RESUMEN
Postoperative routine pathologic evaluation of tonsillectomy and adenoidectomy specimens rarely reveals a diagnosis of malignancy. The object of this case report is to highlight this rare clinical occurrence. A 4-year-old boy presented with symptoms of sleep-disordered breathing and had a history of recurrent tonsillitis. Physical examination revealed adenoid hypertrophy and Brodsky Grade 1 bilateral tonsillar hypertrophy. The patient underwent adenoidectomy and tonsillectomy. The adenoids were found to be MAGS Grade 4 (Modified Adenoid Grading System) hypertrophic causing 100% obstruction. After the histologic examination, T-cell lymphoblastic leukemia/lymphoma was diagnosed. Proper treatment allowed full recovery. Currently, no consensus has been made about routine pathological evaluation. To achieve a cost-effective and precautionary approach, we recommend pathological follow-up of cases with unusual intraoperative findings with/without clinical malignancy suspicion.
Asunto(s)
Linfoma , Leucemia-Linfoma Linfoblástico de Células Precursoras , Masculino , Niño , Humanos , Preescolar , Adenoidectomía , Hipertrofia , Linfocitos TRESUMEN
We aimed to determine the prognostic role of whole tumor-associated inflammatory cells, especially eosinophils, and stromal histological characteristics in relation to other prognostic parameters in patients with colorectal carcinoma (CRC). A total of 122 patients who underwent an operation for CRC were included in this retrospective study. Conventional (tumor grade, TNM stage and venous invasion [VI]) and other histopathological (intratumoral/peritumoral budding [ITB/PTB], desmoplasia) tumor parameters were recorded and classified by density, as were the tumor-associated inflammatory parameters (intratumoral/peritumoral lymphocytes [ITL/PTL], eosinophils [IE/PTE], overall inflammation [ITI/PTI], Crohn-like inflammation [CLI]). Cancer-specific survival data were analyzed with respect to all tumor parameters. High ITB and PTB were significantly correlated with a higher rate of pT4, VI and desmoplasia (p < 0.05). An association of moderate ITL and extensive PTL with lesser likelihood of VI and metastasis; an association of extensive CLI with a significantly lower rate of metastasis and TNM stage IV; and minimal PTE with a significantly higher rate of pT4 stage, metastasis and ITB were detected (p < 0.05 for each). Our findings revealed that low score tumoral budding and an increase in tumor-related inflammation were associated with lesser likelihood of poor prognostic tumor parameters. Nonetheless, given the association of an increase in PTE with lesser likelihood of ITB, pT4, metastasis, and with non-significantly for better survival rates, our findings emphasize the potential role of peritumoral eosinophils as an additional prognostic parameter in CRC.
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Neoplasias Colorrectales , Neoplasias Colorrectales/patología , Eosinófilos/patología , Humanos , Estadificación de Neoplasias , Pronóstico , Estudios RetrospectivosRESUMEN
Invasive aspergillosis is a severe infection that generally involves the lungs. Primary gastrointestinal aspergillosis is the least common form of invasive aspergillosis. A patient aged 65 years developed a febrile neutropenic episode following an autologous stem cell transplant for plasmacytoid variant diffuse large B-cell gastric non-Hodgkin's lymphoma. He had abdominal pain on the second day of the febrile neutropenic episode and ileus occurred on the sixth day. His general condition deteriorated despite broad spectrum antibiotics and caspofungin treatment, and intestinal perforation occurred on the nineteenth day of the febrile neutropenic episode. Pathological examination of the resected jejunum and ileum revealed mould hyphae compatible with aspergillus. The patient died due to massive gastrointestinal bleeding on the fifth post-operative day. Although a rare condition, primary gastrointestinal aspergillosis should be kept in mind while treating neutropenic patients with gastrointestinal symptoms.
Asunto(s)
Aspergilosis/complicaciones , Neutropenia Febril/microbiología , Enfermedades Gastrointestinales/microbiología , Trasplante de Células Madre Hematopoyéticas , Infecciones Fúngicas Invasoras/microbiología , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Aspergilosis/diagnóstico por imagen , Resultado Fatal , Enfermedades Gastrointestinales/diagnóstico por imagen , Humanos , Ileus/etiología , Huésped Inmunocomprometido , Infecciones Fúngicas Invasoras/diagnóstico por imagen , Linfoma de Células B Grandes Difuso/terapia , Masculino , Neoplasias Gástricas/terapiaRESUMEN
Paragangliomas of the head and neck are usually benign tumors. Malignant form is quite rare and criteria for malignancy are not clear. Clinical, biochemical and histological features of malignant forms are not sufficient to reliably distinguish them from benign tumors and malignancy is established only in the presence of distant metastasis. Herein, we report a patient with glomus jugulare on the right, glomus vagale and glomus caroticum tumors on the left side with cervical lymph node metastasis on the right side.
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Neoplasias de Cabeza y Cuello/patología , Neoplasias Primarias Múltiples , Paraganglioma/secundario , Adulto , Diagnóstico Diferencial , Femenino , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Humanos , Metástasis Linfática , Imagen por Resonancia Magnética , Paraganglioma/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
A bezoar is a hard, and solid, foreign body located in the gastrointestinal tract that may recur. Bezoar is classified according to its origin. Pharmacobezoars develop in the gastrointestinal tract due to alterations in anatomical structure and/or intestinal motility. In this paper, a case, not yet defined in the literature, of a pharmacobezoar causing a mechanical obstruction that is accompanied by a malignancy in the colon is reported, with the aim of contributing to the literature.
RESUMEN
OBJECTIVE: The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of intra-articular hyaluronic acid, tenoxicam and vitamin E in osteoarthritis. METHODS: An osteoarthritis model was created by anterior cruciate ligament transection and medial menisectomy in knees of 28 rats. The rats were randomized into four groups; first group served as a control group and received intra-articular injections of saline solution, intra-articular HA, intra-articular tenoxicam and intra-articular Vit E were applied to the treatment groups. First intra-articular injections were applied at second week postoperatively and repeated once a week for 5 weeks. At 8th week after the operation groups were compared based on the histologic scores of cartilage degeneration by Mankin Histological Grading Scale. RESULTS: Total cartilage degeneration score was significantly increased in the control group (P=0.004). Total Mankin scores of HA, tenoxicam and Vit E groups were significantly lower than the control group (P=0.004, P=0.016, P=0.012 respectively). There was no statistically siginificant difference between the treatment groups in terms of total Mankin scores (P>0.05). CONCLUSION: Intra-articular application of HA, tenoxicam and Vit E are chondroprotective in early osteoarthritis model in rats. Chondroprotective activity of tenoxicam and Vit E are comparable with the beneficial effects of HA on articular cartilage.
RESUMEN
The purpose of this study was to determine relationship between HER-2/neu status and estrogen receptor, progesterone receptor, grade and age by comparing fluorescence in situ hybridization and immunohistochemistry. One hundred invasive breast carcinomas were reviewed and fluorescence in situ hybridization analysis was performed in all cases. Immunohistochemical scores showed a perfect concordance with fluorescence in situ hybridization amplification ratios (p < 0.0001). The results indicated a significant correlation between HER-2/neu and grade, but an inverse relationship between HER-2/neu and hormone receptors. In women aged ≤ 45 years, an inverse relationship between HER-2/neu and progesterone receptor was found and no association was noted between HER-2/neu and other factors. In women aged > 45 years, the results indicated a significant correlation between HER-2/neu and grade, and there was an inverse relationship between HER-2/neu and hormone receptors.
Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias de la Mama/diagnóstico , Carcinoma/diagnóstico , Amplificación de Genes , Inmunohistoquímica , Hibridación Fluorescente in Situ , Receptor ErbB-2/genética , Adulto , Factores de Edad , Neoplasias de la Mama/química , Neoplasias de la Mama/genética , Carcinoma/química , Carcinoma/genética , Distribución de Chi-Cuadrado , Femenino , Humanos , Modelos Logísticos , Persona de Mediana Edad , Clasificación del Tumor , Invasividad Neoplásica , Oportunidad Relativa , Valor Predictivo de las Pruebas , Pronóstico , Receptores de Estrógenos/análisis , Receptores de Progesterona/análisis , Medición de Riesgo , Factores de Riesgo , TurquíaRESUMEN
Oncocytic breast carcinomas are tumors composed of no fewer than 70% of oncocytic cells (World Health Organization). The purpose of this study was to determine the frequency, morphologic, immunohistochemical, and clinical features of invasive oncocytic carcinoma in a large series. Twenty-eight cases of putative oncocytic breast carcinoma (selected cases group) and 76 consecutive cases of invasive breast carcinoma (consecutive cases group) were analyzed. Immunohistochemistry for mitochondria, gross cystic disease fluid protein 15, chromogranin, estrogen receptor, progesterone receptor, androgen receptor, HER2/Neu, cytokeratin 7, cytokeratin 14, epithelial membrane antigen, and differentiation cluster 68 was performed. Score for mitochondria was based on intensity and percentage of immunopositive cells. Classes were as follows: (1) oncocytic carcinoma: at least 70%, 3+; (2) mitochondrion-rich carcinoma: 50% to 70%, 3+, or more than 50%, 2+; and (3) all the other cases were referred to as invasive breast carcinoma. Ultrastructural examination was available for 6 cases of oncocytic carcinoma. Morphologic and immunohistochemical features of the 3 groups were compared using Fisher exact test (P < .05). For overall survival analysis, Kaplan-Maier curves were compared using log-rank and Wilcoxon tests (P < .05). Our results suggest that oncocytic breast carcinoma is a morphologic entity with distinctive histologic and ultrastructural features. Mitochondrion-rich carcinomas are histologically similar to oncocytic carcinomas and constitute 19.7% of all invasive carcinomas, indicating that cytoplasmic eosinophilia in breast cancer cells is often due to accumulation of mitochondria. Oncocytic carcinomas and mitochondrion-rich carcinomas are more often grade III tumors and show human epidermal growth factor receptor 2 overexpression. Clinical features and overall survival of oncocytic carcinomas are not distinctive because they are similar to those of the other cases when matched for grade and stage.
Asunto(s)
Adenoma Oxifílico/patología , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Células Oxífilas/patología , Adenoma Oxifílico/metabolismo , Adenoma Oxifílico/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama Masculina/metabolismo , Neoplasias de la Mama Masculina/mortalidad , Neoplasias de la Mama Masculina/patología , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/mortalidad , Recuento de Células , Femenino , Humanos , Italia/epidemiología , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Mitocondrias/inmunología , Mitocondrias/ultraestructura , Células Oxífilas/metabolismo , Pronóstico , Tasa de SupervivenciaRESUMEN
BACKGROUND: Hepatic stellate cells, the main mediators in the pathogenesis of fibrosis, are triggered by free radicals and produce collagen. Melatonin is a powerful physiologic scavenger of hydroxyl radicals. It is also involved in the inhibitory regulation of the collagen content in tissue. There is no effective treatment available for liver fibrosis. Our objective was to evaluate the effects of melatonin on liver fibrosis induced by bile-duct ligation (BDL) in rats. METHODS: We divided male Wistar rats (n = 32) into 4 groups. Two groups received BDL and 2 groups received sham operations. One of the BDL groups and one of the sham groups were administered melatonin (100 mg/kg/day via intraperitoneal injection), and the controls were given vehicle only. After 1 month, we biochemically evaluated the changes in hepatic fibrosis by measuring tissue collagen levels and histopathologic examination. We evaluated the levels of malondialdehyde (MDA), glutathione (GSH), luminal and lucigenin in tissue homogenates, and we studied proinflammatory cytokines in serum using commercially available kits. RESULTS: Bile-duct ligation caused hepatic fibrotic changes, whereas melatonin suppressed these changes in 5 of 8 rats (p < 0.001). Bile-duct ligation resulted in increased collagen, MDA, luminal and lucigenin levels and decreased GSH levels, whereas melatonin reversed these effects. CONCLUSION: We found that melatonin functions as an effective fibrosuppressant and antioxidant, and the results suggest that it can be used as a therapeutic option.
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Antioxidantes/farmacología , Cirrosis Hepática/tratamiento farmacológico , Cirrosis Hepática/patología , Melatonina/farmacología , Acridinas/metabolismo , Alanina Transaminasa/sangre , Fosfatasa Alcalina/sangre , Animales , Aspartato Aminotransferasas/sangre , Conductos Biliares/cirugía , Bilirrubina/sangre , Colágeno/metabolismo , Citocinas/sangre , Glutatión/metabolismo , Ligadura , Hígado/metabolismo , Masculino , Malondialdehído/metabolismo , Fenobarbital/metabolismo , Ratas , Ratas Wistar , gamma-Glutamiltransferasa/sangreRESUMEN
Osteoarthritis, the most common joint disease in the world, is characterized by joint pain, stiffness, and limitation of range of motion. Osteoarthritis is a slowly progressive disease and its morbidity increases with age. The most commonly involved sites are the spine, knee, hip, and hand joints. Although the ideal treatment for osteoarthritis should be the one that acts on the underlying mechanism, thus preventing joint destruction and disease progression, such an effective treatment option does not exist. Therefore, contemporary treatment aims to relieve pain, increase range of motion, and optimize joint function. Analgesics and nonsteroidal antiinflammatory drugs are most commonly used for the symptomatic treatment, but mainly their gastrointestinal side effects, especially in elderly patients, limit their usage. In this study, the chondroprotective effects of an aminomonosaccharide glucosamine and a polysaccharide hyaluronic acid in a rabbit osteoarthritis model were investigated. Anterior cruciate ligament transection was performed in 32 New Zealand rabbits to establish a model of osteoarthritis. Rabbits were randomized into four groups, each consisting of eight rabbits. Two weeks after the operation, intraarticular injections were performed to the right knees once a week for 5 weeks; intraarticular glucosamine to the first group, intraarticular hyaluronate to the second group, intraarticular hyaluronate and intramuscular glucosamine to the third group, and intraarticular saline solution to the fourth group, which served as the control group. At the end of the eighth week, the rabbits were sacrificed and their right knees with proximal femur and distal tibia were harvested. Joint surfaces of their femur and tibia were examined macroscopically, and sections from the medial femoral condyles were examined microscopically. Macroscopic evaluation revealed that the cartilage surface was preserved in the glucosamine, hyaluronate, and hyaluronate plus glucosamine groups, when compared with the control group. Microscopic evaluation showed that glucosamine, hyaluronate, and glucosamine plus hyaluronate have chondroprotective effect, but no statistically significant difference was found between study groups.
Asunto(s)
Acetilglucosamina/farmacología , Ácido Hialurónico/farmacología , Articulación de la Rodilla/efectos de los fármacos , Osteoartritis de la Rodilla/tratamiento farmacológico , Acetilglucosamina/administración & dosificación , Animales , Ligamento Cruzado Anterior/cirugía , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Quimioterapia Combinada , Ácido Hialurónico/administración & dosificación , Inyecciones Intraarticulares , Inyecciones Intramusculares , Articulación de la Rodilla/patología , Articulación de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/patología , Osteoartritis de la Rodilla/fisiopatología , Conejos , Rango del Movimiento Articular , Factores de TiempoRESUMEN
BACKGROUND: Air exposure is a factor that inhibits in vitro cellular proliferation and matrix synthesis in tendons. Aim of this experimental study was to evaluate effect of dehydration and irrigation on healing of Achilles tendon. METHODS: Achilles tenotomy was done in forty-five Sprague-Dawley rats. In control group, tendon was sutured immediately. In the remaining two groups, the Achilles tendons were allowed to direct exposure of air. Irrigation of Achilles tendon was performed in one of exposed groups, while irrigation was not done in other group. After 60 minutes, tendons of both groups were sutured same as control group. Rats were sacrificed at postoperative day 28. Achilles tendons were dissected and histological and biomechanical evaluations were performed. RESULTS: Histological evaluation revealed intense fibrosis formation with adhesion of tendon to surrounding tissues in the air exposed groups. The quantity of angiogenesis and inflammatory reaction were also higher in experimental groups regardless of irrigation. Air exposed tendons had higher tensile strength however lower stiffness than control group in biomechanical evaluation. CONCLUSION: Air exposure decreases quality of healing by increasing fibrosis and adherence formation. These negative effects of exposure to air were not counteracted by irrigation. However, air exposure didn't affect tensile strength of the healing.
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Tendón Calcáneo/lesiones , Traumatismos de los Tendones/terapia , Aire , Animales , Fenómenos Biomecánicos , Deshidratación , Modelos Animales de Enfermedad , Femenino , Ratas , Ratas Sprague-Dawley , Resistencia a la Tracción , Irrigación Terapéutica , Cicatrización de HeridasRESUMEN
BACKGROUND/AIMS: It was speculated that there was a relationship between the intensity of tissue eosinophilic infiltration in colonic malignancies and their prognosis. This retrospective study aimed to investigate the frequency and intensity of tissue eosinophilia in various colonic neoplasms, including serrated adenomas. METHODS: We evaluated 448 colonic neoplasms to determine eosinophilic infiltration: 96 hyperplastic polyps, 50 serrated adenomas, 19 flat adenomas, 154 tubular adenomas, 71 tubulovillous adenomas, 13 villous adenomas and 45 adenocarcinomas. The eosinophilic infiltration was categorized into three groups by evaluating the percentage of eosinophils relative to total stromal inflammatory cells: mild (0-5%), moderate (5-40%), and marked (>;40%). Chi-square and Fisher's exact tests were used for analyses. P value <0.05 was considered statistically significant. RESULTS: Moderate (46.7%) and marked (52.9%) intensity were noted in all colonic adenomas. Most of the hyperplastic polyps (96%) and adenocarcinomas (75.6%) showed mild intensity. Mostly moderate eosinophilic infiltration was observed in serrated adenomas. CONCLUSIONS: Our findings suggest that the intensity of tissue eosinophilia is most prominent in adenomas including serrated adenomas and is diminished from adenoma to carcinoma. This finding may be used as a diagnostic indicator.
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Neoplasias del Colon/patología , Eosinofilia/patología , Distribución de Chi-Cuadrado , Humanos , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
INTRODUCTION: We report a case of unusual co-existence of multiple primary neoplasms of female genital tract. CASE: A 62-year-old gravida 2, para 2 was referred with spotting and vaginal discharge for about 6 months. Fractionate curettage was performed and documented endocervical squamous cell carcinoma in situ. Subsequently total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed. Final pathological report demonstrated cervical squamous cell carcinoma, right ovarian Brenner tumor, left ovarian granulosa tumor and endometrial polyps. DISCUSSION: Multiple primary neoplasms of female genital tract is a well-recognized yet rare occurrence. Although the presented case is probably an incidental event, the pathogenesis of the neoplastic process affecting the tissues with different embryological origin needs further research and evaluation. It is important to distinguish multiple primary neoplasms from metastatic disease because of the fact that overall survival as well as treatment would vary considerably.
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Neoplasias Endometriales/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Ováricas/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Tumor de Brenner/diagnóstico , Tumor de Brenner/patología , Tumor de Brenner/cirugía , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Diagnóstico Diferencial , Neoplasias Endometriales/patología , Neoplasias Endometriales/cirugía , Trompas Uterinas/cirugía , Femenino , Humanos , Histerectomía , Persona de Mediana Edad , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugía , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Ovariectomía , Pólipos/diagnóstico , Pólipos/patología , Pólipos/cirugía , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugíaRESUMEN
BACKGROUND: Infection around an implanted orthopaedic device is a devastating complication, and the treatment of infections involving slime-forming bacteria is especially difficult. The purpose of the present study was to evaluate the effectiveness of a proteolytic enzyme, serratiopeptidase, in the eradication of a periprosthetic infection in an in vivo animal model. METHODS: In sixty Sprague-Dawley rats, the medullary canal of the right femur was drilled through the intercondylar notch and was inoculated with a Staphylococcus epidermidis strain (ATCC 35984) with a high slime-producing capacity. The cavity was filled with polymethylmethacrylate cement, and a Kirschner wire that had contact with the knee joint was inserted. None of the animals received any treatment for two weeks. Twenty rats were killed at two weeks after the inoculation in order to determine if the infection had become established. The remaining forty rats were randomized into two groups. One group received serratiopeptidase enzyme injections into the knee joint in addition to antibiotic therapy for four weeks, and the other group received intra-articular saline solution injections together with the same antibiotic therapy. The animals from both groups were killed two weeks after the end of therapy (on Day 56). The knee specimens were evaluated bacteriologically and histologically to determine the prevalence of persistent infection and the effects of the enzyme on local tissue. RESULTS: At two weeks, inoculated bacteria grew on culture of specimens from twelve (63.2%) of nineteen animals in the no-treatment group. Microbiological testing suggested that infection persisted in only one (5.6%) of eighteen animals in the serratiopeptidase-and-antibiotic group, whereas it was present in six (37.5%) of sixteen animals in the antibiotic-only group (p = 0.001). Histological evaluation showed similar results (kappa = 0.92). CONCLUSIONS: Serratiopeptidase was effective for eradicating infection caused by biofilm-forming bacteria in this experimental animal model. The antibiofilm property of the enzyme may enhance antibiotic efficacy in the treatment of staphylococcal infections.
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Antiinflamatorios no Esteroideos/uso terapéutico , Prótesis de la Rodilla/efectos adversos , Péptido Hidrolasas/uso terapéutico , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus epidermidis , Animales , Antibacterianos/administración & dosificación , Antiinflamatorios no Esteroideos/administración & dosificación , Modelos Animales de Enfermedad , Quimioterapia Combinada , Ofloxacino/administración & dosificación , Péptido Hidrolasas/administración & dosificación , Infecciones Relacionadas con Prótesis/patología , Ratas , Ratas Sprague-Dawley , Infecciones Estafilocócicas/patologíaRESUMEN
The lateral meniscus tends to have more developmental variation than the medial counterpart. This is a report of an accessory discoid layer of lateral meniscus. All arthroscopic, magnetic resonance imaging and histopathological views are presented.
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Meniscos Tibiales/anomalías , Artroscopía , Humanos , Traumatismos de la Rodilla/fisiopatología , Traumatismos de la Rodilla/cirugía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Rango del Movimiento Articular , Lesiones de Menisco TibialRESUMEN
STUDY DESIGN: An animal model of postlaminectomy lumbar column sagittal plane deformity was designed in rats. OBJECTIVES: To analyze the effect of lumbar column deformity (lordosis and kyphosis) on postlaminectomy epidural fibrosis formation. SUMMARY OF BACKGROUND DATA: Incidence of peridural fibrosis formation after lumbar spinal surgery is considerably high. Instability and sagittal plane deformity of the lumbar spine has been implicated (not proven) as the factors for the development of epidural fibrosis. The effect of traction (kyphosis) or relaxation (lordosis) of the lumbar spine on epidural fibrosis formation is not known. METHODS: L4 laminectomies were performed in 30 rats. Three equal groups were formed. In the control group (group I), only laminectomy was performed. In other groups after laminectomy, lumbar lordosis (group II) and kyphosis (group III) was maintained with steel implants. The scar formation was evaluated both histologically and histomorphometrically on the 12th postoperative week. RESULTS: Kyphosis developed in group I. The mean amount of peridural scar tissue was significantly more evident in groups I and III than the lordosis group. The extent of adherence to the dura mater and the nerve roots was most apparent in group III. CONCLUSIONS: Kyphosis and consequent traction of the lumbar spine is one of the causes for increased epidural fibrosis formation after laminectomy. On the contrary, establishment of lordosis and relaxation of the lumbar spine decreased the scar tissue formation in rats.