The influence of the morphometric parameters of the intercondylar notch on occurrence of meniscofemoral ligaments.

BACKGROUND: The purpose of this study was to examine the existence of correlation between the morphometric parameters of the intercondylar notch of the femur and the occurrence of meniscofemoral ligaments (MFLs) and if there is any relationship in the running angle (RA) value between narrowed and normal sized intercondylar notch. MATERIALS AND METHODS: Coronal, sagittal and horizontal magnetic resonance (MR) images of 90 patients with specified exclusion criteria were included in this study. The c2 test was used for statistical analysis. In our research either one or both MFLs were identified in 70 (77.8%) of the 90 coronal MR images. In normal sized intercondylar notch, MFLs was seen in 39 (43.3%) cases and on 31 (34.4%) MR images with narrowed intercondylar notch. RESULTS: A significant correlation was established between the occurrence of the MFL and morphometric parameters of the intercondylar notch (p < 0.05). In normal sized intercondylar notch, 12 posterior meniscofemoral ligaments (pMFLs) of type I were detected (RA value 42°), 8 of type II (RA value 33°), 5 of type III (RA value 23°) and two were of indeterminate type, whilst 10 anterior meniscofemoral ligaments (aMFLs) were of type I (RA value 39°), 7 of type II (RA value 31°), 2 of type III (RA value 25°) and the remaining 6 were indeterminate. In narrowed intercondylar notch, 10 ligaments of pMFLs were of type I (RA value 30°), 8 of type II (RA value 25°), 5 of type III (RA value 20°), 10 ligaments of aMFLs were of type I (RA value 35°) and 9 were indeterminate. Statistically significant differences in the value of the running angle of pMFL type I and of type II were evaluated between two groups with different shaped intercondylar notch (p < 0.05). CONCLUSIONS: The results shown in our study may be useful in medical clinical practice, reconstructive surgery, interpretation of knee MR images as well as genetic research.

[Balancing technique using bone cuts]. / Technik des Balancings durch Knochenschnitte.

BACKGROUND: Kinematic alignment means a surgical technique that focuses on intraarticular balance and laxity and takes into consideration the prearthritic state of the knee joint. AIM: The aim of kinematic alignment is a constitutionally aligned joint space line and balanced tension of the soft tissue covering. By avoiding the proximalization of the joint line and the release of the ligaments, the risk of destabilization of the original physiology of the joint is reduced. METHODS: After resections and recuts of the distal femur, a natural distal femoral joint line in full extension and the posterior line in 90° should be maintained or restored. Therefore, the flexion-extension axis of the femur, around which the knee joint moves, does not change. The principle of KA unequivocally requires the distal femoral cut to be performed before resection of the posterior femoral condyles. RESULTS: The result is a natural knee joint alignment that approximately replicates the anatomy of the femoral and tibial axes. Release of the ligaments is rarely required and all necessary adjustments are usually made using bone recuts.

Concomitant multiple anomalies of renal vessels and collecting system.

Although anomalies of renal vessels and collecting system are relatively frequent, their concomitant occurrence is a rare event. During dissection of a 75-year-old male formalin-embalmed cadaver, we found multiple variations in the renal vessels and renal collecting system. Both kidneys were normal in size and anteriorly malrotated, with duplex collecting system and duplex ureter. One ureter drained the upper part of the kidney and the second ureter drained the lower part of the kidney. Superior and inferior collecting systems were separated by renal parenchyma. The right kidney had two renal arteries, the first renal artery (main renal artery) originating from the abdominal aorta, passing behind the inferior vena cava (IVC) and entering the kidney through the superior and inferior renal hilum. The second artery was the inferior polar artery. In addition, the right kidney had two renal veins as well. Three renal tributaries emerged from the upper and lower portion of the right renal hilum, and they joined to form the main renal vein which drained into the IVC. The lower renal vein was the inferior polar vein. The left kidney had four renal arteries (two hilar arteries and two polar arteries). The main left renal vein emerged from both superior and inferior left renal hilum, passed in front of the abdominal aorta and drained into the IVC. The left kidney also had the inferior polar vein which was divided behind the aorta (retro aortic vein) into two venous trunks. These venous trunks drained separately into posteromedial aspect of the IVC. Finally, the right testicular vein was formed by two tributaries and drained into the IVC, whereas the two left testicular veins drained separately into the left main renal vein.

PEGylation of a glycosaminoglycan-binding, dominant-negative CXCL8 mutant retains bioactivity in vitro and in vivo.

We have recently shown that a dominant-negative mutant of CXCL8, dnCXCL8, with increased glycosaminoglycan (GAG) binding affinity and inactivated GPCR signaling function is able to efficiently prevent neutrophil infiltration into murine lungs (Adage et al., 2015). Here we present evidence that chemical PEGylation of dnCXCL8 with 20 kDa and 40 kDa PEG does not significantly interfere with GAG binding affinity, nor does it influence the mutant's disabled chemotaxis function, while it strongly improved bioavailability and serum half-life of the chemokine mutant. In a murine model of lung inflammation, only the 40 kDa PEGylated dnCXCL8 showed a significant reduction of neutrophils in bronchoalveolar lavage (BAL) fluid. In combination with an almost three-fold increase (compared to non-PEGylated dnCXCL8) in plasma half-life after intravenous administration, our results prove that PEGylation of chemokine-derived biologics is an amenable way for the treatment of chronic inflammatory conditions.

The effect of parathyroidectomy on insulin sensitivity in patients with primary hyperparathyroidism - an never ending story?

Previous studies demonstrated insulin resistance and increased prevalence of impaired glucose tolerance and type 2 diabetes mellitus in patients with primary hyperparathyroidism (PHPT). The effect of curative parathyroidectomy on insulin sensitivity was associated with conflicting results depending on which method for measuring the insulin sensitivity has been used. There was no improvement using HOMA and QUICKI while minimal model demonstrated significant improvement in insulin sensitivity. The aim of our study was to evaluate the insulin sensitivity before and after parathyroidectomy in patients with PHPT using a euglycemic clamp. 44 patients with PHPT and 11 age and body mass index matched healthy controls participated in study protocol. Before surgery M values and HOMA IR suggest insulin resistance in patients with PHPT. There was no difference in M index (3.74±1.89 vs. 4.62±2.27, p>0.05), HOMA IR (2.94±1.39 vs. 3.29±0.81, p>0.05), AUC glucose (863.0±261.3 vs. 842.3±165.5, p>0.05), AUC insulin (7068.7±4159.0 vs. 7229.6±2581.7, p>0.05), ISI (4.73±2.77 vs. 4.25±2.94, p>0.05) and AIR (47.89±32.05 vs. 38.96±21.20, p>0.05) between patients with PHPT and HC. There was significant improvement in insulin sensitivity after parathyroidectomy but both preoperative and postoperative M values were not significantly different in comparison to HC. There were no significant changes in HOMA IR, AUC glucose, AUC insulin, ISI and AIR before and after therapy. In conclusion, we observed significant improvement in insulin sensitivity after parathyroidectomy in patients with PHPT. There was no difference in parameters of insulin secretion before and after parathyroidectomy in patients with PHPT.

An Evaluation of European Countries' Health Systems through Distance Based Analysis.

INTRODUCTION: The issue of evaluating the efficiency of health systems has been elaborated upon frequently. Since "health" is a multi-faceted concept, many variables of different measurement units must be included in its analysis; consequently, this presents a great obstacle for researchers to overcome. MATERIALS AND METHODS: A novel statistical approach for evaluating the efficiency of organizational units is here proposed, which can also be easily applied to the health sector. For these purposes, the health status of the 27 countries belonging to the European Union has been examined by employing a statistical Ivanovic-Jeremic Distance Based Analysis (DBA) on various health indicators. RESULTS: The subsequent outcome of the Distance Based Analysis has shown that Cyprus and Ireland have a most efficient health system sectors. Greece also has exceptional indicators of health service, yet health on the individual level is not comparable. LIMITATIONS: Since it synthesizes many variables into an efficiency score, a DBA can be easily applied to other regions/countries. However, the choice of input and output variables can be considered to be potential limitations since a different choice of variables may cause different efficiency scores for the countries selected. CONCLUSIONS: A DBA approach contributes significantly to the efficiency in the field of research measurement. This analysis can be additionally performed alongside DEA and SFA methods, as a new measure of efficiency.

Primary fallopian tube carcinoma in a 51-year-old postmenopausal woman--case report.

The case of a 51-year-old woman with a primary carcinoma of the left fallopian tube is presented. Laparotomy performed for an ovarian tumour revealed that the patient had normal ovaries, but a left fallopian tube was dilated and filled with a tumour mass. Histopathological examination revealed primary adenosquamous cell carcinoma of the fallopian tube.

Possibilities of the application of regression analysis and analysis of variance. II. Assessment and comparison of acute toxicity: presentation and practical application of the interactive computer program "LD50-MORTALITY".

The paper presents the interactive computer program "LD50-MORTALITY", written in the program language BASIC and used for the assessment of the acute toxicity (calculation of LD50 and other LD values) based on the algorithm of the Finney's probit analysis method. The correctness of the program execution has been shown on the test-example of assessment the acute toxicity (LD50 an LD90) of insecticide rotenone on Macrosiphonelia sanborni (the example is taken from the literature on probit analysis presentation). The results obtained by the program execution have been identical or similar to those given in the example. The results of the assessment and comparison of LD50 have also been presented.

Simultaneous determination of N-unsubstituted and N-substituted nitroazoles and criteria for their identification-III Chromatographic separation and polarographic determination of halo-nitroimidazoles.

Methods for identifying and determining halo-nitroimidazoles appearing together during synthetic processes, regardless of the preparation methods, are proposed. Polarographic determination can be used in all synthetic processes when halo-nitroimidazoles have been obtained by nitration of the halo-imidazoles. When the halo-nitroimidazoles have been obtained from 5(4)-halo-4(5)-nitroimidazoles by substitution of the imino hydrogen atom, and when only one N-substituted derivative has been obtained in a reaction mixture, simultaneous polarographic determination of both compounds is possible, but only when an alkaline medium is used as supporting electrolyte. In some cases, simultaneous polarographic determination of all three compounds present in a reaction mixture during N-substitution processes [one 5(4)-halo-4(5)-nitroimidazole and two N-substituted isomers] is also possible with alkaline supporting electrolyte. Explanations are given of the phenomena on which the simultaneous polarographic determination is based. When simultaneous polarographic determination cannot be used to determine the amount of each polarographically-active compound present in a reaction mixture, the compounds can be separated chromatographically and then determined individually by polarography.

Simultaneous determination of N-unsubstituted and N-substituted nitroazoles and criteria for their identification-II Chromatographic separation and polarographic determination of nitropyrazoles.

The N-unsubstituted nitropyrazoles have an imino hydrogen atom, in contrast to the N-substituted derivatives, and react with hydroxide to give nitropyrazole anions. The strongly negative shift of E(1 2 ) for these anions makes possible simultaneous polarographic determination of any pair of compounds, one of which is an N-unsubstituted nitropyrazole and the other a corresponding N-substituted derivative. Simultaneous polarographic determination of three compounds [3(5)-, 3- and 5-nitropyrazoles] is also possible with 0.1M sodium hydroxide as supporting electrolyte, but only when DeltaE(1 2 ) between the N-substituted isomers is at least 100 mV. In this case adequate DeltaE(1 2 ) is caused by the different electron densities of the nitro-groups of isomers. In the medium mentioned it is possible to determine simultaneously even four compounds [1-, 3(5)-, 3- and 5-nitropyrazoles], because the E(1 2 ) value of 1-nitropyrazole does not change with pH, contrary to other nitropyrazoles. Developers for the chromatographic separation are proposed. Some criteria are given for the distinction of the N-unsubstituted- and the corresponding N-substituted nitropyrazoles. The structures of two new compounds have been determined. Methods are recommended for the simultaneous identification and determination of the compounds appearing together in the reaction mixtures during the substitution of the imino hydrogen atom, or during the rearrangements of the 1-nitropyrazoles to the N-unsubstituted ones.