Functional outcome of minimally invasive posterior stabilisation in dorsal and lumbar spine fractures

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Outcome analysis of surgically managed unstable burst fracture

Background:Burst fractures are common injuries of dorsolumbar spine. In indicated cases, surgery is the treatment of choice. Significant controversy exists regarding surgical intervention for these fractures. Posterior decompression, anterior decompression and instrumentation, and combined anterior decompression and posterior instrumentation have been recommended in various studies. Here we are going to evaluate unstable burst fractures of thoracic and lumbar spine treated by isolated anterior decompression and instrumented fusion with TSM-Bone graft composite.Methods: Prospective study of thirty-six cases of unstable fracture of thoracic and lumbar spine treated in Sri Ramachandra Medical centre from January 2011 to January 2014. The inclusion criteria were burst fractures of thoracic or lumbar spine complete or incomplete neurological deficit and burst fractures of thoracic or lumbar spine without neurological deficit but with mechanical instability. The exclusion criteria were pathological fractures, chance fracture, stable burst, wedge compression and osteoporotic compression fractures. The results were analyzed during the follow-up using the Pain – Visual analogue scale, Fusion status and radiographic parameter – K-angle .For pain score were given as 3,2,1 for absent, moderate and severe pain respectively. Regarding fusion status score of 3,2,1 were given when fusion was good, fair and no sign of fusion respectively.Results:Mean pre-operative K-angle was 28o. Average loss of correction at final follow up was 3o.Mean correction of K-angle was 140.Moderate to severe loss of correction of K- angle was observed in 4 patients. Mild to moderate pain in 5 patients treated with analgesics. Average TSM subsidence was 3mm.Conclusions:Bone graft composite provides stable biomechanical support to deficient anterior column in burst fractures and allows early rehabilitation and mobilization. Neural recovery may occur after anterior decompression, stabilization and fusion with TSM-Bone graft composite in dorsolumbar burst fractures with incomplete cord injury

Management of infected custom mega prosthesis by Ilizarov method

A 26 year old male patient with an aggressive giant cell tumour of the left distal femur was managed by wide excision and insertion of custom mega prosthesis. Patient developed deep infection which did not subside with multiple debridements and antibiotics.  Hence the custom mega prosthesis was removed and the bone gap was managed by Ilizarov method.  Ilizarov fixation of the left femur and tibia was done.  Femoral and tibial corticotomy was done and the bone segments were transported towards the knee to finally achieve a knee arthrodesis.  The case illustrates the method and difficulties encountered during the treatment

Low temperature growth technique for nanocrystalline cuprous oxide thin films using microwave plasma oxidation of copper

We report on the direct formation of phase pure nanocrystalline cuprous oxide (Cu2O) film with band gap ~ 2 eV by microwave plasma oxidation of pulsed dc magnetron sputtered Cu films and the highly controlled oxidation of Cu in to Cu2O and CuO phases by controlling the plasma exposure time. The structural, morphological and optoelectronic properties of the films were investigated. p-type Cu2O film with a grain size ~20-30 nm, resistivity of ~66 Ω cm and a hole concentration of ~2×1017 cm-3 is obtained for a plasma exposure time of 10 min without using any foreign dopants. The optical absorption coefficient (~105 cm-1) of the Cu2O film is also reported

Respiratory Effects of Amifostine and DRDE-07: Probable Prophylactic Agents of Sulphur Mustard in Rats

Amifostine (S-2[3-aminopropylamino]ethyl phosphorothioate) and one of its analogues,DRDE-07 (S-2[2-aminoethylamino]ethyl phenyl sulphide) are promising prophylactic agents forsulphur mustard (SM; a blistering agent) toxicity. When given orally, DRDE-07 was more effectivethan amifostine as a prophylactic agent against SM administered percutaneously. Variouspharmacological and toxicological studies are required before the introduction of a chemical asa drug. The respiratory effects of amifostine and DRDE-07 were carried out in rats using a bodyplethysmograph fitted with a volumetric pressure transducer for sensing the respiratory flowsignals. The signals were amplified, digitised, and stored on a personal computer for furtheranalysis. After taking control recordings of respiratory signals, different doses (0.5 LD50, 1.0 LD50and 2.0 LD50) of amifostine and DRDE-07 were administered orally (LD50 amifostine = 2262 mg/kg; DRDE-07 = 1599 mg/kg), and the respiratory changes were monitored for 4 h. Amifostine andDRDE-07 showed a uniform breathing pattern even in 2.0 LD50 dose. However, a significant dosedependentdecrease in respiratory frequency was observed following amifostine administration.DRDE-07 did not show any significant change. The tidal volume was not altered significantlyboth in amifostine and DRDE-07 administered animals. The study shows that DRDE-07, even inlethal doses, may not affect the respiration immediately, whereas, amifostine may decrease therespiratory frequency

Osteofibrous dysplasia of the proximal tibia: an illustrative case report

A 5 years old girl presented 3 years back with pain and swelling over the upper right leg for 2 years duration. X-ray, CT and MRI revealed osteolytic well defined lesion 2.5 × 2 cm in the meta-diaphyseal region of the proximal tibia with pathological fracture of anterolateral cortex. Child underwent thorough curettage of the lesion and the defect was filled with allograft (iliac crest graft) from mother which was harvested in an adjacent operation theatre. The limb was protected with a plaster splint for a period of 3 months. The graft gradually consolidated and new bone formation was apparent by 6 months. Remodelling of the medullary canal occurred at 1 year follow up. Child has been followed up to 3 years (till date) and there is no evidence of recurrence. The case illustrates that osteofibrous dyplasia can be effectively treated by curettage and replacement of defect by allograft from parents.

UDP-glucose 4, 6-dehydratase Activity Plays an Important Role in Maintaining Cell Wall Integrity and Virulence of Candida albicans

Candida albicans, a human fungal pathogen, undergoes morphogenetic changes that are associated with virulence. We report here that GAL102 in C. albicans encodes a homolog of dTDP-glucose 4,6-dehydratase, an enzyme that affects cell wall properties as well as virulence of many pathogenic bacteria. We found that GAL102 deletion leads to greater sensitivity to antifungal drugs and cell wall destabilizing agents like Calcofluor white and Congo red. The mutant also formed biofilms consisting mainly of hyphal cells that show less turgor. The NMR analysis of cell wall mannans of gal102 deletion strain revealed that a major constituent of mannan is missing and the phosphomannan component known to affect virulence is greatly reduced. We also observed that there was a substantial reduction in the expression of genes involved in biofilm formation but increase in the expression of genes encoding glycosylphosphatidylinositol-anchored proteins in the mutant. These, along with altered mannosylation of cell wall proteins together might be responsible for multiple phenotypes displayed by the mutant. Finally, the mutant was unable to grow in the presence of resident peritoneal macrophages and elicited a weak pro-inflammatory cytokine response in vitro. Similarly, this mutant elicited a poor serum pro-inflammatory cytokine response as judged by IFNγ and TNFα levels and showed reduced virulence in a mouse model of systemic candidiasis. Importantly, an Ala substitution for a conserved Lys residue in the active site motif YXXXK, that abrogates the enzyme activity also showed reduced virulence and increased filamentation similar to the gal102 deletion strain. Since inactivating the enzyme encoded by GAL102 makes the cells sensitive to antifungal drugs and reduces its virulence, it can serve as a potential drug target in combination therapies for C. albicans and related pathogens