Primary Aspergillus spondylodiscitis in a liver transplant recipient / 中华医学杂志(英文版)

Solid organ transplant recipients are at increased risk for Aspergillus infections. However, the cases of Aspergillus spondylodiscitis are rare and mostly resulted from the hematogenous spread of invasive pulmonary Aspergillosis. Here, we report a case of primary spondylodiscitis in a liver transplant recipient. Six months after transplantation, a chronic and progressive lumbar back pain was presented. The patient had no fever and the white blood cell count was normal. High plasma (1→3)-beta-d-glucan (BDG) level was detected at the time of back pain. The pathogen was Aspergillus flavus. Clinical and radiological healing was achieved through posterior only debridement and voriconazole therapy.

Intramedullary fixation of subtrochanteric fractures with long proximal femoral nail or long gamma nail: technical notes and preliminary results

<p><b>INTRODUCTION</b>The objective of this study was to prospectively evaluate the clinical outcome of traumatic subtrochanteric fractures fixed with long proximal femoral nail (PFN) or long gamma nail with particular emphasis on our experience of surgical techniques.</p><p><b>MATERIALS AND METHODS</b>We reviewed the results of 49 consecutive patients who had undergone intramedullary fixation specifically with a long PFN or a long gamma nail for traumatic subtrochanteric fractures in our hospital during a 2-year period from January 2003 to December 2004. The average age of the patients was 53 years. Clinical and radiographic analyses were performed when follow-up was made at 6 weeks, 12 weeks, 6 months, 1 year and 2 years.</p><p><b>RESULTS</b>All the 49 traumatic subtrochanteric fractures healed uneventfully except 1 case of delayed union. Walking and squatting ability was completely restored in every case at follow-up examination 6 months postoperatively. Among them, 32 fractures were successfully reduced with traction on a fracture table under fluoroscopy, but cerclage wiring or cable bandage through a small incision was needed in the other 17 cases. The average operative time was 46 minutes (range, 21 to 98). Eighteen Seinsheimer type II fractures were left unlocked distally, and static distal interlocking with 1 bolt was carried out in the other 31 cases. No complications such as cutout or breakage of the implants were encountered.</p><p><b>CONCLUSIONS</b>This study suggests that long PFN or long gamma nail is a reliable implant for subtrochanteric fractures, leading to high rate of bone union and minimal soft tissue damage. Intramedullary fixation has biological and biomechanical advantages, but the operation is technically demanding. Gradual learning and great patience is needed in order to make this method truly minimally invasive.</p>

Micro-CT observation on blood vessels in tibial metaphysis of ovariectomized mice / 上海第二医科大学学报

Objective To observe the distribution of blood vessels in tibial metaphysis in ovariectomized and control mice by micro-CT(?CT),and investigate the relationship between bone regional blood supply and osteoporosis. MethodsForty mice were randomly divided into ovariectomy group(n=20) and control group(n=20).Four weeks after operation,?CT analysis was conducted to observe the bone blood vessel distribution after silicone rubber perfusion,and bone mineral density measurement,?CT bone microarchitecture analysis and biomechanical test were performed. Results Bone mineral density,bone microarchitecture in ?CT analysis,biomechanical properties and bone blood vessel distribution in ?CT analysis of ovariectomy group were significantly lower than those of control group(P

Imaging diagnosis of thoracolumbar burst fractures / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic value of different imaging methods.</p><p><b>METHODS</b>One hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Plain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively.</p><p><b>RESULTS</b>A total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thoracolumbar burst fractures, leading to delay in diagnosis.</p><p><b>CONCLUSION</b>In regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression fractures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.</p>

Loss of bone mass after Colles' fracture: a follow-up study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Colles' fracture usually associated with osteoporosis is regarded as the predictor of subsequent osteoporotic fracture. However, it is not clear how the local changes of bone mass take place during the course of treatment and whether the changes are related to clinical practice. The objective of the current study was to investigate the local changes of bone mass in patients with Colles' fracture and their possible clinical relevance in a follow-up study.</p><p><b>METHODS</b>The radiograms of the second metacarpal in 64 patients with Colles' fracture were assessed for bone density immediately after fracture, 6 weeks, 6 months and 1 year after fracture, respectively. Functional results were evaluated at one year.</p><p><b>RESULTS</b>Bone mass six weeks after Colles' fracture was significantly decreased without returning to normal at one year though increased bone mass had been identified 6 months after fracture (P < 0.05), (P < 0.01). At one year significant (P < 0.05) or highly significant (P < 0.01) correlations were observed between bone mass indices of metacarpal and functional results, indicating that poor function is associated with lower bone density. Significant differences (P < 0.05) between fracture patterns also suggested that patients with more severe fractures have a more pronounced bone loss.</p><p><b>CONCLUSIONS</b>Bone loss during the course of treatment will have a direct effect upon the prognosis, so different treatment should be proposed for different patterns of fractures. Active exercise should be made to improve the recovery of bone mass.</p>