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Scurvy is caused by prolonged severe dietary deficiency of ascorbic acid, in which the breakdown of intercellular cement substances leads to capillary hemorrhages and defective growth of fibroblasts, osteoblasts and odontoblasts, resulting in impaired synthesis of collagen, osteoid and dentine. It is characterized by hemorrhagic gingivitis, subperiosteal hemorrhages, perifollicular hemorrhages, and frequently petechial hemorrhages (especially on the feet). People with abnormal dietary habits, mental illness or physical disability are prone to develop this disease. Epiphyseal separation is known to occur in scurvy but is rarely seen now. Epiphyseal separation from the metaphysis is always through the zone of calcified cartilage, known as "scorbutic lattice", which in the radiographs is represented as "the white line of Frenkel". We report a case of multiple epiphyseal separations in a cerebral palsy child because of vitamin C deficiency. The child was treated with splintage of extremity and nutritional supplementation. All physeal separation healed completely without any deformity. more...

Monteggia fracture dislocations are uncommon in childhood. Over a period of time, various equivalents of this entity have been described. These fractures with concomitant elbow injuries are exceedingly rare in young children. We present a case of a 6-year-old boy who sustained a fracture of proximal ulna with ipsilateral supracondylar fracture humerus. We suggest that the fracture pattern can be included under type I Monteggia equivalent on the basis of its characteristics, biomechanics and the mode of injury. more...

The cytotoxicity of Al(2)O(3) nanoparticles (NP) at very low exposure levels (1 μg/mL and less) to a dominant bacterial isolate from freshwater (lake water), Bacillus licheniformis, was examined. Sterile lake water was directly used as a test medium or matrix to simulate the freshwater environment. Exposure to 1 μg/mL Al(2)O(3) NP for 2 h caused a 17% decrease in cell viability (as determined by plate count and MTT assay). During the test period, the particles were found to be stable against aggregation in the matrix and exerted a nano-size effect on the exposed test organisms. The decrease in cell viability was proven not to be due to the release of Al(3+) ions from the nanoparticles in the dispersion. The zeta potential and FT-IR analyses suggested that the surface charge based attachment of nanoparticles on to the bacterial cell wall was responsible for flocculation leading to toxicity. The cell wall damage confirmed through SEM and the lipid peroxidation assay also contributed toward toxicity. This study warns of possible ecotoxicity of nanoparticles even at environmentally relevant concentrations. However, detailed studies need to be carried out to establish probable mechanistic aspects of this low concentration toxicity phenomenon. more...

Background: There is scarce information on craniovertebral junction tuberculosis even in developing countries. The pendulum of treatment in craniovertebral junction tuberculosis has periodically vacillated between nonoperative management and radical surgery., Methods: We performed a retrospective review of prospectively collected clinical and radiographic data on twenty-six consecutive patients with craniovertebral junction tuberculosis who were treated nonoperatively in our institution. The patients who had weakness of the limbs, pyramidal signs, or evidence of atlantoaxial dislocation and/or basilar invagination were immediately managed with immobilization with Crutchfield tongs traction (Group A), followed by halo-vest application. Patients without a neurological deficit, pyramidal signs, or atlantoaxial dislocation or basilar invagination were treated with cervical immobilization with early application of a halo vest (Group B)., Results: The common presenting features were neck pain, restriction of neck movement, and spastic weakness of limbs. A retropharyngeal purulent fluid collection and osseous involvement of the dens and lateral mass of the atlas were the common radiographic findings. Twelve patients were partially or completely dependent on others for activities of daily living, and marked ligamentous and bone destruction with displacement at the atlantoaxial level was seen in eight patients at the time of presentation. The twenty patients in group A had cervical traction for a mean of 5.9 weeks, and a halo vest was applied for a mean of 6.9 months with antitubercular therapy for eighteen months. The mean follow-up period was 25.2 months (range, eighteen to forty-two months). All of the patients were independent in activities of daily living at the time of the last follow-up., Conclusions: In the Indian subcontinent, the disease process of craniovertebral junction tuberculosis is usually quite advanced at the time of presentation. On the basis of our study, patients with craniovertebral junction tuberculosis can be managed successfully with nonoperative treatment even with advanced involvement of bone or soft tissues at this spinal level., Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. more...

We describe a new pattern of upper limb injury: a combination of fractures of both radius and ulna, with a rare type of trans-scaphoid transcapitate transhamate greater arc injury of the wrist and fractures of metacarpals, managed successfully., (Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.) more...

Background: The relationship between steatosis and angiogenesis in chronic hepatitis C (CHC) is unclear., Aim and Methods: The aim was to explain whether liver steatosis presence and its extent are associated with the number of new-formed blood vessels in lobules and portal tracts in CHC. 72 CHC patients infected with viral genotype 1b, 35 of whom had steatosis were evaluated. Monoclonal antibody anti-CD34 was used to identify new-formed blood vessels., Results: Patients with steatosis had a significantly more advanced stage of fibrosis (p = 0.002) and higher inflammatory activity grade (p = 0.062). CD34 expression in portal tracts (CD34pt), lobules and fibrous septa (CD34lfs) and total (CD34) were significantly higher in patients with steatosis (p = 0.034; p = 0.021; p = 0.023, respectively). CD34, CD34pt and CD34lfs differed significantly between patients with various steatosis grade (p = 0.006; p = 0.009; p = 0.013, respectively). CD34 and CD34pt differed significantly between each steatosis grade whereas CD34lfs between grade 1 and 3. Fibrosis stage and inflammatory grade were positively associated with steatosis extent (p = 0.015; p = 0.003, respectively)., Conclusions: Our observations suggest that extensive steatosis of liver parenchyma in CHC patients is associated with formation of new blood vessels in lobules and portal tracts. Understanding the relationship between steatosis, fibrosis and angiogenesis is therefore of great importance for the introduction of new therapeutic approaches and in the evaluation of CHC progression. more...

Synthetic polymers belonging to the aliphatic polyester group have become highly promising biomaterials for reconstructive medicine. The purpose of the present work is a biological evaluation of lactide-glycolide co-polymer (PLGA) and its composites with carbon fibers (PLGA+CF) or hydroxyapatite (PLGA+HA). The cytotoxicity of the evaluated materials towards hFOB 1.19 human osteoblast-like cells was assessed. Moreover, during the one-year contact of the assessed materials with living osseous tissue, the progress of bone formation was analyzed and the accompanying process of the materials' degradation was evaluated. The materials under evaluation proved to be biocompatible. more...

Tuberculosis of skeletal muscle is very rare, especially in immunocompetent patients. We describe a case of tuberculous abscess of rectus femoris muscle, which presented as a tender ill-defined mass. Diagnosis was established by PCR and histology. The patient showed marked improvement with a standard four-drug regimen with no evidence of disease activity at the two-year follow-up. more...

Tuberculosis rarely involves wrist joint and is usually diagnosed in arthritic stage. Early presentations are easily confused with traumatic event and commonly missed. We describe a case presenting with scapholunate dissociation initially, which later progressed to full blown arthritis. Similar presentation has never been documented. more...

Purpose: To evaluate the results of early arthroscopic release in the patients of stiff shoulder, Methods: Twenty patients of stiff shoulder, who had symptoms for at least three months and failed to improve with steroid injections and physical therapy of 6 weeks duration, underwent arthroscopic release. The average time between onset of symptoms and the time of surgery was 4 months and 2 weeks. The functional outcome was evaluated using ASES and Constant and Murley scoring systems., Results: All the patients showed significant improvement in the range of motion and relief of pain by end of three months following the procedure. At 12 months, mean improvement in ASES score is 38 points and Constant and Murley score is 4O.5 points. All patients returned to work by 3-5 months (average -4.5 months)., Conclusion: Early arthroscopic release showed promising results with reliable increase in range of motion, early relief of symptoms and consequent early return to work. So it is highly recommended in properly selected patients., Level of Evidence: Level IV. more...

In this study the influence of short carbon fibres (CF) on mechanical properties and degradation time of the lactide-glycolide co-polymer (PGLA) and on the mechanism of bone ingrowth into the implants was determined. Mechanical properties and push-out tests were measured. The pH of solutions and the implants' weights were tested after incubation in Ringer fluid. Analysis was based upon FT-IR and SEM with EDS studies. Pathological examinations were also performed. The in vitro examination revealed that carbon fibres accelerated polymer degradation process and increased the mechanical strength of polymer. In the case of PGLA + CF under in vivo conditions, initially, the superficial polymer degradation with new tissue in-growth was observed. Next, the degradation process included also the inner part of the implant, while the bone began to grow on exposed carbon fibres. In the case of pure PGLA the growth of soft tissue can be observed at the bone-implant interface and in the implant area. Our research indicates that PGLA + CF composite can be used in bone surgery as a short-term multifunctional load-bearing implant, which initially provides a mechanical support. During the time of controlled resorption of PGLA, carbon fibres act as a scaffold for the bone growth. more...

We are presenting a 71-years old male patient with chronic skin lesions that appeared at multiple site of pacemaker implantations in the upper thorax. In spite of many treatment trials, no significant improvements were accomplished. Expanded dermatological tests including serial histopathological examinations were necessarily performed. Based on test results and clinical presentations, the diagnosis of pyoderma gangrenosum was made. Immediate steroid therapy allowed dramatic improvement of the chronic inflammatory condition. The patient is still undergoing a close dermatological and cardiological follow-up. Replacement of the pacemaker into the abdomen is currently being considered. more...

The first post mortem examination was performed in Vilnius by a priest Stefan Bisio in 1770. At the end of the 18th century, Jakub Briotet, a surgeon and anatomist, founded a modest anatomical (surgery) study. In 1804, Jan Piotr Frank and his son Józef arrived to Vilnius and became professors of the University. Jan Piotr Frank took charge of the University Teaching Hospital and Józef of the Chair of Pathology. When, in 1805, Józef Frank took charge, after his father, of the University Hospital, he founded the first anatomopathological examination room there. The samples were obtained mainly from post mortem studies--autopsies. Most of the samples kept in spirit in the Frank's room were eaten by the starving French soldiers during the retreat of Napoleon's army. Getting dead bodies for the Universities was easy thanks to Tsar's decrees from the years 1793-1809 which ordered to open dead bodies and collect monsters. Moreover, a permission to transfer dead bodies from military hospitals to the University was issued in 1810. These decrees did not stop the cases of students digging out dead bodies from the graves, which still happened in 1810 and 1817. Józef Frank acknowledged great role of post mortem in medicine teaching. He wrote: an author describing a disease with lethal outcome, who does not mention pathological changes found through autopsy is backward. Beside Frank's study, there was still a study founded by Briotet at the Vilnius University, at the Chair of Anatomy. In 1808, Tsar Alexander I designed ruins of Spaska Orthodox Church for an anatomic theater. After seven year redecoration works, it was opened. Beside the theater, dissection room and Veterinary Institute, the building included zoological, veterinary and anatomical museum. The growing anatomical museum had, in 1841, 2895 preparations including 1239 anatomopathological preparations. After closing down Vilnius University and opening Medical and Surgery Academy, pathological anatomy classes were introduced for the 5th year students in 1834. The first lecturer of pathological anatomy, as an individual subject, was Ludwik Siewruk. He started the classes in 1840 when he took charge of the Chair of Anatomy at the Moscow University. Jan Leonow continued the classes till the closing down of Medical and Surgery Academy by the tsar in 1842. The classes performed by Siewruk and Leonow were limited to lectures. Practical knowledge, autopsies were a part of pathology classes and specific therapy (3rd and 4th years of studies). After the Academy had been closed down, all the exhibits of the Vilnius anatomical museum, including anatomopathological preparations were moved to the anatomical museum of Kiev University. Few of them remained in the Vilnius Medical Society. more...

Mastocytoses are a heterogeneous group of disorders of unknown etiology characterised by the accumulation of mast cells, particularly in the skin. Mastocytosis may be limited to the skin or involve internal organs, especially those playing the lymphoreticular function. We present a case of 9-year-old girl, with a history of maculopapules at the age of two, followed by yellow-brownish, nodular skin lesions. The skin lesions, located on the trunk, neck and face were accompanied by pruritus. The histopathological examination of the node confirmed the diagnosis of mastocytoma. A bone scintigram showed an increased uptake of radiotechnetium around the right coxal region. Application of antihistaminic drugs and phototherapy (UVA) has led to partial remission of skin manifestations of the disease. A long-term follow-up of the child is necessary. more...

Selenium is an important nutritional factor of human diet. Epidemiological and experimental data indicate that low selenium level can be associated with increased risk of cancer. On the other hand there are some evidence that patients with celiac disease can present selenium deficiency and increased risk of certain malignancies. Therefore the aim of study was to evaluate plasma selenium levels in children with celiac disease. The level of selenium was estimated by flame atomic absorptiometry method according to Whiteside. Celiac disease was diagnosed according to ESPGHAN criteria. Obtained results indicate that in celiac disease low plasma selenium levels are especially marked at preliminary stage of diagnosis and following low compliance to the gluten free diet. Children with this sickness may need supplementation of their diet with selenium. more...

The development of pathological anatomy in the second half of the 19th century was mainly associated with the scientific activity of Rudolf Virchow. Last year we celebrated the 180th birth anniversary and this year the 100th death anniversary of this outstanding man. The paper presents the scientific achievements of Rudolf Virchow as it was presented in Polish medical magazines in the 19th century and the beginning of 20th century. In 1858, his theory of cellular pathology became a basis for the understanding and fight against pathologic processes in living organisms. The theory also contributed to an increased interest in pathologic anatomy, especially histopathology and Virchow himself. In 1859 an extensive summary of the article, issued a year before, entitled "Cellular pathology based on physiological and pathological theory of tissues" appeared in the subsequent issues of "Tygodnik Lekarski" ("Medical Weekly"). Also a translation of the XI chapter of "Cellular pathology..." devoted to nerve tissue appeared in the same magazine. This is the only treatise in Polish on the most important work in the history of pathological anatomy of the 19th century. Three years later, in 1862, Włodzimierz Brodowski delivered to the students of Medical and Surgery Academy in Warsaw a lecture "Introduction to the lecture on pathological anatomy" which was later printed in "Pamietnik Towarzystwa Lekarskiego Warszawskiego" ("Diary of Warsaw Medical Association"). He presented the development of pathological anatomy along with the achievements of Virchow. Brodowski was the first Polish anatomopathologist who lectured to students on Virchow's theory. Moreover, a paper "Scientific activity of Rudolf Virchow and its importance for medicine" by Edward Przewoski was published in the series "Clinical Lectures" issued by the editors of "Gazeta Lekarska" ("Medical Magazine") in 1892. The article included a detailed description of the scientific activity of that outstanding scholar. Apart from the above mentioned examples, Virchow's opinion not only on pathological anatomy and medicine but also on, for example, anthropology was often presented. Rudolf Virchow's death was announced in all the then Polish medical magazines. more...

Selenium (Se) is an essential component of many mammalian enzymes and therefore plays an important role in different metabolic processes. Se deficiency occurs in inadequate diet consumption as well as in some digestive tract and allergic diseases. In this research we showed that Se plasma concentration levels in healthy children was 71.8 mg/l, whereas in those with food allergy 54.1 mg/l (with smaller intestinal villus atrophy) or 50.4 mg/l (with greater intestinal villus atrophy). Obtained results indicate that children with food allergy display higher risk of Se deficiency. Antioxidative and immunomodulatory action of Se, connecting with promising literature data of Se supplementation, promote us to state, that this trace element could be used for accessory food allergies treatment. more...

Two cases of cerebral secretory meningioma, occurring in 57 and 33-year-old females are reported. The tumors were located in the tentorial and frontotemporal region, respectively. The general histologic appearance of the tumors was of meningothelial meningioma (case 1) and meningioma with microcystic and angiomatous features (case 2). The most striking histological finding in both tumors were numerous pseudopsammoma bodies, localized chiefly around blood vessels. The inclusions were slightly eosinophilic, stained strongly with PAS method and were differing in size from 3 to 30 microns. Tumor cells containing or surrounding pseudopsammomas were immunopositive for cytokeratin and epithelial membrane antigen. In the first case, individual pseudopsammomas were strongly positive for carcinoembryonic antigen. Some diagnostic aspects of this antigen and problems regarding differential diagnosis in secretory meningioma are briefly discussed. more...

The letters of dr Wladyslaw Zahorski from Wilno published in "Nowiny Lekarskie" in the years 1899-1914 are a source of information on the condition of health and the level of health care of the Wilno population at the end of the XIXth and at the beginning of the XXth century. The sanitary condition of the city was very bad. Infectious diseases killed people in the thousands. Many superstitions and prejudices were being spread especially during an epidemic. Wilno did not have well equipped and organized hospitals. Apart from state hospitals, there were private small hospitals which had better conditions for treating people. Poor people were given some medical aid free. A fight against social ignorance, infectious diseases and to improve sanitary condition of the city was conducted by Wilno Medical Society. more...

The case of carcinoid of the larynx is presented. Attention is focused on the difficulties with establishing the diagnosis. The principles of treatment this kind of neoplasm are reported.

Mortality from asthma within 1978-1987 was analysed retrospectively. This analysis included selected factors determining the mortality in this disease. Some conditions being able to decrease death risk in asthmatic patients were defined. The results of autopsies of patients who died from asthma were also analysed with an attempt to interpret those results basing on the selected clinical data. Unified scheme of sampling for pathomorphological examinations was proposed together with proper interpretation of histopathologies in the lungs and myocardium. Presented data are preliminary and will be continued in foreseen prospective studies. more...

An analysis was carried out of material biopsied during fiberoptic bronchoscopic examination of 289 patients suspected of lung malignant disorders were present more often in males. In the group of patients older than 40 years the most often diagnosed malignant process was squamous cell carcinoma. A high correlation of clinical suspicion of malignant process and histopathological diagnosis was found. A low rate of diagnosis of operable cases was found. more...

This study represents the first of a two-stage project. The first phase of the study examined the funding sources for the 40 Community Services Boards in Virginia. Data provided from the Department of Mental Health and Mental Retardation in Virginia examined fee collections which are comprised of direct client, commercial insurance, Medicaid and Medicare. An analysis of quarterly reports from 1982 to 1984 revealed that Medicaid collections have decreased significantly, while commercial insurance reimbursements have increased significantly. These results, although limited to data from Virginia, point to the need to examine if these shifts are occurring nationwide, and to determine if the shift toward commercial insurance is impacting upon the delivery of services in Community Mental Health Centers. more...