Comparison of two commercial ELISA kits for serological monitoring of avian encephalomyelitis in a reproductive turkey flock.

Avian encephalomyelitis (AE) is a viral disease of poultry. Although the disease has a milder clinical course in turkeys than in chickens, reproductive flocks of turkeys are vaccinated against AE. Commercial AE ELISA kits are specifically designed for chickens, which makes it difficult to implement these tests in serological monitoring of turkey flocks. The aim of the study was to compare the AE serological results provided by two ELISA kits from different producers when testing an AE-vaccinated flock of turkey hens and their progeny. We detected differences in the sensitivity of the ELISAs for testing specific anti-AE antibody levels in turkey serum samples.

The effect of diet enriched with rapeseed meal on endogenous thiouracil contents in urine of calves.

Thiouracil (TU) is a representative of a group of thyreostatics, orally active drugs that can be used to increase the weight of cattle before slaughter. The use of thyreostats in animal production has been banned in the European Union since 1981. Systematic detection of low concentrations of thiouracil in the urine of livestock is acknowledged to be of endogenous origin due to the use of Brassicaceae plants in the animal diet. The purpose of the study was to determine the effect of diet enriched with rapeseed meal on endogenous thiouracil contents in urine of calves. Two groups of calves of different age were subjected to a rapeseed-supplemented diet. First group (n = 6, 6 months) received a maximum authorized content of rapeseed meal (30%) in diet, second (n = 2, 2 months) after adaptation to solid food and rapeseed, has been subjected to a diet exceeding the maximum recommended dose of rapeseed of 10%. During the experiments, samples of urine and faeces were collected and analyzed by using the accredited LC-MS/MS method. The diet with allowed content of rapeseed did not influenced on concentration of endogenous thiouracil in calves' urine (

The position of a duodenal diverticulum in the area of the major duodenal papilla and its potential clinical implications.

BACKGROUND: Although duodenal diverticula are associated with less frequent pathology than the colonic diverticula in the large intestine, their periampullary position may have significant clinical implications. The aim of the study was to identify any possible correlation between the type of localisation of the major duodenal papilla, duodenal diverticula, and some particular clinical issues. MATERIALS AND METHODS: In total, 628 patients (408 females and 220 males; aged 21-91 years), who underwent endoscopic retrograde cholangiopancreatography were included in this study. The patients were divided into two groups: a study group comprising 66 (10.5%) patients with periampullary position of diverticula (group A), and a control group comprising 562 (89.5%) patients without diverticula (group B). RESULTS: A duodenal diverticulum was diagnosed in the periampullary position in 66/628 (10.5%) patients: 41 women (aged 52-91 years) and 25 men (aged 54-83 years). CONCLUSIONS: Three types of localisation were observed for the major duodenal papilla with regard to the diverticula, with the most common type being next to each other (type III). In patients with diverticula, similar frequencies of gallstone occurrence are observed in men and women. Patients with papilla in the diverticulum who underwent cholecystectomy are more prone to develop lithiasis.

Diagnóstico de la infección por Treponema pallidum en pacientes con sífilis temprana y neurosífilis mediante reacción de la polimerasa en cadena / Laboratory diagnosis of Treponema pallidum infection in patients with early syphilis and neurosyphilis through a PCR-based test

Syphilis is a sexually transmitted disease caused by Treponema pallidum. The diagnosis is based mainly in clinical presentation and non-specific assays. PCR-based diagnosis has been suggested as an attractive alternative method. The aim of this study was the validation of a PCR-based test for the diagnosis of early syphilis (ES) and neurosyphilis (NS). Clinical samples of mucocutaneous lesions and cerebrospinal fluid (CSF) specimens from patients previously diagnosed for ES and NS respectively using an enlarged gold standard, were tested by PCR. The reaction was done using primers targeting the tpN47gene. Twenty out of 21 mucocutaneous samples from patients diagnosed with ES were positive by PCR, with a clinical sensitivity of 95 percent. Four out of 8 CSF samples from patients previously diagnosed with NS were positive by PCR, with a clinical sensitivity of 50 percent. The clinical specificity for both ES and NS was 100 percent. The PCR sensitivity and specificity for mucocutaneous samples allowed us to implement this assay in our laboratory for routine diagnosis. Although the sensitivity of the PCR in CSF was low, it may be useful to support clinical diagnosis.

La sífilis es una enfermedad de transmisión sexual producida por Treponema pallidum, cuyo diagnóstico se realiza presuntivamente basándose en aspectos clínicos y análisis de especificidad limitada. La reacción de la polimerasa en cadena (RPC) ha sido planteada como una alternativa diagnóstica de mayor sensibilidad y especificidad. El objetivo de este trabajo fue validar una RPC para el diagnóstico de sífilis temprana (ST) y neurosífilis (NS). Se utilizaron muestras de lesiones muco-cutáneas y de LCR de pacientes con sospecha de cursar ST y NS respectivamente, previamente diagnosticados, utilizando un estándar de oro ampliado. La RPC fue realizada con partidores dirigidos al gen tpN47. De las 21 muestras de pacientes con ST, la RPC resultó positiva en 20, lo que resulta en una sensibilidad clínica de 95 por ciento. De las 8 muestras de pacientes con NS, la RPC resultó positiva en 4, obteniéndose una sensibilidad clínica de 50 por ciento. La especificidad clínica para ST y NS fue de 100 por ciento. La excelente sensibilidad y especificidad de la RPC para muestras muco-cutáneas permitió la exitosa implementación de este análisis en nuestro laboratorio para el diagnóstico de rutina. Si bien la sensibilidad de la RPC en LCR es baja, es muy útil para apoyar el diagnóstico clínico.

Whole-body cryostimulation in kayaker women: a study of the effect of cryogenic temperatures on oxidative stress after the exercise.

AIM: The aim of this study was to determine the effect of whole-body cryostimulation on the activity of selected antioxidant enzymes and the concentration of lipid peroxidation products in kayaker women in the course of training. METHODS: The study was performed on the group of 9 kayaker women, who underwent two training cycles: one typical ten-day training cycle and the another ten-day cycle preceded by cryostimulation sessions twice a day. The activity of antioxidant enzymes was assayed in erythrocytes, while the concentration of lipid peroxidation products was measured both in erythrocytes and in blood plasma. RESULTS: A statistically significant increase in superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity in erythrocytes and in concentration of conjugated dienes (CD) in blood plasma and erythrocytes and thiobarbituric acid reactive substances (TBARS) in plasma was revealed in kayaker women after the first six days of training without cryostimulation. Comparing two performed training cycles, after the first six days of training preceded by cryostimulation lower SOD and GPx activity in erythrocytes was detected, as well as lower CD levels in blood plasma and erythrocytes and lower TBARS concentration in blood plasma of kayaker women than after the six days of training without cryostimulation. CONCLUSIONS: Whole-body cryostimulation improves the antioxidant capacity of organism exposed to intense exercise. Brief application of cryogenic temperatures is likely related to the activation of adaptive homeostatic mechanisms in accordance with the hormetic dose-response model.

The effect of combined therapy on activity of cathepsin D and alpha-1-antitrypsin in the blood serum of women with cervical cancer.

PURPOSE OF INVESTIGATION: The aim of the study was to determine the activity of cathepsin D (CTSD) and alpha-1-antitrypsin (AAT) in the blood serum of women with cervical carcinoma treated with different modes of therapy. METHODS: The study was conducted on 68 women suffering from carcinoma of the uterine cervix, that were irradiated intracavitarily by a Selectron LDR brachytherapy unit. Additionally, all patients were treated with different therapy methods according to clinical stage. RESULTS: In women with cervical cancer, CTSD activity was higher while AAT activity was lower both before and after brachytherapy sessions as compared to controls. Six months after the end of therapy, the activity of CTSD and AAT reverted back to the values characteristic for healthy women. CONCLUSION: The estimation of cathepsin D and alpha-1-antitrypsin activity during the course of cervical cancer management may be useful in early detection of potential recurrence and/or widespread metastasis formation.

Influence of the management of cervical carcinoma on the activity of catalase and glutathione peroxidase in erythrocytes.

PURPOSE OF INVESTIGATION: The aim of the study was to determine the effect of different types of management on the activity of catalase (CAT) and glutathione peroxidase (GPx) in women with cervical carcinoma. METHODS: The patients were divided into three groups according to the mode of treatment. Patients from the first group were treated brachytherapy prior to surgery. The second group received teletherapy before brachytherapy and additionally chemotherapy. The third group was treated with teletherapy after brachytherapy sessions. RESULTS: CAT activity was higher while GPx activity was lower before and during therapy in all groups as compared to controls. Six months after the end of therapy, the activity of studied enzymes reached the values characteristic of healthy women. No significant differences in enzyme activity among the three groups were revealed. CONCLUSION: Normalization of CAT and GPx activity may prove the efficacy of applied therapy in cervical cancer patients, however enzyme activity recovery was not dependent on treatment mode.

Activity of cathepsin D and alpha(1)-antitrypsin in the blood serum of patients with mammary carcinoma.

UNLABELLED: THE AIM of this study was to determine the activity of cathepsin D and alpha(1)-antitrypsin in the blood serum of patients with mammary carcinoma. PATIENTS AND METHODS: The study was conducted on 52 women operated for a unilateral breast tumor, divided into two groups, according to the number of metastases and tumor size. Cathepsin D activity was determined using the method of Anson, while alpha(1)-antitrypsin activity was determined according to the Eriksson method. RESULTS: Both groups of patients with mammary carcinoma were found to have higher activity of cathepsin D before the treatment compared to healthy females. After the surgery the enzyme activity increased significantly, whereas 6 months after the surgery it generally decreased. The activity of alpha(1)-antitrypsin was significantly lower in patients before the treatment than in the controls, while after 6 months an increase in alpha(1)-antitrypsin activity was observed. The correlation between activity of cathepsin D and alpha(1)-antitrypsin was revealed. High enzyme activity and low alpha(1)-antitrypsin activity may result from the stage of neoplastic transformation. CONCLUSION: The determination of cathepsin D activity together with alpha(1)-antitrypsin activity may serve as useful biochemical marker in monitoring of malignant changes in breast tumor.

Activity of superoxide dismutase (SOD) and concentration of thiobarbituric acid reactive substances (TBARS) in liver and muscles of some fish.

In this study we examined superoxide dismutase (SOD) activity and thiobarbituric acid reactive substances (TBARS) concentration in liver and muscles of four fish species: the carp, the brown trout, the white cod and the flounder. Higher SOD activity and higher TBARS concentration was revealed in the tissues of marine fish in comparison to freshwater fish. The highest SOD activity was observed in the cod while the highest TBARS concentration was in the flounder. The observed differences are probably an effect of the different living mode of the compared fish.

Activity of antioxidant enzymes and concentration of lipid peroxidation products in selected tissues of mice of different ages, both healthy and melanoma-bearing.

The activity of antioxidant enzymes and the concentration of the lipid peroxidation product malondialdehyde (MDA) as indicator of oxidative damage were determined in selected tissues of healthy mice and transplanted B16 melanoma-bearing mice with increasing age. A total of 60 male mice were divided into 6 groups. Groups 1, 2 and 3 consisted of tumor-free, healthy mice aged 1, 9 and 16 months, respectively (average life span: 2 years). Groups 4, 5 and 6 consisted of mice of the same age as the healthy mice, but given intraperitoneally 10(6) cells of B16 melanoma for 2 weeks. An increase in the concentration of MDA was found in all the studied tissues (brain, liver, lungs, erythrocytes) and blood plasma of 16-month old healthy mice compared with the younger ones. The activity of superoxide dismutase (SOD) and catalase (CAT) was elevated in the brain and the activity of CAT and glutathione peroxidase (GPx) in the liver of aged healthy mice. The transplantation of melanoma caused an increase of the concentration of MDA and of the activity of all studied enzymes in all tissues. This elevation was most pronounced in the youngest mice group 4 and was higher than in the oldest healthy group 3. Thus, these early changes of the "(anti-)oxidative status" in the investigated tissues caused by the tumor development have similarities with age-associated alterations of healthy mice, especially in regard to MDA in all tissues or SOD and CAT in brain.

Lipid peroxidation and antioxidant capacity in selected tissues of healthy black C57BL/6J mice and B16 melanoma-bearing mice.

During the process of melanogenesis free radicals are generated. The aim of this study was to investigate the effects of melanogenesis in B16 melanoma on lipid peroxidation and antioxidant capacity in selected tissues of black C57BL/6J mice. The study was conducted on 24 mice: 12 healthy controls and 12 with a transplanted B16 melanoma. Two weeks after the melanoma transplant, when the average weight of the tumours was approximately 2.0 g, blood samples were taken from the orbital venous plexus. The mice were killed by dislocation of the spinal cord, and the brain, liver and lungs were removed for analysis. The level of thiobarbituric acid-reactive substances (TBARS) and of 1,1-diphenyl-2-picrylhydrazyl (DPPH) reactive substances were determined in full liver, lung and brain homogenates and in serum. The activity of superoxide dismutase (SOD) was determined only in homogenized tissue. The concentration of TBARS and the SOD activity were statistically significantly higher in all the studied tissues from mice with B16 melanoma than in tissues from healthy mice. The antioxidant capacity, however, was lower in the tissues of melanoma-bearing mice. The results obtained demonstrate an increase in oxidative stress in the tissues of mice bearing a transplanted B16 melanoma.

Activity of antioxidant enzymes and concentrations of thiobarbituric acid reactive substances (TBARS) in melanotic and amelanotic Bomirski melanoma tissues in the golden hamster (Mesocricetus auratus, Waterhouse).

The activity of superoxide dismutase (SOD) and glutathione peroxidase (GSHPx), as well as the concentration of thiobarbituric acid reactive substances (TBARS) in tissues of transplantable melanoma in the golden hamster were measured and compared. Ten inbred male hamsters were used for the experiment. They were divided into two groups and were given Bomirski melanoma cells subcutaneously. The first group was given melanotic (Ma) melanoma cells. The second group was given amelanotic (Ab) melanoma cells. Thirty days after the transplantation the hamsters were dissected and the tumor tissues were taken and homogenized. A statistically significantly higher activity of the measured antioxidant enzymes was found in homogenates of Ma tumor than in homogenates of the Ab tumor. Activity of SOD is 8% higher in melanotic melanoma, 24% higher in CAT, and 45% higher in GSHPx. Statistically significant differences between TBARS concentrations were not confirmed. The higher activity of antioxidant enzymes in the melanotic tumor is a result of increased generation of oxygen-derived free radicals. It is presumed that it is strictly connected with intensified production of quinone and semiquinone radicals in the process of melanogenesis.

Evaluation of selected parameters of the inflammatory response to endoscopic retrograde cholangiopancreatography.

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is a well-established method in diagnosis and management of biliary and pancreatic diseases. The procedure carries the risk of serious complications; the most common is pancreatitis. The severity of ERCP-related pancreatitis largely depends on the inflammatory response to the procedure. AIMS: The aim of our study was to evaluate the inflammatory response after diagnostic and therapeutic ERCP based on monitoring of plasma concentration of the following substances: amylase, lipase, white blood cells, interleukin 6 (IL-6), C-reactive protein (CRP), hydrogen peroxide, malonylodialdehyde (MDA), and conjugated dienes (CD). METHODOLOGY: The study was performed on 40 patients who were divided into two groups according to the procedure performed: Group1-28 patients after ERCP with endoscopic sphincterotomy (ES) and Group 2-12 patients after diagnostic ERCP. The parameters were measured before ERCP and 2, 24, and 48 hours after the procedure. RESULTS: After diagnostic and therapeutic ERCP, the increase in plasma concentration of amylase, lipase, IL-6, and CRP were observed. Acute pancreatitis developed in three of the patients from group 1. The increase in lipase and CRP concentration was significantly higher after therapeutic ERCP with ES than after the diagnostic procedure. Asymptomatic hyperamylasemia and hyperlipasemia occurred more often after therapeutic than diagnostic ERCP. A positive correlation between the increase of IL-6 and CRP concentration was found. After uncomplicated diagnostic or therapeutic ERCP, no increase of reactive oxygen species and lipid peroxidation products was observed. CONCLUSION: Diagnostic ERCP stimulates a systemic inflammatory response, the intensity of which is magnified after ES. After uncomplicated ERCP, the balance between oxidative and anti-oxidative mechanisms is retained.

Enhanced lipid peroxidation processes in patients after brain contusion.

Erythrocyte superoxide dismutase (SOD-1) activity and cerebrospinal fluid (CSF), blood plasma low-density lipoprotein (LDL) and erythrocyte thiobarbituric acid reactive substance (TBARS) concentrations were determined in 30 patients with brain contusion and in 37 control patients with low back pain due to noninflammatory degenerative lumbar disc disease. In comparison to controls, during 10-day follow-up patients with brain contusion had significantly increased erythrocyte SOD-1 activity and CSF, blood plasma (LDL), and erythrocyte TBARS concentrations. The highest CSF TBARS concentrations were observed in five patients who died 2, 7, or 8 days following head injury. A significant negative correlation was found between erythrocyte SOD-1 activity or TBARS concentrations, in the blood plasma LDL fraction and erythrocytes, and The Glasgow Coma Scale score. These results suggest that enhanced lipid peroxidation processes, which seem to correlate with the severity of head injury, accompany brain contusion.

Effect of novel platinum complexes on survival rate of B16 and Cl S91 melanoma cells and oxidation stress in vitro.

BACKGROUND: The aim of study was the assessment of two novel platinum complexes and their cytotoxic effect on murine melanoma cells. The evaluation of possible oxidation stress in neoplastic cells coexistent with the effect of these cytostatic agents. MATERIAL AND METHODS: Two lines of murine metastatic melanomas: B16 and Cl S91 were selected for the experiments. Two platinum compounds were tested: cis-dichloro(dimethylsulphoxide)(1-beta-D-ribofuranosyl-1,2,4-triazol-3-carboxyamide)platinum (II) called Pt-complex 1 and chloro(dimethylsulphoxide)(1-beta-D-ribofuranosyl-1,2,4-triazol-3-carboxyamide)platinum (II) called Pt-complex 2. Melanoma cells were incubated for 24 hours with the platinum complexes mentioned above and culture medium at the concentration of 0.01, 0.05 and 0.5 mg/ml. Survival rate of melanoma cells, superoxide dismutase (SOD) activity, the concentration of thiobarbituric acid reactive substances (TBARS) and the content of conjugated dienes were estimated. RESULTS: A number of statistically significant relationships between analysed parameters were observed. Negative correlation ratios were found between increasing levels of analysed platinum complexes and the survival rate of the cells of both melanoma lines as well as between the survival rate of Cl S91 melanoma cells and the level of lipid peroxidation products and SOD activity. On the other hand, there was a positive correlation between increasing platinum complexes and the level of lipid peroxidation products as well as between the survival rate of B16 melanoma cells and SOD activity and the content of CD. CONCLUSIONS: Oxygen free radicals may play an important role in the development of melanoma and cytostatic agents disturb the balance between generation and removal of reactive oxygen forms in melanoma cells.

[Endothelin in the plasma and cerebrospinal fluid of patients after head injury]. / Endotelina w osoczu i plynie mózgowo--rdzeniowym chorych po urazie glowy.

UNLABELLED: Endothelin (ET) is identified as a potent vasoconstrictor peptide. It can cause a cerebral vasospam after subarachnoid hemorrhage. Its long-lasting vasoconstricting activity has been well documented. The role of ET in response to head injury is not clear. ET can participate in astrocyte activation and oxidative stress after trauma. The aim of this presentation was to investigate ET in the plasma and cerebrospinal fluid of patients after head injury and estimation of relation between the ET csf level and clinical condition of the patients and also relation of ET csf level and changes in the CT-scan and usefulness of ET as independent prognostic factor. We examined 30 patients at Day 1 after trauma (28 male, 2 female, aged 19-34 y, mean 30, 4, GCS ranged 8-15). CT-examination showed post-traumatic changes in 19 cases (11 with brain edema only, 8 with brain contusion). We measured ET by immunoenzymatic method using standard kits (Biomedica). The ET plasma level reached 1.12 +/- 0.63 fmol/ml (in the control group--0.44 +/- 0.19 fmol/ml) and c ET csf level 1.03 +/- 0.49 (in the control group--0.07 +/- 0.09 fmol/ml). W confirmed the correlation between the ET level and patients consciousness (by GCS) (p < 0.01). The ET csf level was highest in the patients with brain contusion in CT-scan (p < 0.02). Using multivariate analyses, we showed that ET can be used as a prognostic factor of results of treatment (p < 0.02). CONCLUSIONS: The ET level is elevated in the plasma of patients after head injury. ET is also present and strongly elevated in the cerebrospinal fluid of the same patients. The ET level in cerebrospinal fluid is associated with clinical condition of patients and elevated in cases with brain edema and structural brain damage. The ET level in cerebrospinal fluid is related to post-traumatic changes of the brain such as oedema and structural damage present in the CT-scan. ET can be used as a prognostic factor of results of treatment.

[Von Willebrand factor in patients with subarachnoid hemorrhage]. / Czynnik von Willebranda u chorych z krwotokiem podpajeczynówkowym.

UNLABELLED: Von Willebrand factor (vWF) plays an important role in the coagulation system. It affects platelet aggregation in the place of vessel endothelium damage. The importance of vWF in cerebrovascular disease is not clear. The aim of this presentation was to evaluate the vWF level in the plasma and cerebrospinal fluid of patients after subarachnoid hemorrhage including cases with cerebral vasospasm and cerebral infarct. We investigated 66 patients (38 persons graded I-III H&H and 28 persons graded IV H&H). The control group consists of 8 subjects. VWF was measured by ELISA method using standard kit Asserachrom (Boehringer). The vWF level in the plasma reached 288.81 +/- 99.66% (in the control group, 98.84 +/- 14.53%) without significant differences regarding clinical condition of patients. In the cerebrospinal fluid the vWF level was significantly different in I-III H&H patients and in IV H&H patients (1.21 +/- 0.52% and 9.18 +/- 7.58%, respectively, p < 0.001) and in the control group (0.13 +/- 0.33%). Our data indicate that there is correlation (Pearson, p < 0.01) between the level of vWF and neurological condition (GCS) of patients. There is also correlation (p < 0.01) between the level of VWF and the presence of clinical disorders (cerebral vasospasm, delayed neurological deficit (DIND) and cerebral infarct). Based on multivariate analysis, we confirmed that vWF is an independent prognostic factor of cerebral vasospasm (p < 0.01) and ischemic complications (p < 0.02). CONCLUSIONS: vWF is elevated in the plasma of patients after subarachnoid hemorrhage in early stage of the disease. VWF is present in the cerebrospinal fluid of patients with SAH and its level is higher in patients with poor neurological condition. The VWF elevation in csf is correlated with clinical condition of patients and also the presence of cerebral vasospasm and cerebral infarct. VWF can be used as an independent prognostic factor of cerebral vasospasm and ischemic complications.

Use of cryopreserved arterial homografts for management of infected prosthetic grafts: a multicentric study.

The objective of this study was to evaluate the effectiveness of cryopreserved arterial homografts for management of prosthetic graft infection. Between October 1992 and July 1998, 90 patients (84 men) with a mean age of 64 years from six different hospitals were treated for prosthesis infection by in situ replacement using a cryopreserved arterial homograft (CAH). In 43 patients (47%), the primary procedure had been performed at a nonparticipating center. Prosthetic graft infection occurred early (i.e., within 1 month after the primary procedure) in 15 cases and late in 75 cases. In the late group, the mean interval between the primary procedure and CAH replacement was 34 months (range, 3 to 330 months). In 41 patients, infection was located in the aortic region, including 17 presenting with enteroprosthetic fistula (EPF). In 49 patients, infection was confined to the femoral, popliteal, or subclavian region. Bacteriologic cultures were positive for one or more germs in 75 patients and negative in 15. The surgical procedure consisted of complete or partial removal of the infected prosthetic graft, debridement, and in situ reconstruction using one or more CAH. Our results showed that management of prosthetic graft infection, a grave complication, using a CAH is a promising technique, especially for patients in stable condition prior to reconstruction.

Fixation of the cervical spine using a titanium plate.

Surgery of the cervical spine has been developing since the early twentieth century, but significant progress began with the appearance of the anterior approach, thanks to Bailley, Bedgley and Cloward, who developed a special set of instruments to facilitate operations using the anterior approach. In 1967 Haftek became the first surgeon to perform this operation in Poland; since that time the anterior approach has come to be in more and more general use. The first goal of the operation is to remove fragments of bone and intervertebral discs compressing the spinal cord; the second goal is to achieve good fixation of the operated segment of the cervical spine. In the earlier period external immobilization was applied, using campolite collars, Florida collars, Schanz collars, or HALO stabilizers. Currently immobilizing is done with titanium plates, which are well suited to the purpose of internal fixation of the spine.

Surgical treatment of pathologiesof the craniocervical functions.

Spinal fractures at the craniocervical function require surgical treatment. Surgical can be preceded by direct traction of the cranium in order to set the fragments prior to fixation. This paper presents various methods of fixation from the posterior titanium loops.