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We report our experience of treating two patients with ankle amputation with different presentations. The first case was a clean-cut sharp amputation. The second case was an avulsion injury following a motor vehicle accident in a patient who arrived 8 hours after the injury. Replantation was successful in both cases. In avulsion injuries, a secondary operation for wound coverage is required at a later stage. With good strategy and a support team, encouraging limb survival outcomes are possible post-replantation.
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@#Introduction: Lower extremity vascular injury can result in either temporary or permanent disability. Methods: This is a clinical audit involving all patients admitted to our institution from January 2008 to June 2018 of those who had undergone revascularization surgery for lower limb trauma. Results: Fifty-nine patients were in this study with a mean age of 28.1 years. Most of the patients were motorcyclist involved in road traffic accidents with cars (n=30, 50.8%). The popliteal artery was most commonly seen injury (n=41, 69.5%). The mean duration of ischaemia was 14.1 hours. The limb salvage rate was 89.8%. Conclusion: Lower extremity vascular injury caused by RTA treated in our institution predominantly involved young patients aged between 18–30 years associated with long bone fractures causing contusion and thrombosis of the popliteal artery.
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@#When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.
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STUDY DESIGN: A retrospective review of patients who underwent 2-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages for cervical spondylotic myelopathy (CSM). PURPOSE: To evaluate the efficacy of stand-alone PEEK cage in 2-level cervical interbody fusion for CSM. OVERVIEW OF LITERATURE: ACDF is a standard surgical procedure to treat degenerative disc disease. However, the use of additional anterior plating for 2-level ACDF remains controversial. METHODS: We reviewed outcomes of patients who underwent 2-level ACDF with stand-alone PEEK cages for CSM over a 7-year period (2007–2015) in a regional hospital. Japanese Orthopaedic Association (JOA) score, fusion rate, subsidence rate, cage migration, and cervical alignment by the C2–7 angle as well as the local segmental angle (LSA) of the cervical spine were assessed. RESULTS: In total, 31 patients (mean age, 59 years; range, 36–87 years) underwent 2-level ACDF with a cage-only construct procedure between 2007 and 2015. The minimum follow-up was 24 months; mean follow-up was 51 months. C3–5 fusion was performed in 45%, C4–6 fusion in 32%, and C5–7 fusion in 23%. Mean JOA score improved from 10.1±2.2 to 13.9±2.1 (p<0.01) at the 24-month follow-up. Fusion was achieved in all patients. Subsidence occurred in 22.5% of the cages but was not associated with differences in JOA scores, age, sex, or levels fused. Lordosis of the C2–7 angle and LSA increased after surgery, which were maintained for up to 1 year but subsequently disappeared after 2 years, yet the difference was not statistically significant. No cage migration was noted; two patients developed adjacent segment disease requiring posterior laminoplasty 3 years after ACDF. CONCLUSIONS: The use of a stand-alone PEEK cage in a 2-level cervical interbody fusion achieves satisfactory improvements in both clinical outcomes and fusion.
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Animals , Humans , Asian People , Diskectomy , Follow-Up Studies , Laminoplasty , Lordosis , Retrospective Studies , Spinal Cord Diseases , SpineABSTRACT
Background:MicroRNA-9 (miR-9)is involved in the modulation of a variety of physiological process such as organ development and self-renewal and multipotential differentiation of cells. Moreover,its aberrant expression is closely associated with several types of malignant tumors. Aims:To investigate the effect of miR-9 on biological behavior of human gastric cancer cells. Methods:Expression of miR-9 in normal human gastric epithelial cell line GES-1 and human gastric cancer cell line BGC-823 and SGC-7901 was detected by real-time PCR. Then the two gastric cancer cell lines were transiently transfected with miR-9 mimic,miR-9 inhibitor and empty vector,respectively;the efficiency of transfection was assessed by real-time PCR. CCK-8 assay,Transwell assay and wound healing assay were used to examine the cell proliferation and migration capacities. Results:The expression level of miR-9 was significantly higher in gastric cancer cells than in normal gastric epithelial cells (P＜0. 05). Compared with cells transfected with empty vector,overexpression of miR-9 occurred in cells transfected with miR-9 mimic and effectively promoted the proliferation and migration of BGC-823 and SGC-7901 cells (P ＜ 0. 05 ). Conversely,transfection with miR-9 inhibitor significantly suppressed the proliferation and migration of gastric cancer cells (P＜0. 05). Conclusions:Up-regulating miR-9 expression promotes the proliferation and migration of gastric cancer cells,which indicates that miR-9 overexpression may be associated with progression of gastric cancer.
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The management of musculoskeletal tumours has progressed tremendously over the past few decades. Limb salvage surgery has become a standard practise without compromising the oncological outcome. Patients generally will benefit with superior function and a better quality of life compared with definitive amputation. The multidisciplinary approach and advancement of surgeries are important to achieve patient survival and optimum function.
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In this study,the rDNA ITS sequence of isolate of Lactarius deliciosus(L.)Gray was sequenced.Molecular identification was accomplished using phylogenetic tree analysis of 22 Lactarius nrDNA-ITS nucleotide sequence including the 2 new and 20 GenBank sequence.