Search

Background: the COVID-19 pandemic with the following lockdown strategies have affected virtually all aspects of everyday life. Health services all over the world faced the crisis on an unprecedented scale, hampering timely care delivery. The present study was designed to assess the impact of the COVID-19 outbreak on the incidence and treatment of traumatic brain injuries in Poland. Methods: the data on hospital admissions with traumatic brain injuries as the primary diagnosis were extracted from the National Health Fund of Poland. For the purpose of this study, the search was limited to four relevant diagnosis-related groups. The overall in-house mortality was calculated. Results: there were 115,200 hospitalizations due to traumatic brain injury identified in the database. Overall, in comparison with the average of six prior years, in 2020 the volume of patients with traumatic brain injury dropped by 24.68% while the in-house mortality rate was increased by 26.75%. Conclusions: the COVID-19 pandemic with the resulting lockdown caused a radical reduction in human mobility. It had a profound impact on the incidence of traumatic brain injury, which dropped significantly. At the same time, the mortality rate increased drastically.

INTRODUCTION The degenerative process of the intervertebral disc is a heterogeneous process that may exist in two forms, and involves dominant degenerative changes within the nucleus pulposus and the annulus fibrosus. In degenerative disc disease, the oxidative stress factor can play an important role. OBJECTIVE The aim of research was to present a new approach to understanding the role of the analyzed elements in the process of degeneration of the intervertebral disc. MATERIAL AND METHODS Selected elements from oxidative groups (Fe, Zn, Mo, As, Se), associated with enzymatic processes (Fe, Mo, Se, Zn, Ag, As, Bi), metals (Fe, Zn, Mo, Li) and metalloids (As, Bi) and their content was analyzed depending on the changes in the radiological images of the intervertebral disc. Elemental content analysis was performed by Inductively Coupled Plasma Mass Spectrometry analytical technique. RESULTS The similarity between Fe and Se has been demonstrated during different stages of the analysis of groups of patients with degenerative disc disease. There was a negative correlation between Li and degenerative disc disease. The results also suggest that Fe and Ag are involved in degenerative changes within the intervertebral disc. A potential relationship between As/Bi and Fe/Mo in the degeneration of the intervertebral disc was demonstrated. CONCLUSIONS Only some of the correlations can be explained by the metabolism of morphological elements of the intervertebral disc. The relationships indicate new directions for further studies on the degeneration process of the intervertebral disc. The presented study may reflect metabolic changes in the intervertebral disc and adjacent structures in response to the progressive degenerative process.

(1) Background: A lower limb prosthesis replaces a lost body part with a differential representation of gait function and its symmetry. Many physical, personal, and specific factors in amputees influence gait asymmetry. The aim of this study was to determine the factors influencing the asymmetry of gait in amputated patients. (2) Methods: The study group consisted of 12 people. Gait quality was assessed using the MoCap OptiTrack® Motion Capture System and the results were correlated with demographic factors (age, gender), morphological features (height, weight), amputation-related factors (cause and side of amputation, prosthesis time, and prosthesis fixation), and ailment pain. The control group consisted of 12 people. (3) Results: In the study group, a positive correlation between the mean walking speed and height in the study group was demonstrated, as well as a positive correlation between the difference in ROM and height, and a negative correlation between the mean walking speed and age. A negative correlation between the difference in ROM and age was found in both groups. A positive correlation was found between the width of the support and the weight in the control group. No other statistical relationship with the parameters describing gait asymmetry was found. (4) Conclusions: Statistical analysis showed that mean walking speed and ROM difference in the study group were positively related to height and negatively to age. No other statistical relationship with the parameters describing gait asymmetry was found.

(1) Background: Studies have established that exercises shaping the sense of deep sensation are an important element of medical rehabilitation of patients after vaporization of the femoral insertion of the anterior cruciate ligament and affect the restoration of correct movement patterns, thus reducing the risk of injuries. The aim of this study was to determine the factors influencing the treatment outcome and deep-feeling function after applying a specific rehabilitation scheme 12 weeks after anterior cruciate ligament electrocoagulation surgery. (2) Methods: The study group consisted of 41 patients after partial rupture of the anterior cruciate ligament, who underwent electrocoagulation of the femoral cruciate ligament attachment and microfracture of the femoral attachment area. All patients were operated on by the same surgeon and then rehabilitated according to the same medical rehabilitation protocol. The anthropometric and clinical data were collected through an anterior drawer test, Lachman test, assessment of the range of movements in the knee joint, muscle strength test, Unterberger test and Lysholm questionnaire. The assessment was performed before the surgery, and then on days 7–10, after 6 and 12 weeks of rehabilitation treatment. (3) Results: Statistical improvement of the parameters was demonstrated by strength of the quadriceps and hamstrings muscle, the Unterberger test, and the Lysholm scale after surgery. A negative correlation was found between the Unterberger test and Lysholm scale at the end of the research period and it differed depending on the gender and the dominant limb. The Lysholm scale and muscle strength were independent of sex, dominant extremity and associated damage of the meniscus and cartilage. The Lysholm scale 6 weeks after surgery negatively correlated with BMI. (4) Conclusions: Stability of the knee joint and improvement of proprioception were demonstrated 12 weeks after treatment with an ACL electrocoagulation and rehabilitation regimen. The factors contributing to a better treatment outcome were greater muscle strength, less thigh asymmetry, better sense of depth, younger age and lower body weight.

The enhanced recovery after surgery protocol (ERAS) – is generally modern comprehensive perioperative care to improve the treatment results. It is more widely used in surgery, including orthopedics. Implementation of the ERAS protocol has been shown to accelerate post-operative recovery, shorten hospital stays, increase patient satisfaction, and improve clinical outcome. This article describes the main elements of the ERAS protocol with the stages that are possible to implement in Polish conditions.

Introduction Diffuse idiopathic skeletal hyperostosis of cervical spine can lead to dysphagia. Presentation of case A 73-year-old male weighing 110 kg and diagnosed with diffuse idiopathic skeletal hyperostosis in cervical spine with dysphagia. Patient manifested local pain of neck, a gradual limitation of spinal mobility. The surgery decision was based on swallowing problems, not pain in the spine. Before surgery radiographs, magnetic resonance images, computed tomography of the cervical spine and gastroscopy were obtained. Osteophytes were removed from the anterior approach with present otolaryngologist by surgery. Discussion In this case used gastroscopy, CT and MRI for diagnostics. During the procedure we had support otolaryngologist. The patient has not been found a stenosis spinal canal and neurological symptoms. We were removed the ostheophytes. Interbody implants have not been applied. Conclusion Disc degeneration disease itself can be asymptomatic or not a dominant problem for the DISH patients. Clinical signs may pharyngoesophageal and tracheal compression, causing dysphagia, shortness of breath and stridor. In this case, the cervical spine was stability and not demonstrated a stenosis in the spinal canal. Isolate removing of the osteophytes without implants in DISH of cervical spine can be enough solution., Highlights • DISH of cervical spine may pharyngoesophageal and tracheal compression, causing dysphagia, shortness of breath and stridor. • In this case, the cervical spine was stability and not demonstrated a stenosis in the spinal canal. • Isolate removing of the osteophytes without implants in DISH of cervical spine can be enough solution.

Although many studies have investigated the role of cytokines in bone metastases, our knowledge of their function in spine metastasis is limited. Therefore, we performed a systematic review to map the available evidence on the involvement of cytokines in spine metastasis in solid tumors. A PubMed search identified 211 articles demonstrating a functional link between cytokines/cytokine receptors and bone metastases, including six articles confirming the role of cytokines/cytokine receptors in spine metastases. A total of 68 cytokines/cytokine receptors were identified to mediate bone metastases; 9 (mostly chemokines) played a role in spine metastases: CXC motif chemokine ligand (CXCL) 5, CXCL12, CXC motif chemokine receptor (CXCR) 4, CXCR6, interleukin (IL) 10 in prostate cancer, CX3C motif chemokine ligand (CX3CL) 1 and CX3C motif chemokine receptor (CX3CR) 1 in liver cancer, CC motif chemokine ligand (CCL) 2 in breast cancer, and transforming growth factor (TGF) β in skin cancer. Except for CXCR6, all cytokines/cytokine receptors were shown to operate in the spine, with CX3CL1, CX3CR1, IL10, CCL2, CXCL12, and CXCR4 mediating bone marrow colonization, CXCL5 and TGFβ promoting tumor cell proliferation, and TGFβ additionally driving bone remodeling. The number of cytokines/cytokine receptors confirmed to mediate spinal metastasis is low compared with the vast spectrum of cytokines/cytokine receptors participating in other parts of the skeleton. Therefore, further research is needed, including validation of the role of cytokines mediating metastases to other bones, to precisely address the unmet clinical need associated with spine metastases.

Medical Science Monitor is retracting the following publication on the basis of duplicated published content. 1) Kubaszewski Ł, Zioła-Frankowska A, Frankowski M, Rogala P, Gasik Z, Kaczmarczyk J, Nowakowski A, Dabrowski M, Labedz W, Miękisiak G, Gasik R. Comparison of trace element concentration in bone and intervertebral disc tissue by atomic absorption spectrometry techniques. J Orthop Surg Res. 2014 Oct 25;9: 99. doi: 10.1186/s13018-014-0099-y. PMID: 25342441; PMCID: PMC4220064. 2) Kubaszewski Ł, Zioła-Frankowska A, Frankowski M, Nowakowski A, Czabak-Garbacz R, Kaczmarczyk J, Gasik R. Atomic absorption spectrometry analysis of trace elements in degenerated intervertebral disc tissue. Med Sci Monit. 2014 Nov 4;20: 2157-64. doi: 10.12659/MSM.890654. PMID: 25366266; PMCID: PMC4301216. 3) Nowakowski A, Kubaszewski Ł, Frankowski M, Wilk-Frańczuk M, Zioła-Frankowska A, Czabak-Garbacz R, Kaczmarczyk J, Gasik R. Analysis of trace element in intervertebral disc by Atomic Absorption Spectrometry techniques in degenerative disc disease in the Polish population. Ann Agric Environ Med. 2015;22(2): 362-7. doi: 10.5604/12321966.1152096. PMID: 26094540. We have reviewed the content of all three similar publications. We note that Medical Science Monitor was the second to publish this study, in November 2014. At that time, the Corresponding Author gave no declaration of submitting this study to any other journal, nor of previously publishing this study. Reference: Łukasz Kubaszewski, Anetta Zioła-Frankowska, Marcin Frankowski, Andrzej Nowakowski, Róża Czabak-Garbacz, Jacek Kaczmarczyk, Robert Gasik. Atomic Absorption Spectrometry Analysis of Trace Elements in Degenerated Intervertebral Disc Tissue. Med Sci Monit, 2014; 20: 2157-2164. DOI: 10.12659/MSM.890654.

Asymmetry in the degenerative lumbar spine may eventually evolve to debilitating scoliosis. The point where it starts to accelerate in some individuals is obscure. Discreet preclinical asymmetry may be a prognostic feature of the condition. The aim of this study was to assess the asymmetry of the intervertebral foramina of lower lumbar motion segments of the spine based on morphometric measurements using novel techniques of three-dimensional imaging. Computed tomography scans of 19 subjects with axial low back pain aged 50 to 78 of both sexes were digitally processed, and 3D reconstruction of L4/L5 and L5/S1 motion segments were obtained. The planes of intervertebral foramina were defined in reference to the axis of the pedicles bordering the intervertebral canal and the measurements were performed yielding absolute values in millimeters. The circumference ranged from 33.4 mm to 63.86 mm on the left side and from 33.01 mm to 73.54 mm on the right side. The horizontal dimension ranged from 6.86 mm to 17.84 mm on the left side and from 5.41 mm to 17.63 mm on the right side. The vertical dimension ranged from 10.17 mm to 23.65 mm on the left side and from 9.04 mm to 29.69 mm on the right side. All the measurements were combined to assess the asymmetry. Only in three cases (15%), symmetry in both segments was confirmed. No defined lateralization of asymmetry was found, as well as no significant link between the sex and age could be confirmed. This is the first study confirming the asymmetry among the intervertebral foramina. It seems that it is the dominant phenotype for intervertebral foramina. As the observed asymmetry lacks the dominant lateralization, it may be linked with the same trait of degenerative scoliosis. Though no direct link between the age and sex was confirmed in this study, it suggests other factors should be considered in prediction of the progress and magnitude of the deformity.

The aim of the study was to modify human skeletal muscle-derived stem/progenitor cells (SkMDS/PCs) and demonstrate the optimal cell preparation protocol for application in post-infarction hearts. We used conditioned SkMDS/PC culture medium with α-phenyl-N-tert-butyl nitrone (PBN). SkMDS/PCs were cultured under hypoxic conditions and the results were compared to the standard ones. We observed a significant increase of CD-56 positive phenotypic marker the ability to form functional myotubes, increase in the proportion of young cells in cell primary suspensions, and a decrease in the percentage of apoptotic cells among PBN-conditioned cells in normoxia an hypoxia. We also observed significantly higher levels of SOD3 expression, maintained expression of SOD1, SOD2, and CAT, a higher level of BCL2 gene expression, and a rather significant decrease in Hsp70 gene expression in PBN-conditioned SkMDS/PCs compared to the WT population under hypoxic conditions. In addition, significant increase of myogenic genes expression was observed after PBN addition to culture medium, compared to WT population under hypoxia. Interestingly, PBN addition significantly increased the lengths of telomeres under hypoxia. Based on the data obtained, we can postulate that PBN conditioning of human SkMDS/PCs could be a promising step in improving myogenic cell preparation protocol for pro-regenerative treatment of post-infarction hearts.

Bone metabolism and the trace element content associated with it change at each stage of degenerative disease. The aim of this study was to find out about the role of the analyzed elements in different stages of hip osteoarthritis. Elements associated with oxidative and enzymatic processes were analyzed depending on the changes in the radiological images of the hip joint. Element content analysis was performed by the inductively coupled plasma mass spectrometry analytical technique. The femoral head in severely osteoarthritic hips (KL3–4) compared to mild grade osteoarthritis (KL2) had a greater content of Cu (median 1.04 vs. 0.04), Sr (median 38.71 vs. 29.59), and Zn (median 75.12 vs. 63.21). There were no significant differences in the content of Mo, Cr, and Fe in the femoral head and neck between the groups. The Cu/Fe correlation was negative in the KL2 group (−0.47) and positive in the KL3–4 groups (0.45). Changes in the content and correlation of trace elements in the hip joint explain the changes in metabolism dependent on the severity of degenerative changes.

In the present study, the genetic modification of human skeletal muscle-derived stem/progenitor cells (SkMDS/PCs) was investigated to identify the optimal protocol for myogenic cell preparation for use in post-infarction heart therapy. We used two types of modifications: GFP-transfection (using electroporation) and SOD3 transduction (using a lentiviral vector). SkMDS/PCs were cultured under different in vitro conditions, including standard (21% oxygen) and hypoxic (3% oxygen), the latter of which corresponded to the prevailing conditions in the post-infarction heart. Transfection/transduction efficacy, skeletal myogenic cell marker expression (CD56), cellular senescence, and apoptosis, as well as the expression of antioxidant (SOD1, SOD2, and SOD3), anti-aging (SIRT1 and FOXO), anti-apoptotic (BCL2), and myogenic (MyoD and MyoG) genes, were evaluated. The percentage of GFP-positive SkMDS/PCs was determined as an indicator of the efficacy of transfection, which reached 55%, while transduction showed better efficiency, reaching approximately 85% as estimated by fluorescence microscopy. The CD56-positive SkMDS/PCs were present in approximately 77% of the tested cells after transient transfection and approximately 96% after transduction. Under standard in vitro culture conditions, the ability of the differentiated, transfected SkMDS/PCs to form myotubes was greater than that of the wild type (WT) cell population (p &lt, 0.001), while the cells transduced with the SOD3 gene exhibited an increase in cell fusion under both standard (p &lt, 0.05) and hypoxic conditions (p &lt, 0.001). In transduced SkMDS/PCs, we observed a positive influence of SOD3 overexpression on cell ageing and apoptosis. We observed an increase in the percentage of young cells under standard (p &lt, 0.05) and hypoxic (p &lt, 0.001) in vitro culture conditions, with a notable decrease in the percentage of senescent and advanced senescent cells in the SOD3-overexpressing cell population detected compared to that observed for the untransduced muscle-derived cells. A lower percentage of apoptotic cells was observed for transduced SkMDS/PCs than that for WT cells under hypoxic in vitro culture conditions. In transiently transfected SkMDS/PCs, we observed significantly higher gene expression levels of SOD2 (almost 40-fold) (p &lt, 0.001) and FOXO (p &lt, 0.05) (approximately 3-fold) under both normoxic and hypoxic culture conditions and of BCL2 under hypoxia compared to those observed in untreated cells (WT). In addition, myogenic genes showed a significant increase in MyoD (almost 18-fold) expression under standard culture conditions (p &lt, 0.0001) and decreased MyoG expression (approximately 2-fold) after transfection (p &lt, 0.05) compared with that detected in the WT skeletal muscle-derived cell control. Taken together, these results demonstrate that SOD3-tranduced skeletal muscle-derived cells may have potential for use in the regenerative treatment of the post-infarction heart.

Elements in the human body come from contaminated food, water, and air from the living area. Bones are a marker of long-term exposure to elements and show a relationship between them. The aim of the study was to analyze the correlation between the contents of Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femoral head (cancellous bone) and femoral neck (cortical bone) in rural and urban populations. The study included 96 patients who were operated on for total hip replacement (THR), acquired in a surgical procedure with atomic absorption spectrometry, and the content of Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb was evaluated. In rural areas, significant negative correlations were observed for Mo/Cr, Mo/Cu, and Ni/Fe, and positive correlations were observed for Fe/Zn and Pb/Zn. In urban areas, a negative correlation was found for Pb/Mo. Pb and Ni increased with age only in villagers, and Zn and Sr decreased with age in urban citizens. Ba decreased with age in people from rural areas. The correlation showed variances mainly in molybdenum, nickel, and oxidative elements between rural and urban populations.

Hemophilic arthropathy (HA) is one of the most common and typical manifestation in the course of recurrent bleeding episodes in patients with hemophilia. Clinical and subclinical joint bleeding episodes gradually lead to irreversible changes manifesting themselves as pain, progressing ankylosis, marked limitation of the range of motion, muscle atrophy and osteoporosis commonly concomitant with joint deformity resulting from chronic proliferative synovitis and both cartilage and bone degeneration leading to the final functional impairment of the joint. In spite of numerous studies, the pathophysiology of HA has not been fully elucidated, especially as regards immunopathological mechanisms which are associated with the subclinical and early stage of the disease and to be more precise, with chronic joint inflammation. It needs to be emphasized that the pathophysiological processes occurring in a joint with HA are most probably highly mediated by interactions within the cytokine network and other inflammatory mediators present in the tissues of affected joint. Among numerous compounds participating in the induction of an inflammatory process in the pathogenesis of HA, cytokines seem to play a leading role. The most important group controlling the disease seems to be well known inflammatory cytokines, including IL-1β, TNFα and IL-6. The second group with antagonistic effect is formed by anti-inflammatory cytokines such as IL-4 and IL-10. The role of inflammatory and anti-inflammatory cytokines in the pathogenesis of HA with respect to cellular and intracellular signaling pathways is still under investigation. This review, summarizes and discusses the current knowledge about cytokine network in the pathogenesis of HA, indicating possible molecular and cellular mechanisms that may provide potential new therapeutic directions.

The possibility of using stem cell-derived cardiomyocytes opens a new platform for modeling cardiac cell differentiation and disease or the development of new drugs. Progress in this field can be accelerated by high-throughput screening (HTS) technology combined with promoter reporter system. The goal of the study was to create and evaluate a responsive promoter reporter system that allows monitoring of iPSC differentiation towards cardiomyocytes. The lentiviral promoter reporter system was based on troponin 2 (TNNT2) and alpha cardiac actin (ACTC) with firefly luciferase and mCherry, respectively. The system was evaluated in two in vitro models. First, system followed the differentiation of TNNT2-luc-T2A-Puro-mCMV-GFP and hACTC-mcherry-WPRE-EF1-Neo from transduced iPSC line towards cardiomyocytes and revealed the significant decrease in both inserts copy number during the prolonged in vitro cell culture (confirmed by I-FISH, ddPCR, qPCR). Second, differentiated and contracting control cardiomyocytes (obtained from control non-reporter transduced iPSCs) were subsequently transduced with TNNT2-luc-T2A-Puro-CMV-GFP and hACTC-mcherry-WPRE-EF1-Neo lentiviruses to observe the functionality of obtained cardiomyocytes. Our results indicated that the reporter modified cell lines can be used for HTS applications, but it is essential to monitor the stability of the reporter sequence during extended cell in vitro culture.

Objective To assess feasibility and accuracy of a new insertion technique of S1 transpedicular screw. Summary of background data Transpedicular stabilization in the first sacral vertebra (S1) is a technically demanding surgical procedure with inherent risk of loosening of the implant. A modification of the technique was recently proposed, along with the analytical verification which was performed based on the available literature. In the study, we performed radiological assessment of screws inserted into the S1 using the classical and modified techniques. Methods The analysis was performed in two parts. The first part was performed on eight cadaver specimens after implantation of the screws. In the second part, we used computed tomography images of patients with degenerative disk disease with a superimposed representation of screws. The thickness of the posterior cortex adherent to the screws, screw trajectory and their position with regard to the spinal canal was measured. The area of posterior cortex in contact with the screws was also calculated. Results The contact length and area was found to be two times greater for screws introduced with the modified technique. The convergence angle was comparable between the techniques, despite the shift of entry point. There was no canal breach, although with the modified technique the screws passed closer to the spinal canal. Conclusions The modified technique is considered safe. In this technique, the screws pass through a thicker portion of the posterior cortex compared to the classical technique that aims at improving the stability of the fixation.

CX3CL1 (fractalkine) is the only member of the CX3C (delta) subfamily of chemokines which is unique and combines the properties of both chemoattractant and adhesion molecules. The two-form ligand can exist either in a soluble form, like all other chemokines, and as a membrane-anchored molecule. CX3CL1 discloses its biological properties through interaction with one dedicated CX3CR1 receptor which belongs to a family of G protein-coupled receptors (GPCR). The CX3CL1/CX3CR1 axis acts in many physiological phenomena including those occurring in the central nervous system (CNS), by regulating the interactions between neurons, microglia, and immune cells. Apart from the role under physiological conditions, the CX3CL1/CX3CR1 axis was implied to have a role in different neuropathologies such as traumatic brain injury (TBI) and spinal cord injury (SCI). CNS injuries represent a serious public health problem, despite improvements in therapeutic management. To date, no effective treatment has been determined, so they constitute a leading cause of death and severe disability. The course of TBI and SCI has two consecutive poorly demarcated phases: the initial, primary injury and secondary injury. Recent evidence has implicated the role of the CX3CL1/CX3CR1 axis in neuroinflammatory processes occurring after CNS injuries. The importance of the CX3CL1/CX3CR1 axis in the pathophysiology of TBI and SCI in the context of systemic and direct local immune response is still under investigation. This paper, based on a review of the literature, updates and summarizes the current knowledge about CX3CL1/CX3CR1 axis involvement in TBI and SCI pathogenesis, indicating possible molecular and cellular mechanisms with a potential target for therapeutic intervention.

The existing biomechanical models of the lumbo-sacral spine do not explain the role of the dorsal extensor muscle and fascia. The study attempts to explain the action of paraspinal muscles based on the mechanism of contraction and “hydro skeleton”. It was assumed that the muscle contracting produces hydrostatic pressure and in this way is able to resist and transfer loads. In this mechanism, inside ventricular pressure can modify the load transfer through the spine. To confirm the hypothesis discussed above, a simplified simulation model of the lumbar spine was built. For this purpose, scientific software named ABAQUS, using finite element methods was used. The model of the spine was mainly a kinematic model aimed at reflecting the impact of the spinal muscle function on lumbar lordosis.

Previous studies have demonstrated that the length of the lumbar spine is decreasing with age. Despite considerable research based on sagittal measurements, little is known about the changes in the volume of vertebrae. The objective of this study was to evaluate the changes in the volume of either column of the spine with age.Computed tomography scans of 62 asymptomatic subjects, performed for thoracolumbar trauma evaluation were used to create virtual 3D models. At least 10 patients were assigned to every decade of life from third to eight. We used a novel technique to measure the volume of anterior column (AC) and posterior column (PC) per each segment (a total of 310 segments). Midline sagittal images were used to measure disc height (DH) and vertebral body height (VH).With age, both DH increases, whereas the VH decreases. The overall length of lumbar segment of the spine decreases with age. The volumetric measurements performed on same subjects showed that volume of both AC and PC does not change with age in females. In males, there is a weak but statistically significant correlation between AC volume and age and no change in the volume of PC. The ratio of PC:AC volume does not change with age in women, although it decreases slightly but significantly (in favor of AC) with age in males.The overall length of lumbar spine decreases with age. This process is not a result of mere changes in the volume of either AC or PC.

Ischemic heart disease, also known as coronary artery disease (CAD), poses a challenge for regenerative medicine. iPSC technology might lead to a breakthrough due to the possibility of directed cell differentiation delivering a new powerful source of human autologous cardiomyocytes. One of the factors supporting proper cell maturation is in vitro culture duration. In this study, primary human skeletal muscle myoblasts were selected as a myogenic cell type reservoir for genetic iPSC reprogramming. Skeletal muscle myoblasts have similar ontogeny embryogenetic pathways (myoblasts vs. cardiomyocytes), and thus, a greater chance of myocardial development might be expected, with maintenance of acquired myogenic cardiac cell characteristics, from the differentiation process when iPSCs of myoblastoid origin are obtained. Analyses of cell morphological and structural changes, gene expression (cardiac markers), and functional tests (intracellular calcium transients) performed at two in vitro culture time points spanning the early stages of cardiac development (day 20 versus 40 of cell in vitro culture) confirmed the ability of the obtained myogenic cells to acquire adult features of differentiated cardiomyocytes. Prolonged 40-day iPSC-derived cardiomyocytes (iPSC-CMs) revealed progressive cellular hypertrophy; a better-developed contractile apparatus; expression of marker genes similar to human myocardial ventricular cells, including a statistically significant CX43 increase, an MHC isoform switch, and a troponin I isoform transition; more efficient intercellular calcium handling; and a stronger response to β-adrenergic stimulation.

Supplementary_table for The impact of in vitro cell culture duration on the maturation of human cardiomyocytes derived from induced pluripotent stem cells of myogenic origin by Jarosław Lewandowski, Natalia Rozwadowska, Tomasz J Kolanowski, Agnieszka Malcher, Agnieszka Zimna, Anna Rugowska, Katarzyna Fiedorowicz, Wojciech Łabędź, Łukasz Kubaszewski, Katarzyna Chojnacka, Katarzyna Bednarek-Rajewska, Przemysław Majewski, and Maciej Kurpisz in Cell Transplantation

Background The work is designed to uncover the pattern of mutual relation among trace elements and epidemiological data in the degenerated intervertebral disk tissue in humans. Hitherto the reason of the degenerative process is not fully understood. Trace elements are the basic components of the biological compound related both its metabolism as well as environmental exposure. The relation pattern among elements occurs gives new perspective in solving the cause of the disease. Material and methods We have analysed trace elements content in the 30 intervertebral disc from 22 patients with degenerative disc disease. The concentrations of Al, Cu, Cd, Mo, Ni and Pb were determined with Atomic Absorption Spectrometry. To analyse the multidimentional relation between trace element concentration and epidemiological data the chemometric analysis was applied. Results The similarity have been shown in occurrence of following pairs: Cd-Mo as well as Mg-Zn. The second pair was correlated with Pb concentration. Pb levels are observed to be competitive to Cu concentration. Cd concentration was related to Zn and Mg deficiency. No single but rather cluster of epidemiological data show observable influence on the TE tissue variance. Zn and Cu was related to the male sex. Operation with orthopedic implants were related to combined Al, Mo and Zn concentration. Conclusions This is the first chemometric analysis of trace elements in disk tissue. It shows multidimentional relations that are missed by the classical statistic. The analysis shows significant relation. The nature of the relations is the basis for further metabolic and environmental research.

Vertebral body fractures are most commonly observed fractures of the patients with osteoporosis. Most often are observed in the thoraco-lumbar junction and thoracic spine. It is rather seldom observed in the sacral bone. In case where sacral fracture was diagnosed in patient with osteoporosis, the available treatment procedures are similar to those used in the other vertebral compression fractures. Contemporary treatment protocol along with pharmacotherapy to slow down the bone turn-over, rehabilitation, orthotic treatment, advocates also for percutaneous injection with the bone cement of the sacral bone – sacroplasty. Sacroplasty procedure gives chance to decrease the pain related to the fracture, limiting the immobilisation time, directly related to the bone density loss. The procedure can be performed in local anaesthesia with sedation, which is beneficial for elderly patients with co-morbidities. Contraindications for it are similar to those underlined in the rest of the spine: posterior wall fracture endangering the cement leakage to the spinal canal, neurological symptoms aggravated by the fracture occurrence, as well the general ones. In spite the sacroplasty is to be considered low risk procedures, serious complication might be observed. The most serious are cement leakage into the spinal canal or pulmonary or central nervous system embolisation with the cement. Sacroplasty, similarly to the vertebroplasty in the thoracic or lumbar spine might be a suitable procedure in osteoporotic fracture treatment of the sacrum.

Background One of the most important elements of the transpedicular screw implantation technique, which enables a strong screw-bone interface, is the precise choice of the site of screw insertion and the screw's trajectory. Due to the complex biomechanics of the lumbosacral interface and different shape of the sacrum, fixation of this segment remains a challenge for surgeons. Because of this, Kubaszewski et al. proposed a modified technique in which the entry point for screw insertion in the S1 vertebra is changed. Methods Six human cadaver specimens of the S1 vertebrae were examined. Two transpedicular screws were inserted into the body of each examined vertebra using two implantation methods with different screw entry points and trajectories. The screws were subjected to cyclic preloading, followed by the pull-out test. The ultimate pull-out force, displacement, stiffness, and failure energy were measured. Findings The average pull-out force obtained for the standard method of implantation was 498 N (SD 201), whereas for the modified technique, it was 1308 N (SD 581). Displacement of the inserted screws in the new method was 36% higher than in the case of the standard method. This method is also characterized by the greater stiffness of the obtained interface and greater failure energy than the normally used technique. Interpretation The obtained results demonstrate that the use of the new technique of implantation significantly increases the strength of the obtained screw-bone interface. It should also increase the success rate of the performed fixations and increase the safety of such fixations in clinical practice.

Background Degenerative disease of the lumbar spine is characterized by symptoms related to the affected nerve root. A recently described method allows the classification of the roots in relation to the occurrence of compression on its course. This method can serve as a clinical selection tool and decision support for semi-invasive pain therapy in back pain patients. Material/Methods We examined 40 lumbar spine MRIs in 3 sessions of transcription each, according to the method being evaluated. Every MRI evaluation was performed by each of 3 different observers. Intra- and interobserver reproducibility was calculated using chance-corrected agreement using a weighted kappa (κ) value with quadratic weights to assess reliability for each nerve root separately. Results We found high intraobserver agreement in indication of the root with most pronounced interference due to potential compression by degenerative changes, at the level mean κ=0.81 (with 95% CI, range 0.04). Less agreement was observed in the interobserver evaluation test with the mean κ=0.75 (95% CI within the range not exceeding 0.03), although it still reached the substantial agreement. Conclusions This zstudy provides evidence for substantial inter- and intraobserver agreement for the decision support method allowing selection of the most serious nerve structure compression in degenerative disease of the lumbar spine based on of the MRI description.

There is a growing body of evidence concerning the significant role of silicon in development and composition of both connective and bone tissue. Bio-essential silicon shows strong chemical and biological affinity to aluminum, which is toxic and biologically inessential element. The presence of silicon was confirmed in a variety of tissues; however, it has never been examined in intervertebral disc tissue, neither in healthy nor in degenerated one. In this paper, for the first time in the literature, we present the content of silicon in the degenerated intervertebral disc tissue. We also compared the results of silicon analysis with aluminum values in degenerated intervertebral disc tissue in humans. We used chemometric methods to find correlations and similarities between silicon, aluminum, and elements associated with tissue metabolism (Mg) and degenerative processes (Zn and Cu). The presence of silicon was confirmed in all 30 samples harvested from 22 patients operated on due to degenerative changes. Its concentration was within the range of 5.37–12.8 μg g−1 d.w., with the mean concentration of 7.82 μg g−1 d.w. The analysis showed significant correlation between Si and both Al and Mg and weak or negative correlation with Zn and Cu, where the latter was probably the result of degenerative processes. Although silicon is considered essential in glycosaminoglycan and collagen synthesis in connective tissue, it did not show any correlation nor similarities with elements reflecting changes associated with the degenerative process of the intervertebral disc. Silicon showed significant correlation with aluminum, similar to those observed in other human tissues.

The objective of this study was to discuss the variables influencing alignment mechanisms of the spine, with particular consideration of post-surgical alignment in adolescent idiopathic scoliosis. The analysis is based on information currently available in the literature, and on the authors' own experience, which includes surgical material from over 2200 cases of idiopathic scoliosis. Over 50% of cases of adolescent idiopathic scoliosis are decompensated before surgical treatment. Spinal alignment is most significantly influenced by the position of the pelvis. Surgical restoration of lumbar lordosis is more important than attempting to restore thoracic kyphosis in the sagittal plane. The sagittal profile has an essential impact on spinal alignment. The same curves in the coronal plane can have various 3-dimensional configurations. Clinical difficulties in the assessment of thoracic kyphosis and lumbar lordosis result from the fact that they undergo constant change with age. Thoracic hypokyphosis diagnosed before surgery is a very frequent symptom of curve progression. The presence of proximal (thoraco-thoracic) and distal (thoraco-lumbar) junctional kyphosis is very important for planning the scope of spondylodesis. The natural tendency of the spine for alignment (compensation) after surgery nowadays occurs more naturally by applying derotational forces through pedicle screws, compared to the distraction devices (eg, Harrington rod) used in the past.

Tissues for the study were obtained intraoperatively during hip replacement procedures from 96 patients. In all the cases, the indication for this treatment was primary or secondary degenerative changes in the hip joint. The subject of the study was the head and neck of the femur, resected in situ. Aluminium concentrations measured in femoral head and neck samples from patients aged between 25 and 91 were varied. Statistical methods were applied to determine the variations in relation to the parameters from the background survey. Significant differences in the aluminium content of femoral head samples were observed between patients under and over 60 years of age. Based on the results, it was confirmed that the aluminium accumulates in bones over a lifetime. The study showed that the content of aluminium in the head and neck of the femur depends on the factors such as: type of medicines taken, contact with chemicals at work, differences in body anatomy and sex. The study on the levels of aluminium in bones and the factors affecting its concentration is a valuable source of information for further research on the role of aluminium in bone diseases. Based on the investigations, it was found that the GF-AAS technique is the best analytical tool for routine analysis of aluminium in complex matrix samples. The use of femoral heads in the investigations was approved by the Bioethics Committee of the University of Medical Sciences in Poznan (Poland).

The aim of the study was to determine the content of particular elements Ca, Mg, P, Na, K, Zn, Cu, Fe, Mo, Cr, Ni, Ba, Sr, and Pb in the proximal femur bone tissue (cancellous and cortical bone) of 96 patients undergoing total hip replacement for osteoarthritis using ICP-AES and FAAS analytical techniques. The interdependencies among these elements and their correlations depended on factors including age, gender, place of residence, tobacco consumption, alcohol consumption, exposure to environmental pollution, physical activity, and type of degenerative change which were examined by statistical and chemometric methods. The factors that exerted the greatest influence on the elements in the femoral head and neck were tobacco smoking (higher Cr and Ni content in smokers), alcohol consumption (higher concentrations of Ni, Cu in people who consume alcohol), and gender (higher Cu, Zn, and Ni concentrations in men). The factors influencing Pb accumulation in bone tissue were tobacco, alcohol, gender, and age. In primary and secondary osteoarthritis of the hip, the content and interactions of elements are different (mainly those of Fe and Pb). There were no significant differences in the concentrations of elements in the femoral head and neck that could be attributed to residence or physical activity.

Background: Trace element (TE) analysis in human tissue has the dual purpose of assessing environmental pollution and metabolism. In literature, bone TE analysis is common, but studies in intervertebral disc (IVD) tissue are lacking. The aim of the study was evaluation of the difference of TE concentration in intervertebral disc and bone in patients with degenerative changes. The comparison of the tissues differing in metabolism, blood perfusion, or separateness from adjoining tissues but playing similar biomechanical role and presenting some common morphological traits may shed new light on metabolism nuances, degenerative process, as well as accumulation potential of IVD in respect to bone. Methods: In the study, we analyzed two types of samples: intervertebral disc (n =30, from 22 patients operated due to degenerative disc disease) and femoral bone (n =26, separately femoral head and neck, from 26 patients, acquired in total hip arthroplasty procedure in course of idiopathic osteoarthritis of the hip joint). In the samples we analyzed, with atomic absorption spectrometry, the concentrations of Pb, Ni, Mo, Cu, Mg, and Zn. Results: The element concentrations identified in bone are comparable to those presented in the literature. In the case of Pb, Ni, Mo, Mg, and Zn, the concentration in the bone was 2 to 25.8 times higher than that observed in the disc. Only the Cu concentration was higher in disc tissue than in bone. In disc tissue, fewer samples had TE concentrations below the detection threshold. We found significant differences in TE profiles in the compared tissues. Conclusions: The results show that the disc could serve as a more stable compartment for evaluating TE concentration, especially for TEs that are environmentally related.

Male breast cancer (MBC) represents a rare cause of vertebral body compression fractures along with severe pain restricting the patient's daily functioning. Limited number of cases, lack of awareness among patients and physicians leading to delayed management, further increase the average age and disease progression at presentation, resulting in a poor prognosis. Additionally, studies on MBC treatment protocols and the use of female algorithms are unavailable. The implementation of vertebroplasty or kyphoplasty often results in unsatisfactory outcome due to recurrent pain and loss of vertebral height. Stentoplasty could become an alternative procedure, as described in the following case study.54-yr-old male patient with history of breast carcinoma presented with pain in the vertebral column. Baseline X-ray and CT scan revealed multiple osteosclerotic and osteolytic metastatic lesions in the thoracic vertebrae along with a compression fracture at T9. Stentoplasty was performed to limit fracture progression. Intraoperative scan revealed restoration of the vertebral body shape. Following surgery, direct reduction in pain was obtained. Postoperative 1-year follow-up did not show any loss in height of the operated vertebra. Results of adjuvant chemotherapy administration and a new method of treatment of compression fractures caused by metastatic lesions were compared with previously published studies.Stentoplasty with Vertebral Body Stenting-System is an innovative method that can be applied in kyphoplasty for compression fractures caused by metastatic lesions. Nevertheless, further research on the systemic treatment of MBC is needed.

The amount and diversity of scientific publications requires a modern management system. By "management" we mean the process of gathering interesting information for the purpose of reading and archiving for quick access in future clinical practice and research activity. In the past, such system required physical existence of a library, either institutional or private. Nowadays in an era dominated by electronic information, it is natural to migrate entire systems to a digital form.In the following paper we describe the structure and functions of an individual electronic library system (IELiS) for the management of scientific publications based on the Google Drive service.Architecture of the system. Architecture system consists of a central element and peripheral devices. Central element of the system is virtual Google Drive provided by Google Inc. Physical elements of the system include: tablet with Android operating system and a personal computer, both with internet access. Required software includes a program to view and edit files in PDF format for mobile devices and another to synchronize the files.Functioning of the system. The first step in creating a system is collection of scientific papers in PDF format and their analysis. This step is performed most frequently on a tablet. At this stage, after being read, the papers are cataloged in a system of folders and subfolders, according to individual demands. During this stage, but not exclusively, the PDF files are annotated by the reader. This allows the user to quickly track down interesting information in review or research process. Modification of the document title is performed at this stage, as well. Second element of the system is creation of a mirror database in the Google Drive virtual memory. Modified and cataloged papers are synchronized with Google Drive. At this stage, a fully functional scientific information electronic library becomes available online. The third element of the system is a periodic two-way synchronization of data between Google Drive and tablet, as occasional modification of the files with annotation or recataloging may be performed at both locations.The system architecture is designed to gather, catalog and analyze scientific publications. All steps are electronic, eliminating paper forms. Indexed files are available for re-reading and modification. The system allows for fast access to full-text search with additional features making research easier. Team collaboration is also possible with full control of user privileges. Particularly important is the safety of collected data. In our opinion, the system exceeds many commercially available applications in terms of functionality and versatility.

This paper presents a method for determining the proper diagnostic techniques and the respective therapy in patients affected with nerve root compression in the lumbar region of the spine based on developing an algorithm that attempts to assess the level of compression and determine the afflicted nerve root. The clinical picture of degenerative disease of the lumbar spine is characterized by symptoms related to the affected nerve root. The diagnosis and respective therapy benefits from the use of minimally invasive techniques, such as selective root blocks or use of the radiofrequency. For instance, with changes on many levels it is necessary to comply with the rules for the selection of the correct nerve roots so there can be referral for proper treatment. The method of selection is dependent on the correlation of the results of the clinical examination, as well as secondary diagnostic studies, of which the gold standard is the MRI. In clinical practice we rely on the results of magnetic resonance imaging to determine the nerve root level in the lumbar spine. This allows the classification of the roots in relation to the frequency of compression occurrence along its course. The morphologic changes resulting in a similar clinical picture may indirectly suggest a degree of exacerbated risk. In addition, we suggest a system of describing the MRI scans, which allows us to retrospectively obtain information on the locations of potential compression of nerve roots.

Cubital tunnel syndrome is the second, according to the frequency, neuropathie of the upper limb. This article reveals the newest views on the diagnostic and methods of treatment of this illness. Authors show enormous meaning of the clinical examination and verify indications for the auxiliary investigations. The most popular techniques of the operative treatment of this neuropathy are discussed.

In this case report the authors present the 74 year old female patient with multifragmental fracture of the proximal humerus, treated with the hemiarthroplasty of the humeral joint. The clinical and radiological outcome was satisfactory.