Poor mid-term survival of the low-carbide metal-on-metal Zweymüller-plus total hip arthroplasty system: a concise follow-up, at a minimum of ten years, of a previous report*.

Between 1994 and 1999, 217 metal-on-metal total hip arthroplasties with a low-carbide bearing surface were performed with use of the cementless Zweymüller SL-Plus stem and the Bicon-Plus threaded cup in 194 consecutive patients. After a minimum follow-up of ten years, 181 living patients (203 hips) were available for evaluation. The revision rate after an average of twelve years was 18% (thirty-six hips in thirty-six patients were revised).

Balloon kyphoplasty versus KIVA vertebral augmentation--comparison of 2 techniques for osteoporotic vertebral body fractures: a prospective randomized study.

Study Design: Prospective, parallel-group, controlled comparative randomized study.

Objective: This study compares the efficacy in sagittal vertebral height and wedge deformity restoration, polymethylmethacrylate cement leakage safety, and functional outcome of balloon kyphoplasty (BK) versus KIVA (a novel vertebral augmentation technique) implant for the augmentation of fresh osteoporotic vertebral body fractures.

Summary Of Background Data: Minimally invasive vertebral augmentation procedures have been widely used to treat vertebral compression fractures caused by osteoporosis.

Transforming growth factor β repressor, SnoN, is overexpressed in human gastrointestinal stromal tumors.

Purpose: The transforming growth factor bgr; (TGF-β)/ Smad pathway is implicated in the development of interstitial cells of Cajal. The aim of this study was to examine the role of this pathway in human gastrointestinal stromal tumors (GISTs).

Methods: The expression of TGF-β receptor II (TβRII), phosphorylated Smad2 (p-Smad2), SnoN, p21(WAF17sol;CIP1) and p27(KIP1) was examined by immunohistochemistry in 30 hu-man GISTs in relation to prognostic factors.

Low back pain and sciatica prevalence and intensity reported in a Mediterranean country: ordinal logistic regression analysis.

The objective of this retrospective cross-sectional study was to estimate the 6-month prevalence and severity of low back pain and sciatica in a representative sample of an adult Mediterranean population. The study group comprised a sample of 674 adults aged 20 years or older from a mainly (74.8%) urban population.

Posterolateral versus circumferential instrumented fusion for monosegmental lumbar degenerative disc disease using an expandable cage.

Background: Theoretically, 360° instrumented fusion has been considered to offer better radiological correction than PLF. Despite numerous publications, this correlation is still weak with several controversies in the relative literature.

Purpose: This prospective randomized study was designed to compare the radiological segmental results, complications and outcome of 360° instrumented fusion with the use of a single diagonal expandable PLIF device versus posterolateral pedicle screw fixation in monosegmental lumbar DDD and to show that the use of an novel expandable cage is associated with low PLIF-related complication rate compared to conventional cages reported previously.

Massive septic pelvic osteolysis following revision total hip arthroplasty in a patient with sickle cell anemia: clinical presentation and review of the literature.

Total hip arthroplasty (THA) performed in patients with osteonecrosis, caused by sickle cell disease, carries a higher risk of medical and orthopedic complications, than those observed after THA for osteonecrosis related to other conditions. We report such a case of a male patient, who underwent one-stage revision hip arthroplasty due to septic cup loosening after primary cementless THA and later developed severe septic osteomyelitis of the ipsilateral hemipelvis that had a fatal outcome. The relative literature regarding loosening and infection after THA in patients with sickle cell disease is thoroughly reviewed.

Hematogenous pyogenic spinal infection: current perceptions.

As a result of reading this article, physicians should be able to:1.Understand the importance of early diagnosis and treatment of spinal infection in an effort to avoid devastating and crippling complications such as paralysis, painful deformity, and death.2.

Central foveal thickness before and after cataract surgery in normal and in diabetic patients without retinopathy.

Background: This study aims to evaluate and compare central foveal thickness (CFT) changes after cataract surgery between normal and diabetic patients without retinopathy, using optical coherence tomography (OCT).

Patients And Methods: Ninety-eight patients (49 patients with type 2 diabetes and 49 healthy controls, sex- and age-matched) undergoing phacoemulsification in one eye were included. The presence of retinopathy was an exclusion criterion.

Kounis syndrome: a new twist on an old disease.

Kounis syndrome is the concurrence of acute coronary syndromes with conditions associated with mast cell activation, such as allergies or hypersensitivity and anaphylactic or anaphylactoid insults that can involve other interrelated and interacting inflammatory cells behaving as a 'ball of thread'. It is caused by inflammatory mediators such as neutral proteases including tryptase and chymase, arachidonic acid products, histamine, platelet activating factor and a variety of cytokines and chemokines released during the activation process. Platelets with FCεRI and FCεRII receptors also participate in the above cascade.

An atypical case of Brugada syndrome.

Polymorphic ventricular tachycardia and ventricular fibrillation are the most common arrhythmias in Brugada syndrome causing syncope or sudden death. Sustained monomorphic ventricular tachycardias are rare in this context. We report of a patient with syncopal episodes due to episodes of sustained ventricular tachycardia, where a Type-I Brugada pattern was revealed after pharmacological provocation with procainamide.

Initial clinical experience with a novel vertebral augmentation system for treatment of symptomatic vertebral compression fractures: a case series of 26 consecutive patients.

Background: Minimally invasive vertebral augmentation procedures are widely used to treat vertebral compression fractures although procedural polymethylmethacrylate cement leakage remains common. We report herein our initial experience with a novel vertebral augmentation technique designed to treat symptomatic vertebral osteoporotic fractures and osteolytic metastases with minimal cement extravasation.

Methods: Forty-two vertebral fractures were identified in 26 consecutive patients (mean age 74 ± 9 years).

Myxoglobulosis of the appendix: a case associated with ruptured diverticulum.

We describe a case of the extremely rare entity of myxoglobulosis of the appendix from a 45-year-old white man who was operated urgently with the clinical diagnosis of acute appendicitis. Sectioning of the appendix revealed the presence in the dilated appendiceal lumen of numerous whitish opaque globules ranging in size from 0.2 to 0.

High medium-term survivorship and durability of Zweymüller-Plus total hip arthroplasty.

Background And Purpose: The Zweymüller-Plus system (SL-Plus stem, Bicon-Plus threaded cup) for primary total hip arthroplasty (THA) was introduced in 1993, as a successor of the Alloclassic THA with a few modifications in the conical stem shape and a new biconical threaded cup with a spherical shape. The medium-term performance of this system is not well established. To better understand the potential impact these design changes have had on (1) survivorship, (2) implant stability and (3) periprosthetic osteolysis, we studied patients who underwent THA using the SL-Plus stem and Bicon-Plus.

Effect of sagittal spinal balance, levels of posterior instrumentation, and length of follow-up on low back pain in patients undergoing posterior decompression and instrumented fusion for degenerative lumbar spine disease: a multifactorial analysis.

Study Design: Prospective controlled clinical study on low back pain (LBP).

Objective: To investigate the possible effects of radiographic and other related parameters on LBP in patients underwent decompression and posterolateral instrumented fusion for degenerative lumbar spine disease.

Summary Of Background Data: Sagittal balance of the spine after spine surgery has gained increasing interest regarding its correlation with LBP and fusion rate.

Factors affecting low back pain in adolescents.

Study Design: Prospective multifactorial study on low back pain (LBP) in adolescents.

Background Data: Most studies on LBP have focused on adults although many investigations have shown that the roots of LBP lie in adolescence. Several mechanical, physical, and behavioral factors have been associated with nonspecific LBP in adolescents.

Immunologic adverse reaction associated with low-carbide metal-on-metal bearings in total hip arthroplasty.

Background: An increased incidence of periprosthetic osteolysis, resulting in loss of biologic fixation, has been reported in contemporary THAs with low-carbide metal-on-metal compared with metal-on-polyethylene couple bearings. Although a hypersensitivity reaction attributable to Co and Cr debris is reportedly a potential cause for failure of THAs with high-carbide bearings, there are no evidence-based data for this reaction in low-carbide metal-on-metal bearings, although such hypersensitivity might be related to osteolysis.

Questions/purposes: We investigated whether there were differences in immunologic hypersensitivity reactions in retrievals from revised THAs with ceramic-on-polyethylene versus metal-on-metal bearing couples.

A case of complete androgen insensitivity syndrome presenting with incarcerated inguinal hernia: an immunohistochemical study.

Objective: To present a case of complete androgen insensitivity syndrome that initially presented as incarcerated inguinal hernia and to investigate the expression of antimüllerian hormone (AMH), SOX-9 (SRY-box-containing gene 9), prostaglandin D synthase (PGDS), and androgen receptors (AR).

Design: Case report.

Setting: District hospital.

Does Wallis implant reduce adjacent segment degeneration above lumbosacral instrumented fusion?

Delayed complications following lumbar spine fusion may occur amongst which is adjacent segment degeneration (ASD). Although interspinous implants have been successfully used in spinal stenosis to authors' knowledge such implants have not been previously used to reduce ASD in instrumented lumbar fusion. This prospective controlled study was designed to investigate if the implantation of an interspinous implant cephalad to short lumbar and lumbosacral instrumented fusion could eliminate the incidence of ASD and subsequently the related re-operation rate.

Late postoperative opacification of hydrogel intraocular lenses: analysis of 13 explanted lenses.

Purpose: We report the clinical, morphological, and ultrastructural findings of 13 consecutively explanted opacified Hydroview(R) (hydrogel) intraocular lenses (IOLs). Our purpose was to provide a comprehensive account on the possible factors involved in late postoperative opacification of these IOLs.

Patients And Methods: Thirteen consecutive opacified hydrogel IOLs (Hydroview H 60 M, Bausch & Lomb) were explanted due to the significant visual impairment they caused.

High medium-term survival of Zweymüller SLR-plus stem used in femoral revision.

Unlabelled: Revision after failed THA resulting from loosening of the femoral component can be challenging even for experienced surgeons. Aseptic loosening usually is associated with some degree of bone loss. We asked whether the Zweymüller SLR-Plus((R)), along with allograft reconstruction of the deficient femoral bone stock, would provide survivorship, osseointegration, and stability similar to or better than previously reported implants for femoral revision.

Investigating differentiation mechanisms of the constituent cells of sex cord-stromal tumours of the ovary.

SOX-9, an essential factor for male sexual development, can be induced by prostaglandin D2 in a Sry-independent mechanism. Recent data suggest that the hedgehog pathway is involved in the differentiation of normal Sertoli and Leydig cells. The purpose of our study was to investigate the mechanisms involved in the differentiation of ovarian sex cord-stromal tumour (SCST) cells.