The Experts below are selected from a list of 714 Experts worldwide ranked by ideXlab platform
Kengo Yamamoto - One of the best experts on this subject based on the ideXlab platform.
-
bacille calmette guerin bcg Spondylitis with adjacent mycotic aortic aneurysm after intravesical bcg therapy a case report and literature review
BMC Infectious Diseases, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Although intravesical bacille Calmette-Guerin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG Spondylitis. Accurate diagnosis of BCG Spondylitis is important because it is an iatrogenic disease, and its treatment is different from usual Tuberculous Spondylitis. However, distinguishing BCG Spondylitis from usual Tuberculous Spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG Spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). We encountered a case of BCG Spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the Spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded.
-
Bacille Calmette-Guérin (BCG) Spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy: a case report and literature review
BMC, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Abstract Background Although intravesical bacille Calmette-Guérin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG Spondylitis. Accurate diagnosis of BCG Spondylitis is important because it is an iatrogenic disease, and its treatment is different from usual Tuberculous Spondylitis. However, distinguishing BCG Spondylitis from usual Tuberculous Spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG Spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). Case presentation We encountered a case of BCG Spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the Spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. Conclusions BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded
Byungjoon Shin - One of the best experts on this subject based on the ideXlab platform.
-
Safety and Efficacy of Pedicle Screws and Titanium Mesh Cage in the Treatments of Tuberculous Spondylitis of the Thoracolumbar Spine
2013Co-Authors: Jae Chul Lee, Yonil Kim, Byungjoon ShinAbstract:Study Design: This is a retrospective series. Purpose: We wanted to analyze the safety and effectiveness of using the newer generation metallic implants (pedicle screws and/or titanium mesh) for the treatment of Tuberculous Spondylitis. Overview of the Literature: There have been various efforts to prevent the development of a kyphotic deformity after the treatment of Tuberculous Spondylitis, including instrumentation of the spine. Pedicle screws and titanium mesh cages have become more and more popular for treating various spinal problems. Methods: Twenty two patients who had Tuberculous Spondylitis were treated with anterior radical debridement and their anterior column of spine was supported with a tricortical iliac bone graft (12 patients) or by mesh (10 patients). Supplementary posterior pedicle screw instrumentation was performed in 17 of 22 patients. The combination of surgeries were anterior strut bone grafting and posterior pedicle screws in 12 patients, anterior titanium mesh and posterior pedicle screws in 5 patients and anterior mesh only without pedicle screws in 5 patients. The patients were followed up with assessing the laboratory inflammatory parameters, the serial plain radiographs and the neurological recovery. Results: The erythrocyte sedimentation rate and C-reactive protein levels were eventually normalized and there was no case of persistent infection or failure to control infection in spite of a mettalic implant in situ. The overall correction of kyphotic deformity was initially 8.9 degrees, and the loss of correction was 6.2 degrees. In spite of some loss of correction
-
safety and efficacy of pedicle screws and titanium mesh cage in the treatments of Tuberculous Spondylitis of the thoracolumbar spine
Asian Spine Journal, 2008Co-Authors: Jae Chul Lee, Yonil Kim, Byungjoon ShinAbstract:Study Design: This is a retrospective series. Purpose: We wanted to analyze the safety and effectiveness of using the newer generation metallic implants (pedicle screws and/or titanium mesh) for the treatment of Tuberculous Spondylitis. Overview of the Literature: There have been various efforts to prevent the development of a kyphotic deformity after the treatment of Tuberculous Spondylitis, including instrumentation of the spine. Pedicle screws and titanium mesh cages have become more and more popular for treating various spinal problems. Methods: Twenty two patients who had Tuberculous Spondylitis were treated with anterior radical debridement and their anterior column of spine was supported with a tricortical iliac bone graft (12 patients) or by mesh (10 patients). Supplementary posterior pedicle screw instrumentation was performed in 17 of 22 patients. The combination of surgeries were anterior strut bone grafting and posterior pedicle screws in 12 patients, anterior titanium mesh and posterior pedicle screws in 5 patients and anterior mesh only without pedicle screws in 5 patients. The patients were followed up with assessing the laboratory inflammatory parameters, the serial plain radiographs and the neurological recovery. Results: The erythrocyte sedimentation rate and C-reactive protein levels were eventually normalized and there was no case of persistent infection or failure to control infection in spite of a mettalic implant in situ. The overall correction of kyphotic deformity was initially 8.9 degrees, and the loss of correction was 6.2 degrees. In spite of some loss of correction, this technique effectively prevented clinically significant kyphotic deformity. The preoperative Frankel grades were B for 1 patient, C for 4, D for 4 and E for 13. At the final follow-up, 7 of 9 patients recovered completely to Frankel grade E and only two patients showed a Frankel grade of D. Conclusions: Stabilizing the spine with pedicle screws and/or titanium mesh in patients with tubercuous Spondylitis effectively prevents the development of kyphotic deformity and this did not prevent controlling infection when this technique was combined with radical debridement and anti-Tuberculous chemotherapy.
Y Sugioka - One of the best experts on this subject based on the ideXlab platform.
-
differentiation of vertebral osteomyelitis and Tuberculous Spondylitis by magnetic resonance imaging
International Orthopaedics, 1995Co-Authors: Tuyoshi Arizono, Masayoshi Oga, E Shiota, Katsusada Honda, Y SugiokaAbstract:Twenty patients with vertebral osteomyelitis and 18 with Tuberculous Spondylitis were investigated by magnetic resonance imaging to identify the distinguishing features. The number of vertebral bodies involved was less in vertebral osteomyelitis than in Tuberculous Spondylitis, and the paravertebral abscesses were smaller. The magnetic resonance intensity of the involved vertebral bodies was more homogeneous in vertebral osteomyelitis than in Tuberculous Spondylitis. Rim enhancement with Gadolinium-DTPA was less frequent in vertebral osteomyelitis. The differentiation of the two conditions by MRI was helpful in establishing the correct diagnosis of the infection.
Takuya Kusakabe - One of the best experts on this subject based on the ideXlab platform.
-
bacille calmette guerin bcg Spondylitis with adjacent mycotic aortic aneurysm after intravesical bcg therapy a case report and literature review
BMC Infectious Diseases, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Although intravesical bacille Calmette-Guerin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG Spondylitis. Accurate diagnosis of BCG Spondylitis is important because it is an iatrogenic disease, and its treatment is different from usual Tuberculous Spondylitis. However, distinguishing BCG Spondylitis from usual Tuberculous Spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG Spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). We encountered a case of BCG Spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the Spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded.
-
Bacille Calmette-Guérin (BCG) Spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy: a case report and literature review
BMC, 2018Co-Authors: Takuya Kusakabe, Kenji Endo, Itaru Nakamura, Hidekazu Suzuki, Hirosuke Nishimura, Shinji Fukushima, Kengo YamamotoAbstract:Abstract Background Although intravesical bacille Calmette-Guérin (BCG) therapy is accepted as an effective treatment for bladder cancer, serious complications may occur in rare cases. To date, only 4 cases have been reported in which the patient developed a combination of mycotic aortic aneurysm and BCG Spondylitis. Accurate diagnosis of BCG Spondylitis is important because it is an iatrogenic disease, and its treatment is different from usual Tuberculous Spondylitis. However, distinguishing BCG Spondylitis from usual Tuberculous Spondylitis is very difficult and takes a long time. In this study, we were able to suspect BCG Spondylitis at an early stage from the result of the interferon-gamma release assay (IGRA). Case presentation We encountered a case of BCG Spondylitis with adjacent mycotic aortic aneurysm after intravesical BCG therapy in a 76-year-old man. We performed a 2-stage operation to obtain spine stabilization and replace the aneurysm with a synthetic graft. We started multidrug therapy with antituberculosis medication, excluding pyrazinamide, because the patient’s history of BCG therapy, negative IGRA, and positive of tuberculosis-polymerase chain reaction (Tb-PCR) suggested that the pathogenic bacteria of the Spondylitis was BCG. Eventually the bacterial strain was identified as BCG by PCR-based genomic deletion analysis. Conclusions BCG infection should be considered in patients who have been treated with BCG therapy, even if the treatment was performed several months to several years previously. In the case of a patient with a history of BCG therapy, a positive Tb-PCR result and negative IGRA result probably suggest BCG infections, if the possibility of false-negative IGRA result can be excluded
Jae Chul Lee - One of the best experts on this subject based on the ideXlab platform.
-
Safety and Efficacy of Pedicle Screws and Titanium Mesh Cage in the Treatments of Tuberculous Spondylitis of the Thoracolumbar Spine
2013Co-Authors: Jae Chul Lee, Yonil Kim, Byungjoon ShinAbstract:Study Design: This is a retrospective series. Purpose: We wanted to analyze the safety and effectiveness of using the newer generation metallic implants (pedicle screws and/or titanium mesh) for the treatment of Tuberculous Spondylitis. Overview of the Literature: There have been various efforts to prevent the development of a kyphotic deformity after the treatment of Tuberculous Spondylitis, including instrumentation of the spine. Pedicle screws and titanium mesh cages have become more and more popular for treating various spinal problems. Methods: Twenty two patients who had Tuberculous Spondylitis were treated with anterior radical debridement and their anterior column of spine was supported with a tricortical iliac bone graft (12 patients) or by mesh (10 patients). Supplementary posterior pedicle screw instrumentation was performed in 17 of 22 patients. The combination of surgeries were anterior strut bone grafting and posterior pedicle screws in 12 patients, anterior titanium mesh and posterior pedicle screws in 5 patients and anterior mesh only without pedicle screws in 5 patients. The patients were followed up with assessing the laboratory inflammatory parameters, the serial plain radiographs and the neurological recovery. Results: The erythrocyte sedimentation rate and C-reactive protein levels were eventually normalized and there was no case of persistent infection or failure to control infection in spite of a mettalic implant in situ. The overall correction of kyphotic deformity was initially 8.9 degrees, and the loss of correction was 6.2 degrees. In spite of some loss of correction
-
safety and efficacy of pedicle screws and titanium mesh cage in the treatments of Tuberculous Spondylitis of the thoracolumbar spine
Asian Spine Journal, 2008Co-Authors: Jae Chul Lee, Yonil Kim, Byungjoon ShinAbstract:Study Design: This is a retrospective series. Purpose: We wanted to analyze the safety and effectiveness of using the newer generation metallic implants (pedicle screws and/or titanium mesh) for the treatment of Tuberculous Spondylitis. Overview of the Literature: There have been various efforts to prevent the development of a kyphotic deformity after the treatment of Tuberculous Spondylitis, including instrumentation of the spine. Pedicle screws and titanium mesh cages have become more and more popular for treating various spinal problems. Methods: Twenty two patients who had Tuberculous Spondylitis were treated with anterior radical debridement and their anterior column of spine was supported with a tricortical iliac bone graft (12 patients) or by mesh (10 patients). Supplementary posterior pedicle screw instrumentation was performed in 17 of 22 patients. The combination of surgeries were anterior strut bone grafting and posterior pedicle screws in 12 patients, anterior titanium mesh and posterior pedicle screws in 5 patients and anterior mesh only without pedicle screws in 5 patients. The patients were followed up with assessing the laboratory inflammatory parameters, the serial plain radiographs and the neurological recovery. Results: The erythrocyte sedimentation rate and C-reactive protein levels were eventually normalized and there was no case of persistent infection or failure to control infection in spite of a mettalic implant in situ. The overall correction of kyphotic deformity was initially 8.9 degrees, and the loss of correction was 6.2 degrees. In spite of some loss of correction, this technique effectively prevented clinically significant kyphotic deformity. The preoperative Frankel grades were B for 1 patient, C for 4, D for 4 and E for 13. At the final follow-up, 7 of 9 patients recovered completely to Frankel grade E and only two patients showed a Frankel grade of D. Conclusions: Stabilizing the spine with pedicle screws and/or titanium mesh in patients with tubercuous Spondylitis effectively prevents the development of kyphotic deformity and this did not prevent controlling infection when this technique was combined with radical debridement and anti-Tuberculous chemotherapy.
