The aim of this study is to test the possible prognostic significance of p53 and Ki67 expression in inverted papilloma of the lateral nasal wall and adjacent sinuses regarding their malignant ...potential and recurrence. 49 biopsies of the lateral nasal wall and adjacent sinuses obtained from 41 patients from three hospitals were investigated. Immunohistochemically demonstrated p53 and Ki67 expression was measured and statistically evaluated. p53 immunoreactivity was demonstrated in most of papillomas with carcinomas but only in two benign papillomas, while Ki67 demonstrated stronger immunoreactivity in carcinomas and surrounding epithelium. Immunohistochemical staining of inverted sinonasal papillomas for p53 and Ki67 can give useful information concerning the existence of synchronous carcinoma and, in case of high Ki67, a hint toward possible recurrence.
Mogućnosti Liječenja Osteoporotskih Prijeloma Kralježnice
Osteoporotski prijelomi kralježnice dva do tri puta su učetaliji nego prijelomi kuka, posebice u žena. Vertebralni osteoporotski kompresijski ...prijelomi tipično uključuju srednju i donju torakalnu kralježnicu i torakolumbalni prijelaz. Klinička slika očituje se u akutnom stanju u obliku nagle boli u leđima nakon minimalne ozljede a često i kad ozljede nema. U dijagnostici je osnovno uzeti dobru anamnezu te provesti klinički pregled pacijenta. Temelj radiološke dijagnostike je standardni RTG. Ako postoji klinička indikacija (diferencijalna dijagnostika tumora ili spondilitisa, neurološka slabost) radi se i CT i/ili MR. Pristup liječenju osteoporotskih prijeloma kralježnice je individualan i temelji se na povijesti bolesti, lokalizaciji simptoma, te korelaciji kliničkog pregleda i radiološkog nalaza. Česte su posljedice prijeloma dugotrajni bolovi, gubitak visine i deformacije kralježnice, koje znatno koreliraju sa smetnjama hoda i pokretljivosti, smanjenjem funkcije pluća, gubitkom teka i na kraju povećanom smrtnošću. Otvorena repozicija, dekompresija i fiksacija indicirana je u pacijenata s posttraumatskom stenozom i neurološkom slabošću. Moderne kirurške tehnike liječenja su vertebroplastika i kifoplastika koje znatno smanjuju bol i poboljšavaju pokretljivost pacijenata, a time i kvalitetu života.
Abstract only
Background
Previously pentadecapeptide BPC 157 exhibited a strong healing effect on brain traumas and peripheral nerve injuries (Regul Pept. 2010;160(1‐3):26‐32; Regul Pept. ...2010;160(1‐3):33‐41). Aim. To verify influence of BPC 157 on rat spinal cord injury. Materials and methods. Deeply anaesthetized Wistar Albino male rats, 350 g b.w., were subjected to surgery (all experimental procedures were approved by the local Ethics Committee): after laminectomy on level L2‐L3 (correspond to sacrocaudal spinal cord) 60 second compression with neurosurgical piston (60‐66 g) on exposed dural sac. One single medication (IP) (saline 5ml/kg; pentadekapeptide BPC 157 200µg/kg; 2 µg/kg) was 10 min post‐injury and sacrifice was at 1, 2, 4, 12, 26 and 52 weeks. Tail motor function (1 paralysis; 5 normal) and spasticity (1 normal; 5 maximum) was scored daily. Histology samples of spinal cord were taken from lesion site, and tail samples 10 mm distal from base. Results.
Tail motor function
. BPC 157 rats have significantly higher motor score in all investigated time.
Tail spasticity
. BPC 157 rats have significantly less spasticity starting from 4 weeks to the end of experiments.
Histology of spinal cord
. From 2 weeks to the end of follow up BPC 157 rats have less grey matter edema and less cyst and axonal necrosis in white matter.
Histology of rat tail
. All treatment groups show increased number of all and small axons starting from 4 weeks but without statistically difference between groups. Conclusions. Given after sacrocaudal spinal cord injury, BPC 157 recovered rat tail function with single treatment. Specifically, BPC 157 decreased secondary injury of spinal cord, and consequently, improved neurologic function recovery. Supported by Grant 108‐1083570‐3635, Croatia.
The known effects of a novel stomach pentadecapeptide BPC157 (10 microg or 10 ng/kg), namely its salutary activity against ethanol (96%, i.g.)-induced gastric lesions (simultaneously applied i.p.) ...and in blood pressure maintenance (given i.v.), were investigated in rats challenged with a combination of N(G)-nitro-L-arginine methylester (L-NAME) (5 mg/kg i.v.), a competitive inhibitor of endothelium nitric oxide (NO)-generation and NO precursor, L-arginine (200 mg/kg i.v.) (D-arginine was ineffective). In the gastric lesions assay, NO agents were given 5 min before ethanol injury and BPC 157 medication. Given alone, BPC157 had an antiulcer effect, as did L-arginine, but L-NAME had no effect. L-NAME completely abolished the effect of L-arginine, whereas it only attenuated the effect of BPC 157. After application of the combination of L-NAME + L-arginine, the BPC157 effect was additionally impaired. In blood pressure studies, compared with L-arginine, pentadecapeptide BPC 157 (without effect on basal normal values) had both a mimicking effect (impaired L-NAME-blood pressure increase, when applied prophylactically and decreased already raised L-NAME values, given at the time of the maximal L-NAME-blood pressure increase (i.e., 10 min after L-NAME)) and preventive activity (L-arginine-induced moderate blood pressure decrease was prevented by BPC 157 pretreatment). When BPC 157 was given 10 min after L-NAME + L-arginine combination, which still led to a blood pressure increase, its previously clear effect (noted in L-NAME treated rats) disappeared. In vitro, in gastric mucosa from rat stomach tissue homogenates, BPC 157, given in the same dose (100 microM) as L-arginine, induced a comparable generation of NO. But, BPC 157 effect could not be inhibited by L-NAME, even when L-NAME was given in a tenfold (100 versus 1000 microM) higher dose than that needed for inhibition of the L-arginine effect. NO synthesis was blunted when the pentadecapeptide BPC 157 and L-arginine were combined. In summary, BPC 157 could interfere with the effects of NO on both gastric mucosal integrity and blood pressure maintenance in a specific way, especially with L-arginine, having a more prominent and/or particularly different effect from that of NO.
The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< ...5 years, 5-10 years, 10-20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery).
A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson's chi-square or Fisher's exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility.
The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5-10 years: 0.69 vs 10-20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5-10 years: 0.62 vs 10-20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5-10 years: 0.61 vs 10-20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36).
The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system.
Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with vertebral compressive fractures (VCFs) that may occur as a ...consequence. Vertebral compression fractures (VCFs) can lead to severe acute and chronic pain, impaired mobility, reduced quality of life and an increased risk of mortality due to decreased mobility and pulmonary dysfunction. When painful VCFs do come to clinical attention, they are typically treated with optimal pain management (OPM). Although the natural course of pain due to vertebral fractures decreases within the first weeks in the majority of patients, a number of them remain with persistent pain and/or ongoing vertebral collapse. Facet joint injections are an emerging procedure as possible treatment for a subgroup of patients with persistent pain after VCFs. In case of vertebral collapse or persistent pain after facet joint injections, patients have to be treated with percutaneous vertebroplasty (PVP) or percutaneous balloon kyphoplasty (BKP). PVP is a minimally invasive surgical procedure in which bone cement is injected into a fractured vertebra under radiological guidance using fluoroscopy. BKP is a variation of this approach, in which an inflatable balloon tamp is placed in the collapsed vertebra prior to cement injection, in order to create a cavity allowing low pressure injection. For peo- ple with painful osteoporotic VCFs refractory to analgesic treatment, PVP and BKP perform significantly better in unblinded trials than OPM in terms of improving quality of life and reducing pain and disability. It is possible that BKP and PVP may lead to reductions in mortality. In small subgroup of patients with neurological injury related to an osteoporotic fracture, different open surgical techniques were used to suit different fracture patterns, with good clinical and radiological results.
PDF
