Recurrence after surgical treatment of hydatid cyst of the spine is extremely common. Preexisting fibrosis, fragility of the cyst wall, confluent cysts and proximity to vital structures makes radical ...excision difficult and repeated recurrences are inevitable. This case report describes a recurrent hydatid cyst presenting as three separate cysts in the dorsal spine in a middle-aged male. The extradural cyst caused paraplegia. The extraspinal cyst presented as an extrapleural mass in relation with the eighth, ninth and the tenth ribs near the costo-vertebral junction. The three cysts were resected en masse. Complete neurological recovery occurred with no recurrence at four years follow-up. Resection of the hydatid cyst en masse offers the best chance of cure and must be attempted in all cases. A prolonged chemotherapy should be administered in all cases.
We report a rare patient of a simultaneous extradural and intradural compression of the cervical spinal cord due to co-existent intervertebral disc herniation and an intradural schwannoma at the same ...level. The intradural lesion was missed resulting in recurrence of myelopathy after a surprisingly complete functional recovery following anterior cervical discectomy. Retrospectively, it was noted that the initial cord swelling noticed was tumor being masked by the compression produced by the herniated disc. A contrast magnetic resonance imaging scan is important in differentiating intradural tumors of the spinal cord. A high index of suspicion is often successful in unmasking both the pathologies.
BACKGROUNDSteroid-related spinal epidural lipomatosis (SEL) is a well-known condition most commonly encountered in patients taking chronic steroid medications. Endogenous Cushing syndrome is a rare ...cause of SEL. The authors report an unusual presentation of acute thoracic myelopathy due to SEL with osteoporotic vertebral compression fractures in a patient with Cushing disease. CASE DESCRIPTIONA 33-year-old man presented with thoracic myelopathy due to SEL and multiple vertebral compression fractures. He had Cushingoid clinical features, and investigations revealed a pituitary microadenoma as the cause of hypercortisolism. The diagnosis was missed on multiple occasions before the onset of paraparesis. The patient was treated with urgent thoracic laminoplasty followed by transsphenoidal surgery on the same day. Although normalization of the serum cortisol levels was delayed by 6 months, he had a complete neurologic recovery and remains symptom free at 2 years follow-up. CONCLUSIONSThis is a rare presentation of Cushing disease and has been reported only twice before in the 1990s. This case highlights the need to keep a high degree of suspicion for development of thoracic myelopathy in a patient with Cushing syndrome who develops thoracic compression fractures associated with SEL. Early recognition of this clinical association and addressing the primary endocrine problem urgently could have prevented spinal cord involvement and the subsequent spine surgery. This scenario is also documented in previous published case reports of this association where the diagnosis of Cushing syndrome has been revealed retrospectively after the development of neurologic symptoms.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Minimally invasive approaches to the lumbar spine continue to gain in popularity due to reduction in approach-related morbidity compared to the traditional midline open techniques. One of the more ...common surgical conditions in the lumbar spine in the adult population is isthmic or degenerative spondylolisthesis. The surgical management of spondylolisthesis requires decompression and stabilization. This chapter will highlight the minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) technique for this pathology. In skilled hands, this technique is ideal for the surgical management of spondylolisthesis because it provides a structural interbody implant, provides for direct and indirect decompression, and allows for pedicle screw insertion.
Diagnosis of extrapulmonary tuberculosis (EPTB) poses serious challenges. A careful selection of appropriate gene targets is essential for designing a multiplex-polymerase chain reaction (M-PCR) ...assay.
We compared several gene targets of Mycobacterium tuberculosis, including IS6110, devR, and genes encoding MPB-64 (mpb64), 38kDa (pstS1), 65kDa (hsp65), 30kDa (fbpB), ESAT-6 (esat6), and CFP-10 (cfp10) proteins, using PCR assays on 105 EPTB specimens. From these data, we chose the two best gene targets to design an M-PCR.
Among all gene targets tested, mpb64 showed the highest sensitivity (84% in confirmed cases and 77.5% in clinically suspected cases), followed by IS6110, hsp65, 38kDa, 30kDa, esat6, cfp10, and devR. We used mpb64+IS6110 for designing an M-PCR assay. Our M-PCR assay demonstrated a high sensitivity of 96% in confirmed EPTB cases and 88.75% in clinically suspected EPTB cases with a high specificity of 100%, taking clinical diagnosis as the gold standard.
These M-PCR results along with the clinical findings may facilitate an early diagnosis of EPTB patients and clinical management of disease.
OBJECTIVES: Psoriasis is a chronic inflammatory disease showing co-existence with metabolic syndrome (MS), as has been confirmed by numerous epidemiologic studies in recent times. In this study, the ...aim was to ascertain the beneficial effects of pioglitazone in psoriasis, simultaneously targeting the improvement of MS parameters.
MATERIALS
AND METHODS: We conducted a prospective randomized open-labeled parallel-group interventional study in patients of moderate-to-severe chronic plaque psoriasis. A total of 90 patients were inducted in study and divided into three groups of standard treatment (methotrexate 7.5 mg/week for 12 weeks), active treatment (pioglitazone 15 mg tablets once daily for 12 weeks), and their combination. Primary outcome was taken as percentage Psoriasis Area and Severity Index (PASI) improvement from baseline; secondary outcomes were PASI-75, safety profile, and MS parameters.
RESULTS: Intergroup evaluation of PASI score showed that standard treatment methotrexate and active treatment pioglitazone were comparable. Combination of methotrexate and pioglitazone proved superior in efficacy from both standard and active treatment in 8 and 12 weeks. Adverse drug reactions were mild and treated symptomatically. Pioglitazone and combination group also demonstrated beneficial efficacy in parameter of MS hence establishing it as a potential therapy in psoriasis with MS.
CONCLUSIONS: Pioglitazone alone or in combination with standard treatment may be a safe alternative drug for psoriasis coexisting with MS proving beneficial for both.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
In this paper, we present a method for generating bird’s eye video from egocentric RGB videos. Working with egocentric views is tricky since such the view is highly warped and prone to occlusions. On ...the other hand, a bird’s eye view has a consistent scaling in at least the two dimensions it shows. Moreover, most of the state-of-the-art systems for tasks such as path prediction are built for bird’s eye views of the subjects. We present a deep learning-based approach that transfers the egocentric RGB images captured from a dashcam of a car to bird’s eye view. This is a task of view translation, and we perform two experiments. The first one uses an image-to-image translation method, and the other uses a video-to-video translation. We compare the results of our work with homographic transformation, and our SSIM values are better by a margin of 77% and 14.4%, and the RMSE errors are lower by 40% and 14.6% for image-to-image translation and video-to-video translation, respectively. We also visually show the efficacy and limitations of each method with helpful insights for future research. Compared to previous works that use homography and LIDAR for 3D point clouds, our work is more generalizable and does not require any expensive equipment.
The influence of small molecule (SM) α, ω-di-hexyl-sexithiophene (DH6T) concentration, in the blends of conjugated polymer (CP) poly (3-hexylthiophene) (P3HT) and DH6T, was investigated in terms of ...barrier potential reduction and improved photoresponse of the fabricated photoconductor using these blends. Barrier potential in Au/P3HT:DH6T/Au device structure, occurring at the interface of Au (top)/P3HT:DH6Twas estimated by Fowler Nordheim (FN) tunneling model-based analysis of I-V characteristics. The barrier potential of the fabricated device was observed to decrease upon addition of a small quantity of DH6T in comparison to the pristine polymer-based device. This reduction in barrier was attributed to the improved ordering and morphology of the polymer chains upon blending it with an SM. The variation in the ordering of the polymer chains was further confirmed with Photoluminescence spectroscopy, Absorption spectroscopy, and XRD data. Subsequently, it was also observed that only up to a definite SM concentration (25% in this study) ordering of polymer chains improved causing a reduction in barrier potential and subsequent improvement in the photoresponse of the fabricated devices. Finally, it was observed that the optimized blending of CP and SM could to be useful in reducing the effect of penetration of Au inside the CP matrix in the top contact configuration thereby resulting in the reduction of a barrier for carrier injection which is generally lower in the bottom contact configurations. These studies are critical from the point of view of the development of photoconductors and photosensitive top contact organic field effect transistors (OFETs).
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•Blending of DH6T with P3HT was performed.•Polymer-metal interface morphology is critical to decide charge injection and collection; hence device performance.•Blending helps to restrict the Au penetration during electrode deposition in top electrode geometry devices.•Interpenetrating network of P3HT and DH6T helps in exciton dissociation; hence improved photoresponse.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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