Expression levels of selected cytokines and microRNAs in response to vitamin D supplementation in ultra-marathon runners.

Ultra-marathon (UM) running is an extreme endurance exercise. However, the mechanisms triggered with its practice remain unclear. While it is documented that strenuous physical activity activates immune responses and vitamin D plays a role in immune system suppression, data on the relationship between vitamin D status and cytokine profile in athletic populations are limited. To analyse the relative mRNA expression levels of selected pro-inflammatory cytokines (IL-1ß, IL-6, IL-8, IL-17, TNF-α), COX-2, vitamin D receptor and abundance of selected inflammatory microRNAs (Hsa-miR-21, -miR-146a, -miR-150, -miR-155, -miR-222, -miR-223) before and after a 100 km race in amateur runners in the presence or absence of vitamin D supplementation. Twenty runners aged 36-40years were divided into two groups: with and without vitamin D3 supplementation (10,000units daily). Blood samples were collected before and 12 h after the UM. The mRNA expression levels of selected cytokines, COX-2 and VDR in peripheral blood and abundance of serum exosomal miRNAs were investigated using q-RT-PCR. After UM, the significant up-regulation of TNF-α and hsa-miR-155 and down-regulation of IL-1ß were observed in the group with vitamin D supplementation. In its absence, hsa-miR-155 and -miR-223 were significantly up-regulated. Additionally, a reverse correlation was observed between IL-6 expression level and abundance of hsa-miR-155 and -miR-223 in both groups. No statistical differences were noted when the other miRNAs and genes were examined in the groups and at the time points. The UM-induced mRNA expression pattern of pro-inflammatory cytokines could be influenced by vitamin D supplementation and/or miRNA.

[Use of transpedicular fixation in treatment of thoraco-lumbar spinal injuries]. / Zastosowanie stabilizacji transpedikularnej w leczeniu urazowych uszkodzen czesci piersiowo-ledzwiowej kregoslupa.

In Orthopaedic University Department in Lublin in years 1993-1998 39 patients with thoraco-lumbar spine injuries were treated including 34 fractures and 5 luxations. All of them were treated by surgery. Complete neurological palsy (Frankel A) occurred in 16 patients. Grade E on Frankel scale e.g. no neurological symptoms was in 2 cases. The operations consisted of wide laminectomy with interpedicular joints resection. It gave chance to mobilise the dural sac with its contents. In this situation it was possible to remodel the anterior wall of spinal canal by removal of fractured bony pieces from vertebral body or fibroid remnants of damaged disc. Injured segments of the spine were stabilized by Kluger's fixateur. In 20 cases reduction of vertebral body fracture and filting of bone loss by autogenic spongiosa grafts from iliac crest as proposed by Daniaux was done. In 6 patients posterior interbody spondylodesis was done also with iliac crest grafts. In 9 patients who had only reduction of injured segments, without vertebral body reconstruction and spondylodesis loss of correction occurred after fixateur removal. In 3 patients fatigue break of screws or stabilizing rods developed. It happened 12-16 months after surgical procedure. In patients with primary complete neurological palsy from the level of injury (Frankel A) no symptoms of function improvement appeared higher than one grade in Frankel's scale.

[The evaluation of preliminary results of spondylolisthesis treatment in adults by Kluger's transpedicular stabilization]. / Ocena wczesnych wyników leczenia kregozmyków osób doroslych transpedikularnym sposobem Klugera.

There were 13 adults with spondylolisthesis treated operatively from 1994 to 1997 in University Orthopaedics Department in Lublin. The surgical procedures consisted of displacement reduction by transpedicular device and stabilization with Kluger's system. Patient's age ranged from 39 to 60 years. The follow-up examination took place 1 to 4 years from surgery. In 10 cases isthmal spondylolisthesis and in additional 3 iatrogenic (because of previous operations) were diagnosed. There was pathology on level L4/L5 in 6 and L5/S1 in other 7 patients. The first grade of displacement had 7 persons and the second one other 6. The vertebral body displacement ranged from 15% to 35%. All patients 3-6 months before admission had had pain intensification because of instability and nerve's roots irritation. Wide laminectomy with osteophytes removal from anterior wall od spinal canal gave chance to decompress neural structures. There were 3 patients who had posterior spondylodesis between transverse processes, 2 who had ALIF two weeks after operation from posterior approach. In 7 cases posterior intervertebral spondylodesis (PLIF) was performed during the same procedure with displacement reduction. Follow-up examination found full reduction and sufficient interbody fusion in all cases. In 1 patient there was transpedicular screw loosening because ALIF as the second step of procedure wasn't done. There was one deep infection and necessity of fixateur removal 9 months postop. The others hadn't symptoms of screw loosening and it suggests sufficient spondylodesis. Ten patients returned to their previous occupation.

[Preliminary evaluation of the efficacy of transpedicular refilling of spongiosa loss with autologous grafts in thoraco-lumbar vertebral bodies using the Daniaux method]. / Wczesna ocena skutecznosci transpedikularnego wypelniania przeszczepami ubytków kosci gabczastej zlamanych trzonów kregów piersiowo-ledzwiowej czesci kregoslupa wg Daniaux.

In Orthopaedic University Clinic in Lublin there were 35 patients with thoraco-lumbar spine fractures since 1993 to 1997. In 18 operated patients fractures of vertebral bodies were reduced and bone loss refilled by autogenous morselised grafts implanted through arc's basis using Daniaux method. There were 9 L1 fractures, 6 Th12 and single one on levels of Th11, L2 and L3. Complete spinal cord injury had 5 patients and partial 13. The degree of vertebral body compression was counted using Taillard's formula preoperatively, 4 weeks, 6 and 12 months after surgery. The anterior wall of vertebral body was decline ranged from 20% to 77%, average 51.9%. There were evaluations of 7 patients 6 months from fixator removal. Presented results support the opinion that operative reconstruction of vertebral body's fracture with autologous spongiosa grafts implantation in place of bone loss gives better chance for anterior wall height reconstitution. Small loss of correction after metal fixator removal, average 7.7%, testify good graft's remodeling and sufficient durability of Daniaux's method of treatment.

Engineering investigation of the Kensey dynamic angioplasty catheter.

This article describes an in vitro experimental study which was designed to gain a better understanding of the mechanism by which the Kensey catheter mediates atherosclerotic tissue. The major goals of the study were to observe the generation of debris particles during revascularization and to elucidate the fluid dynamic effects associated with particle motions at and around the tip of the catheter. To investigate these phenomena, in vitro actual size and large scale model experiments were conducted. The results of these experiments provide a reference for the significance of the clinical performance of the Kensey catheter.

Recanalization of total arterial occlusions with the Kensey dynamic angioplasty catheter.

The Kensey dynamic angioplasty catheter is a new device for recanalization of peripheral arterial occlusions. Twelve patients with segmental occlusions who were not considered candidates for conventional bypass surgery because of cardiovascular risk factors were studied. Four of the patients were treated in the operating room. Two had excellent primary results in limb salvage situations, and recanalization of an occluded femoropopliteal bypass graft was successful in another. Bilateral iliac recanalizations in the fourth patient were locally successful but did not prevent the patient's death from advanced ischemic disease. Eight patients were treated percutaneously. Initial recanalization was successful in seven. Four had early reocclusions and required amputation below the knee. One suffered distal embolization after recanalization of a 6-cm popliteal segment and underwent above-the-knee amputation. Long-term follow-up (7-18 months) in the other three patients with successful primary recanalizations has confirmed patency of the recanalized segments.