Innate Immunity in the Development of Connective Tissue Dysplasia: Pilot Study in Children with Congenital Hip Dislocation

Introduction: Observing and treatment of hip dysplasia in children have always been in the sphere of interest of modern molecular medicine. The role of molecular factors in the formation of connective tissue dysplasia in children is considered crucial for such multisystem disorders, and connective tissue dysplasia progressing involves immune system parameters and biochemical markers. The aim of this work was to establish the relationship between immune status indicators and biochemical markers of connective tissue using bioinformatics and modeling methods. Materials and Methods: 27 patients with congenital hip dislocation, admitted to the University Clinic of Privolzhsky Research Medical University, Department of children orthopedics for surgical treatment, were examined. Determination of 10 blood parameters was conducted by modern biochemical and immunological methods. Statistica 12.0 software from StatSoft was used for statistical data processing. Methods of nonparametric statistics were used since the samples in the control group partially follow the normal distribution. Correlation methods and regression modeling methods were used to evaluate the relationship of indicators. Results and Conclusion: In our investigation we have shown the presence of statistical and mathematical interactions between the parameters of innate immunity and indicators of connective tissue metabolism. The leading role of the immune system in the development of pathologies associated with connective tissue dysplasia is assumed. In further investigations it is necessary to clarify the role hypoxia in HIF-1 stimulated control of skeletal dysplasia, collagen modification, connective tissue dysplasia development.

THE WAVELET ANALYSISOF EVOKED POTENTIALS

Abstract: In this paper,we use the orthogonal wavelet based on 3-order splines function to processthe somatosensory evoked potentials and cognitive event-related potentials. The experiments onhuman subjects have showed that this method is valuable and practicable.INTRODUCTIONEvoked potentials(EP' s) are electrical responses of the central nervous system to stimulusapplied in a controlled manner. They can not only be used to diagnose the diseases on the sensorypathway and brain but also be frequently monitored intraoperatively to assess the effects ofsurgery or to detect unexpected neurological injury [1][2]. But the Signal-to-Noise ratios (SNRIs) of EP' s are vary low. The: are many methods in order to improve the SNR' S and identify theEP' s signal perfectly with less stimuli such as ensembl averaging,post-wiener filtering,adaptedfiltering and parametric modeling and even single stimulus. The purpose of this paper is to applyrnultiresolution wavelet analysis method for identification of short-latency somatosensory evokedpotentials and long-latency evoked--related potentials.METHODMultiresolution Wavelet analysis and pyramid algorithm was constructed by Mallat [3] andwidely used in signal processing pattern recognition and image processing. Here,we applyed thisto decompose EP' S signal into different frequency bands and reconstructed them with time-varying weight method.Based on 3-order splines functions,we constructed orthogonal wavelet and scale function. According to the dual-scale function,we could get transform function h and its mirror filter g,theyare related by gn(- l)nhn+1. More detail could see Mallat' theory[3]. Through fast pyramid algorithm,the EP' S signal can be decomposed into detail and coarse parts on a dyadic scales by scalefunction like this Here Cj is coarse signal and Dj is detail signal. C, is signal on scale 0 and is the same as originalsignal. With j increasing,the EP' S signal were projected to different frequency bands. The reconstructed function for signal on j scale to j-1 scale isAccording to the character of EP' S signals and their decomposition on different scales ,we choosethe following signal processing principle.To somatosensory EPI S (SEP),we choose coarse and detail signal on scale 6 to reconstructsignalS(t) ~W, (t) o C,(t) +WZ(t) o D,(t)W, and W, are time--varying weight and are decided by the amplitude of detail and coarse signalson scale 6.To Event--related optentials (P300 waveform),because the noise is mainly on high frequencyband gwe choose coarse signal of scale 6 to reconstruct signal.RESULTThere are ten subjects taking part in the experiment. The instrument is SPECTRUM32 ofCADWELL corporation. To SEP signals,The medial nerve of left wrist was stimulated,activeelectrode was attached to Cll (3 cm lateral to the midline and posterior to the coronal suture).reference electrode at Al (left ear) and ground electrode at Fpz according to 'the international 10-20system of electrode placement.Figurel is the original SEPI S signal and processed signal, (a) is the SEPI S signal averaged by250 times. (b) is the signal averaged by 30 times and (c) is the signal of (b) be processed. Fromthe figure,we could see that the method is effectively,noise ate inhibited greatly and the waveform of (c) is almost the same as the signal (a).Figure 2 .The EPRI S signal and processed signalTo ERP,active electrode was attached to Cz.reference electrode at Al and ground electrodeat Fpz. The stimulus is auditory and the probability of target stimulus is 20 percent.FigureZ is the EPR signal, (a) is the signal average 40 times, (b) is the single trial signal and(c) is the processed signal of (b). From the figure, we could say that multiresolution waveletanalysis can get single trial signal of ERP. The signal (c) is almost the same as signal of (a).From the experiments,we could say that the time--varying weighted multiresolution waveletanalysis method is suitable and practicable and may be vary useful in identification of single trialEPI s signal.

Total hip arthroplasty with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis

Objective: To evaluate the outcome of total hip arthroplasty (THA) with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis. Methods: Between 1995 and 2002, we implanted 23 cementless cups and femoral head autografts in 20 patients with hip dysplasia and osteoarthritis. In this study, a retrospective study was made on 21 hips in 20 patients (18 females and 2 males, aged 50 years on an average) with developmental hip dysplasia treated by THA with a cementless cup and femoral head autograft. The acetabular cup was placed at the level of the true acetabulum and all the patients required autogenous femoral head grafts due to acetabular deficiency. The average rate of the acetabular cup covered by the femoral head autograft was 31% (ranging from 10% to 45%). Eight hips had less than 25% cup coverage and thirteen between 25% and 50%. The average follow-up period was (4.7) years (range, 1-8 years). The replacing outcome was evaluated by modified Harris hip score. Preoperative and follow-up radiographs were made. Results: All the autografts were united to the host bones. No autograft was collapsed or no component from the hip was loosed in all the patients. According to the modified Harris hip score, the average hip score increased from 46 before operation to 89 at the final review. Before operation, the leg-length discrepancy was greater than 2 cm in all the patients except one with bilateral hip dysplasia. After operation, only 2 out of 20 patients had a leg-length discrepancy greater than 1 cm. Three hips showed minor bone resorption in the lateral portion of the graft, which did not support the cup. Three hips developed Grade 1 Brooker heterotopic ossification and one developed Grade 2. Conclusions: THA with a cementless cup and a femoral head autograft for patients with osteoarthritis resulted from hip dysplasia can result in favorable outcomes. This method can provide reliable acetabular fixation and restore the acetabular bone stock in patients with developmental hip dysplasia when the cementless cup covered by the graft does not exceed 50%.

Increasing thickness and fibrosis of the cartilage in acetabular dysplasia： a rabbit model research

Background The order and mechanism of pathological changes in acetabular dysplasia are still unclear. This study investigated cartilage changes in rabbit acetabular dysplasia models at different ages.Methods Twenty-seven 1-month-old New Zealand rabbits underwent cast immobilization of the left hind limb in knee extension. Serial acetabular dysplasia models were established by assessment of the acetabular index and Sharp＇s angle on radiographs. The thickness of the acetabular cartilage was measured under a microscope, and fibrosis was observed. Ultrastructural changes were investigated with scanning electron microscopy and transmission electron microscopy. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 were measured by real-time fluorescence quantitative polymerase chain reaction.Results In an immature group of rabbits, the acetabular index of the treated hip increased with animal growth. The cartilage on the brim of the left acetabulum was significantly thicker than that on the right side. The collagen fibrils on the surface of the cartilage became gross, and the chondrocytes in the enlargement layer underwent necrosis. In a mature group of rabbits, the left Sharp＇s angle increased in the rabbits with 6-week casting. The cartilage on the brim of the left acetabulum underwent fibrosis. The chondrocytes were weakly stained, and the number of lysosomes was much larger than normal. The messenger RNA expression of collagen Ⅰ and Ⅱ, β1 integrin, and caspase-9 in the cartilage differed significantly at different ages.Conclusions Increasing thickness followed by fibrosis may be the order of pathological cartilage changes in acetabular dysplasia, with changes in ultrastructure and collagen expression contributing to the process.