The aim of this study was to retrospectively analyze and evaluate the effect of treatment employing pedicle subtraction osteotomy for chronic, posttraumatic thoracolumbar kyphosis. This study included 19 patients, 11 males and 8 females, with chronic, posttraumatic thoracolumbar kyphosis. Pre-operative kyphosis ranged from 31° to 63°. The history of trauma ranged from 8 to 63 months. All patients were treated with pedicle subtraction osteotomy. A mean 40.2° improvement in sagittal alignment was achieved with a mean correction rate of 85.8 %. Perioperative complications were encountered in two patients, one with cerebrospinal fluid leakage followed by encephalitic infection and one with a wound infection. Both were treated conservatively with antibiotics and local wound care. There were no other severe complications. The average follow-up period was 15 months (range 6-41 months). At the last follow-up, clinical symptoms and neurological function were significantly improved. Of 14 patients presenting with intractable back pain, VAS scores improved from a preoperative mean of 6.7 (range 5.0-8.0) to an average 2.0 (range 0-3.0) at final follow-up. No significant loss of correction was observed (loss of 1.7°), and solid fusion was achieved in all 19 patients. A single-stage posterior pedicle subtraction osteotomy is a safe and effective procedure for correction of posttraumatic thoracolumbar kyphosis. Using this technique, it is possible to safely obtain no greater than 55° of correction at a single level.
Background Bone marrow mesenchymal stem cells (BMSCs) are commonly used in regenerative medicine. However, it is not clear whether transplantation of BMSCs can improve cardiac function of the X-Linked Muscular Dystrophy Mice (mdx) and how to detect it. We aimed to investigate the role of speckle tracking echocardiography (STE) in detecting cardiac function of the BMSCs-transplanted mdx in comparison with the untreated mdx. Methods The experimental mice were divided into the BMSCs-transplanted mdx, untreated mdx, and control mice groups (n = 6 per group). The BMSCs were transplanted via tail vein injections into a subset of mdx at 20 weeks of age. After four weeks, the cardiac functional parameters of all the mice in the 3 groups were analyzed by echocardiography. Then, all the mice were sacrificed, and the cardiac tissues were harvested and analyzed by immunofluorescence. The serum biochemical parameters were also analyzed to determine the beneficial effects of BMSCs transplantation. Results Traditional echocardiography parameters did not show statistically significant differences after BMSCs transplantation for the three groups of mice. In comparison with the control group, mdx showed significantly lower left ventricular (LV) STE parameters in both the long-axis and short-axis LV images (P < 0.05). However, BMSCs-transplanted mdx showed improvements in several STE parameters including significant increases in a few STE parameters (P < 0.05). Immunofluorescence staining of the myocardium tissues showed statistically significant differences between the mdx and the control mice (P < 0.05), and the mdx transplanted with BMSCs demonstrated significantly improvement compared with the untreated mdx (P < 0.05). Conclusion This study demonstrated that the early reduction in the LV systolic and diastolic function in the mdx were accurately detected by STE. Furthermore, our study demonstrated that the transplantation of BMSCs significantly improved myocardial function in the mdx.
Abstract. Phaeohyphomycosis (PHM) is a term used to describe any fungus presenting in tissues with pseudohyphae, hyphae, brown yeast-like cells or a combination of these forms. Sinusitis and skin infections are the most common presentation of subcutaneous PHM caused by the fungus Bipolaris spicifera. However, the majority of cases have so far been encountered in tropical climatic zones. The present study documents a case of subcutaneous PHM caused by infection with Bipolaris spicifera in a 56-year-old Chinese man, who presented with plaque papillomatosis on the left foot. The organism isolated from the lesion scar and tissue was identified as Bipolaris spicifera by its morphology, histopathology and DNA sequencing. The patient was successfully treated with itraconazole and terbinafine. IntroductionPhaeohyphomycosis (PHM) refers to phaeoid fungal infections with specific structures including pseudohyphae, hyphae and brown yeast-like cells seen in tissue samples (1,2). Currently, there are at least 60 genera and 109 species that can cause PHM. The most frequent etiologic agents are Exophiala spinifera, Wa ngiella spinifera, Phialophora spinifera a nd Bipolaris spinifera (3).PHM-inducing agents are widely distributed around the world; however, they are more frequently observed in tropical and subtropical climates (4). PHM occurs in immunocompromised and immunocompetent individuals, although organ transplantation, cancer, leukemia, prolonged hospitalization and corticosteroid therapy are predisposing factors (5,6). Cases of PHM have been reported in different regions such as the Caribbean islands, parts of South America, Africa, the Indian subcontinent, Southeast Asia, and the West Pacific Islands (3). The incidence in patients with solid organ transplantation is ~9% (5).PHM may be categorized as either superficial, cutaneous and corneal, subcutaneous, and systemic PHM (5). Bipolaris spicifera is typically associated with subcutaneous PHM and symptoms such as sinusitis and skin infections (7,8). The majority of cases so far have been encountered in tropical climatic zones (5). The present case, however, exhibits the first case of subcutaneous phaeohyphomycosis caused by Bipolaris spicifera in Northern China, in an area with a subtropical climate. Case reportA 56-year-old Chinese male presenting with papular nodules and plaque papillomatosis on the left foot was admitted into the Department of Dermatology, Qingdao University Affiliated Hospital (Qingdao, China) in June 2014. Initial onset was characterized by the appearance of scattered papules and nodules on the dorsum of the left foot 10 years previously, without clinical symptoms. The lesion converged gradually, formed a granuloma-like lesion and spread from the hallux to the dorsum of the foot and the second, third and fourth toes, with occasional co-presentation of bloody pus. The patient also had a prior medical history of rheumatoid arthritis for one year prior to this onset. The patient was a farmer living in Shandong Province, had never traveled outside the ...
Background:Ossification of the ligamentum flavum (OLF) is being increasingly recognized as a cause of thoracic myelopathy. This study was to describe a rare clinical entity of spinal cord kinking (SK) in thoracic myelopathy secondary to OLF.Methods:The data of 95 patients with thoracic myelopathy secondary to OLF were analyzed retrospectively. The incidence and location of SK were determined using preoperative magnetic resonance imaging (MRI). The clinical presentation and radiological characteristics in patients with SK were analyzed. Posterior en bloc laminectomy with OLF was performed, and the surgical results were evaluated.Results:SK was found in seven patients (7.4%) based on preoperative MRI. The patients included one male and six females with an average age of 55.6 years (range, 48–64 years). Five patients presented with radiculomyelopathy and two presented with typical thoracic myelopathy of spastic paraparesis. In all cases, the kinking was located just above the end of the spinal cord where the conus medullaris (CM) was compressed by the OLF. The degree of SK varied from mild to severe. The tip of the CM was located between the upper third of T11 to the lower third of L1, above the lower edge of L1. With an average follow-up of 30.4 months, the modified Japanese Orthopedic Association score significantly improved from 5.7 ± 1.8 preoperatively to 8.9 ± 1.4 postoperatively (t = 12.05; P < 0.0001) with an improvement rate of 63.1 ± 12.3%.Conclusions:SK is a rare radiological phenomenon. It is typically located at the thoracolumbar junction, where the CM is compressed by the OLF. Our findings indicate that these patients may benefit from a posterior decompressive procedure.
acquired reactive perforating collagenosis (arPC) is a rare chronic skin disease associated with various internal diseases, particularly diabetes and chronic renal failure. the present study describes the case of a patient with arPC combined with methicillin-resistant Staphylococcus aureus (MrSa), in an aim to broaden the current understanding of arPC. a 75-year-old female presented with a 5-year history of pruritus and ulcerative eruptions on the trunk of her body, which became more severe within 1 year. a cutaneous examination revealed a diffuse distribution of erythema and papules, and nodules of various sizes, some of which sagged at the center and had a dark brown crust. a histopathological analysis revealed typical perforations of the collagen fibers. The patient was initially treated with topical corticosteroids and oral antihistamines for skin lesions and pruritus. Medications for glucose control were also administered. Upon the second admission, a combination of antibiotics and acitretin was added. the keratin plug shrank, and the pruritus was relieved. To date, to the best of our knowledge, this is the first reported case of concurrent arPC and MrSa.
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