MRI Measurement of Neuroforaminal Dimension at the Index and Supradjacent Levels after Anterior Lumbar Interbody Fusion: A Prospective Study

BACKGROUND: Anterior interbody fusion has previously been demonstrated to increase neuroforaminal height in a cadaveric model using cages. No prior study has prospectively assessed the relative change in magnetic resonance imaging (MRI) demonstrated neuroforaminal dimensions at the index and supradjacent levels, after anterior interbody fusion with a corticocancellous allograft in a series of patients without posterior decompression. The objective of this study was to determine how much foraminal dimension can be increased with indirect foraminal decompression alone via anterior interbody fusion, and to determine the effect of anterior lumbar interbody fusion on the dimensions of the supradjacent neuroforamina. METHODS: A prospective study comparing pre- and postoperative neuroforaminal dimensions on MRI scan among 26 consecutive patients undergoing anterior lumbar interbody fusion without posterior decompression was performed. We studies 26 consecutive patients (50 index levels) that had undergone anterior interbody fusion followed by posterior pedicle screw fixation without distraction or foraminotomy. We used preoperative and postoperative MRI imaging to assess the foraminal dimensions at each operated level on which the lumbar spine had been operated. The relative indirect foraminal decompression achieved was calculated. The foraminal dimension of the 26 supradjacent untreated levels was measured pre- and postoperatively to serve as a control and to determine any effects after anterior interbody fusion. RESULTS: In this study, 8 patients underwent 1 level fusion (L5-S1), 12 patients had 2 levels (L4-S1) and 6 patients had 3 levels (L3-S1). The average increase in foraminal dimension was 43.3% (p 0.05). CONCLUSIONS: Anterior interbody fusion with a coriticocancellous allograft can significantly increase neuroforaminal dimension even in the absence of formal posterior distraction or foraminotomy; anterior interbody fusion with a coriticocancellous allograft has little effect on supradjacent neuroforaminal dimensions.

[Prevalence of fungal and fungal like superficial infections in patients who refered to skin clinic of Arak university of medical science]

There are wide-ranging types of fungal infection and dependent on the site of involvement it is divided into five groups; superficial, cutaneous, mucocutaneous, subcutaneous and visceral infections. In humans cutaneous infection includes skin hair and nail disease. This study was done on 148 patients suspected to fungal infection. Samples were studied by direct smear and culture in S, SC and SCC culture media. From 148 patients referred to Medical laboratory, 90 patients had cutaneous infection [60.8%] among which 11 were infected with Tinea versicolor [12.23%], 4 with Candidiasis [4.44%], 73 with dermatophytosis [81.11%] and finally 2 patients with Demodecosis [2.22%]. In this study, dermatophytosis was the most prevalent infection and Tinea corporis had the most incidence among fungal infections. T. verocosome, a zoophyllic fungus, was the main culprit

Fungal nail infections in Tehran, Iran

Onychomycosis results from invasion of the nail plate by dermatophytes, yeasts or mould species of fungi. The objective was to determine the etiological agents of onychomycosis. A total of 549 patients clinically suspected of onychomycosis were examined for causative fungal agents. Both direct microscopy and the cultures of the nail material were performed to identify the causative agents between 2004-2005 in Tehran, Iran. Out of 549 cases examined, 263 [47.9%] were mycologically proven cases of onychomycosis [139 finger, 124 toe nails], among those 33 [6.09%] were only positive in direct microscopic examination. From an etiological point of view, 21.85% of nail infections were caused by yeasts, 10.55% were infected by dermatophytes and 15.5% by non-dermatopyte moulds.Candida albicans was the common yeast causative agent [16.73%] followed by A. flavus [11.78%], T. mentagrophytes [10.26%], [2.66%], Aspergillus spp [1.90%], each of Rhizopus spp and Cladosporium spp [1.52%], C.giulliermondii [1.14%], Scopolariopsis spp. [1.14%], each of C. famata, C.glabrata, C. krusei, S. lusitania, Acremonium spp. [0.76%] and C. homicola [0.38%], T. rubrum [4.94%]. Candida species were most common responsible agent for onychomycosis in female hands [74.1%] followed by 17.26% non-dermatophyte moulds. Dermatophytes caused tinea unguim of hand [8.63%] and peduum [37.1%] in males. The yeasts of the Genus Candida and non-dermatophyte moulds are dominant cause of female finger nail onychomycosis and dermathophytes are principal causes of both finger and toe nails in males in Tehran

Toxoplasma gondii infection in neonates

To study toxoplasmosis in neonates using PCR and serological methods. Sera and CSF of 104 neonates, hospitalized in infants' ward of Taleghani Hospital, Tehran, Iran were examined. The sera were examined for anti Toxoplasma gondii lgM and lgG specific antibodies with ELISA and IFA techniques, respectively. Meanwhile, obtained CSFs of the cases were evaluated for the genome of this parasite by PCR technique. Results showed positivity in 7 neonates [6.73%] which suggested congenital toxoplasmosis. Results of PCR were positive in 6 neonates [5.77%]. The 1/100 titer of lgM specific antibodies was positive in 5[4.81%] of them by IFA technique and 6 neonates [5.77%] had positive results by ELISA technique for IgM specific. The rate of mortality was 0.96%. Forty one neonates had 1/200 titer of specific lgG antibodies by IFA technique and 38 neonates had positive results by ELISA technique for IgG antibodies. The prevalence of chronic toxoplasmosis in mother was 32.7% and 30% by IFA and ELISA techniques, respectively. Toxoplasmosis is still highly prevalent in neonates and should be considered due to the fact that suspected cases might be misdiagnosed and subsequently led to life- threatening or fatal condition

Seroepidemiology assay of toxoplasmosis in infants who were confined to bed in infants ward of Taleghani hospital during 1379-1380

As some of the mortality and morbidity of infants who are less than one year, is related to contamination with Toxoplasma gondii parasite during fetal time, the aim of this survey is to study the prevalence of Toxoplasmosis in infants visiting Taleghani medical center during 1379-1380. In this survey the sera of 106 and 104 newborn infants from 1 day to 1 month who were suspected to congenital Toxoplasmosis and were hospitalized in Infantile ward of Taleghani hospital were evaluated for IgM and IgG specific antibodies with ELISA and IFA techniques, respectively. According to the results of IFA technique, if the 1/100 is the minimum titer for specific Ig M antibody against Toxoplasmosis, 5 infants were positive and if 1/200 is the minimum titer for specific Ig G antibody against Toxoplasmosis, 41 infants were positive. 6 infants had specific Ig M antibody and 38 infants had specific IgG antibody against Toxoplasmosis by ELISA technique. As a whole, 6 infants [5.66%] were positive which were suggested congenital Toxoplasmosis. With deletion of 6 infected infants, the prevalence of chronic Toxoplasmosis between the mother whose infant was confined in Taleghani hospital was 34 percent by IFA and 30.2 percent by ELISA technique

[Seroepidemiology assay of toxoplasmosis in infants who was confined to bed in infants ward of Taleghani hospital during 1379-1380]

Background: As some of the mortality and morbidity of infants who are less than one y ear, is related to contamination with Toxoplasma gondii parasite during fetal time, the aim of this survey is to study the prevalence Toxoplasmosis in infants visited Taleghani medical center during 1379-1380

Materials and methods: In this survey the sera of 106 and 104 newborn infants from 1 day to 1 month who were suspected to congenital Toxoplasmosis and were hospitalized in Infantile ward of Taleghani hospital were evaluated for lgM and lgG specific antibodies with ELISA and IFA techniques, respectively

Results: According to the results of IFA technique, if the 1/100 is the minimum titer for specific lg M antibody against Toxoplasmosis, 5 infants were positive and if 1/200 is the minimum titer for specific lgG antibody against Toxoplasmosis, 41 infants were positive. 6 infants had specific lg M antibody and 38 infants had specific lgG antibody against Toxoplasmosis by ELISA technique

Conclusions: As a whole, 6 infants [5.66%] were positive which were suggested congenital Toxoplasmosis. With deletion of 6 infected infants, the prevalence of chronic Toxoplasmosis between the mother whose infants was confined in Taleghani hospital was 34 percent by IFA and 30.2 percent by ELISA technique

puzzle of the false positive reaction in Cr neoformans'es capsular antigen slide latex agglutination test by sera of patients with rheumatoid arthritis

Different examination have shown that rheumatoid factor is not responsible for false positive reaction [F.P.R.] in Cr. Neoformanse's free capsular antigen latex agglutination test, whereas high levels of iron in sera of patients with rheumatoid arthritis as well as other sera was responsible not only for this F.P.R., but also had an important role in the production of F.P.R. in many slide latex agglutination tests. This is because of Iron's Ion reaction with reagent's preservative: sodium azid and/or negative charge of the antigens fixed to the latex particles