[Evaluation of the efficacy of a carbon brace ("Corset monocoque carbone respectant la respiration" [CMCR]) preserving lung capacity to treat idiopathic scoliosis in children and adolescents: a retrospective study of 115 patients]

OBJECTIVES

The purpose of this retrospective study was to investigate whether treatment with a carbon brace (CMCR) stops the progression of idiopathic scoliosis in children and adolescents affected by combined or thoraco-lumbar scoliosis.

METHOD

We compared clinical features (hump and vital capacity) and radiolographic data (Cobb angle, sacral slope, lumbar lordosis and thoracic kyphosis) at brace set-up and removal in 115 children and adolescents with combined or thoraco-lumbar scoliosis. The impact of the brace was evaluated in 2 subgroups: patients who started the treatment at Risser stages 0, 1 or 2 and those who started the treatment at Risser stages 3 or 4. With 95 patients, a questionnaire was used to evaluate the physical and psychological tolerance of the brace and technical difficulties during treatment with the orthosis.

RESULTS

At brace set-up, the immediate angular correction was about 50% compared to the pre-brace angle; the reduction of the vital capacity was weak. After brace removal, radiographic data showed significant improvement in thoraco-lumbar scoliosis and in the lumbar curve of patients with combined scoliosis, although the thoracic curvature of the combined scoliosis was unchanged. No significant efficiency on the hump was observed.

CONCLUSION

The CMCR brace can stop the progression of moderate combined or thoraco-lumbar scoliosis in growing children and adolescents, with little consequence to vital capacity, but seems to have no efficacy on the hump. This type of orthosis provides a better outcome in terms of thoracic mobility and vital capacity. The CMCR brace is indicated for children and growing teenagers with flexible, progressive scoliosis. This "mobile" brace definitely has its place in the current therapeutic arsenal.

Measurement of CP-violating asymmetries in B0 decays to CP eigenstates

We present measurements of time-dependent CP-violating asymmetries in neutral B decays to several CP eigenstates. The measurement uses a data sample of 23x10(6) Upsilon(4S)-->BbarB decays collected by the BABAR detector at the PEP-II asymmetric B Factory at SLAC. In this sample, we find events in which one neutral B meson is fully reconstructed in a CP eigenstate containing charmonium and the flavor of the other neutral B meson is determined from its decay products. The amplitude of the CP-violating asymmetry, which in the standard model is proportional to sin2beta, is derived from the decay time distributions in such events. The result is sin2beta = 0.34+/-0.20 (stat)+/-0.05 (syst).

[Inefficacy of bothropic antivenin in the neutralization of the coagulation activity of Lachesis muta muta venom. Report of a case and experimental confirmation]

In the State of Amazonas and in areas nearby Manaus, the snakes responsible for the majority of accidents are Bothrops atrox and Lachesis muta muta, with a percentage of confirmed species of 76% and 17%, respectively. Frequently, in the absence of the laquetic and bothropic-laquetic antivenoms, the Instituto de Medicina Tropical de Manaus (IMTM) has been using bothropic antivenom in the treatment of laquetic accident. In this paper is related a case of accident caused by L. muta muta; the patient was treated with bothropic antivenom, and after received twenty ampoules of this antivenom, maintained blood incoagulability until the 13th day after the accident. Experiments to obtain the potency of the bothropic antivenom for the coagulant and hemorrhagic activities has been done, using Bothrops atrox venom as control. The results showed that the potency of the antivenom for the hemorrhagic activity was similar, and the potency for the coagulant activity for the L. m. muta venom was 9.2 times minor than that for B. atrox. The antibodies titles from three different lots of bothropic antivenom varied for the L. m. muta venom, and were constant for the B. atrox venom. Due to the inefficiency of the bothropic antivenom on the neutralization of the coagulant activity for the L. m. muta venom, the use of bothropic antivenom is not recommended in the treatment of Lachesis muta muta accidents.

Lymphocytic orchitis: a case report

A young man with a unilateral testicular mass of short duration was found on histopathologic examination of the orchiectomy specimen to have a nongranulomatous, lymphocytic orchitis. No evidence of any infectious agent, autoimmune disease, or lymphoma could be found. We believe that this case represents an example of a nonspecific or idiopathic lymphocytic orchitis that is distinct from the hitherto recognized granulomatous orchitis.

A human adult Wilms' tumor. Histologic, ultrastructural, and cytogenetic analysis

The cytogenetic, histologic, and electron microscopic studies of an adult patient with Wilms' tumor are presented. Wilms' tumor (nephroblastoma) is a common renal tumor of childhood but is extremely rare in people over 15 years old. The histologic analysis of the patient's tumor, including both light and electron microscopic analysis, indicated that this tumor satisfies the histologic criteria for an adult Wilms' tumor, namely, blastemic cells that are immature renal parenchymal cells, embryonic tubular structures, and a scanty stromal component consisting of loosely arranged spindle cells. The tumor showed several ultrastructural features characteristic of adult Wilms' tumor, namely, markedly elongated mitochondria, autophagic vacuoles, and intracytoplasmic filaments. Karyotypic analysis was performed on the patient's peripheral leukocytes and tumor cells. The leukocytes showed no significant increase in gaps and breaks, and the patient appears to have a normal male karyotype. Some interesting chromosomal anomalies were observed in the cultured tumor cells: at least one chromosome 13, both chromosomes 22, and the X chromosome are missing, three markers are present, and there is a possible deletion of 12p.

Takayasu's arteritis. A worldwide entity

Anomalous arterial supply to the temporal and occipital lobes was studied retrospectively in 320 patients with 640 bilateral carotid angiograms. An unusual artery arising from the supraclinoid part of the internal carotid artery was identified in seven angiograms (six patients). Proximally, this artery takes the same course as the cisternal segment of the anterior choroidal artery, gives rise to the choroidal branch to the choroid plexus of the lateral ventricle, and then supplies the medial and inferior parts of the temporal and occipital lobes. It was concluded that this artery represents anomalous development of the anterior choroidal artery, having large temporal and occipital branches that supply the medial and inferior parts of the temporal and occipital lobes.

Computerized axial tomography in chromic intracranial disorders

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Takayasu's arteritis: an unrecognized cause of pulmonary hypertension

Pulmonary arteritis and secondary pulmonary hypertension are common in patients with Takayasu's arteritis. These sequelae of arteritis have not been previously emphasized in the literature. In some patients, particularly young and middle-aged women, disproportionately severe involvement of the pulmonary arteries may be the cause of pulmonary hypertension of unknown etiology.

Crescent sign in pulmonary hematoma

The pathophysiology of pulmonary hematoma is discussed. The presence of the air-crescent sign in a coin lesion is nonspecific; however, it may direct the attention of the physician to consider a traumatic etiology.

Celiac arteriography following percutaneous splenoportography

Splenic arteriography was performed in 14 patients immediately following antecedent splenoportography. Arteriographic evidence of splenic hematoma was demonstrated in 3 patients while in the remaining 11, no arteriographic abnormalities were detected.

Pneumomediastinum complicating pregnancy

Pneumomediastinum and subcutaneous emphysema is a rare complication of the second stage of labor. Although this entity runs a benign course, fatalities have been reported. Clinical findings of subcutaneous emphysema necessitate a chest X-ray to document pneumomediastinum. If pneumomediastinum is present, rapid delivery via elective forceps or even surgery may be considered to prevent serious complications.

Ultrasonic diagnosis of abdominal aortic aneurysms

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