Compartment syndrome causes systemic inflammation in a rat.

AIMS: Compartment syndrome results from increased intra-compartmental pressure (ICP) causing local tissue ischaemia and cell death, but the systemic effects are not well described. We hypothesised that compartment syndrome would have a profound effect not only on the affected limb, but also on remote organs. METHODS: Using a rat model of compartment syndrome, its systemic effects on the viability of hepatocytes and on inflammation and circulation were directly visualised using intravital video microscopy. RESULTS: We found that hepatocellular injury was significantly higher in the compartment syndrome group (192 PI-labelled cells/10(-1) mm(3), standard error of the mean (sem) 51) compared with controls (30 PI-labelled cells/10(-1) mm(3), sem 12, p < 0.01). The number of adherent venular white blood cells was significantly higher for the compartment syndrome group (5 leukocytes/30s/10 000 µm(2), sem 1) than controls (0.2 leukocytes/30 s/10 000 µm(2), sem 0.2, p < 0.01). Volumetric blood flow was not significantly different between the two groups, although there was an increase in the heterogeneity of perfusion. CONCLUSIONS: Compartment syndrome can be accompanied by severe systemic inflammation and end organ damage. This study provides evidence of the relationship between compartment syndrome in a limb and systemic inflammation and dysfunction in a remote organ. Cite this article: Bone Joint J 2016; 98-B:1132-7.

Contribution of inflammation to cellular injury in compartment syndrome in an experimental rodent model.

Compartment syndrome, a devastating consequence of limb trauma, is characterised by severe tissue injury and microvascular perfusion deficits. We hypothesised that leucopenia might provide significant protection against microvascular dysfunction and preserve tissue viability. Using our clinically relevant rat model of compartment syndrome, microvascular perfusion and tissue injury were directly visualised by intravital video microscopy in leucopenic animals. We found that while the tissue perfusion was similar in both groups (38.8% (standard error of the mean (sem) 7.1), 36.4% (sem 5.7), 32.0% (sem 1.7), and 30.5% (sem 5.35) continuously-perfused capillaries at 45, 90, 120 and 180 minutes compartment syndrome, respectively versus 39.2% (sem 8.6), 43.5% (sem 8.5), 36.6% (sem 1.4) and 50.8% (sem 4.8) at 45, 90, 120 and 180 minutes compartment syndrome, respectively in leucopenia), compartment syndrome-associated muscle injury was significantly decreased in leucopenic animals (7.0% (sem 2.0), 7.0%, (sem 1.0), 9.0% (sem 1.0) and 5.0% (sem 2.0) at 45, 90, 120 and 180 minutes of compartment syndrome, respectively in leucopenia group versus 18.0% (sem 4.0), 23.0% (sem 4.0), 32.0% (sem 7.0), and 20.0% (sem 5.0) at 45, 90, 120 and 180 minutes of compartment syndrome in control, p = 0.0005). This study demonstrates that the inflammatory process should be considered central to the understanding of the pathogenesis of cellular injury in compartment syndrome.

Monitoring of tritium, 60Co and 137Cs in the vicinity of the warm water outlet of the Paks Nuclear Power Plant, Hungary.

Danube water, sediment and various aquatic organisms (snail, mussel, predatory and omnivorous fish) were collected upstream (at a background site) and downstream of the outlet of the warm water channel of Paks Nuclear Power Plant. Gamma emitters, tissue free-water tritium (TFWT) and total organically-bound tritium (T-OBT) measurements were performed. A slight contribution of the power plant to the natural tritium background concentration was measured in water samples from the Danube section downstream of the warm water channel. Sediment samples also contained elevated tritium concentrations, along with a detectable amount of (60)Co. In the case of biota samples, TFWT exhibited only a very slight difference compared to the tritium concentration of the Danube water, however, the OBT was higher than the tritium concentration in the Danube, independent of the origin of the samples. The elevated OBT concentration in the mollusc samples downstream of the warm water channel may be attributed to the excess emission from the nuclear power plant. The whole data set obtained was used for dose rate calculations and will be contributed to the development of the ERICA database.

Voice quality improvement after management of unilateral vocal cord paralysis with different techniques.

The aim of this study was to objectively evaluate the voices of patients suffering from unilateral vocal cord paralysis, before and after endoscopic augmentation and thyroplasty. In the past, we used injectable Teflon to treat this condition; later techniques included collagen injection and Isshiki thyroplasty. In the last 7 years, preferred treatment methods have included Bioplastique injection and lipoaugmentation of the vocal cords as well as medialization thyroplasty using a titanium implant according to Friedrich. Pre- and postoperative data was evaluated and compared to 25 patients. Appropriate glottic closure of the vocal cords was achieved in every case, in most cases after the first intervention. We used voice range profile measurements to evaluate the results. An objective evaluation was performed using the Friedrich dysphonia index. Significant improvements were found: the dysphonia index decreased in every case, from an average of 2.47, preoperatively, to an average of 1.18 postoperatively. In agreement with earlier studies, voice pitch range was the only parameter that not significantly improved. There was no statistical difference between the lipoaugmentation and thyroplasty according to Friedrich. We concluded that both endoscopic methods and thyroplasty can be used to achieve an optimal result. Cases must be evaluated individually so that the best technique, or combination of methods can be determined.

Therapy of periprosthetical leakage with tissue augmentation using Bioplastique around the implanted voice prosthesis.

Having a voice prosthesis provides a good possibility for speech rehabilitation after total laryngectomy has been performed, especially if common complications such as leakage around the valve can be reduced effectively. The early applications of a voice prosthesis-which was originally invented and applied by Mozolewski in 1972, was further developed by Blom and Singer and became an internationally available implantable instrument by 1980- already made clear not only the typical benefits, but also the complications, such as possible leakage around the implanted valve. Remacle proposed the injection of collagen into the surrounding tissues in order to stop leakage. Knowing that collagen is usually resorbed as time goes by, new substances that can be tolerated by human tissues must be found. This article reports the experiences of the authors in the search for such an injectable material that cannot be resorbed and does not migrate. In order to solve the above-mentioned problem, Lichtenberger introduced the injection of Bioplastique into the perivalvular tissues. This delivered the best results ever achieved in this field at our department. During the past 2 years, Bioplastique augmentation was performed for seven laryngectomized and speech-rehabilitated patients in order to reduce periprosthetical leakage. All procedures were successful in terms of either eliminating or reducing the leakage, and also the non-resorbable property of Bioplastique has been proven.

Evaluation of the lung function test in reversible glottis-dilating operations.

Our aim was to obtain an objective evaluation of the airway before and after reversible glottis-dilating operations using the lung function test. Bilateral abductor vocal cord paralysis remains mostly a complication of thyroid surgery. After thyroid surgery, the paralysis is potentially reversible, and the patient has a chance for recovery mostly in the first 6 months. According to these considerations, a reversible vocal cord laterofixation procedure was used instead of tracheostomy. The operations were performed endoscopically using high-frequency JET ventilation and the special endo-extralaryngeal suture technique by Lichtenberger. This technique was used in 92 cases. The pre- and postoperative data of reversible glottis-dilating techniques could be compared in 23 non-selected patients. Lung function tests that were performed were forced inspiratory volume (FIV1), forced expiratory volume (FEV1), peak inspiratory flow rate (PIF), peak expiratory flow rate (PEF) and resistance of the airways (Raw). For the evaluation of the functional results, we used the body-pletysmograph. Our aim was to obtain a quantitative evaluation of the results. These values allow us to compare the results achieved by using different glottis-dilating methods. The FEV1 (forced expiratory volume) improved 25%, and the FIV1 (forced inspiratory volume) improved 39% after the operations on average. PEF (peak expiratory flow rate) and PIF (peak inspiratory flow rate) improved 37 and 45% after glottis-dilating surgery on average. The Raw (resistence of airways) was 271.5% on average before the operations, and after reversible glottis-dilating operations decreased to a level of 200.6%.

Cotransfection of heme oxygenase-1 prevents the acute inflammation elicited by a second adenovirus.

The acute inflammatory response elicited by adenovirus vectors results in loss of gene expression and tissue injury in the target organ. This acute inflammation is now believed to be the major limiting factor for the use of adenovirus vectors in gene therapy. While exploring the level of acute inflammation caused by the adenovirus encoding the gene for the anti-inflammatory enzyme heme oxygenase-1, we discovered that this adenovirus not only did not elicit acute inflammation, but could prevent the inflammation caused by a second adenovirus. Here we describe a new approach to gene therapy, which uses the encoding of the potent anti-inflammatory enzyme heme oxygenase-1 to prevent early host inflammatory responses normally associated with adenovirus vectors.

[Screening of sexually transmitted diseases (Mycoplasma hominis, Ureaplasma urealyticum and Chlamydia trachomatis) in young women]. / Szexuálisan közvetített (STD) betegségek (Mycoplasma hominis, Ureaplasma urealyticum és Chlamydia trachomatis) szürése fiatal nök körében.

The author searched for sexually transmitted Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis infection among young females under 30. Out of the 400 women examined (including 86 primigravidas) 46 percent, and out of the pregnant women 52.3 percent proved to be colonized by one of the above pathogens. 11 percent carried Mycoplasma hominis, 44.75 percent Ureaplasma urealyticum and 7.75 percent Chlamydia trachomatis. Positivity was more frequent among those having several partners and those not using condoms regularly. The author thinks the pathogen infection rate found can be one of the main causes of urogenital inflammations, fertility problems and premature deliveries. Due to the earlier and earlier start of sexual lives, more effective sanitary/sexual education will be needed.

Survey of obesity in child communities.

Authors conducted the weight-height measurements of 12,751 children in the district of Monor on the basis of the IW/AH index and found 705 obese children. Childhood obesity rate of the district was 5.53%. The questionnaires sent to the affected children's families revealed diabetes in the families of 784 children, 66 of whom were obese, which is 8.4% - much higher than the populations's value. The highest obesity rate was found in puberty, while in children with a family background for diabetes this value was found in 14-18 years of age. The groups investigated are given special nursing. Authors express thanks to all the persons who contributed to carry out the measurements.