Nutrient Distributions in the Highly Turbid Chikugo River Estuary and the Difference Between the Early Spring and The Summer of 2010

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

Radiological Evaluation of the Initial Fixation between Cortical Bone Trajectory and Conventional Pedicle Screw Technique for Lumbar Degenerative Spondylolisthesis

Study DesignRetrospective study.PurposeTo compare initial fixation using the cortical bone trajectory (CBT) technique versus conventional pedicle screws (PS) in radiographs of postsurgical lumbar degenerative spondylolisthesis.Overview of LiteratureFew reports have documented the holding strength of CBT technique for spondylolisthesis cases.MethodsFrom October 2009 to June 2014, 21 cases of degenerative spondylolisthesis were surgically treated in our institution. Ten were treated with conventional PS technique and 11 of with CBT technique. Mean lumbar lordosis and percent slippage were evaluated preoperatively, immediately after surgery, and 6 months and 1 year postoperatively using radiographs. We also investigated percent loss of slip reduction.ResultsThere were statistically significant differences between preoperative percent slippage and postoperative slippage in both PS and CBT procedures over 1 year, and both techniques showed good slip reduction. On the other hand, lumbar lordosis did not change significantly in either the PS or CBT groups over 1 year.ConclusionsCBT technique showed similarly good initial fixation compared with the PS procedure in the treatment of lumbar degenerative spondylolisthesis

Clear Zone Formation around Screws in the Early Postoperative Stages after Posterior Lumbar Fusion Using the Cortical Bone Trajectory Technique

Study DesignRetrospective study.PurposeTo evaluate the initial fixation using the cortical bone trajectory (CBT) technique for posterior lumbar fusion through assessment of the clear zones around the screws and the risk factors involved.Overview of LiteraturePostoperative radiolucent zones (clear zones) are an indicator of poor conventional pedicle screw fixation.MethodsBetween January 2013 and April 2014, 19 patients (8 men and 11 women) underwent posterior lumbar interbody fusion or posterior lumbar fusion using the CBT technique. A total of 109 screws were used for evaluation with measurement of the maximum insertional torque of last two screw rotations. Clear zone-positivity on plain radiographs was investigated 6 months after surgery. The relation between intraoperative insertional torque and clear zone-positivity was investigated by one-way analysis of variance. In addition, the correlation between clear zone-positivity and gender, age (75 years old), or operative stabilization level (3 vertebral levels) was evaluated using the chi-square test.ResultsClear zones were observed around six screws (5.50%) in five patients (26.3%). The mean insertional torque (4.00±2.09 inlbs) of clear zone-positive screws was lower than that of clear zone-negative screws (8.12±0.50 in-lbs), but the difference was not significant. There was a significant correlation between clear zone-positivity and operative level of stabilization.ConclusionsThe low incidence of clear zone-positive screws indicates good initial fixation using the CBT technique. Multilevel fusions may be risk factors for clear zone generation

Thermoreversible behavior of κ-carrageenan and its apatite-forming ability in simulated body fluid

Osteoconductive materials with self-setting ability have received much attention because their properties allow developing injectable materials for bone defects. Thermosensitive hydrogel with ability of bone-like apatite formation in a body environment is a candidate of injectable bone fillers with osteoconductivity because the apatite formation on materials is an essential to show osteoconduction. The present study focused on the development of a thermosensitive hydrogel through modifications of the sulphonic groups of the polysaccharide, κ-carrageenan, with potassium chloride (KCl) and calcium chloride (CaCl2). We found that the gelation temperature of κ-carrageenan solutions increased with increasing amounts of K+ ions. Apatite formation was observed on the gel after exposure to simulated body fluid for 0.5 day when the gel was prepared with a molar ratio of Ca2+/sulfonic groups = 1.5. These results indicate that a thermosensitive κ-carrageenan hydrogel with apatite-forming ability was obtained through the incorporation of K+ and Ca2+ ions into the solution

Cervical Osteomyelitis with Thoracic Myelitis and Meningitis in a Diabetic Patient

A 45-year-old man with a history of untreated diabetes mellitus had a persisting fever, back pain, and diarrhea. The primary care physician diagnosed the patient with the flu and gastroenteritis. The patient developed paraplegia for two weeks and was admitted to another hospital. The physician in this hospital suspected infectious meningitis and myelitis, and administered piperacillin and steroids without cerebrospinal fluid (CSF) examination. On referral to our hospital, he presented a high fever and complete paraplegia. The lumbar puncture revealed a yellowish CSF, polynucleosis, and hypoglycorrhachia. Bacteria were not detected on Gram's staining and were not confirmed by CSF culture. Magnetic resonance imaging (MRI) showed no thoracolumbar lesion and suggested a cervical epidural abscess without any spinal cord compression. He was diagnosed as having osteomyelitis with meningitis and thoracic myelitis. The infection subsided with broadspectrum antibiotics. After two weeks, bilateral sensorimotor disturbances of the upper extremities appeared. MRI findings showed the epidural abscess compressing the cervical spinal cord. We performed debridement of the epidural abscess. The infection was clinically controlled by using another antibiotic. One month after the infection subsided, a 360° reconstruction was performed. In this case, the misdiagnosis and the absence of CSF examination and culture to detect the pathogenic bacteria at an earlier stage in the patient's disease course might have led to the exacerbation of the pathology

A Case of Apoplexy of Rathke’s Cleft Cyst Followed by Cerebral Infarction

Rathke’s cleft cyst (RCC) apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious. She had fallen from her motorbike. On referral to our hospital she gradually regained consciousness and presented with no neurological deficits. CT showed a round and slightly hyperdense area in the suprasellar region. However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day. Thirteen days after the first emergency visit she developed left hemiparesis and dysarthria. CT showed a round hypodense area in the suprasellar region. The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. CT also showed a low density area in the territory of the right middle cerebral artery, which indicated the cerebral infarction. MR angiography revealed poor visibility and stenotic changes of right middle cerebral arteries. Transsphenoidal surgery was performed. Histopathological findings confirmed a hemorrhagic RCC. Postoperative MR angiography showed that the visibility and stenosis of right middle cerebral arteries were recovered. This is the rare case of apoplexy of an RCC followed by cerebral infarction