Sagittal classification in adolescent idiopathic scoliosis: original description and therapeutic implications.

INTRODUCTION: Surgical treatment of AIS aims to correct the coronal and sagittal alignment of the spine. The global alignment of the spine may be normalized through reciprocal changes between the fused spine and adjacent segments. We propose a new classification system describing the specific sagittal patterns induced by AIS to define reproducible guidelines for the surgical strategy. METHODS: We analyzed 100 consecutive AIS patients aged between 12 and 18 years candidate for spinal fusion. The following parameters were measured and compared for each pattern: spino-pelvic parameters, magnitude and length of the lumbar sagittal angle, magnitude and length of the thoracic sagittal angles (T1T12 and T4T12 angles, TKmax), T10 L2 angle, C7 slope and C2C7 angle. RESULTS: Three parameters strongly differentiated the four patterns: thoracic sagittal angles (T1T12 and T4T12 angles, TKmax), T10 L2 angle and C7 slope. Less than half of the patients (44%) had a normal sagittal shape. Within, Type 2 characterized by thoracic hypokyphosis, Type 2a (thoracic hypokyphosis) were mostly Lenke type 1 or 2 curves, and type 2b (thoracic hypokyphosis with TL kyphosis) occurred specifically in double major or TL/L curves. Type 3 were two-curve sagittal shape with cervicothoracic kyphosis and TL lordosis (9%), mainly in Lenke 1 curves. DISCUSSION: This new classification summarizes all the pathological scenarios of the sagittal alignment of AIS into four patterns. A specific surgical planning can be extrapolated for each pattern. In type 1, the objective is to preserve the sagittal shape. In type 2, the objective is to restore thoracic kyphosis. In type 2b, TL junction should be straightened. In type 3, the objective is to reshape the lower arc of thoracic sagittal angle and straighten the TL junction. These slides can be retrieved under Electronic Supplementary Material.

The supramedullary cells of the teleost Coris julis (L.): a noradrenergic neuronal system.

This study, carried out on Coris julis (Labridae), is a contribution to the immunocytochemical characterization of fish supramedullary neurons. The significance of these giant cells has been debated since the beginning of the twentieth century. Our research provides the first evidence for a noradrenergic feature of this neuronal system. The possible role of supramedullary neurons as components of the autonomic nervous system is discussed. Moreover, the present results, taken together with our previous studies, surmise that this the first known case of colocalization of a neuropeptide (gastrin/CCK-like) and noradrenaline in the nervous system of teleosts.

Interactions of signaling pathways in ACTH (1-24)-induced cell shape changes in invertebrate immunocytes.

ACTH (1-24) induces cell shape changes in the immunocytes of the bivalve mollusc, Mytilus galloprovincialis. Using computer-assisted microscopic image analysis, we have found that the G protein antagonist suramin sodium, the adenylate cyclase inhibitor 2',5'-dideoxyadenosine, and the protein kinase inhibitor staurosporine inhibit this effect. The highly specific inhibitors H-89 (for protein kinase A) and calphostin C (for protein kinase C) only inhibited partially the morphological alterations. In contrast, the simultaneous action of H-89 and calphostin C completely blocked these changes. The above findings indicate that ACTH (1-24) induces cell shape changes in molluscan immunocytes via adenylate cyclase/cAMP/protein kinase A pathway, as well as the activation of protein kinase C.

PDGF and TGF-beta induce cell shape changes in invertebrate immunocytes via specific cell surface receptors.

The presence of PDGF receptor-alpha- and -beta- and TGF-beta-receptor (type II)-like molecules on the plasma membranes of the immunocytes of the mollusc Mytilus galloprovincialis was demonstrated by an immunocytochemical procedure. Furthermore, the present study provides evidence that PDGF-AB and TGF-beta1 provoke cell shape changes in immunocytes via interactions with the respective receptors and that these extracellular signals are transduced along the phosphoinositide signaling pathway.

PDGF- and TGF-beta-induced changes in cell shape of invertebrate immunocytes: effect of calcium entry blockers.

The cellular activity of hemocytes from the marine mollusc Mytilus galloprovincialis was studied using computer-assisted microscopic image analysis. PDGF-AB and TGF-beta 1 caused changes in cellular shape and induced the immunocytes to migrate in a chemotactic manner. The effect of PDGF-AB was more potent than that of TGF-beta 1, and the responses were dose-correlated for PDGF-AB, while they were dose-dependent up to 5 pg/ml for TGF-beta 1. Moreover, the PDGF-AB response was extracellular Ca(2+)-independent, while TGF-beta 1 was Ca(2+)-dependent.

Cytofluorometric evidence for differential genome endoreplication in the cluster neurons of Lophius piscatorius L. (Osteichthyes, Lophiiformes).

Quantitative microfluorometric evaluation indicated that, in Lophius piscatorius, the DNA content of large neurons of a cluster located at the boundary between the medulla oblongata and the spinal cord varied from 4C to more than 5000C. This finding must be considered exceptional for the nervous system of Vertebrates. DNA contents were correlated to both nuclear and animal size. Utilization of AT and GC specific fluorochromes showed that the increase in DNA content is due to differential genome amplification involving GC-rich DNA sequences.