WordNet

work natural fibers into a thread; "spin silk"
prolong or extend; "spin out a visit" (同)spin out
the act of rotating rapidly; "he gave the crank a spin"; "it broke off after much twisting" (同)twirl, twist, twisting, whirl
a distinctive interpretation (especially as used by politicians to sway public opinion); "the campaign put a favorable spin on the story"
a short drive in a car; "he took the new car for a spin"
a swift whirling motion (usually of a missile)
revolve quickly and repeatedly around ones own axis; "The dervishes whirl around and around without getting dizzy" (同)spin around, whirl, reel, gyrate
form a web by making a thread; "spiders spin a fine web"
make up a story; "spin a yarn"
stream in jets, of liquids; "The creek spun its course through the woods"
twist and turn so as to give an intended interpretation; "The Presidents spokesmen had to spin the story to make it less embarrassing"
of or relating to the spine or spinal cord; "spinal cord"; "spinal injury"
infection transmitted by inhalation or ingestion of tubercle bacilli and manifested in fever and small lesions (usually in the lungs but in various other parts of the body in acute stages) (同)TB, T.B.

PrepTutorEJDIC

(羊毛などから)〈糸など〉‘を'『紡ぐ』《+『名』+『out of』+『名』〈羊毛〉》,(糸などに)〈羊毛など〉‘を'紡ぐ《+『名』〈羊毛〉+『into』+『名』》 / 〈クモ・カイコなどが〉〈糸〉‘を'『吐く』;〈巣・繭〉‘を'かける / …‘を'くるくる回す / 〈物語など〉‘を'作る,話す / 『糸を紡ぐ』;〈クモ・カイコなどが〉糸を吐く / 〈こまなどが〉くるくる回る / 〈車などが〉疾走する / 〈頭などが〉くらくらする / 〈C〉〈U〉くるくる回すこと;回転 / 〈C〉《単数形で》(車などの)一走り / 〈C〉(飛行機の)きりもみ降下 / 〈C〉《単数形で》(価値などの)急落
背骨の / せき髄麻酔
結核({略}TB,T.B.) / 肺結核

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/06/13 18:28:03」(JST)

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Not to be confused with Postural orthostatic tachycardia syndrome.

Tuberculosis of the spine in an Egyptian mummy

Pott's disease or Pott disease is a presentation of extrapulmonary tuberculosis which is called so when tuberculosis bacillus is seen in any other organ other than lung.^[1]Extrapulmonary tuberculosis can affect the spine, a kind of tuberculous arthritis of the intervertebral joints. It is named after Percivall Pott (1714–1788), a British surgeon. The lower thoracic and upper lumbar vertebrae are the areas of the spine most often affected. Scientifically, it is called tuberculous spondylitis and it is most commonly localized in the thoracic portion of the spine. Pott’s disease results from haematogenous spread of tuberculosis from other sites, often pulmonary. The infection then spreads from two adjacent vertebrae into the adjoining intervertebral disc space. If only one vertebra is affected, the disc is normal, but if two are involved, the disc, which is avascular, cannot receive nutrients and collapses. The disc tissue dies and is broken down by caseation, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage. A dry soft tissue mass often forms and superinfection is rare.

Signs and symptoms[edit]

Back pain
Fever
Night sweating
anorexia
Spinal mass, sometimes associated with numbness, paraesthesia, or muscle weakness of the legs
Difficulty standing

Diagnosis[edit]

blood tests

- CBC : leukocytisis – elevated erythrocyte sedimentation rate >100 mm/h

tuberculin skin test

- Tuberculin skin test (purified protein derivative [PPD]) results are positive in 84-95% of patients with Pott disease who are not infected with HIV.

radiographs of the spine

- Radiographic changes associated with Pott disease present relatively late. The following are radiographic changes characteristic of spinal tuberculosis on plain radiography:

Lytic destruction of anterior portion of vertebral body
Increased anterior wedging
Collapse of vertebral body
Reactive sclerosis on a progressive lytic process
Enlarged psoas shadow with or without calcification

- Additional radiographic findings may include the following:

Vertebral end plates are osteoporotic.
Intervertebral disks may be shrunk or destroyed.
Vertebral bodies show variable degrees of destruction.
Fusiform paravertebral shadows suggest abscess formation.
Bone lesions may occur at more than one level.

bone scan
CT of the spine
bone biopsy
MRI

Late complications[edit]

Vertebral collapse resulting in kyphosis
Spinal cord compression
sinus formation
paraplegia (so called Pott's paraplegia)

Prevention[edit]

Controlling the spread of tuberculosis infection can prevent tuberculous spondylitis and arthritis. Patients who have a positive PPD test (but not active tuberculosis) may decrease their risk by properly taking medicines to prevent tuberculosis. To effectively treat tuberculosis, it is crucial that patients take their medications exactly as prescribed.

Therapy[edit]

non-operative – antituberculous drugs
Chiropractic treatments
analgesics
immobilization of the spine region different types of braces and collars
Surgery may be necessary, especially to drain spinal abscesses or debride bony lesions fully or to stabilize the spine
Thoracic spinal fusion with or without instrumentation as a last resort
Physical Therapy for pain relieving modalties, postural education and teaching a home exercise program for strength and flexibility.

Cultural references[edit]

The fictional Hunchback of Notre Dame had a gibbous deformity (humpback) similar to the type caused by tuberculosis. In Henrik Ibsen's play "A Doll's House," Dr. Rank suffers from "consumption of the spine." Furthermore, Jocelin, the Dean who wanted a spire on his cathedral in William Golding's "The Spire" probably suffered and died as a result of this disease. English poets Alexander Pope and William Ernest Henley both suffered from Pott's disease. Anna Roosevelt Cowles, sister of president Theodore Roosevelt, suffered from Pott's Disease. Chick Webb, swing era drummer and band leader, was afflicted with tuberculosis of the spine as a child, which left him hunchbacked. The Sicilian mafia boss Luciano Leggio had Pott's disease and wore a brace. Morton, the railroad magnate in Once Upon a Time in the West, suffers from the disease and needs crutches to walk. Writer Max Blecher also had Pott's Disease. Marxist thinker and Communist leader Antonio Gramsci suffered from Pott's disease, probably due to the bad conditions of his incarceration in fascist Italy during the 1930s. Italian writer, poet and philosopher Giacomo Leopardi suffered from this disease. It also features prominently in the book This Is a Soul, which chronicles the work of American physician Rick Hodes in Ethiopia. Imogen in the novella The Princess with the Golden Hair, part of Memoirs of Hecate County by Edmund Wilson (1946) has Pott's disease.

References[edit]

^ http://www.tbsymptoms.net/2013/03/extrapulmonary-tuberculosis/

External links[edit]

Pott Disease — Tuberculous Spondylitis (medical article with MRI picture), eMedicine .
"Tuberculous arthritis", MedlinePlus, USA: NIH . Public domain.

UpToDate Contents

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1. 骨格系結核 skeletal tuberculosis
2. 中枢神経系結核 central nervous system tuberculosis
3. 脊髄に影響を与える疾患 disorders affecting the spinal cord
4. 肺外結核および粟粒結核の臨床症状、診断、および治療 clinical manifestations diagnosis and treatment of extrapulmonary and miliary tuberculosis
5. 非結核性抗酸菌による骨髄炎の疫学、臨床症状、および診断 epidemiology clinical manifestations and diagnosis of osteomyelitis due to nontuberculous mycobacteria

English Journal

Functional polymorphisms of Monocyte Chemoattractant Protein-1 gene and Pott's disease risk.

Mecabih F1, Sadouki F2, Bennabi M3, Salah S1, Boukouaci W3, Amroun H4, Fortier C5, Marzais F5, Charron D6, Djoudi H2, Abbadi MC4, Krishnamoorthy R3, Tamouza R7.
Immunobiology.Immunobiology.2016 Mar;221(3):462-7. doi: 10.1016/j.imbio.2015.11.004. Epub 2015 Nov 18.
OBJECTIVE: Monocyte Chemoattractant Protein-1 (MCP-1/CCL2), a key player in immune-mediated responses against Mycobacterium tuberculosis, is encoded by a polymorphic gene. Functionally relevant polymorphic variations in the MCP-1 gene have been associated with both susceptibility to and protection a
PMID 26626202

Pregnancy with hypoplastic left lung complicated by pneumothorax and pulmonary embolism.

Zainudin LD1, Abdul Hafidz MI1, Zakaria AF1, Mohd Zim MA1, Ismail AI1, Abdul Rani MF1.
Respirology case reports.Respirol Case Rep.2015 Dec 15;4(1):19-21. doi: 10.1002/rcr2.143. eCollection 2016.
We report a case of a 34-year-old lady with past history of asthma and pulmonary tuberculosis, who presented 5 weeks pregnant with acute dyspnea. Her chest X-ray showed left-sided complete lung collapse and concomitant right-sided pneumothorax. The pneumothorax was initially managed conservatively w
PMID 26839696

Treatment of lumbosacral spinal tuberculosis by one-stage anterior debridement and fusion combined with dual screw-rod anterior instrumentation underneath the iliac vessel.

Zhang T1, He X2, Li H1, Xu S1.
BMC musculoskeletal disorders.BMC Musculoskelet Disord.2016 Feb 1;17(1):49. doi: 10.1186/s12891-016-0902-5.
BACKGROUND: There has been no consensus regarding what is the optimal means of treating lumbosacral segment tuberculosis. The aim of this study was to evaluate the clinical outcomes of our newly developed one-stage anterior debridement and fusion combined with dual screw-rod construct anterior instr
PMID 26832740