Motion of the anterior cruciate ligament during internal and external rotation at the knee: A cadaveric study.

Despite advances in our understanding of anterior cruciate ligament (ACL) anatomy and function, the change in position of the ACL during tibial rotation is not well understood. The purpose of this study was to quantify and compare the movements of the anteromedial (AM) and posterolateral (PL) bundles of the ACL during 15° of medial and lateral rotation (with & without a shear force). Cadaveric knees (12 male/12 female) were dissected and mounted at 90° of knee flexion. Anthropometric features of the ACL and distal femur were recorded, and each bundle was marked at: femoral attachment (FA), midpoint of ligament (MP), and tibial attachment (TA). Digital images of ACL motion in the frontal plane were taken as the tibia was rotated about a fixed femur. Using digitizing software, the change in position of the markers was quantified. Measurements suggested the ACL pattern of motion was consistent between sexes, regardless of shear force. The greatest amount of movement of both the AM and PM bundles occurred at the TA marker. The FA marker moved more during medial rotation, and the MP and TA markers moved more with lateral rotation. The 20 lb-shear force affected medial rotation most. This study is the first to quantify movement of the ACL during medial and lateral tibial rotation. Data should assist surgeons to select a graft position that is capable of replicating the rotational movement of the native ACL, and help improve three-dimensional stability of the ACL reconstructed knee. Clin. Anat. 30:861-867, 2017. © 2017 Wiley Periodicals, Inc.

Histologic Lesions Induced by Murine Norovirus Infection in Laboratory Mice.

Murine noroviruses (MNVs) are highly prevalent in laboratory mice, can cause persistent infections, and have been shown to infect macrophages, dendritic cells, and B cells. To address the potential impact of MNV infection on research outcomes, numerous studies have been conducted with various mouse models of human disease and have generated mixed results, ranging from no impact to significant disease. Many of these studies included histologic evaluations after MNV infection, and these results have similarly been variable in terms of whether MNV induces lesions, despite the fact that localization of MNV by viral culture and molecular techniques have demonstrated systemic distribution regardless of mouse immune status. The aim of this review is to summarize the histologic findings that have been reported with MNV infection in several mouse models. The studies demonstrate that experimental infection of MNV in wild-type mice results in minimal to no histologic changes. In contrast, immunodeficient mice consistently have detectable MNV-induced lesions that are typically inflammatory and, in the most severe cases, accompanied by necrosis. In these, the liver is commonly affected, with more variable lesions reported in the lung, gastrointestinal tract, mesenteric lymph nodes, brain, and spleen. In specific disease models including atherosclerosis, MNV infection had a variable impact that was dependent on the mouse model, viral strain, timing of infection, or other experimental variables. It is important to recognize the reported MNV lesions to help discern the possible influence of MNV infection on data generated in mouse models.

A conserved MADS-box phosphorylation motif regulates differentiation and mitochondrial function in skeletal, cardiac, and smooth muscle cells.

Exposure to metabolic disease during fetal development alters cellular differentiation and perturbs metabolic homeostasis, but the underlying molecular regulators of this phenomenon in muscle cells are not completely understood. To address this, we undertook a computational approach to identify cooperating partners of the myocyte enhancer factor-2 (MEF2) family of transcription factors, known regulators of muscle differentiation and metabolic function. We demonstrate that MEF2 and the serum response factor (SRF) collaboratively regulate the expression of numerous muscle-specific genes, including microRNA-133a (miR-133a). Using tandem mass spectrometry techniques, we identify a conserved phosphorylation motif within the MEF2 and SRF Mcm1 Agamous Deficiens SRF (MADS)-box that regulates miR-133a expression and mitochondrial function in response to a lipotoxic signal. Furthermore, reconstitution of MEF2 function by expression of a neutralizing mutation in this identified phosphorylation motif restores miR-133a expression and mitochondrial membrane potential during lipotoxicity. Mechanistically, we demonstrate that miR-133a regulates mitochondrial function through translational inhibition of a mitophagy and cell death modulating protein, called Nix. Finally, we show that rodents exposed to gestational diabetes during fetal development display muscle diacylglycerol accumulation, concurrent with insulin resistance, reduced miR-133a, and elevated Nix expression, as young adult rats. Given the diverse roles of miR-133a and Nix in regulating mitochondrial function, and proliferation in certain cancers, dysregulation of this genetic pathway may have broad implications involving insulin resistance, cardiovascular disease, and cancer biology.

[Double adenoid cystic and squamous cells carcinoma of the hypopharynx and larynx. A contribution to the issue of multicomponent neoplasms]. / Podwójny rak gruczolowo-torbielowaty i plaskonablonkowy czesci krtaniowej gardla i krtani. Przyczynek do problematyki wieloskladnikowych nowotworów zlosliwych.

Bicomponent cancer of the piriform fossa and larynx of 55 years old man has been described. The patient was treated surgically and by radiotherapy. The performance of laryngectomy and partial pharyngectomy with conservative bilateral neck dissection was used as surgical treatment. In histopathological findings of postoperative specimens two types of neoplasms: squamous cells and adenoid-cystic cancers were stated. The authors presented opinions on the affection arising of multicomponent tumours of the aerodigestive truct.

[The case of Wegener's granulomatosis of the nose, larynx and ear]. / Przypadek choroby Wegenera z lokalizacja w obrebie nosa, ucha i krtani.

We have described a rare case of Wegener's granulomatosis in our 41-year old patient, located in the nose, larynx and ear. The disease usually presents as a triad of respiratory, vascular and kidney location. It may occur as a rapid or indolent progress. We have shown in our paper diagnostic difficulties connected with this disease. The biopsies of involved organs and blood tests are the best steps of establish proper diagnosis. Antineutrophil cytoplasmic antibodies (ANCA) are typical markers of Wegeners's granulomatosis. The conservative therapy including immunosuppression and surgical treatment (laserotherapy) are main methods of management. Our patient was given antibiotic therapy, and immunosuppressive therapy. Her condition improved during the first hospitalisation. Remission lasted very short, and she was admitted to the hospital again and underwent intensive investigations and therapy. We observed dyspnea caused by subglottic stenosis. The histologic examination of the tracheal mucosa showed granulomatous inflammation. After intensive therapy our patient felt better. She has been in our records till now, we observe no progress of disease. Finally, we would like to pay attention to the fact, that early diagnosis is important to prevent complications such subglottic stenosis which can lead to death.

Spatial complexity in children's language.

The purpose of this research was to explore the properties of locative scenes which influence the sequence of the acquisition of spatial prepositions in English. Children ranging in age from about 2;8 to 5;6 were tested with a comprehension test involving a sentence-picture matching task. The comprehension test contained six kinds of spatial contrasts which were judged to vary in the geometric complexity of the scene. The order of acquisition was as follows: (1) into/out of & onto/off of, (2) in/on, (3) into/onto & out of/off of and through/over (around), (4) between X & Y/Y & Z, and (5) across/along. Complexity depends on a number of factors such as the number of referent objects and the nature of the relationship between the object to be located and the critical feature of the referent object. Prepositions which involve a more complex spatial geometry are more difficult for young children to comprehend. It was argued that the sequence of acquisition is partially determined by the course of conceptual development.

[Impairment of the vocal fold after radiotherapy as a significant sign of the persistent laryngeal cancer]. / Unieruchomienie faldu glosowego po radioterapii jako objaw wskazujacy na obecnosc przetrwalego raka krtani.

Among 30 patients suffered from laryngeal cancer and treated surgically after failed radiotherapy histologic study of vocal folds were performed. The aim of this study was to find a cause of impairment of the vocal fold after radiotherapy. In 27 cases histologic specimens shown the presence of the cancer in the impaired vocal fold, but only in specimens of 3 patients which had immobile fold, author find massive inflammatory process. These data show that impairment vocal fold after radiotherapy is a significant sign of the presence of the persistent laryngeal cancer.

[Hemangioendothelioma of the larynx]. / Sródbloniak krwionosny krtani.

The authors present a case of 37 years old patient suffered from the laryngeal tumour, which was hemangioendothelioma. Recurrence was observed three times after surgically treatment. The difference between histopathological "benign" character and clinically "malignant" course is interested. The authors put attention on the difficulties with establish right management. Occurrence of the hemangioendothelioma in the larynx is very rare. The authors stressed the big difference in estimate of hemangioendothelioma malignancy presented in literature.

[The results of salvage surgery in the patients with the laryngeal cancer after failed radiotherapy]. / Wyniki chirurgicznego leczenia chorych z rakiem krtani po niepowodzeniu radioterapii.

The authors present material of 50 patients suffered from laryngeal cancer, who had performed salvage laryngectomy after failure radiotherapy. Greatest influence on the results of treatment had local and regional advanced of cancer and immediately tracheotomy before laryngectomy. The performance oft total laryngectomy is advocated as a salvage treatment in the ceases of failed radiotherapy. The authors underline that performance of laryngectomy after obtaining of laryngeal cancer on the basis of histopathological examination in a number of cases delayed the surgical treatment and thus caused in some of them that the patient's chance to be cured was lost.

[An unusual case of the otogenic purulent thrombosis of the sigmoid sinus and internal jugular vein]. / Rzadki przypadek usznopochodnego zakrzepowo-ropnego zapalenia zatoki esowatej i zyly szyjnej wewnetrznej.

The authors present a case of 51 years old female suffering from the purulent thrombophlebitis of the sigmoid sinus and internal jugular vein. The disease developed in the course of chronic otitis media. During first 2 weeks she was treated with antibiotics because of the septic fever without significant otogenic symptoms. An incidental otolaryngologic examination showed the reason of the illness. The authors emphasise the thrombophlebitis process extended from transverse sinus to the lower end of internal jugular vein. Nowadays the otogenic thrombophlebitis complications are rare, but the knowledge of them is indispensable in the everyday practice. The authors emphasise the necessity of cooperation otolaryngologists with other specialists. Especially it is important in the Polish new model of health service, which place the main role of the treatment to general practitioners.

[Intracranial complication of sinusitis in a 18-year old patient]. / Zatokopochodne powiklanie wewnatrzczaszkowe u 18-letniej chorej.

We have described a case of intracranial complications, which were caused by acute inflammation of maxillary sinus. In our patient we observed the development of multilocular intracranial abscesses located in left temporal lobe. However intracranial complications of sinusitis are rare, but they are still a serious problem that results in high mortality. The dominant features were: nighttime headache, fever, amnestic aphasia. The patient was treated surgically--utilizing traditional operation Caldwell-Luce'a. A conservative treatment was administrated during a long period including high-doses of i.v. antibiotics. This kind of patients require an interdisciplinary approach--radiological, neurosurgical and otolaryngological. The diagnosis was made with the aid of X-ray, CT-scan and cerebrospinal fluid examination. In spite of very intensive treatment the patient was unconscious one week. Her condition improved in the third week of her admission. CT-scanning carried out in first week showed brain infection. Repetition of Ct-scans of the head evidenced progression of disease by forming multiple abscesses in left temporal lobe excluding any neurosurgical treatment. Finally the patient's condition improved in the third week of her admission. She was discharged after six weeks of treatment without cranial nerve palsies. Amnestic aphasia lasted next six months.

[Teratoma in the middle ear and throat of an infant]. / Guz potworniakowy (teratoma) ucha srodkowego i gardla u niemowlecia.

The authors present a case of an 8-moth-old female infant treated for prolonged otitis media. The inflammatory process was connected with teratoma of tympanum and throat. The authors discuss presumable connection of the both masses. The child was completely cured by surgical treatment.

[Nasal dermoid cysts and sinuses]. / Przetoki i torbiele skórzaste nosa.

The authors discuss problems of the nasal dermoids treatment. They point at difficulties with settlement of right term of operation, and they stress that X-ray diagnosis before operation should be taken into consideration to exclude the contact of the dermal cyst or sinuses with cranial cavity. They confirm necessities of radical removal of the cyst or/and the sinus to gain the recovery. They analyse the material of 6 patients with dermal cysts or sinuses who were operated since 1988 to 1997 in the ENT Department of Municipal Hospital, Gdynia. They were 4 boys and 2 girls. In each case a cyst with fistulas was observed. All children were treated surgically, and their ages were 2-14 years (mean 6 1/2). In 2 cases there was self-existent destruction of the nasal bones, other 2 patients had median rhinotomy made, in 2 cases only simple excision of the cyst and sinuses was performed. In any case it was no recurrence of the disease (time of follow-up is 1-10 years). The analysis is illustrated with two case reports. The first case was a 2-year-old boy who had a dermal cyst with sinus penetrating into the cranial cavity. CT imaging did not reveal obvious evidences of that. During operation, a momentary CSF leak was observed but it was stopped using oxycel and tissucol. The second case, a 7-year-old boy, was treated by curettage of the dermoid, with recurrence after 6 months. This patient was cured after total resection of the cyst and sinuses. In conclusion, the authors present in detail signs that can attest that contact of the cyst with the cranial cavity exists. They stress the necessity of right surgical treatment in cases of dermal cysts of the nose to avoid recurrence or complications.

[Merkel cell carcinoma of the auricle]. / Rak z komórek Merkela malzowiny usznej.

A case of a 80-year-old woman suffering from Merkel cell carcinoma of the auricle with regional cervical lymph nodes metastases has been described. Surgical treatment (tumour and regional lymph nodes dissection) was applied at first. Metastasis to one lymph node was established in postoperative histological examination. Chemotherapy (farmorubicin, cyclophosphamide, vincristine) in 3 cycles was applied within 2 months. In spite of the above, 4 months after tumour excision, metastatic lymph node manifested in the neck. Combined treatment, radical neck dissection and radiotherapy was applied then.

[Laryngological aspects of treatment of male-female transsexuals]. / Laryngologiczne aspekty leczenia transseksualistów typu M/K.

The authors discuss laryngologist's participation in the adapting treatment of transsexuals of M/F type, including reduction of laryngeal prominence of thyroid cartilage, voice rehabilitation and nose operation. Literary reference is presented in the paper, as well as a case of a 27-year-old patient a transsexual of M/F type, in whom the prominence of thyroid cartilage was removed. Ethic and legal aspects of that management are also demonstrated.

[Mycosis infection (candidiasis) of the lingual thyroid gland]. / Grzybicze (drozdzycowe) zapalenie tarczycy jezykowej.

The authors present a case of 60-year-old woman who suffered from a mycosis (Candidosis) infection of the ectopic lingual thyroid gland. Intensive inflammatory process caused enlargement of lingual goiter and dysphagia occurred consequently. Right diagnosis was made after scyntygraphic examination (the presence of lingual thyroid gland only), as well as histopathological and microbiological examinations which revealed the presence of Candida forms. Recovery was achieved after 5 weeks of antifungal treatment--Diflucan during a 2-week initial period, then followed by 3 weeks of local treatment with nystatin.

[Dilemas in the evaluation of post-radiation lesions of the larynx]. / Dylematy w ocenie zmian popromiennych krtani.

The authors analyse the post-radiation lesions in larynx taking into consideration the cases of coexistence with residual or recurrent tumour. They underline the difficulties in obtaining a true picture of the condition of the larynx on the basis of histopathological examination. In a number of cases repeated histopathological examinations delayed the surgical treatment and thus caused in some them that the patient's chance to be cured was lost. The authors characterise clinical symptoms with strongly suggest the presence of tumour in those cases.

[Head and neck lymphomas in the material of the ENT department of Municipal Hospital in Gdynia in 1977-1996]. / Chloniaki glowy i szyi w materiale Oddzialu Otolaryngologicznego Szpitala Miejskiego w Gdyni w latach 1977-1996.

The authors present data relating to patients with malignant lymphoma of the head and neck diagnosed at the ENT Department, Municipal Hospital in Gdynia, during the years 1977-1996. The material is analysed in relation to the sex and age of the patient and the localisation of tumour. Some cases are presented in detail depending on localisation or difficulties in diagnosis (lymphoma of the larynx and ethmoidal sinus).

[Rhinologic changes in cystic fibrosis and hypogammaglobulinemia]. / Zmiany rynologiczne w mukowiscydozie i hipogammaglobulinemii.

Nasal and paranasal findings in cystic fibrosis and hypogammaglobulinaemia are presented. Two cases are discussed. Case one that is 20 year old man with oedemato-polypoid changes of nasal mucosa and diagnosis of cystic fibrosis was made during his staying in hospital. Case 2 that is 12 year old boy with previously diagnosed hypogammaglobulinaemia also presented oedemato-polypoid changes of nasal mucosa. Both pharmacological and surgical treatments were brought. Authors' observations are compared with the literature and necessity of detailed diagnosis of oedemato-polypoid changes of nasal and paranasal sinus' mucosa is stressed.

[The evaluation of certain psychological indices concerning cognitive and emotional behaviors in patients after radical neck dissection]. / Ocena niektórych psychologicznych wskazników zachowan poznawczo-emocjonalnych u chorych po radykalnym usunieciu wezlów chlonnych szyi.

Every disease and especially neoplasmatic disease is a source of deep mental experiences. The aim of this study was the establishment of some psychological behavioural parameters in 55 patients who underwent radical neck dissection and in 32 patients operated for other, non-neoplasmatic laryngologic diseases. In order to evaluate psychological state of the patients the following of States and Personality Traits (TISCO), 2. Feeling of Safety Question Sheet (KPB), 3. Profile of Mood States (POMS), 4. Scale of Hopelessness (HS-8). It was stated, that patients after radical neck dissection have deviations concerning indexes of cognitive and emotional behaviour and that there are differences between patients operated as the reason of neoplastic processes and other patients. These differences appear also among persons examined in the period shorter than 1 year from their surgery as opposed to patients operated earlier than 1 year before examinations. The fact of laryngectomy did not appear to have significant influence upon most of the evaluated indexes of cognitive and emotional behaviours.