Many believe the reduction in the number of mobile segments causes an increased strain in the unfused segments, predisposing them to early degeneration. This degeneration of the adjacent segment could be a cause of low back pain after spinal fusion. The clinical manifestations supporting the increased stress of the unfused segments are the significant incidence rates of spondylolisthesis, spondylolysis acquisita and spinal stenosis. However, there was a paucity of reports in the literature on the histological observation at the adjacent, unfused sgements. Therefore, the purpose of this study was to observe the histological changes of the unfused, mobile segments following fixation in the cat spine. The cat lumbar spines from L6 to L7 were fixed posteriorly with acrylic cement and wires. Histological and histochemical observation of the upper adjacent segment were performed after H-E, trichrome, reticulin and Safranin-O staining at postoperative 6 and 12 months, respectively. The results were as follows: 1. There were mild degenerative changes in the intervertebral disc, but no evidence of definitive degeneration in the articular cartilage of the facet joints at postoperative 6 months in the spinal fixation group. 2. The marked degenerative changes of the intervertebral disc were shown at postoperative 12 months in the spinal fixation group. Of 5 cats sacrificed at 12 months, 3 cats had irregular configuration of the fiber's arrangement of the annulus fibrosus. 3. At postoperative 12 months in the spinal fixation group, marked degeneration was noted on the articular cartilage of the adjacent facet joints. Through this study, it is clarified that degenerativce changes of the intervetebral disc and facet joint at the adjacent segments will develop after certain period of time following spinal fusion. Especially the facet joints of the adjacent, unfused segment were found to be most vulnerable to the adverse effects. This may be responsible for the back pain in the future after spine fusion.
Animals ; Back Pain ; Cartilage, Articular ; Cats* ; Incidence ; Intervertebral Disc ; Low Back Pain ; Reticulin ; Spinal Fusion ; Spinal Stenosis ; Spine* ; Spondylolisthesis ; Spondylolysis ; Zygapophyseal Joint

The clinical data of 27 patiets with hypophosphatemic rickets treated with phosphate and 1alpha-hydroxyvitamin D were analysed retrospectively. The median age at diagnosis was 4 years, and the main clinical manifestations were bowleg and short stature. Among total 24 families, 5 families (21%) had X-linked dominant mode of inheritance, 1 family (4%) had autosomal dominant mode and 17 families (71%) had no family history, The serum phosphorus concentration rose from initial value of 2.7+/-0.13mg/dl to 3.5+/-0.19mg/dl. The serum alkaline phosphatase was reduced from 871+/-63IU/L to 393+/-41IU/L. Healing of rickets was demonstrated by radiography. Patients treated for at least two years before the onset of puberty had an increase in the mean height SD score from -1.58 to -0.79. Orthopedic surgeries for severe lower extremity deformity were performed in 11 patients, of whom 8(73%) were dignosed over 5 years of age. Complications of therapy were as follows; 12 patients (44%) developed more than one episode of hypercalciuria, 5 patients (19%) developed more than one episode of hypercalcemia, and nephrocalcinosis was noted in 5(33%) out of 15 patients by renal ultrasound. The group with nephrocalcinosis had a higher incidence of hypercalemic episodes than the group without nephrocalcinosis. In conclusion, treatment of hypophosphatemic rickets results in healing of rickets and acceleration of growth, and we must evaluate complications of therapy such as hypercalcemia and nephrocalcinosis.
Acceleration ; Adolescent ; Alkaline Phosphatase ; Congenital Abnormalities ; Diagnosis ; Humans ; Hypercalcemia ; Hypercalciuria ; Incidence ; Lower Extremity ; Nephrocalcinosis ; Orthopedics ; Phosphorus ; Puberty ; Radiography ; Retrospective Studies ; Rickets ; Rickets, Hypophosphatemic* ; Ultrasonography ; Wills

No abstract available.
Liver* ; Neoplasm Metastasis*

No abstract available.
Pressure Ulcer*

A case of autonephrectomized tuberculosis of right kidney in 14-year old boy, complaining of abdominal pain, fever, and fist sized mass in right upper abdomen was reported with a brief review of the related literature.
Abdomen ; Abdominal Pain ; Adolescent ; Fever ; Humans ; Kidney* ; Male ; Tuberculosis*

PURPOSE: To determine whether neoadjuvant androgen deprivation therapy (NADT) improves clinical outcomes in patients with prostate cancer treated with definitive radiotherapy. MATERIALS AND METHODS: We retrospectively reviewed medical records of 201 patients with prostate cancer treated with radiotherapy between January 1991 and December 2008. Of these, 156 patients with more than 3 years of follow-up were the subjects of this study. The median duration of follow-up was 91.2 months. NADT was given in 103 patients (66%) with median duration of 3.3 months (range, 1.0 to 7.7 months). Radiation dose was escalated gradually from 64 Gy to 81 Gy using intensity-modulated radiotherapy technique. RESULTS: Biochemical relapse-free survival (BCRFS) and overall survival (OS) of all patients were 72.6% and 90.7% at 5 years, respectively. BCRFS and OS of NADT group were 79.5% and 89.8% at 5 years and those of radiotherapy alone group were 58.8% and 92.3% at 5 years, respectively. Risk group (p = 0.010) and radiation dose > or =70 Gy (p = 0.017) affected BCRFS independently. NADT was a significant prognostic factor in univariate analysis, but not in multivariate analysis (p = 0.073). Radiation dose > or =70 Gy was only an independent factor for OS (p = 0.007; hazard ratio, 0.261; 95% confidence interval, 0.071-0.963). CONCLUSION: NADT prior to definitive radiotherapy did not result in significant benefit in terms of BCRFS and OS. NADT should not be performed routinely in the era of dose-escalated radiotherapy.
Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Prostatic Neoplasms* ; Radiotherapy* ; Radiotherapy, Intensity-Modulated ; Retrospective Studies

No abstract available.
Spondylosis*

No abstract available.
Hemorrhage*

No abstract available.
Humans

No abstract available.