uniwersyteckiego CM UMK w Bydgoszczy leczono 10-ciu chorych z powodu złamania kości ramiennej, które nastąpiło podczas siłowania się na rękę. Ocena stanu kończyny przed leczeniem operacyjnym obejmowała badanie podmiotowe i przedmiotowe. Wszyscy chorzy leczeni byli operacyjnie, metodą otwartej repozycji i stabilnym zespoleniem złamania. Celem pracy było wyjaśnienie mechanizmu powstawania złamań kości ramiennej podczas siłowania się na rękę o powtarzającej się topografii

Chronic traumatic wound. A case report

Among many types of chronic wounds there is a place for traumatic wounds. The circumstances in which they appeared influence their nature. Traumatic wounds are often very deep and a fight to save the wounded parts of the body such as the upper limb requires medical and nursing actions. Proceedings in accordance with the applicable recommendation of scientific societies guarantee a success in the form of restoration of continuity of the skin. A case of 23 years old- man, whose accident at the workplace caused a deep loss for the dorsum of left hand, is presented in the study. Interdisciplinary and local actions based on the latest recommendations in line with the foundation’s strategy resulted in a T.I.M.E strategy have been appliedWśród wielu rodzajów ran przewlekłych szczególne miejsce zajmują rany urazowe. Na ich zróżnicowany charakter bardzo często mają wpływ okoliczności, w jakich doszło do jej powstania. Niejednokrotnie rany urazowe są bardzo rozległe, głębokie i „walka” o uratowanie okaleczonej części ciała np. kończyny górnej, wymaga podejmowania wielokierunkowych i zespołowych działań lekarsko-pielęgniarskich. Postępowanie zgodne z obowiązującymi rekomendacjami towarzystw naukowych gwarantuje sukces w postaci odtworzenia ciągłości skóry. W pracy zaprezentowano opis przypadku 23- letniego mężczyzny, u którego w wyniku wypadku w miejscu pracy powstał głęboki ubytek na dłoni kończyny górnej lewej. Interdyscyplinarne, zespołowe działania i postępowanie miejscowe oparte na najnowszych rekomendacjach, zgodne z założeniami strategii T.I.M.E, wpłynęło na uzyskanie postawionego wspólnie celu w postaci przygotowania łożyska rany do przeszczepu skórnego

Withdrawal from cocaine self-administration and yoked cocaine delivery dysregulates glutamatergic mGlu_{5} and NMDA receptors in the rat brain

In human addicts and in animal models, chronic cocaine use leads to numerous alterations in glutamatergic transmission, including its receptors. The present study focused on metabotropic glutamatergic receptors type 5 (mGluR(5)) and N-methyl-D-aspartate receptor subunits (NMDAR: GluN1, GluN2A, GluN2B) proteins during cocaine self-administration and after 10-day of extinction training in rats. To discriminate the contingent from the non-contingent cocaine delivery, we employed the “yoked”-triad control procedure. Protein expression in rat prefrontal cortex, nucleus accumbens, hippocampus, and dorsal striatum was determined. We also examined the Homer1b/c protein, a member of the postsynaptic density protein family that links NMDAR to mGluR(5). Our results revealed that cocaine self-administration selectively increased GluN1 and GluN2A subunit in the rat hippocampus and dorsal striatum, respectively, while mGluR(5) protein expression was similarly increased in the dorsal striatum of both experimental groups. Withdrawal from both contingent and non-contingent cocaine delivery induced parallel increases in prefrontal cortical GluN2A protein expression, hippocampal mGluR(5), and GluN1 protein expression as well as in accumbal GluN1 subunit expression, while the mGluR(5) expression was reduced in the prefrontal cortex. Extinction training in animals with a history of cocaine self-administration resulted in an elevation of the hippocampal GluN2A/GluN2B subunits and accumbal mGluR(5), and in a 50 % decrease of mGluR(5) protein expression in the dorsal striatum. The latter reduction was associated with Homer1b/1c protein level decrease. Our results showed that both contingent and non-contingent cocaine administration produces numerous, brain region specific, alterations in the mGluR(5), NMDA, and Homer1b/1c protein expression which are dependent on the modality of cocaine administration

A maternal high-fat diet during pregnancy and lactation induced depression-like behavior in offspring and myelin-related changes in the rat prefrontal cortex

In accordance with the developmental origins of health and disease, early-life environmental exposures, such as maternal diet, can enhance the probability and gravity of health concerns in their offspring in the future. Over the past few years, compelling evidence has emerged suggesting that prenatal exposure to a maternal high-fat diet (HFD) could trigger neuropsychiatric disorders in the offspring, such as depression. The majority of brain development takes place before birth and during lactation. Nevertheless, our understanding of the impact of HFD on myelination in the offspring’s brain during both gestation and lactation remains limited. In the present study, we investigated the effects of maternal HFD (60% energy from fat) on depressive-like and myelin-related changes in adolescent and adult rat offspring. Maternal HFD increased immobility time during the forced swimming test in both adolescent and adult offspring. Correspondingly, the depressive-like phenotype in offspring correlated with dysregulation of several genes and proteins in the prefrontal cortex, especially of myelin-oligodendrocyte glycoprotein (MOG), myelin and lymphocyte protein (MAL), 2′,3′-cyclic-nucleotide 3′-phosphodiesterase (CNPase), kallikrein 6, and transferrin in male offspring, as well as of MOG and kallikrein 6 in female offspring, which persist even into adulthood. Maternal HFD also induced long-lasting adaptations manifested by the reduction of immature and mature oligodendrocytes in the prefrontal cortex in adult offspring. In summary, maternal HFD-induced changes in myelin-related genes are correlated with depressive-like behavior in adolescent offspring, which persists even to adulthood

Maternal Diet Influences the Reinstatement of Cocaine-Seeking Behavior and the Expression of Melanocortin-4 Receptors in Female Offspring of Rats

Recent studies have emphasized the role of the maternal diet in the development of mental disorders in offspring. Substance use disorder is a major global health and economic burden. Therefore, the search for predisposing factors for the development of this disease can contribute to reducing the health and social damage associated with addiction. In this study, we focused on the impact of the maternal diet on changes in melanocortin-4 (MC-4) receptors as well as on behavioral changes related to cocaine addiction. Rat dams consumed a high-fat diet (HFD), high-sugar diet (HSD, rich in sucrose), or mixed diet (MD) during pregnancy and lactation. Using an intravenous cocaine self-administration model, the susceptibility of female offspring to cocaine reward and cocaine-seeking propensities was evaluated. In addition, the level of MC-4 receptors in the rat brain structures related to cocaine reward and relapse was assessed. Modified maternal diets did not affect cocaine self-administration in offspring. However, the maternal HSD enhanced cocaine-seeking behavior in female offspring. In addition, we observed that the maternal HSD and MD led to increased expression of MC-4 receptors in the nucleus accumbens, while increased MC-4 receptor levels in the dorsal striatum were observed after exposure to the maternal HSD and HFD. Taken together, it can be concluded that a maternal HSD is an important factor that triggers cocaine-seeking behavior in female offspring and the expression of MC-4 receptors