A semi-automated quantitative CT method for measuring rotator cuff muscle degeneration in shoulders with primary osteoarthritis.

BACKGROUND: Rotator cuff muscle degeneration is an important parameter to consider when planning shoulder arthroplasty. HYPOTHESIS: We hypothesized that rotator cuff muscle degeneration is correlated with scapulohumeral subluxation in patients planned for anatomical total shoulder arthroplasty (TSA). MATERIALS AND METHODS: We developed a semi-automated quantitative CT method to measure rotator cuff muscle degeneration, and retrospectively analyzed 107 preoperative shoulder CT scans of patients with primary osteoarthritis. On a standardized sagittal-oblique CT slice perpendicular to the scapular axis, two observers measured the cross-sectional areas of residual rotator cuff muscle tissues, normalized by the estimated area of healthy muscles. Muscle degeneration was quantified in a semi-automated manner, and divided into atrophy and fatty infiltration. Scapulohumeral subluxation was determined in 3D as the distance between the humeral head center and the glenoid surface center, projected on the same CT slice, and normalized by the humeral head radius. We tested all potential correlations between muscle degeneration and scapulohumeral subluxation. RESULTS: Muscle degeneration, primarily due to atrophy, predominated in the supraspinatus; it varied from 0.8% to 88.8%. Scapulohumeral subluxation varied from 2.5% to 72.9%, and was mainly in a posterior and postero-superior orientation. There was a significant but weak correlation between the amount of subluxation and both supraspinatus (R=0.207, P=0.032) and infraspinatus (R=0.225, P=0.020) degeneration. Inter- and intra-observer reproducibility of muscle degeneration measurements were both excellent (ICCs range=0.955-0.987 and 0.971-0.988, respectively). CONCLUSION: This new semi-automated CT method allows to quantitatively and reproducibly measure rotator cuff muscle degeneration in shoulders with primary osteoarthritis. Muscle degeneration is weakly correlated with scapulohumeral subluxation in patients planned for anatomical TSA. LEVEL OF EVIDENCE: Level IV. TYPE OF STUDY: Diagnostic retrospective study.

Measurements of three-dimensional glenoid erosion when planning the prosthetic replacement of osteoarthritic shoulders.

The three-dimensional (3D) correction of glenoid erosion is critical to the long-term success of total shoulder replacement (TSR). In order to characterise the 3D morphology of eroded glenoid surfaces, we looked for a set of morphological parameters useful for TSR planning. We defined a scapular coordinates system based on non-eroded bony landmarks. The maximum glenoid version was measured and specified in 3D by its orientation angle. Medialisation was considered relative to the spino-glenoid notch. We analysed regular CT scans of 19 normal (N) and 86 osteoarthritic (OA) scapulae. When the maximum version of OA shoulders was higher than 10°, the orientation was not only posterior, but extended in postero-superior (35%), postero-inferior (6%) and anterior sectors (4%). The medialisation of the glenoid was higher in OA than normal shoulders. The orientation angle of maximum version appeared as a critical parameter to specify the glenoid shape in 3D. It will be very useful in planning the best position for the glenoid in TSR.

Effect of Trisetum flavescens P.B. on calcium and phosphorus metabolism in rats. Experimental evidence for the principle actively affecting phospho-calcium homeostasis.

After reviewing the literature on the vitamin D3-like activity of certain plants [Solanum malacoxylon, Cestrum diurnum and Trisetum flavescens], the authors present results of experiments in which dried Trisetum flavescens was administered perorally to rats. The addition of 2.5% dried Trisetum flavescens to the standard laboratory diet caused a drop in blood phosphate levels and a simultaneous marked increase in the calcium and phosphorus content of bones of the experimental animals. The mechanism of the action of Trisetum flavescens on phosphocalcium metabolism is discussed.

Effect of antiandrogen cyproterone acetate on the action of testosterone on mouse kidney.

The loss of endogenous testosterone in castrated male mice leads to a marked decrease in seminal vesicle and kidney tissue weight. 21 days' administration of exogenous testosterone abolished the effect of castration on the seminal vesicles and kidney tissue. The antiandrogen cyproterone acetate produced significant changes in the target tissue for androgens, i.e. in the seminal vesicles. In every case it blocked the action of both exogenous and endogenous testosterone on the seminal vesicles, but failed to block the "renotropic" action of testosterone, expressed as relative kidney weight. Contrary to its effect on the seminal vesicles, it did not influence relative kidney weight in normal animals. It likewise did not block the effect of exogenous testosterone on kidney tissue. The mechanism of the action of cyproterone acetate in androgen-dependent tissues is known to consist in inhibition of androgen binding to specific cell receptors in the target tissues. Some of the specific androgen receptors in mouse kidney are evidently different in character from those in the accessary sex glands, that being the reason why cyproterone acetate has an antiandrogenic, but not an antirenotropic effect. In agreement with experiments on rats, adrenal weight also decreases in mice after the administration of cyproterone acetate.

[Medullary carcinoma of the thyroid gland producing calcitonin]. / Medulární karcinom stítné zlázy produkující kalcitonin.

PIP: The authors describe histologically confirmed medullary carcinoma of the thyroid gland in a living patient. The tumor produces excessive amounts of calcitonin and releases it into the blood stream. In healthy subjects, the plasma concentration of calcitonin is 0.2-1.0 mU MRC/ml plasma; in medullary carcinoma it is 5.66 mU/ml. The tumor responds to artificially induced hypercalcemia by a further increase of plasma calcitonin. 60-120 minutes after a hypercalcemic stimulus, the calcitonin level declines well below the initial value but remains elevated. The patient has a permanently normal blood calcium level. This is probably due to secondary hyperparathyroidism, a compensatory phenomenon. (Author's modified)^ieng