We report a case of ulcerative colitis (UC) after mitral valve replacement (MVR) surgery due to infective endocarditis (IE). A 59-year-old woman underwent MVR for mitral regurgitation due to IE. Six days after the surgery, melena was observed suddenly, and she received a blood transfusion. Ulcer and erosion were observed in the rectum 5 to 10 cm from the anal ring by endoscopy. We changed her antibiotic treatment and stopped warfarin potassium. Heparin sodium was started 2 days after melena. We diagnosed ulcerative colitis from the finding of the rectal lesion and biopsy. We gave mesalazine and betamethasone as treatment for UC. The patient's condition improved and her general condition stabilized. She was discharged 36 days after surgery.

A 51-year-old man with osteogenesis imperfecta and who had aortic regurgitation was admitted to our hospital for aortic valve replacement. His height was 146cm and his weight was 49kg. The patient had suffered from bone fractures several times since childhood. Bone deformity, blue sclera and his status were clinically indicative of osteogenesis imperfecta. Aortic valve replacement with a 25mm SJM^® prosthetic valve was successfully performed for aortic valve insufficiency and slight annulo-aortic ectasia. Soft tissues and the sternum were fragile. Pathological examination (Elastica-Masson stain) of the aortic valve and left ventricular wall revealed a loss of fibrous tissues and remarkable thickening due to elastic fibers. The patient was discharged 31 days after surgery. Osteogenesis imperfecta is one of the collagen diseases caused by gene abnormality, in which fragile bones are easily fractured. Cardiovascular disease is rarely associated with it and the surgery-related mortality rate is reported to be approximately 30%, due to bleeding.

Methods: We reviewed 74 patients who underwent surgery for ASD. PJK was defined as a proximal junction sagittal Cobb angle exceeding 10°, and at least 10° greater than the preoperative measurement. We investigated the following as risk factors: age, sex, body mass index, medical history, number of fused segments, number of interbody fusions, number of OLIFs, number of osteotomies, level of upper instrumented vertebrae, lowest instrumented vertebrae, and radiographic parameters. Results: The mean follow-up duration was 22.4 months and the mean age of the patients was 73.6 years. PJK was present in 19/74 patients (25.7%) and absent in 55/74 (74.3%). In the univariate analysis, those with PJK had a significantly higher proportion of patients with a history of vertebral compression fracture (7/19 patients [36.8%] vs. 6/55 patients [10.9%], p=0.027). Those with PJK had a significantly higher proportion of patients with fusion to the pelvis (18/19 patients [94.7%] vs. 34/55 patients [61.8%], p=0.016). According to the multivariate analysis, fusion to the pelvis was a significant risk factor for PJK. Conclusions Fusion to the pelvis was the most important risk factor for PJK. A history of vertebral compression fracture served as an additional risk factor for PJK. Clinicians should consider these factors before treating ASD patients with OLIF.

Methods: Eighty-six patients were enrolled in this study (group O: OLIF-LPF, n=38; group T: MIS-TLIF, n=48). We evaluated the operation time, estimated blood loss (EBL), postoperative laboratory data, preoperative and postoperative radiographic parameters, overall functional outcome with the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) effectiveness rate, and Visual Analog Scale (VAS) score for low back pain, leg pain, and leg numbness. Results: No statistical differences in operation time, EBL, and C-reactive protein level, 5 days postoperatively, between groups O and T. With respect to radiological outcome, preoperative and postoperative disc height change was significantly greater in group O than in group T (3.8 vs. 1.8 mm, p<0.05). Both groups showed postoperative improvements in the clinical outcome scores of all JOABPEQ domains, but the effectiveness rate increase in the psychological domain was significantly higher in group O than in group T (47.1% vs. 14.6%, p<0.05). No differences in the preoperative and postoperative VAS score change were noted between the two groups in any of the items. Conclusions The changes in physical function and QOL parameters after OLIF-LPF and MIS-TLIF were almost equivalent; however, OLIF-LPF had significant superiority in the psychological domain.