BACKGROUND: The objective of this prospective randomized monocentric study is to compare the speed and quality of interbody fusion of implanted porous Al2O3 (aluminium oxide) cages with PEEK (polyetheretherketone) cages in ACDF (anterior cervical discectomy and fusion). MATERIALS AND METHODS: A total of 111 patients were enrolled in the study, which was carried out between 2015 and 2021. The 18-month follow-up (FU) was completed in 68 patients with an Al2O3 cage and 35 patients with a PEEK cage in one-level ACDF. Initially, the first evidence (initialization) of fusion was evaluated on computed tomography. Subsequently, interbody fusion was evaluated according to the fusion quality scale, fusion rate and incidence of subsidence. RESULTS: Signs of incipient fusion at 3 months were detected in 22% of cases with the Al2O3 cage and 37.1% with the PEEK cage. At 12-month FU, the fusion rate was 88.2% for Al2O3 and 97.1% for PEEK cages, and at the final FU at 18 months, 92.6% and 100%, respectively. The incidence of subsidence was observed to be 11.8% and 22.9% of cases with Al2O3 and PEEK cages, respectively. CONCLUSIONS: Porous Al2O3 cages demonstrated a lower speed and quality of fusion in comparison with PEEK cages. However, the fusion rate of Al2O3 cages was within the range of published results for various cages. The incidence of subsidence of Al2O3 cages was lower compared to published results. We consider the porous Al2O3 cage as safe for a stand-alone disc replacement in ACDF.

• Klíčová slova
• Al2O3, Fusion rate, Non-union, PEEK, Quality of fusion, Subsidence,
• MeSH
• diskektomie * MeSH
• ketony MeSH
• lidé MeSH
• oxid hlinitý * MeSH
• polyethylenglykoly MeSH
• poréznost MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• ketony MeSH
• oxid hlinitý * MeSH
• polyetheretherketone MeSH Prohlížeč
• polyethylenglykoly MeSH

AIM: The aim of this study was to identify retrospectively, lumbar sympathectomy (SE) using thermography (TG) and to evaluate clinically, the severity of post-sympathectomy (post-SE) dysfunction after anterior and lateral lumbar interbody fusion procedures (ALIF, XLIF). METHODS: Twenty eight patients with suspected SE were referred for TG to both legs. They completed our questionnaire on severity of difficulties after SE. We evaluated the ability of physical examinations to reveal the SE in contrast to TG and compared the symptoms (warmer leg and inhibited leg sweating) of SE with questionnaire responses as subjective measure and TG as objective measure. RESULTS: SE was diagnosed in 0.5% after ALIF at L5/S1, in 15% after ALIF at Th12-L5 and in 4% after XLIF at T12-L5. SE severely reduced the quality of life in two cases. The ability to distinguish differences in leg temperature by palpation after SE was found in 32%. All physical examinations together were insufficient for reliably disclosing SE. Subjective symptoms of SE were often false positive and proven SE by TG was often a clinically false negative. CONCLUSION: This is the first study to examine post-SE dysfunction objectivelya using TG after ALIF and XLIF, and the first to evaluate clinically, the severity of the post-SE syndrome. Before surgery we cannot foresee potentially poor SE results. For this reason, injury to the sympathetic chain during surgery must be avoided. The advantage of TG for identifying SE is its non-invasiveness and reliability.

• Klíčová slova
• interbody fusion, lumbar spine, sympathectomy, thermography,
• MeSH
• bederní obratle chirurgie   MeSH
• dospělí MeSH
• fúze páteře škodlivé účinky   metody   MeSH
• hypohidróza etiologie   MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• neurologické vyšetření metody   MeSH
• pooperační komplikace etiologie   MeSH
• poranění nervového systému etiologie   MeSH
• retrospektivní studie MeSH
• sympatický nervový systém zranění   MeSH
• tělesná teplota fyziologie   MeSH
• termografie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH

BACKGROUND CONTEXT: Several minimally invasive lumbar interbody fusion techniques may be used as a treatment for spondylolisthesis to alleviate back and leg pain, improve function and provide stability to the spine. Surgeons may choose an anterolateral or posterior approach for the surgery however, there remains a lack of real-world evidence from comparative, prospective studies on effectiveness and safety with relatively large, geographically diverse samples and involving multiple surgical approaches. PURPOSE: To test the hypothesis that anterolateral and posterior minimally invasive approaches are equally effective in treating patients with spondylolisthesis affecting one or two segments at 3-months follow-up and to report and compare patient reported outcomes and safety profiles between patients at 12-months post-surgery. DESIGN: Prospective, multicenter, international, observational cohort study. PATIENT SAMPLE: Patients with degenerative or isthmic spondylolisthesis who underwent 1- or 2-level minimally invasive lumbar interbody fusion. OUTCOME MEASURES: Patient reported outcomes assessing disability (ODI), back pain (VAS), leg pain (VAS) and quality of life (EuroQol 5D-3L) at 4-weeks, 3-months and 12-months follow-up; adverse events up to 12-months; and fusion status at 12-months post-surgery using X-ray and/or CT-scan. The primary study outcome is improvement in ODI score at 3-months. METHODS: Eligible patients from 26 sites across Europe, Latin America and Asia were consecutively enrolled. Surgeons with experience in minimally invasive lumbar interbody fusion procedures used, according to clinical judgement, either an anterolateral (ie, ALIF, DLIF, OLIF) or posterior (MIDLF, PLIF, TLIF) approach. Mean improvement in disability (ODI) was compared between groups using ANCOVA with baseline ODI score used as a covariate. Paired t-tests were used to examine change from baseline in PRO for both surgical approaches at each timepoint after surgery. A secondary ANCOVA using a propensity score as a covariate was used to test the robustness of conclusions drawn from the between group comparison. RESULTS: Participants receiving an anterolateral approach (n=114) compared to those receiving a posterior approach (n=112) were younger (56.9 vs 62.0 years, p <.001), more likely to be employed (49.1% vs 25.0%, p<.001), have isthmic spondylolisthesis (38.6% vs 16.1%, p<.001) and less likely to only have central or lateral recess stenosis (44.9% vs 68.4%, p=.004). There were no statistically significant differences between the groups for gender, BMI, tobacco use, duration of conservative care, grade of spondylolisthesis, or the presence of stenosis. At 3-months follow-up there was no difference in the amount of improvement in ODI between the anterolateral and posterior groups (23.2 ± 21.3 vs 25.8 ± 19.5, p=.521). There were no clinically meaningful differences between the groups on mean improvement for back- and leg-pain, disability, or quality of life until the 12-months follow-up. Fusion rates of those assessed (n=158; 70% of the sample), were equivalent between groups (anterolateral, 72/88 [81.8%] fused vs posterior, 61/70 [87.1%] fused; p=.390). CONCLUSIONS: Patients with degenerative lumbar disease and spondylolisthesis who underwent minimally invasive lumbar interbody fusion presented statistically significant and clinically meaningful improvements from baseline up to 12-months follow-up. There were no clinically relevant differences between patients operated on using an anterolateral or posterior approach.

• Klíčová slova
• Effectiveness, Fusion rate, Lumbar interbody fusion, Minimally invasive spine surgery, Patient reported outcomes, Spondylolisthesis,
• MeSH
• bederní obratle chirurgie   MeSH
• bolesti zad etiologie   MeSH
• fúze páteře * škodlivé účinky   metody   MeSH
• kvalita života MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony škodlivé účinky   metody   MeSH
• následné studie MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• spondylolistéza * chirurgie   etiologie   MeSH
• stenóza MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

Reverse engineering is the process of creating a digital version of an existing part without any knowledge in advance about the design intent. Due to 3D printing, the reconstructed part can be rapidly fabricated for prototyping or even for practical usage. To showcase this combination, this study presents a workflow on how to restore a motorcycle braking pedal from material SS316L with the Powder Bed Fusion (PBF) technology. Firstly, the CAD model of the original braking pedal was created. Before the actual PBF printing, the braking pedal printing process was simulated to identify the possible imperfections. The printed braking pedal was then subjected to quality control in terms of the shape distortion from its CAD counterpart and strength assessments, conducted both numerically and physically. As a result, the exterior shape of the braking pedal was restored. Additionally, by means of material assessments and physical tests, it was able to prove that the restored pedal was fully functional. Finally, an approach was proposed to optimize the braking pedal with a lattice structure to utilize the advantages the PBF technology offers.

• Klíčová slova
• 3D scanning, SS316L, electronic speckle pattern interferometry, lattice structure, powder bed fusion, printing simulation, reverse engineer,
• Publikační typ
• časopisecké články MeSH

BACKGROUND/AIM: Current research of prostate cancer (PCa) offers a promising way of identifying patients with adverse prognosis who do benefit from radical treatment that can affect quality of life as resections are associated with numerous side-effects. The aim of our study was to evaluate the relationship of TMPRSS2-ERG fusion gene status, tumor tissue prostate-specific antigen (PSA), prostate cancer antigen 3 (PCA3), miR-23b, miR-26a and miR-221 expression levels in combination with preoperative serum PSA level to the risk of PCa recurrence after radical prostatectomy. PATIENTS AND METHODS: The study group consisted of 108 patients who underwent radical prostatectomy. PSA was measured in peripheral blood collected preoperativelly. The expression of TMPRSS2-ERG transcript and the expression of miR-23b, miR-26a and miR-221 in formalin-fixed, paraffin-embedded (FFPE) tumor tissues was analyzed by reverse transcription (RT) real-time polymerase chain reaction (PCR). RESULTS: Significantly shorter time to recurrence was observed in patients with high expression of TMPRSS2-ERG (p=0.0020). High levels of preoperative PSA (>10.0 ng/ml) proved to be marker of shorter time to recurrence (p=0.0153). The most promising marker of the risk of recurrence after radical prostatectomy was a combination of high level of preoperative serum PSA and high expression of TMPRSS2-ERG fusion transcript in tumor tissue (p=0.0001). CONCLUSION: A combination of high preoperative serum PSA and high expression of TMPRSS2-ERG could be promising in distinguishing those tumors that are aggressive and life-threatening.

• Klíčová slova
• PCA3, PSA, Prostate cancer, TMPRSS2-ERG, microRNA, prognosis,
• MeSH
• antigeny nádorové biosyntéza   genetika   MeSH
• dospělí MeSH
• fúzní onkogenní proteiny genetika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru krev   genetika   patologie   MeSH
• mikro RNA biosyntéza   genetika   MeSH
• nádorové biomarkery biosyntéza   krev   genetika   MeSH
• nádory prostaty krev   genetika   patologie   chirurgie   MeSH
• prediktivní hodnota testů MeSH
• prognóza MeSH
• proporcionální rizikové modely MeSH
• prostata patologie   MeSH
• prostatektomie MeSH
• prostatický specifický antigen krev   MeSH
• regulace genové exprese u nádorů MeSH
• rizikové faktory MeSH
• senioři MeSH
• zalévání tkání do parafínu MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antigeny nádorové MeSH
• fúzní onkogenní proteiny MeSH
• mikro RNA MeSH
• MIRN221 microRNA, human MeSH Prohlížeč
• MIRN23a microRNA, human MeSH Prohlížeč
• MIRN26A microRNA, human MeSH Prohlížeč
• nádorové biomarkery MeSH
• prostate cancer antigen 3, human MeSH Prohlížeč
• prostatický specifický antigen MeSH
• TMPRSS2-ERG fusion protein, human MeSH Prohlížeč

This paper aims at an in-depth and comprehensive analysis of mechanical and microstructural properties of AISI 316L austenitic stainless steel (W. Nr. 1.4404, CL20ES) produced by laser powder bed fusion (LPBF) additive manufacturing (AM) technology. The experiment in its first part includes an extensive study of the anisotropy of mechanical and microstructural properties in relation to the built orientation and the direction of loading, which showed significant differences in tensile properties among samples. The second part of the experiment is devoted to the influence of the process parameter focus level (FL) on mechanical properties, where a 48% increase in notched toughness was recorded when the level of laser focus was identical to the level of melting. The FL parameter is not normally considered a process parameter; however, it can be intentionally changed in the service settings of the machine or by incorrect machine repair and maintenance. Evaluation of mechanical and microstructural properties was performed using the tensile test, Charpy impact test, Brinell hardness measurement, microhardness matrix measurement, porosity analysis, scanning electron microscopy (SEM), and optical microscopy. Across the whole spectrum of samples, performed analysis confirmed the high quality of LPBF additive manufactured material, which can be compared with conventionally produced material. A very low level of porosity in the range of 0.036 to 0.103% was found. Microstructural investigation of solution annealed (1070 °C) tensile test samples showed an outstanding tendency to recrystallization, grain polygonization, annealing twins formation, and even distribution of carbides in solid solution.

• Klíčová slova
• AISI 316L, additive manufacturing, anisotropy, focus level parameter, laser powder bed fusion, melting level, porosity, solution annealing,
• Publikační typ
• časopisecké články MeSH

Spinal fusion is a surgical procedure used to join two or more vertebrae to prevent movement between them. This surgical procedure is considered in patients suffering from a wide range of degenerative spinal diseases or vertebral fractures. The success rate of spinal fusion is frequently evaluated subjectively using X-ray computed tomography. The pig was chosen as an animal model for spinal fusion, since its spinal structure is similar to the human spine. Our paper presents an automatic approach for pig's spinal fusion evaluation in 3D. The proposed approach is based on the determination of the vertebral fused area, which reflects the fusion quality. The approach was applied and tested on microCT (μCT) data of fused porcine vertebrae ex-vivo. In our study, three types of implants were used to perform spinal fusion: the iliac crest bone graft used as the gold standard, and two types of novel scaffold implants based on the polymer/ceramic porous foam involving either growth factors or polyphosphates. The evaluation worked automatically for all three types of used implants, and the fusion quality was determined quantitatively. The calculation is based on the detection of the fused area and area of facies intervertebralis, so the percentual representation of the vertebral joint can be determined. Since this approach is versatile and is described in detail as a guide for image processing the data of vertebrae fusion, this methodology has the potential to establish a standard approach for evaluating the fusion quality in ex-vivo samples that can be tested on clinical data.

• Klíčová slova
• Computed tomography, Image processing, Lumbar spinal surgery, Regenerative medicine, Spinal fusion, Vertebrae fusion,
• MeSH
• bederní obratle diagnostické zobrazování   chirurgie   MeSH
• fúze páteře * MeSH
• lidé MeSH
• lumbosakrální krajina MeSH
• nemoci páteře * MeSH
• prasata MeSH
• rentgenová mikrotomografie MeSH
• rentgenové záření MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The low specific density and good strength-to-weight ratio make magnesium alloys a promising material for lightweight applications. The combination of the properties of magnesium alloys and Additive Manufacturing by the Laser Powder Bed Fusion (LPBF) process enables the production of complex geometries such as lattice or bionic structures. Magnesium structures are intended to drastically reduce the weight of components and enable a reduction in fuel consumption, particularly in the aerospace and automotive industries. However, the LPBF processing of magnesium structures is a challenge. In order to produce high-quality structures, the process parameters must be developed in such a way that imperfections such as porosity, high surface roughness and dimensional inaccuracy are suppressed. In this study, the contour scanning strategy is used to produce vertical and inclined struts with diameters ranging from 0.5 to 3 mm. The combination of process parameters such as laser power, laser speed and overlap depend on the inclination and diameter of the strut. The process parameters with an area energy of 1.15-1.46 J/mm2 for struts with a diameter of 0.5 mm and an area energy of 1.62-3.69 J/mm2 for diameters of 1, 2 and 3 mm achieve a relative material density of 99.2 to 99.6%, measured on the metallographic sections. The results are verified by CT analyses of BCCZ cells, which achieve a relative material density of over 99.3%. The influence of the process parameters on the quality of struts is described and discussed.

• Klíčová slova
• laser powder bed fusion, lattice structure, magnesium alloy WE43, relative density, scanning strategy,
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY: To evaluate the effect of complications on the quality of life in patients after elective stabilisation surgery on the lumbar spine. MATERIAL AND METHODS: Between January 2005 and June 2007, 208 patients (120 women and 88 men) were included in the prospective study carried out at our department. These patients were undergoing elective surgery for lumbar spinal disease, namely, central and lateral stenosis, degenerative disc disease and degenerative and isthmic spondylolisthesis. All patients were treated by transpedicular fixation and fusion involving transforaminal lumbar interbody fusion (TLIF) in 165 patients, anterior lumbar interbody fusion (ALIF) in five and posterolateral fusion (PLF) in 38 patients. Satisfaction of the patients with surgery outcomes was assessed on a three-point scale, using the Visual Analogue Scale (VAS), and the Short Form health survey questionnaire (SF-36v2) for life quality evaluation. The follow-up period ranged from 6 months to 2 years. The results were statistically analysed using the chi-square test and t-test. RESULTS: A total of 30 complications were recorded in 28 patients (13.5 %). Revision surgery was necessary in 18 patients (8.7%). Pedicle screw misplacement was found in eight patients and permanent neurological deficit with paresis of the unilateral lower limb in three patients. Carbon cage break-down during surgery occurred in one patient, misinsertion of the cage was in one patient. The dural sac was damaged in five patients, superficial and deep wound infection was found in four and two patients, respectively. Broken screws were detected in seven patients. Donor-site pain persisted in two patients. The patients free from complications were more satisfied (partial or full satisfaction in 86%) than the patients with complications, who reported satisfaction in 78%. However, the difference was not statistically significant. The complications had no significant effect on either any of the SF-36v2 health domains or the total physical and mental score or pain intensity. The ALIF procedure was associated with no complications, PLF with three (13%) and TLIF with 23 (14%) complications, but the differences were not statistically significant. DISCUSSION: Complications and revision surgery were relatively frequent in our group, but not excessive compared with the published data which report their occurrence from 3% to 30%. This large range is related to an ambiguous definition and specification of complications. A significantly fewer complications have been reported in the studies supported by companies, or in those in which the author/s participate in instrumentation development. Some studies suggest that novel and more complex techniques bring about a higher risk of complications and repeat surgery, others report better results and fewer reoperations following a 360-degree fusion than after PLF. The difference in complications between TLIP and PLF in our group was not significant. CONCLUSIONS: Complications are a serious issue of spinal surgery. The majority of complications in our group were associated instrumentation--most frequently with incorrect screw misinsertion. On the whole, the complications did not significantly influence the quality of life and pain intensity after surgery. Most of them were treated successfully with no permanent consequences. The permanent neurological deficit in three patients, because of the small number, had no effect on the whole group results. A reduction in the number of complications would not produce any expected improvement of functional out- come.

• MeSH
• bederní obratle chirurgie   MeSH
• dospělí MeSH
• fúze páteře škodlivé účinky   MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci páteře chirurgie   MeSH
• pooperační komplikace MeSH
• reoperace MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

This study was undertaken to determine the frequency, and the clinicopathologic and genetic features, of colon cancers driven by neurotrophic receptor tyrosine kinase (NTRK) gene fusions. Of the 7008 tumors screened for NTRK expression using a pan-Trk antibody, 16 (0.23%) had Trk immunoreactivity. ArcherDx assay detected TPM3-NTRK1 (n=9), LMNA-NTRK1 (n=3), TPR-NTRK1 (n=2) and EML4-NTRK3 (n=1) fusion transcripts in 15 cases with sufficient RNA quality. Patients were predominantly women (median age: 63 y). The tumors involved the right (n=12) and left colon unequally and were either stage T3 (n=12) or T4. Local lymph node and distant metastases were seen at presentation in 6 and 1 patients, respectively. Lymphovascular invasion was present in all cases. Histologically, tumors showed moderate to poor (n=11) differentiation with a partly or entirely solid pattern (n=5) and mucinous component (n=10), including 1 case with sheets of signet ring cells. DNA mismatch repair-deficient phenotype was seen in 13 cases. Tumor-infiltrating CD4/CD8 lymphocytes were prominent in 9 cases. Programmed death-ligand 1 positive tumor-infiltrating immune cells and focal tumor cell positivity were seen in the majority of cases. CDX2 expression and loss of CK20 and MUC2 expression were frequent. CK7 was expressed in 5 cases. No mutations in BRAF, RAS, and PIK3CA were identified. However, other genes of the PI3K-AKT/MTOR pathway were mutated. In several cases, components of Wnt/β-catenin (APC, AMER1, CTNNB1), p53, and TGFβ (ACVR2A, TGFBR2) pathways were mutated. However, no SMAD4 mutations were found. Two tumors harbored FBXW7 tumor suppressor gene mutations. NTRK fusion tumors constitute a distinct but rare subgroup of colorectal carcinomas.

• MeSH
• adenokarcinom diagnóza   genetika   patologie   MeSH
• fúzní onkogenní proteiny genetika   metabolismus   MeSH
• imunohistochemie MeSH
• lidé středního věku MeSH
• lidé MeSH
• membránové glykoproteiny genetika   metabolismus   MeSH
• nádorové biomarkery genetika   metabolismus   MeSH
• nádory tračníku diagnóza   genetika   patologie   MeSH
• následné studie MeSH
• onkogenní fúze MeSH
• receptor trkA genetika   metabolismus   MeSH
• receptor trkB genetika   metabolismus   MeSH
• receptor trkC genetika   metabolismus   MeSH
• regulace genové exprese u nádorů MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• staging nádorů MeSH
• tyrosinkinasové receptory genetika   metabolismus   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fúzní onkogenní proteiny MeSH
• membránové glykoproteiny MeSH
• nádorové biomarkery MeSH
• receptor trkA MeSH
• receptor trkB MeSH
• receptor trkC MeSH
• tropomyosin-related kinase-B, human MeSH Prohlížeč
• tyrosinkinasové receptory MeSH