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  • ISSN: 2373-9290
    Volume 2, Issue 1
    January-March 2013
    Case Report
    Li R, Smith D, Sambaziotis C, Kim S*, Courtney J and Cobelli NJ
    Abstract: Pituitary apoplexy following total knee or hip replacement is a rarely documented postoperative complication and is caused by the sudden enlargement of a preexisting pituitary adenoma. Patients with this condition commonly complain of severe headache, altered mental status, ophthalmoplegia, and visual changes secondary to the mass effect of the tumor on its surrounding structures. We present a case of a 64-year-old male who underwent elective total hip arthroplasty and developed postoperative pituitary apoplexy secondary to a pituitary adenoma that was subsequently surgically resected. We believe that early diagnosis and surgical treatment with a multidisciplinary team led to a favorable outcome for this potentially fatal and debilitating condition.
    Kazuaki Mineta1, Yuichiro Goda1, Toshinori Sakai1*, Yoichiro Takata1, Kosaku Higashino1, Shinsuke Katoh2, Hideyuki Uraoka1, Masami Takahashi1 and Koichi Sairyo1
    Abstract: Here we report a case of late-onset non-dysraphic intradural spinal cord lipoma and provide a brief review of the literature. A 67-year-old man was referred to our department with a 6-month history of progressive gait ataxia. He had spastic paraparesis with left iliopsoas muscle weakness and hypoesthesia predominantly in the left leg. Magnetic resonance imaging (MRI) revealed an intradural extramedullary tumor suggestive of a lipoma at the T11-12 level. After laminectomy at T11-12 and resection of approximately 20-30% of the tumor according to intraoperative neuromonitoring findings, we performed duraplasty to decompress the spinal cord and posterior fusion (T11-L1) to prevent deterioration due to post-laminectomy kyphosis. The pathological diagnosis was lipoma. Gait ataxia and left paraparesis were improved at the 1-year follow up, and postoperative MRI demonstrated sufficient decompression of the affected spinal segments. Decompression with duraplasty, in addition to adequate tumor resection based on neuromonitoring findings, is an optimal treatment for non-dysraphic intradural spinal cord lipoma and is recommended to avoid postoperative neurological deterioration. Furthermore, posterior fusion can prevent deterioration due to post-laminectomy kyphosis and postoperative tethering.
    Shiro Hirose*, Hiromi Otsuka, Takkan Morishima, Kazutaka Watanabe, Keiji Sato
    Abstract: An uncommon case of idiopathic chondrolysis of the hip in a 21-year-old male is reported. It was diagnosed by clinical presentation, laboratory tests, radiological and pathological findings. Surgical dislocation of the hip was performed as operative treatment to remove the severe osteophytes after failure of conservative treatment. This paper reviews the cases described in the literature.
    Kalpita Hatti*#, Vincent Giuliano#
    Abstract: Strictures of the small bowel resulting from ingestion of non steroidal anti inflammatory drugs (NSAIDs), also known as small bowel diaphragm disease, were first described by Lang et al. in 1988. NSAIDs are the most commonly prescribed drugs in the world and, although their adverse effects on the upper gastrointestinal tract are widely recognized, their effects on the small bowel are under-reported.
    We present a case of a 58-year-old man who presented with multiple strictures of the small bowel, initially suspected to be due to inflammatory bowel disease (IBD) who, after partial small bowel resection, developed recurrent strictures due to ongoing NSAID use.
    Fumitake Tezuka*, Toshinori Sakai, Yoichiro Takata, Kosaku Higashino and Koichi Sairyo
    Abstract: Study Design: Retrospective case review.
    Objective: To report a technique of transdiscal screwing applied in a patient with multi-level spondylolisthesis.
    Summary of background Data: Although a technique of transdiscal screwing is sometimes used in patients with severe L5-S1 spondylolisthesis in clinical practice, it has been rarely reported. The concept of transdiscal fixation for severe L5-S1 spondylolisthesis was first reported by Bohlman, and the transdiscal L5-S1 screw was first introduced by Minamide et al., who performed a biomechanical study using a cadaveric model of L5-S1 spondylolisthesis. However, due to the rareness of cases requiring this technique in clinical practice, there has been no clinical report using this technique, except for L5-S1 spondylolisthesis.
    Methods: The clinical and radiologic findings are discussed in the case report.
    Results: The patient was a 72-year-old woman who had undergone partial laminectomy of L3 and L4 due to lumbar spinal canal stenosis at another hospital. Radiographical studies showed multi-level spondylolisthesis of L3-L4, L4-L5, and vertebral deformities of L4 and L5. The vertebral body of L4 had a common wedged deformity, while that of L5 whose anterior wall height was diminished, had a reverse wedged deformity. Preceded by fixation, laminectomy of L3, L4, and L5 was performed to decompress L4 and L5 nerve roots. The L3 pedicle screws were placed as usual, L5 screws were placed through the L5 pedicles, through the superior endplate of L5, and through the inferior endplate of L4, to terminate in L4 body. As a result, double-level fixation of L3-L4 and L4-L5 was performed. Immediately after the operation, the patient experienced relief from pain. Thereafter she could walk unaided.
    Conclusions: We present a rare case of multi-level spondylolisthesis requiring the transdiscal screws due to unique deformities at L4 and L5 vertebral bodies.
    Research Article
    Efthymia Kitraki1*, Stefanos Zakkas2#, Eugenia Synolaki1#, Evangelia Diamanti1, Dina G. Tiniakos3, Antonios Stamatakis4, Chrysanthi Matsioula1, Fotini Stylianopoulou4 and Theodoros Papapolychroniou2
    Abstract: Contemporary therapeutic approaches to treat unsuccessful union of long bone fractures include bone marrow stem cell-based enhancement of the healing process. This study examined whether dental pulp cells, known to contain stem cells of mesenchymal origin, could improve curing in a tibia fracture model. Osteotomies were performed in two groups of adult male rats and stabilized with intramedullary nailing. Dental pulp cells, harvested from human impacted third molars, were cultured and characterized using mesenchymal stem cell markers. Pulp cells or the vehicle were administered locally at the fracture site. Healing was evaluated radiologically from the 2nd to 8th week and histologically at the 8th week post surgery. Advanced and more efficient bone healing was observed in the cell-treated group compared to the control. This was deduced by the increased callus homogeneity and its earlier size decline as well as by the higher percentage of lamellar newly formed bone and the lower incidence of non-bridging and fibrous tissue detected in the experimental group. These findings confer indications that dental pulp cells, sharing mesenchymal stem cell properties, provide a healing advantage in tibia fractures and encourage further research towards their potential use in bone repair.
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