The Evaluation of Supraspinatus Muscle of Patients with Rotator Cuff Tear on Magnetic Resonance Imaging

We examined the intensity of the supraspinetus muscles of patients with a rotator cuff tear in Magnetic Resonance Imaging (MRI) findings. 109 shoulders in patients with rotator cuff tears were preoperatively scanned by MRIs. Using MRIs, the linear bands of the supraspinatus muscle were classified into three grades. Between each grade the following were examined; the age, the disease contraction period, the distribution of large tears and reruptures, and those chosen for patch graft method, as well as the postoperative JOA scores. There were 46 cases in grade 1(G-1), 28 in grade 2(G-2), and 35 in grade 3(G-3). The mean ages of patients in the three grades were 53.4 years old, 56.7 years old, 61.3 years old respectively. The age of G-3 was significantly higher than the other grades. The period from onset of the G-3 was shorter than the other grades, but there was no statistic significance. The ratio of massive tears were 2.2%, 27.0% and 46.2% respectively. Reruptures were observed only in grade 3 and there were none in G-2. and G-3. The patch graft method was performed on one shoulder in G-2 and three shoulders in G-3. The average JOA scores were 89.5 in G-1, 88.4 in G-2 and 85.0 in G-3. The JOA score of G-3 was significantly lower than G-1. Especially function of JOA score was lower than the other grades. The results of the present study suggest that high intensity on MRI is associated with poor clinical results in operative treatment. Some authers reports that these findings of MRI demonstrate a fatty degeneration of muscles. So we should select the best operation and carefuly rehabilitate patients with a high intensity of the supraspinatus muscle belly on MRI

Epidural Calcified Sequestration of Cervical Intervertebral Disk

A 57-year-old man with epidural calcified disk sequestration in the cervical spine, which was discovered after trauma, is reported. Differentiation between cervical disk herniation and other disease entities on magnetic resonance imaging (MRI) was difficult. The confirmation of the presence of extradural calcification by computed tomography (CT) was helpful in the diagnosis of this disease

Epidural Calcified Sequestration of Cervical Intervertebral Disk

A 57-year-old man with epidural calcified disk sequestration in the cervical spine, which was discovered after trauma, is reported. Differentiation between cervical disk herniation and other disease entities on magnetic resonance imaging (MRI) was difficult. The confirmation of the presence of extradural calcification by computed tomography (CT) was helpful in the diagnosis of this disease

Clinicopathological analysis of polyploid diffuse large B-cell lymphoma.

Polyploid chromosomes are those with more than two sets of homologous chromosomes. Polyploid chromosomal abnormalities are observed in various malignant tumors. The prognosis in such cases is generally poor. However, there are no studies examining the prognosis of diffuse large B-cell lymphoma (DLBCL) with polyploid chromosomal abnormalities. Therefore, we statistically compared the clinicopathological features between polyploid DLBCL and DLBCL without polyploid abnormalities. Herein, 51 polyploid DLBCL and 53 control (without polyploid chromosomal abnormalities) cases were examined. G-banding method was employed to define polyploidy by cytogenetic analysis. Subsequently, flow cytometric immunophenotyping and immunohistochemical staining were performed. Polyploid DLBCL was defined as DLBCL with either near-tetraploid or greater number of chromosomes, as detected by the G-band. In a survival analysis, a significantly worse overall survival (OS) was observed for polyploid DLBCL (p = 0.04; p = 0.02 in cases who received R-CHOP regimens). In a multivariate analysis of OS, polyploid chromosomal abnormalities were an independent prognostic factor. Our results suggest that polyploid chromosomal abnormalities detected through G-band may represent a new poor prognostic factor for DLBCL

Can Proximal Junctional Kyphosis after Surgery for Adult Spinal Deformity Be Predicted by Preoperative Dynamic Sagittal Alignment Change with 3D Gait Analysis? A Case–Control Study

Background: Severe spinal deformity is a risk factor for proximal junctional kyphosis (PJK) in surgery for adult spinal deformity (ASD). However, standing X-ray imaging in patients with dynamic spinal imbalance can underestimate the risk of PJK because of compensation mechanisms. This study aimed to investigate whether preoperative dynamic spinal alignment can be a predictive factor for PJK. Methods: We retrospectively included 27 ASD patients undergoing three-dimensional (3D) gait analysis before surgery. Dynamic spinal parameters were obtained using a Nexus motion capture system (Vicon, Oxford, UK). The patients were instructed to walk as long as possible around an oval walkway. The averaged dynamic parameters in the final lap were compared between patients with PJK (+) and with PJK (−). Results: PJK occurred in seven patients (26%). The dynamic angle between the thoracic spine and pelvis was larger in patients with PJK (+) than in those with PJK (−) (32.3 ± 8.1 vs. 18.7 ± 13.5 °, p = 0.020). Multiple logistic regression analysis identified this angle as an independent risk factor for PJK. Conclusions: Preoperative thoracic anterior inclination exacerbated by gait can be one of preoperative independent risk factors for PJK in patients undergoing corrective surgery for ASD

A Case of Cardiac Arrest during C1 Laminectomy for Irreducible Atlantoaxial Subluxation

We report a case of cardiac arrest, which occurred during C1 laminectomy for irreducible atlantoaxial subluxation, with return of spontaneous circulation (ROSC) upon interruption of the laminectomy. A 60-year-old woman with rheumatoid arthritis presented with neck pain, bilateral finger numbness, and bladder-rectal disturbance. Simple radiograph images showed that the atlantodental interval (ADI) was enlarged to 8 mm, and magnetic resonance imaging revealed severe spinal stenosis at C1. She was diagnosed with cervical spondylotic myelopathy due to atlantoaxial subluxation. Cardiac arrest occurred twice during the C1 laminectomy and occipito-cervical fusion (Occ-C3), and ROSC occurred without any treatment. There was no postoperative worsening of neurological symptoms, and the improvement of sensory and motor palsy was favorable. The pathogenic mechanism was presumed to be trigeminocardiac reflex. Cardiac arrest during upper cervical spine surgery is an important intraoperative complication of which operators should be made aware