20 research outputs found

    Reproducibility of thoracic kyphosis measurements in patients with adolescent idiopathic scoliosis

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    BACKGROUND: Current surgical treatment for adolescent idiopathic scoliosis (AIS) involves correction in both the coronal and sagittal plane, and thorough assessment of these parameters is essential for evaluation of surgical results. However, various definitions of thoracic kyphosis (TK) have been proposed, and the intra- and inter-rater reproducibility of these measures has not been determined. As such, the purpose of the current study was to determine the intra- and inter-rater reproducibility of several TK measurements used in the assessment of AIS. METHODS: Twenty patients (90% females) surgically treated for AIS with alternate-level pedicle screw fixation were included in the study. Three raters independently evaluated pre- and postoperative standing lateral plain radiographs. For each radiograph, several definitions of TK were measured as well as L1–S1 and nonfixed lumbar lordosis. All variables were measured twice 14 days apart, and a mixed effects model was used to determine the repeatability coefficient (RC), which is a measure of the agreement between repeated measurements. Also, the intra- and inter-rater intra-class correlation coefficient (ICC) was determined as a measure of reliability. RESULTS: Preoperative median Cobb angle was 58° (range 41°–86°), and median surgical curve correction was 68% (range 49–87%). Overall intra-rater RC was highest for T2–T12 and nonfixed TK (11°) and lowest for T4–T12 and T5–T12 (8°). Inter-rater RC was highest for T1–T12, T1-nonfixed, and nonfixed TK (13°) and lowest for T5–T12 (9°). Agreement varied substantially between pre- and postoperative radiographs. Inter-rater ICC was highest for T4–T12 (0.92; 95% CI 0.88–0.95) and T5–T12 (0.92; 95% CI 0.88–0.95) and lowest for T1-nonfixed (0.80; 95% CI 0.72–0.88). CONCLUSIONS: Considerable variation for all TK measurements was noted. Intra- and inter-rater reproducibility was best for T4–T12 and T5–T12. Future studies should consider adopting a relevant minimum difference as a limit for true change in TK. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13013-017-0112-4) contains supplementary material, which is available to authorized users

    Transcriptome analysis of the adult human Klinefelter testis and cellularity-matched controls reveals disturbed differentiation of Sertoli- and Leydig cells article

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    AbstractThe most common human sex chromosomal disorder is Klinefelter syndrome (KS; 47,XXY). Adult patients with KS display a diverse phenotype but are nearly always infertile, due to testicular degeneration at puberty. To identify mechanisms causing the selective destruction of the seminiferous epithelium, we performed RNA-sequencing of 24 fixed paraffin-embedded testicular tissue samples. Analysis of informative transcriptomes revealed 235 differentially expressed transcripts (DETs) in the adult KS testis showing enrichment of long non-coding RNAs, but surprisingly not of X-chromosomal transcripts. Comparison to 46,XY samples with complete spermatogenesis and Sertoli cell-only-syndrome allowed prediction of the cellular origin of 71 of the DETs. DACH2 and FAM9A were validated by immunohistochemistry and found to mark apparently undifferentiated somatic cell populations in the KS testes. Moreover, transcriptomes from fetal, pre-pubertal, and adult KS testes showed a limited overlap, indicating that different mechanisms are likely to operate at each developmental stage. Based on our data, we propose that testicular degeneration in men with KS is a consequence of germ cells loss initiated during early development in combination with disturbed maturation of Sertoli- and Leydig cells.</jats:p
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