Degree Of Degenerative Changes Research Articles

Success predictors of decompressive surgical treatment for lumbar degenerative spinal canal stenosis

BACKGROUND: Decompressive surgical treatment for degenerative lumbar stenosis significantly improves patient clinical status. However, in some cases, patients are not satisfied with the outcomes. Various studies have examined clinical and morphological factors to improve the results of surgical interventions. AIM: To identify clinical and morphological predictors of the success of decompressive surgical interventions for lumbar degenerative stenosis. MATERIALS AND METHODS: This retrospective study included 61 patients who underwent surgery for mono- and postsegmental lumbar degenerative stenosis. Clinical and demographic data and the stage of degenerative changes in the functional spinal unit and sagittal balance of the spine were assessed. The success of surgical treatment was defined as simultaneous compliance with three criteria after 6–18 months: achievement of MCID for ODI (≥12%), recalibration of the spinal canal at the level of intervention according to MRI data (Schizas regression to ≥1 stage), and improvement of the patient’s subjective feeling (4–5 on the Likert scale). Logistic regression analysis was used to identify predictors of treatment outcome. RESULTS: A significant decrease in the intensity of pain syndrome (VAS in back and leg) and an improvement in the quality of life (ODI) after surgery (p 0.001) were found in all patients. In 73.8% of cases, the MCID threshold exceeded for ODI, whereas in 75.41%, patients were satisfied with surgical treatment. The success rate of surgical intervention was 65.57%. In one-factor regression analysis of clinical, demographic, and morphological parameters, the only independent predictor of surgical treatment was neuropathic pain before surgery according to the DN4 questionnaire (OR=1.52; p=0.011). CONCLUSION: Decompressive surgical treatment for degenerative lumbar stenosis is an effective treatment method, regardless of the extent and degree of degenerative changes in the spinal–motor segments and concomitant degenerative pathology, including disruption of sagittal balance. The predicting factor of the success of decompressive intervention is the severity of preoperative neuropathic pain.

Clinico-haematobiochemical and cardiac alterations in Trypanosoma evansi infected buffaloes of Andhra Pradesh, India.

The present research aimed to document the incidence, clinical signs, haematological, and serum biochemical alterations, as well as electrocardiography and echocardiography findings in 62 buffaloes (selected from a total of 240) infected with Trypanosoma evansi. The study spanned one year, from January 2022 to December 2022. Morphological identification of Trypanosoma evansi was done by the presence of a centrally positioned nucleus with a small sub-terminal kinetoplast at the posterior position through microscopic examination of Giemsa stained peripheral blood smears. The incidence of trypanosomosis were determined to be 26% (62/240) using stained blood smear examination and 41% (98/240) through polymerase chain reaction assay. Clinical signs exhibited by buffaloes with trypanosomosis included the lack of rumination (94%; 58/62), anorexia (90%; 56/62), emaciation (87%; 54/62), loss of milk yield (84%; 52/62), ocular discharges (82%; 51/62), depressed demeanour (81%; 50/62), sunken eye balls (61%; 38/62), fever (60%; 37/62), scleral congestion (56%; 35/62) and intermittent fever (42%; 26/62). Cardiovascular clinical findings in affected buffaloes included tachycardia (44%; 27/62), cardiac arrhythmia (24%; 15/62), cardiac murmurs (19%; 12/62) and muffled heart sounds (18%; 11/62). In the present study, buffaloes with trypanosomosis exhibited significant reduction in haemoglobin (p = 0.008), packed cell volume (p = 0.004), total erythrocyte count (p = 0.003), mean corpuscular volume (p = 0.042), total leucocyte count (p = 0.048) and absolute neutrophil count (p = 0.012); a significant increase in absolute eosinophil count (p = 0.011) and absolute monocyte count (p = 0.008) compared to the apparently healthy buffaloes. Additionally significant decrease in albumin (p = 0.001), A/G ratio (p = 0.007), calcium (p = 0.008), glucose (p = 0.007), phosphorous (p = 0.048), sodium (p = 0.008), potassium (p = 0.041) and chloride (p = 0.046) were observed in buffaloes with trypanosomosis compared to healthy ones. Buffaloes with trypanosomosis also showed significant increase in globulin (p = 0.004), aspartate aminotransferase (p = 0.008), bilirubin (p = 0.034), blood urea nitrogen (p = 0.071), creatinine (p = 0.029), cholesterol (p = 0.046), lactate dehydrogenase (p = 0.009), gamma-glutamyl transferase (p = 0.004) and creatine kinase-myoglobin binding levels (p = 0.005). Electrocardiography explorations in buffaloes with trypanosomosis revealed sinus tachycardia, low voltage QRS complex, ST segment elevation, wide QRS complex, sinus arrhythmia, sinus bradycardia, wandering pace maker, first degree atrio ventricular block, biphasic T wave and tall T wave. Echocardiography examination unveiled cardiac chamber dilatation, ventricular wall thickening and indications of pericarditis/cardiac tamponade. Necropsy was carried on the dead buffaloes during the study period disclosed severely congested blood vessels on epicardial surface, endocardial haemorrhages, and presence of pericardial fluid. Histopathological examination of the heart revealed hyaline degeneration, haemorrhages in the cardiac muscles and varying degrees of degenerative changes. Additionally, the pericardium displayed increased thickness due to presence of more elastic fibres, fibroblast cells in the myocardium, discontinuity of muscle layers, vascular congestion, perivascular mono nuclear cell infiltration and augmented thickness of the endocardium with fibroblast cell proliferation. The study's conclusion highlights cardiac alterations as secondary complications in buffaloes infected with Trypanosoma evansi. Further investigations are recommended to elucidate therapeutic modifications and refine the treatment paradigm.

Assessing the Correlation between the Radiological, Macroscopic and Histological Examination of Degenerative Changes of Articular Surfaces in Knee Osteoarthritis with Varus Deformity

Our study aims to compare the results of preoperative radiography and intraoperative visual assessment of the cartilage with histological assessment of joint surfaces of the medial and lateral compartments resected in patients during the total knee replacement. The cohort included 20 patients (9 men and 11 women) with the mean age of 66.6 (±7.0) years who met the inclusion criteria of the study. Degenerative changes of the knee joint seen on a preoperative weight-bearing anteroposterior X-ray were evaluated according to the Kellgren-Lawrence grading system separately for the medial and lateral compartment. Based on the visual appearance, the condition of articular surfaces was assessed using the International Cartilage Repair Society Score (ICRS Grade). The histological assessment of degenerative changes was conducted by a pathologist with the use of the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment System based on six grades of articular cartilage degeneration. The mean degree of degenerative changes based on the radiological classification was assessed as 3.5 (±0.6) for the medial compartment and 2.1 (±0.4) for the lateral compartment. The visually assessed chondropathy according to the ICRS Grade was 3.7 (±0.6) for the medial femoral condyle and 1.8 (±1.0) for the lateral femoral condyle. The histological score obtained using the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment was 4.9 (±1.1) for the medial femoral condyle and 2.4 (±0.7) for the lateral femoral condyle. In respect of the medial compartment, there was no statistically significant parametric correlation between the intraoperative visual assessment of the cartilage degeneration and the preoperative radiological grade r = 0.45. The histological assessment showed a statistically significant concordance both with the degree of chondropathy r = 0.76 and the radiological grade r = 0.64. In the lateral compartment, the parametric test showed a statistically significant concordance only between the radiological grade and the histological score r = 0.72. The correlation between the visual assessment of chondropathy and the radiological grade r = 0.27 as well as the histological score r = 0.24 was very low. In our cohort assessing the early degenerative changes of the lateral compartment as well as the more advanced degenerative changes of the medial compartment, the correlation between the intraoperative assessment of cartilage degeneration as a diagnostic method to examine the lateral compartment and the preoperative radiological grade was not confirmed. Our results failed to confirm a better reporting value of the visual cartilage degeneration assessment of the lateral compartment as against the preoperative X-ray. The space width without narrowing on an X-ray has no reporting value for this compartment in case of varus deformity. The results clearly indicate that the assessment of macroscopic appearance of the cartilage degeneration during arthroscopy does not necessarily guarantee good long-term clinical outcomes after high tibial osteotomy. The respective degrees of cartilage degeneration identified during the intraoperative visual assessment and the radiological grading of osteoarthritic changes did not correlate in either compartment. In the lateral compartment, the initial radiological and histological findings preceded the visually detectable cartilage changes. knee, cartilage, osteoarthritis, radiology, histology, arthroscopy, osteotomy.

Use of Absolute Alcohol in Preservation of Cell Morphology in Fluid Cytology at Various Temperatures: A Cross-sectional Study

Introduction: Fluid cytology and the examination of malignant cells play an important role in the treatment of critical cases. The Department of Pathology (Cytopathology laboratory) receives samples for fluid cytology and examines malignant cells, reporting the White Blood Cell (WBC) count in the received fluid and the morphological findings of the cells examined on smears. Degeneration of cells in these body fluid samples, especially if the samples are not stored under proper conditions, is a common problem faced by many laboratories. Even overnight storage (12 hours) of these body fluids at temperatures of 4-8ºC (domestic refrigerators) may still cause some degree of degenerative changes. This becomes problematic in cytopathological reporting of body fluids, particularly when the samples are limited in amount or are from areas that cannot be re-aspirated {e.g., Cerebrospinal Fluid (CSF)}. While alcohol is a common fixative used for cell fixation in cytopathology, it is rarely used for fixing cells in fluid samples. Aim: To test the usage of absolute alcohol as a fixative in body fluid samples received in the cytopathology laboratory, which have been stored for 12 hours at two temperatures: room temperature and 4-8ºC. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology at Subharti Medical College, Meerut, Uttar Pradesh, India. The study was conducted over the periods of two months, from February 2022 to March 2022. A total of 100 body fluid samples (including CSF, ascitic fluid, pleural fluids, etc.) sent for routine workup to the cytopathology laboratory were included in the study. Each body fluid sample (1 mL) was taken in two test tubes, and four drops of 100% (absolute) alcohol were added to both test tubes. The mixture of body fluid and absolute alcohol was then gently shaken, and one set of test tubes was kept at room temperature while the other set was kept at 4-8ºC. The data was tabulated in an MS Excel worksheet, and basic statistical analysis was performed. Results: The age range of cases whose samples were analysed was from one-week-old neonates to 65-year-old adults. The total number of fluid samples was 100, including 42 CSF samples, 23 ascitic fluid samples, 18 pleural fluid samples, and 17 Bronchoalveolar Lavage (BAL) fluid samples. Out of the 42 CSF samples, 15 showed preservation of morphology when the alcohol-body fluid mixture was kept at room temperature, while 22 cases showed preservation of the same mixture at 4-8ºC. Some samples showed no preservation (5 CSF), the reasons for which are discussed below. All the examined body fluids showed better preservation with alcohol at 4-8ºC. Conclusion: The addition of absolute alcohol as a fixative in fluids helps preserve the cytomorphological features of cells and provides better preservation for the diagnosis of fluid samples.

Degenerative changes in the intervertebral joints of the cervical spine after anterior interbody fusion and intervertebral disc arthroplasty

Objective. To study the effect of arthroplasty and anterior interbody fusion in the cervical spine on degenerative changes in the adjacent intervertebral joints.Material and Methods. A retrospective cohort study included 46 patients (22 with cervical total disc arthroplasy – CTDA, and 24 with anterior cervical discectomy and fusion – ACDF) with symptoms of cervical spondylogenic compression myelopathy and/or radiculopathy. The degree of degeneration of facet joints adjacent to the operated segments was evaluated 12 months after surgical treatment. Degenerative changes in the cervical spine were assessed using CT according to the Okamoto classification. Vidar Dicom Viewer 3.2 software was used to view images and evaluate intervertebral joints. Statistical processing was performed using IBM SPSS Statistics 23. Data were presented as median and 25th and 75th percentiles – Me [Q1; Q3].Results. The mean age of patients in both groups was 47 [39; 52] years (Mann – Whitney U-test, p = 0.047). In the ACDF group it was 48 [42; 55] years and in the CTDA group – 42 [36; 52] years. Comparison of degenerative changes in the ACDF group before and after treatment (Wilcoxon analysis) showed a statistically significant difference in the cranial (p = 0.023), and caudal (p = 0.001) joints, with the progression of degeneration degree. In the CTDA group, no difference between pre- and post-treatment degeneration degree (Wilcoxon analysis) was found in either cranial joints (p = 0.157) or caudal joints (p = 0.161).Conclusion. Surgeries to stabilize spinal segments in degenerative diseases undeniably affect the development of the adjacent level syndrome. However, the use of endoprosthetic technology makes it possible to aggravate the degree of degenerative changes in the intervertebral joints of adjacent segments to a lesser extent.

Is the presence of foraminal stenosis associated with outcome in lumbar spinal stenosis patients treated with posterior microsurgical decompression

BackgroundWe aim to investigate associations between preoperative radiological findings of lumbar foraminal stenosis with clinical outcomes after posterior microsurgical decompression in patients with predominantly central lumbar spinal stenosis (LSS).MethodsThe study was an additional analysis in the NORDSTEN Spinal Stenosis Trial. In total, 230 men and 207 women (mean age 66.8 (SD 8.3)) were included. All patients underwent an MRI including T1- and T2-weighted sequences. Grade of foraminal stenosis was dichotomized into none to moderate (0–1) and severe (2–3) category using Lee’s classification system. The Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and numeric rating scale (NRS) for back and leg pain were collected at baseline and at 2-year follow-up. Primary outcome was a reduction of 30% or more on the ODI score. Secondary outcomes included the mean improvement on the ODI, ZCQ, and NRS scores. We performed multivariable regression analyses with the radiological variates foraminal stenosis, Pfirrmann grade, Schizas score, dural sac cross-sectional area, and the possible plausible confounders: patients’ gender, age, smoking status, and BMI.ResultsThe cohort of 437 patients presented a high degree of degenerative changes at baseline. Of 414 patients with adequate imaging of potential foraminal stenosis, 402 were labeled in the none to moderate category and 12 in the severe category. Of the patients with none to moderate foraminal stenosis, 71% achieved at least 30% improvement in ODI. Among the patients with severe foraminal stenosis, 36% achieved at least 30% improvement in ODI. A significant association between severe foraminal stenosis and less chance of reaching the target of 30% improvement in the ODI score after surgery was detected: OR 0.22 (95% CI 0.06, 0.83), p=0.03. When investigating outcome as continuous variables, a similar association between severe foraminal stenosis and less improved ODI with a mean difference of 9.28 points (95%CI 0.47, 18.09; p=0.04) was found. Significant association between severe foraminal stenosis and less improved NRS pain in the lumbar region was also detected with a mean difference of 1.89 (95% CI 0.30, 3.49; p=0.02). No significant association was suggested between severe foraminal stenosis and ZCQ or NRS leg pain.ConclusionIn patients operated with posterior microsurgical decompression for LSS, a preoperative severe lumbar foraminal stenosis was associated with higher proportion of patients with less than 30% improvement in ODI.Trial registrationThe study is registered at ClinicalTrials.gov (22.11.2013) under the identifier NCT02007083.

Osteophyte-related medial collateral ligament injury in asymptomatic osteoarthritis following minor trauma: a case report.

A 78-year-old Thai female presented with left knee pain 1h after a low-energy trauma caused by a fall. The MRI showed deep MCL and medial meniscal root injuries, a nondisplaced lateral femoral condyle, and also revealed a large osteophyte near the midpart of the MCL, with a blunt persistent projection from the osteophyte pushing against the MCL where the injury was located. She was treated with a knee brace, a gait aid for walking, and analgesic pain control. Her symptoms gradually improved over the next few weeks. If an osteophyte touches a ligament, it can cause degenerative changes to the ligament from chronic irritation, resulting in reducing the strength of the ligament and may be causing some degree of degenerative changes and tightening of the MCL in its at-rest state, resulting in an increased chance of injury when it is required to resist a sudden external force, even from a minor trauma. When there is an osteophyte pushing against a ligament, there is an increased chance of ligament injury when even a minor trauma stresses that ligament.

Haematological and Histological Assessment of Clarias gariepinus Juveniles Exposed to Crude Extract of Albizia Chevalier Sawdust

The toxicity of Albizia chevalier sawdust extract was investigated with emphasis on histopathological and haematological effects on African catfish (Clarias gariepinus) juveniles. A static bioassay was conducted to determine the LC50 of Albizia chevalier sawdust extract to Clarias gariepinus juveniles. The fish were exposed to 55, 63.1, 67.6, and 73.9mI/L of Albizia chevalier sawdust extract. The result of the acute toxicity showed that the extract was toxic to the fish with an LC50 value of 54.42mI/L. The pH, DO and temperature values of the water in the different concentrations differed significantly from the control (p ≤ 0.05). Furthermore, the haematological assessment revealed that values of the blood parameters (WBC, RBC, HGB, HCT, PCV, LYM, MxM, NEUT and PLT) of fish in the different concentrations were significantly different from the control (p<0.05). Histopathological examinations of the gills and liver of Clarias gariepinus juvenile exposed to Albizia chevalier sawdust extract in the control showed normal gill and liver architecture. However, there were varying degrees of degenerative changes in the gills and liver of fish in different concentrations of the Albizia chevalier sawdust extract. The results of the study revealed that crude extract Albizia chevalier is toxic to fish organs and causes histopathological changes in the gills and liver and cause stress to the fish. Therefore indiscriminate discharge of sawdust by sawmills into the environment should be discouraged particularly into water bodies.

Prevalence of accessory sacroiliac joint anatomy and associated clinical features.

The accessory sacroiliac joint (ASIJ) is the most common sacroiliac joint anatomical variant; however, its literature-reported prevalence is inconsistent. Previous CT-based studies of the ASIJ have used thick axial slices, which may not adequately detail ASIJ anatomy. The aims of this study are to (1) evaluate ASIJ prevalence and radiographic features in a large age- and sex-balanced cohort using thin-section CT and (2) determine associations between ASIJ anatomy, patient features, and treatment strategies. Thin-section CTs (0.75 to 2.00mm) of the pelvis from 800 patients were reviewed by two musculoskeletal radiologists. Degree of degenerative change and ankylosis at ASIJs were detailed. The EMR was used to capture demographics, lower back or sacroiliac joint symptoms, and treatments. The ASIJ was present in 25.8% of patients and bilateral in 53.3% of those with any ASIJ. ASIJs were more common at the S2 than S1 neural foramen level (75.7% and 27.2%). There was a statistically significant difference between age and presence of any ASIJ anatomy (mean (SD) 69.0 (19.8) with ASIJ versus 55.9 (22.1) years without ASIJ). Degenerative changes and ankylosis were found in 93.5% and 20.3% of ASIJs, respectively. There was a higher odds ratio of having received a sacroiliac joint corticosteroid injection in those with ASIJ anatomy. Radiologists should be familiar with the ASIJ and consider its age-related association, propensity to show ASIJ degenerative change, and ability to serve as a potential pain generator. Steroid injections may be considered for diagnostic and therapeutic purposes.

RADIOLOGICAL CHANGES OF THE RABBIT KNEE JOINT IN EXPERIMENTAL OSTEOARTHRITIS

In veterinary medicine, radiological examinations are considered to be the most common and affordable method of diagnosing diseases of the musculoskeletal system in animals [1]. In this regard, the studies described in this article were aimed at assessing the degree of degenerative changes during the modelling of knee osteoarthritis using an X-ray apparatus. The material of the study was the joints of experimental animals (rabbits) with formed osteoarthritis of the knee joint on days 14, 21 and 28 of the experiment. The rabbits were modelled for degenerative changes in the knee joint by intra-articular injection of a 4% solution of retinol acetate and kojic acid. On days 7, 14, 21, and 28 of the experiment, X-ray examination was performed. Radiological examinations were performed in two projections, namely, in the direct (ventro-dorsal) and lateral (medio-lateral) projections. The study was carried out on the basis of the training laboratory "Veterinary Radiology and Radiodiagnostics" of the Department of Therapy and Clinical Diagnostics of the Faculty of Veterinary Medicine of the National University of Life and Environmental Sciences of Ukraine using the radiological device VATEL-1. On the 14th day of experimental studies, no visible bone pathology was observed in animals, the height of the joint gap was preserved bilaterally. On the 21st day, in the area of the right knee joint (where the pathological process was formed), a moderate decrease in the height of the joint gap was noted during radiography with a predominance in the medial section. On the 28th day of the experiment, a uniform decrease in the height of the joint gap was observed in the right knee joint during radiography. These changes indicate progressive degenerative changes with cartilage loss in the knee joint of the experimental animals. Thus, on X-ray images on days 21 and 28 of the experiment, a decrease in the height of the articular gap in the knee joint was noted.

Study of Pedicles in Dried Human Lumbar Vertebra : A Morphometric Analysis

Background: In the dynamic part of the spinal column the lumbar vertebra are the largest vertebra that support the maximum body weight and exhibit the greatest degree of degenerative changes. Pedicles of the vertebra act as a port to perform procedures inside the bodies of the vertebra such as biopsies, vertebroplasties or kyphoplasties. Pedicle screw fixation is a technically demanding procedure. Accurate anatomical knowledge of the morphometry of vertebral pedicle are also important for preoperative procedure, planning and in the design and manufacture of pedicle screws. The objective of this study to observe the morphometry of lumbar pedicles to determine the size of the screw in transpedicular screw fixation on the perspective of Bangladesh.
 Materials and methods: A descriptive observational study was conducted at Southern Medical College and Hospital in the Department of Anatomy on 65 dry adult human lumbar vertebra from December 2020 to May 2021. Width height of pedicle along with antero-posterior diameter of lateral recess (Depth) were observed by using digital Vernier Calipers and after recording data were analysed.
 Results: The study shows that there is gradual increase in the mean width of the pedicles on both right and left side from L1 to L5. Mean height of the pedicle and antero-posterior diameter of lateral recess both showed decrease at the level of L3 both on the right and left side. Conclusions: The measured data will give a gross measurement of pedicle of lumbar vertebra on Bangladeshi people, hope to provide the clinicians a better support during working with pedicles.
 IAHS Medical Journal Vol 4(2), December 2021; 51-54

ПУТИ СНИЖЕНИЯ ПЕРИНАТАЛЬНЫХ ПОТЕРЬ У ЖЕНЩИН С САХАРНЫМ ДИАБЕТОМ

One of the leading conditions that complicates the course of pregnancy and adversely affects the condition of the woman, the fetus and the newborn is the mother’s diabetes mellitus.
 The objective of this paper is to study the features of pregnancy, childbirth and fetal development and women with diabetes of varying severity.
 Matherials and Methods. 185 pregnant women with diabetes mellitus were examined: 1 group – 25 women with mild diabetes; 2 group – 50 women with moderate severity; 3 group – 48 women with severe; 4 group – 29 women with gestational diabetes mellitus. The control group consisted of 30 healthy women who had uneventful pregnancy and childbirth.
 Results. The analysis of 185 cases of the course of pregnancy monitoring and childbirth in patients with diabetes mellitus of various degrees of severity and gestational diabetes mellitus revealed a direct relationship between the form and severity of diabetes mellitus with the frequency of complications of pregnancy and childbirth, the degree of degenerative changes in the placenta, deterioration of the fetal state, as well as perinatal morbidity and mortality.
 Conclusions. In patients with gestational diabetes, with mild, moderate and severe diabetes, pathological changes in the placenta are more often detected by histochemical and ultramicroscopic studies, compared with microscopic and macroscopic methods, which can be used for early diagnosis and prevention of complications in this category of patients.

The Relationship of Radiographic Parameters and Morphological Changes at Various Stages of Degeneration of the Lumbar Facet Joints: Cadaver Study.

Cadaveric specimens. To perform a pathomorphological analysis of the degree of facet joint (FJ) degeneration utilizing fresh cadaveric models and correlating these structural changes with imaging findings. L1-L5 FSU including all tissue between the anterior longitudinal ligament to the posterior spinal structures were obtained on 28 patients at a mean of 5.7 hours post-mortem. The samples were fixed in an agar medium and CT and MRI were performed. The level of FJ degeneration was identified based on prior classifications Osteoarthritis Research Society International (OARSI), as was the facet angle and tropism. Pathomorphological assessment including articular cartilage cell density was performed according to prior established methodology. Radiographically, a direct association was identified between FJ degeneration and patient age. Facet angle and tropism did not significantly vary by patient age. Pathomorphologically, there was a decrease in the cellular density of articular cartilage with increasing patient age. Similarly, there was a significant direct correlation between radiographic degree of degenerative changes in FJs with the age of cadavers and the degree of degeneration of FJs according to the morphological classification of OARSI, as well as a significant inverse correlation with cell density. A comprehensive assessment of various signs of FJ degeneration using cadaveric material has established that, based on radiographic imaging, it is possible to assess the microstructural state of FJ, including at an early stage of the disease. This data may be useful for surgeons in guiding therapeutic strategies based on individual biometric parameters of the FJ.

Effects of nitrogen fertilizer on Capoeta capoeta: an immunohistopathological and biochemical investigation

Increased use of fertilizers to increase plant production causes important environmental pollution not only in soil but also in water resources. Soil structure, water quality, water systems, and biodiversity are adversely affected by the unconscious use of fertilizers. In this study, Capoeta capoeta (Guldenstaedt 1773) were used to investigate the degenerative effects of nitrogen fertilizer. Twentyfour fish were equally allocated into three groups; group 1 (control), group 2 (15 mg/L nitrogen fertilizer in water) and group 3 (15 mg/L nitrogen fertilizer in water). Fish were exposed to the fertilizer for 15 days and then the tissues of gill, liver and intestine were investigated by immunohistopathological and biochemical means to assess the tissue degenerative effects of nitrogen fertilizers in water. Varying degrees of degenerative changes were observed in all of the investigated organs. In histopathological examinations, hydropic degeneration was observed in hepatocytes in fish exposed to fertilizer. Blunting and association in the gill tissue and occasional blunting in the intestinal tissue were detected. Catalase and SOD immunoreactivities increased in liver and gill tissues. There was also an increase in SOD immunoreactivity in the intestine of nitrogen fertilizer exposed fish. Total antioxidant status (TAS) also increased in both of the experimental groups (p < 0.05), but total oxidant status (TOS) did not change. The results of the experiment showed that nitrogen fertilizer in water resources may impair health status of fish by adversely affecting tissues in cellular level.

Expression of tissue inhibitors of metalloproteinases type 1 and type 2 in the leaflets of explanted bioprosthetic heart valves: a new pathogenetic parallel between structural valve degeneration and calcific aortic stenosis

Objective: to study cellular and lipid infiltration, as well as the expression of tissue inhibitors of metalloproteinases (TIMP) types 1 and 2 in biological prosthetic heart valves (BPHVs) explanted due to dysfunction.Material and Methods. We examined 17 leaflets from 6 BPHVs, dissected from the aortic and mitral positions during valve replacement. For microscopic analysis, fragments of the BPHV leaflets were frozen and serial sections were made using a cryotome. In order to study cellular infiltration and the degree of degenerative changes in the prosthetic biomaterial, the sections were stained with Gill’s hematoxylin and eosin; Oil Red O stain was used to assess lipid deposition. Immunohistochemistry was used for cell typing and detection of TIMP-1/-2. The stained samples were analyzed by light microscopy.Results. Cellular and lipid infiltration of xenogeneic tissues was detected in all BPHV flaps studied. Recipient cells coexpressed pan-leukocyte and macrophage markers PTPRC/CD45 and CD68. Positive staining for TIMP-1/-2 co-localized with cell clusters but was absent in acellular sections.Conclusion. Cells infiltrating xenogeneic BPHV tissues express TIMP-1/-2. This suggests that BPHV immune rejection pathophysiology is partially similar to that of calcific aortic stenosis.

Impact of osteogenic activity on degenerative aortic valve disease in patients with osteoporotic hip fracture

BackgroundPrevious studies have proposed that osteogenic and apoptotic processes of valve interstitial cells contribute to the mineralization and then calcification of the aortic valve. Osteoblast-like cells subsequently mediate calcification of the aortic valve as part of a highly regulated process analogous to skeletal bone formation. The objective of this study was to evaluate the pathogenesis of the sclerotic/calcific changes in the aortic valve from histological and biological findings, and investigate the role of osteoblasts in the calcified pathway of aortic stenosis. MethodsPreoperative echocardiography in 550 consecutive patients with osteoporotic hip fracture were retrospectively examined (475 females, mean 25th–75th, 89 [85–93] years). One hundred sixteen patients were under medical treatment with anti-osteoporosis drugs. We evaluated the prevalence and degree of degenerative changes in the aortic valve and examined the associations of bone turnover biomarkers N-terminal pro-peptide of type 1 collagen (P1NP) and serum tartrate-resistant acid phosphatase (TRACP-5b) with degenerative calcific changes in the aortic valve. ResultsOf 550 patients, 112 patients (20.9%) showed no leaflet calcification; 296 (53.8%), 1 leaflet calcification; and 142 (25.8%), 2 ≥ leaflets calcification. Significant (peak velocity ≥ 3.0m/s) Aortic stenosis was found in 43 patients (7.8%). In patients who were not taking anti-osteoporotic drugs, P1NP was higher in the 2 ≥ leaflets calcification group than in the other groups (p < 0.01). TRACP-5b was not significantly different among the three groups (p = 0.15). ConclusionsDegenerative changes in the aortic valve were related to bone biomarker activation in osteoporotic hip fracture patients.

Feasibility of two-dimensional speckle-tracking echocardiography of aortic valve in patients with calcific aortic valve disease

Calcific aortic valve (AV) disease is associated with increased stiffness and reduced motion of AV leaflets, has a progressive course, and can develop into aortic stenosis (AS). Our aim was to evaluate whether two-dimensional speckle-tracking echocardiography (STE) may be used for the assessment of AV stiffness. We applied STE to AV leaflets in patients with various degrees of degenerative changes of AV and measured strain as an absolute value of the radial deformation of AV leaflets. Deformation of AV expressed as averaged AV strain was greatest in patients with a normal AV (23.4 ± 6.4%), compared to those with aortic sclerosis (12.9 ± 3.2%), moderate-to-severe AS (11.9 ± 4%), and severe AS (10.9 ± 3.5%) (p < 0.01). A non-linear relationship and moderate correlation of AV strain with transvalvular hemodynamic parameters was observed. In patients with mild-to-moderate AS, the strain of AV leaflets also correlated negatively with AV calcification (r = −0.59, p = 0.008). Good inter-observer agreement was obtained for averaged AV strain with a coefficient of variation of 0.15 and an interclass correlation coefficient of 0.94 (p < 0.0001). In this study we demonstrated that deformation of AV leaflets as assessed by STE might be a potential method for a non-invasive evaluation of AV biomechanical properties and of the progression of calcific aortic disease. Further development of the two-dimensional speckle tracking technique specifically for valve structures is needed to enable a better quantification of leaflet deformation.

Functional outcome of arthroscopic reconstruction of chronic anterior cruciate ligament ruptures using single-bundle triple-weaved hamstring tendons in northern Nigeria

Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the world, its arthroscopic reconstruction was relatively less frequent in the West African sub region until recently. The patronage of the traditional bone setters in the acute phase of closed knee injuries has made Chronic ACL injury the main form of presentation with significant secondary injuries and degenerative changes from sub-optimal initial care. The aim of this study was to determine functional outcome and patient’s satisfaction from Arthroscopic chronic ACL injury repair. Diagnoses were made using clinical parameters and MRI. Lysholm scores were determined preoperatively, and repeated with patient’s satisfaction assessment (using the Likert scale) at 3, 6, 12, 24 and 48 months postoperatively. Arthroscopic single-bundle ACL repair using a triple-weaved hamstring tendon (s) was done for all the patients. Debridement and meniscectomy were done for various degrees of degenerative changes and irreparable meniscal injuries respectively. No one was dissatisfied and 91.4% of the patients had well to excellent Lysholm scores at 2 years of follow up. It was concluded that arthroscopic chronic ACL rupture reconstruction using single-bundle triple-weaved hamstring autografts with good rehabilitation offers good to excellent knee function and patients’ satisfaction with minimal complications.

Individual and combined toxicopathology of chlorpyrifos and cypermethrin in broiler chickens

The present study was conducted to evaluate the individual and combined toxicopathology of chlorpyrifos and cypermethrin in broiler chickens. Broiler chicks (80), day-old, were divided into four groups. Group T1 served as control, whereas Group T2 was treated with chlorpyrifos @ 50 mg/kg feed, T3 with cypermethrin @ 200 mg/kg feed and T4 with chlorpyrifos @ 50 mg/kg + cypermethrin @ 200 mg/kg feed for 4 weeks. During 5th week, the dietary treatment was withdrawn and observed for withdrawal effect. At the end of 4th and 5th week, six birds from each group were sacrificed and examined for gross and histopathological changes. Microscopically, liver showed mild to extensive granular and vacuolar changes, necrosis and lymphoid aggregation. Granular and vacuolar changes in tubular epithelium along with necrosis of tubules and detachment of tubule from the basement membrane were observed in kidneys. Heart showed varying degrees of degenerative changes in cardiac muscle fibres. Intestine showed diffuse degenerative changes along with necrosis and fusion of villi. Brain showed mild to moderate degenerative changes and neuronophagia. Sciatic nerve showed degenerative changes along with infiltration of mononuclear cell and swelling of axons. The lesions were more prominent in combined toxicity group. However, at 7th day post withdrawal, restoration towards normal parenchyma was observed in visceral organs. Ultra structure of liver at 4th week revealed pronounced pathological lesions in cell organelles. Thus it can be concluded that chlorpyrifos and cypermethrin induced adverse toxic effect individually as well as in combination.

Meta-Analysis of the Surgical and Rehabilitative Outcomes of Hip Arthroscopy in Athletes With Femoroacetabular Impingement.

Femoroacetabular impingement (FAI) poses a threat to athletes' capacity to compete. This review aims to estimate the rate of return to sport after hip arthroscopy for treatment of FAI as well as identify factors that may affect athletes' outcomes. Meta-analysis. Four databases (EMBASE, PubMed, Web of Science, and Cochrane) were searched in July 2015 by 2 reviewers. Studies were required to include athletes who were treated with hip arthroscopy for symptomatic FAI and also report return to sport as an outcome. A validated tool was used for quality assessment and level of agreement between raters was calculated. A meta-analysis for proportions returning to sport was performed on the available data using MedCalc software. Additional outcomes were descriptively analyzed. A total of 15 case series involving 823 patients were included in the review, with moderate to high methodological quality. 88.3% [95% confidence interval (CI), 83.4%-92.4%] of athletes returned to sport after arthroscopy and 85.3% (95% CI, 77.6%-91.6%) returned to preinjury level. All outcome measures used reported measurable improvements. Complication rates were low. The majority of athletes return to sport after hip arthroscopy for symptomatic FAI. Severity of intraarticular damage and degree of degenerative changes affect ability to return to sport. Additional validated outcome measures should be used together with return to sport. Future studies should be prospective with longer-term follow-up to provide a higher level of evidence for outcomes.