Polyetheretherketone (PEEK) cages for anterior column reconstruction in pyogenic vertebral osteomyelitis.

The objective of study was to evaluate a case series of patients in whom polyetheretherketone (PEEK) cages were used for anterior column reconstruction in vertebral osteomyelitis. Fifteen patients underwent clinical and radiological evaluation with average follow-up of 26 months. Parameters assessed were time of surgery, blood loss, segmental kyphosis or lordosis angle, time to solid bony fusion, ambulatory status, and functional outcome.

Vertebral End-Plate Perforation for Intervertebral Disc Height Preservation After Single-level Lumbar Discectomy: A Randomized-controlled Trial.

Study Design: Pilot single-centre, stratified, prospective, randomized, double-blinded, parallel-group, controlled study.

Objective: To determine whether vertebral end-plate perforation after lumbar discectomy causes annulus reparation and intervertebral disc volume restoration. To determine that after 6 months there would be no clinical differences between the control and study group.

Endplate changes following discectomy: natural history and associations between imaging and clinical data.

Purpose: Some patients will experience post-operative back pain following lumbar discectomy, and the potential sources for that pain are poorly understood. One potential source is the vertebral endplates. The goal of this study was to document the changes that occur in lumbar endplates following discectomies, and to assess associations between endplate changes and clinical outcomes.

Posterior instrumentation, anterior column reconstruction with single posterior approach for treatment of pyogenic osteomyelitis of thoracic and lumbar spine.

Purpose: Surgical treatment of thoracolumbar osteomyelitis consists of radical debridement, reconstruction of anterior column either with or without posterior stabilization. The objective of present study is to evaluate a case series of patients with osteomyelitis of thoracic and lumbar spine treated by single, posterior approach with posterior instrumentation and anterior column reconstruction.

Methods: Seventeen patients underwent clinical and radiological evaluation pre and postoperatively with latest follow-up at 19 months (8-56 months) after surgery.

Bioactive glass enhances bone ingrowth into the porous titanium coating on orthopaedic implants.

Purpose: The aim of the study was to verify the ability of nanoparticulate bioactive glass (BAG) to infiltrate into the porous titanium (Ti) layer on Ti-based implants to promote osseointegration.

Methods: The porous titanium layer on Ti-based implants was impregnated with nanoparticulate BAG. The implants without or with BAG were implanted bilaterally in tibial holes of ten New Zealand white rabbits.

A prospective cohort study of close interval computed tomography and magnetic resonance imaging after primary lumbar discectomy: factors associated with recurrent disc herniation and disc height loss.

Study Design: Prospective cohort study.

Objective: We performed a prospective cohort study with standardized postoperative lumbar imaging every 3 months for a year then annually to assess the incidence and factors associated with same-level recurrent disc herniation.

Summary Of Background Data: The true incidence of same-level recurrent disc herniation after lumbar discectomy is unclear.

Evaluation of rabbit auricular chondrocyte isolation and growth parameters in cell culture.

Auricular cartilage is an attractive potential source of cells for many tissue engineering applications. However, there are several requirements that have to be fulfilled in order to develop a suitable tissue engineered implant. Animal experiments serve as important tools for validating novel concepts of cartilage regeneration; therefore rabbit auricular chondrocytes were studied.

An in vitro study of Hoechst 33342 redistribution and its effects on cell viability.

Although Hoechst 33342 (H342) is frequently used to label donor cells in cell transplantation research, it has been noted that it might secondarily label the host cells. Furthermore, its potential toxicity leading to cell death has been described. We studied the time course of H342 redistribution from the primary labeled rat bone marrow stromal cells (rBMSC) into the non-labeled rBMSC population over 7 days in culture; we evaluated the nuclear H342 fluorescence intensity as a possible criterion for distinguishing the primary from the secondary labeled cells, and determined the viability of rBMSC after an overnight incubation in 1 microg/mL of H342.

Nucleus pulposus repair with cultured autologous elastic cartilage derived chondrocytes.

Low back pain is one of the most common medical conditions in the Western world. Disc degeneration, an inevitable process of ageing, is one of the major causes of low back pain. Autologous chondrocyte transplantation (ACT) is an increasingly popular method of addressing pathological disorders of cartilage.

Association of sternal wound infection with parasternal muscle sutures.

Background: Sternal wound infection complicating open-heart surgery is a potentially devastating complication that has been associated with a number of risk factors. We recently consulted on three consecutive patients with this complication who had heavy nonabsorbable parasternal sutures placed in muscle tissue adjacent to the sternum. The aim of this report is to document our findings and caution that this technique to control bleeding from the parasternal intercostal muscles my increase risk of infection.

The outcome of autologous chondrocyte transplantation treatment of cartilage lesions in the knee.

Recent results of the clinical outcome of autologous chondrocyte transplantation (ACT) treatment in a group of 28 patients with focal femoral condyle cartilage lesions revealed a correlation trend with the quality of the in vitro cell culture matrix-protein synthesis. No impact of the patients' age and chondrocyte cryopreservation prior to implantation was observed. Further studies are needed to confirm the preliminary results.

Is a one-week course of triple anti-Helicobacter pylori therapy sufficient to control active duodenal ulcer?

Background: Triple therapy currently forms the cornerstone of the treatment of patients with Helicobacter pylori-positive duodenal ulcer.

Aim: To establish whether prolonged antisecretory therapy is necessary in patients with active duodenal ulcer.

Methods: A total of 77 patients with H.

Cluster of five children with acute encephalopathy associated with cat-scratch disease in south Florida.

Between August 12 and September 27, 1994, five children in South Florida were hospitalized at a single hospital because of encephalopathy, presenting as status epilepticus, associated with cat-scratch disease (CSD). Diagnoses were confirmed by using an indirect fluorescent antibody test to detect antibody to Bartonella henselae, the causative agent of CSD. These cases represent the first cluster of CSD encephalopathy cases to be recognized in the United States.

Selective bowel decontamination with quinolones and nystatin reduces gram-negative and fungal infections in orthotopic liver transplant recipients.

Gram-negative and fungal infections are the most important cause of morbidity and mortality after liver transplantation, especially in the first postoperative month. From February 1989 to February 1990, all liver transplant recipients at The Cleveland Clinic Foundation, Cleveland, Ohio, were placed on a selective bowel decontamination regimen employing oral quinolones and nystatin beginning at the time they were put on the active waiting list for transplantation and continuing until the fourth postoperative week. The incidence of gram-negative and fungal infections for these patients was compared against a historical control group.

Chronic fatigue and depression in the ambulatory patient.

Fatigue, pain, and emotional upset remain the most common problems affecting humanity and for which we still know so very little. Chronic fatigue syndrome is most likely a number of as yet unproven various undifferentiated illnesses that are exceedingly difficult to distinguish from depression. There probably is a subset of patients with CFS who do have true immune dysfunction and persistent viral infection, and this particular group of patients should be further investigated.

A multivariate analysis of risk factors for cytomegalovirus infection in liver-transplant recipients.

Thirty-three consecutive liver-transplant recipients were prospectively studied over a 37-mo period for evidence of cytomegalovirus infection. Sixteen (48%) episodes of cytomegalovirus infection were identified; 9 were primary infections and 7 were recurrent infections. Beginning with patient 8, gamma-globulin prophylaxis was routinely administered to most patients.

Decreased infections in cardiac transplant recipients on cyclosporine with reduced corticosteroid use.

Fifty patients undergoing orthotopic cardiac transplantation were monitored over 34 months for evidence of infection. Four separate immunosuppressive protocols were used during the course of the study; the most recent protocol (protocol 4) employed significantly lower overall steroid dosages than the earlier protocols (protocols 1,2, and 3). All immunosuppressive regimens used cyclosporine, and azathioprine was added in the last three protocols.

The immunocompromised host.

Infection still remains the most common immediate cause of death in the immunocompromised host. Because of the decreased host defenses leading not only to an increased susceptibility to a variety of opportunistic pathogens (in particular the fungi) but also to a decreased host inflammatory response and resultant clinical findings, infections in these patients are difficult to diagnose. Skin lesions occur in up to a third of infections in compromised hosts and can often be the first presentation of a systemic illness.

Peritonitis in children with nephrotic syndrome.

In a retrospective review of 214 children with nephrotic syndrome seen at Children's Medical Center and Parkland Memorial Hospital in Dallas throughout the 20-year period from 1967 to 1986, 62 cases of primary peritonitis were identified in 37 patients (17.3% rate). Streptococcus pneumoniae was the major pathogen, accounting for 38% of the cases.

A multivariate analysis of the risk of cytomegalovirus infection in heart transplant recipients.

Thirty-four consecutive heart transplant recipients were studied over a two-year period for evidence of cytomegalovirus (CMV) infection. Twenty-three episodes of CMV infection were identified; 19 of these occurred within 120 d after transplantation and were statistically analyzed. Fifteen potential risk factors were evaluated, including the following: pretransplant CMV serological status of donor and recipient; recipient's age, sex, race, and cardiac disease; number and type of blood products transfused; type and intensity of immunosuppression; occurrence of rejection; and leukopenia.