No abstract

All patients with a Type I or Type III congenital kyphosis or kyphoscoliosis should be treated by a posterior arthrodesis before the age of 5 years and before the kyphosis exceeds 50 degrees. A kyphosis that does not reduce to less than 50 degrees as measured on the lateral spine radiograph made with the patient supine requires an anterior release and arthrodesis with strut grafting followed by posterior arthrodesis with instrumentation (if possible).

Ageing is one of the main contributing factors towards increasing arterial stiffness, leading to changes in peripheral pulses propagation. Therefore the characteristics of the photoplethysmogram (PPG) pulse, especially the rising edge and peak position, are greatly affected. In this study, the PPG pulse rising edge and corresponding peak position have been investigated non-invasively in human subjects as a function of age. Fifteen healthy subjects were selected and grouped in five age intervals, from 20 to 59 years, based on their comparable systolic-diastolic blood pressure and PPG amplitude. As expected, the peripheral pulse shows a steep rise and early peak in younger subjects. With age, the slope becomes blunted and in older subjects, the rise is very gradual and the pulse peak appears much later. Qualitative results were further verified by a modified 10-element Windkessel model to quantify the lumped parameter changes with ageing. This verification highlighted some specific changes in vascular parameters with aging. The rising edge could be considered as one parameter in determining the age-dependent vascular state.

An increasing severity of kyphosis was associated with a significant increase in respiratory impairment (P<0.005). A more cranial level of the kyphosis, especially above T10, had a significantly greater effect on respiratory impairment (P<0.001). One untreated patient with a severe kyphosis (128 degrees) died from cor pulmonale.

Sixty welders (20 each from Plants A, B, and C) and 20 control subjects were investigated for the possible occurrence of manganese poisoning among welders exposed to the welding fumes containing this metal. Ten, 9, and 5 welders from Plants B, C, and A, respectively, were diagnosed as suspected cases of early manganese poisoning. The diagnosis was based on the proof of overexposure to manganese by the findings of increased urinary levels of this metal, signs of early neurological involvement, and increased contents of serum calcium. These results are discussed in relation to the manganese concentration in the air around the welder's breathing zones.