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PIRCHE–II is an algorithm used to estimate the risk for developing alloreactivity towards HLA mismatches. A 35–year–old man with idiopathic dilated cardiomyopathy with several previous hospitalizations for heart failure is admitted to our unit for a new episode in August 2021. After evaluation, the patient was placed on the waiting list for transplant. The following month the patient underwent heart transplant. The donor had a compatible CDC crossmatch and was negative for anti–HLA antibodies. After 46 days, the patient was discharged at home in stable conditions after 2 negative endomyocardial biopsies (EMB): ISHLT’04 0. In January 2021, the patient was newly admitted for dyspnea and oliguria. Imaging revealed bilateral severe pleural effusion, biventricular cardiac disfunction; EMB showed acute rejection (ISHLT’04 3R). Panel–reactive antibody (PRA) screening found 93 % of class I PRA, 3 % of class II PRA with IgM and IgG donor–specific antibodies (DSA), C1q–positive. After 2 months, the patient was placed again on the transplant waitlist for a persistent severe biventricular disfunction, massive tricuspid regurgitation and diffuse myocardial fibrosis; class I PRA was decreasing (41 % in March 2022, 31 % in April 2022). Unfortunately, the patient died of infection before re–transplantation. After the event, which was recognized as AMR caused by class I DSA, a form rarely described in literature, we employed the PIRCHE (Predicted Indirectly Recognizable HLA Epitopes) algorithm to predict indirect donor–recipient alloreactivity: PIRCHE–II was 54. Is a high PIRCHE–II score a reliable predictor of AMR following heart transplant? More data and deeper understanding is surely needed. A correct after–transplant serologic monitoring is definitely needed to search for de–novo DSA.

Introduction Coronary artery bypass graft is considered the most frequently performed cardiac surgery and involves the use of different types of grafts: internal mammary artery, saphenous vein, radial artery. The venous graft is often subject to early failure due to various factors such as thrombus formation, intimal hyperplasia or formation of atherosclerotic plaques. Several studies have highlighted various mechanisms that may be responsible for these processes. This study aims to find a statistically significant correlation between the use of hyperkalaemic cardioplegic solutions and endothelial damage. Materials and methods For sample collection, saphenous vein segments were taken from each patient: one was taken when it was isolated to take the graft, and a second sample was taken after administration of St. Thomas no. 2 cardioplegic solution. Both collected specimens were stored in formalin and analyzed by light microscopy following hematoxylin–eosin staining and staining with monoclonal antibodies targeting CD31 and CD34. Discussion From the study with hematoxylin and eosin staining, it was observed that in the vein taken before the infusion of cardioplegia, the endothelium was present, continuous, clearly visible and without lesions. In the specimens taken after the infusion of hyperkalaemic cardioplegic solution, it is noted that the endothelium, although present, is more difficult to visualize and is discontinuous to a variable extent from 20 to 60%. This reduction in the percentage of visible continuous endothelium was confirmed by analysis with CD31 and CD34 immunohistochemical stains. Previous studies already confirm that the venous endothelium is affected by a high concentration of potassium, producing acute and chronic lesions. This result would seem to demonstrate how the endothelial tissue is also susceptible to hyperacute damage following short–term exposure to potassium. Conclusions The short–term results of this study would seem to confirm the initial hypothesis of a relationship between the use of hyperkalemic cardioplegia and the formation of acute or hyperacute lesions in the saphenous vein graft at the endothelial level. This conclusion could be one of the explanations of the high failure rate of the venous bypass, which in fact has a 10–year occlusion rate of 60/65%.

Introduction We report the case of a 52–year–old patient with a history of multiple myeloma undergoing chemotherapy treatment according to the DaraRD scheme and currently in remission. Associated with haematological pathology, infiltrative hypertrophic cardiomyopathy of ndd is highlighted. Following haematological and instrumental screening tests, the patient underwent a heart transplant for frequent exacerbations of heart failure. Case Report A 52–year–old patient, suffering from multiple myeloma for about 1 year, for which he began chemotherapy treatment with DaraRD scheme and good response to therapy. The patient also presented dyspnoic symptoms and declining edema with echocardiographic finding of infiltrative hypertrophic heart disease for which he undergoes diagnostic investigations. He performs: • Serial echocardiograms which showed marked uniform hypertrophy with ground glass appearance of the left ventricle and severely reduced systolic function; • PET–CT with no hyperaccumulation of the radiopharmaceutical; • Cardiac MRI with evidence of severely hypocontractile left ventricle and wall changes which could be associated with amyloid infiltration; • myocardial scintigraphy that does not give evidence for the deposit of the amyloid substance of the ATTR type in the heart; • biopsy of umbilical fat and cardiac biopsy, both negative for deposition of substance AL with Congo Red staining; • Right cardiac catheterization with evidence of post–capillary pulmonary hypertension. The patient was subjected to several exacerbations of heart failure which required continuous infusion therapy with inotropes and, ultimately, heart transplantation. At the time of surgery, the heart appeared enlarged, extremely hypocontractile and with rigid walls, with poor compliance of the ventricular muscle wall. The patient responded well to the surgical procedure, in the absence of signs and symptoms of rejection, with improvement of general clinical condition. Conclusions At the end of the surgical procedure and the rehabilitation period, the patient was discharged home, without showing signs and symptoms of graft rejection or multiple myeloma exacerbations, in stable and satisfactory general clinical conditions.

During SARS–CoV2 pandemic, transplant programs had to devise strategies to deal with the possibility of COVID–19–positive donors and recipients. In March 2022, a 60–year–old man with dilated cardiomyopathy on the transplant waitlist was admitted to our Unit as a possible donation was presented. On arrival, he tested positive for SARS–CoV2. The patient had no clinical evidence of COVID–19; he had completed the vaccination cycle; chest X–rays did not show interstitial pneumonia. Aware of the increased risk, we proceeded with the transplant. Sotrovimab, a novel anti–viral agent specific for COVID–19, was administered. Prophylactic antibiotics were started. He received anti–thymocyte immunoglobulins 125 mg for 2 days and methylprednisolone 1 g after aortic declamping and then 125 mg TID for 2 days for induction immunosuppression. Maintaining therapy included corticosteroids and tacrolimus. On the 7th day the patient tested negative at SARS–CoV2 swab. As kidney function worsened, hemodialysis was started. On the 17th day signs of cellulitis of the left thigh appeared, and inflammation indices (CRP, PCT) rose. A hemoculture positive for A. baumannii (MDR–AB) was obtained; hence the patient was treated with Cefiderocol and Colistine. A Cytosorb filter was added to the hemodialysis and Pentaglobin was started. After 3 weeks, hemodynamics started to improve, inotrope support was suspended, with reduction of inflammation indices, negative hemocultures, recovering kidney function. After two weeks, the patient abruptly presented fever, marked hypotension and dyspnea. He underwent intubation, inotrope therapy, broad–spectrum antibiotic therapy, intravenous Immunoglobulins and a cycle of Polymyxin B Hemoperfusion. Nevertheless, hemodynamics decidedly failed. Chest X–rays showed bilateral pneumonia. Hemocultures were positive for MDR–AB. Leukopenia developed (WBC 0,10). Three days after the first signs of a new infective episode, the patient had died. Notwithstanding the difficulties of SARS–CoV2 pandemic, tempestive diagnosis and treatment allow transplant programs to proceed unhindered.

A 44–year–old man in apparent good health thus far presented with weight loss and fever preceded by shivers, profuse sweating, and arthralgias. Blood tests documented normal white blood count with slightly altered CRP and ESR. Chest X–rays did not find pleuro– parenchymal lesions with normal cardiac silhouette. Abdomen ultrasounds was regular. Due to the persistence of the symptoms, he was referred to a rheumatologist who diagnosed Adult Still’s disease (AOSD) and recommended therapy with prednisone and sulfasalazine, interleukin–1 inhibitor, with the resolution of the fever. After three months, because of the recrudescence of the fever, he was admitted to the emergency room a total–body CT–scan documented inflammatory–abscess lesions in the brain and hypodense areas in the spleen. ECG showed type 1 second–degree atrioventricular (AV) block. The patient was therefore transferred to the Cardiology Department; echocardiograms documented an endocardic mass on the aortic valve and suspected periannular abscess also infiltrating the interventricular septum. The patient underwent urgent surgery with excision of the aortic valve, opening and draining of the abscessual cavities, reconstruction of the aortic annulus with bovine pericardium patch and aortic valve replacement with bioprosthesis. The patient did not present further febrile episodes after surgery but a pacemaker implantation was necessary due to persistent AV block. Biological material sent for culture was positive for S. gallolyticus. AOSD is one of the most common conditions responsible for fevers of unknown origin. It is characterized by fever, arthritis, evanescent rash, leukocytosis, and multiorgan involvement. Yamaguchi criteria required for the diagnosis of AOSD are as follows: main criteria: Fever >39°C, lasting 1 week or more, Arthralgia or arthritis, lasting 2 weeks or more, Typical rash, Leukocytosis >10,000/mm3; Minor criteria: Sore throat, Recent development of significant lymphadenopathy, Hepatomegaly or splenomegaly, Negative tests for antinuclear antibodies and rheumatoid factor; Exclusion criteria: Infections, Malignancies, Other rheumatic diseases.

The purpose of this study is to evaluate the efficacy of medical therapies, especially infliximab, to induce remission of enteric fistulas in Crohn's disease (CD). Similarly to CD, chronic transmural inflammation of the bowel, diverticulitis and other pathologies may predispose to the development of fistulas. The risk of fistulization secondary to CD ranges from 17% to 80%. We focused on enterovesical fistulas, which statistically represent 10% of all fistulas secondary to CD. Material and Methods In this study we decided to implement a therapeutic program with infliximab 5 mg/kg associated with steroids, which proved to be the most effective method of treatment. From January 2003 to March 2005, we studied 4 patients with CD and enterovesical fistulas. All patients underwent NMR, colonoscopy and cystoscopy combined with fistulography; a therapeutic strategy with cortisone, mesalazine, nutritional therapy and infliximab was established. Results No regression was observed; therefore, all the four patients underwent surgery with complete remission of symptoms. Conclusions Data reported in literature and the evidence from our experience seem to be contradictory; we concluded therefore that it is mandatory to consider different therapeutic approaches, according to the fistulizing pathways, to such a complex disease, and to formulate some hypothesis that might explain why this treatment was unsuccessful in our patients.

The purpose of this study is to evaluate the efficacy of medical therapies, especially infliximab, to induce remission of enteric fistulas in Crohn's disease (CD). Similarly to CD, chronic transmural inflammation of the bowel, diverticulitis and other pathologies may predispose to the development of fistulas. The risk of fistulization secondary to CD ranges from 17% to 80%. We focused on enterovesical fistulas, which statistically represent 10% of all fistulas secondary to CD. MATERIAL AND METHODS. In this study we decided to implement a therapeutic program with infliximab 5 mg/kg associated with steroids, which proved to be the most effective method of treatment. From January 2003 to March 2005, we studied 4 patients with CD and enterovesical fistulas. All patients underwent NMR, colonoscopy and cystoscopy combined with fistulography; a therapeutic strategy with cortisone, mesalazine, nutritional therapy and infliximab was established. RESULTS. No regression was observed; therefore, all the four patients underwent surgery with complete remission of symptoms. CONCLUSIONS. Data reported in literature and the evidence from our experience seem to be contradictory; we concluded therefore that it is mandatory to consider different therapeutic approaches, according to the fistulizing pathways, to such a complex disease, and to formulate some hypothesis that might explain why this treatment was unsuccessful in our patients.

Renal cell carcinoma (RCC) is a relatively rare tumor representing 2-3% of all neoplasias. Approximately 30% of patients diagnosed as having RCC present metastases: mean survival ranges between 6 and 10 months, whilst 10-20% present a 2-year survival rate. Treatment of patients with metastatic RCC is a difficult challenge. Hormones and chemotherapy, either alone or associated with surgical resection of the primary lesion have been used. In our experience, IL-2 + IFN-a has been shown to be an encouraging form of treatment.During the period between October 1997 and December 1999, 5 patients (3 males, 2 females), mean age 52.5 years, with metastatic RCC, came to our attention. TC revealed a circumscribed area the margins of which were not well defined, in a mid-renal localization, positive inter aorta caval and obturator lymph nodes, but no lung, brain or hepatic involvement. Patients were submitted to nephrectomy and lymphadenectomy followed later by immunotherapy with IFN-alpha (3 Mil twice a week) + low dose IL-2 (1 Mil/m2/12 h): treatment was given for 4 consecutive weeks and then repeated every 3 weeks for 1 year.At 30 months' follow-up all patients showed regression of the disease (100% of cases) and in none of the cases there was evidence of metastases. Only one patient (20%) presented side-effects (nausea, vomiting, slight rise in temperature) all of which disappeared at the end of the first week of treatment.These results, even if on a limited number of patients and for a limited follow-up period, show that in some patients with metastatic renal cell carcinoma, treatment with IL-2 and IFN-a following nephrectomy and lymphadenectomy should be considered the therapy of choice.

To describe personal experience on stenosis of the new bladder neck, a complication of radical prostatectomy. After a review of the literature, guidelines are proposed to avoid this complication, both from a prophylactic and treatment point of view.Between 1992 and 2000, 54 patients were submitted to radical prostatectomy, 18 of whom later presented stenosis in the new bladder neck. Mean age of patients was 65.6 years (range 55-76). According to TNM classification, 46 patients (85%) were stage pT2N0M0 and eight patients (15%) stage pT3N0M0, no significant correlation being found with PSA values. All patients were submitted to pre- and postmicturition retrograde cystourethrography, four weeks after surgery; patients presenting dysuric symptoms also underwent further retrograde cystourethrography and flowmeter examinations.Of the 54 patients, 18 (33%) presented stenosis of the new bladder neck as a complication of radical prostatectomy. Of these 18 patients, 12 (22%) presented acute dysuria symptoms. In 14 cases, one-two cycles of urethral dilation were sufficient to improve flowmeter values. In the four remaining cases showing no improvement following urethral dilations, endoscopic resection was necessary in two and urethrotomy according to Sachse in the other two.Stenosis of the anastomosis of the new bladder neck is a complication of radical prostatectomy occurring within six months of surgery, no correlation being found with tumour stage, recurrence, or duration of catheter in situ. Of the 18 patients presenting stenosis in the series described, in 78%, cycles of urethral dilation were sufficient to successfully resolve the complication thus avoiding further surgery, which, on the other hand, was necessary in four patients, two submitted to endoscopic resection of the stenosis and the other two to incision according to Sachse.

To evaluate frequency of postprostatectomy urinary incontinence in order to establish the last invasive and most efficacious treatment to completely restore urinary incontinence.Between 1992 and 2000, twenty-four patients with retropubic postprostatectomy urinary incontinence were studied. The symptoms reported by all patients referred to lack of control of urine with consequent leakage upon activities exerting increased abdominal pressure (sneezing, lifting of heavy weights). These patients were submitted to urodynamic examinations and the degree of incontinence was further evaluated from the number of pads used daily (slight, 0-1; medium 2-3; severe,3). Mean follow-up was three years, eight months.Of the twenty-four patients, twenty (83%) presented stress incontinence, two (8.5%) urge incontinence, and two (8.5%) a mixed type incontinence. Eighteen patients (36%) reported slight precocious incontinence which disappeared spontaneously within three-six months. Six patients (12%) reported total incontinence which had not improved within twelve months, in four of these patients, continence was achieved by means of perineal rehabilitation whilst in the remaining patients, use of pads (up to three pads/day) was necessary, due to failure of rehabilitation.Once the need has been established for radical anatomic prostatectomy which offers the possibility of postoperative continence, perineal rehabilitation represents the first choice treatment on account not only of the high percentage of successful results but also due to low invasiveness, whilst the use of the AMS 800 sphincter offers the only solution in those forms of severe incontinence refractory to less invasive forms of treatment.

To evaluate the frequency of erectile dysfunction in patients submitted to radical prostatectomy due to prostate carcinoma and to the possibility, with appropriate treatment, of restoring adequate erections for a satisfactory sexual activity.Between 1996 and 2000, thirty-eight patients with prostate carcinoma have been submitted to radical prostatectomy. According to TNM classification upon diagnosis, thirty-three patients (87%) were stage pT2N0M0 and five patients (13%) stage pT3N0M0. Mean age of patients was 62.4 years (range 55-76). Mean follow-up was two years and seven months. Diagnosis of erectile dysfunction was made from personal history as well as that of the patient plus partner, and from nocturnal penile tumescence evaluation with Rigiscan.Eighteen patients (47%) presented erectile dysfunction as a complication 16 (89%) of whom showed no nocturnal reaction at the Rigiscan test, while in the remaining two (1%), one-two nocturnal erections of less than five minutes were obtained. Of the eighteen patients, 14 (78%) showed a positive response to treatment with intracavernous drug infusion (papaverine+Phentolamine+Alprostadil), whilst only one patient benefited from treatment with oral Sildenafil.This study showed the high frequency (47%) of erectile dysfunction in patients submitted to radical prostatectomy as well as the need to perform radical nerve-sparing surgery (particularly in the neoplastic forms not involving the prostate capsule) which is useful not only for preserving erectile function but also on account of better response to oral Sildenafil treatment following the use of this technique.

To evacuate the efficacy of conservative treatment in invasive stage T2 bladder tumours by means of deep transurethral resection of the bladder (TURB) followed by three cycles of chemotherapy with methotrexate, vinblastin, adriamycin and cisplatin (M-VAC).Between September 1998 and March 2000, 5 patients have been submitted to transparietal TURB for endovesical neoplasia. Following histological confirmation of muscle involvement (stage T2), all patients were assigned to the M-VAC chemotherapy protocol after having established clinical stage with chest, abdominal and pelvic computed tomography (CT) and bone scintiscan. All cases were followed up for 18 months. Patients were evaluated by means of diagnostic cystoscopy, TURB and bladder mapping, 4 weeks after completing treatment.Of these patients, 4 (80%) completed the treatment protocol. The patient who failed to complete the third cycle due to severe myelosuppression was submitted, two weeks later, to a lower dosage (25%). Of these 5 patients 3 (60%) were tumour-free at the follow-up observation 4 weeks after chemotherapy, one patient (20%) still presented with involvement of the bladder wall, and one (20%) presented both with a superficial stage (Ta) and carcinoma in situ (Cis).Deep TURB followed by three cycles of chemotherapy according to the M-VAC protocol, could be an effective alternative to conservative treatment of stage T2 bladder tumours.

Liposarcoma is the most common adult soft tissue sarcoma. The hallmark is the immature fat cell or lipoblast. It occurs in late adult life, frequently in the lower extremities, in the retroperitoneal, perineal and mesenteric region. Retroperitoneal liposarcoma doesn't produce symptoms until it is very large. A review of the literature is made and the case of a 65-years old man, submitted to surgical treatment for a bulky retroperitoneal mixoid liposarcoma is reported.

Primary absolute anorgasmia is the impossibility to have orgasm and ejaculation during wake or every kind of sexual activity, in men with normal erectile function and nocturnal emission. In this syndrome the nervous system is unimpaired; the frequency is very low, with a very small number of reported cases in literature. Andrologists are generally requested by the patients for the first clinical approach. They should collaborate with sexologists for the diagnosis and treatment. Personal experience in 3 cases of anejaculatory men aged between 28 and 34, observed in the years 1995-1996, is presented and the clinical features of the patients and therapeutic strategy described. In two cases a sexual behavioral therapy was performed with success; in the third an electrovibration was employed to obtain the first orgasmic sensation.

Müllerian duct alterations in development or fusion in the embryo cause congenital uterine anomalies which may be responsible for decreased fertility or problems in carrying out a normal pregnancy. In this study, the MR findings in uterine agenesis (1 case), unicornuate (2 cases), didelphys (3 cases), bicornuate (3 cases), arcuate (6 cases) and septate uterus (8 cases) are described, together with the optimal section planes for their demonstration. The examinations were performed with an 0.5-T superconductive magnet, the spin-echo technique and mostly T2-weighted sequences. The anomalies were grouped according to Buttram and Gibbons classification, which is the most used in clinics. In particular, the bicornuate uterus was distinguished from the septate uterus, the latter associated with the highest spontaneous abortion rates, on the basis of external fundal outline appearance. In such anomalies, the muscular or fibrotic nature of any intracavitary septum was assessed based on septal thickness more than on signal intensity at this level. MR diagnostic accuracy in 23 patients with Müllerian anomalies, compared with surgical, hysteroscopic, laparotomic and laparoscopic findings, was 100%. Nevertheless, if Müllerian duct anomalies responsible for gynecologic-obstetric problems are known or suspected, MRI should always be used, on the basis of a close gynecologist-radiologist collaboration, for classification agreement and the evaluation of any intracavitary septum morpho-biometric appearance and possibly nature, to discuss treatment options.

In uterine cervical canal carcinoma, the current clinical FIGO criteria often fail not only to differentiate stage IA2 from stage IB but also to demonstrate possible parametrial involvement. Moreover, the analysis of tumor volume and of the depth of neoplastic stromal invasion is not very reliable. The authors investigated MR accuracy in the definition of such variables: to this purpose, 24 patients with histologically confirmed endocervical adenocarcinoma were submitted to MRI, which was performed with an 0.5-T superconductive magnet. Sagittal and oblique transverse or sometimes coronal SE images, oriented so as to be perpendicular to longitudinal cervical major axis were obtained with T2 weighting (TR 1800 ms, TE 25-90 ms). MR data were correlated with pathologic findings. MR accuracy in demonstrating parametrial involvement was 92%, its sensitivity was 86% and specificity 97%. Volumetric MR data showed a high correlation (r = 0.970) with those derived from pathologic findings. In 92% of cases stromal invasion exceeded 5 mm. MRI, thanks to its high accuracy, should be included in diagnostic pretreatment protocols, even though FIGO criteria do not require it yet, especially in the presence of an endocervical adenocarcinoma. Moreover, the accurate definition of tumor volume can allow less extensive surgery with the same survival rates and fewer complications, which are frequently observed after radical hysterectomy.

The paper examines to treatment of 40 cases of urinary infections and compares the efficacy of pipemidic acid, norfloxacin, cinoxacin and ofloxacin. All these compounds demonstrated a good level of therapeutic efficacy, both in terms of management and effectiveness; in particular, norfloxacin and ofloxacin were preferable to the other compounds since they caused fewer side-effects.

The Authors describe a case of congenital diverticulum of hypopharynx in a newborn. The lesion, early recognised, is successfull treated with surgical removal by a transcervical approach. The revision of the literature confirms the extreme rarity of this affection in the newborn and the correlated mortality if not early diagnosed and then confused with an atresia of the oesophagus it often simulates whose symptomatology.

One hundred fifty sera from handlers of squirrel monkeys and 100 sera from individuals who had never handled monkeys were tested by immunofluorescence for antibodies reactive to structural proteins of Herpesvirus saimiri (HVS). Eleven (7.3%) of the occupationally exposed group and 4 (4%) of the noncontact group were seropositive for HVS by immunofluorescence assay, and 10 of these 15 (6.7 and 2%, respectively) were also seropositive for either the major glycoprotein (140 kD) or the major capsid protein (160 kD) of HVS by radioimmunoprecipitation assay. Two sera from handlers of squirrel monkeys, however, recognized many different HVS structural antigens by immunoprecipitation, and it seems unlikely that they could also be cross-reactive antibodies. Since these two sera did not contain antibodies to HVS early antigens or to the nonstructural antigens present in infected owl monkey kidney cells, and follow-up sera collected from the same individuals several months later were negative for antibodies to HVS, these individuals do not appear to have been infected by the virus. The risk that HVS poses to humans appears to be very low.

Introduction: Taekwondo elite athletes should have excellent qualities in several aspects of fitness, as well as peculiar pos- tural characteristics in terms of balance and postural control, to achieve the best possible results during competitions. Moreover, it is known that taekwondo shows high risk of injury. The aim of this case study is to evaluate the effects of a specific training pro- tocol on posturographic parameters of a taekwondo elite athlete in order to prevent the risk of injury. Materials and methods: The specific training protocol provided 2 months of general strength conditioning, which included pre-conditioning in the first 2 weeks, physical training to improve explosive strength, balance and postural control and athletic training to improve the combat technique. The experimental design included three assessment times: the pre-test (T0), the interme- diate-test (T1) and the post-test (T2). Each test provided the same evaluations: anthropometric measurements, cervical ROM assessment and posturographic evaluation. Results: Stabilometric parameters showed a good balance and postural control both in T0 and T2. Baropodometric parame- ters showed a physiological load pressure distribution between the left and the right foot in T0 (left foot 54% - right foot 46%) as well as in T2 (left foot 45% - right foot 55%). The left forefoot-rearfoot ratio pressure showed no differences between T0 and T2 (p>0.05); we found an improvement on the right forefoot-rearfoot ratio (p0.05) on rotation and lateral bending movements; we found an improvement on the exten- sion movement from T0 to T2 (p0.05). Conclusion: The presented case study showed that the experimental protocol improved the postural parameters of this taek- wondo elite athlete. We believe that other athletes may adopt this protocol in order to improve own sports performance and to pre- vent injuries.