Effects of Breast and Prostate Cancer Metastases on Lumbar Spine Biomechanics: Rapid In Silico Evaluation.

Metastases to distant organs are a frequent occurrence in cancer diseases. The skeletal system, especially the spine, is one such organ. The objective of this study was to apply a numerical modeling, using a finite element method (FEM), for the evaluation of deformation and stress in lumbar spine in bone metastases to the spine. We investigated 20 patients (10 women and 10 men) aged 38-81 years. In women, osteolytic lesions in lumbar spine accompanied breast cancer, in men it was prostate cancer. Geometry of FEM models were built based on CT scans of metastatic lumbar spine. We made the models for osteolytic metastases, osteosclerotic metastases, and metastases after surgery. Images were compared. We found a considerable concentration of strain, especially located in the posterior part of the vertebral body. In osteolytic lesions, the strain was located below the vertebral body with metastases. In osteosclerotic lesions, the strain was located in the anterior and posterior parts in and below the vertebral body with metastases. Surgery abolished the pathological strain. We conclude that metastases to the lumbar spine introduce a pathological strain on the lumbar body. The immobilization of the vertebral body around fractures abolished the strain.

Shoulder ring complaints as a rare first symptom of malignant pleural mesothelioma.

The prevalence of malignant pleural mesothelioma is often encountered in the areas highly exposed to asbestos. The aim of this paper was a retrospective analysis of shoulder pain as a rare, first symptom of pleural mesothelioma, which constitutes an interdisciplinary diagnostic problem concerning both orthopedics and pulmonology. The research was based on a retrospective review of the patients' medical records. The considered period of time included the years 2006-2012. The study group included a total of 49 patients. Seven patients (14.3%) presented a complain of shoulder pain, as the first symptom of mesothelioma. The remaining 42 mesothelioma patients, without this symptom, constituted a reference group. The intensity of shoulder pain was, on average, 4/10 on an analog scale. A concomitant limitation of mobility was observed in five out of the seven subjects. In one case, limitation of motion and dysfunction of the shoulder joint were at an advanced stage. Neuralgia of upper limbs was found in two cases. We conclude that shoulder pain may be a manifesting symptom of malignant pleural mesothelioma. The neoplasm appears to have a pleiotropic effect on human body, reflected in different ways of its primary manifestation which may also include the motor system.

Management of factor VII-deficient patients undergoing joint surgeries--preliminary results of locally developed treatment regimen.

Inherited factor VII (FVII) deficiency is a rare coagulation disorder with variable haemorrhagic manifestations. In severely affected cases spontaneous haemarthroses leading to advanced arthropathy have been observed. Such cases may require surgery. Therapeutic options for bleeding prevention in FVII deficient patients undergoing surgery comprise various FVII preparations but the use of recombinant activated factor VII (rFVIIa) seems to be the treatment of choice. To present the outcome of orthopaedic surgery under haemostatic coverage of rFVIIa administered according to the locally established treatment regimen in five adult patients with FVII baseline plasma levels below 10 IU dL(-1). Two patients required total hip replacement (THR); three had various arthroscopic procedures. Recombinant activated factor VII was administered every 8 h on day of surgery (D0) followed by every 12-24 h for the subsequent 9-14 days, depending on the type of surgery. Factor VII plasma coagulation activity (FVII:C) was determined daily with no predefined therapeutic target levels. Doses of rFVIIa on D0 ranged from 18 to 37 µg kg(-1) b.w. and on the subsequent days--from 13 to 30 µg kg(-1) b.w. Total rFVIIa dose per procedure ranged from 16 to 37.5 mg, and the total number of doses per procedure was 16-31. None of our patients developed excessive bleeding including those in whom FVII:C trough levels returned nearly to the baseline level on the first post-op day. Preliminary results demonstrate that rFVIIa administered according to our treatment regimen is an effective and safe haemostatic agent for hypoproconvertinaemia patients undergoing orthopaedic surgery.

[Solitary extra-bone-marrow form of plasmacytoma: diagnostic difficulties]. / Odosobniona pozaszpikowa postac szpiczaka plazmocytowego--trudnosci diagnostyczne.

We present the patient with soft tissue tumor, which in histopathological examination proved to be plasmacytoma. Initial laboratory and radiological diagnostics did not suggest recognition.

[A case of posterior dislocation of the shoulder with fracture of the humeral neck]. / Przypadek tylnego zwichniecia stawu ramiennego ze zlamaniem szyjki kosci ramiennej.

A case of posterior dislocation of the shoulder with concomitant fracture of the humeral neck and diagnostic difficulties are discussed. An axial radiograph of the shoulder was omitted at the first examination and posterior dislocation was unrecognized. It was diagnosed only after one month. Surgical reduction with Steinman pin and Kirschner wires fixation rendered good final outcome.

[Lower limb injury and Sudeck's syndrome]. / Uraz konczyny dolnej a zespól Sudecka.

The term Sudeck's case is traditionally and commonly used to describe after injury painful and swelling changes which are accompanied by radiographic symptoms like pain, swelling, colour changes and warm changes of the skin of the limbs, trophic changes of hair and nails and acute period, dystrophy and disappearance in neurologic and cardiologic, rheumatologic, internistic cases are present, therefore, different synonyms are possible such as: reflex sympathetic dystrophy, algodystrophy, acute Sudeck's osteoporosis etc. The Sudeck's set treatment is complicated. There are several main groups: 1) treatment concerning sympathetic set of the limb, 2) calcitonin, 3) physiotherapy, 4) corticosteroids, 5) sweepers of free oxygen and hydroxylic, 6) pharmacotherapy, psychotherapy and, 7) some other forms of treatment. On the basis of literature and my own experiences I paid special attention to the role of calcitonin, calcium compounds and physiotherapy in Sudeck's case treatment after lower injury extremities and I gave scheme of treating of this difficult illness.

[Consequences of exposure to asbestos dust]. / Skutki narazenia na pyl azbestu.

Mesotheliomas of pleura are neoplasms that rarely occur. Their etiology is connected with occupational exposure as well as environmental contact with asbestos dust. In this work, two cases of mesotheliomas of pleura are presented: first one with occupational exposure, the other one with environmental exposure. An increased number of mesothelioma diseases has been emphasised and endangerment of inhabitants health living closely to asbestos processing factory as well.

[Clinical use of magnesium]. / Kliniczne zastosowanie magnezu.

The next matter under discussion is magnesium. It has the greatest meaning in metabolism. The magnesium activates more than 300 enzymes and takes part in almost all functions of cellular life. Shortage of magnesium shows almost 100% of our population. Supplementation improves treatment of patients and prevents many diseases- first of all: circulatory system and nervous system, and in many cases absolutely prolongations life time.

[Pathogenesis and pathologic anatomy of degenerative knee joint disease]. / Patogeneza i anatomia patologiczna choroby zwyrodnieniowej kolana.

Etiopathogenesis of degenerative disease of knee joint has been presented in this work. The role of instability of the joint, disturbances of biochemical processes of cartilage, synovial membrane or joint fluid and microinjuries in pathogenesis of this disease has been discussed as well.

[Clinical, radiologic and other examinations in diagnosis of knee joint changes]. / Badanie kliniczne, radiologiczne i inne badania w diagnostyce zmian stawowych kolana.

In this work, a review of diagnostic methods of disease changes in the area of knee joint, has been presented. The important role of interview, clinical examination, diagnostic arthroscopy or non invasive methods of visualisation such as computer tomography and magnetic resonance has been emphasized as well.

[Conservative treatment of degenerative changes in the knee joint]. / Leczenie zachowawcze zmian zwyrodnieniowych stawu kolanowego.

The theory on pain pathogenesis in degenerative changes of knee joints has been discussed here as well as the response mechanism to anti-inflammatory non steroid drugs. The special attention has been paid to the role of rehabilitation in gonarthrosis treatment.

[Results of surgical treatment for acromioclavicular joint dislocation using the carbon fiber prosthesis]. / Wyniki operacyjnego leczenia zwichniecia stawu obojczykowo-barkowego wiezadlowa proteza weglowa.

The method, algorithm and results of treatment for acromioclavicular dislocation with carbon fiber prosthesis in 12 male patients has been presented. Excellent results have been achieved in all cases.

[Results of surgical treatment for intraarticular fracture of the distal humeral epiphysis]. / Wyniki leczenia operacyjnego zlaman sródstawowych nasady dalszej kosci ramiennej.

The paper deals with modalities and results of surgical treatment for intraarticular fracture of distal humeral epiphysis. Nineteen patients out of 22 operated in the department between 1982 and 1992 were reviewed. There were 6 good results, 11 fair and 2 poor ones.

[A complicated case of multiple trauma in a 40-year old male patient]. / Skomplikowany przypadek uszkodzenia wielonarzadowego u 40-letniego pacjenta.

The method, algorithm and result of treatment of 40 years old patient with multiple trauma has been presented. Despite ruptured diaphragm and pericardium, sub-diaphragm displacement of the heart and supra-diaphragm transposition of the stomach and bowels the final result was entirely positive.

[Benefits and dangers connected with clinical use of microelements]. / Korzysci i niebezpieczenstwa zwiazane z klinicznym zastosowaniem mikroelementów.

Microelements deficiency is getting more and more common on account of the greatest instability in environmental balance. Normal diet does not meet all the necessities of an organism, the result of this is a great number of shortage ststes. Their manifestations are whole ranges of sufferings more or less acute. The clinical aspect of copper, zinc and iron deficiency is presented here. Correct diagnosis of microelements deficiency makes treatment procedure easier. Supplementation of appropriate amount of microelements is much more effective than traditiond, symptomatic, farmacoligical treatment.

[Incidence of mesothelioma among asbestos plant workers]. / Zachorowalnosc na miedzybloniaka oplucnej wsród pracowników zakladów azbestowych.

Pleural mesothelioma is a very rare neoplasm. Its aetiology is connected with exposure to asbestos dust. In the paper 12 cases are presented of pleural mesothelioma out of 34 cases of lung cancer diagnosed in Asbestos-Cement Factory workers and in persons living in the vicinity of this plant. The attention is paid to the increase of incidence of pleural mesothelioma and health risk connected with it for the population of that region, caused by the production of the plant.