br Conclusion Since minimally invasive

Conclusion Since minimally invasive cardiac surgery was introduced, there has been a significant expansion in popularity and experience. Various techniques for obtaining appropriate exposure have been developed and put into practice. Regardless of the variety of surgical approaches, the overall objectives of minimally invasive cardiac surgery remain constant, in order to provide a safe and effective approach with the benefits associated with minimal access surgery. As with many surgical techniques, patients with particular risks are better candidates for certain techniques. A patient-centered approach for the selection of different approaches must be implemented. Meanwhile, the surgeon should always take the capability of himself, team members, and the institute into consideration. Although the difficult learning curve of minimally invasive cardiac surgery has been discussed, the central concepts to adopt new techniques and technologies should always include the initial selection of uncomplicated patients, the buildup of a consistent operative team, and following modular and stepwise approaches in order to increase complexity and reduce the MAPK Inhibitor Library incision. More and more evidence supports the notion that minimally invasive cardiac surgery is feasible and reproducible. A greater number of requests for minimally invasive cardiac surgery by patients seems inevitable. It should not only be the alternative to conventional cardiac surgery, but also the standard of care in experienced hands.
Introduction Tuberculosis (TB) remains a leading cause of death among infectious diseases, and there is an estimation of over 3 million deaths in the world annually. The World Health Organization estimates the global incidence of tuberculosis to be at 9 million new cases/year, and 1–2% of these TB patients to have spinal vertebral involvement. Although there are well-established chemotherapeutic agents against TB, the complications after TB of the spine, such as syringomyelia, permanent neurological deficits, and spinal osseous defects, sometimes remain unresolved after eradication of pathogens. Therefore, surgical approaches are indicated for TB of the spine to minimize the devastating complications. In Taiwan, the estimated TB burden was 44/million population/year in 2009, and the incidence in eastern Taiwan, including Hualien and Taitung counties, was almost twice as high as in west Taiwan. The mortality was almost three times higher in east Taiwan than in the overall Taiwan population. However, there have been few studies in the treatments for TB of the spine in east Taiwan, especially those investigating the surgical approaches for those post-infectious complications. Hence, we conducted this study to investigate the results of treatments for TB spine.
Methods
Results
Discussion Spinal TB, also known as Pott\'s disease, was first described by Percival Pott in 1782. The disease results from infection of spinal vertebra by hematologic spreading of the organism of Mycobacterium tuberculosis. The organism is insidious and stays in the skeletal system for a period prior to clinical detection. After the clinical evident infection, the subsequent bony destruction and spinal nerve or cord compression can result in severe neurological deficits, such as paraplegia or fecal incontinence. In contrast to the demographic report of spinal TB from western Taiwan, in which the affected patients were older (55% of patients older than 70 years), our study revealed that 62% of all patients were younger than 65 years. In addition, our age distribution was bimodal, with the first peak at the 4th decade and second peak at the 7th decade, and younger patients were diagnosed to have spinal TB in eastern Taiwan, whereas in most literature on TB spine demographics, the age distribution was unimodal. Different sex predominance has been published without definite conclusions, but our study showed a male preponderance.