The impact of spino-pelvic parameters on pathogenesis of lumbar disc herniation.

PURPOSE: Controversies exist on the relative contribution of sagittal spino-pelvic alignment on pathogenesis of lumbar disc herniation. METHODS: Spinopelvic alignment parameters, pelvic incidence, pelvic tilt, sacral slope, pelvic radius-S1 end-plate ratio and pelvic radius-S1 angle, in 52 patients with lumbar disc herniation were compared with the same measurements in 43 healthy adult volunteers. RESULTS: Statistical analysis revealed significant difference in pelvic incidence and sacral slope between patients with lumbar disc herniation and normal population. CONCLUSION: Patients with lumbar disc herniation have a more vertical sacrum compared to the normal population which may result in higher intradiscal pressure in these patients.

Internal dosimetry studies of 170Tm-EDTMP complex, as a bone pain palliation agent, in human tissues based on animal data.

Radiopharmaceuticals with therapeutic applications are designed to deliver high doses of radiation to target organs with minimizing unwanted radiation to healthy tissues. Owing to the potential of targeted radiotherapy to treat a wide range of malignancies, 170Tm -EDTMP was developed for possible therapeutic applications. This study describes absorbed dose prediction of 170Tm-EDTMP in human organs after animal injection which is determined via medical internal radiation dose (MIRD) and MCNP-4C code methods. It was estimated that a 1-MBq administration of 170Tm-EDTMP into the human body would result in an absorbed dose of 37.9 mGy (MIRD method) and 38.02 mGy (MCNP-4C code) in the bone surface after 60 days post injection. Highest and lowest difference between MIRD and MCNP results are for lung and bone surface respectively. Finally, the results show that there is a good agreement between MIRD method and MCNP-4C simulation code for absorbed dose estimation.

Decellularized liver transplant could be recellularized in rat partial hepatectomy model.

In situ recellularization of the liver decellularized scaffold is a potential therapeutic alternative for liver transplantation. We aimed to develop an in situ procedure for recellularization of the rat liver using sodium lauryl ether sulfate (SLES) compared with Triton X-100/SDS. Rat liver specimens were rinsed with PBS, decellularized with either Triton X-100/SDS or SLES, and finally rinsed by distilled water. The efficiency of decellularized liver scaffolds was evaluated by histological, confocal Raman microscopy, histochemical staining, and DNA quantification assessments. Finally, in vivo studies were done to assess the biocompatibility of the liver scaffold by serum biochemical parameters and the recellularization capacity by histological and immunohistochemistry staining. Findings confirmed the preservation of extracellular matrix (ECM) components such as reticular, collagen, glycosaminoglycans, and neutral carbohydrates in both Triton X-100/SDS- and SLES-treated livers. Hoechst, feulgen, Hematoxylin and eosin, and DNA quantification assessments confirmed complete genetic content removal. The serological parameters showed no adverse impact on the liver functions. Transplantation of SLES-treated cell-free decellularized liver showed extensive neovascularization along with migration of the fibrocytes and adipocytes and some immune cells. Also, immunohistochemical staining showed that the oval cells, stellate cells, cholangiocytes and hepatocytes invaded extensively into the graft. It is concluded that SLES can be considered as a promising alternative in the liver decellularization process, and the transplanted decellularized liver can appropriately be revascularized and regenerated.

Concomitant Traumatic Peroneal Tendon Dislocation and Medial Malleolus Fracture: A Case Report.

Peroneal tendon dislocation in association with medial malleolus fracture is a very rare traumatic injury to the ankle. A 19-year old male patient was referred after injury sustained in a motorcycle accident with car, with concomitant traumatic peroneal tendon dislocation and medial malleolus fracture. The possible mechanism of this unusual injury could have been sudden external rotation force to the pronated foot in full dorsiflexed position of the ankle. Diagnosis of peroneal tendon subluxation or dislocation should be carefully evaluated in patients with single medial malleolus fracture.

Results of fusion and instrumentation of thoracic and lumbar vertebral fractures in children: a prospective ten-year study.

BACKGROUND: Researches on the results of surgical treatment of thoracolumbar spine fractures are infrequent. The aim of this study was to determine midterm outcomes of surgical treatment of these fractures in a prospective survey. METHODS: A case series study on pediatric patients with the diagnosis of thoracic and/or lumbar vertebral fractures was conducted over a ten-year period. Surgically treated patients were evaluated in the follow-up period, based on back pain, independent function, neurological status, and radiographic indices. RESULTS: There were 102 pediatric individuals, 61 boys and 41 girls, aged 3-17 years (mean 12 years of age) with thoracic and/or lumbar spinal fractures. Motor vehicle accident was the most common mechanism of injury (45.0 %). L1 was the most frequent level of fractured vertebra (24.4 %), and pelvic fracture was the most common associated orthopedic injury (21.5 %). Totally, 20 patients underwent surgery, but only fifteen (14 boys and one girl) participated in follow-up (mean 49 months; range 12-81 months). Posterior spinal fusion and instrumentation was accomplished in 12 cases. Three patients were operated by anterior approach and fusion followed by posterior fusion and instrumentation because of delay in diagnosis. There were no major perioperative complications. Two cauda equina syndromes and two incomplete spinal cord injuries improved back to normal. Five cases (33.3 %) reported occasional back pain, and all patients were functionally independent. Radiographic indices improved significantly. CONCLUSIONS: Spinal fusion and instrumentation in pediatric patients with unstable thoracolumbar vertebral fractures with or without spinal cord injuries have favorable radiographic and functional outcomes.

Evaluation of a new radiolabeled bombesin derivative with 99mTc as potential targeted tumor imaging agent.

Gastrin-releasing peptide (GRP) receptors are over-expressed in various human tumor including breast and prostate which can be targeted with bombesin for diagnosis and targeted therapy. High abdominal accumulation and the poor in vivo stability of radiolabeled bombesin analogues may represent a limitation for diagnostic imaging and targeted therapy. In this study a new bombesin derivative was labeled with 99mTc via HYNIC and tricine as a coligand and investigated further. The peptide HYNIC conjugate was synthesized on a solid phase using Fmoc strategy. Labeling with 99mTc was performed at 100 °C for 10 min and radiochemical analysis involved ITLC and HPLC methods. The stability of radiopeptide was checked in the presence of human serum at 37 °C up to 24 h. Internalization was studied with the human GRP receptor cell line PC-3. The Biodistribution was studied in mice. Labeling yield of >98 % was obtained to correspond a specific activity of ~80.9 GBq/µmol. Radioconjugate internalization into PC-3 cells was high and specific (15.6 ± 1.9 % at 4 h). A high and specific uptake in GRP-receptor-positive organs such as mouse tumor and pancreas (2.11 ± 0.18 and 1.78 ± 0.09 % ID/g after 1 h respectively) was also determined.

(99m)Tc-labeled ubiquicidin scintigraphy: a promising method in hip prosthesis infection diagnosis.

AIM: Hip prosthesis implantation has witnessed a significant increase in recent years. Despite the advantages of this surgical procedure, it has some complications, the most serious of which is prosthetic infection. This study was conducted to investigate the feasibility of 99mTc-UBI scintigraphy in detection of infectious foci in painful hip prosthesis. UBI (Ubiquicidin 29-41) is an antimicrobial peptide fragment with the ability to target the bacterial colony directly. PATIENTS, METHODS: 34 patients, aged 20-79 years, with painful hip prosthesis were included. 99mTc-UBI scan and three phase bone scan were performed and two nuclear medicine specialists interpreted the UBI scans with and without bone scan results at hand. Both qualitative and semi-quantitative methods were used to interpret the 30 minute post injection images. The patients were actively followed up. According to the surgical findings, microbiological culture and active follow up, final diagnosis was made. RESULTS: 24 negative and 10 positive UBI scans were recorded. The sensitivity, specificity, negative and positive predictive values and accuracy of the study were all 100%. Bone scan did not have any influence on UBI interpretation. We were able to achieve excellent differentiation between infected and non-infected prostheses with a cut off value of 1.8 for target to non target (T/NT) ratio. No adverse effects were noticed following UBI scan. CONCLUSION: Based on the findings, the authors believe that 99mTc-UBI scintigraphy, with its high sensitivity and specificity, provides the physician with an excellent tool for differentiating infection from aseptic loosening of hip prostheses. Using this radiopharmaceutical, it is possible to obtain highly accurate results only 30 minutes after the beginning of the study.