Enicostemma littorale prevents tumor formation in 7,12-dimethylbenz(a)anthracene-induced hamster buccal pouch carcinogenesis

Oral cancer is one of the most common malignancies worldwide, and India has recorded the highest annual incidence of oral cancer in comparison with other countries. Altered lipid peroxidation and antioxidant status along with defect in detoxification cascade have been implicated in the pathogenesis of several cancers including oral cancer. The aim of this study was to investigate the chemopreventive potential of ethanolic extract of Enicostemma littorale leaves (ElELet) in 7,12-dimethylbenz(a)anthracene (DMBA)-induced hamster buccal pouch carcinogenesis. Oral tumor was developed in the buccal pouches of male golden Syrian hamsters by painting with 0.5% DMBA three times a week for 14 weeks. We observed 100% tumor formation with increase in tumor volume and tumor burden in the hamsters treated with DMBA alone. Imbalance in phase I (cytochrome P450 and cytochrome b5) and phase II (glutathione reductase, glutathione- S-transferase, glutathione, and Deoxythymidine-diaphorase (DT)-diaphorase) detoxification agents and lipid peroxidation by-products (thiobarbituric acid reactive substances) and antioxidant (superoxide dismutase, catalase, glutathione peroxidase, and vitamins E and C) status was noticed in hamsters treated with DMBA alone. Oral administration of ElELet at a dose of 250 mg/kg body weight to hamsters treated with DMBA significantly prevented both precancerous and cancerous lesions in the oral cavity. ElELet modulated the status of phase I and II detoxification agents and antioxidants in favor of the suppression of oral carcinogenesis. This study thus suggests that E. littorale might have inhibited the oral carcinogenesis in DMBA-treated hamsters through its antioxidant potential. The present findings are also substantiated by histological studies during DMBA-induced oral carcinogenesis.

Minimal Invasive Anterior Decompression in Tuberculosis of Thoracolumbar Junction of the Spine – Experience With SynFrame

Introduction: This study assesses the role of new retractor system SynFrame for anteriordecompression of tuberculosis of thoracolumbar junction of the spine.Methods: This study includes fi ve consecutive patients with tuberculosis of thoracolumbar junctiontreated with minimal invasive anterior decompression using a new table mounted retractor systemSynFrame (Stratec Medical, Switzerland). The thoracolumbar junction was approached by a left sidedthoracotomy. Short construct pedicle screw stabilization was done in all cases before decompression.The anterior column was reconstructed using expandable cage (n=3) and autologous tricortical graft(n=2).Results: The mean operating time was 100 minutes (range 90-120). Mean overall blood loss was 400ml. No operation had to change into an open procedure. There were neither intra nor postoperativecomplications related to minimal access in particular, nor visceral/vascular complications.Conclusions: The ring retractor system allows minimal open surgery to the spine by carryingdifferent devices as well as endoscope, providing an excellent visualization of the operating fi eld,and is safe and easy to use. The only disadvantage is its high cost.Key Words: anterior decompression, minimal invasive spine surgery, SynFrame

Minimal invasive anterior decompression in tuberculosis of thoracolumbar junction of the spine--experience with SynFrame

INTRODUCTION

This study assesses the role of new retractor system SynFrame for anterior decompression of tuberculosis of thoracolumbar junction of the spine.

METHODS

This study includes five consecutive patients with tuberculosis of thoracolumbar junction treated with minimal invasive anterior decompression using a new table mounted retractor system SynFrame (Stratec Medical, Switzerland). The thoracolumbar junction was approached by a left sided thoracotomy. Short construct pedicle screw stabilization was done in all cases before decompression. The anterior column was reconstructed using expandable cage (n=3) and autologous tricortical graft (n=2).

RESULTS

The mean operating time was 100 minutes (range 90-120). Mean overall blood loss was 400 ml. No operation had to change into an open procedure. There were neither intra nor postoperative complications related to minimal access in particular, nor visceral/vascular complications.

CONCLUSIONS

The ring retractor system allows minimal open surgery to the spine by carrying different devices as well as endoscope, providing an excellent visualization of the operating field, and is safe and easy to use. The only disadvantage is its high cost.

Tuberculosis of lower cervical spine--a prospective study

Tuberculosis was a leading cause of mortality in the beginning of the twentieth century. Tuberculosis of the spine is one of the oldest diseases afflicting humans. A prospective study was carried out among 45 cases of tuberculosis of lower cervical spine and an attempt was made to highlight some of its features. Pain and stiffness were important and dominant complaints. Commonest level affected was C5-C6 vertebrae. The overall incidence of cord compression was 37.8 per cent. The commonest modality of treatment was antituberculous drugs, anterior excision of diseased bone and tricortical bone grafting. This regime rapidly relieves pain, compressive respiratory symptoms due to large abscess and neurological deficit.

Anterior decompression for cervicothoracic pathology: A study of 14 patients

INTRODUCTION

Various anterior approaches to the cervicothoracic junction have been described. This study reports our experience with 14 patients who had cervical anterior approaches to the cervicothoracic junction (C6-T2). This technique was evaluated with regard to the extent of exposure, ease of technique, and postoperative morbidity. We have chosen the low cervical approach to obtain exposure up to T2. For T3-T4 pathology, we use the transthoracic, periscapular approach. We do not practice bone-splitting approaches because of the morbidity associated with these approaches.

METHODS

Fourteen patients with C6-T2 pathology who required anterior decompression and fusion were studied for a period of 2 years. In all cases, the low cervical anterior approach was used.

RESULTS

This approach is simple, requires less operative time, and provides excellent exposure up to the level of T2. There was no long-term morbidity attributed to the approach and procedure.

CONCLUSION

The low cervical anterior approach is an excellent approach that provides adequate exposure for spinal pathology to T2 that requires anterior decompression and fusion.