Hand Function Deficiency in Patients with Dupuytren's Disease and Course of Recovery after Palmar Fasciectomy.

PURPOSE OF THE STUDY To evaluate hand function deficiency in patients with Dupuytren's disease (DD) in addition to assessing the improvement of function after palmar fasciectomy by using different hand-related questionnaires. MATERIAL AND METHODS A total of 121 hands (95 patients) underwent surgery. Disease severity was designated using Tubiana's Staging System. The Tendency of changes of Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), Patient Evaluation Measure (PEM), and Hand Function Score (HFS) scores of patients with DD undergoing palmar fasciectomy were assessed prior to, 3 months after, and 1 year after the operation. Moreover, total loss of extension (TLoE) was evaluated using a goniometer in the same time intervals. Repeated measure ANOVA Friedman's test were used. Responsiveness to clinical change was calculated by using standardized response means (SRMs). RESULTS The results showed statistically significant improvement of the originally obtained questionnaire results after 3 months for DASH and HFS and 12 months for all forms; only the PEM and DASH score significantly changed between 3 and 12 months. TLoE before surgery was 144.1 o ±99.6 o ; 3-month and 1-year after surgery: 14.3 o ±58.0 o and 19.3 o ±34.7 o respectively. SRMs for 1 year after surgery was large for PEM (1.11) and medium for DASH (0.7) and HFS (0.79). CONCLUSIONS DASH, PEM, and HFS are valuable tools to monitor the hand function of patients with DD after surgery. Key words:hand function, Dupuytren's disease, palmar fasciectomy.

Hand anthropometry in patients with carpal tunnel syndrome: a case-control study with a matched control group of healthy volunteers.

BACKGROUND: The aim of this study was to perform anthropometrical measure- ments of patients' hands with carpal tunnel syndrome (CTS) in order to evaluate if there is a correlation between CTS occurrence and hand features regarding sexual dimorphism, age and physical activity. MATERIALS AND METHODS: Study sample consisted of 48 patients (33 females) and control group included 80 healthy volunteers (58 females) with no history of CTS. The following measurements were performed: the wrist circumference, length of the hand, the hand's width, width of the wrist, thickness of the wrist, height of the hypothenar and thenar, length of the arm and forearm, circumference of the proximal phalanges and width of the digits; as well as several indexes were calculated i.e.: body mass index (BMI), shape index, digit index, wrist index, hand length/height ratio (HLH-ratio) and hand length/upper limb length ratio (HLULL-ratio). RESULTS: Correlation coincidences were analysed between circumferences within the hand, palm and body weight. All parameters except fingers were correlated with body weight in either gender in both groups (p < 0.05; r = 0.40-0.80); Furthermore, width of the hand was correlated with body height (p < 0.001; r = 0.56-0.71). Mean values of wrist index for CTS patients were: males: 0.8, females: 0.74 (significantly higher than in healthy individuals and indicating square shape); shape index: males 76.5, females 75.8; digit index: males 55.7, females 56.5. The calculated HLH-ratio in CTS group was: males 10.6, females 10.9; HLULL-ratio: males 23.6, females 24.9 and they did not differ significantly from healthy volunteers. Almost 90.0% of females with diagnosed CTS have BMI > 25.0 kg/m2. CONCLUSIONS: There are significant differences in morphometrical features of the upper limbs between CTS patients and healthy individuals. Hands of patients with CTS are more massive and with 'plumb' fingers and square shape of the wrist. Furthermore, higher BMI values were confirmed to be predisposing factors in CTS occurrence.

Characterisation, in vitro release study, and antibacterial activity of montmorillonite-gentamicin complex material.

The present paper concerns the potential use of montmorillonite as a drug carrier and focusses on the intercalation of the studied clay with gentamicin (an aminoglycoside antibiotic) at various temperatures (20, 50 and 80°C). The experiments were performed to identify the temperature required for the optimum intercalation of gentamicin into the interlayer of montmorillonite. The structural and microstructural properties of gentamicin and the potential for introducing it between smectite clay layers were investigated by means of X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopic techniques, and SEM with EDS analysis. Additionally, the in vitro drug release behaviour of the montmorillonite-gentamicin complex and its antibacterial activity against Escherichia coli (E. coli) bacteria was investigated. Based on these studies, the impact of temperature on the intercalation of the drug between layers of smectite was evaluated. It was found that an intercalation temperature of 50°C resulted in the highest shift in the position of principle peak d(001) as measured by XRD, suggesting, that the greatest amount of gentamicin had been introduced into the interlayer space of montmorillonite at this temperature. Subsequently, the montmorillonite-gentamicin complex material obtained at 50°C revealed the greatest capacity for killing E. coli bacteria during an in vitro test.

[Drug-related hyperkalemia resulted from spironolactone and angiotensin converting enzyme inhibitors therapy]. / Polekowa hiperkaliemia spowodowana lacznym stosowaniem spironolaktonu i inhibitora enzymu konwertujacego angiotensyne.

A case of drug-related hyperkaliemia linked to treatment with angiotensin converting enzyme inhibitors and spironolactone simultaneously. The paper presents the case of drug-related hiperkaliemia induced by captopril and spironolactone combined treatment in a patient with early stage of renal failure.

[Immunophenotype of blood lymphocytes in elderly patients with laryngeal cancer]. / Immunofenotyp limfocytów krwi obwodowej u osób w podeszlym wieku chorych na raka krtani.

In a group of 42 patients with surgically treated laryngeal carcinoma, who were divided into those before their 50 and after 60 years of age, main lymphocyte subsets of peripheral blood lymphocytes were assessed by means of flow cytometry. In the group after 60 years of age significantly increased percentage and raised total number of NK (natural killer) cells were found. In the whole group increased total number of all lymphocyte subsets was found. These data indicate that older patients despite an increased number of total to lymphocytes NK cells show higher percentage and total number as compared with normal population at that age.

Correlation between DNA content, expression of Ki-67 antigen of tumor cells and immunophenotype of lymphocytes from malignant pleural effusions.

Malignant cells isolated from 26 malignant pleural effusions, collected from patients bearing metastatic carcinoma, were examined using flow cytometry. Expression of Ki-67 antigen, DNA ploidy, S phase fraction, DNA index of tumor cells and the percentage of aneuploid cell populations were determined. Lymphoid cells from the same malignant effusions and from 10 nonmalignant ones were examined using a panel of monoclonal antibodies (mAb) versus several CD antigens. While the percentages of T cells (CD3+, CD4+, CD8+) and B cells (CD19+) did not differ significantly in malignant versus nonmalignant effusions, those of CD56+ lymphocytes were found to be significantly depressed in malignant diploid and malignant aneuploid effusions as compared to benign ones. Expression of IL-2 receptors on lymphocytes, demonstrated by anti-CD25 mAb, was significantly higher in malignant diploid and malignant aneuploid effusions as compared with nonmalignant ones. An increase in the percentage of Ki-67-positive malignant cells was significantly correlated with the decrease of NK cells. S phase fraction, DNA index and the percentage of aneuploid populations did not correlate with the picture of lymphoid cells from pleural effusion. On the other hand, the percentage of Ki-67-positive tumor cells in pleural effusions was inversely proportional to the patients' survival time, although it was not statistically significant. Our data suggest that the poor prognosis of cancer characterized by the presence of an aneuploid cell population of malignant cells and the high percentage of proliferating cells in pleural effusions can be linked to the depression of NK cells.

[Autogeneic bone transplants in the treatment of nose deformities]. / Przeszczepy autogenne kosci w leczeniu nosów siodelkowatych.

The late results of the nasal reconstruction by means of the autogenic osseous grafts from hip were described. 24 patients were described after being controlled 3 to 15 years after surgery. The deteriorations of the cosmetic effects were observed, because of the graft resorption. The complications at the place of taking graft were also possible. However, the authors stressed the usefulness of this autogenic osseous graft method of surgery.

[Implants in reconstructive surgery of the nasal bone]. / Wszczepy w chirurgii odtwórczej szkieletu nosa.

Development of the conception of using alloplastic materials in restoration of nose skeleton or in completion of its loss was presented in a sketch. Some of the incontemporary implantations were briefly discussed indicating the main advantages and disadvantages in comparison with autogenic implants most often used in similar treatments.

[Modeling of implants for filling up defects of the nasal bone]. / Modelowanie wszczepów uzupelniajacych ubytki szkieletu nosa.

Our technique of modelling implantations completing the losses of nose skeleton on the basis of before-treatment nose measurement was presented. Depending on the character of distortion two different types of implantations were made, modifying the shape of one of them to achieve better stabilisation in tissues.

[Limitation of hand function in workers with Dupuytren's contracture]. / Organiczenie czynnosci reki u pracowników fizycznych z przykurczem Dupuytrena.

A group of 72 physical workers with Dupuytren's contracture, subject to operation, was examined. Such advantages of early operative treatment as facility of surgery, shorter hospitalisation, shorter rehabilitation after operation, and quick return to previous occupation have been pointed out.

[Early mechanical strength of sutures of the finger flexor tendons]. / Frühe mechanische Festigkeit von Nähten der Fingerbeugesehnen.

The authors observed the behaviour of flexor tendon repair under the influence of distracting loads. The methods of Bunnell, Kleinert and Kessler, who use the imbedded suture, were compared with the method of Becker, in which an external cross suture is used. The authors tested their own technique, using transplants or implants of corium, fascia, dura mater and polyester net, internally in the tendons, fastening them with an external cross suture. In the authors' technique the disruption of the tenorrhaphy occurs only with forces much greater than those needed for treatment by controlled mobilization.