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Purpose Idiopathic scoliosis is a developmental deformation of the vertebral column of an unknown aetiology. Its clinical symptoms and hypothetical causative factors may affect the stomatognathic system. The aim of this study was to analyse the relationships between the prevalence and type of malocclusions, and the presence of idiopathic scoliosis, its location and severity. Methods This was a prospective longitudinal study. The study group consisted of 80 patients with idiopathic scoliosis and the control group of 61 healthy individuals. Standard standing long-cassette radiographs were taken of all of the patients in the idiopathic scoliosis group in order to confirm diagnosis, to determine localization and the Cobb angle of the curve. Both groups underwent standard clinical dental examination. Results The most commonly observed types included right main thoracic (R-MT) and thoracolumbar or left lumbar scoliosis (Cobb angle 11° to 125°). In the idiopathic scoliosis group, prevalence of malocclusions was greater than in the control group (95% versus 82%). In the idiopathic scoliosis group more than one type of malocclusion was observed with a higher incidence than that in the control group (63.8% versus 37.7%; p = 0.002). A correlation between the left proximal thoracic (L-PT) curve with anterior partial open bite was demonstrated (p = 0.323), between thoracic dextroscoliosis main thoracic with lateral partial cross bite (p = 0.230) and a correlation between scoliosis severity and malocclusion in the event of L-PT and anterior partial open bite (p = 0.330) and R-MT and scissors bite (p = 0.248). Conclusion The incidence of malocclusions is greater in children with idiopathic scoliosis than in their healthy peers Level of Evidence III

Introduction The most significant blood vessel supplying the hip joint is the medial femoral circumflex artery (MFCA). MFCA with lateral femoral circumflex artery (LFCA) are the first branches of the deep femoral artery (DFA) or they originate directly from the common femoral artery (CFA) or superficial femoral artery (SFA). Purpose and methods We analyzed 100 CT angiogram of the hip region [72 men, 28 women; mean age 46.4 (14–80)] to assess the frequency of each type of division of the MFCA and LFCA from either the DFA or directly from the CFA or SFA. To assess the variations on each side in one individual we analyzed both hips in 73 patients [mean age 46.6 (14–80)]. Results Many different types of division have been described. The most frequent one in which both the MFCA and LFCA originate from the DFA, was observed in 50% of patients. In 31% of hips the MFCA originates from the CFA. In our study, a normal origin of the obturator artery from the internal iliac artery was observed in 67% of patients and an atypical origin, called corona mortis was observed in 33% of patients. Conclusions The deep branch of the MFCA is the main artery supplying the femoral head, it is at risk during surgical approach to the hip joint. The atypical anastomosis called corona mortis is also at risk while performing the approach to pubic bone. Therefore, knowledge of their topography is very important.

Interferon alpha-producing plasmacytoid dendritic cells (pDC) are crucial contributors to pro-inflammatory or tolerogenic immune responses and are important in autoimmune diseases such as psoriasis. pDC accumulate in the lesional skin of psoriasis patients, but are rarely found in the affected skin of patients with atopic dermatitis (AD). While homeostatic chemokine CXCL12 and inducible pro-inflammatory CXCR3 chemokine ligands may regulate pDC influx to psoriatic skin, the mechanism responsible for selective pDC recruitment in psoriasis vs. AD remains unknown. Circulating pDC from normal donors express a limited number of chemoattractant receptors, including CXCR3 and CMKLR1 (chemokine-like receptor 1). In this work, we demonstrate that circulating pDC from normal donors as well as psoriasis and AD patients express similar levels of CXCR3 and responded similarly in functional migration assays to CXCL10. We next found that blood pDC from normal, AD, and psoriasis patients express functional CMKLR1. In contrast to normal skin, however, lesional skin from psoriasis patients contains the active form of the CMKLR1 ligand chemerin. Furthermore, in affected skin from psoriatic patients the level of active chemerin was generally higher then in AD skin. Taken together, these results indicate that local generation of active chemerin may contribute to pDC recruitment to psoriatic skin.

Staphylococcus aureus colonization is accepted to be an important triggering factor in patients with atopic dermatitis (AD) and antibiotic resistance has been recognized to be a serious problem as a consequence and for the management of AD treatment.To investigate the antibiotic resistance pattern of S. aureus strains isolated from patients with AD with apparent (lesional and nonlesional skin areas) and recurrent skin colonization and strains obtained from healthy nasal carriers.Eighty-seven patients (age 23+/-11.5 years) with mild to severe AD (SCORAD 46.9+/-16.6), 21 patients (age 19.8+/-6.7 years) before antistaphylococcal treatment and 177 healthy nasal carriers (age 27.5+/-8.4 years) were microbiologically assessed for carriage of S. aureus. Colonization of lesional and nonlesional skin areas was quantified by counting the number of colony forming units on the skin surface (log(10) CFU cm(-2)). Antimicrobial susceptibility and resistance phenotypes of 179 S. aureus strains were assessed with the agar disc-diffusion method.Staphylococcus aureus was isolated from 87% of lesional and 44% of nonlesional skin samples from patients with AD. The colonization density of S. aureus was markedly higher in lesional than in nonlesional skin (P0.001), and was positively correlated with AD severity (P0.001) and total serum IgE (P0.05). Patients with AD had a significantly higher prevalence of chloramphenicol-resistant S. aureus than nasal carriers (P0.01). Similar rates of resistance were expressed to tetracycline, erythromycin, mupirocin, clindamycin and penicillin. Nearly 35% of S. aureus strains from the lesional skin demonstrated different antimicrobial sensitivity pattern compared with strains from nonlesional skin of the same patients with AD. The trend of increasing resistance to chloramphenicol, erythromycin and fusidic acid was observed among S. aureus strains recovered from patients after approximately 75 days of antibiotic treatment. Methicillin-resistant S. aureus isolates were cultured from two patients, one during exacerbation and the other after subsequent bacterial recolonization.Discrepancies in antibiotic sensitivity pattern were observed among S. aureus strains colonizing different sites of AD skin (lesional and nonlesional areas), and also in AD patients with prior antibiotic treatment. Therefore, clinicians should consider repeat microbial susceptibility testing on different body sites of patients with AD when clinically indicated.

To check post penetrating keratoplasty (PK) corneal wound healing characteristics after epidermal growth factor (EGF) application and to compare it with controls.The PK was performed in the group of 72 young, healthy New Zealand rabbits (36 females and 36 males). Slit-lamp examination, tonometry and corneal topography by Tomey's corneal modeling system (TMS-1) were carried out before and after surgery. The PK was performed in both eyes. Half of animals were used as a bilateral donor for the other half, with a rule: right eye cornea to the right eye and left eye cornea to the left eye. As a result, after completed surgery 36 rabbits had bilateral grafts. The animals were divided into 3 equal groups (12 in each). Two drops of the human recombined EGF dissolved in the saline solution with concentration varied from 500 to 1500 ng in each drop were applied to the right eye according to schedule. The left eye was used as a control and did not receive EGF. Time of observation varied from 24 hours to 6 months. The tensinometry and the histopathologic study--light and electron microscopy were performed to determine corneal scarring.The wound healing pattern after PK was characteristic and constant in each group. The corneal wound healing significantly accelerated in the EGF treated group of rabbits compared with the controls (p0.05). In the group of rabbits receiving 1000 ng of hrEGF 3 times/day, after two weeks of application we noted increase of the wound strength up to 600 folds, comparing with controls. Well-organized scar was histologically seen on the 21st post-surgery day. The post-operative corneal astigmatism was less expressed in the eyes treated with EGF comparing to controls.These preliminary results of our experimental study indicated accelerated effect on the corneal wound healing after PK with topical, low dose hrEGF application. Clinical observation of utilization of similar low doses of the hrEGF after PK--is in progress.

A case of 21 year old woman with corneal degeneration similar to Salzmann's degeneration and binocular cataract is presented. A successful corneal transplantation combined with extracapsular cataract extraction followed by posterior chamber lens implantation was performed. Patient is undergoing a treatment in endocrinology ward. A rare idiopathic hypoparathyroidism with Fahr syndrome was ascertained.

Eleven re-transplantations of the cornea were performed between October 1988 and October 1991. Utilized was the material selected according to a partial compatibility of the HLA factor in 11 men with opacified transplants performed previously without antigen selection in high risk leukoma (in 10 cases after severe eye burns). In 3 patients the transplant was the fifth one, in 1 patient the fourth, in two--the third and in 5 the second one. Favourable results (transparent and semi-transparent grafts) were obtained in 8 patients (72.7 p.c.).

One of the main problems of corneal transplantation is the postoperative astigmatism. In the last period the intraoperative application of the kerato-scope, new type of needles and threads in stitching the corneal patch created a chance for solving this problem. The authors present the methods used for stitching of the corneal patch, their advantages and the defects with consideration of differences resulting from the thickness and kind of the thread, from the length and form of the needle. Basing on personal experience and data from the literature they propose the technique of the suture which they are using.

In the period of 1985-1992 we performed in our centres 34 operations of a double procedure and 12 operations of a triple procedure. During the observation--from 2 months to 7 years--we obtained favourable results encouraging to connect the corneal grafting with cataract extraction in high myopia and with extracapsular cataract extraction with implantation of an artificial lens in emmetropic eyes. Presented is the appropriate technique of operation and the results obtained.

On examining about 300 patients with keratoconus in the period of 20 years the authors detected in a number of cases variations of the intraocular pressure. By means of a pneumo-tonometer Digilab 30R periodic variations of the IOP were measured in 76 patients and daily variations in 42. The statistical analysis showed that the application of Timolol and reduction of the IOP variations has a decisive influence on the improvement of objective changes and the visual acuity without correction. Presently in our Department Timolol is used successfully in 160 patients. There was no deterioration in either patient at that time and many patients showed an improvement of the condition of keratoconus.

The discussion on this topic was considered as advisable because of frequent diagnostic faults and an incorrect treatment of keratoconus. The authors presents the diagnosis, foundations of the general and topical treatment of keratoconus.

The study presents conditions mostly described as co-existing with the keratoconus in 7 patients (from among 300 examined) born from an uni-ovular twin pregnancy. Only one pair of twins showed keratoconus of both eyes and developing identically in both eyes.

Fifteen corneal grafts were performed in 15 men with high risk leukoma (5+) in the period October 1988--November 1990. The age of the patients oscillated between 11 and 76 years. In 5 patients the grafting was done in only eye. The period of observation after surgery amounted 4-29 months. The favourable results (transparent and ++semi-transparent grafts) were obtained in 9 eyes (60 p.c.) and partly opacified grafts in 6 (40 p.c.). Neither of the grafts opacified. In the preceding years--without taking into account the antigenic selection of the donor--favourable results in similar leukoma cases were achieved in ca. 42 p.c. of cases.

Ten corneae from donors selected in respect of partial compatibility of the HLA antigens were transplanted in the period October 1988--October 1989. The grafting was performed in 10 patients with leukomas included in the group of maximal risk (5+). In 9 patients the leukomas were due to ocular burns (chemical in 8 patients and thermal in 1 patient). In 1 patient, a 74 years old man the grafting was performed in the single eye with Salzman's corneal dystrophy with a simultaneous cataract extraction. During observation, which lasted 2 to 12 months 6 grafts remained transparent, 1--partly opacified. Not any transplant did totally opacify.