椎体间融合术治疗颈椎病及颈椎间盘突出症42例

目的：观察颈椎椎体间融合器（BAK）在颈椎前路减压融合术中的临床疗效。方法：应用颈椎前路减压BAK融合术治疗颈椎病、颈椎间盘突出症共42例，术后复查X线片及CT片，观察手术椎节的稳定性和融合情况。结果：随访6－18个月，手术节段稳定，术后3月开始出现骨融合。结论：BAK固定融合技术使施术椎节得到即刻稳定，为椎间植骨融合创造了良好环境，可替代传统的植骨融合术。     

颈椎前路减压BAK颈椎间融合器的临床应用

目的：探讨BAK椎间融合器做椎体间融合的临床效果。方法：自1998年2月～2002年1月间应用BAK椎体间融合器治疗颈椎间盘疾病48例，其中4例患者置人2枚BAK。术后观察减压、固定、融合及神经功能恢复情况，并行X线或CT检查。结果：患者获得1～3年半的随访，神经功能得到不同程度的改善，无加重情况。椎间隙无高度丢失，无成角，均获骨性融合，3d后在颈领固定下下床活动，4周可恢复较轻工作。结论：此术式可避免传统手术方法的缺点，不取髂骨，融合率高，稳定性好，并可维护正常的椎间隙，是取代传统方法的新技术，值得推广应用。     

Anterior Interbody Fusion with the BAK-Cage in Cervical Spondylosis

Summary BAK-C is a new autostabilizing interbody cage which is implanted during an anterior cervical procedure to provide stability to the motion segment and allow fusion to occur. Special intrumentation is provided with a bone collecting reamer. The system utilizes surgical site bone graft as the osteo-inductive material within the implant. Biomechanical testing indicates improved stability and animal studies show good fusion. The basic principle is distraction-compression using the tension forces of the annulus fibrosus. Operative material concerns a two years experience with 80 patients (101 levels), 72 with cervical radiculopathy, 8 with myelopathy. Clinical evaluation is assessed on a ten point analogue pain scale for neck and arm/shoulder pain, with neurological examination. Radiological evaluation includes dynamic X-rays, myelo-CT and MRI. Patients are re-evaluated at 1, 6, 12 months postoperatively. Results for neck and radicular pain is excellent, but neurological recovery for radiculopathy and myelopathy is quite different. Radiological results are also good with (except one case) no instability, no cage migration, no kyphosis, no pseudarthrosis. Bone fusion is assessed at 6 and 12 months. Complications are few with proper technique, mainly correct distraction, symmetrical endplate drilling and lateral X-ray control. Only one patient needed an early re-operation with additional miniplate fixation. Immediate stability with good clinical response and no graft morbidity are the advantages of this implant compared to conventional cervical interbody grafting techniques.     

BAK在颈椎前路融合术中的应用

目的：探讨BAK在颈椎前路椎体融合术中的应用价值。方法：在32例脊髓型颈椎病，6例久治不愈的根型颈椎病，4例外伤性颈椎间盘突出症患者行颈椎前路手术中，将BAK插入到49个病变椎间隙，术后观察临床效果。结果：42例患者平均随访37月，临床效果满意，无神经并发症发生，术前JOA评分5－14分，术后JOA评分12－17分，恢复率为40％－100％，无BAK移位或脱出。所融合间隙无塌陷及成角畸形，并均在3－6个月骨性愈合。结论：颈椎椎体间固定融合技术使施术节段稳定，避免了自体植骨引起的并发症，可作为代替传统颈椎前路椎体间植骨融合术的新方法。     

腰椎间盘突出症再手术中BAK的应用

目的：本文报告8例腰椎间盘突出症再手术治疗使用BAK作后路植骨融合，目的在于明确手术适应征和探讨BAK在再手术治疗的优点及并发症。方法：对1998-2001年8例腰突症再手术病人的临床资料，影像学资料及手术操作进行分析，6例为原间隙椎间盘再突出，2例为原间隙侧隐窝狭窄。结果：本组病例随访8-30月，全部骨性融合BAK移动、脱落、下陷，术前症状基本消除。结论：严格掌握手术适应证，进行规范操作，腰突症再手术中使用BAK作后路植骨融合是安全、疗效显著。     

Bimatoprost 0.01% vs bimatoprost 0.03%: a 12-month prospective trial of clinical and in vivo confocal microscopy in glaucoma patients

Purpose

To evaluate the safety of two commercially available formulations of bimatoprost eye drops: 0.03 and 0.01% ophthalmic solutions.

Methods

This was a randomized, prospective, parallel-group, open-label, cohort study. A total of 60 glaucoma patients (60 eyes) under bimatoprost 0.03% monotherapy since at least 1 year were enrolled. Selected patients were randomized to receive a single drop of bimatoprost 0.01% (n=30) or bimatoprost 0.03% (n=30) ophthalmic solutions for 12 months. Statistical analysis was performed using paired t-test and repeated measures ANOVA test.

Results

Global clinical score (the sum of pruritus, stinging/burning, blurred vision, sticky eye sensation, eye dryness sensation, and foreign body sensation) significantly decreased in the bimatoprost 0.01% group from baseline 4.7±3.8 to 2.9±2.3 (P<0.001) and 2.5±2.0 (P<0.001) at 6-month and 12-month follow-ups, respectively. Comparison between groups showed differences at both follow-up visits (P=0.003 and P<0.001, respectively). In vivo confocal microscopy revealed a significant increase in goblet cell density in the bimatoprost 0.01% group compared with the bimatoprost 0.03% group (P<0.001 at both follow-up visits). All functional parameters and conjunctival hyperemia improved in the bimatoprost 0.01% group at each follow-up visit (P<0.05) and in comparison with bimatoprost 0.03% (P<0.05).

Conclusion

The results of this trial suggest that bimatoprost 0.01% eye drops seem to decrease the ocular discomfort with respect to bimatoprost 0.03% eye drops.     

Tear cytokine profile of glaucoma patients treated with preservative-free or preserved latanoprost

Purpose

To determine variations in cytokine levels of glaucoma patients treated either with preservative-free latanoprost or preserved latanoprost, relative to healthy individuals.

BCG (bacille Calmette-Guérin)-activated lymphocytes (BAK cells) induce apoptosis in urinary bladder carcinoma cell line T24 in vitro

Background. We previously reported the basic characteristics of BCG (bacille Calmette-Guérin)-activated killer (BAK) cells, which exhibited antitumor effects against the bladder cancer cell line T24. Our study suggested that both BCG and BAK cells were responsible for the inhibition of tumor cell proliferation; however, the basic mechanism of BCG or BAK cells in this inhibition was not clear. We here report the antitumor effects of BAK cells, which correlated with the induction of apoptosis in T24 cells. Methods. Lymphocytes were cultured with BCG to examine ³H-thymidine uptake, and the subpopulation was evaluated by immunocytometry. T24 cells were then cultured with BAK cells for the analysis of ³H-thymidine uptake and apoptosis induction by DNA electrophoresis; pathology study, and cell-cycle analysis were also done. Culture supernatants of BAK and T24 cells were also investigated to detect interferon-γ (IFN-γ), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Results. The ³H-thymidine uptake study of lymphocytes showed that BCG activated the lymphocytes. Evaluation by immunocytometry revealed that CD4⁺ and CD8⁺ T cells were induced by BCG. The ³H-thymidine uptake study of T24 cells revealed that BAK cells inhibited tumor cell proliferation. DNA electrophoresis, the morphological study, and cell-cycle analysis by immunocytometry demonstrated that apoptosis in T24 cells was induced when they were cultured with BAK cells. IFN-γ, IL-6, and TNF-α were detected in the culture supernatants of BAK and T24 cells. Conclusions. Cytokine production and the induction of apoptosis may, together, be the major mechanisms of the antitumor action seen when BAK cells were employed against T24 cells; BAK cells could be employed as clinical effectors against bladder cancer. Received: January 7, 2000 / Accepted: April 27, 2000