ABSTRACT
Objective To evaluate the incidence and microbiology profile of infectious complications ( namely menin-gitis and/or bacteremia ) after trans-sphenoidal pituitary adenomectomies ( TSPA ) .Methods All hospitalized patients undergoing TSPA in Dept .Neurosurgery of Peking Union Medical College Hospital ( PUMC) between January 2012 and December 2016 were retrospective recorded .Results The incidence of postoperative meningitis and/or bacteremia was 1.2%( 59/5098) .27 cases of meningitis were documented for a total of 41 isolates, 26 cases of bacteremia for 34 isolates, and 6 cases of coinfection.Gram-positive organisms predominated (27 cases, 65.9%) in meningitis, among which Coagulase-negative staphylococci were the main isolates (14 cases).The most common organisms causing bacteremia were Gram-negative organisms (25 case,73.5%),including Klebsiella pneu-monia ( 9 cases ) , Enterobacter aerogenes ( 7 cases ) and Escherichia coli ( 5 cases ) , all of which were sensitive to amikacin, imipenem and meropenem .Fifty-two patients were cured after antibiotic treatment , whereas 7 died.The morality in patients with meningitis was relatively lower than those with bacteremia (21.2%vs 3.1%,P<0.001). Conclusions Postoperative meningitis and/or bacteremia can occur after TSPA .They differ in etiology profile and prognosis , and should be treated with proper antibiotics according to the drug resistance .
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OBJECTIVE: To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. METHODS: A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. RESULTS: Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and 5.34degrees compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by 8.32degrees (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). CONCLUSION: In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.
Subject(s)
Humans , Absorptiometry, Photon , Bone Density , Bone Diseases, Metabolic , Congenital Abnormalities , Fractures, Compression , Inflation, Economic , Kyphoplasty , Osteoporosis , SpineABSTRACT
<p><b>OBJECTIVE</b>To explore surface roughness of bone cement and surround tissue on histological characteristic of induced membranes.</p><p><b>METHODS</b>Bone cements with smooth and rough surface were implanted in radius bone defect, intramuscular and subcutaneous sites of rabbits, and formed induced membranes. Membranes were obtained and stained (HE) 6 weeks later. Images of membrane tissue were obtained and analyzed with an automated image analysis system. Five histological parameters of membranes were measured with thickness,area,cell density,ECM density and microvessel density. Double factor variance analysis was used to evaluate the effect of the two factors on histological characteristics of induced membranes.</p><p><b>RESULTS</b>Membranes can be induced by each kind of bone cement and at all the three tissue sites. In histological parameters of thickness,area and micro vessel,there were significant differences among the membranes induced at different tissue sites (P = 0.000, P = 0.000, P = 0.000); whereas, there were no significant differences in histological parameters of cell density and ECM density (P = 0.734, P = 0.638). In all five histological parameters of membranes, there were no significant differences between the membranes induced by bone cements with different surface roughness (P = 0.506, P = 0.185, P = 0.883, P = 0.093, P = 0.918).</p><p><b>CONCLUSION</b>Surround tissue rather than surface roughness of bone cements can affect the histological characteristics of induced membranes. The fibrocystic number, vascularity, mechanical tension and micro motion of the surround tissue may be closely correlated with the histological characteristics of induced membranes.</p>