Wczesne i odległe wyniki leczenia pojedynczych złamań osteoporotycznych za pomocą wertebroplastyki

Background and purpose Percutaneous vertebroplasty (PVP) is a minimally invasive vertebral augmentation procedure for the treatment of recent, osteoporotic vertebral compression fractures. The aim of the study was to determine the early and late outcomes of PVP for osteoporotic vertebral compression fractures. Material and methods We prospectively assessed outcomes of PVP in 200 patients with single, osteoporotic vertebral compression fracture. Follow-up assessment was made 12 hours after surgery as well as after 7 days, 30 days, 3 months, 6 months, and 1 year after surgery. A subgroup of 80 patients was evaluated also 2 years after PVP. A 100-mm visual analogue scale of pain was used for outcome measurement. Results Twelve hours after PVP, very significant relief of pain was obtained in 85% of patients; on the 7th and 30th day a very good result of treatment was noted in 96%. The same result was noted in 92% of patients at the 6th month, and in 90% of patients at the 12th month. Among the 80 patients followed for 2 years, 3 patients reported recurrence of pain and were subsequently diagnosed with new osteoporotic fractures. Conclusions Percutaneous vertebroplasty is a minimally invasive method of treatment for fresh osteoporotic fractures, which provides a significant and sizeable reduction of pain in the short as well as long term after surgery. Complete relief of pain was noted 12 hours after PVP in 94% of patients, and was noted in 90% two years after treatment. Despite some literature data suggesting no beneficial effect of PVP, it can be concluded that PVP is the most effective and the safest method for fresh vertebral compression fracture treatment.Wstęp i cel pracy Wertebroplastyka jest szeroko stosowaną, minimalnie inwazyjną metodą leczenia świeżych kompresyjnych złamań osteoporotycznych trzonów kręgów. Celem pracy była ocena wczesnych i odległych wyników leczenia świeżych złamań osteoporotycznych trzonów kręgów za pomocą przezskórnej wertebroplastyki. Materiał i metody Prospektywnej analizie poddano 200 pacjentów leczonych za pomocą wertebroplastyki z powodu pojedynczego, osteoporotycznego złamania trzonu kręgu. Stan pacjentów oceniano 12 godz. po zabiegu, po upływie 7 dni, miesiąca, 3 miesięcy, 6 miesięcy i 12 miesięcy, a 80 pacjentów oceniono także po upływie 24 miesięcy. Wynik był oceniany przy użyciu 100-milimetrowej wzrokowej analogowej skali oceny bólu. Wyniki Po 12 godz. po zabiegu ustąpienie dolegliwości lub istotną poprawę zanotowano u 85% pacjentów, w 7. i 30. dniu bardzo dobre wyniki stwierdzono u 96% pacjentów. Po 6 miesiącach bardzo dobry wynik utrzymywał się u 92%, a po 12 miesiącach – u 90% leczonych. Spośród 80 pacjentów obserwowanych po 2 latach nawrót dolegliwości bólowych wystąpił tylko u 3 pacjentów, u których doszło do złamania kolejnego trzonu kręgu. Wnioski Wertebroplastyka jest minimalnie inwazyjną metodą leczenia świeżych złamań osteoporotycznych, pozwalającą na uzyskanie bardzo dobrych wyników leczenia, zarówno wczesnych, jak i późnych. Całkowite ustąpienie dolegliwości obserwowano już po 12 godz. u 94% chorych, taki wynik utrzymywał się przez kolejne dwa lata u 90% leczonych. Mimo pojedynczych doniesień o nieskuteczności tej metody wydaje się, że w świeżych złamaniach osteoporotycznych wertebroplastyka jest najskuteczniejszą i najbezpieczniejszą metodą leczenia dolegliwości bólowych, będących wynikiem złamań trzonów kręgów

From red to green luminescence via surface functionalization. Effect of 2-(5-mercaptothien-2-yl)-8-(thien-2-yl)-5-hexylthieno[3,4-c]pyrrole-4,6-dione ligands on the photoluminescence of alloyed Ag-In-Zn-S nanocrystals

A semiconducting molecule containing a thiol anchor group, namely 2-(5-mercaptothien-2-yl)-8-(thien-2-yl)-5-hexylthieno- [3,4-c]pyrrole-4,6-dione (abbreviated as D-A-D-SH), was designed, synthesized, and used as a ligand in nonstoichiometric quaternary nanocrystals of composition Ag1.0In3.1Zn1.0S4.0(S6.1) to give an inorganic/organic hybrid. Detailed NMR studies indicate that D-AD- SH ligands are present in two coordination spheres in the organic part of the hybrid: (i) inner in which the ligand molecules form direct bonds with the nanocrystal surface and (ii) outer in which the ligand molecules do not form direct bonds with the inorganic core. Exchange of the initial ligands (stearic acid and 1-aminooctadecane) for D-A-DSH induces a distinct change of the photoluminescence. Efficient red luminescence of nanocrystals capped with initial ligands (λmax = 720 nm, quantum yield = 67%) is totally quenched and green luminescence characteristic of the ligand appears (λmax = 508 nm, quantum yield = 10%). This change of the photoluminescence mechanism can be clarified by a combination of electrochemical and spectroscopic investigations. It can be demonstrated by cyclic voltammetry that new states appear in the hybrid as a consequence of D-A-D-SH binding to the nanocrystals surface. These states are located below the nanocrystal LUMO and above its HOMO, respectively. They are concurrent to deeper donor and acceptor states governing the red luminescence. As a result, energy transfer from the nanocrystal HOMO and LUMO levels to the ligand states takes place, leading to effective quenching of the red luminescence and appearance of the green one

Vertebroplasty (PVP) is effective in the treatment of painful vertebral hemangiomas

Purpose: We assessed the results of percutaneous vertebroplasty treatment of painful vertebral hemangiomas in 110 patients, with a three years follow-up.Patients and methods: 110 patients with painful vertebral hemangiomas were treated by percutaneous vertebroplasty. The patients were diagnosed by MRI and observed for 3 years after surgery. Visual Analog Scale was used to assess the level of pain.  Results: Pain significantly diminished in all patients, 90% were free of pain for three years after augmentation. In 10% some pain appeared after 1 year, but less intensive than before surgery. 3 years after vertebroplasty 90% of patients were free of pain. No complications of PVP were observed. In 3 patients extravertebral leakage was noted with no clinical symptoms.Conclusions: PVP is highly effective in the treatment of painful vertebral hemangiomas. The method is safe, produce minimal complications and eliminates, or highly reduces pain for a long time period

Keyhole surgery of pineal area tumors - personal experience in 22 patients

Pineal area tumors are challenging for surgery due to their location. However, the removal of the lesion is critical for further treatment and survival of the patient

Chronic subdural hematoma (CSH) is still an important clinical problem. Analysis of 700 consecutive patients

Chronic subdural hematoma (CSH) is still an important neurosurgical problem and the number of patients increases despite the progress in early diagnosis of cerebral lesions