Cementless RM Pressfit Cup: a clinical and radiological study of 91 cases with at least four years follow-up.

UNLABELLED: Cementless metal-back acetabular cups have good long-term results, but some problems have appeared due to the shell's stiffness, modularity and required bearing surfaces. The RM Pressfit Cup is a single-piece polyethylene cementless acetabular cup that is covered by a thin layer of titanium. This allows for bone integration without limitations related to the stiffness of a metal-back shell. There is very little published information about this new, innovative implant design. The purpose of this study was to evaluate the clinical and radiological results from a continuous series of 91 cups (85 patients) with a follow-up of at least 4 years. No patients were lost to follow-up. The Harris Hip Score (HHS) was used to assess the clinical outcome. To assess the radiological outcomes, digital X-rays were used to evaluate the cup position and integration; wear was measured using Livermore's technique. The clinical results were excellent: the mean HHS was 94 and 82% of cases had good or excellent scores. Three of the cups had to be revised because of dislocation brought on by incorrect positioning. X-rays revealed that three implants had shifted during the first 6 weeks, but had stabilized afterwards. Bone integration on X-rays was satisfactory in all cases with no signs of osteolysis. The configuration of the bone trabeculae showed that loads between the implant and peri-acetabular cancellous bone were evenly distributed. The wear of the polyethylene cup-ceramic head bearing was 0.07 mm/year. The results of this series are consistent with recent published studies with the RM Pressfit Cup. LEVEL OF EVIDENCE: IV.

[Proximal median nerve compression. A series of 35 consecutive cases]. / Compressions du nerf médian dans la région du coude et de la partie proximale de l'avant-bras. À propos d'une série de 35 cas consécutifs.

Median nerve entrapment at the elbow and the proximal forearm represents 7 to 10 % of median nerve mononeuropathies. Literature distinguishes two distinct syndromes: the pronator syndrome and the anterior interosseous nerve syndrome. We report a retrospective series of 35 cases of proximal compression of the median nerve, including a previous study of 13 cases assessed in 2001. Thirty-four patients were operated on between 1994 and 2011. The series included 15 men and 19 women with a mean age of 57 years. Subjective complaints were the main reason of consulting with or without a deficit. All but one benefited from a preoperative electrical study. Neurography showed abnormalities in 18 cases and myography in 30 cases. At least one site of compression was found at surgery. Thirty-one cases, including nine of the 13 cases previously evaluated in 2001, were assessed with a mean follow-up of 69 months. Twenty-height considered them improved and all but one were objectively improved by surgery. The nine cases evaluated in 2001 had better results in 2011. Through this series and an exhaustive literature review, we concluded that there are no preoperative criteria that can differentiate a pronator teres syndrome from an anterior interosseous nerve syndrome. If no improvement occurs, surgical treatment should be proposed, one must then assess all potential sites of nerve entrapment. Patients must be informed that improvement can take several years.

Cytoprotection by Achyrocline satureioides (Lam) D.C. and some of its main flavonoids against oxidative stress.

Epidemiological studies indicate that dietary antioxidants can influence the incidence of neurodegenerative diseases. Among them flavonoids have been proposed to be effective cytoprotectors. Consequently, herbs with a high concentration of these compounds such as Achyrocline satureioides, Ginkgo biloba and Epilobium parviflorum are of special interest. In this context a comparative study of the cytoprotective capacity of infusions from the three plants against an oxidative insult was performed. Hence, the cytoprotective activity of each infusion against H2O2 injury to PC12 cells was tested and the antioxidant capacity was assessed by the ABTS*+ radical bleaching assay. Free and glycosylated flavonoids contained in the infusions were identified by HPLC and the cytoprotective effect of some of these individual flavonoids was tested. The analysis of the flavonoid content of the infusions revealed different profiles. Epilobium parviflorum infusion showed the highest antioxidant capacity but only Achyrocline satureioides infusion proved to be cytoprotective. Moreover, the free flavonoids quercetin and luteolin contained in this infusion were also cytoprotective. In conclusion, the free radical scavenger capacity did not correlate with the cytoprotective profile of the infusions. The special mixture of unglycosylated Achyrocline satureioides flavonoids could be a clue to explain the unique effect of this plant.

Neuroprotection by flavonoids.

The high morbidity, high socioeconomic costs and lack of specific treatments are key factors that define the relevance of brain pathology for human health and the importance of research on neuronal protective agents. Epidemiological studies have shown beneficial effects of flavonoids on arteriosclerosis-related pathology in general and neurodegeneration in particular. Flavonoids can protect the brain by their ability to modulate intracellular signals promoting cellular survival. Quercetin and structurally related flavonoids (myricetin, fisetin, luteolin) showed a marked cytoprotective capacity in in vitro experimental conditions in models of predominantly apoptotic death such as that induced by medium concentrations (200 M) of H2O2 added to PC12 cells in culture. Nevertheless, quercetin did not protect substantia nigra neurons in vivo from an oxidative insult (6-hydroxydopamine), probably due to difficulties in crossing the blood-brain barrier. On the other hand, treatment of permanent focal ischemia with a lecithin/quercetin preparation decreased lesion volume, showing that preparations that help to cross the blood-brain barrier may be critical for the expression of the effects of flavonoids on the brain. The hypothesis is advanced that a group of quercetin-related flavonoids could become lead molecules for the development of neuroprotective compounds with multitarget anti-ischemic effects.

Neuroprotection by flavonoids

The high morbidity, high socioeconomic costs and lack of specific treatments are key factors that define the relevance of brain pathology for human health and the importance of research on neuronal protective agents. Epidemiological studies have shown beneficial effects of flavonoids on arteriosclerosis-related pathology in general and neurodegeneration in particular. Flavonoids can protect the brain by their ability to modulate intracellular signals promoting cellular survival. Quercetin and structurally related flavonoids (myricetin, fisetin, luteolin) showed a marked cytoprotective capacity in in vitro experimental conditions in models of predominantly apoptotic death such as that induced by medium concentrations (200 æM) of H2O2 added to PC12 cells in culture. Nevertheless, quercetin did not protect substantia nigra neurons in vivo from an oxidative insult (6-hydroxydopamine), probably due to difficulties in crossing the blood-brain barrier. On the other hand, treatment of permanent focal ischemia with a lecithin/quercetin preparation decreased lesion volume, showing that preparations that help to cross the blood-brain barrier may be critical for the expression of the effects of flavonoids on the brain. The hypothesis is advanced that a group of quercetin-related flavonoids could become lead molecules for the development of neuroprotective compounds with multitarget anti-ischemic effects.

Screening of antioxidant activity of three Indian medicinal plants, traditionally used for the management of neurodegenerative diseases.

A number of Indian medicinal plants have been used for thousands of years in the traditional system of medicine (Ayurveda). Amongst these are plants used for the management of neurodegenerative diseases such as Parkinson's, Alzheimer's, loss of memory, degeneration of nerves and other neuronal disorders by the Ayurvedic practitioners. Though the etiology of neurodegenerative diseases remains enigmatic, there is evidence, which indicates that defective energy metabolism, excitotoxicity and oxidative damage may be crucial factors (Ann. Neurol. 38 (3) (1995) 357). The part of the Ayurvedic system that provides an approach to prevention and treatment of degenerative diseases is known as Rasayana, and plants used for this purpose are classed as rejuvenators. This group of plants generally possesses strong antioxidant activity (Pharmacol. Biochem. Behav. 43 (1992) 1175), but only a few have been investigated in detail. In the present study, three such rasayana plants were tested for the first time for their toxicity and free radical scavenging activity both in vitro and ex vivo. All the three plant infusions (up to 1 mg/ml) showed no toxic effects on the viability of PC12 cell line as judged by MTT-test. Both ethanolic extracts and water infusions of the plants were tested for their antioxidant activity in the 2,2'-azinobis-3-ethyl-benzothiazoline-6-sulfonic acid (ABTS*(+)) radical cation decolorization assay; inhibition of lipid peroxidation by plant infusions was carried out using spontaneous lipid peroxidation of rat brain homogenate, and IC50 values were determined. The results from the ABTS assay showed that the ethanolic extract of Sida cordifolia was found to be most potent (IC50 16.07 microg/ml), followed by Evolvulus alsinoides (IC50 33.39 microg/ml) and Cynodon dactylon (IC50 78.62 microg/ml). The relative antioxidant capacity for the water infusions was observed in the following order: E. alsinoides (IC50 172.25 microg/ml)>C. dactylon (IC50 273.64 microg/ml)>S. cordifolia (IC50 342.82 microg/ml). The results of water infusions of the plants on lipid peroxidation were as follows: E. alsinoides (IC50 89.23 microg/ml)>S. cordifolia) (IC50 126.78 microg/ml)>C. dactylon (IC50 608.31 microg/ml).