Árpád Bellyei

DSC analysis of the abnormalities of human leg skeletal muscles: A preliminary study

Abstract The standard calorimetric properties of the healthy human skeletal muscle are presented and compared to the same of human skeletal muscles in primary peripheral leg deformities (congenital clubfeet) and secondary deformities caused by the malfunction of the central nervous system (cerebral palsy). To our best knowledge no calorimetric analysis of either the healthy or pathologic human skeletal muscles have been reported previously. Eleven muscle samples from the three groups of patients were analyzed and compared. We hope to add to the understanding of the primary and consecutive functional behavioral changes of the human skeletal muscle due to different etiologic reasons. It has been found that the human muscles have different DSC scans than the rabbit skeletal ones and they are very characteristic for the actual functional and structural state, they behave as a fingerprint. To find the precise biochemical and structural explanation of these alterations there is need for further detailed examinations.

Prevalence of radiographic primary hip and knee osteoarthritis in a representative Central European population

The aim of our study was to determine the radiographic prevalence of hip and knee osteoarthritis and compare our results with prevalence data reported by other studies, as no similar study had been performed in Hungary previously. Our aim was also to investigate the usefulness of the different radiological scoring methods for the definition of osteoarthritis. Patients who earlier reported complaints and gave written consent were asked to participate in a clinical follow-up. In the 682 participants Harris hip score, visual analogue pain scale values for both joints, Knee Society score and knee functional score were calculated. Weight-bearing radiographs were taken of both joints. Kellgren-Lawrence radiological evaluation was performed and osteoarthritis prevalence was defined. Hip osteoarthritis was found in 109 cases (16.49%), and knee osteoarthritis was found in 111 cases (16.54%). Harris hip score, Knee Society score, functional score and visual analogue scale values were significantly worse in people with radiographically proven osteoarthritis compared to the control group (p < 0.05). Significantly higher osteoarthritis prevalence of both joints was found in those with increased body mass index values. Age also plays a significant role in the development of both hip and knee osteoarthritis. No significant difference was observed between male and female participants regarding osteoarthritis prevalence. The Kellgren-Lawrence score with a cut-off value of 2 or more is a useful evaluation method for the detection of osteoarthritis prevalence in epidemiological studies; according to our observations, in clinical practice a cut-off value of three or more is more relevant.

Prevalence of degenerative joint complaints of the lower extremity: a representative study

As part of the international campaign of the bone and joint decade, we aimed to present epidemiological data on the prevalence of major joint complaints in a Central European region. Ten thousand subjects aged between 14 and 65, selected randomly by the Hungarian central office of statistics from three counties in southern Hungary, were surveyed using our own questionnaire based on widely accepted scoring systems in the literature, focusing on major degenerative joint complaints, and using the short form 36 (SF-36) questionnaire. We found that the prevalence of hip pain in the observed group was 22.2%, the prevalence of knee pain 30.3%, and frequent ankle pain occurred in 9.7%. The results of the SF-36 questionnaire showed that with the exception of social function, neither of the values of the examined health dimensions reached levels of other international surveys. Details of the survey and the possible causes of the higher prevalence are discussed, along with the results of the SF-36 questionnaire.RésuméEn collaboration avec la campagne internationale sur la bone and joint decade, notre but a été de mettre en évidence des données épidémiologiques sur la prévalence des lésions articulaires, dans une région du centre Europe. Pour cela, 10.000 patients âgés entre 14 et 65 ans ont été sélectionnés par l’Office Cental Hongrois de Statistiques, patients provenant de trois comtés du Sud de la Hongrie en usant d’un questionnaire, rempli par les patients eux-mêmes et basé sur des scores largement acceptés par la population orthopédique et, notamment, le score SF 36. Nous avons trouvé une prédominance de douleur de la hanche dans ce groupe, avec un taux de 22,8%, le pourcentage de douleur du genou étant de 30,8% et, celle de la cheville, de 9,7%. Les résultats du questionnaire SF 36 ont montré qu’en dehors des problèmes sociaux, les valeurs retrouvées se situaient à des niveaux comparables à ceux d’autres études internationales. Les détails de cette étude et les étiologies possibles sont discutés avec les résultats du questionnaire SF 36.

Acetabular Development in Legg-Calvé-Perthes Disease

The normal development of the proximal femur epiphysis and the acetabulum of 50 children with unilateral Perthes disease were analyzed on the unaffected side with serial x-rays using the epiphysis and the acetabular index. The same factors were studied on the affected side. A pathological process has been established in the affected hip. However, while these pathological processes run parallel up to 9 to 10 years of age on the femur epiphysis and in the acetabulum, the elastic ability of the acetabulum ceases over 9 years of age. This smaller plastic ability is the probable cause of unfavorable results in older children.

Radiographic parameters of the hip joint from birth to adolescence

BackgroundVarious qualitative and quantitative radiological geometrical parameters can be of great help when assessing dysplasia of the hip joint and in understanding developmental processes of the infant hip. There are few data on the normal values of the hip joint at different ages.ObjectiveTo perform radiographic measurements on hip joints considered to be anatomically normal and to provide data for each age group, thus describing features of the radiographic development of the hip.Materials and methodsRadiographs were examined from 355 children (age 0–16 years) undergoing examination for scoliosis (long film), urography or plain abdominal radiography. Qualitative and quantitative signs were observed and measured, focusing on the Hilgenreiner, Wiberg and Idelberger angles and the decentric distance.ResultsBefore the age of 9 years measurable data from neighbouring age groups differed significantly, indicating typical radiological changes of the joint. For the same age range, qualitative changes could also be observed. After 9 years of age, radiological development of the normal hip joint during childhood is much slower.

Long-term results of derotational femoral varus osteotomy in Legg-Calvé-Perthes disease: 26-year follow-up.

The long-term results of 30 patients (31 hips) who underwent derotational femoral varus osteotomy for Legg-Calvé-Perthes disease are presented. Pain, leg-length discrepancy, Trendelenburg sign, and range of motion at the operated hip were examined clinically. Radiographic analysis included measurement of the Wiberg angle, epiphyseal index, acetabular index, and the Mose index. All were found to be satisfactory for patients in the good/fair category. Good/fair results were obtained in 27 (87%) of 31 hips according to Catteralls postoperative classification. Four patients were classified in the poor category due to severe restriction of movement and constant hip pain. Therefore, derotational femoral varus osteotomy is recommended for the treatment of patients with Legg-Calvé-Perthes disease.

Osteochondral integration of multiply incised pure cartilage allograft: repair method of focal chondral defects in a porcine model.

Background A focal cartilage lesion has limited capacity to heal, and the repair modalities used at present are still unable to provide a universal solution. Pure cartilage graft implantation appears to be a simple option, but it has not been applied widely as cartilage will not reattach easily to the subchondral bone. Hypothesis We used a multiple-incision technique (processed chondrograft) to increase cartilage graft surface. We hypothesized that pure cartilage graft with augmented osteochondral fusion capacity may be used for cartilage repair and we compared this method with other repair techniques. Study Design Controlled laboratory study. Methods Full-thickness focal cartilage defects were created on the medial femoral condyle of 9-month-old pigs; defects were repaired using various methods including bone marrow stimulation, autologous chondrocyte implantation, and processed chon-drograft. After the repair, at weeks 6 and 24, macroscopic and histologic evaluation was carried out. Results Compared with other methods, processed chondrograft was found to besimilarly effective incartilage repair. Defects without repair and defects treated with bone marrow stimulation appeared slightly irregular with fibrocartilage filling. Autologous chondrocyte implantationproducedhyalinelikecartilage, althoughitscellularorganizationwasdistinguishablefromthesurroundingarticularcartilage. Processed chondrograft demonstrated good osteochondral integration, and the resulting tissue appeared to be hyaline cartilage. Conclusion The applied cartilage surface processing method allows acceptable osteochondral integration, and the repair tissue appears to have good macroscopic and histologic characteristics. Clinical Relevance If further studies confirm its efficacy, this technique could be considered for human application in the future.

Prevalence of knee osteoarthritis in Hungary. Study conducted in a representative Hungarian population

UNLABELLED In an earlier publication, authors have already reported the result of a survey conducted in a representative Hungarian population, where joint complaint prevalence data were presented, including those of the knee joint. AIMS Following the above mentioned publication, in the current study authors aimed to determine the clinical and radiological prevalence of knee osteoarthritis using internationally accepted scoring methods for evaluation. METHODS 2422 patients with complaints and consent were invited for a clinical follow up. 682 people (244 male; 438 female) came to participate in the study. After recording case history, and anthropometric parameters, a thorough musculoskeletal examination was carried out. Using these data Knee Society Score, Functional score and visual analogue pain scale values were calculated. On the AP and lateral view X-rays joint space width was measured, Kellgren-Lawrence radiological evaluation was performed and osteoarthritis prevalence was defined. RESULTS radiological evaluation was possible in 676 cases. Knee osteoarthritis was found in 91 people (13.3%), severe osteoarthritis in 20 people (2.9%). Functional parameters of radiologically negative and positive cases were compared. Knee Society Score, functional score and visual analogue scale values were significantly worse in people with defined osteoarthritis (p<0.05). Regarding Body Mass Index, significantly higher values were found in those with osteoarthritis as well. CONCLUSIONS Authors presented radiographic knee osteoarthritis prevalence data for the first time in the Hungarian literature. According to their observations, age and higher BMI values play a significant role in the development of knee osteoarthritis. After discussing the details of the survey, an overview and comparison with data of international literature is given.

A sejt- és szövettenyésztés jogi vonatkozásai. Hazai és külföldi tapasztalatok@@@Legal regulation in the field of tissue engineering

Az utobbi evekben a sejt- es szovettenyesztessel foglalkozo biotechnologiai kutatasi agazat, valamint az erre alapulo tissue engineering technika rohamleptekkel fejlodott. E fejlodessel parhuzamosan a kidolgozott uj eljarasok jogi szabalyozasa, annak harmonizalasa is egyre surgetobbe valt. A szerzok a tissue engineering technika hazai es kulfoldi jogi kereteinek felterkepezesere es osszehasonlitasara vallalkoztak. Az altaluk vegzett szeles koru jogszabalyi ertelmezes ravilagitott arra a tenyre, hogy a hazai szabalyozas ezen a teruleten meg gyermekcipoben jar, osszehasonlitva a kulfoldi orszagok gyakorlataval, ahol ervenyes es hatalyos, bar nem egyseges jogforrasok szabalyozzak a kerdeskort. Egy ujonnan elfogadott europai unios bizottsagi rendelet azonban stabil es szigoru jogi keretet hataroz meg a sejt- es szovettenyesztesek alkalmazhatosagara. Kulcsszavak: sejt- es szovettenyesztes, tissue engineering, jogi szabalyozas, fokalis porcdefektus, autolog chondrocytaimplantacio Legal regulation in the field of tissue engineering. In the past few years, biotechnology and tissue engineering have de veloped a great deal. Legislation, however, has not been able to keep pace with the rapid changes in the research and treatment using tissue-engineered products. The authors tried to explore and compare all the regulatory factors concerning cell and tissue engineering in the Hungarian and foreign law. The thorough study elucidated that the Hungarian regulation in this area is fairly deficient when compared with the regulations of other European countries, where quite extensive direc tives are applied. A currently accepted regulation fills this void efficiently in the European Union providing strong base for tissue engineering-related research and therapy for the future.In the past few years, biotechnology and tissue engineering have developed a great deal. Legislation, however, has not been able to keep pace with the rapid changes in the research and treatment using tissue-engineered products. The authors tried to explore and compare all the regulatory factors concerning cell and tissue engineering in the Hungarian and foreign law. The thorough study elucidated that the Hungarian regulation in this area is fairly deficient when compared with the regulations of other European countries, where quite extensive directives are applied. A currently accepted regulation fills this void efficiently in the European Union providing strong base for tissue engineering-related research and therapy for the future.

Legal regulation in the field of tissue engineering

Az utobbi evekben a sejt- es szovettenyesztessel foglalkozo biotechnologiai kutatasi agazat, valamint az erre alapulo tissue engineering technika rohamleptekkel fejlodott. E fejlodessel parhuzamosan a kidolgozott uj eljarasok jogi szabalyozasa, annak harmonizalasa is egyre surgetobbe valt. A szerzok a tissue engineering technika hazai es kulfoldi jogi kereteinek felterkepezesere es osszehasonlitasara vallalkoztak. Az altaluk vegzett szeles koru jogszabalyi ertelmezes ravilagitott arra a tenyre, hogy a hazai szabalyozas ezen a teruleten meg gyermekcipoben jar, osszehasonlitva a kulfoldi orszagok gyakorlataval, ahol ervenyes es hatalyos, bar nem egyseges jogforrasok szabalyozzak a kerdeskort. Egy ujonnan elfogadott europai unios bizottsagi rendelet azonban stabil es szigoru jogi keretet hataroz meg a sejt- es szovettenyesztesek alkalmazhatosagara. Kulcsszavak: sejt- es szovettenyesztes, tissue engineering, jogi szabalyozas, fokalis porcdefektus, autolog chondrocytaimplantacio Legal regulation in the field of tissue engineering. In the past few years, biotechnology and tissue engineering have de veloped a great deal. Legislation, however, has not been able to keep pace with the rapid changes in the research and treatment using tissue-engineered products. The authors tried to explore and compare all the regulatory factors concerning cell and tissue engineering in the Hungarian and foreign law. The thorough study elucidated that the Hungarian regulation in this area is fairly deficient when compared with the regulations of other European countries, where quite extensive direc tives are applied. A currently accepted regulation fills this void efficiently in the European Union providing strong base for tissue engineering-related research and therapy for the future.In the past few years, biotechnology and tissue engineering have developed a great deal. Legislation, however, has not been able to keep pace with the rapid changes in the research and treatment using tissue-engineered products. The authors tried to explore and compare all the regulatory factors concerning cell and tissue engineering in the Hungarian and foreign law. The thorough study elucidated that the Hungarian regulation in this area is fairly deficient when compared with the regulations of other European countries, where quite extensive directives are applied. A currently accepted regulation fills this void efficiently in the European Union providing strong base for tissue engineering-related research and therapy for the future.