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BACKGROUND: Metal hypersensitivity, mostly documented in prosthesis implantation, is a rare complication after arthroplasty. Such cases become rarer and more difficult to diagnose when it comes to lumbar surgery. CASE PRESENTATION: We present the case of a 52-year-old female patient with reoccured low back pain and sciatica after posterior lumbar decompression and fusion (PLDF) for her lumbar disc herniation. The initial clinical and radiological examinations showed no pathologies. Further imaging and histopathological studies in later period revealed an aseptic loosening of the hardware and an aseptic inflammatory response which was diagnosed to be metal hypersensitivity. To our knowledge, few allergic cases in the matter of spinal fusion were reported so far. CONCLUSIONS: Metal hypersensitivity after spinal fusion should be considered in patients with representation of postoperative back pain. And elaborate history taking would conduce a lot to it's diagnose.
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Dermatitis por Contacto/diagnóstico por imagen , Vértebras Lumbares/diagnóstico por imagen , Metales/efectos adversos , Fusión Vertebral/efectos adversos , Dermatitis por Contacto/cirugía , Femenino , Humanos , Persona de Mediana Edad , Radiografía , Fusión Vertebral/instrumentación , Resultado del TratamientoRESUMEN
BACKGROUND: Currently, Posterior Short Segment Pedicle Screw Fixation is a popular procedure for treating unstable thoracolumbar/lumbar burst fracture. But progressive kyphosis and a high rate of hardware failure because of lack of the anterior column support remains a concern. The efficacy of different methods remains debatable and each technique has its advantages and disadvantages. METHODS: A consecutive series of 20 patients with isolated thoracolumbar/lumbar burst fractures were treated by posterior short segment pedicle screw fixation and transforaminal thoracolumbar/lumbar interbody fusion (TLIF) between January 2005 and December 2007. All patients were followed up for a minimum of 2 years. Demographic data, neurologic status, anterior vertebral body heights, segmental Cobb angle and treatment-related complications were evaluated. RESULTS: The mean operative time was 167 minutes (range, 150-220). Blood loss was 450 ~ 1200 ml, an average of 820 ml. All patients recovered with solid fusion of the intervertebral bone graft, without main complications like misplacement of the pedicle screw, nerve or vessel lesion or hard ware failure. The post-operative radiographs demonstrated a good fracture reduction and it was well maintained until the bone graft fusion. Neurological recovery of one to three Frankel grade was seen in 14 patients with partial neurological deficit, three grades of improvement was seen in one patient, two grades of improvement was observed in 6 patients and one grade of improvement was found in 6 patients. All the 6 patients with no paraplegia on admission remained neurological intact, and in one patient with Frankel D on admission no improvement was observed. CONCLUSION: Posterior short-segment pedicle fixation in conjunction with TLIF seems to be a feasible option in the management of selected thoracolumbar/lumbar burst fractures, thereby addressing all the three columns through a single approach with less trauma and good results.
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Tornillos Óseos , Fijación de Fractura/instrumentación , Vértebras Lumbares/cirugía , Fracturas de la Columna Vertebral/cirugía , Fusión Vertebral/instrumentación , Vértebras Torácicas/cirugía , Adolescente , Adulto , Pérdida de Sangre Quirúrgica , Trasplante Óseo , Femenino , Fijación de Fractura/efectos adversos , Curación de Fractura , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/lesiones , Vértebras Lumbares/fisiopatología , Masculino , Persona de Mediana Edad , Tempo Operativo , Oseointegración , Complicaciones Posoperatorias/etiología , Estudios Prospectivos , Diseño de Prótesis , Radiografía , Recuperación de la Función , Fracturas de la Columna Vertebral/diagnóstico , Fracturas de la Columna Vertebral/fisiopatología , Fusión Vertebral/efectos adversos , Vértebras Torácicas/diagnóstico por imagen , Vértebras Torácicas/lesiones , Vértebras Torácicas/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
HIV subtypes convey important epidemiological information and possibly influence the rate of disease progression. In this study, HIV disease progression in patients infected with CRF01_AE, CRF07_BC, and subtype B was compared in the largest HIV molecular epidemiology study ever done in China. A national data set of HIV pol sequences was assembled by pooling sequences from public databases and the Beijing HIV laboratory network. Logistic regression was used to assess factors associated with the risk of AIDS at diagnosis ([AIDSAD], defined as a CD4 count < 200 cells/µL) in patients with HIV subtype B, CRF01_AE, and CRF07_BC. Of the 20,663 sequences, 9,156 (44.3%) were CRF01_AE. CRF07_BC was responsible for 28.3% of infections, followed by B (13.9%). In multivariable analysis, the risk of AIDSAD differed significantly according to HIV subtype (OR for CRF07_BC vs. B: 0.46, 95% CI 0.39â0.53), age (OR for ≥ 65 years vs. < 18 years: 4.3 95% CI 1.81â11.8), and transmission risk groups (OR for men who have sex with men vs. heterosexuals: 0.67 95% CI 0.6â0.75). These findings suggest that HIV diversity in China is constantly evolving and gaining in complexity. CRF07_BC is less pathogenic than subtype B, while CRF01_AE is as pathogenic as B.
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Infecciones por VIH , VIH-1 , Minorías Sexuales y de Género , Anciano , China/epidemiología , Progresión de la Enfermedad , Genotipo , Infecciones por VIH/epidemiología , VIH-1/genética , Homosexualidad Masculina , Humanos , Masculino , Filogenia , Análisis de Secuencia de ADNRESUMEN
Organic charge-transfer (CT) complexes with a unique electrical performance are attractive materials for organic electronics. However, achieving breakthroughs in the practical application of CT complexes through rational design have always been a challenge. For the first time, a chemiresistive sensor for nerve agent that mimics (diethyl chlorophosphate) vapor detection is rationally designed based on organic CT complexes. Such CT complex chemiresistive sensor realizes a subppb detection of diethyl chlorophosphate (DCP) within 5 s under atmospheric conditions at room temperature with a high selectivity. Meanwhile, based on the highly tunable characteristics of CT complexes, the influence of morphology and intermolecular interaction on the sensing response are investigated. It is worth noting that a stronger intermolecular interaction results in lower sensing responses for CT complexes with a different D/A combination but with the same ratio. The organic charge-transfer materials not only provide a highly tunable platform for the chemiresistive sensor but also have the special properties such as solution processability, flexibility, and molecular recognition, which provides more possibilities for the application of flexible and wearable biosensors.
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Bone marrow mesenchymal stem cells (BMSCs) are a good candidate for tissue engineering and clinical application. One of the challenges in its cell therapy is how to quickly obtain an adequate number of seed cells and meanwhile maintain suitable differentiation potential. In this study we combined three-dimensional (3D) collagen porous scaffolds with rotary cell culture system (RCCS) (RCCS-3D) to create a stereoscopic dynamic environment for the amplification of rat BMSCs in vitro. The results revealed that this RCCS-3D system could enhance BMSCs' proliferation and colony formation, as well as maintain the differentiation potential compared with conventional static two-dimensional (2D) and 3D cell culture conditions. In addition, high-throughput microarray analysis showed that gene expressions of RCCS-3D system displayed significant differences in cell proliferation and differentiation compared with static-2D conditions. Thus, RCCS-3D system could provide an effective means for BMSCs cell proliferation in vitro and meanwhile maintain differentiation potential in tissue engineering.