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Background: Although osteoblastoma is an uncommon benign bone tumor, it sometimes behaves in a locally aggressive fashion. We herein report a case of recurrent lumbar spine osteoblastoma that was treated by repeated surgery and carbon ion radiotherapy.Case Presentation: A 13-year-old Japanese girl presented with left side lumbar pain. Computed tomography and magnetic resonance imaging of the lumbar spine demonstrated a tumorous lesion in the left side pedicle of L4. Although gross total resection of the mass, including the nidus, was performed in the initial surgery, recurrence was observed repeatedly in the short term and the pathological diagnosis of all of the resected tumors was conventional osteoblastoma. We finally performed carbon ion radiotherapy after the patient's 3rd palliative operation, and achieved a good outcome. No further recurrence has been observed in 10 years of follow-up.Conclusion: We performed carbon ion radiotherapy for a case of recurrent spinal osteoblastoma and achieved a good outcome without recurrence at 10 years after carbon ion radiotherapy treatment. To the best of our knowledge, this is the first case of osteoblastoma that was treated with carbon ion radiotherapy after multiple surgeries. [ABSTRACT FROM AUTHOR]

Background: Hand infection in diabetics is an often ignored but challenging condition. If not addressed effectively, it may result in long term disability, contracture, amputation and even death. Methods: From August 2014 to December 2015, a study was done in our centre, where 49 diabetic hand infection cases were analyzed in two groups, superficial and deep hand infection. Results: Mean age of the patients was 51.63 years. There were 21 superficial infections and 28 deep infections. Cause of infection was unknown or spontaneous in 16 cases, traumatic laceration or crush in 14 patients, following minor prick in 10 cases. Most of the cases were the results of neglected minor wound. Forty-one patients were insulin dependent. Five cases were diagnosed as diabetic at the time of treatment. Four patients were treated conservatively and 45 (92%) cases required operation in the form of incision, drainage and debridement. In 16 (35%) cases, wound was left open and was healed by secondary intention following regular dressing. In five patients, wound was closed secondarily. Partial thickness skin graft was applied in 15 cases. Seven patients were treated with flap coverage. Partial digital or ray amputation were done in 16 cases. All fingers except thumb were amputated in one case and amputation from wrist was done in another patient. Wound swabs were taken, and antibiotics were changed or continued accordingly. But reports of 26 cases were available. No growth was found in four cases, monomicrobial infection was found in 15 patients and polymicrobial in seven cases. Infection resolved with healing in 47 cases. Two patients died during treatment from sepsis, both were insulin dependent, had associated renal failure and from deep infection group. One patient developed severe mental disorder. Conclusions: For diabetic hand infection, early diagnosis and prompt treatment with appropriate antibiotics and emergency surgery with extensile incision is crucial. Primary amputation of the part could be life and limb saving. [ABSTRACT FROM AUTHOR]

Objective To investigate whether multiple surgery is responsible for the high prevalence of latex hypersensitivity in patients with spinal dysraphism by comparing the results of a skin-prick test in three groups of patients with different surgical histories. Patients and methods An in vivo diagnostic kit was used to determine the sensitivity to latex using a skin-prick test in three groups of patients, 23 with spinal dysraphism who had undergone surgery, 20 patients who had undergone non-urological surgery and urological patients who had not undergone surgery (control). There was no history of latex allergy in any individual from the three groups. Results The skin-test was positive in six patients with spinal dysraphism, in one who had undergone previous non-urological surgery and in none of the control patients. The prevalence of latex hypersensitivity was significantly higher in patients with spinal dysraphism than in the other groups (non-urological surgery P <0.05 and control P<0.01). This difference occurred despite the patients in each surgical group having undergone a mean of less than two operations. There was no significant difference in latex sensitivity between control patients and those undergoing non-urological surgery. Conclusion Despite having no history of latex hypersensitivity, about a quarter of patients with spinal dysraphism were sensitive to latex. Repeated surgery alone cannot be responsible for the greater incidence of latex hypersensitivity in these patients. Despite multiple surgery being accepted as playing a major role in the development of latex hypersensitivity, relatively fewer surgical episodes than reported previously seem to be sufficient to elicit latex allergy. [ABSTRACT FROM AUTHOR]