(J Am Vet Med Assoc 2011;239:992-997)”
“Karyomegalic interstitial nephritis (KIN) is a rare and certainly underdiagnosed nephropathy. selleck kinase inhibitor It is characterized by a peculiar histological picture of interstitial nephritis associated with the presence of hyperchromatic, abnormally enlarged nuclei of tubular epithelial cells. KIN has an uncertain etiology, but should be suspected in young patients in the second or third decade of life presenting with progressive renal failure, proteinuria and/or hematuria and a history of recurrent respiratory infections. In these cases, the diagnosis should
be suspected and confirmed by a renal biopsy. Herein, we report a case of KIN with atypical clinical presentation in a young patient with progressive kidney failure without proteinuria or hematuria or history of recurrent respiratory infections.”
“Study Design. Biomechanical evaluation of
occipitocervical instrumentation techniques.
Objective. Compare methods of occipital instrumentation by quantifying load sharing of occipital screws and measuring motion across instrumented occipitocervical PCI32765 spines.
Summary of Background Data. Newer occipitocervical plate/screw systems that attach to longitudinal rods have been developed to improve fixation. These devices place screws in the center of occipital bone or off- midline. Midline plates offer screw purchase in thicker bone. Off-midline systems may increase the effective moment arm for torsional and lateral bending control. Measurement of screw loads within occipital plates is useful for determining optimal plate configuration.
Methods. Ten cadaveric specimens (occiput-C4) were tested in flexion/extension (FE),
lateral bending (LAT), and axial rotation (ROT) over +/- 3 Nm pure moment. After intact testing, 4 occipitocervical fixation constructs were tested using washer load cells to assess loading across screws used to fix the plates to the occiput. Parasagittal occipital plates were positioned either convex or concave side facing medially. Each plate was first fixed using 3 screws (rostral, middle, caudal), then with the caudal screw eliminated (simulated failure). Range of motion (ROM) and peak screw loads are reported.
Results. ROM decreased from intact to any GW786034 of the 4 fusion plate configurations in FE, LAT, and ROT (P << 0.05), but not between plate configurations. Screw load significantly decreased from medially convex to medially concave configurations in LAT, but no significant changes were observed in FE or ROT. With caudal screws removed, middle screws peak loads significantly increased in FE and LAT (P << 0.05), but not ROT.
Conclusion. Occipital screw placement off- midline improves screw loads under lateral bending forces on occipitocervical constructs, though loads for FE and ROT are unchanged. As screws pullout, the loads may be redistributed, resulting in increased screw pullout forces above.