Man-made soil drainage alters the vegetation structure and woody species distribution in campo de murundus

Campos de murundus work as recharge zones and are important for the maintenance of water resources in Brazilian Cerrado. However, with the expansion of the agricultural frontier, this ecosystem may disappear or suffer high anthropogenic disturbances. The aim of the study was to evaluate the structure and distribution of woody species, after the implantation of artificial drainage channels in campo de murundus, in plots near and distant of the drains in the soil. We sampled woody individuals with ≥ 3 cm diameter at the base, and established 20 permanent plots of 20×50 m, 10 of which were between 0-20 m of the drains (edge) and 10 between 150-200 m distant from the drains (interior), totaling two hectares of survey. We recorded 47 species with total density of 230.5 ind.ha-1 and total basal area of 1.331 m2 ha-1. The diversity index of species was H’ = 3.18. We recorded higher density and basal area in the edge, and differential distribution and occupation of woody species in the microrelief of the murundus. This provides us strong evidence that the drains have altered the vegetation structure, especially in the edge of the remnant campos de murundus turning the vegetation woodier and denser.

Therapeutic Effect of Posterior Decompression, Internal Fixation and Interlaminar Fusion for Severe Osteoporotic Vertebral Fractures and Collapse Complicated with Spinal Canal Encroachment / 广州中医药大学学报

Objective To evaluate the clinical effect of posterior decompression, internal fixation and interlaminar fusion for the treatment of severe osteoporotic vertebral fracture and collapse complicated with spinal canal encroachment. Methods A retrospective study was carried out in 27 cases of severe osteoporotic vertebral fractures complicated with spinal canal encroachment. The patients were treated with posterior decompression, internal fixation and interlaminar fusion during the period from January 1, 2009 to December 31, 2014. All patients were given vertebral pedicle screw fixation after pedicle augmentation with bone cement. The pain scores of visual analogue scale(VAS), Oswestry Disability Index(ODI), Cobb angle , thoracolumbar Cobb angle and the recovery of neurological function(estimated by Frankel grading system) of the patients were compared beforeoperation, one week after operation and at the end of follow-up. The incidences of internal fixation failure, adjacent vertebral fracture and bone cement leakage also were recorded. Results The patients were followed up for an average of 27 months. The spinal canal occupation rate caused by fracture fragment of posterior vertebral wall was 27.41%~63.85%, with an average of(43.24 ± 10.61)%. Postoperative VAS pain scores, ODI, Cobb angle and thoracolumbar Cobb angle were statistically different from those before operation (P 0.05). In respect of Frankel grading of neurological function at the end of the follow-up, 6 cases were in grade D and 19 cases were in grade E, but the differences were insignificant compared with those before operation (P > 0.05). None of the patients had surgical site infection, screw looseness or breakage, or rod breakage during the follow-up period. There were 8 patients with asymptomatic bone cement leakage after operation. Vertebral compression fractures recurred in 5 patients, of which 2 had adjacent vertebral fractures and 3 had non -adjacent segment. Conclusion The therapy of posterior decompression, internal fixation and interlaminar fusion is effective for the treatment of severe osteoporotic vertebral fracture and collapse complicated with spinal canal encroachment by obviously relieving pain, improving the physiological function of the spine and stabilizing the spine.

Measurement of Canal Encroachment Using Axial and Sagittal-Reconstructed Computed Tomographic Images in Thoracolumbar Burst Fractures

STUDY DESIGN: A retrospective study. OBJECTIVES: The aim of this study was to examine the usefulness of axial and sagittal-reconstructed CT images in the evaluation of spinal canal encroachment by thoracolumbar burst fractures. SUMMARY OF LITERATURE REVIEW: The dimensions of spinal canal encroachment by burst fractures have been described using axial CT images in the thoracolumbar region and sagittal-reconstructed images in the lower cervical region. However, the validity and reliability, depending on the measuring method, have not been fully evaluated. MATERIALS AND METHODS: A hundred and ninety-nine patients, who had diagnosed as a thoracolumbar burst fracture, were included in this study. Three orthopedic surgeons independently measured the canal encroachment of the burst fragment in the axial CT images and the sagittal-reconstructed images using the ratio of spinal length (method 1) and the ratio of area (method 2). The validity for the evaluation of the deformity and fracture stability was evaluated. In addition, the reliability of each method was assessed. RESULTS: Sixty-seven stable burst fractures and 132 unstable burst fractures were assessed. The mean kyphotic angle of stable and unstable burst fracture were 11.89 +/- 8.49degreesand 15.90 +/- 9.63degrees(P=0.005). The mean canal encroachment ratios of stable fracture were 17.21 +/- 15.82 % (axial-method 1), 16.71 +/-16.49 % (axial-method 2), 19.54 +/- 17.03 % (sagittal reconstructed-method 1), and 11.75 +/- 12.33 % (sagittal reconstructed-method 2). The mean canal encroachment ratios of unstable fracture were 31.54 +/- 17.10 % (axial-method 1), 29.67 +/- 18.47 % (axial-method 2), 28.53 +/- 18.60 % (sagittal reconstructed-method 1), and 21.20 +/- 15.11 % (sagittal reconstructed-method 2). There was no relationship between the fracture deformity and the canal encroachment ratio in all 4 methods. All ratios in the 4 method showed significant differences in the evaluation of fracture stability. All methods except method 1 in the sagittal-reconstructed images showed significant differences in the assessment of neurologic compromise. CONCLUSIONS: The measurement of a canal encroachment area using axial and sagittal-reconstructed images was valid in the description of fracture stability.

Conservative Treatment of Lumbar Disc Herniation: A Prospective Study of Disc Herniation Encroaching More than One-third of Spinal Canal

STUDY DESIGN: Prospective study. OBJECTIVES: To investigate the clinical results of conservative treatment for mid-to-large lumbar disc herniation diagnosed via magnetic resonance imaging (MRI) and the factors influencing treatment. SUMMARY OF LITERATURE REVIEW: There is limited information regarding the clinical results of conservative treatment for lumbar disc herniation. The recent studies using MRI have suggested favorable treatment results. MATERIALS AND METHODS: The study subjects were 39 cases of herniated disc patients with over a 1/3 spinal canal encroachment -- based on MRI -- that were followed up for at least 1 year. The average age was 42.6-years-old (range of 12-76 years-old), and the average follow-up period was 28 months. The neurological deficit and the visual analogue scale (VAS) of back pain and radiating pain at the time of initial diagnoses and final follow-ups were compared, and the clinical results were evaluated based Kim & Kim's criteria. RESULTS: Although 4 of the 39 patients needed to undergo surgery during the follow-up period, 33 of the remaining 35 patients showed satisfactory (excellent and good ratings) results: 27 excellent, 6 good, 2 fair, i.e., a 85% (33 out of 39) satisfactory results. Of the 14 cases that had neurological defect at the initial diagnosis, only 1 case needed surgery, thereby resulting in a 93% (13 out of 14) satisfactory result. There were no statistically significant correlations among the degree of spinal canal encroachment and other factors such as age, sex, herniation type, and neurological deficit at initial diagnosis, and the clinical results at the final follow-up, conversion to surgery during follow-up, and remaining pains. CONCLUSIONS: The clinical results of conservative treatment in lumbar disc herniation were satisfactory even in cases of high degree of spinal canal encroachment. Therefore, conservative treatment of lumbar disc herniation should be considered first before resorting to surgical treatment.

Histopathological change of axillary lymph nodes and ecto-node encroachment of breast cancer following neoadjuvant chemotherapy in locally advanced breast Cancer / 国际外科学杂志

Objective To investigate histopathological change of axillary lymph nodes and ecto-node encroachment of breast cancer following neoadjuvant chemotherapy in locally advanced breast cancer.Methods Second Hospital Affiliated to University of South China had received 86 patients with breast carcinoma from June 2002 to August 2009,these patients suffered lump over 5 cm and homonymy nonfusion lymphadenectasis.All samples were grouped on the basis of wether or not accept neoadjuvant chemotherapy.The first group included 46 patients,who were reluctant to receive neoadjuvant chemotherapy,operated after pricking pathological diagnosis.There were 40 patients with metastatic axillary lymph nodes and 17 patients with axillary ecto-node encroachment in the first group.The second group included 40 patients,who were voluntary to receive neoadjuvant chemotherapy,and operated after pricking pathological diagnosis and received three cycles of neoadjuvant chemotherapy on average.There were 26 patients with metastatic axillary lymph nodes and 6 patients with axillary ecto-node encroachment in the second group.Results The rate of metastatic axillary lymph nodes was 86.9% and the rate of axillary ecto-node encroachment was 36.9% in the first group,while 65% and 15% respectively in the scond group.There were significant deference in the rate of metastatic lymph node and axillary ecto-node encroachmen between two groups.Conclusion Neoadjuvant chemotherapy is effective to treat metastatic lymph node and axillary ecto-node encroachment in breast cancer.

The Effect of Pedicle Screw Instrumentation on Fractured Vertebrae in Unstable Thoracolumbar Burst Fractures with Canal Encroachment and Clinical Result / 대한척추외과학회지

STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the canal encroachment of fractured bony fragments and neurological deficits of pedicle screw instrumentation for the treatment of unstable thoracolumbar burst fractures with pedicle screws inserted into the fractured vertebrae. MATERIALS AND METHODS: The authors evaluated 18 patients treated surgically with posterior fusions using pedicle screws for unstable thoracolumbar burst fractures, from March 2000 to September 2004. The ratios of the areas occupied by the fractured bony fragments in the canals were analyzed, before and after pedicle screw insertion, by computed tomography scans of the fractured vertebrae. The kyphotic angles, anterior vertebral heights, and neurological deficits were evaluated. RESULTS: The areas occupied by the fractured fragments in the canals were improved significantly after surgery and there were no neurological complications resulting from the placement of pedicle screws or fragment displacements. The kyphotic angles and anterior vertebral heights at the last follow-up visits were improved significantly compared with the preoperative radiographs. The neurological deficits were not aggravated after pedicle screw insertion. CONCLUSION: Our results suggest that pedicle screw instrumentation in fractured vertebrae is safe and effective for the treatment of unstable thoracolumbar burst fractures.

Arthroscopic Finding of Anterior Cruciate Ligament with Femoral Intercondylar Notch Stenosis

PURPOSE: My goal was to evaluate and summarize the results of treatment of patients with anterior cruciate ligament injury with intercondylar notch stenosis. MATERIALS AND METHODS: I reviewed the 8 anterior cruciate ligament(ACL) injuries with inte#rcondylar notch stenosis treated between November 1996 and August 1999. A study group of 8 consecutive patients underwent a magnetic resonance imaging(MRI) evaluation for unspecified knee pain and swelling. The inetrcondylar notch width were measured with MRI at the notch entrance, at the central notch. Arthro- scopic surgery in all patients was performed. RESULTS: Several patients had clinical symptoms and signs of patello femoral syndrome, unspecified synovitis, etc. that it has limited specific diagnostic value, but nobody showed motion loss of their knees or evidence of instability. MRI demonstrated intrasubstance edema of ACL impling a complete tear in sagittal image. Absolute widths at notch entrance were ranged 11 14mm in men, 10 12mm in women. At the central notch, notch widths measured 13-19mm in men and 11-16mm in women. Arthroscopic finding revealed impingement with whole notch stenosis(5 cases) or with encroachment of lateral notch wall(3 cases). ACLs of all patients were frayed, but those of 2 patients were partially torn. No chondral lesions or degenerative changes were noted. A 3-5mm notchplasty was performed to remove of bone at the anteri- or outlet of the intercondylar notch in all patients. In one patient, the MRI study performed 19 months postoperatively revealed normal ACL signal. I underwent second-look arthroscopy 2 years postoperative- ly in another one patient. The notchplasty site appeared to have minimally recorticated and ACL showed almost normal state. After 17 months of average follow-up, every clinical symptoms and signs was signif- icantly disappeared in 6 patients. On the other hand, 1 patients have intermittent pain and joint swelling over their knees and need some medicine. One of 8 patients had a tear of his ACL at 20 months after notchplasty and underwent anterior cruciate ligament reconstruction. CONCLUSTION: Although the small cases were evaluated, there was a trend that the patients with narrower notches or with encroachment of the lateral walls have abnormal clinical symptoms and signs. I believe that sufficient understanding of the disease and early performance of notchplasty with arthroscopy may prevent the possibility of complete rupture.

Spinal Canal Remodelling after Stabilization of Thoracolumbar Burst Fractures / 대한정형외과학회잡지

About half of all burst fractures at the thoracolumbar junction lead to neurological impairment and several clinical series have demonstrated a statistically significant correlation between canal encroachment and neurologic impairment, but not directly related. Spontaneous canal remodelling over time due to bone resorption has been observed in conservatively treated burst fractures. The aim of this study was to measure spinal canal remodelling after stabilization of burst fractures. So, we evaluated 22 cases of surgically stabilized burst fractures of thoracolumbar junction about pre and postoperative spinal canal stenotic ratio and canal remodelling by bone resorption over time. The results were as follows; l. Pedicle splaying increases the spinal canal area and necessitates correction. 2. Patients with neurological deficits had average 53% encroachment and the neurological normal patient had a canal compromise of 33.9%. 3. Postoperatively canal encroachment had decreased to a mean of 17.4% and further reduced by resorption of bony fragment to a mean of 8.3% within 14 months. In conclusions, remodelling of the spinal canal by resorption of encroaching bone fragments is a consistent feature in surgically stabilized thoracolumbar burst fractures and most patients regain their prefracture canal demensions within 14 months.

Discussion of proof-providing methods, procedures and contents in medical encroachment disputes / 中华医院管理杂志

Objective To enable medical institutions and personnel in the case of a medical encroachment dispute to provide precise proof in court, use standard format for the legal complaint, employ the appropriate proofgathermg method, ensure the simplicity of the proof-providing procedure, and avoid the waste of manpower and material resources and the liability of economic compensations in the course of compromise settlement, mediation by the health administrative department or adjudication by the court. Methods Regulations were laid down within the hospital for proof-providing procedures, methods, contents, the contents and format of legal complaints and reply letters, and documents in preparation for the provision of proof. Results Through the handling of over 900 medical encroachment disputes, the above methods proved to be practical, applicable and up to the standard. They could save the time of the hospital, the patient and the lawyer on blind surveys, reduce proof-providing time, and improve efficiency in handling medical encroachment disputes. Conclusion Standardizing proof-providing procedures, methods, and contents and the format of legal complaints or reply letters is of great significance in improving efficiency in handling medical encroachment disputes and reducing the hospital's chances of losing lawsuits.