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INTRODUCTION: Posterior ankle arthroscopy allows the diagnosis and treatment of multiple pathologies through minimal trauma. The use of posterior portals associated or not to mechanical distraction, allows a good vision of the posterior ankle, tendons of the region, and subtalar joint. OBJECTIVES: We evaluated intra- and postoperative complications of posterior ankle arthroscopy without joint distraction, and compared them with those described in international literature. MATERIAL AND METHODS: A retrospective study that evaluated 49 patients undergoing posterior ankle arthroscopy for several pathologies. All of them operated by a single surgeon, in two health institutions, for seven years. RESULTS: were analyzed using the visual analog scale and the AOFAS score. Intra- and postoperative complications were recorded. The average follow-up was 28 months. RESULTS: 33 men and 16 women. The average age was 38.6 years old. There were seven complications (14.3%): paresthesia and - or hypoesthesia of the sural nerve (four cases), residual pain in the portal (two cases), and portal scar dehiscence (one patient). The average improvement of VAS was 5.53 points, and the improved AOFAS score was an average of 35.78 points. CONCLUSIONS: Posterior ankle arthroscopy without distraction through the classic postero-lateral and posteromedial portals is a safe technique, with a low rate of complications.

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INTRODUCCIÓN: La artroscopía posterior de tobillo permite el diagnóstico y tratamiento de múltiples patologías a través de un mínimo trauma. Los portales posteriores, asociados o no a distracción mecánica, permiten una buena visión de los tendones de la región y articulación substragalina. OBJETIVO: del presente estudio es evaluar las complicaciones intraoperatorias y postoperatorias de la artroscopía posterior del tobillo y retropié sin distracción articular y compararlas con las descritas en la bibliografía internacional. MATERIAL Y MÉTODOS: Estudio retrospectivo que evaluó 49 pacientes sometidos a artroscopía posterior de tobillo por diversas patologías. Todos operados por un único cirujano, en dos instituciones de salud, durante un período de siete años. Se analizaron los resultados mediante la escala visual analógica (EVA) y la escala de la American Orthopaedic Foot and Ankle Society (AOFAS, por sus siglas en inglés). Se consignaron las complicaciones intra- y postoperatorias. El seguimiento promedio fue de 28 meses. RESULTADOS: 33 varones y 16 mujeres (edad promedio 38.6 años). Hubo siete complicaciones (14.3%): cuatro parestesias y/o hipoestesia del nervio sural, dos casos de dolor residual en un portal y un caso de dehiscencia de cicatriz. Mejoría promedio de EVA de 5.53 puntos y mejoría promedio del AOFAS de 35.78 puntos. CONCLUSIONES: La artroscopía posterior de tobillo sin distracción por medio de los clásicos portales posterolateral y posteromedial es una técnica segura, con un bajo índice de complicaciones mayores y una baja morbilidad para el paciente.

Asunto(s)

Tobillo , Artroscopía , Adulto , Articulación del Tobillo/cirugía , Femenino , Humanos , Masculino , Estudios Retrospectivos , Tendones

RESUMEN

Deformation twins are three-dimensional domains, traditionally viewed as ellipsoids because of their two-dimensional lenticular sections. In this work, we performed statistical analysis of twin shapes viewing along three orthogonal directions: the 'dark side' (DS) view along the twin shear direction (η1), the twinning plane normal (TPN) view (k1) and the 'bright side' (BS) view along the direction λ(=k1 × Î·1). Our electron back-scatter diffraction results show that twins in the DS and BS views normally exhibit a lenticular shape, whereas they show an irregular shape in the TPN view. Moreover, the findings in the TPN view revealed that twins grow faster along λ the lateral direction than along η1 the forward propagation direction at the initial stages of twin growth. These twin sections are irregular, indicating that growth is locally controlled and the overall shape is not perfectly ellipsoidal. We explain these findings using atomistic models, and ascribe them to differences in the mobility of the edge and screw components of the twinning dislocations.

RESUMEN

Hexagonal close packed (HCP) Mg and Zr are being used in transportation and nuclear industries, respectively. The ductility and formability of these materials is significantly limited by the activation of prevalent deformation twinning. Twins in HCP polycrystals usually nucleate at grain boundaries (GBs), propagate into the grain, and they either terminate at opposing GBs (isolated-twins) or transmit into a neighboring grain (adjoining-twin-pairs: ATPs). Because twin interfaces provide a path for crack propagation, twin transmission is relevant to material ductility. This study combines electron backscatter diffraction (EBSD) based statistical analysis of twinning microstructures and crystal plasticity modeling, to characterize twin thickening processes away from and near GBs. Analysis of deformed Mg and Zr microstructures reveals that local twin thicknesses at GBs are statistically larger for ATPs compared to isolated-twins. Further, thicknesses are found to decrease with increasing GB misorientation angle. Full-field Fast-Fourier-Transform micromechanics modeling shows that shear-transformation induced backstress are locally relaxed at GBs for ATPs, but not for isolated-twins. As a consequence, ATPs can thicken locally at GBs and the preferential site for twin thickening shifts from the middle of the twin to common GB.

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Pervasive deformation twinning in magnesium greatly affects its strength and formability. The local stress fields associated with twinning play a key role on deformation behavior and fracture but are extremely difficult to characterize experimentally. In this study, we perform synchrotron experiments with differential-aperture X-ray microscopy to measure the 3D stress fields in the vicinity of a twin with a spatial resolution of 0.5 micrometer. The measured local stress field aids to identify the sequence of events involved with twinning. We find that the selected grain deforms elastically before twinning, and the twin formation splits the grain into two non-interacting domains. Under further straining one domain of the grain continued to deform elastically, whereas the other domain deforms plastically by prismatic slip. This heterogeneous deformation behavior may be mediated by the surrounding medium and it is likely to lead to asymmetric twin growth.

RESUMEN

Materials with a hexagonal close-packed (hcp) crystal structure such as Mg, Ti and Zr are being used in the transportation, aerospace and nuclear industry, respectively. Material strength and formability are critical qualities for shaping these materials into parts and a pervasive deformation mechanism that significantly affects their formability is deformation twinning. The interaction between grain boundaries and twins has an important influence on the deformation behaviour and fracture of hcp metals. Here, statistical analysis of large data sets reveals that whether twins transmit across grain boundaries depends not only on crystallography but also strongly on the anisotropy in crystallographic slip. We show that increases in crystal plastic anisotropy enhance the probability of twin transmission by comparing the relative ease of twin transmission in hcp materials such as Mg, Zr and Ti.

RESUMEN

The three-dimensional nature of twins, especially the atomic structures and motion mechanisms of the boundary lateral to the shear direction of the twin, has never been characterized at the atomic level, because such boundary is, in principle, crystallographically unobservable. We thus refer to it here as the dark side of the twin. Here, using high-resolution transmission electron microscopy and atomistic simulations, we characterize the dark side of deformation twins in magnesium. It is found that the dark side is serrated and comprised of coherent twin boundaries and semi-coherent twist prismatic-prismatic boundaries that control twin growth. The conclusions of this work apply to the same twin mode in other hexagonal close-packed materials, and the conceptual ideas discussed here should hold for all twin modes in crystalline materials.

RESUMEN

Combining transmission electron microscopes and density functional theory calculations, we report the nucleation and growth mechanisms of room temperature rolling induced face-centered cubic titanium (fcc-Ti) in polycrystalline hexagonal close packed titanium (hcp-Ti). Fcc-Ti and hcp-Ti take the orientation relation: 〈0001〉hcp||〈001〉fcc and , different from the conventional one. The nucleation of fcc-Ti is accomplished via pure-shuffle mechanism with a minimum stable thickness of three atomic layers, and the growth via shear-shuffle mechanisms through gliding two-layer disconnections or pure-shuffle mechanisms through gliding four-layer disconnections. Such phase transformation offers an additional plastic deformation mode comparable to twinning.

RESUMEN

PURPOSE: The Cervical Spine Research Society Europe (CSRS-E) actively promotes scientific activities, the annual meeting being the most evident of them. The publication rate of oral and poster presentations at the annual meeting could be a measure for the success of the promotional activities. The publication rates of abstracts presented at the annual European meetings of the CSRS are unknown. The quality of the abstracts presented at a conference is reflected by the publication rate. A high publication rate is usually interpreted as representative of high scientific value of the conference. METHODS: Poster and podium presentations from the 2007 to 2012 annual meetings were identified. Pubmed was used to search for the abstract title and/or the combination of authors to verify whether the data were published in a peer-reviewed journal. Abstracts were considered published if the data presented at the meeting were identical to that in the publication. The journals in which the data were published were identified, as well as the origin of the research centre. RESULTS: From 2007 to 2012 826 abstracts were featured at the CSRS Europe annual meetings. There were 236 podium presentations and 590 poster presentations. 42 % of the podium presentations resulted in a publication, and 28 % of the poster presentations led to a publication. Overall, 32 % of accepted abstracts effectuated a publication in a peer-reviewed scientific journal. Abstracts from European research groups had a publication rate of 29 % compared to 34 % for abstracts from non-European research groups. Spine, European Spine Journal, Journal of Spinal Disorders and Techniques and J Neurosurgery Spine were the most common publication journals for the abstracts. The mean impact factor of the journals in which was published was 2.2. CONCLUSION: 42 % of the abstracts that were accepted for podium presentation at the CSRS Europe resulted in a publication in peer-reviewed MEDLINE indexed journals. Publication rates are at the high end of the publication rate spectrum of abstracts accepted for European scientific meetings.

Asunto(s)

Bibliometría , Edición/estadística & datos numéricos , Enfermedades de la Columna Vertebral , Indización y Redacción de Resúmenes , Vértebras Cervicales , Europa (Continente) , Humanos , Factor de Impacto de la Revista , Revisión por Pares , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Sociedades Médicas

RESUMEN

Fundamento: Las imágenes obtenidas mediante estudios con TC pueden ser alteradas por la presencia de artefactos metálicos, induciendo en ocasiones a malinterpretación en la correcta ubicación de los tornillos pediculares en columna lumbar. El objetivo de este trabajo es desarrollar un protocolo de atenuación del artefacto metálico con el propósito de reducir el artefacto generado por los tornillos pediculares de titanio en aquellos pacientes a los que se ha requerido instrumentación lumbar, permitiendo a los cirujanos de columna realizar un diagnóstico preciso de la ubicación del tornillo pedicular instrumentado. Material y métodos: En la primera parte del trabajo se realizó un estudio observacional, analítico, longitudinal y retrospectivo en 23 pacientes (103 tornillos pediculares) a los que se requirió artrodesis lumbar por patología degenerativa. En el postoperatorio se les realizó un estudio con TC secuencial evaluando la sobredimensión generada por el artefacto del tornillo, aplicando un protocolo estándar de obtención de imágenes. En la segunda parte del estudio se diseñó un estudio observacional, analítico, longitudinal y prospectivo empleando un equipo de TCMC de 64 coronas aplicando un protocolo específico de adquisición de imagen sobre 18 pacientes (104 tornillos pediculares) intervenidos mediante artrodesis lumbar. Resultados: En la primera parte del estudio el artefacto medio a ambos lados del tornillo que se genera tras el estudio de TC es de 1,045 mm (DE: 0,45). En el grupo en el que se aplica el protocolo de atenuación del artefacto tras la TCMC la sobredimensión fue de 0,005 en la porción proximal del tornillo y de 0,025 en la parte distal del tornillo. Conclusiones: Los resultados obtenidos sugieren que tras la aplicación del protocolo de atenuación del artefacto en equipo de TCMC de 64 coronas el artefacto es reducido a unas dimensiones similares a la dimensión real del tornillo pedicular(AU)

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Background: In postoperative patients with metallic implants, CT scans can become less effective due to metal-related artifacts. The purpose of our study was to evaluate the effectiveness of a specific metal artifact reduction image protocol, in order to reduce the metal artifact caused by titanium pedicular screws in patients undergoing lumbar pathology by lumbar fusion. This enables surgeons to make an accurate diagnosis of the exact placement of inserted pedicle screws, making this the preferred image modality for assessing screw position after surgery. Methods: In the first part of the study, CT scans were performed on 23 patients (103 titanium alloy pedicle screws) undergoing a lumbar instrumented fusion for treatment for degenerative disease with a standard image acquisition protocol evaluating the possible overdimension caused by the artifact. In the second part, a prospective study was performed using 64-slice multidetector-row computed tomography (MDCT) on 18 patients (104 titanium alloy pedicle screws) undergoing a lumbar instrumented fusion using a specific image acquisition protocol. Results: Our results show that in the sequential CT scan group, mean overdimension (on each side) due to brightness was 1.045 mm (SD 0.45). In the 64-slice multichannel CT group, mean overdimension (on each side) due to brightness was 0.005 mm at the proximal part of the screw and 0.025 mm at the distal part of the screw. Conclusions: The use of a specific metal artifact reduction image protocol in MDCT produces a minimal artifact following lumbar fusion with pedicle screws (AU)

Asunto(s)

Humanos , Masculino , Femenino , Dolor de la Región Lumbar/metabolismo , Dolor de la Región Lumbar/patología , Protocolos Clínicos/clasificación , Tomografía Computarizada por Rayos X/instrumentación , Tomografía Computarizada por Rayos X/métodos , Artrodesis/métodos , Artrodesis/normas , Estudios Retrospectivos , Artefactos , Dolor de la Región Lumbar/complicaciones , Dolor de la Región Lumbar/diagnóstico , Protocolos Clínicos/normas , Tomografía Computarizada por Rayos X/normas , Tomografía Computarizada por Rayos X , Artrodesis/efectos adversos , Artrodesis , Estudio Observacional

RESUMEN

BACKGROUND: In postoperative patients with metallic implants, CT scans can become less effective due to metal-related arti-facts. The purpose of our study was to evaluate the effectiveness of a specific metal artifact reduction image protocol, in order to reduce the metal artifact caused by titanium pedicular screws in patients undergoing lumbar pathology by lumbar fusion. This enables surgeons to make an accurate diagnosis of the exact placement of inserted pedicle screws, making this the preferred image modality for assessing screw position after surgery. METHODS: In the first part of the study, CT scans were performed on 23 patients (103 titanium alloy pedicle screws) undergoing a lumbar instrumented fusion for treatment for degenerative disease with a standard image acquisition protocol evaluating the possible overdimension caused by the artifact. In the second part, a prospective study was performed using 64-slice multide-tector-row computed tomography (MDCT) on 18 patients (104 titanium alloy pedicle screws) undergoing a lumbar instrumented fusion using a specific image acquisition protocol. RESULTS: Our results show that in the sequential CT scan group, mean overdimension (on each side) due to brightness was 1.045 mm (SD 0.45). In the 64-slice multichannel CT group, mean overdimension (on each side) due to brightness was 0.005 mm at the proximal part of the screw and 0.025 mm at the distal part of the screw.

Asunto(s)

Artefactos , Tomografía Computarizada Multidetector , Fusión Vertebral , Tornillos Óseos , Humanos , Vértebras Lumbares , Estudios Prospectivos , Prótesis e Implantes

RESUMEN

Propósito: El melanoma uveal es el tumor intraocular primario más frecuente en la edad adulta. El objetivo de este trabajo es mostrar cómo se ha construido una base de datos informatizada con aplicaciones, tanto clínicas como de investigación concretas, a un grupo extenso de pacientes diagnosticados de melanoma de la úvea. Métodos: Para el diseño de la base de datos se realizó una selección de categorías, atributos y valores basándose en las clasificaciones y parámetros dados por diferentes autores en artículos que han tenido gran relevancia en el campo del melanoma uveal en los últimos años. Resultados: La base de datos cuenta en la actualidad con más de 250 registros de pacientes, con información específica sobre su clínica, diagnóstico, tratamiento y evolución. Nos permite realizar búsquedas sobre cualquier parámetro del registro y hacer estudios estadísticos de estos de una forma rápida y sencilla. Conclusión: Los modelos de bases de datos se han convertido en un arma fundamental para la práctica clínica, pues constituyen una forma eficaz tanto de almacenamiento como de recopilación y búsqueda selectiva de información. A la hora de realizar una base de datos es muy importante la definición de una estrategia común y el uso de un idioma normalizado (AU)

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Purpose: The uveal melanoma is the most common primary intraocular tumour in adults. The objective of this work is to show how a computerised database has been formed with specific applications, for clinical and research use, to an extensive group of patients diagnosed with uveal melanoma. Method: For the design of the database a selection of categories, attributes and values was created based on the classifications and parameters given by various authors of articles which have had great relevance in the field of uveal melanoma in recent years. Results: The database has over 250 patient entries with specific information on their clinical history, diagnosis, treatment and progress. It enables us to search any parameter of the entry and make quick and simple statistical studies of them. Conclusion: The database models have been transformed into a basic tool for clinical practice, as they are an efficient way of storing, compiling and selective searching of information. When creating a database it is very important to define a common strategy and the use of a standard language (AU)

Asunto(s)

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Melanoma/complicaciones , Melanoma/diagnóstico , Melanoma/patología , Melanoma/terapia , Interpretación Estadística de Datos , Análisis de Datos

RESUMEN

PURPOSE: The uveal melanoma is the most common primary intraocular tumour in adults. The objective of this work is to show how a computerised database has been formed with specific applications, for clinical and research use, to an extensive group of patients diagnosed with uveal melanoma. METHOD: For the design of the database a selection of categories, attributes and values was created based on the classifications and parameters given by various authors of articles which have had great relevance in the field of uveal melanoma in recent years. RESULTS: The database has over 250 patient entries with specific information on their clinical history, diagnosis, treatment and progress. It enables us to search any parameter of the entry and make quick and simple statistical studies of them. CONCLUSION: The database models have been transformed into a basic tool for clinical practice, as they are an efficient way of storing, compiling and selective searching of information. When creating a database it is very important to define a common strategy and the use of a standard language.

Asunto(s)

Bases de Datos Factuales , Melanoma/terapia , Neoplasias de la Úvea , Adulto , Técnicas de Diagnóstico Oftalmológico , Manejo de la Enfermedad , Control de Formularios y Registros , Hospitales Universitarios , Humanos , Sistemas de Registros Médicos Computarizados , Servicio de Oncología en Hospital , Programas Informáticos , España/epidemiología , Interfaz Usuario-Computador , Neoplasias de la Úvea/diagnóstico , Neoplasias de la Úvea/epidemiología , Neoplasias de la Úvea/patología , Neoplasias de la Úvea/terapia

RESUMEN

OBJECTIVE: The aim of this work is to describe the ultrasound features in vasoproliferative tumours of the ocular fundus (VPTOF). METHODS: The medical records corresponding to eight patients were retrospectively studied. Clinical data from the complete ophthalmologic examination and ultrasonographic findings were analysed. RESULTS: Nodular masses affecting either the retina or both the retina and the choroid were found. The surface contour of the tumour was regular in 5, and irregular in 3 cases. In terms of dimensions (mm/ SD), the average major base was 7.14/2.56; the minor base 6.74/2.48 and the height 2.38/1.26. Internal structure was always solid and irregular and reflectivity was mostly medium to high in 6 eyes. Angle kappa was not present in any case. No vascularity signs were detected. CONCLUSION: According to the results it is suggested that when a differential diagnosis of VPTOF is carried out, not only should ophthalmoscopic signs be studied, but an ultrasound examination should also be done.

Asunto(s)

Enfermedades de la Coroides/diagnóstico por imagen , Errores Diagnósticos , Gliosis/diagnóstico por imagen , Neovascularización Patológica/diagnóstico por imagen , Enfermedades de la Retina/diagnóstico por imagen , Adulto , Anciano , Carcinoma/diagnóstico , Carcinoma/secundario , Enfermedades de la Coroides/patología , Neoplasias de la Coroides/diagnóstico , Diagnóstico Diferencial , Oftalmopatías/complicaciones , Femenino , Fondo de Ojo , Gliosis/patología , Hemangioma/diagnóstico , Humanos , Masculino , Melanoma/diagnóstico , Persona de Mediana Edad , Neovascularización Patológica/patología , Oftalmoscopía , Enfermedades de la Retina/patología , Neoplasias de la Retina/diagnóstico , Estudios Retrospectivos , Ultrasonografía , Adulto Joven

RESUMEN

Objetivo: Describir las características ecográficas en los tumores vasoproliferativos del fondode ojo (TVPFO).Métodos: Se estudiaron retrospectivamente las historias clínicas correspondientes a8 pacientes afectados de TVPFO. Se analizaron los datos correspondientes a la exploraciónoftalmológica completa y a la exploración ecográfica.Resultados: Se encontraron masas nodulares afectando a la retina o bien a la retina y la coroides.La superficie tumoral era regular en 5 casos e irregular en los 3 restantes. La media de lasdimensiones fue (mm/DE): base mayor, 7,14/2,56; base menor, 6,74/2,48 y altura 2,38/1,26. Laestructura interna fue siempre sólida e irregular y la reflectividad era media-alta en 6 casos.No se detectó ni ángulo kappa ni vascularidad interna en ningún caso.Conclusión: De acuerdo con los resultados obtenidos se propone que tanto el diagnósticocomo el diagnóstico diferencial de los TVPFO deben ser llevados a cabo no solo con laoftalmoscopia sino también con la exploración ecográfica(AU)

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Objective: The aim of this work is to describe the ultrasound features in vasoproliferativetumours of the ocular fundus (VPTOF).Methods: The medical records corresponding to eight patients were retrospectively studied.Clinical data from the complete ophthalmologic examination and ultrasonographic findingswere analysed.Results: Nodular masses affecting either the retina or both the retina and the choroid werefound. The surface contour of the tumour was regular in 5, and irregular in 3 cases. In termsof dimensions (mm/ SD), the average major base was 7.14/2.56; the minor base 6.74/2.48 andthe height 2.38/1.26. Internal structure was always solid and irregular and reflectivity was mostly medium to high in 6 eyes. Angle kappa was not present in any case. No vascularitysigns were detected.Conclusion: According to the results it is suggested that when a differential diagnosis ofVPTOF is carried out, not only should ophthalmoscopic signs be studied, but an ultrasoundexamination should also be done(AU)

Asunto(s)

Humanos , Masculino , Femenino , Fondo de Ojo , Neoplasias del Ojo , Melanoma , Neovascularización Patológica , Estudios Retrospectivos

RESUMEN

Introducción. En la práctica clínica observamos con cierta frecuencia una prominencia esternoclavicular dolorosa, deformidad que constituye el principal signo de dos entidades con baja incidencia, aunque bien definidas: la hiperostosis esterno-costo-clavicular (HECC) y la osificación inter-esterno-costo-clavicular (OIECC). El diagnóstico diferencial de estas afecciones debe incluir la artrosis esterno-clavicular, la enfermedad de Paget, la osteitis condensante, la osteomielitis, la pustulosis, la enfermedad de Friederich, el síndrome de Tietze y el osteoma osteoide. Esto es especialmente importante en los casos en los que la afectación sea unilateral. Material y método. Presentamos una serie de nueve pacientes cuyo motivo de consulta fue una prominencia esterno-costo-clavicular, compatible con HECC u OIECC. El motivo de consulta en la mayoría de los pacientes fue el descartar la presencia de un tumor en esa localización. Resultados. Los estudios radiológicos mostraron un aumento variable tanto de la densidad como de la masa ósea, así como diferentes intensidades de afectación de la articulación esterno-costo-clavicular. Discusión. Descartado un tumor y con un diagnóstico concreto de la causa de la prominencia, generalmente, se considera suficiente con el tratamiento antiinflamatorio en la mayoría de los pacientes. En la práctica clínica parece irrelevante la diferenciación entre HECC y OIECC, ya que el tratamiento y el pronóstico de ambas afecciones son superponibles. La biopsia de la articulación y los procedimientos diagnósticos invasivos pueden ser innecesarios(AU)

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Introduction. In clinical practice, we see quite often painful sterno-clavicular prominence, deformity, which is the hallmark of two entities with a low incidence, although well defined hyperostosis cost sterno-clavicular (HECC) and ossification cost inter-sterno-clavicular (OIECC). The differential diagnosis of these conditions, you must include sterno-clavicular arthritis, Paget's disease, condensing osteitis, osteomyelitis, pustulosis, Friederich's disease, Tietze's syndrome and osteoid osteoma. This is especially important in cases where the involvement is unilateral. Material and methods. We present a series of nine patients complaining of a painful sterno- clavicular prominence, compatible with HECC or OIECC. The reason for consultation in most patients was rule out the presence of a tumor in that location. Results. Image studies showed a variable increase both the density and bone mass as well as different intensities of joint involvement sterno-clavicular cost. Conclusion. Ruled out a tumor and a specific diagnosis of these, you do not need aggressive treatment, is generally considered sufficient anti-inflammatory treatment in most patients. In clinical practice, it is irrelevant and OIECC HECC differentiation, since treatment and prognosis of both conditions are similar. The biopsy of the joint and aggressive diagnostic procedures may be unnecessary (AU)

Asunto(s)

Humanos , Masculino , Femenino , Articulación Esternoclavicular/anomalías , Hiperostosis Esternocostoclavicular/complicaciones , Hiperostosis Esternocostoclavicular/diagnóstico , Osteogénesis/fisiología , Osteoartritis/complicaciones , Osteoma Osteoide/complicaciones , Articulación Esternoclavicular/patología , Articulación Esternoclavicular , Hiperostosis Esternocostoclavicular/patología , Hiperostosis Esternocostoclavicular/fisiopatología , Hiperostosis Esternocostoclavicular , Diagnóstico Diferencial , Osteítis Deformante/complicaciones , Psoriasis/complicaciones , Síndrome de Tietze/complicaciones

RESUMEN

PURPOSE: To determine whether iodine 125 brachytherapy or enucleation is better for quality of life in patients treated for choroidal melanoma. PATIENTS AND METHODS: Sixty-five patients with choroidal melanoma were treated with a modified version of VF-14 iodine 125 brachytherapy, enucleation or both. Results of this treatment were then statistically analyzed. RESULTS: Statistically significant differences were found between visual acuity in the affected eye and binocular vision (initial and final), with an important decline after the treatment. The global medial score in the VF questionnaire decreased in a statistically significant manner after the treatment. CONCLUSION: We can confirm that patients treated with brachytherapy had better health-related quality of life than those who had their eye enucleated and were more likely to have higher (better) scores on the VF questionnaire items. On the other hand, the binocular vision and time after the treatment correlated with the quality of life in long-term follow-up.

Asunto(s)

Braquiterapia , Neoplasias de la Coroides/radioterapia , Neoplasias de la Coroides/cirugía , Enucleación del Ojo , Radioisótopos de Yodo/uso terapéutico , Melanoma/radioterapia , Melanoma/cirugía , Calidad de Vida , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios

RESUMEN

Age-dependent, neuronal apoptosis following N-methyl-D-aspartate receptor blockade has been linked to loss of calcium. To further explore this relationship, we examined expression of activated caspase-3, as well as the calcium binding proteins, calbindin-D 28K, calretinin and parvalbumin, following injection of vehicle or the N-methyl-D-aspartate receptor blocker, MK801, in postnatal day 7 or 21 rats. At postnatal day 7, MK801-induced activated caspase-3 expression was most frequently found in mutually exclusive cell populations to those expressing any of the three calcium binding proteins. For example, in the somatosensory cortex, most immunoreactivity for activated caspase-3 was found in layers IV/V, layered between areas of high calbindin or calretinin expression. Further, in the caudate putamen, activated caspase-3 rarely invaded zones of intense calbindin immunoreactivity. Suggesting expression patterns of these proteins were inversely related, these same brain regions no longer displayed MK801-induced activated caspase-3 at postnatal day 21, but instead robustly expressed calcium binding proteins. This later surge in expression was especially true for parvalbumin in regions such as the somatosensory and retrosplenial cortex, as well as the subicular complex. Calbindin-D 28K was also found to increase in the same regions though not as impressively as parvalbumin. Thus, developmental regulation of calcium binding protein expression may be a critical factor in age-dependent sensitivity to agents that disrupt calcium homeostasis in maturing neurons, providing a possible mechanistic explanation for age-dependent MK801 toxicity.

Asunto(s)

Encéfalo/efectos de los fármacos , Encéfalo/crecimiento & desarrollo , Proteínas de Unión al Calcio/metabolismo , Caspasas/metabolismo , Maleato de Dizocilpina/farmacología , Antagonistas de Aminoácidos Excitadores/farmacología , Factores de Edad , Análisis de Varianza , Animales , Animales Recién Nacidos , Encéfalo/anatomía & histología , Caspasa 3 , Recuento de Células/métodos , Relación Dosis-Respuesta a Droga , Regulación del Desarrollo de la Expresión Génica/efectos de los fármacos , Inmunohistoquímica/métodos , Ratas , Ratas Sprague-Dawley

RESUMEN

Introducción: La finalidad de este estudio prospectivo es analizar los resultados de un método ideado para evitar los errores durante la colocación de los tornillos en raquis lumbosacro, el cual está basado en una valoración preoperatoria de la morfología vertebral y una actuación ordenada en quirófano. Material y métodos: Se realizó una TAC preoperatoria con cortes a la altura de los pedículos para evaluar la morfometría pedicular y la morfología vertebral y preparar un plan preoperatorio. La colocación de los tornillos pediculares fue realizada por un cirujano experiencia y un residente, siguiendo los siguientes pasos utilizando escopia con Rx: durante la introducción del tornillo proyección AP perfecta, si pasa el borde interno del pedículo la proyección lateral nos muestra la situación de la punta del tornillo. La proyección lateral evalúa la ruptura de la cortical craneo-caudal pedicular. La proyección oblicua y proyección de desfiladero pélvico evalúan la ruptura de la cortical lateral pedicular y anterior del cuerpo vertebral. Se realizó una TAC postoperatoria con cortes a la altura de los tornillos para evaluar la posición exacta. Resultados: 21 pacientes operados con nuestra instrumentación (CUN) para artrodesis lumbosacra. 103 tornillos introducidos: 74 por el cirujano y 29 por el residente. Seis rupturas de cortical (5,8 per cent): tres mediales, dos anteriores y una lateral, ninguna de ellas por más de 2 mm y ninguna lesión radicular. Tiempo de radiación: 40 segundos por tornillo. Conclusiones: Basados en el bajo número y repercusión de los 'tornillos mal colocados', la simplicidad del método de introducción, la fácil reproductibilidad del método por cirujanos no experimentados y el bajo tiempo de radiación, concluimos que nuestro método proporciona un muy aceptable bajo número de errores en los tornillos pediculares colocados (AU)

Asunto(s)

Humanos , Errores Médicos/prevención & control , Columna Vertebral/cirugía , Plexo Lumbosacro/cirugía , Tornillos Óseos , Traumatismos de la Espalda/cirugía , Estudios Prospectivos , Resultado del Tratamiento , Tomografía Computarizada por Rayos X

RESUMEN

La morfología vertebral y pedicular condiciona el tamaño de los implantes pediculares tanto en anchura como en longitud y orientación del tornillo en el momento de su introducción. Se procedió a medir la anchura pedicular cortical y endostal, la angulación de los pedículos y la longitud del cuerpo vertebral, así como a valorar la forma del cuerpo vertebral en 45 pacientes españoles estudiados mediante TAC. Para este estudio los cortes pasaban por el pedículo de L3 en 8 vértebras, de L4 en 37 vértebras, de L5 en 44 vértebras L5 y de S1 en 40 vértebras. Se compararon estadísticamente los valores obtenidos entre varones y mujeres. La anchura cortical aumentaba desde L3 con 8,7 mm hasta S1 con 21,3 mm, la anchura pedicular endostal desde 6,2 mm en L3 hasta 17,4 mm en S1, la angulación pedicular de 10,3° en L3 hasta 28,2° en S1 y la longitud del cuerpo vertebral desde 33,0 mm en L3 a 35,4 mm en S1. Las vértebras lumbares desde L3 admitían, en la mayoría de los casos, tornillos pediculares de 5,5 mm. Por la forma y tamaño vertebral, en L5 y S1 se debe introducir los tornillos pediculares de modo convergente si se utilizan tornillos de más de 40 mm de longitud para evitar traspasar la pared anterior del cuerpo vertebral. (AU)

Asunto(s)

Femenino , Masculino , Humanos , Región Lumbosacra/anatomía & histología , Vértebras Lumbares/anatomía & histología , Tornillos Óseos , Tomografía Computarizada por Rayos X/métodos , Región Lumbosacra , Vértebras Lumbares