AIM Children with severe forms of cerebral palsy (CP) are at high risk of hip joint displacement.Various studies have found that the pain from affected joints occurs in 40 to 84% of studied individuals. The purpose of this study was to establish a correlation between the density of nociceptors localized in selected areas of the spastic dislocated hip joint and clinical evidence of hip joint pain in children with CP.

BackgroundsNon-traumatic hip dislocation in children is most often observed in the course of developmental dysplasia of the hip (DDH) and infantile cerebral palsy. The risk of pain sensations from dislocated hip joint differentiates the discussed groups of patients. Will every painless hip joint in children with cerebral palsy painful in the future?MethodsMaterial included 34 samples of joint capsule and 34 femoral head ligaments, collected during open hip joint reduction from 19 children with CP, GMFCS level V and from 15 children with DDH and unilateral hip dislocation. All the children were surgically treated.The density of nociceptive fibres was compared between the children with CP and DDH, using S-100 and substance P monoclonal antibodies.ResultsMore frequent positive immunohistochemical reaction to S-100 protein concerned structures of the femoral head ligaments in children with CP and cartilage losses on the femoral head, when compared to the same structures in children with DDH (p = 0.010). More frequent were found positive immunohistochemical reactions for S-100 protein in the joint capsules of children with cartilage losses (p = 0.031) and pain ailments vs. the children with DDH (p = 0.027). More frequent positive reaction to substance P concerned in femoral head ligaments in CP children and cartilage lesions (p = 0.002) or with pain ailments (p = 0.001) vs. the DDH children.ConclusionsSurgical treatment of hip joint dislocation should be regarded as a prophylactics of pain sensations, induced by tissue sensitisation, inflammatory process development or articular cartilage defects.

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The phenomenon of skip metastases depends on the occurrence of direct metastases of non-small cell lung cancer into mediastinal lymph nodes without the involvement of hilar lymph nodes. The medical literature suggests that this prevalence ranges between 13 and 37.8% of cases. The goal of our study was to evaluate the prevalence of subpleural superficial lymphatic vessels carrying the lymph from the bronchopulmonary segments directly to the mediastinal nodes thus skipping the hilar nodes and determine whether there is a tendency towards differentiation in lymph drainage between males and females. During autopsy, 27 left and 27 right lungs were removed from 19 male and eight female cadavers. The lymphatic vessels were visualized at the mediastinal and interlobar surface of the lung by visual inspection. These vessels were then cannulated and injected with drawing ink. The first lymph node to become ink-colored via injection was dissected and histologically examined. The lymph flowed into hilar lymph nodes in 79.5% of the cases and into the mediastinal nodes in 20.5% of all the 83 vessels injected; of these 13.2% were from the right lung and in 7.2% from the left lung. The upper right lobe (5/14 vessels) and its anterior segment (3/14 vessels) were the most common source of the direct lymph drainage to the mediastinum. Vessels of 15.4% in female cadavers (4/26) and 22.8% vessels in male cadavers (13/57) traveled directly to mediastinal nodes skipping the hilar nodes. This difference was not statistically significant.

BackgroundThe purpose of the study was an evaluation of fetal hip joint morphology during the second and the third trimester of pregnancy. Serial sections were performed on 23 cadaver infants.ResultsThe mean lunar age was 6.6 months. Femoral shaft length (FSL) and width of the proximal and distal epiphysis were x-rayed to determine fetal age. The neck shaft angle (NSA), the femoral antetorsion angle (FAA), the acetabulum anteversion angle (AAA) and the acetabulum slope angle (ASA) were measured. Hip development ratios were plotted for all cadaveric species and revealed: flat FSL/NSA slope pattern, upward FSL/FAA slope pattern and downward slope pattern for FSL/ASA and FSL/AAA ratios. The changes, observed during the developmental period, were not statistically significant. NSA did not change during the second or the third pregnancy trimester. FAA increased during pregnancy but the changes were not statistically significant. AA, as well as ASA, showed a decreasing trend during the second and the third pregnancy trimester, however, with no correlations to age.ConclusionDespite an increasing depth and growing dimensions of the acetabulum in the uterus, its orientation does not change in any significant way.