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Indian Journal of Orthopaedics Feb 2023Fusion surgery is applied to prevent segmental instability after surgery for cervical disk herniation. Motion-sparing surgeries have been developed to prevent adjacent...
BACKGROUND
Fusion surgery is applied to prevent segmental instability after surgery for cervical disk herniation. Motion-sparing surgeries have been developed to prevent adjacent segment disease after fusion surgery. Total disk replacement, one of these methods, has been applied in the cervical region for more than 20 years. We aimed to investigate the medium-term radiological and clinical outcomes of patients who had received Alpha-D disk prosthesis after cervical disk surgery, in terms of incidence of heterotopic ossification (HO) and other complications.
METHODS
We included 33 patients (17 women and 16 men) diagnosed with single-level cervical disk herniation and who had received prosthesis after anterior discectomy. The average follow-up period was 36 (18-78) months. The patients were followed up postoperatively at month 4, year 1, and annually thereafter. Patients, who had Alpha-D cervical disk prosthesis (CDP) (Medikon, Turkey), were monitored via radiological (standard and dynamic X-ray) and clinical (visual analog scale [VAS] and neck disability index [NDI]) modalities. Dynamic X-ray images were evaluated by an independent radiologist for HO and prosthesis movement.
RESULTS
Mean patient age was 40 ± 6.88 years. HO was observed in 7 (21.21%) patients, 6 of which were men. Significant intersex differences were noted for HO and movement rates ( = 0.039). Clinically, the mean preoperative and post-operative NDI levels were 35.4 ± 3.9 and 4 ± 2, respectively, whereas the mean pre- and post-operative VAS levels were 7 ± 1 and 1 ± 1, respectively. There was a clinically significant postoperative improvement in all the patients. However, there was no significant difference between the patients with and without HO in terms of age, operation level, and mean pre- and postoperative VAS, and postoperative NDI levels ( > 0.05). Despite the fact that there was a significant difference ( = 0.038) in favor of patients without HO in terms of mean preoperative NDI levels, this was not considered clinically significant.
CONCLUSION
In the present study, all the patients demonstrated clinically significant improvement following CDP surgery. HO rate after CDP surgery was 21.21% in the medium term, and movement was preserved in 5 of the 7 patients with partial HO. The fact that the CDP design was based on the one-to-one reproduction of the movement segment in the cervical spine, might account for the underlying cause of success. However, these good results in the medium term may change in cases with long-term clinical follow-up.
PubMed: 36777117
DOI: 10.1007/s43465-022-00803-4 -
Micromachines Dec 2023A diamond gel polishing disk with self-sharpening ability is proposed to solve the problem of glazing phenomenon in the gel polishing disks. Aluminum nitride (AlN)...
A diamond gel polishing disk with self-sharpening ability is proposed to solve the problem of glazing phenomenon in the gel polishing disks. Aluminum nitride (AlN) powder with silica sol film coating (A/S powder) is added to the polishing disk, and a specific solution is used to dissolve the A/S powder during polishing, forming a pore structure on the polishing disk. To realize the self-sharpening process, the dissolution property of the A/S powder is analyzed. The effect of A/S powder content on the friction and wear performance and the polishing performance of 4H-SiC wafers are investigated. Results showed that the friction coefficient of the polishing disk with 9 wt% A/S powder content is the most stable. The surface roughness of 2.25 nm can be achieved, and there is no obvious glazing phenomenon on the polishing disk after polishing. The surface roughness of the 4H-SiC wafer is reduced by 38.8% compared with that of the polishing disk with no A/S powder addition after rough polishing, and the 4H-SiC wafer then obtained a damage-free surface with a less than 0.4 nm after fine polishing by chemical mechanical polishing (CMP).
PubMed: 38258175
DOI: 10.3390/mi15010056 -
Frontiers in Immunology 2023Intervertebral disk degeneration (IDD) is a chronic inflammatory disease with intricate connections between immune infiltration and oxidative stress (OS). Complex cell...
Intervertebral disk degeneration (IDD) is a chronic inflammatory disease with intricate connections between immune infiltration and oxidative stress (OS). Complex cell niches exist in degenerative intervertebral disk (IVD) and interact with each other and regulate the disk homeostasis together. However, few studies have used longitudinal approach to describe the immune response of IDD progression. Here, we conducted conjoint analysis of bulk-RNA sequencing and single-cell sequencing, together with a series of techniques like weighted gene co-expression network analysis (WGCNA), immune infiltration analysis, and differential analysis, to systematically decipher the difference in OS-related functions of different cell populations within degenerative IVD tissues, and further depicted the longitudinal alterations of immune cells, especially monocytes/macrophages in the progression of IDD. The OS-related genes CYP1A1, MMP1, CCND1, and NQO1 are highly expressed and might be diagnostic biomarkers for the progression of IDD. Further landscape of IVD microenvironment showed distinct changes in cell proportions and characteristics at late degeneration compared to early degeneration of IDD. Monocytes/macrophages were classified into five distinct subpopulations with different roles. The trajectory lineage analysis revealed transcriptome alterations from effector monocytes/macrophages and regulatory macrophages to other subtypes during the evolution process and identified monocytes/macrophage subpopulations that had rapidly experienced the activation of inflammatory or anti-inflammatory responses. This study further proposed that personalized therapeutic strategies are needed to be formulated based on specific monocyte/macrophage subtypes and degenerative stages of IDD.
Topics: Humans; Intervertebral Disc Degeneration; Monocytes; Transcriptome; Base Sequence; Macrophages
PubMed: 36817437
DOI: 10.3389/fimmu.2023.1090637 -
JMIR Medical Informatics May 2021Disk herniation and disk bulge are two common disorders of lumbar intervertebral disks (IVDs) that often result in numbness, pain in the lower limbs, and lower back...
BACKGROUND
Disk herniation and disk bulge are two common disorders of lumbar intervertebral disks (IVDs) that often result in numbness, pain in the lower limbs, and lower back pain. Magnetic resonance (MR) imaging is one of the most efficient techniques for detecting lumbar diseases and is widely used for making clinical diagnoses at hospitals. However, there is a lack of efficient tools for effectively interpreting massive amounts of MR images to meet the requirements of many radiologists.
OBJECTIVE
The aim of this study was to present an automatic system for diagnosing disk bulge and herniation that saves time and can effectively and significantly reduce the workload of radiologists.
METHODS
The diagnosis of lumbar vertebral disorders is highly dependent on medical images. Therefore, we chose the two most common diseases-disk bulge and herniation-as research subjects. This study is mainly about identifying the position of IVDs (lumbar vertebra [L] 1 to L2, L2-L3, L3-L4, L4-L5, and L5 to sacral vertebra [S] 1) by analyzing the geometrical relationship between sagittal and axial images and classifying axial lumbar disk MR images via deep convolutional neural networks.
RESULTS
This system involved 4 steps. In the first step, it automatically located vertebral bodies (including the L1, L2, L3, L4, L5, and S1) in sagittal images by using the faster region-based convolutional neural network, and our fourfold cross-validation showed 100% accuracy. In the second step, it spontaneously identified the corresponding disk in each axial lumbar disk MR image with 100% accuracy. In the third step, the accuracy for automatically locating the intervertebral disk region of interest in axial MR images was 100%. In the fourth step, the 3-class classification (normal disk, disk bulge, and disk herniation) accuracies for the L1-L2, L2-L3, L3-L4, L4-L5, and L5-S1 IVDs were 92.7%, 84.4%, 92.1%, 90.4%, and 84.2%, respectively.
CONCLUSIONS
The automatic diagnosis system was successfully built, and it could classify images of normal disks, disk bulge, and disk herniation. This system provided a web-based test for interpreting lumbar disk MR images that could significantly improve diagnostic efficiency and standardized diagnosis reports. This system can also be used to detect other lumbar abnormalities and cervical spondylosis.
PubMed: 34018488
DOI: 10.2196/14755 -
BioNanoScience 2022Interest is growing in nanopores as real-time, low-cost, label-free virus size sensors. To optimize their performance, we evaluate how external electric field and ion...
Interest is growing in nanopores as real-time, low-cost, label-free virus size sensors. To optimize their performance, we evaluate how external electric field and ion concentrations and pore wall charges influence currents and object (disk) radius-current relationship using simulations. The physics was described using the Poisson-Nernst-Planck and Navier-Stokes equations. In a charged cylindrical nanopore with a charged disk, elevated external electric field produces higher (and polarity independent) ion concentrations and greater ion current (largely migratory). Elevated external ion concentrations also lead to higher concentrations (mainly away from the pore wall), greater axial electric field especially in the disk-pore wall space, and finally larger current. At low concentrations, current is disk radius independent. The current rises as concentrations increase. Interestingly, the rise is greater for larger disks (except when the pore is blocked mechanically). Smaller cross-sectional area for current flow or volume exclusion of electrolyte by object thus cannot be universally accepted as explanations of current blockage. Ion current rises when pore wall charge density increases, but its direction is independent of charge sign. Current-disk radius relationship is also independent of pore wall charge sign. If the pore wall and disk charges have the same sign, larger current with bigger disk is due to higher counter-ion accumulation in the object-pore wall space. However, if their signs are opposite, it is largely due to elevated axial electric field in the object-pore wall space. Finally in uncharged nanopores, current diminishes when disk radius increases making them better sensors of virus size.
PubMed: 35607652
DOI: 10.1007/s12668-022-00990-2 -
Frontiers in Medicine 2023Intervertebral disk (IVD) degeneration (IVDD) is a main factor in lower back pain, and immunomodulation plays a vital role in disease progression. The IVD is an immune... (Review)
Review
Intervertebral disk (IVD) degeneration (IVDD) is a main factor in lower back pain, and immunomodulation plays a vital role in disease progression. The IVD is an immune privileged organ, and immunosuppressive molecules in tissues reduce immune cell (mainly monocytes/macrophages and mast cells) infiltration, and these cells can release proinflammatory cytokines and chemokines, disrupting the IVD microenvironment and leading to disease progression. Improving the inflammatory microenvironment in the IVD through immunomodulation during IVDD may be a promising therapeutic strategy. This article reviews the normal physiology of the IVD and its degenerative mechanisms, focusing on IVDD-related immunomodulation, including innate immune responses involving Toll-like receptors, NOD-like receptors and the complement system and adaptive immune responses that regulate cellular and humoral immunity, as well as IVDD-associated immunomodulatory therapies, which mainly include mesenchymal stem cell therapies, small molecule therapies, growth factor therapies, scaffolds, and gene therapy, to provide new strategies for the treatment of IVDD.
PubMed: 38179277
DOI: 10.3389/fmed.2023.1289642 -
Asian Spine Journal Aug 2022Retrospective observational study.
STUDY DESIGN
Retrospective observational study.
PURPOSE
In this study we identify risk factors, including patient demographics, sagittal parameters, and clinical examinations, affecting incomplete L5/S posterior lumbar interbody fusion (PLIF).
OVERVIEW OF LITERATURE
The lumbosacral spine is considered to have an interbody fusion rate lower than that of the lumbar spine, but few studies have investigated the cause, including investigating the pelvis. We believe that pelvic morphology can affect L5/S interbody fusion of the lumbosacral spine.
METHODS
We observed 141 patients (61 men, 80 women; average age, 65.8 years) who had undergone PLIF and checked for the presence of L5/S interbody fusion. We investigated factors such as age, gender, the presence of diffuse idiopathic skeletal hyperostosis (DISH), fusion level, and grade 2 osteotomy, as well as pre-, post-, and post-preoperative L5/S disk height and angle, lumbar lordosis, Visual Analog Scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and pelvic incidence (PI), comparing those with and without L5/S interbody fusion. In addition, we analyzed the patients classified into short-level (n=111) and multi-level fusion groups (n=30).
RESULTS
Overall, the L5/S interbody fusion rate was 70% (short-level, 78%; multi-level, 40%). Age and pre- and post-preoperative L5/S disk angle were significantly different in each fusion level group. DISH presence, grade 2 osteotomy, and postoperative VAS and JOA scores were significantly different in the short-level fusion group, whereas PI was significantly different in the multi-level fusion group.
CONCLUSIONS
Incomplete union after L5/S PLIF correlates with advanced age, many fusion levels, and a large value of preoperative and a small value of post-preoperative L5/S disk angles.
PubMed: 34470098
DOI: 10.31616/asj.2021.0064 -
Annals of Clinical Microbiology and... May 2022Detection of Extended-Spectrum Beta-Lactamases (ESBLs) depends on screening for resistance to certain cephalosporins, confirmation with selective ESBL inhibitors, and...
INTRODUCTION
Detection of Extended-Spectrum Beta-Lactamases (ESBLs) depends on screening for resistance to certain cephalosporins, confirmation with selective ESBL inhibitors, and ESBL genes detection. New tests are required for accurate ESBL detection.
AIMS
To test the ability of cefixime (CFM) and cefixime-amoxicillin/clavulanate (CFM-AMC) as a screening and confirmatory test for ESBL identification.
METHODS
246 clinical isolates of Escherichia coli were tested by an ESBL screening test, a double-disk synergy test (DDST), a disk replacement test, the Vitek 2 ESBL test, and an ESBL genes test by PCR. CFM ESBL Screening was performed by disk diffusion, while CFM-AMC confirmation was performed by DDST and a disk replacement test.
RESULTS
246 E. coli clinical isolates from two referral hospitals were collected over 2 years. The mean age ± standard deviation of patients was 43.8 ± 27.7 years and 76.8% were females. Resistance rates to penicillins, first, second, and third generation cephalosporins, and monobactams were very high at 97%, 84%, 100% and 97%, respectively. ESBL screening was positive in 81.3% of isolates, DDST was positive in 74.8%, disk replacement was positive in 79%, Vitek 2 ESBL test was positive in 67.3%, and ESBL genes were detected in 85.8% of isolates (CTX-M 75%, TEM 42.5%, SHV 4.6%). Compared to genotyping, screening with CFM achieved 87.7% sensitivity and 64.7% specificity. CFM-AMC DDST achieved 75.8% sensitivity and 75.4% specificity, and CFM-AMC disk replacement had 73% sensitivity and 70% specificity.
CONCLUSIONS
High prevalence of ESBLs was noted among E. coli isolates, dominated by CTX-M genotype. ESBL screening and confirmation using CFM and CFM-AMC is a new and accurate method for ESBLs detection.
Topics: Adolescent; Adult; Aged; Cefixime; Cephalosporins; Clavulanic Acid; Escherichia coli; Escherichia coli Infections; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Young Adult; beta-Lactamases
PubMed: 35599329
DOI: 10.1186/s12941-022-00508-4 -
Cureus Mar 2022Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high morbidity and mortality due to the development of antimicrobial resistance...
Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high morbidity and mortality due to the development of antimicrobial resistance secondary to irrational use of antibiotics, nonadherence to infection control practices, and increased use of intravascular devices in healthcare systems. Detection of MRSA is critical in clinical microbiology laboratories as it helps identify MRSA carriers and avoid treatment failure in patients. Hence, this study compared various phenotypic methods with the standard genotyping method to determine a method that permits rapid and accurate detection of MRSA. Materials & Methods () was initially identified based on colony morphology, Gram staining, standard biochemical tests, and antibiotic susceptibility using disk diffusion. MRSA was identified based on the detection of the mecA gene by polymerase chain reaction (PCR) and subsequent gel electrophoresis. Disk diffusion using cefoxitin or oxacillin and mannitol salt agar with 6-µg/ml oxacillin were used for phenotypic detection of MRSA. The D test was used to detect inducible clindamycin resistance in isolates. Results Of the 100 isolates analyzed, 37% were identified as MRSA by PCR and the cefoxitin disk diffusion method; however, only 31% were detected by the oxacillin disk diffusion method and 29% by the mannitol salt agar method. The sensitivity of the cefoxitin disk diffusion test, oxacillin disk diffusion, and mannitol salt agar methods was 86.05%, 83.78%, and 70.73%, respectively. Specificity was 100% for all the three phenotypic methods (p < 0.001). Notably, inducible clindamycin resistance was found in 37.2% of the MRSA isolates, indicating potential challenges in treatment. Conclusion Among the three phenotypic methods tested, the cefoxitin disk diffusion method had 100% sensitivity and specificity, which is similar to that of PCR-based MRSA detection. Hence, the cefoxitin disk diffusion method is recommended for use in clinical laboratories, where molecular methods are not available as it is both cost-effective and easy to perform.
PubMed: 35481290
DOI: 10.7759/cureus.23396 -
Indian Journal of Ophthalmology Mar 2023: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the...
BACKGROUND AND PURPOSE
: "Congenital cavitary optic disk anomalies" is a term used to include optic disk pit (ODP), optic disk coloboma, and morning glory disk anomaly (MGDA). Imaging the radial peripapillary capillary (RPC) network in congenital optic disk anomalies with optical coherence tomography-angiography (OCTA) can shed light on its pathogenesis. This video describes the OCTA findings of optic nerve head and RPC network using the angio-disk mode in five cases of congenital cavitary optic disk anomalies.
SYNOPSIS
The video presents characteristic RPC network alterations in two eyes of ODP, one eye of optic disk coloboma, and two eyes of noncontractile MGDA.
HIGHLIGHTS
OCTA in ODP and coloboma shows absence of RPC microvascular network and a region of capillary dropout. This finding is in contrast to MGDA, where the microvascular network is dense. OCTA is an effective imaging modality to study vascular plexus and RPC and their alteration in congenital disk anomalies, which could provide information about the structural differences among them.
VIDEO LINK
https://youtu.be/TyZOzpG4X4U.
Topics: Humans; Optic Disk; Coloboma; Eye Abnormalities
PubMed: 36872758
DOI: 10.4103/IJO.IJO_2743_22