COMPARISON OF THE CLINICAL RESULTS FROM THE RECONSTRUCTION OF АCL WITH AUTOGRAFT AND ALLOGRAFT TISSUE.

The ACL is the primary stabilizer of the knee joint. The injury leads to instability of the knee joint, which is a trigger for the subsequent destructive changes of the intra-articular structures such as menisci and cartilage of the joint surfaces. The most affected group is people of an active age, engaged in amateur sports. Also, this pathology is an occupational hazard in the military. In this community, ACL injuries have reached 3.24% in men and 3.51% in women, with increasing trends, especially among women. This data is derived from a study by Keller Army Hospital, West Point, New York. In this study we selected 2 groups of patients - operated with autograft and operated with allograft. The groups included 25 patients followed for a period of 18 months. The tissues used for ACL reconstruction were: 1) for allograft - BTB donor tissue / allograft / 2) for autologous transplantation - mm. Semitendinosus et Gracillis / autograft /. After the operation, the patients are placed in a rehabilitation program in five interconnected phases. The way they are performed allows the principle of gradual loading and constant feedback between the patient and the physiotherapist to be observed. Each of the phases has specific goals in the rehabilitation cycle, which has a certain approximate duration. After completion of the rehabilitation process, the clinical outcomes of both groups were compared using the International Documentation Committee (IKDC), Lysholm, and three in-house diagnostic methods. Our own diagnostic methods are Power test (a strength simulator is used, which directly examines the strength of the limb in flexion and extension in real life test. The results from IKDC were in favor of the autograft group (92.82) and from Lischolm of the allograft group (92.24). In terms of the power test the results were in favor of the allograft group. The result from the Power 1 test clearly shows statistically significant difference in symmetry of power in flexion and extension which is better in the allograft group compared to the autograft group. In our research we did not come across such a test in other studies. In conclusion we proved that the development of a single strict rehabilitation protocol focusing on the principle of gradual increase in workloads achieves comparable results in the frequency of re-rupture in both the allograft and auto-graft groups.

[Anti-HMG-CoA reductase necrotizing myopathy: A report of 4 cases]. / Myopathies nécrosantes à anti-HMG-CoA réductase : à propos de 4 observations.

INTRODUCTION: Anti-3-hydroxy-3-méthylglutaryl-coenzyme A reductase antibody-associated necrotizing autoimmune myopathy has been recently described (2011). This myopathy is distinct from statin toxic myopathy. Our objective is to report on the clinical and para-clinical characteristics of this myopathy and to show the difficulties of therapeutic care. CASE REPORTS: We describe 4 cases of patients followed-up in Brittany, France. All data have been analyzed retrospectively. The mean age of our patients was 59.5 years, with a sex ratio of 1. The clinical presentation was homogeneous, with a subacute painful proximal and symmetrical weakness, without extra-muscular involvement. Other presentations have been described (including pseudo-dystrophic presentation). All patients had a previous statin medication (mean duration of 3.75 years) although this criteria is not a requisite. All patients had high levels of creatine kinase and abnormal electromyographic examination. The pathological pattern on muscular biopsy was a necrotizing myopathy without significant inflammatory cells infiltration. Cardio-respiratory function was normal and no associated neoplasia was found. Over the follow-up, we observed a marked corticosteroid-dependence, not improved by immunosuppressive drugs (azathioprine and methotrexate). The benefit of intravenous immunoglobulin was clear with, sometimes, prolonged responses. CONCLUSION: An early diagnosis of this myopathy is necessary in order to introduce an immunotherapy associated with a close monitoring. The therapeutic strategy (within which the stead of intravenous immunoglobulin seems increased) remains to be defined and long-term prospective studies are thus needed.

Lidar determination of winds by aerosol inhomogeneities: motion velocity in the planetary boundary layer.

The paper presents results from lidar measurements of wind velocity in the planetary boundary layer using correlation data processing. Two lidars are used in our experiments: a ruby lidar operating along slant paths and a YAG:Nd lidar operating for near vertical sounding used by us for the first time. On the basis of our experience the optimal sizes of aerosol inhomogeneities (30-300 m), the duration of the experiments (2-10 min), and the repetition rate of laser shots (fractions of hertz to several hertz) are determined. The results are compared to independent data obtained from anemometer measurements, theodolite- and radar-tracked pilot balloons. The range of differences is ~1-2 m/s in speed and 10-15 degrees in direction. Preliminary results from the use of lidar data to remotely sound the wind speed for various atmospheric stratifications and synoptic situations are described as well.