Retracted: Atomic Absorption Spectrometry Analysis of Trace Elements in Degenerated Intervertebral Disc Tissue.

Medical Science Monitor is retracting the following publication on the basis of duplicated published content. 1) Kubaszewski L, Ziola-Frankowska A, Frankowski M, Rogala P, Gasik Z, Kaczmarczyk J, Nowakowski A, Dabrowski M, Labedz W, Miekisiak G, Gasik R. Comparison of trace element concentration in bone and intervertebral disc tissue by atomic absorption spectrometry techniques. J Orthop Surg Res. 2014 Oct 25;9: 99. doi: 10.1186/s13018-014-0099-y. PMID: 25342441; PMCID: PMC4220064. 2) Kubaszewski L, Ziola-Frankowska A, Frankowski M, Nowakowski A, Czabak-Garbacz R, Kaczmarczyk J, Gasik R. Atomic absorption spectrometry analysis of trace elements in degenerated intervertebral disc tissue. Med Sci Monit. 2014 Nov 4;20: 2157-64. doi: 10.12659/MSM.890654. PMID: 25366266; PMCID: PMC4301216. 3) Nowakowski A, Kubaszewski L, Frankowski M, Wilk-Franczuk M, Ziola-Frankowska A, Czabak-Garbacz R, Kaczmarczyk J, Gasik R. Analysis of trace element in intervertebral disc by Atomic Absorption Spectrometry techniques in degenerative disc disease in the Polish population. Ann Agric Environ Med. 2015;22(2): 362-7. doi: 10.5604/12321966.1152096. PMID: 26094540. We have reviewed the content of all three similar publications. We note that Medical Science Monitor was the second to publish this study, in November 2014. At that time, the Corresponding Author gave no declaration of submitting this study to any other journal, nor of previously publishing this study. Reference: Lukasz Kubaszewski, Anetta Ziola-Frankowska, Marcin Frankowski, Andrzej Nowakowski, Róza Czabak-Garbacz, Jacek Kaczmarczyk, Robert Gasik. Atomic Absorption Spectrometry Analysis of Trace Elements in Degenerated Intervertebral Disc Tissue. Med Sci Monit, 2014; 20: 2157-2164. DOI: 10.12659/MSM.890654.

Impact of the oxidative and enzymatic metals in degenerated intervertebral disc disease.

INTRODUCTION: The degenerative process of the intervertebral disc is a heterogeneous process that may exist in two forms, and involves dominant degenerative changes within the nucleus pulposus and the annulus fibrosus. In degenerative disc disease, the oxidative stress factor can play an important role. OBJECTIVE: The aim of research was to present a new approach to understanding the role of the analyzed elements in the process of degeneration of the intervertebral disc. MATERIAL AND METHODS: Selected elements from oxidative groups (Fe, Zn, Mo, As, Se), associated with enzymatic processes (Fe, Mo, Se, Zn, Ag, As, Bi), metals (Fe, Zn, Mo, Li) and metalloids (As, Bi) and their content was analyzed depending on the changes in the radiological images of the intervertebral disc. Elemental content analysis was performed by Inductively Coupled Plasma Mass Spectrometry analytical technique. RESULTS: The similarity between Fe and Se has been demonstrated during different stages of the analysis of groups of patients with degenerative disc disease. There was a negative correlation between Li and degenerative disc disease. The results also suggest that Fe and Ag are involved in degenerative changes within the intervertebral disc. A potential relationship between As/Bi and Fe/Mo in the degeneration of the intervertebral disc was demonstrated. CONCLUSIONS: Only some of the correlations can be explained by the metabolism of morphological elements of the intervertebral disc. The relationships indicate new directions for further studies on the degeneration process of the intervertebral disc. The presented study may reflect metabolic changes in the intervertebral disc and adjacent structures in response to the progressive degenerative process.

Comparison of Bone Tissue Trace Element Content in the Different Radiological Stages of Hip Osteoarthritis.

Bone metabolism and the trace element content associated with it change at each stage of degenerative disease. The aim of this study was to find out about the role of the analyzed elements in different stages of hip osteoarthritis. Elements associated with oxidative and enzymatic processes were analyzed depending on the changes in the radiological images of the hip joint. Element content analysis was performed by the inductively coupled plasma mass spectrometry analytical technique. The femoral head in severely osteoarthritic hips (KL3-4) compared to mild grade osteoarthritis (KL2) had a greater content of Cu (median 1.04 vs. 0.04), Sr (median 38.71 vs. 29.59), and Zn (median 75.12 vs. 63.21). There were no significant differences in the content of Mo, Cr, and Fe in the femoral head and neck between the groups. The Cu/Fe correlation was negative in the KL2 group (-0.47) and positive in the KL3-4 groups (0.45). Changes in the content and correlation of trace elements in the hip joint explain the changes in metabolism dependent on the severity of degenerative changes.

Surgical treatment of diffuse idiopathic skeletal hyperostosis of cervical spine with dysphagia - Case report.

INTRODUCTION: Diffuse idiopathic skeletal hyperostosis of cervical spine can lead to dysphagia. PRESENTATION OF CASE: A 73-year-old male weighing 110 kg and diagnosed with diffuse idiopathic skeletal hyperostosis in cervical spine with dysphagia. Patient manifested local pain of neck, a gradual limitation of spinal mobility. The surgery decision was based on swallowing problems, not pain in the spine. Before surgery radiographs, magnetic resonance images, computed tomography of the cervical spine and gastroscopy were obtained. Osteophytes were removed from the anterior approach with present otolaryngologist by surgery. DISCUSSION: In this case used gastroscopy, CT and MRI for diagnostics. During the procedure we had support otolaryngologist. The patient has not been found a stenosis spinal canal and neurological symptoms. We were removed the ostheophytes. Interbody implants have not been applied. CONCLUSION: Disc degeneration disease itself can be asymptomatic or not a dominant problem for the DISH patients. Clinical signs may pharyngoesophageal and tracheal compression, causing dysphagia, shortness of breath and stridor. In this case, the cervical spine was stability and not demonstrated a stenosis in the spinal canal. Isolate removing of the osteophytes without implants in DISH of cervical spine can be enough solution.

XUV diagnostic to monitor H-like emission from B, C, N, and O for the W7-X stellarator.

The "C/O Monitor" system for the Wendelstein 7-X (W7-X) stellarator is a dedicated spectrometer with high throughput and high time resolution (order of 1 ms) for fast monitoring of content of low-Z impurities in the plasma. The observed spectral lines are fixed to Lyman-α lines of H-like atoms of carbon (3.4 nm), oxygen (1.9 nm), nitrogen (2.5 nm), and boron (4.9 nm). The quality of the wall condition will be monitored by the measurements of oxygen being released from the walls during the experiments. The strong presence of carbon is an indication for enhanced plasma-wall interaction or overload of plasma facing components. The presence of nitrogen (together with oxygen) may indicate a possible leakage in the vacuum system, whereas the intensity of the spectral emission of boron indicates the status of the boron layer evaporated onto the wall in order to reduce the influx of heavier steel ingredients or oxygen. The spectrometer will be fixed in a nearly horizontal position and is divided into two vacuum chambers, each containing two spectral channels assigned to two impurity species. Each channel will consist of a separate dispersive element and detector. The line-of-sight of both subspectrometers will cross at the main magnetic axis. This paper presents the conceptual design of the "C/O Monitor" for W7-X which has already entered the executive stage.

Short-Term Effects of Kinesio Taping® on Electromyographic Characteristics of Paraspinal Muscles, Pain, and Disability in Patients With Lumbar Disk Herniation.

Context: Kinesio taping® (KT) is a therapeutic modality frequently used in the clinical practice for the treatment of various musculoskeletal disorders. It is often applied in patients with chronic low back pain to decrease pain and improve functional capacity. However, it is not known, whether thoracolumbar fascia KT technique can decrease back pain, restore normal activity of paraspinal muscles, and improve functional capacity in patients with lumbar disk herniation (LDH). Objective: To evaluate the impact of 7-day new KT stabilizing application on lumbar paraspinal muscles function, pain perception, and disability in patients with LDH. Design: A randomized controlled trial. Setting: Human Performance Laboratory. Patients: A number of 38 patients with LDH were randomized into KT (n = 19) and placebo taping (n = 19) groups. Interventions: Both groups received the same "x" type application running over the back along fibers of superficial lamina of the posterior layer of thoracolumbar fascia. Main Outcome Measures: The primary outcome measures were flexion-relaxation and extension-relaxation ratios calculated from electromyographic activity of lumbar multifidus and longissimus thoracic muscles. Pain intensity rating (Quadruple Visual Analogue Scale), pressure pain thresholds of the lower back, Roland-Morris Disability Questionnaire score, back extension force, and flexion range of motion (ROM) were among secondary outcomes. Results: KT application did not affect the lumbar multifidus and longissimus thoracic muscles flexion-relaxation and extension-relaxation ratios, lower back pressure pain thresholds, back flexion ROM, and back extension force (no group × time interaction [GTI]). KT and placebo taping comparably decreased disability level (time effect: F1,36 = 22.817, P < .001; GTI: F1,36 = 0.189, P = .67), average pain (time effect: F1,36 =39.648, P < .001; GTI: F1,36 = 2.553, P = .12), and the worst pain (time effect: F1,36 = 36.039, P < .001; GTI: F1,36 = 0.003, P = .96) intensity. Conclusion: Seven-day KT does not normalize lumbar paraspinal muscle function and is not superior to placebo in reducing disability and pain intensity in patients with LDH.

Biomechanical analysis of the durability of a modified S1 vertebrae transpedicular screws insertion technique.

BACKGROUND: One of the most important elements of the transpedicular screw implantation technique, which enables a strong screw-bone interface, is the precise choice of the site of screw insertion and the screw's trajectory. Due to the complex biomechanics of the lumbosacral interface and different shape of the sacrum, fixation of this segment remains a challenge for surgeons. Because of this, Kubaszewski et al. proposed a modified technique in which the entry point for screw insertion in the S1 vertebra is changed. METHODS: Six human cadaver specimens of the S1 vertebrae were examined. Two transpedicular screws were inserted into the body of each examined vertebra using two implantation methods with different screw entry points and trajectories. The screws were subjected to cyclic preloading, followed by the pull-out test. The ultimate pull-out force, displacement, stiffness, and failure energy were measured. FINDINGS: The average pull-out force obtained for the standard method of implantation was 498 N (SD 201), whereas for the modified technique, it was 1308 N (SD 581). Displacement of the inserted screws in the new method was 36% higher than in the case of the standard method. This method is also characterized by the greater stiffness of the obtained interface and greater failure energy than the normally used technique. INTERPRETATION: The obtained results demonstrate that the use of the new technique of implantation significantly increases the strength of the obtained screw-bone interface. It should also increase the success rate of the performed fixations and increase the safety of such fixations in clinical practice.

Chemometric evaluation of concentrations of trace elements in intervertebral disc tissue in patient with degenerative disc disease.

BACKGROUND: The work is designed to uncover the pattern of mutual relation among trace elements and epidemiological data in the degenerated intervertebral disk tissue in humans. Hitherto the reason of the degenerative process is not fully understood. Trace elements are the basic components of the biological compound related both its metabolism as well as environmental exposure. The relation pattern among elements occurs gives new perspective in solving the cause of the disease. MATERIAL AND METHODS: We have analysed trace elements content in the 30 intervertebral disc from 22 patients with degenerative disc disease. The concentrations of Al, Cu, Cd, Mo, Ni and Pb were determined with Atomic Absorption Spectrometry. To analyse the multidimentional relation between trace element concentration and epidemiological data the chemometric analysis was applied. RESULTS: The similarity have been shown in occurrence of following pairs: Cd-Mo as well as Mg-Zn. The second pair was correlated with Pb concentration. Pb levels are observed to be competitive to Cu concentration. Cd concentration was related to Zn and Mg deficiency. No single but rather cluster of epidemiological data show observable influence on the TE tissue variance. Zn and Cu was related to the male sex. Operation with orthopedic implants were related to combined Al, Mo and Zn concentration. CONCLUSIONS: This is the first chemometric analysis of trace elements in disk tissue. It shows multidimentional relations that are missed by the classical statistic. The analysis shows significant relation. The nature of the relations is the basis for further metabolic and environmental research.

Modified methods for efficiently differentiating human embryonic stem cells into chondrocyte-like cells.

INTRODUCTION: Human articular cartilage has a poor regenerative capacity. This often results in the serious joint disease- osteoarthritis (OA) that is characterized by cartilage degradation. An inability to self-repair provided extensive studies on AC regeneration. The cell-based cartilage tissue engineering is a promising approach for cartilage regeneration. So far, numerous cell types have been reported to show chondrogenic potential, among others human embryonic stem cells (hESCs). MATERIALS AND METHODS: However, the currently used methods for directed differentiation of human ESCs into chondrocyte-like cells via embryoid body (EB) formation, micromass culture (MC) and pellet culture (PC) are not highly efficient and require further improvement. In the present study, these three methods for hESCs differentiation into chondrocyte-like cells in the presence of chondrogenic medium supplemented with diverse combination of growth factors (GFs) were evaluated and modified. RESULTS: The protocols established here allow highly efficient, simple and inexpensive production of a large number of chondrocyte-like cells suitable for transplantation into the sites of cartilage injury. The most crucial issue is the selection of appropriate GFs in defined concentration. The obtained stem-derived cells reveal the presence of chondrogenic markers such as type II collagen, Sox6 and Sox9 as well as the lack or significantly lower level of pluripotency markers including Nanog and Oct3/4. DISCUSSION: The most efficient method is the differentiation throughout embryoid bodies. In turn, chondrogenic differentiation via pellet culture is the most promising method for implementation on clinical scale. The most useful GFs are TGF-ß1, -3 and BMP-2 that possess the most chondrogenic potential. These methods can also be used to obtain chondrocyte-like cells from differentiating induced pluripotent stem cells (iPSCs).

Correlations between serum adipocytokine concentrations, disease stage, radiological status and total body fat content in the patients with primary knee osteoarthritis.

PURPOSE: The study was designed to investigate whether serum concentrations of leptin, resistin and adiponectin in obese and normal-weight patients with primary knee osteoarthritis (OA) correlate with clinical and radiological stages of the disease and percentage of total body fat. METHODS: Seventy-three patients with knee OA, divided into obese and normal-weight groups, were clinically evaluated according to the Knee Society Score (KSS), and radiologically assessed using Kellgren and Lawrence scale. The percentage of total body fat and some anthropometric data were also given. Serum leptin, resistin and adiponectin concentrations were measured by Elisa and were correlated with the clinical, radiological and anthropometric parameters. RESULTS: Leptin concentrations were significantly higher (p = 0.001) in the obese patients and positively correlated (R = 0.63) with radiologically assessed OA grade, but only in the normal-weight group. Resistin and adiponectin concentrations were identical in obese and normal-weight patients and negatively correlated (R = -0.41) with the clinical status of obese patients. In both groups, percentage of total body fat positively correlated (R = 0.29 and R = 0.53 for obese and normal-weight respectively) with radiologically assessed OA grade. However, no correlations were found with clinical status of the patients. CONCLUSIONS: It was found that in the obese patients with knee OA, increased percentage of total body fat and elevated serum leptin concentration might favour the advancement of clinical but not radiologically assessed changes in the joint structures, while in normal-weight patients it correlates only with radiologically assessed changes but does not affect to an appreciable extent the clinical status of the patients.

Feasibility and accuracy of new insertion technique of S1 transpedicular screw. Computed tomography-based morphometric analysis.

OBJECTIVE: To assess feasibility and accuracy of a new insertion technique of S1 transpedicular screw. SUMMARY OF BACKGROUND DATA: Transpedicular stabilization in the first sacral vertebra (S1) is a technically demanding surgical procedure with inherent risk of loosening of the implant. A modification of the technique was recently proposed, along with the analytical verification which was performed based on the available literature. In the study, we performed radiological assessment of screws inserted into the S1 using the classical and modified techniques. METHODS: The analysis was performed in two parts. The first part was performed on eight cadaver specimens after implantation of the screws. In the second part, we used computed tomography images of patients with degenerative disk disease with a superimposed representation of screws. The thickness of the posterior cortex adherent to the screws, screw trajectory and their position with regard to the spinal canal was measured. The area of posterior cortex in contact with the screws was also calculated. RESULTS: The contact length and area was found to be two times greater for screws introduced with the modified technique. The convergence angle was comparable between the techniques, despite the shift of entry point. There was no canal breach, although with the modified technique the screws passed closer to the spinal canal. CONCLUSIONS: The modified technique is considered safe. In this technique, the screws pass through a thicker portion of the posterior cortex compared to the classical technique that aims at improving the stability of the fixation.

Treatment of lumbar disc herniation with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery.

INTRODUCTION: Herniated lumbar disc (HLD) is arguably the most common spinal disorder requiring surgical intervention. Although the term is fairly straightforward, the exact pathology and thus the clinical picture and natural history may vary. Therefore, it is immensely difficult to formulate universal guidelines for surgical treatment. AIM: The aim of this paper is to organize the terminology and clear the inconsistencies in phraseology, review treatment options and gather available published evidence to address the clinical questions to create a set of clinical guidelines in relevant to the topic. METHODS AND RESULTS: Twelve queries, addressing optimal surgical treatment of the HLD have been formulated. The results, based on the literature review are described in the present work. The final product of the analysis was a set of guidelines for the surgical treatment of symptomatic HLD. Categorized into four tiers based on the level of evidence (I-III and X), they have been designed to assist in the selection of optimal, effective treatment leading to the successful outcome. CONCLUSIONS: The evidence based medicine (EBM) is becoming ever more popular among spinal surgeons. Unfortunately this is not always feasible. Lack of uniform guidelines and numerous conflicts of interest introduce flaws in the decision making process. The key role of experts and professional societies is to provide high value recommendation based on the most current literature. Present work contains a set of guidelines for the surgical treatment of HLD officially endorsed by the Polish Spine Surgery Society.

Treatment of degenerative cervical spondylosis with radiculopathy. Clinical practice guidelines endorsed by The Polish Society of Spinal Surgery.

INTRODUCTION: Degenerative cervical spondylosis (DCS) with radiculopathy is the most common indication for cervical spine surgery despite favorable natural history. Advances in spinal surgery in conjunction with difficulties in measuring the outcomes caused the paucity of uniform guidelines for the surgical management of DCS. AIMS: The aim of this paper is to develop guidelines for surgical treatment of DCS. For this purpose the available up-to-date literature relevant on the topic was critically reviewed. METHODS AND RESULTS: Six questions regarding most important clinical questions encountered in the daily practice were formulated. They were answered based upon the systematic literature review, thus creating a set of guidelines. The guidelines were categorized into four tiers based on the level of evidence (I-III and X). They were designed to assist in the selection of optimal and effective treatment leading to the most successful outcome. CONCLUSIONS: The evidence based medicine (EBM) is increasingly popular among spinal surgeons. It allows making unbiased, optimal clinical decisions, eliminating the detrimental effect of numerous conflicts of interest. The key role of opinion leaders as well as professional societies is to provide guidelines for practice based on available clinical evidence. The present work contains a set of guidelines for surgical treatment of DCS officially endorsed by the Polish Spine Surgery Society.

Application of cell and biomaterial-based tissue engineering methods in the treatment of cartilage, menisci and ligament injuries.

Over 20 years ago it was realized that the traditional methods of the treatment of injuries to joint components: cartilage, menisci and ligaments, did not give satisfactory results and so there is a need of employing novel, more effective therapeutic techniques. Recent advances in molecular biology, biotechnology and polymer science have led to both the experimental and clinical application of various cell types, adapting their culture conditions in order to ensure a directed differentiation of the cells into a desired cell type, and employing non-toxic and non-immunogenic biomaterial in the treatment of knee joint injuries. In the present review the current state of knowledge regarding novel cell sources, in vitro conditions of cell culture and major important biomaterials, both natural and synthetic, used in cartilage, meniscus and ligament repair by tissue engineering techniques are described, and the assets and drawbacks of their clinical application are critically evaluated.

Bioimaging: An Useful Tool to Monitor Differentiation of Human Embryonic Stem Cells into Chondrocytes.

To improve the recovery of damaged cartilage tissue, pluripotent stem cell-based therapies are being intensively explored. A number of techniques exist that enable monitoring of stem cell differentiation, including immunofluorescence staining. This simple and fast method enables changes to be observed during the differentiation process. Here, two protocols for the differentiation of human embryonic stem cells into chondrocytes were used (monolayer cell culture and embryoid body formation). Cells were labeled for markers expressed during the differentiation process at different time points (pluripotent: NANOG, SOX2, OCT3/4, E-cadherin; prochondrogenic: SOX6, SOX9, Collagen type II; extracellular matrix components: chondroitin sulfate, heparan sulfate; beta-catenin, CXCR4, and Brachyury). Comparison of the signal intensity of differentiated cells to control cell populations (articular cartilage chondrocytes and human embryonic stem cells) showed decreased signal intensities of pluripotent markers, E-cadherin and beta-catenin. Increased signal intensities of prochondrogenic markers and extracellular matrix components were observed. The changes during chondrogenic differentiation monitored by evaluation of pluripotent and chondrogenic markers signal intensity were described. The changes were similar to several studies over chondrogenesis. These results were confirmed by semi-quantitative analysis of IF signals. In this research we indicate a bioimaging as a useful tool to monitor and semi-quantify the IF pictures during the differentiation of hES into chondrocyte-like.

Traumatic brain injury in Poland from 2009-2012: A national study on incidence.

BACKGROUND: Traumatic brain injury (TBI) remains one of the leading causes of mortality and morbidity worldwide. The purpose of this study was to provide data on epidemiology of TBI in Poland during 2009-2012. METHODS: The national data on hospitalizations with TBI as a primary diagnosis was obtained from the National Health Fund of Poland. The sub-set of two diagnosis-related groups (DRG) was used for analysis. The incidence and mortality were calculated with the emphasis on diagnosis. The external causes of injuries were investigated based on the representative sample. RESULTS: Within the study period there were 194,553 hospitalizations due to the TBI in two DRGs. The overall incidence was 126.52/10(5)/year (95% CI = 125.96-127.09). The most common diagnosis was concussion, with an incidence of 81.66/10(5)/year, and the most prevalent structural injury was subdural haematoma (15.27/10(5)/year). The predominant external causes were traffic accidents (40.52%) followed by falls (32.77%). CONCLUSIONS: The incidence of TBIs in Poland compared with other countries in Europe is relatively low. The incidence of concussions mirrored current treatment guidelines rather than real epidemiology.