ABSTRACT
Rheumatoid arthritis (RA) and osteoarthritis (OA) are chronic diseases associated with morphological joint changes. Synovial membrane (SM) involvement was established for RA, but the data for OA are limited, because OA is usually regarded as noninflammatory disease. Changes in immune system in RA are not limited to joints, and the significant role of T cells of peripheral blood (PB) is not disputable. However, there is still an open debate about PB immunological profile in OA. Therefore, we decided to measure the distribution of CD4+ and CD8+ T cells, regarding CD28 expression, both in PB and SM of RA and OA patients, on the same day. Altogether, eleven RA patients, 11 OA patients and similar numbers of age-matched healthy controls were included into the study. Flow cytometry was used for T cells subpopulation distinguishing and quantification; monoclonal antibodies against CD3, CD4, CD8 and CD28 with different fluorochromes were used for stainings. The RA patients had significantly higher percentage of CD3+4+ cells in PB as compared to OA patients and relevant control group. Both within the CD4+ and CD8+ compartments, significantly lower percentages of cells bearing the CD28 marker were found in the PB of OA as compared to RA patients. The proportion of CD3+CD4+ cells in SM was dependent on age of OA patients, older OA patients had significantly higher value of their SM/blood ratio than RA patients. Older OA subjects were also characterized by higher values of the SM/blood ratio of both CD4+CD28+ and CD8+CD28+ subpopulations than RA or younger OA patients. In conclusion, in contrast to the traditional view of OA disease, our results give support to the hypothesis that OA may also (like RA) be a disease with a local immunological involvement.
Subject(s)
Arthritis, Rheumatoid , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Osteoarthritis , Synovial Membrane , Adult , Aged , Aged, 80 and over , Arthritis, Rheumatoid/immunology , Arthritis, Rheumatoid/pathology , CD4-Positive T-Lymphocytes/cytology , CD8-Positive T-Lymphocytes/cytology , Female , Humans , Male , Middle Aged , Osteoarthritis/immunology , Osteoarthritis/pathology , Synovial Membrane/cytology , Synovial Membrane/immunology , T-Lymphocyte Subsets/cytology , T-Lymphocyte Subsets/immunologyABSTRACT
We evaluated 5 patients who had soft tissue sarcoma of the extremity treated by limb sparing surgery. All tumors were adjacent to bone, with no features of infiltration. According to the Surgical Staging System, all tumors were IIB. The mean follow-up was 13 months. To achieve wide resections of the tumors in such cases we recommend resections of the tumor with part of the bone, which is in direct contact with the tumor. Wide resection margins were achieved in all patients and none had local recurrence during the observation period.
Subject(s)
Extremities/surgery , Sarcoma/surgery , Soft Tissue Neoplasms/surgery , Adolescent , Adult , Aged , Female , Humans , Middle Aged , Sarcoma/pathology , Soft Tissue Neoplasms/pathology , Time Factors , Treatment OutcomeABSTRACT
Complete acromioclavicular separation is frequent injury during practice of judo. Fourteen athletes aged 17-33 (mean 23) were treated non-operatively. All patients received cryotherapy and Velpeau bandage for two weeks, intensive rehabilitation of the shoulder followed. The patients were reviewed after mean 4.5 years (range 3-7 years). A 100-point scale designed specifically for this study, inclusive of pain, function, strength, range of motion and return to preinjury level of sports activity was used for clinical assessment. Follow-up radiographs were compared to those taken immediately after injury but no correlation with clinical results has been found. Eight results were rated excellent (90-100 points), 5 results good (80-89 points) and one result was fair (70-79 points). Short period of immobilization and early rehabilitation seems to be efficient management in highly active individuals.
Subject(s)
Acromioclavicular Joint/injuries , Martial Arts , Shoulder Dislocation/therapy , Sports , Acromioclavicular Joint/diagnostic imaging , Acute Disease , Adolescent , Adult , Female , Follow-Up Studies , Humans , Injury Severity Score , Male , Radiography , Retrospective Studies , Shoulder Dislocation/diagnostic imagingABSTRACT
Eight patients with acute, grade III acromioclavicular dislocation were treated by closed reduction and fixation with Kirschner wires introduced through the acromion into distal end of the clavicle. Desault plaster cast was discarded and K-wires removed after 6 weeks (in 3 patients after 4 weeks due to loosening). Minimum follow-up was 2 years. Patients were assessed with a 100 points scale of Kawabe et al., initial and final radiographs were compared. Four results were rated excellent (between 90 and 100 points), 3 results good (between 80 and 89 points) and in one case result was fair. Normal anatomy of acromioclavicular joint has been found in 75% of patients. Partial loss of reduction was found in two patients. It has been concluded, that closed reduction and fixation with Kirschner wires is simple, barely invasive method of treatment for acromioclavicular dislocation and gives good final results.
Subject(s)
Clavicle/injuries , Clavicle/surgery , Muscle, Skeletal/surgery , Shoulder Dislocation/surgery , Acute Disease , Adult , Female , Follow-Up Studies , Humans , Internal Fixators , Male , Muscle, Skeletal/injuries , Retrospective Studies , Treatment OutcomeABSTRACT
A case of 10 years old boy with foot skin loss due to the traffic accident is presented. Free vascularized skin flap from scapular area has been used. The healing was uneventful. Advantages and disadvantages of this type of flap have been discussed.
