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At least 19 recordsLinked to original sources
PubMed2002

Delayed post-traumatic osteonecrosis of a vertebral body (Kummell's disease).

Kummell's disease is a rare spinal disorder characterized as avascular necrosis of a vertebral body occurring in a delayed fashion after minor trauma. The disease derives its name from the German surgeon Hermann Kummell, who described a series of patients with the disorder in 1895. Kummell's disease is distinguished from typical osteoporotic compression fractures, by virtue of the fact that patients with Kummell's disease develop symptoms in delayed fashion. In addition, Kummell's disease exhibits different signal characteristics on magnetic resonance imaging when compared to osteoporotic compression fractures. In this review we discuss the pathophysiology, histopathology and treatment of this interesting disorder.

Aged↗
PubMed1993

Delayed post-traumatic vertebral collapse (Kummell's disease): case report with serial radiographs, computed tomographic scans, and bone scans.

A case of delayed posttraumatic vertebral collapse (Kummell's disease) is described and documented with serial radiographs, computed tomographic scans, and bone scans. The bone scan was normal before the back injury occurred and showed increased radionuclide uptake 3 weeks after injury and before vertebral collapse. Plain radiographs and computed tomographic scans taken during the interval between injury and collapse revealed no evidence of fracture or bone destruction. The authors believe this represents the first example of Kummell's phenomenon documented with serial computed tomographic and bone scans, and provides further support to the ischemic necrosis theory as the underlying process.

Aged↗
PubMed1996

[Our clinical experience with the diagnosis and treatment of Kummell-Verneuille disease].

Pathology and clinical symptoms in 10 patients with Kümmell-Verneuille disease treated in CMKP Orthopaedic Department are presented. Special attention is given to the course of the disease, natural history of vertebral body necrosis and serious neurological complications. Every phase of the disease is radiographically documented. The preferred treatment, both in early and late phase, is posterior fusion embracing adjacent vertebrae. In neurologically complicated cases anterior spinal decompression and perivertebral fusion is recommended.

Adult↗
PubMed2002

Delayed posttraumatic vertebral collapse with intravertebral vacuum cleft.

OBJECTIVE: To discuss the case of a 79-year-old man who had a delayed posttraumatic vertebral collapse and an intravertebral vacuum cleft. The patient had been on long-term corticosteroid therapy. A discussion of Kummell's disease and the controversy surrounding the etiology of the condition is also presented. CLINICAL FEATURES: Six weeks before coming to the clinic, the patient remembered twisting, hearing a pop, and having severe low back pain. Two weeks after the incident, while hospitalized for bacterial cellulitis, he underwent lumbar spine radiography. The radiographs showed degenerative changes and remote (healed) compression fractures but did not demonstrate any deformity of L2. Four weeks later, he sought care for persistent low back pain. Radiographs revealed marked compression of the L2 vertebral body with an intravertebral vacuum phenomenon. INTERVENTION AND OUTCOME: The patient was referred to his geriatrician for evaluation as a candidate for vertebroplasty or other stabilization procedures. He required a moderately high dose (60 mg) of prednisone daily to combat the symptoms of myasthenia gravis; therefore, the prognosis appears unfavorable for this patient. CONCLUSION: Clinical research is needed to determine the definitive etiology and pathophysiology of Kummell's disease. This case demonstrates that the intravertebral vacuum is a dynamic entity, subject to changes in size and shape. Previous case reports have suggested that Kummell's disease only presents as a linear, horizontal cleft. This disease needs further investigation to determine the true correlation between radiographic signs and the underlying pathophysiology.

Aged↗
PubMed1983

Experimental canine scabies in humans.

Adult female Sarcoptes scabiei var. canis mites were applied to human skin for 96 hours in an experimental chamber. Clinical lesions produced during this period were studied histologically. The organisms burrowed, defecated, and laid up to nine eggs that developed normally. Two eggs hatched after removal from the host. A life cycle was not completed during this short experiment, but these results suggest canine scabies are capable of such activities on human skin.

Animals↗
PubMed2000

Prolapse of the fallopian tube after hysterectomy associated with exuberant angiomyofibroblastic stroma response: a diagnostic pitfall.

We report two cases of prolapse of the fallopian tube associated with an exuberant angiomyofibroblastic stroma response, which occurred after hysterectomy and which is a hitherto unreported feature of this lesion. The tumors were composed of richly vascularized stroma arranged in a retiform pattern and mildly atypical glandular inclusions, which had the morphology of tubal epithelium. The stroma of the lesion was composed of either thin bipolar cells with tapered nuclei and stellate-shaped cells with minimal amount of cytoplasm or small epithelioid-looking cells with eosinophilic cytoplasm. The tubal glandular inclusions displayed mildly atypical nuclear features. If the tubal glandular component was overlooked, these tumors might be erroneously diagnosed as mesenchymal lesions of the vagina, such as vaginal fibroepithelial polyp, angiomyofibroblastoma, aggressive angiomyxoma, or superficial myofibroblastoma.

Adult↗
PubMedDate not supplied

Prognostic implications of the degree of shunt narrowing and of the portal vein diameter in dogs with congenital portosystemic shunts.

OBJECTIVE: To determine prognostic evaluation and correlation of the degree of narrowing and the diameter of the portal vein in dogs with a congenital portosystemic shunt (CPS). STUDY DESIGN: Longitudinal prospective study. ANIMALS: Ninety-seven dogs with CPS. METHODS: Shunt diameter was recorded before and after silk ligation to calculate degree of closure. Portal vein diameter was measured in 74 dogs. Short-term (30 days) and long-term (>1 year) outcome were evaluated. Dogs with clinical signs after 1 year were re-examined to assess the degree of portosystemic shunting and compared with matched operated dogs without clinical signs. Correlations between clinical outcome, degree of closure, and portal vein diameter were statistically analyzed. RESULTS: Short-term and long-term mortality were 27% and 2.9% respectively. Clinical recurrence occurred in 10% of dogs. The degree of closure was significantly associated with mortality, but not with clinical recurrence. A significant correlation was found between degree of closure and the diameter of the cranial part of the portal vein. Portal vein diameter was only significantly associated with mortality in extrahepatic CPS. Subclinical portosystemic shunting was confirmed in 3 of 10 dogs. CONCLUSION: The degree of shunt closure depended on portal development. Long-term outcome did not depend on the degree of closure or portal development at the time of surgery. This suggested that factors such as hepatic and portal regeneration after surgery may be important. CLINICAL RELEVANCE: Determination of factors that predict the outcome after surgical treatment of CPS in dogs is important to gain insight in treatment selection or new therapeutic options.

Animals↗
PubMed1998

Closure of the rectus sheath with a continuous looped suture and the skin with staples in dogs: speed, safety, and costs compared to closure of the rectus sheath with interrupted sutures and the skin with a continuous subdermal suture.

In dogs requiring a midline celiotomy, closure of the rectus sheath with a continuous polyglyconate looped suture and closure of the skin with stainless steel staples (group 1, 20 dogs) were compared with closure of the rectus sheath with interrupted polyglyconate sutures and closure of the skin with a continuous subdermal polyglactin suture (group 2, 20 dogs) with respect to speed, safety, and costs. The subcutis was closed with a continuous polyglactin suture in all dogs. The use of a looped suture saved 3.4 minutes and the use of staples saved 5.6 minutes. Total mean time saved for all layers was 7.7 minutes (38%). Wound healing was not significantly different between group 1 and group 2. There was one case of dehiscence of the rectus sheath in group 2 and two cases of wound infection in group 1. It was concluded that closing the rectus sheath with a continuous looped suture and the skin with staples is equally safe and significantly faster than closing the rectus sheath with simple interrupted sutures and the skin with a continuous subdermal suture. Additional costs were balanced by the reduction in surgery time.

Abdomen↗
PubMed1996

Nonorganic signs of significance in low back pain.

STUDY DESIGN: Medical records and imaging studies including one or more interviews and physical examinations by the author were reviewed in 878 people remaining out of work for 13 weeks or more because of occupational low back pain. OBJECTIVES: To assess the prognostic value of nonorganic signs, including those validated by Waddell et al and two others previously undescribed, limitation of shoulder motion with production of low back pain, and low back pain resulting from movement limited to the cervical spines. SUMMARY OF BACKGROUND DATA: Review of all records of people evaluated by the author over a 3-year period (1990-1993) provided the material for this study. All available medical, insurance, and legal records were reviewed, including reports or examination results of radiographic films, or both. In the majority, more sophisticated investigation had been performed with complete reports of the studies themselves being available to the author. METHODS: A complete history and physical examination were accomplished by the author on each individual, including evaluation of each of the test results for nonorganicity. Medical records, including radiographic films, magnetic resonance imaging, computerized axial tomography, myelography, bone scan, electromyography, etc., were collated. Statistical analysis of results followed. RESULTS: The finding of limitation of shoulder motion resulting in low back pain indicated a worse prognosis for return to work than that of positive Waddell signs alone, 69.6% versus 52.9%. If cervical motion additionally produced low back pain, the outlook was poorer (no return to work in 73.1%). CONCLUSION: When present with a triad of the signs validated by Waddell, the new signs significantly increase the predictability of failure to return to work by workers with compensable low back pain.

Absenteeism↗
PubMedDate not supplied

Coagulation profiles in dogs with congenital portosystemic shunts before and after surgical attenuation.

BACKGROUND: Serious postoperative hemorrhage has been reported in dogs after closure of congenital portosystemic shunts (CPS). HYPOTHESIS: In dogs with portosystemic shunting, low coagulation factor activity is responsible for coagulopathy, which can cause complications after surgery. ANIMALS: Thirty-four dogs with CPS and 39 healthy dogs. METHODS: In a prospective study, coagulation times, platelet count, and the activity of 8 coagulation factors were measured in dogs before and after surgical shunt attenuation and in 31 healthy dogs. The effect of abdominal surgery on hemostasis was determined at ovariectomy in 8 healthy dogs. RESULTS: Dogs with CPS had lower platelet counts, lower activity of factors II, V, VII, and X, and increased factor VIII and activated partial thromboplastin time (APTT) compared to healthy dogs. After surgical attenuation, dogs with CPS had decreased platelet counts and activity of factors I, II, V, VII, IX, X, and XI and a prolonged prothrombin time (PT). Ovariectomy resulted in decreased activity of factors VII and X. Six weeks after surgery, portosystemic shunting persisted in 9 of 30 dogs, with no improvement of hemostatic values. CPS dogs without shunting had improved coagulation times and increased activity of factors II, V, VII, and X. CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with CPS have lower activity of clotting factors compared to healthy dogs, resulting in a prolonged APTT. Surgical attenuation of the shunt results in increased abnormalities in coagulation times and factors immediately after surgery. Hemostasis is normalized after complete recovery of shunting after attenuation, in contrast to dogs with persistent shunting.

Animals↗