Background/Aim. Psammoma bodies (PB) are regarded as benign consequences of ageing in choroid plexus stroma. The aim of this study was to assess the morphometric characteristics of psammoma bodies of all four choroid plexuses during the ageing process. Our intention was to find the possible relations between psammoma bodies and choroid plexus and blood vessels parameters. Methods. This study was conducted on the material taken from 15 cadavers during routine autopsies. Tissue samples were collected from both lateral, third and forth ventricles? choroid plexus. Slices were stained with Mallory trichrome stains. In each image, we analyzed morphometrically the epithelium, blood vessels present and all the psammoma bodies. Results. With age, right choroid plexus surface density decreases (p < 0.05), while the psammoma bodies volume density increases (p < 0.05). A decrease in the blood vessels volume density was observed in the third ventricle?s choroid plexus (p < 0.05), as well as an age-related decrease in the psammoma bodies perimeter (p < 0.01). Not associated with ageing, the increase in psammoma bodies perimeter and volume density predicts a decrease in choroid plexus surface density (p < 0.05 and p < 0.001, respectively). There was a decrease in the volume density of blood vessels with age and with the increase in Feret?s diameter of psammoma bodies, (p < 0.001 and p < 0.05, respectively). Conclusion. We want to point out that there is an association between ageing and increased size and volume density of psammoma bodies. More important is the fact that psammoma bodies? presence and their morphometric characteristics are good predictors of changes occurring on the level of choroid plexus structure and vascularization, which may have crucial effects on the choroid plexus physiology.
Posterior wall acetabular fractures associated with hip dislocation are severe injuries. Urgent, closed reduction of the hip, early definitive stable osteosynthesis of acetabulum and the experience of surgical team are factors that greatly decrease the possibility for AVN occurence. Later reduction, comminution of posterior wall of the acetabulum (Thompson- Epstein III et IV), impaction, chondral lesion of the femoral head and associated fractures of femoral head, increase the possibility for AVN occurence.
Various methods can be applied for treatment of knee deformity. One of them is open wedge osteotomy and callus distraction by means of the external fixator. This paper presents the results of treatment of 16 patients with knee arthrosis associated with varus and valgus deformities (10 varus and 6 valgus deformities). Open wedge osteotomy of the varus deformity was performed in the proximal tibia, and in case of the valgus deformity in the distal part of the femur. The patients who were operated on had a knee varus larger than 10 degrees and a knee valgus larger than 12 degrees. Prior to open wedge osteotomy and application of the external fixator, knee arthroscopy was performed (meniscectomy, cartilage drilling and shaving, debridement, the extraction of loose bodies). After one-year follow-up, the final outcome of the treatment was positive in all patients. The treatment alleviated the pain in these patients. The method is minimally invasive and relatively easily applied. Mitkovic's external fixator type M20-CD-V allows for continuous callus distraction with simultaneous correction of the varus or valgus knee deformity.
These injuries are extremely rare and severe. The literature describes only individual cases of such injuries. We report a case of a displaced fracture of the talar neck with a complete posterior dislocation and rotation of the body of the talus (Hawkins type III) associated with medial malleolus fracture, treated with the method of urgent open reduction and internal fixation of the talar neck and medial malleolus as well as with the method of distraction external fixation.A 26-year-old male was injured after a fall from a height of over 8 m and was admitted as an emergency to the University Orthopedic and Traumatology Clinic in Nis. Surgery was performed within 4 h postinjury. He was mobilized with crutches with non-weight bearing. The external fixator was removed 10 weeks postsurgery, when physical therapy was initiated. The follow-up was 3 years. There were neither early nor late postoperative complications. Three years postinjury, movements in the ankle joint were satisfactory (plantar flexion 35 degrees , dorsal flexion up to 10 degrees , moderately limited movements in the subtalar joint). There were no signs of avascular necrosis; the patient walked normally and went back to physical work 2 years postinjury. Urgent open reduction and internal fixation of the Hawkins type III fracture with dislocation of the talus and distraction external fixation can play an important role in the prevention of avascular necrosis of the talus and other complications which follow this injury.
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