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At least 469 records · Page 26Linked to original sources
PubMed1998

[Clinical features, diagnosis and treatment of solitary vertebral arch tuberculosis].

OBJECTIVE: To explore clinical features of vertebral arch tuberculosis, and to discuss the diagnosis and treatment of this illness. METHOD: Seventeen of 3,825 cases of spinal tuberculosis who were hospitalized and treated from 1956 to 1996 were reviewed, and their clinical features, diagnosis and treatment were analyzed and reported. RESULT: Sixteen cases of vertebral arch tuberculosis were in adolescence and prime of life, and another one was a 2-year-old child. Their symptoms in early stages were untypical, including local fixed pain and tenderness, and later, abscess, fistula and symptoms of nerve system appeared. All the cases were diagnosed through summarizing of their history, signs, imaging examination and bacteriology tests, and only one case was misdiagnosed. In one of 17 cases, antituberculosis chemotherapy was conducted alone and non-operation was performed. In the other 16 cases, focal debridement of vertebral arch was performed on the basis of antituberculous chemotherapy, and in 4 cases of them with symptoms of nerve system, laminectomy and spinal decompression was performed homochronously. All the cases were healed and no relapse occurred during follow-up. CONCLUSION: It is difficult to diagnose vertebral arch tuberculosis in early stages due to its occult symptoms, but the symptom of confined pain and manifestation in X-ray, CT and MRI are much useful for early diagnosis. Abscess puncture and acid-fast staining smear microscopy can usually be used to confirm diagnosis. And surgical intervention is an important measure for its treatment.

Adolescent↗
PubMed1999

Galen: a pioneer of spine research.

Galen of Pergamum AD (2nd century), the most eminent Greek physician after Hippocrates, marked the history of medicine for more than 14 centuries. His doctrines, expressed in his voluminous work, combined the medical heritage of the Hippocratic, the Alexandrian, and some of the most important medical schools of antiquity. The strong influence of the Hippocratic tradition can characteristically be traced in orthopaedics and particularly in Galen's presentation of the spine. Based on his observations, derived from dissection and vivisection of animals, Galen established a pioneer model for the study of human spine. His research ended in an accurate description of the vertebral column and the spinal cord. He also described the course and the distribution of the nerves emerging from the spine. In addition, he dealt with the diseases affecting these structures focusing on spinal tuberculosis and the injuries of the spine and the spinal marrow. Galen was the first physician to demonstrate the neurological implications following transection of the spinal cord at several levels. The predominant feature in Galen's reference to spine is its teleological perspective; the great physician tended to attribute the prodigious structure of the spine to nature's providence. Despite the inevitable anatomical errors, Galen's inspired experiments remained the only thorough approach of spinal anatomy and pathology until the recent centuries, when the evolution of sophisticated technical aids opened new pathways to spine research.

Greece, Ancient↗
PubMed2006

Adrenal tuberculosis in Cushing's disease with bilateral macronodular adrenocortical hyperplasia.

Cushing's disease is a disorder of hypercortisolism caused by a pituitary micro- or macro-adenoma. Most patients with Cushing's disease have a bilateral adrenal enlargement, which depends on the duration of the disease, as a result of the long standing ACTH stimulation of both adrenal glands. However, in macronodular adrenocortical hyperplasia (MNH) that is caused by Cushing's disease, if the MNH gains autonomy, a bilateral adrenalectomy, as well as the removal of pituitary adenoma, is often essential. We encountered a patient diagnosed with Cushing's disease with bilateral adrenal tuberculosis simulating MNH. She had taken anti-tuberculosis medications one year prior to admission due to spinal tuberculosis. Sellar MRI revealed a pituitary macroadenoma, but adrenal CT showed enlargement in both adrenal glands that appeared to be MNH. A hormonal study and bilateral inferior petrosal sinus sampling revealed Cushing's disease. Therefore, she underwent trans-sphenoidal surgery of the pituitary mass. The pituitary surgery was successful and the serum cortisol returned to normal range. However, the adrenal mass rapidly enlarged after removing the pituitary tumor without showing evidence of a recurrence or adrenal autonomy of hypercortisolism. Accordingly, a laparoscopic left adrenalectomy was performed to examine the nature of the mass. The resected left adrenal gland was pathologically determined to have a lesion of tuberculosis with some part of the intact cortex. So we assumed that the cause of rapid adrenal enlargement might be due to adrenal tuberculosis. In summary, to the best of our knowledge, this is the first case of Cushing's disease coexisting with both adrenal tuberculosis simulating a bilateral MNH.

Adrenal Gland Diseases↗
PubMed2004

[Demonstration of tuberculosis by DNA ribotyping of Mycobacterium tuberculosis in a Colombian prehispanic mummy].

The mummy studied belonged to the prehispanic Guane society. According to the Mom 003 record of the Archaeological Museum of the House of the Marqués de San Jorge, it was found in a cave in the department of Santander, Colombia, and was donated to the Culture Promotion Fund of the Banco Popular more than 30 years ago. The gender of the mummy had been previously determined by PCR study of the Y chromosome; computerized tomography studies (CT) were carried out and samples of lung tissue, vertebral spine and skin were taken for studying tuberculosis. The CT scans clearly show the presence of spinal tuberculosis, accounting for its important angular cifosis or Pott's disease. DNA obtained from lung tissue was submitted to ribotyping with genes of the 16S ribosomal subunit, giving positive results. This finding demonstrates the presence of tuberculosis in prehispanic Colombia.

Colombia↗
PubMedDate not supplied

[Pott disease: current diagnostic and therapeutic approaches].

Spinal tuberculosis, or Pott's disease, has been known since ancient times; it was a common orthopaedic illness until 1950, but the progress of specific therapies confined it to third word countries; its resurgency in recent years in developed countries is due to drug resistance, immigration from endemic areas, and an increase in immunodeficient patients. Spinal disease is found in about 1% of all tuberculosis cases. Modern treatment consists of a diagnostic phase, based on clinical findings and imaging exams, and of a medical and surgical therapy. Our patients have been treated with a three antibiotic drugs scheme, and underwent early surgical treatment, in order to assure the curettage of the lesion and obtain spine stabilization, so as to avoid spinal deformity.

Humans↗
PubMed2003

[Dysfunctions of respiration and blood circulation in patients with concomitant tuberculosis of the spinal column and lungs].

Functional disorders in the respiratory apparatus and blood circulation were studied in 76 patients with tuberculosis of the spinal column concomitant with pulmonary tuberculosis. Spirography, pneumotachography, elctrocardiography, integral rheography and the method variability of cardiac rate were made use of in the diagnostics of the mentioned disorders. Combined tuberculosis of the spinal column and lungs was found to be accompanied, in case of an active pulmonary process, by instable hemodynamic indices, a reduced contractive myocardium function, an insufficient hemodynamic provision and an increased tension in the respiratory system (impaired ventilation and bronchial patency). Simultaneously, a significant vegetative imbalance with an extremely pronounced hypersympathicotonia and over-tension of the adaptation mechanisms in an active pulmonary process, were registered. The detected dysfunctions need to be corrected due to a forthcoming surgical treatment of tuberculous spondylitis.

Adult↗