Systematic changes of the static upper body posture with a symmetric occlusion condition.

BACKGROUND: Temporary occlusal changes and their influence on the upper body statics are still controversially discussed. Furthermore, concrete statements on whether age- or gender-specific differences in neurophysiological reactions exist are missing. Therefore, it is the aim of this study to evaluate the immediate effects of a symmetrical occlusion blocking on the upper body posture. These effects shall be investigated for both genders and for a larger age range. METHODS: In this study, 800 (407f/393 m) subjects volunteered aged from 21 to 60 years. Both genders were divided into four age groups according to decades. The three-dimensional upper body posture was measured by using the rasterstereography (ABW-Bodymapper). The habitual static posture was measured in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking in the bicuspid region by cotton rolls. RESULTS: A significant reduction of the trunk length (0.72 mm; p <  0.001), an increase of the lumbar (0.30°; p <  0.001) and the thoracic bending angle (0.14°; p = 0.001), a reduction of the spinal forward decline (0.16°; p <  0.001) and a reduction of the scapular distance (0.36 mm; p = 0.001) was found. Gender-specific reactions can only be recorded in scapular distance, in that regard men reduce this distance while over all age groups women did not show a significant change. DISCUSSION: Slight gender- and age-independent reactions due to a symmetric occlusion blockade are shown: A gender independent reaction of the spinal related variables in the sagittal plane (thoracic and lumbar flexion angle, trunk length, spinal forward decline). In addition, a gender specific change of the shoulder blade distance could be observed, where men reduced the distance while female did not show a change. However, since these reactions are of a minimum amount, it can be concluded that neurophysiological compensation mechanisms work equally well regardless of age and sex, and the upper body posture of healthy people changes only very slightly due to a temporarily symmetrical altered bite position.

Evaluation of CR-POSSUM, original ACPGBI and new ACPGBI scoring systems for colorectal cancer surgery.

PURPOSE: To compare the Colorectal Physiological and Operative Score for enUmeration of Mortality and Morbidity (Cr-POSSUM) with the original Association of Coloproctology of Great Britain and Ireland (ACPGBI) and new ACPGBI scoring systems for their ability to predict mortality after colorectal cancer surgery. METHODS: We retrospectively calculated the Cr-POSSUM,original ACPBGI and new ACPGBI scores of 105 patients who underwent colorectal cancer surgery. Data were obtained from patients'€™ medical records and operative notes.Mortality was defined as death within 30 days of surgery.Scores were validated by assessing their calibration and discrimination. Calibration was assessed using the Hosmer-Leme show test and corresponding calibration curves. The discriminative capability of the models was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: The observed mortality rate was 4.8 %. The over all estimated risks of death of the Cr-POSSUM, original ACPGBI, and new ACPGBI scores were 9.92%, 7.35% and 4.20%, respectively. The results of areas under the curve(AUC) for Cr-POSSUM, original ACPGBI and new ACPGBI scores were 0.792, 0.844 and 0.801 respectively. CONCLUSIONS: The Cr-POSSUM, original ACPGBI and new ACPGBI scoring syStems are accurate in determining mortality rates and for predicting the risks of death in individual patients. The new and original ACPGBI scoring systems performed slightly better than the Cr-POSSUM scoring system.

Standard values of the upper body posture in healthy adults with special regard to age, sex and BMI.

In order to classify and analyze the parameters of upper body posture in clinical or physiotherapeutic settings, a baseline in the form of standard values with special regard to age, sex and BMI is required. Thus, subjectively healthy men and women aged 21-60 years were measured in this project. The postural parameters of 800 symptom-free male (n = 397) and female (n = 407) volunteers aged 21-60 years (Ø♀: 39.7 ± 11.6, Ø â™‚: 40.7 ± 11.5 y) were studied. The mean height of the men was 1.8 ± 0.07 m, with a mean body weight of 84.8 ± 13.1 kg and an average BMI of 26.0 ± 3.534 kg/m2. In contrast, the mean height of the women was 1.67 ± 0.06 m, with a mean body weight of 66.5 ± 12.7 kg and an average BMI of 23.9 ± 4.6 kg/m2. By means of video rasterstereography, a 3-dimensional scan of the upper back surface was measured when in a habitual standing position. The means or medians, confidence intervals, tolerance ranges, the minimum, 2.5, 25, 50, 75, 97.5 percentiles and the maximum, plus the kurtosis and skewness of the distribution, were calculated for all parameters. Additionally, ANOVA and a factor analyses (sex, BMI, age) were conducted. In both sexes across all age groups, balanced, symmetrical upper body statics were evident. Most strikingly, the females showed greater thoracic kyphosis and lumbar lordosis angles (kyphosis: Ø â™€ 56°, Ø♂ 51°; lordosis: Ø â™€ 49°, Ø♂ 32°) and lumbar bending angles (Ø â™€ 14°, Ø♂ 11°) than the males. The distance between the scapulae was more pronounced in men. These parameters also show an increase with age and BMI, respectively. Pelvic parameters were independent of age and sex. The upper body postures of women and men between the ages of 21 and 60 years were found to be almost symmetrical and axis-conforming with a positive correlation for BMI or age. Consequently, the present body posture parameters allow for comparisons with other studies, as well as for the evaluation of clinical (interim) diagnostics and applications.

Oxidative stress in cows according to calving season: passive calf immunity and its relationship with colostrum quality.

This study details the relationship between maternal plasma oxidant-antioxidant enzymes with colostrum quality, serum gamma glutamyl transferase (GGT), immunoglobulin G (IgG) and IgM concentrations of calves in the different calving seasons. Holstein breed cows between two and eight lactations and their calves were enrolled in the study. Holstein cows calving in winter (n=45) and their calves (n=45) were assigned to the winter group, while cows calving in summer (n=45) and their calves (n=45) were assigned to the summer group. Samples for malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) were collected on day -21±3 before expected calving and also on calving day (Day 0). IgG and the specific gravity of the colostrum were determined after calving. Serum GGT and IgG and IgM were measured before the feeding, with colostrum, of calves (0 hours) and also in the 24th hour following the feeding of colostrum. Plasma MDA levels at -21±3 and 0 days in the summer cows were determined to be higher. GSH-Px activity was higher in the winter cows. IgG levels and the specific gravity of the colos- trum were also higher in the winter cows. Calf IgG levels at the 24th hour of life were higher in the winter cows. In the winter group, IgM levels at 0 and 24 hours were also higher. While MDA was negatively correlated with IgG, IgM, GGT, IgG and the specific gravity of colostrum, GSH-Px activity had a positive correlation with IgG, IgM, GGT, IgG and the specific gravity of colostrum. The observed differences in plasma MDA, GSH-Px, calf serum IgG and IgM levels, and colostrum quality between both groups suggest a possible seasonal effect. The relationship between maternal oxidant-antioxidant enzymes, colostrum quality, and passive calf immunity revealed that these enzymes could be used as indicators in the evaluation of calf health and colos- trum quality.

Symmetrical dental occlusion blocking - changes of body sway and weight distribution in healthy subjects across 4 age decades.

OBJECTIVES: Symmetrical dental occlusion blocking is used in dentistry as a quick diagnostic tool to test for potential influences of the craniomandibular system on body sway and weight distribution. This study presents the changes of body sway and pressure distribution in healthy subjects, free of a temporomandibular dysfunction (TMD). Immediate effects between occlusal blocking and rest position on body sway and body weight distribution in general, as well as for both genders and for four age decades will be evaluated. MATERIALS AND METHODS: 725 (396f/329 m) subjects (neither subjective signs of TMD nor acute/chronic complaints in the musculoskeletal system) volunteered (21 to 60 years) while both genders were divided into four age groups according to decades. A pressure measuring platform was used. Body sway and weight distribution were recorded in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking (bicuspid region) by cotton rolls. RESULTS: Both, the frontal sway and the sagittal sway reduced by 0.67 mm (t(724) = - 3.9 (p <  0.001)) and by 0.33 mm (t(724) = - 3.4 (p <  0.001)). The relative pressure under the left forefoot increased by 0.33% (t(724) = 2.88 (p <  0.001)) and the relative pressure overall under the forefoot increased by 0.67% (t(724) = - 3.4 (p <  0.001)). Gender-specific, age-specific and BMI-specific reactions could not be identified. CONCLUSIONS: Subjects, free of any TMD and with no complaints of the musculoskeletal system, show small changes of the body sway and weight distribution when biting symmetrically on a cotton roll. These changes are independent of age, gender or body mass index (BMI). Due to the relative large sample size, the presented results can also be seen as norm values when body sway is used as an additional assessment of a TMD.

Does increased immune response at early postpartum period have a relationship with metabolic markers and subsequent fertility?

The aim of the present study was to investigate blood parameters and subsequent fertility in cows with or without increased postpartum polymorphonuclear neutrophil activity. The study was conducted with 15 Brown Swiss cows between 1-3 lactations. Polymorphonuclear neutrophil activities were assessed at 10±4 days before and after parturition. The cows which maintained their phagocytic and oxidative burst activites compared to the prepartum period were classified as control (CON), and cows which increased phagocytic and oxidative burst activites were defined as increased cellular immune response (ICIR) cows. Energy, protein metabolism markers, hepatic enzymes, blood mineral levels and body condition scores were measured at -10±4, 3±2, 10±4 days relative to parturition. Pregnancy rates, the number of inseminations, and calving to pregnancy intervals were evaluated. The mean non-esterified fatty acid (NEFA) and beta- -hydroxybutyric acid (BHB) concentrations were lower in ICIR cows. Mean serum calcium (Ca) concentrations were in subclinical hypocalcemia level at day 3±2, 10±4 days postpartum in CON cows. Postpartum immune cell functions and NEFA, BHB concentrations were negatively cor- related. The calving to pregnancy interval were longer in the control cows. However, total preg- nancy rates and the number of insemination in both groups were similar. In conclusion, postpar- tum polymorphonuclear neutrophil activity is affected by periparturient metabolic status. Postpartum energy metabolites negatively affected the postpartum cellular immune response. The increased postpartum polymorphonuclear neutrophil activity at early postpartum period is positively related with subsequent fertility in dairy cows.

A rare simultaneous occurrence: Mitral valve endocarditis complicated by iliac saddle and cerebral embolisms / Un incidente simultáneo inusual: endocarditis de la válvula mitral complicada por embolia ilíaca en silla de montar y embolia cerebral

Abstract Infective endocarditis is a severe disease with a high mortality and morbidity, and its clinical heterogeneity is a challenging barrier to rapid diagnosis and treatment. Diagnosis of infective endocarditis is based on clinical, microbiological, and echocardiographic findings; however, a high index of suspicion is mandatory because this disease may present either as an acute, rapidly progressive infection or as a chronic disease. Approximately 20-50% of cases show multiple embolic events as the first presentation of infective endocarditis. We report a patient with a rare case of infective endocarditis complicated with iliac saddle and cerebral embolisms who underwent simultaneous operations for mitral valve endocarditis and iliac embolism.

Resumen La endocarditis infecciosa es una enfermedad grave, que conlleva alta morbimortalidad; su heterogeneidad clínica constituye una barrera desafiante para un rápido diagnóstico y tratamiento. El diagnóstico se basa en hallazgos clínicos, microbiológicos y ecocardiográficos; sin embargo, se requiere un alto índice de sospecha ya que esta enfermedad puede debutar ya sea como una infección aguda de rápida evolución o como una enfermedad crónica. Aproximadamente, 20 a 50% de los casos presentan múltiples eventos embólicos como primera manifestación de la endocarditis infecciosa. Se informa de un paciente con un caso inusual de endocarditis infecciosa complicada por embolia ilíaca en silla de montar y embolia cerebral, quien fue sometido a cirugías simultáneas por endocarditis de la válvula mitral y embolia ilíaca.

Intracranial hydatid cysts. Study of 17 cases.

The authors report 17 cases of intracranial hydatid cyst out of 500 brain tumors seen in 20 years, and analyze clinical, investigative, diagnostic, and operative findings.

Metamorphic development of the bronchial columella of the larval bullfrog (Rana catesbeiana).

Histological and immunohistochemical analyses of head and respiratory structures in bullfrog (Rana catesbeiana) tadpoles were undertaken to address the hypothesis that the bronchial columella (BC) is the primary sound conduction pathway in these larval anurans. In postembryonic tadpoles, the BC is composed of fibroblasts surrounded by a Type I collagen matrix, with Type II collagen located in basement membranes at the distal ends. It provides a highly flexible tendon-like attachment between the round window and the membranous sac of the primary bronchus of the ipsilateral lung. As the animals approach metamorphic climax stages, the fibroblasts decrease in number and the BC becomes almost exclusively collagenous. During metamorphic climax, the BC degenerates and is completely resorbed by the time the animal becomes a postmetamorphic froglet. At all larval stages examined, the BC is structurally and immunohistochemically different from both the opercularis muscle of tadpoles and the tympanic columella (stapes homolog) of postmetamorphic animals. These observations suggest that the BC may not be rigid enough to provide an effective coupling between the lungs and the round window. An alternative hypothesis for the function of the BC, based on its structure, is presented.

Intracranial extradural hydatid cysts: report of three cases.

Intracranial extradural hydatid cysts are a rare occurrence with unclear pathogenesis. Three different cases are reported and the postoperative courses are discussed. Of the 11 cases found in the literature, all eight cases whose sex and age were reported are men, and seven of the eight are clustered in between the second and fourth decades.

The effect of extracorporeal shock wave treatment (ESWT) on bone defects. An experimental study.

The aim of this study was to investigate the effects of extracorporeal shock wave therapy (ESWT) on the formation of callus in bone defects created in rabbit radii. this study searches for an answer to whether ESWT may have a therapeutic effect on bone defects. A bone defect with a radius of 1 cm was created in both forelimbs of 20 rabbits. At the 7th, 14th, and 21st days ESWT treatment was applied to the forming callus in the right radius under fluoroscopic control. At the 6th and 12th weeks, the animals were sacrificed and callus analysis was performed by computerized scan, dual energy x-ray absorptiometer. Histological analyses were also performed. The results revealed that the average callus area in the right (ESWT applied) radial defect was greater in both groups and statistically significant at the 12th week (p < 0.05). There was no difference in bone density between defects. Histologically the callus area was greater on the right side (ESWT applied side) in both groups. However in the first group trabeculae were occupying less space on the right side. Granulation tissue areas and chondroid areas were greater on the right side. We conclude that ESWT has a disorganizing and dispersing rather than a direct osteoinductive effect on forming callus. This effect may play a therapeutic role in bone defects and in situations like callus lengthening where a greater amount of callus is necessary.

Is computed tomography necessary to determine liver injury in pediatric trauma patients with negative ultrasonography?

PURPOSE: Abdominal trauma is the third most common cause of all trauma-related deaths in children. Liver injury is the second most common, but the most fatal injury associated with abdomen trauma. Because the liver enzymes have high sensitivity and specificity, the use of tomography has been discussed for accurate diagnosis of liver injury. METHODS: Our study was based on retrospective analyses of hemodynamically stabil patients under the age of 18 who were admitted to the emergency department with blunt abdominal trauma. RESULTS: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly higher as a result of liver injury. In the patients whose AST and ALT levels were lower than 40 IU/L, no liver injury was observed in the contrast-enhanced computed tomography (CT). No liver injury was detected in the patients with AST levels lower than 100 IU/L. Liver injury was detected with contrast-enhanced CT in only one patient whose ALT level was lower than 100 IU/L, but ultrasonography initially detected liver injury in this patient. CONCLUSIONS: According to our findings, abdominal CT may not be necessary to detect liver injury if the patient has ALT and AST levels below 100 IU/L with a negative abdominal USG at admission and during follow-up.

Surgical management of intravenous leiomyoma with cardiac extension. Do we need total circulatory arrest?

Intravenous leiomyoma of the uterus is a histologically benign, smooth-muscle tumor and may extend through the inferior vena cava into the right atrium. Surgical treatment is mandatory and single-stage resection of the tumor has gained wide acceptance as a safe and easy procedure. We describe a single-stage surgical procedure for an intravenous leiomyoma extending to the right atrium diagnosed in a routine control after myomectomy.

Intraspinal hemorrhage in a child with factor XIII deficiency.

The rarity of spinal cord injuries and hemorrhages and of fibrin-stabilizing factor XIII deficiency during childhood has induced us to report the case of this two-year-old boy with factor XIII deficiency who presented with cervical intraspinal hemorrhage between the C4 and C7 levels as well as paraplegia presumably following a minor trauma. The findings in this patient, who was brought in two weeks after the appearance of the first symptoms, indicate the importance of early diagnosis and early intervention to minimize the extent of the damage from the injury in such cases. The case also points to the need for close follow-up of patients with factor XIII deficiency for CNS bleeding.

Lipid peroxidation in experimental spinal cord injury: time-level relationship.

Damage which occurs following spinal traumas is often irreversible. During recent years free oxygen radicals formed due to the pathological changes following neural tissue ischemia have been identified as being responsible for the ethio-pathogenesis of such damage. In our experimental study, model lesions are formed in spinal cords of rats by standard trauma. Malondialdehyde (MDA), a lipid peroxidation product, was measured in the spinal tissues distal to the trauma in order to examine indirectly the time-quantity relationship of free oxygen radicals in the area. For this study 60 rats in six groups, including one control group, were used to determine the formation of MDA. Under a surgical microscope, the spines of all rats were exposed by C5-Th6 laminectomy, and pressure was applied to the spinal cords of animals, except the members of the control group, at the level of C7 by a Yasargil aneurysm clip. MDA was measured in spinal cord tissues in order to determine free oxygen radicals at the first and fifteenth minutes and at the first, second, and fourth hours. The statistical evaluation of the findings revealed a significant increase in MDA, starting from the 15th minute after the compression, reaching a maximum at 1 hour, and then decreasing. This observation may provide an important guide for studies on prevention of neural destruction.

Long-term follow-up and results of thirty pediatric intracranial hydatid cysts: half a century of experience in the Department of Neurosurgery of the School of Medicine at the University of Istanbul (1952-2001).

A series of 30 documented cases of intracranial hydatid cyst out of 33 pediatric and 45 total patients admitted to the Department of Neurosurgery of the School of Medicine at Istanbul University within the years 1952-1996 is presented. The pediatric population consisted of 73% of the series. Twenty patients (66%) are alive and well after a follow-up period of 8-45 years (mean 21.5 years). Six patients (20%) died and 4 (13%) were lost to follow-up. There were 3 early postoperative deaths (10%), 2 being in the pre-CT era. In 4 cases (13%), brain involvement was secondary, and 2 cases (7%) had multiple intracranial hydatid cysts. Age ranged from 4 to 16 years, with a mean of 10.4. There were 5 intraventricular (17%) and 2 (7%) intracranial extradural settlements. No children with posterior fossa hydatid cyst, primary skull hydatidosis or concomitant spinal involvement were detected. One patient (3%) presented with "rhinorrhea" which in fact was a hydatid fluid leak. Preoperative pseudocerebellar syndrome, convulsion and extrapyramidal signs were seen in 6 patients each (20%). Five patients (17%) had permanent visual deficits, 3 being in pre-CT era. Out of 29 patients operated on, hydatid birth with intact cyst removal was achieved in 18 cases (62%), with no other manipulation needed. This rate has increased to 70% in the CT era. Intraoperative accidental rupture occurred in 8 cases (28%), of which 7 were localized frontally or had a frontal involvement (88% of the ruptured cases). Of the patients with intraoperative rupture, 5 are dead (63%) and they were all primary. In contrast, all 3 cases alive with intraoperative rupture are secondary. Three cases were punctured on purpose (10%). Four of the operated patients (14%) required long-term antiepileptic therapy, 3 having no preoperative seizures. Only 1 patient required a shunt (3%). Four cases had recurrence, all with intraoperative cyst rupture (14%). The long-term evaluation of the results yielded an overall mortality rate of 21%. Routine use of CT after the 80s decreased the rate to 14%. With the analysis of 50 years of data, it is strongly concluded that brain involvement in pediatric hydatid disease is a primary process if delayed diagnosis and insufficient treatment of extraneural hydatidosis are prevented.