Effects of Breast and Prostate Cancer Metastases on Lumbar Spine Biomechanics: Rapid In Silico Evaluation.

Metastases to distant organs are a frequent occurrence in cancer diseases. The skeletal system, especially the spine, is one such organ. The objective of this study was to apply a numerical modeling, using a finite element method (FEM), for the evaluation of deformation and stress in lumbar spine in bone metastases to the spine. We investigated 20 patients (10 women and 10 men) aged 38-81 years. In women, osteolytic lesions in lumbar spine accompanied breast cancer, in men it was prostate cancer. Geometry of FEM models were built based on CT scans of metastatic lumbar spine. We made the models for osteolytic metastases, osteosclerotic metastases, and metastases after surgery. Images were compared. We found a considerable concentration of strain, especially located in the posterior part of the vertebral body. In osteolytic lesions, the strain was located below the vertebral body with metastases. In osteosclerotic lesions, the strain was located in the anterior and posterior parts in and below the vertebral body with metastases. Surgery abolished the pathological strain. We conclude that metastases to the lumbar spine introduce a pathological strain on the lumbar body. The immobilization of the vertebral body around fractures abolished the strain.

Finite Elements Modeling in Diagnostics of Small Closed Pneumothorax.

Posttraumatic pneumothorax still remains to be a serious clinical problem and requires a comprehensive diagnostic and monitoring during treatment. The aim of this paper is to present a computer method of modeling of small closed pneumothorax. Radiological images of 34 patients of both sexes with small closed pneumothorax were taken into consideration. The control group consisted of X-rays of 22 patients treated because of tension pneumothorax. In every single case the model was correlated with the clinical manifestations. The procedure of computational rapid analysis (CRA) for in silico analysis of surgical intervention was introduced. It included implementation of computerize tomography images and their automatic conversion into 3D finite elements model (FEM). In order to segmentize the 3D model, an intelligent procedure of domain recognition was used. In the final step, a computer simulation project of fluid-structure interaction was built, using the ANSYS\Workbench environment of multi-physics analysis. The FEM model and computer simulation project were employed in the analysis in order to optimize surgical intervention. The model worked out well and was compatible with the clinical manifestations of pneumothorax. We conclude that the created FEM model is a promising tool for facilitation of diagnostic procedures and prognosis of treatment in the case of small closed pneumothorax.

Shoulder ring complaints as a rare first symptom of malignant pleural mesothelioma.

The prevalence of malignant pleural mesothelioma is often encountered in the areas highly exposed to asbestos. The aim of this paper was a retrospective analysis of shoulder pain as a rare, first symptom of pleural mesothelioma, which constitutes an interdisciplinary diagnostic problem concerning both orthopedics and pulmonology. The research was based on a retrospective review of the patients' medical records. The considered period of time included the years 2006-2012. The study group included a total of 49 patients. Seven patients (14.3%) presented a complain of shoulder pain, as the first symptom of mesothelioma. The remaining 42 mesothelioma patients, without this symptom, constituted a reference group. The intensity of shoulder pain was, on average, 4/10 on an analog scale. A concomitant limitation of mobility was observed in five out of the seven subjects. In one case, limitation of motion and dysfunction of the shoulder joint were at an advanced stage. Neuralgia of upper limbs was found in two cases. We conclude that shoulder pain may be a manifesting symptom of malignant pleural mesothelioma. The neoplasm appears to have a pleiotropic effect on human body, reflected in different ways of its primary manifestation which may also include the motor system.

Quality of life of patients with diseases of sinuses.

Contemporary studies provide proof of coincidence between diseases of upper and lower airways ("united airways disease"; "one-airway disease"). 184 patients from Szczecin with acute (AS) and chronic sinusitis (CS), aged between 18-78 years (mean age 45.7+/-14.7) were examined. The questionnaire used (SF-36; short form, 36 questions) allowed for a comparison of the quality of life of patients with sinuses' disease with healthy subjects. Patients from the groups studied indicated more restrictions of their daily life than did the subjects from a control group (CG). Among the CS patients the mean quality of life index was 75.5, among the AS patients--60.8 and among healthy subjects--51.8. The differences between the groups were significant at P<0.001. Our study indicate that sinusitis strongly influenced functioning of patients in all eight domains of life.

[Congenital dislocation of the patella in children and adolescents]. / Wrodzone zwichniecia rzepki u dzieci i mlodziezy.

Eleven patients were treated at Orthopaedic Unit of Pediatric Surgery Department because of congenital dislocation of the patellae between 1988 and 1995. In 4 cases the condition was bilateral. Mean follow-up was 3 years and 7 months. Surgical procedures of Ali-Krogius-Roux-Goldwaith or Ali-Krogius-Hauser were performed. According to Hall and Michelli classification 6 results were rated excellent, 4 good, 3 fair and 2 poor. Flexion contracture of the knee resolved in all cases. Surgery employed proved efficient in treatment for congenital dislocation of the patella.

[Clinical use of underoot pressure measurements done with the Emed-system for diagnosis of foot deformities and disorders]. / Zastosowanie kliniczne badania nacisków stopy na podloze za pomoca Emed-systemu w diagnostyce wad i chorób stóp.

Emed-system is used for assessment of pressure distribution under the foot at standing and walking since 1985. The method is non-invasive, useful in diagnosing and monitoring of treatment for foot disorders both in children and adults. It may be utilized in orthopedics, traumatology, rehabilitation, rheumathology and diabetology.

[Intraoperative sectional anatomy of congenital absence of tibia type I A]. / Anatomia sródoperacyjna i sekcyjna wrodzonego braku kosci piszczelowej typu I A.

Intraoperative, angiographic and preparation findings within lower leg and foot of a child with tibial hemimelia type IA according to Jones are presented. Disarticulation at the knee has been performed bilaterally. Dysplasia of the distal femur, absence of the patellae, extensor apparatuses and cruciates were found. Amputated preparation revealed fibrotic band attached via interosseus membrane to the fibula, presence of unidentified muscle attached to the tip of the lateral malleolus, doubled tibialis anterior muscle on one side and accessory extensor digiti II. Talocalcaneal synostosis was bilateral, abnormal cuboids and accessory bones were found. Popliteal artery division was found at the mid-length of the fibula. Unidentified thick nerve passed the lateral ankle and divided at the sole of the foot.