Subacute Posttraumatic Ascending Myelopathy: Case Report and Systematic Review of the Literature.

STUDY DESIGN: Case report and literature review. OBJECTION: Aim of this study was to summarize the current evidence base behind subacute posttraumatic ascending myelopathy (SPAM) including the epidemiology, presentation, diagnosis, prognosis, and etiology. SUMMARY OF BACKGROUND DATA: SPAM is a rare, potentially fatal disorder which is not attributable to ongoing mechanical instability, syrinx formation, or iatrogenic causes. METHODS: A systematic literature search on SPAM was performed on Medline, Ovid, Cochrane, Embase, and PubMed databases between 1969 and 2021. Cases were reviewed and the findings summarized. Further evidence was reviewed to support the hypothesis that disruption of cerebrospinal fluid (CSF) circulation is the underlying etiology of the condition. RESULTS: It is estimated to occur in 0.4%-0.7% of spinal cord injuries and may have a mortality of up to 10%. The most likely etiology disruption of CSF circulation leading to further damage to the spinal cord presumably through pressure mediated effects such as a reduction in cellular perfusion. CONCLUSION: There is effectively no treatment of this condition, however, with interest developing in monitoring of CSF pressures during spinal cord injury this may help confirm the etiology, and allow the suggestion of therapies such as drains or expansion duraplasty to reduce spinal cord pressures. LEVEL OF EVIDENCE: Level II-case report and systematic review.

Juvenile muscular atrophy of the distal upper extremity (Hirayama syndrome): a systematic review.

INTRODUCTION: Hirayama syndrome is likely caused by a forward displacement of the posterior dura during cervical flexion leading to changes in the muscles of the fingers and wrist. The aim of this systematic review was to document the number of reported cases, the necessity of dynamic MRI of the cervical spine and the subsequent treatment. METHODS AND MATERIALS: A systematic review was conducted and the Pubmed/Medbase, Cochrane, Google, Embase and Ovid database were searched for (Hirayama) AND ((disease) OR (syndrome)). A total of 42 studies were included for analysis reporting 2311 patients. RESULTS: The mean age was 20.2 ± 2.26 years and predominantly males (92.8%) were identified. On MRI the "snake eyes" appearance of the spinal cord was present in 27.8% and the typical time between onset of symptoms and diagnosis was 41.5 ± 16.4 months. A variety of different treatments have been reported, although there is no substantial evidence that any of them are superior to observation. CONCLUSION: The delay in diagnosis from initial presentation of symptoms shows that this condition may be underdiagnosed in a variety of cases. Further, this study shows the necessity of either a dynamic MRI in flexion or a static MRI scan in neutral position and in flexion, to identify functional spinal and/or foraminal stenosis for a prompt diagnosis and subsequent treatment.

Enhancement of the photoelectrochemical conversion efficiency of nanotubular TiO2 photoanodes using nitrogen plasma assisted surface modification.

A synergistic combination of nanostructure synthesis and plasma surface modification was used to enhance the photoelectrochemical activity of titania (TiO(2)) anodes. Titania nanotubular photoanodes were synthesized by electrochemical anodization of Ti thin foils. Nitrogen plasma was used to dope N at the surface of the photoanodes while removing chemisorbed species. X-ray photoelectron spectroscopy analysis showed an increase in the surface concentration of nitrogen. The photocurrent density of plasma treated samples was approximately 80% higher than that of the control. The open circuit potential of the plasma treated samples was more negative compared to that of the control, implying a favorable energetics for water splitting. This increase in photoactivity could be ascribed to: (1) increased absorption of visible light due to bandgap reduction, (2) minimization of charge carrier traps, (3) optimal oxygen vacancies, and (4) increased surface area for enhanced optical absorption and improved charge carrier generation.