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1

Validation of spinal motion with the spine reposition sense device  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background A sagittal plane spine reposition sense device (SRSD has been developed. Two questions were addressed with this study concerning the new SRSD: 1 whether spine movement was occurring with the methodology, and 2 where movement was taking place. Methods Sixty-five subjects performed seven trials of repositioning to a two-thirds full flexion position in sitting with X and Y displacement measurements taken at the T4 and L3 levels. The thoracolumbar angle between the T4 and the L3 level was computed and compared between the positions tested. A two (vertebral level of thoracic and lumbar by seven (trials mixed model repeated measures ANOVA indicated whether significant differences were present between the thoracic (T4 and lumbar (L3 angular measurements. Results Calculated thoracolumbar angles between T4 and L3 were significantly different for all positions tested indicating spinal movement was occurring with testing. No interactions were found between the seven trials and the two vertebral levels. No significant findings were found between the seven trials but significant differences were found between the two vertebral levels. Conclusion This study indicated spine motion was taking place with the SRSD methodology and movement was found specific to the lumbar spine. These findings support utilizing the SRSD to evaluate changes in spine reposition sense during future intervention studies dealing with low back pain.

Rundquist Peter J

2009-04-01

2

A new measurement method for spine reposition sense  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background A cost effective tool for the measurement of trunk reposition sense is needed clinically. This study evaluates the reliability and validity of a new clinical spine reposition sense device. Methods The first part of this three part investigation included 45 asymptomatic subjects examined in the first 20 repeated trials portion assessing spine reposition sense. The second portion, test-retest, examined 57 asymptomatic subjects. Initial testing consisted of subjects sitting on the device and performing 20 trials of a self-determined 2/3 trunk flexion position. The second portion of the study involved 7 trials of trunk flexion performed twice. The angular position for each trial was calculated and the mean reposition error from the initial 2/3 position was determined. For the third portion, the new device was compared to the Skill Technologies 6D (ST6D Imperial Motion Capture and Analysis System. Results ICC (3,1 for trials 4–7 was 0.79 and 0.76 for time one and time two, respectively and the test-retest ICC (3,k was 0.38. Due to the poor test-retest ICC, the Bland Altman method was used to compare test and retest absolute errors. Most measurement differences were small and fell within the 95% confidence interval. Comparable measures between the two methods were found using the Bland Altman method to compare the reposition sense device to the ST6D system. Conclusion The device may be a cost effective clinical technique for sagittal trunk reposition sense measurement.

Cope Steven

2008-03-01

3

[Treatment of compression fractures of the spine by repositioning and immobilization in hyperextensive plaster casts].  

Science.gov (United States)

The treatment results of 57 patients were evaluated clinically and radiologically according to Daniaux. A comparison of the X-ray pictures taken immediately after injury and after reposition of displacement with those after removal of a plaster cast and at a follow-up examination revealed in all the patients improvement of various degree of the wedge-shaped deformation after reposition and application of a plaster cast. Loss of correction after removal of a plaster cast was found in 11 patients, mainly with the wedge shaped deformation and lowering also of the posterior part of the vertebral body. On final follow-up examination, loss of correction was found in further 12 patients. They were mainly patients aged over 50 years, most of them women, and patients with primary vertebral body deformation of over 1/3 of the height. The best results were obtained in young persons with the wedge-shaped deformation of the vertebral body of less than 1/3 of the original vertebral body height. PMID:2634520

Bohatyrewicz, A; Gusta, A; Matwiejko, L

1989-01-01

4

Three-dimensional repositioning tasks show differences in joint position sense between active and passive shoulder motion.  

Science.gov (United States)

Proprioception is important in maintaining shoulder joint stability. Previous studies investigated the effects of unconstrained multiplanar motion, with subjects able to move freely in space, on repositioning tasks for active shoulder motion but not passive motion. We sought to further explore joint position sense with 3D passive, robot-guided motions. We hypothesized that target repositioning error would be greater in the case of passively placed targets than for actively placed targets. To investigate, 15 healthy individuals participated (8 female, 7 male), who were at most 6?ft (183?cm) tall to accommodate the equipment, and who had no history of shoulder injury, surgery, or significant participation in throwing sports. Target orientations were centered at 44° of elevation and 32° of horizontal rotation from the frontal plane. Two sets of 10 trials were performed. The first set involved active placement followed by active replacement, and the second set involved passive, robot-guided, placement followed by active replacement. Repositioning error was greater following passive placement than active placement (p?sense at the shoulder. PMID:22072560

Erickson, R I Carl; Karduna, Andrew R

2012-05-01

5

Lip repositioning.  

Science.gov (United States)

Excessive gingival display is a frequent finding that can occur because of various intraoral or extraoral etiologies. This report describes the use of surgical lip repositioning technique for the management of a gummy smile associated with vertical maxillary excess and hypermobility of the upper lip. The procedure restricts the muscle pull of the elevator lip muscles by shortening the vestibule, thus reducing the gingival display when smiling. Healing was uneventful and follow-up examinations of 10 months revealed reduced gingival display. For patients desiring a less invasive alternative to orthognathic surgery, lip repositioning is a viable alternative. PMID:24872640

Gaddale, Reetika; Desai, Shrikar R; Mudda, Jayashree A; Karthikeyan, I

2014-03-01

6

Creativity Repositioned  

Science.gov (United States)

Creativity is the cultural capital of the twenty-first century. This article presents an argument for the arts to lead a new wave of education reform that repositions creativity as the centerpiece of an education that prepares a generation of change agents for doing good.

Sheridan-Rabideau, Mark

2010-01-01

7

Thoughtful Repositioning.  

Science.gov (United States)

Reveals how creative design can reposition older campus buildings and preserve their historical or sentimental value to the school community. The following three case studies illustrate these design techniques: Virginia Polytechnic Institute and State University, Blacksburg, Virginia; Williams College, Williamstown, Massachusetts; and Mary…

Buffington, Beth; Baxter, John

2001-01-01

8

STRATEGICALLY REPOSITIONING RUSSIA  

Directory of Open Access Journals (Sweden)

Full Text Available Positioning is a very important marketing concept. Its importance was strongly emphasized and implemented in the case of companies, but is somehow neglected when it comes to states. A country acquires a position in the mind of a person very much like any other product does, which is very important especially when that person exerts an executive role. Nowadays Russia has a poor image or no image at all, both internationally and in Romania. In order to regain an important position in the Balkans region, Russia must set aside any political agenda and reposition itself as a business partner on equal terms. The first goal of this article is to clarify Russias position in the minds of future Romanian executives. The second goal is to outline a recommended course of actions for Russias repositioning.

Brandabur Raluca Ecaterina

2011-07-01

9

Challenges and opportunities of drug repositioning.  

Science.gov (United States)

Drug repositioning is an innovation stream of pharmaceutical development that offers advantages for drug developers along with safer medicines for patients. Several drugs have been successfully repositioned to a new indication, with the most prominent of them being viagra and thalidomide, which have generated historically high revenues. In line with these developments, most of the recent articles and reviews on repositioning are focused on success stories, leaving behind the challenges that repositioned compounds have on the way to the clinic. Here, I analyze repositioning as a business opportunity for pharmaceutical companies, weighing both challenges and opportunities of repositioning. In addition, I suggest extended profiling as a lower-risk cost-effective repositioning model for pharmaceutical companies and elucidate the novel collaborative business opportunities that help to realize repositioning of shelved and marketed compounds. PMID:23582281

Novac, Natalia

2013-05-01

10

Lumbar position sense and the risk of low back injuries in college athletes: a prospective cohort study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Impaired proprioception in the lumbar spine has often been reported in people with low back pain. However, no prospective studies exist to assert the cause and effect of this association. We hypothesized that athletes with a history of low back injury (LBI would demonstrate poorer lumbar position sense (PS than athletes without a history of LBI, and that this deficit would be a risk factor for future LBI. Methods This was a prospective cohort study with 2–3 year follow-up. Lumbar spine PS in the transverse plane was evaluated in 292 athletes using three tests: 1 passive and 2 active trunk repositioning, and 3 motion perception threshold. Mean absolute (accuracy and variable (precision errors were computed. Results There were no significant differences in the repositioning errors or motion perception threshold between athletes with and without a history of LBI or between those who did and did not get injured during the follow-up. Active trunk repositioning resulted in smaller errors than passive repositioning (1.6°± 0.8° versus 2.1°± 1.0° and 1.7°± 0.8° versus 2.3°± 1.1° for the absolute and relative errors, respectively. Conclusion Poor trunk PS in transverse plane is not associated with LBI in athletes, nor does it appear that poor trunk PS predisposes athletes to LBI.

Reeves N Peter

2007-12-01

11

Nucleosome repositioning via loop formation  

CERN Document Server

Active (catalysed) and passive (intrinsic) nucleosome repositioning is known to be a crucial event during the transcriptional activation of certain eucaryotic genes. Here we consider theoretically the intrinsic mechanism and study in detail the energetics and dynamics of DNA-loop-mediated nucleosome repositioning, as previously proposed by Schiessel et al. (H. Schiessel, J. Widom, R. F. Bruinsma, and W. M. Gelbart. 2001. {\\it Phys. Rev. Lett.} 86:4414-4417). The surprising outcome of the present study is the inherent nonlocality of nucleosome motion within this model -- being a direct physical consequence of the loop mechanism. On long enough DNA templates the longer jumps dominate over the previously predicted local motion, a fact that contrasts simple diffusive mechanisms considered before. The possible experimental outcome resulting from the considered mechanism is predicted, discussed and compared to existing experimental findings.

Kulic, M L

2002-01-01

12

Polymer reptation and nucleosome repositioning  

CERN Document Server

We consider how beads can diffuse along a chain that wraps them, without becoming displaced from the chain; our proposed mechanism is analogous to the reptation of "stored length" in more familiar situations of polymer dynamics. The problem arises in the case of globular aggregates of proteins (histones) that are wound by DNA in the chromosomes of plants and animals; these beads (nucleosomes) are multiply wrapped and yet are able to reposition themselves over long distances, while remaining bound by the DNA chain.

Schiessel, H; Bruinsma, R F; Gelbart, W M

2001-01-01

13

Transfemoral Repositioning of Malpositioned Central Venous Catheters  

International Nuclear Information System (INIS)

Purpose: To determine the efficacy of the transfemoral vein approach to repositioning malpositioned central venous catheters. Methods: During a 41/2-year period, malpositioned central venous catheters were repositioned 91 times in 83 patients via the transfemoral vein approach. All repositioning was initially attempted with a Grollman catheter or other pigtail catheter and a tip-deflecting wire. If these techniques failed or the venous anatomy was unfavorable, gooseneck or long loop snares were used. Results: During 48 repositionings, rotating a pigtail-type catheter alone was used successfully in 39 (81%). In 6 of 9 failures, the addition of a tip-deflecting wire also failed. A Grollman catheter and tip-deflecting wire were used initially in 39 repositionings (6 failures; 85% success). Successful repositioning required a snare in 8 (4 as the primary repositioning technique) and a long-loop technique in 5. All repositionings were ultimately successful and there were no complications. Conclusion: Central venous catheters can be repositioned consistently by the transfemoral route. Pigtail catheters or tip-deflecting wires alone are successful in over 80% of cases

14

Tunica vaginalis hydrocele of reposited testis  

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Full Text Available Tunica vaginalis hydrocele (TVH is a relatively common entity. The procedure of testicular reposition in a subcutaneous pouch following severe scrotal avulsion injury is also a standard line of care. Though, the occurrence of TVH in such a reposited testis is extremely rare clinical presentation. We herein report a case of 55-year male patient who presented with swelling over medial aspect of left upper thigh which was diagnosed as TVH of reposited testis on detailed assessment. The patient was managed on the usual lines of management protocols of TVH with successful outcome.

Tiwari Manish

2009-01-01

15

Case reports: headache caused by a spinal cord stimulator in the upper cervical spine.  

Science.gov (United States)

We report persistent headaches developing in a patient subsequent to the placement of a spinal cord stimulator in the upper cervical spine. These persistent headaches responded to dihydroergotamine and sumatriptan. Headaches ceased upon repositioning of the stimulator lower in the cervical spine. We postulate an effect of the device on the trigeminovascular system via the nucleus caudalis trigeminalis and/or spinal trigeminal tract. PMID:10971668

Ward, T N; Levin, M

2000-09-01

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Temporal Optimization Planning for Fleet Repositioning  

DEFF Research Database (Denmark)

Fleet repositioning problems pose a high financial bur- den on shipping firms, but have received little attention in the literature, despite their high importance to the shipping industry. Fleet repositioning problems are characterized by chains of interacting activities, but state-of-the-art planning and scheduling techniques do not offer cost models that are rich enough to represent essential objectives of these problems. To this end, we introduce a novel framework called Temporal Optimization Planning (TOP). TOP uses partial order planning to build optimization models associated with the different possible activity scenarios and applies branch-and-bound with tight lower bounds to find optimal solutions efficiently. We show how key aspects of fleet repositioning can be modeled using TOP and demonstrate experimentally that our approach scales to the size of problems considered by our industrial collaborators.

Tierney, Kevin; Jensen, Rune MØller

17

Human experience with canalith repositioning maneuvers.  

Science.gov (United States)

Three distinct pathological conditions, related to different means by which dense intralabyrinthine particles interfere with the function of a semicircular canal and cause nystagmus and vertigo, are amenable to treatment with repositioning maneuvers. Known as benign paroxysmal positional vertigo and variants, these conditions are better designated collectively by the term "vestibular lithiasis." Each form requires a different treatment strategy of head maneuvers and application of other modalities to restore normal semicircular function and thereby eliminate the positional nystagmus and vertigo. Real-time observation of the nystagmus induced by the particles during the maneuvers can greatly facilitate the repositioning process. PMID:11710460

Epley, J M

2001-10-01

18

Light-regulated gene repositioning in Arabidopsis.  

Science.gov (United States)

Plant genomes are extremely sensitive to, and can be developmentally reprogrammed by environmental light cues. Here using rolling-circle amplification of gene-specific circularizable oligonucleotides coupled with fluorescence in situ hybridization, we demonstrate that light triggers a rapid repositioning of the Arabidopsis light-inducible chlorophyll a/b-binding proteins (CAB) locus from the nuclear interior to the nuclear periphery during its transcriptional activation. CAB repositioning is mediated by the red/far-red photoreceptors phytochromes (PHYs) and is inhibited by repressors of PHY signalling, including COP1, DET1 and PIFs. CAB repositioning appears to be a separate regulatory step occurring before its full transcriptional activation. Moreover, the light-inducible loci RBCS, PC and GUN5 undergo similar repositioning behaviour during their transcriptional activation. Our study supports a light-dependent gene regulatory mechanism in which PHYs activate light-inducible loci by relocating them to the nuclear periphery; it also provides evidence for the biological importance of gene positioning in the plant kingdom. PMID:24390011

Feng, Chun-Miao; Qiu, Yongjian; Van Buskirk, Elise K; Yang, Emily J; Chen, Meng

2014-01-01

19

Training Student Teachers to Reposition Infants Frequently  

Science.gov (United States)

We evaluated the effects of an intervention designed to increase the variety of positions experienced by infants in a child-care setting. Six student teachers were trained, using a multicomponent intervention, to reposition infants according to a chart. The intervention was successful in increasing the mean percentage of correct position changes…

Cotnoir-Bichelman, Nicole M.; Thompson, Rachel H.; McKerchar, Paige M.; Haremza, Jessica L.

2006-01-01

20

GREPOS: A GENESIS database repositioning program.  

Science.gov (United States)

GREPOS is a mesh utility program that repositions or modifies the configuration of a two-dimensional or three-dimensional mesh. GREPOS can be used to change the orientation and size of a two-dimensional or three-dimensional mesh; change the material block...

G. D. Sjaardema

1990-01-01

 
 
 
 
21

DNA bending potentials for loop-mediated nucleosome repositioning  

Energy Technology Data Exchange (ETDEWEB)

Nucleosome repositioning is a fundamental process in gene function. DNA elasticity is a key element of loop-mediated nucleosome repositioning. Two analytical models for DNA elasticity have been proposed: the linear sub-elastic chain (SEC), which allows DNA kinking, and the worm-like chain (WLC), with a harmonic bending potential. In vitro studies have shown that nucleosomes reposition in a discontiguous manner on a segment of DNA and this has also been found in ground-state calculations with the WLC analytical model. Here we study using Monte Carlo simulation the dynamics of DNA loop-mediated nucleosome repositioning at physiological temperatures using the SEC and WLC potentials. At thermal energies both models predict nearest-neighbor repositioning of nucleosomes on DNA, in contrast to the repositioning in jumps observed in experiments. This suggests a crucial role of DNA sequence in nucleosome repositioning.

Langowski, Jorg [German Cancer Research Center, Heidelberg

2012-01-01

22

Automated Planning for Liner Shipping Fleet Repositioning.  

DEFF Research Database (Denmark)

The Liner Shipping Fleet Repositioning Problem (LSFRP) poses a large financial burden on liner shipping firms. During repositioning, vessels are moved between services in a liner shipping network. The LSFRP is characterized by chains of interacting activities, many of which have costs that are a function of their duration; for example, sailing slowly between two ports is cheaper than sailing quickly. Despite its great industrial importance, the LSFRP has received little attention in the literature. We show how the LSFRP can be solved sub-optimally using the planner POPF and optimally with a mixed-integer program (MIP) and a novel method called Temporal Optimization Planning (TOP). We evaluate the performance of each of these techniques on a dataset of real-world instances from our industrial collaborator, and show that automated planning scales to the size of problems faced by industry.

Tierney, Kevin; Jensen, Rune MØller

2012-01-01

23

The spine  

International Nuclear Information System (INIS)

High-resolution magnetic resonance imaging (MRI) of the spine promises to replace all other imaging modalities including plain films, computed tomography (CT), and myelography, in most disorders affecting the cord or canal. Stringent objective criteria of high-quality, high-resolution images have not been firmly established. Critical components revolve about optimization of signal to noise (S/N), good contrast, and good edge definition, the latter representing an important component of spatial detail. Signal-to-noise ratio is influenced by gradient coils, power supplies, preamps, fringe fields, eddy currents, software, etc.;and S/N also increases linearly with increasing field strength. A three- to five-fold increase in S/N can be achieved with surface receiving coils. Surface coils must be designed so that they are appropriate in size and impedance for the object being imaged and the size and weight of the patient. Depth resolution of surface coils is defined by the radius of the coil

24

Dual cervical thoracic coil for spine magnetic resonance imaging  

International Nuclear Information System (INIS)

The need for repositioning of surface coils and patients in MR examinations of the cervical and thoracic spin prolongs examination time. A new receiver design is proposed which overcomes this problem. The device is composed of two actively decoupled receiver coils mounted on the frame of a Philadelphia collar. These coils may be used separately to image either the thoracic or cervical spine or together to produce larger field-of-view images of the combined region. Signal-to-noise ratios of the separate cervical and thoracic spine images are not degraded as a result of mounting the receivers together. The full cervical and thoracic region is shown to be imaged at a signal-to-noise ratio significantly higher than that afforded by the body coil. A retrospective review of our case load suggests that a time saving could be achieved in approximately 1/3 of spine examinations by using this coil. (orig.)

25

Surgical repositioning of the impacted immature maxillary central incisor.  

Science.gov (United States)

Surgical repositioning is a treatment option for an impacted tooth with root dilaceration in an inverted position. In this case report, surgical repositioning of an abnormally impacted and labially dilacerated maxillary right central incisor is described. The impacted and dilacerated maxillary incisor was surgically repositioned in the early root development period and erupted into proper position with normal root development during a 2-year follow-up period. PMID:21206930

Choi, Sung Chul; Park, Jae Hong; Kwon, Yong-Dae; Yoo, Eun Kyu; Yoo, Jung Eun

2011-01-01

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Control rod repositioning considerations in core design analysis  

International Nuclear Information System (INIS)

Control rod repositioning is a method for minimizing rod cluster control assembly (RCCA) wear in the upper internals area where the guide cards interface with the rodlets of the RCCAs. A number of utilities have implemented strategies for rod repositioning, which often has no impact on the nuclear analysis for cases where the control rods are never repositioned into the active fuel. Other strategies involve repositioning the control rods several steps into the active fuel. The impact of this type of repositioning on the axial power shape and consequently the total peaking factor FQT varies, depending on the method in which the repositioning is implemented at the plant. Operating for long periods with all the control and shutdown rods inserted several steps in the active fuel followed by withdrawing them fully from the core results in a shifting of the power distribution toward the top of the core and must be accounted for in the design analysis. On the other hand, an optional plan for control rod repositioning that considers margins available in related design parameters can be devised that minimizes the effects of the repositioning for the reload. This paper summarizes a rod repositioning strategy implemented for a recent reload and some calculated power shape results for this strategy and other scenarios

27

Accurate patient repositioning for fractionated radiosurgery  

International Nuclear Information System (INIS)

Purpose/Objective: Fractionated radiosurgery can achieve better treatment results than conventional single session radiosurgery. Nevertheless, lack of accuracy in patient repositioning in consecutive sessions is the main concern in such techniques. In the present work a novel approach to address the issue of patient repositioning accuracy is presented. The method is developed such that patient repositioning accuracy is significantly increased. Patient discomfort, setup speed, robustness and cost were key factors considered during the development. Also, the method is developed such that it can be used along with frameless and frame based brain tumor radiosurgery systems. Methods and Material: A pair of common CCD cameras are employed to locate the patient in the 3D space. Skin markers are employed as features to generate a 3D model of the initial patient positioning. Initial patient setup can be performed utilizing either a stereotactic frame based or a frameless system. The repositioning process relies solely on accurate and robust detection of the markers. These markers remain on the patient until the entire fractionated radiosurgery is complete. The intersection point of two LASER beams, in the therapy room, defines the reference zero for the physical 3D space. Marker positions are calculated with respect to this reference. During follow-up sessions the system recalculates the patients position with respect to the constant reference and determines any deviations from the initial setup. Any incurring errors are in turn applied to correct deviations from the original plan parameters. In a frame based radiosurgery, after the initial setup, the frames can be removed from consecutive sessions, as the repositioning calculations are independent of the stereotactic frames. However, a fixture is required to keep the head motionless during consecutive treatment sessions. Results: Tests were performed on phantom head positioning and on human subjects. Errors induced from human positioning are in the order of millimeters. The new system achieves sub-millimetric accuracy in the human case, and in the order of (1(10)) of a millimeter for the phantom case. Accuracy of the technique is directly related to the camera resolution. As such, higher resolution cameras can provide improved accuracy. Influence of the number of markers utilized and the positioning was also evaluated. As a general rule, double redundancy in marker placement was sufficient to achieve the above stated accuracy. About 1-2 min were required to build the model and compare it to the reference on a 100 MHz Pentium based PC. Conclusion: High accuracy in repositioning facilitates the use of fractionated therapy. Due to the non-invasive nature of the markers and processing speed, the system results in no additional discomfort for the patient. The system is very cost effective as all the components are readily available in the market. Further considerations need to be addressed such that the method can be applied to areas other than the brain

28

Osteoporosis and Your Spine  

Science.gov (United States)

... spine, from the bottom (sacrum) to the top (cervical). People with osteoporosis most often break bones in the upper (thoracic) spine. When these bones break, they can cause pain, height loss and stopped or hunched posture, called ...

29

The SLAR (spacer location and repositioning) tool  

International Nuclear Information System (INIS)

The SLAR tool is a multifunctional device for locating and repositioning pressure tube to calandria tube spacers in a CANDU nuclear reactor. Eddy current and ultrasonic probes are used to detect the location of the spacers, measure the pressure tube to calandria tube gap, determine the tilt of the spacers, and inspect the pressure tube for indications of cracked hydride blisters. Hydraulic jacks are used to unload the spacers, and electromagnetic devices are used to move the spacers. The tool was extensively tested in a mock-up of a CANDU reactor. A demonstration of the tool was performed on a single fuel channel at the Pickering Nuclear Generating Station

30

Optimizing Liner Shipping Fleet Repositioning Plans  

DEFF Research Database (Denmark)

With the incredible growth of containerization over the past half century, shipping lines and ports are facing increasing challenges in ensuring that containers arrive at their destinations on time and on budget. This dissertation addresses several critical problems to the operations of shipping lines and ports, and provides algorithms and mathematical models for use by shipping lines and port authorities for decision support. One of these problems is the repositioning of container ships in a liner shipping network in order to adjust the network to seasonal shifts in demand or changes in the world economy. We provide the rst problem description and mathematical model of repositioning and dene the liner shipping eet repositioning problem (LSFRP). The LSFRP is characterized by chains of interacting activities with a multi-commodity ow over paths dened by the activities chosen. We rst model the problem without cargo ows with a variety of well-known optimization techniques, as well as using a novel method called linear temporal optimization planning that combines linear programming with partial-order planning in a branch-and-bound framework. We then model the LSFRP with cargo ows, using several dierent mathematical models as well as two heuristic approaches. We evaluate our techniques on a real-world dataset that includes a scenario from our industrial collaborator. We show that our approaches scale to the size of problems faced by industry, and are also able to improve the prot on the reference scenario by over US$14 million. This dissertation also addresses the topic of inter-terminal transportation (ITT), which involves minimizing the delay experienced by containers being transported between terminals in a port under varying infrastructure congurations and material handling equipment properties. Minimizing the delay of ITT is an important problem in the strategic planning of new ports and port expansions, and one that has not yet been addressed in an optimization based approach. We provide the rst mathematical model of ITT and show how the model can be used to provide critical information to port authorities on two real ports, the port of Hamburg, Germany, and the Maasvlakte area of the port of Rotterdam, Netherlands. Finally, this thesis gives a polynomial time algorithm for an open problem from the container stowage literature, the capacitated k-shift problem with a xed number of stacks and stack heights, providing an answer to a 13 year old theoretical question in the container stowage domain.

Tierney, Kevin

2013-01-01

31

South American policy: a sign for Argentine international repositioning  

Scientific Electronic Library Online (English)

Full Text Available SciELO Social Sciences | Language: English Abstract in english This paper summarises some comments and preliminary conclusions of a research project on the Argentine role in South American policy. The starting point is the importance the South American space has gained within the international context, in spite of the fact that it is excluded from the world age [...] nda. One of the fundamental problems of the evolution within this context since the 80s has been the frustration due to the lack of institutionalisation of the different integrationist schemes. In spite of rivalries, differences and mutual distrust, South American countries have organised a co-operation matrix, tightly-knit and significant. This proves that beyond interstate structures and their crises, the idea of South American integration is always in vogue. In this sense, a response based on the preservation of this idea can be given by Argentina by encouraging initiatives and strategies tending to improve co-operation through consensus in intraregional interdependence matters. This would contribute to reducing the influence of foreign factors as well as setting limits to possible hegemonic roles deriving from regional leaderships. In this way, Argentine participation in South American policy can be an effective possible path way towards international repositioning.

Roberto, Miranda; Andrea Assenti del, Rio.

32

An innovative cosmetic technique called lip repositioning  

Directory of Open Access Journals (Sweden)

Full Text Available A clinical report describing the successful use of the lip repositioning technique for the reduction of excessive gingival display. A female patient aged 34 years reported with a chief complaint of gummy smile and was treated with this technique performed under local anesthesia with the main objective to reduce gummy smile by limiting the retraction of elevator muscles (e.g., zygomaticus minor, levator anguli, orbicularis oris, and levator labii superioris. The technique is fulfilled by removing a strip of mucosa from maxillary buccal vestibule and creating a partial thickness flap between mucogingival junction and upperlip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display.

Gupta Krishna

2010-01-01

33

Lumbosacral spine x-ray  

Science.gov (United States)

X-ray - lumbosacral spine; X-ray - lower spine ... an x-ray. The most common reason for lumbosacral spine x-ray is to look for the ... Lumbosacral spine x-rays may show: Abnormal curves of the spine Abnormal wear on the cartilage and ...

34

Spine surgery - discharge  

Science.gov (United States)

... Hu SS. Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational ...

35

The ‘addicted’ spine.  

Directory of Open Access Journals (Sweden)

Medium Spiny Neurons of the Nucleus Accumbens show a reduced number of dendritic spines and a decrease in TH-positive terminals upon withdrawal from opiates, cannabinoids and alcohol. The reduction is localized ‘strictly’ to second order dendritic branches where, dopamine-containing terminals impinging upon spines, make synaptic contacts. In addition, long-thin spines seems preferentially affected raising the possibility that cellular learning of these neurons may be selectively hampered. These findings suggest that dendritic spines are affected by drugs widely abused by humans and provide yet another example of drug-induced aberrant neural plasticity with marked reflections on the physiology of synapses, system structural organization, and neuronal circuitry remodeling.

Marco Diana

2014-10-01

36

Cervical Spine Axial Rotation Goniometer Design  

Directory of Open Access Journals (Sweden)

Full Text Available To evaluate the cervical spine rotation movement is quiet harder than other joints. Configuration and arrangement of current goniometers and devices is not always practic in clinics and some methods are quiet expensive. The cervical axial rotation goniometer designed by the authors is consists of five pieces (head apparatus, chair, goniometric platform, eye pads and camera. With this goniometer design a detailed evaluation of cervical spine range of motion can be obtained. Besides, measurement of "joint position sense" which is recently has rising interest in researches can be made practically with this goniometer.

Emin Ula? Erdem

2012-06-01

37

Thoracic spine x-ray  

Science.gov (United States)

Vertebral radiography; X-ray - spine; Thoracic x-ray; Spine x-ray; Thoracic spine films; Back films ... care provider's office. You will lie on the x-ray table in different positions. If the x-ray ...

38

Magnetic Resonance Imaging (MRI) - Spine  

Science.gov (United States)

... artificial limbs or metallic joint prostheses implanted nerve stimulators metal pins, screws, plates, stents or surgical staples ... the spine may be imaged. For example, the cervical (neck) portion, the thoracic (chest) spine or the lumbar (lower) spine. If a contrast ...

39

Vertebroplasty for Spine Fracture Pain  

Science.gov (United States)

MENU Return to Web version Vertebroplasty for Spine Fracture Pain Vertebroplasty for Spine Fracture Pain More than 40 million people in the ... bones that puts them at risk for spine fractures (broken bones). Thinning of the bones can occur ...

40

Multiplanner spine computed tomography  

Energy Technology Data Exchange (ETDEWEB)

The computed tomography is useful in evaluation of bony structures and adjacent soft tissues of the spine. Recently, the multiplanar spine CT scan is highly superior than usual axial scan, because of easily demonstrable longitudinal dimension, level of spine and spinal canal. We evaluated 62 cases of spine CT, whom complains of spinal symptoms, from July, 1982 to January, 1983. The results were as follows: 1. The sex distribution of cases were 45 male and 17 female, ages were from 15 years to 76 years, and sites were 15 cervical spine, 7 thoracic spine, 42 lumbar spine and 21 sacral spine. 2. Sixty two cases of the CT diagnosis were reviewed and shows 19 cases of herniated intervertebral disc, 7 cases of spine fracture, 5 cases of degenerative disease, 4 cases of metastatic cancer, 2 cases of posterior longitudinal ligament ossification, 1 case of cord injury and 24 cases of normal. 3. The CT findings of herniated intervertebral disc were protruding disc, obliteration of anterior epidural fat, with or without indentation of dural sac and calcification within posterior disc margin. In cases of trauma, the multiplanar spine CT scan detects more specific extension of the fracture sites, and it is able to demonstrate relationship between fracture fragment and spinal cord, therefore operability can be decided. In case of posterior longitudinal ligament ossification, it is easy to demonstrate linear high density along posterior margin of vertebral bodies on sagittal reconstruction scan. 4. The computed tomography is diagnostic in detection of spinal disease. However, multiplanar spine CT is more diagnostic than axial computed tomography such as detecting the longitudinal dimension and demonstration of spinal canal.

Chung, H. K.; Jeon, H. J.; Hong, K. C.; Chung, K. B.; Suh, W. H. [Korea University College of Medicine, Seoul (Korea, Republic of)

1983-06-15

 
 
 
 
41

Shopping mall repositioning : a case study of New Town Plaza  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Hong Kong is an international metropolis and “Shopping Paradise”. Therefore, shopping in Hong Kong becomes one of the popular and important customary activities for the people. To compete with the keen and rapid change of market competition and shoppers’ living style and prevent old and deteriorated mall image, it is important for mall owner and operator to upkeep mall’s competitiveness by refurbishment work and repositioning exercises. To examine the repositioning strategies of Shopp...

Lai, Wai-kwan; ???

2013-01-01

42

The ageing spine  

International Nuclear Information System (INIS)

This book contain 15 selections. Some of the titles are: Effects of age on the appearance of magnetic resonance images of the spine; Potential for image analysis in quantitative magnetic resonance imaging of the aging spine; Potential of x-ray diffraction computed tomography for discriminating between normal and osteoporotic bone; and Spinal fusion in the elderly

43

Laryngeal dislocation after ventral fusion of the cervical spine.  

Science.gov (United States)

We report on a 70-year-old patient who underwent ventral fusion of the cervical spine (C3/4 and C4/5) for spinal canal stenosis performed by the neurosurgery department. The patient suffered an exceedingly rare complication of the surgery - laryngeal dislocation. Had the deformed laryngeal structures been overlooked and the patient extubated as usual after surgery, reintubation would have been impossible due to the associated swelling, which might have had disastrous consequences. Leftward dislocation of the larynx became apparent post-operatively, but prior to extubation. Extubation was therefore postponed and a subsequent computed tomography (CT) scan revealed entrapment of laryngeal structures within the osteosynthesis. A trial of repositioning using microlaryngoscopy performed by otolaryngology (ears, nose and throat) specialists failed, making open surgical revision necessary. At surgery, the entrapped laryngeal tissue was successfully mobilised. Laryngeal oedema developed despite prompt repositioning; thus, necessitating tracheotomy and long-term ventilation. Laryngeal dislocation may be an unusual cause of post-operative neck swelling after anterior cervical spine surgery and should be considered in the differential diagnosis if surgical site haematoma and other causes have been ruled out. Imaging studies including CT of the neck may be needed before extubation to confirm the suspicion and should be promptly obtained to facilitate specific treatment. PMID:23983289

Krauel, Jenny; Winkler, Dietrich; Münscher, Adrian; Tank, Sascha

2013-05-01

44

Case report: Non-operative repositioning and fixation of a fractured calcaneum in the operating theater; Fallstudie: Unblutige Reposition und Fixierung einer Fersenbeinfraktur im OP  

Energy Technology Data Exchange (ETDEWEB)

Using the mobile CT system Tomoscan M for non-operational repositioning and fixation of a fractured calcineum reduces the risk of infection and achieves anatomically exact and correct repositioning. (orig./CB) [German] Der Einsatz eines mobilen CT-Systems Tomoscan M bei der unblutigen Reposition und Fixierung einer Fersenbeinfraktur senkt das Infektionsrisiko und sorgt fuer eine exakte anatomische Repositionierung. Eine Fallstudie. (orig.)

Haeuser, H. [Zentralklinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie

2000-05-01

45

Revision cervical spine surgery.  

Science.gov (United States)

Principles of revision cervical spine surgery are based on adequate decompression of neural elements and mechanical stability via appropriate selection of surgical approach and constructs producing long-term stability with arthrodesis. When planning revision surgery, the surgeon must consider the cause of the underlying problem (eg, biological, mechanical), the potential for complications, and clinical outcomes that can reasonably be expected. This information should be clearly explained to the patient during the informed consent process. This article provides the spine care provider with an understanding of how to appropriately evaluate and manage the most common cervical conditions that require revision cervical spine surgery. PMID:22082635

Rihn, Jeffrey A; Harrod, Chambliss; Albert, Todd J

2012-01-01

46

Spine and sport.  

Science.gov (United States)

The spine, in athletes is a relatively frequent origin of problems. Chronic spine problems are much more common compared to acute injuries. Chronic injuries to the spine most often occur in low-contact sports like gymnastics and are most commonly the result of overuse. Acute injuries are more common in high-speed and full contact sports and are traumatic in origin. Injuries to the spinal cord can be devastating but are fortunately very uncommon. Although imaging of the spine appears to be straightforward, any radiologist will acknowledge that the optimal imaging strategy is often unclear due to several reasons. For the cervical spine much has improved since the NEXUS and CCR studies appeared in which clear rules were defined when to image the C-spine in acute trauma situations. For the thoracic and lumbar spines such rules are not defined. Although conventional imaging has long been the primary imaging modality of choice there is ample evidence that this should be abandoned in favor of multidetector CT for the C-spine. This is reflected in the ACR criteria in which conventional imaging of tile C-spine in trauma is rated as the least appropriate imaging method. However, this is not true in children and adolescents although a strict age criterion is not defined. It is also not true for injuries to the thoracic and lumbar spine in which conventional imaging still plays a large role as primary imaging modality followed by evaluation by CT in trauma situations. The role for MRI in acute situations is increasing especially with the increasing use of the TLICS system to classify injuries of the thoracic and lumbar spine in which the evaluation of the integrity of the posterior ligamentous structures is included. For the evaluation of chronic complaints, the roles of CT and MRI are basically reversed in which MRI will become the prime imaging modality of choice after conventional imaging after which CT can be reserved for a selected patient group. The merit of the different imaging modalities will be discussed together with a spectrum of acute and chronic injuries often encountered in the spine in athletes. PMID:24896742

de Jonge, Milko C; Kramer, Josef

2014-07-01

47

Design of an Automatic Repositioning Mortar System.  

Science.gov (United States)

The report describes the design, operation and test results of a fluidic system for automatic control of elevation and azimuth of a mortar. The sensing, logic and actuation are accomplished utilizing air. Interface problems are minimized by operating the ...

G. W. Woods, W. H. Ziegler

1973-01-01

48

Skeletal spine (image)  

Science.gov (United States)

The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae ...

49

Protecting Your Fragile Spine  

Science.gov (United States)

... also help certain individuals prevent disability and further curvature of the spine. The two options that are ... the vertebral area to create a space. The space is then filled with bone cement. ...

50

Lumbar Repositioning in Chronic Low Back Pain and Healthy Females  

Directory of Open Access Journals (Sweden)

Full Text Available Background and aim: Proprioception is a main component of somatosensory system that plays a protective role in acute injuries through reflex muscular splinting. Proprioception reduction could be a source of deficits in reaction time, postural control and postural stability. In chronic low back pain patients (CLBP the proprioception is decreased and leads to dysfunction in motor control and increased the risk of injury. Evaluation the repositioning of lumbar region could be an indication to measure the lumbar proprioception . The purpose of this study was to compare the lumbar repositioning in CLBP and healthy females. Material and Methods: Eighteen CLBP (22.83 ± 2.93 years and 18 healthy females (23.33 ± 2.19 years participated in this study. Lumbar repositioning error in 30% and 60% of lumbar full flexion and neutral position with closed eye in standing was evaluated with electrogoniometer. Absolute and constant error for 3 repositioning points were obtained and analyzed.Results: Absolute error in patients with low back pain was significantly higher than control subjects in all 3 position points (P0.05Conclusion: Increased in absolute error of females with CLBP in lumbar repositioning implies that some aspects of proprioception may lose in patients with CLBP.

S Mortezaiefar

2012-01-01

51

The "addicted" spine  

Science.gov (United States)

Units of dendritic branches called dendritic spines represent more than simply decorative appendages of the neuron and actively participate in integrative functions of “spinous” nerve cells thereby contributing to the general phenomenon of synaptic plasticity. In animal models of drug addiction, spines are profoundly affected by treatments with drugs of abuse and represent important sub cellular markers which interfere deeply into the physiology of the neuron thereby providing an example of the burgeoning and rapidly increasing interest in “structural plasticity”. Medium Spiny Neurons (MSNs) of the Nucleus Accumbens (Nacc) show a reduced number of dendritic spines and a decrease in TH-positive terminals upon withdrawal from opiates, cannabinoids and alcohol. The reduction is localized “strictly” to second order dendritic branches where dopamine (DA)-containing terminals, impinging upon spines, make synaptic contacts. In addition, long-thin spines seems preferentially affected raising the possibility that cellular learning of these neurons may be selectively hampered. These findings suggest that dendritic spines are affected by drugs widely abused by humans and provide yet another example of drug-induced aberrant neural plasticity with marked reflections on the physiology of synapses, system structural organization, and neuronal circuitry remodeling. PMID:25324733

Spiga, Saturnino; Mulas, Giovanna; Piras, Francesca; Diana, Marco

2014-01-01

52

The Liner Shipping Fleet Repositioning Problem with Cargo Flows  

DEFF Research Database (Denmark)

We solve an important problem for the liner shipping industry called the Liner Shipping Fleet Repositioning Problem (LSFRP). The LSFRP poses a large financial burden on liner shipping firms. During repositioning, vessels are moved between services in a liner shipping network. Shippers wish to reposition vessels as cheaply as possible without disrupting the cargo flows of the network. The LSFRP is characterized by chains of interacting activities with a multi-commodity flow over paths defined by the activities chosen. Despite its great industrial importance, the LSFRP has received little attention in the literature. We introduce a novel mathematical model of the LSFRP with cargo flows based on a carefully constructed graph and evaluate it on real world data from our industrial collaborator.

Tierney, Kevin; Jensen, Rune MØller

2012-01-01

53

Case report: Non-operative repositioning and fixation of a fractured calcaneum in the operating theater  

International Nuclear Information System (INIS)

Using the mobile CT system Tomoscan M for non-operational repositioning and fixation of a fractured calcineum reduces the risk of infection and achieves anatomically exact and correct repositioning. (orig./CB)

54

47 CFR 76.1601 - Deletion or repositioning of broadcast signals.  

Science.gov (United States)

... false Deletion or repositioning of broadcast signals. 76.1601 Section 76...COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO...1601 Deletion or repositioning of broadcast signals. Effective April 2,...

2010-10-01

55

CAMIF, an SME Repositioning Its Line as Sustainable Development Products  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of this article is to review the application of Sustainable Development (SD in the marketing strategies of French firms, and to show how one SME, CAMIF, has repositioned its product line around SD. Although SD policies in France are now driven by rising demands from lawmakers and consumers alike, their application has not yet become a central feature of the strategies of major companies and SMEs. In this regard, the innovative repositioning of CAMIF around fair and responsible value is found to be consistent with the firm’s values, and permeates its marketing mix.

Leïla Loussaïef

2012-06-01

56

A PDDL Domain for the Liner Shipping Fleet Repositioning Problem  

DEFF Research Database (Denmark)

The Liner Shipping Fleet Repositioning Problem (LSFRP) poses a large financial burden on liner shipping firms. During repositioning, vessels are moved between services in a liner shipping network. The LSFRP is characterized by chains of interacting activities, many of which have costs that are a function of their duration; for example, sailing slowly between two ports is cheaper than sailing quickly. Despite its great industrial importance, the LSFRP has received little attention in the literature. We model the LSFRP using PDDL and solve it using the planner.

Tierney, Kevin; Coles, Amanda

2012-01-01

57

Pediatric thoracolumbar spine trauma.  

Science.gov (United States)

Thoracolumbar spine trauma is an important cause of morbidity and mortality in pediatric patients. Special attention to this population is necessary because several unique features of the growing pediatric spine separate these patients from adult patients. These injuries are frequently associated with high-energy trauma and concurrent thoracic or abdominal injuries that require coordinated multidisciplinary care. Thoracolumbar spine trauma in pediatric patients may lead to compression fractures, burst fractures, flexion-distraction injuries (ie, Chance fracture), fracture-dislocation injuries, apophyseal fractures/herniations, and spinous process and transverse process fractures. Depending on the nature of the injury and the patient's level of skeletal maturity, thoracolumbar spinal injuries may have substantial ability to heal and remodel. Because the impact of thoracolumbar spinal injury on pediatric patients can be devastating, appropriate early diagnosis and management, as well as long-term follow-up, are imperative. PMID:24292927

Daniels, Alan H; Sobel, Andrew D; Eberson, Craig P

2013-12-01

58

A simple technique for head repositioning in CT scanning  

International Nuclear Information System (INIS)

With conventional CT scans, alterations of morphology on repeated examinations can only be appreciated if significant, because identical slice positions are impossible to achieve. The authors have developed a simple and accurate method of repositioning the head not requiring conventional stereotactic head fixation and suitable for the outpatient situation. (orig.)

59

Repositioning Ideology Critique in a Critical Theory of Adult Learning.  

Science.gov (United States)

Reexamines critical theory as a response to Marxism and repositions ideology critique as a crucial adult learning process. Argues that a critical theory of adult learning should focus on how adults learn to recognize and challenge ideological domination and manipulation. (Contains 31 references.) (SK)

Brookfield, Stephen

2001-01-01

60

Solving The Liner Shipping Fleet Repositioning Problem with Cargo Flows  

DEFF Research Database (Denmark)

We solve a central problem in the liner shipping industry called the Liner Shipping Fleet Repositioning Problem (LSFRP). The LSFRP poses a large financial burden on liner shipping firms. During repositioning, vessels are moved between routes in a liner shipping network. Shippers wish to reposition vessels as cheaply as possible without disrupting the cargo flows of the network. The LSFRP is characterized by chains of interacting activities with a multi-commodity flow over paths defined by the activities chosen. Despite its industrial importance, the LSFRP has received little attention in the literature. We introduce a novel mathematical model and a simulated annealing algorithm of the LSFRP with cargo flows that makes use of a carefully constructed graph and evaluate them on real world data from our industrial collaborator. Additionally, we compare our approach's performance against an actual repositioning scenario, one of many undertaken by our industrial collaborator in 2011, in which our simulated annealing algorithm is able to double the profit earned in our industrial collaborator's solution to $15.5 million dollars using only few minutes of CPU time, showing that our algorithm could be used in a decision support system to solve the LSFRP.

Tierney, Kevin; Áskelsdóttir, Björg

2013-01-01

 
 
 
 
61

Repositioning for the Future: Franklin and Marshall College.  

Science.gov (United States)

Franklin and Marshall College (Pennsylvania) has used institutional mission, strategic planning, lessons learned from previous experience, and sound general management principles to guide reallocation of resources during a period of financial constraint. The objective was repositioning, not retrenchment, and the resulting academic program is…

Hoffman, Richard B.

1992-01-01

62

Cervical spine chordoma  

Directory of Open Access Journals (Sweden)

Full Text Available Chordomas are neoplasms that arise from notochord embryonic remnants, been the sacrococcygeal spine the main site of involvement; the cervical spine site is uncommon and it account for less than 10% of chordomas. Because of their slow growth, the diagnosis is delayed until they reach a large size, despite which they are locally aggressive tumours due to their relation to critical neurovascular structures and present a high rate of local recurrence. Radical surgery is the elective treatment and proton radiotherapy is used when residual tumour tissue and recurrences.Because of the uncommonness of this pathology, we report a case of a patient with cervical chordoma.

Díez-González L

2012-03-01

63

Spine Involvement in Rheumatoid Arthritis  

Directory of Open Access Journals (Sweden)

Full Text Available Rheumatoid arthritis affecting the cervical spine has been well described. In contrast with the neck, thoracic and lumbar spine involvement has not been widely investigated. In this paper, pathophysiology, clinical findings and radiological imaging methods of spine involvement in rheumatoid arthritis was reviewed with the current reports. Turk J Phys Med Rehab 2008; 54 Suppl 1: 15-9

Ömer Faruk ?ENDUR

2008-05-01

64

Tuberculosis of the spine  

International Nuclear Information System (INIS)

Two surgically proven cases of turberculous psoas abscess are presented. The common findings on CT were low-density paraspinal masses and extension of the lesions which followed the typical distribution of iliopsoas muscle in both cases. The skeletal findings from the spine are also discussed. Our cases indicate the complementary use of plain radiography and CT in the investigation of tuberculous spondylitis. (orig.)

65

Tuberculosis of the spine  

Energy Technology Data Exchange (ETDEWEB)

Two surgically proven cases of turberculous psoas abscess are presented. The common findings on CT were low-density paraspinal masses and extension of the lesions which followed the typical distribution of iliopsoas muscle in both cases. The skeletal findings from the spine are also discussed. Our cases indicate the complementary use of plain radiography and CT in the investigation of tuberculous spondylitis.

Psarras, H.; Faraj, J.; Gouliamos, A.; Kalovidouris, A.; Vlahos, L.; Papavassiliou, C.

1985-07-01

66

Cervical spine in psoriasis  

Directory of Open Access Journals (Sweden)

Full Text Available X-rays of the cervical spines from patients with psoriasis and psoriatic arthritis were compared with similar films from a control population. Apophyseal narrowing, sclerosis, and calcification of anterior ligamants were found more commonly in patients than in controls

Banerjee Kalyan

1995-01-01

67

[Results of treatment of tibial spine fracture in children].  

Science.gov (United States)

In this work there are presented the results of the treatment of 10 patients with avulsion fracture of tibial spine. In this group were 9 boys and 1 girl. The age range was from 9 to 14, and the median age was 11.5. In 6 cases the diagnosed injuries were of I and II degree according to the classification of Meyers and McKeever. These were treated conservatively. In 4 cases the results were very good, in other two there occurred the extension deficiency lower than 5 degrees. 4 patients with the III degree injury underwent operation which constituted in the fracture reposition and stabilization with wire suture. In all cases the clinical results were very good. PMID:15307380

Rokicki, Rafa?; Ga?dzik, Tadeusz Szymon

2004-01-01

68

Lip repositioning: An alternative cosmetic treatment for gummy smile.  

Science.gov (United States)

Excessive gingival display, commonly referred to as 'gummy smile' is a major hurdle in overall personality of an individual. Gummy smile, secondary to altered passive eruption and tooth mal-positioning, can be predictably treated with Surgery and orthodontic therapy. In patients with jaw deformities, orthognathic surgery can be performed. However, this requires hospitalization and entails significant discomfort. Lip repositioning is a simple surgical procedure to treat 'gummy smile'. The procedure restricts the muscle pull of the elevator lip muscles thereby reducing the gingival display while smiling. This procedure is safe and predictable with minimal risk or side effects. This case report describes the successful treatment of excessive gingival display using surgical lip repositioning procedure which can be used as an alternative treatment modality for treatment of excessive gingival display. PMID:25210272

Dayakar, Mudnoor Manjunath; Gupta, Sachin; Shivananda, Hiranya

2014-07-01

69

Garter spring repositioning in Pickering and Bruce reactors  

International Nuclear Information System (INIS)

Several garter springs are strategically located in each fuel channel of a CANDU reactor to prevent the hot pressure tube from contacting the surrounding colder calandria tube. Many of the garter springs, though, are not in their design locations. This paper discusses the results of Ontario Hydro investigations into the movement of garter springs in CANDU reactors and presents the strategies the utility has adopted to reposition the springs in its Bruce and Pickering reactors

70

Chordoma Of Lumbar Spine  

Directory of Open Access Journals (Sweden)

Full Text Available Chordoma, lesion derived from the notochord, represents about 4% of the primary malignant bone tumours. Males are affected more commonly than females and it is very rare in children;the peak incidence is in the sixth decade of life.The sacrococcygeal region accounts for 50% of cases and the spheno-occipital region or the base of the skull for 37% of cases.The remainder of the cases reported occur in the descending order of frequency in the cervical,thoracic and the lumbar spine.It is found to be rarely involving the lumbar spine(about 2%.We present a case of chordoma involving L4 and L5 vertebral body and disc.The role of epithelial cell marker study has proved a well adjunct to the histopathological diagnosis of chordoma.

Nirmala M.J.*, H.A. Parshwanath and A.M.Patil

2010-10-01

71

Interventional spine procedures  

International Nuclear Information System (INIS)

Minimally invasive techniques for the treatment of some spinal diseases are percutaneous treatments, proposed before classic surgery. By using imaging guidance, one can significantly increase accuracy and decrease complication rates. This review report physiopathology and discusses indications, methods, complications and results of performing these techniques on the spine, including different level (cervical, thoracic, lumbar and sacroiliac) and different kind of treatments (nerve block, disc treatment and bone treatment). Finally the present article also reviews current literature on the controversial issues involved

72

Cervical Spine In Psoriasis  

Directory of Open Access Journals (Sweden)

Full Text Available Clinical study and X-ray of the cervical spine from patients with psoriasis and psoriatic arthritis were compared with similar films from a control population. Evidences suggest that neck is involved in psoriasis similar to those described for spondylitis. Apophyseal narrowing is 60% compared to 20% in control, apophyseal sclerosis is 40% compared to 15% in control, and an apophyseal calcification of anterior ligaments is 25% compared to 10% in control.

Banerjee Kalya

1995-01-01

73

Bony reconstruction by reposition of bony chips in suboccipital craniectomy  

Directory of Open Access Journals (Sweden)

Full Text Available In suboccipital craniectomy where the bone is not repositioned, there may be a significant cosmetic defect due to lack of skull bone in the suboccipital region. It may accompanied by sensory symptoms, including pain. To prevent any cosmetic defect and sensory symptoms we repositioned the bone chips at the craniectomy site in 42 suboccipital craniectomies before the closure of the scalp. At a mean follow-up of 22 months (range: 5-44 months, two patients complained of mild discomfort in the healed wound or of occasional local pain. One patient complained of mild itching at the site. In two patients, bone chips were accumulated at the lower part of the suboccipital craniectomy and failed to form a uniform bone cover at the operated site. In one patient, all bone chips were reabsorbed and there was no bone at the operated site. There was pseudomeningocele formation in one patient. In the rest of the cases there was satisfactory bone coverage at the operated site, both clinically and radiologically. The wound sites were aesthetically acceptable in 40 cases. Our study suggests that in the majority of cases where suboccipital craniotomy is not possible or not done, repositioning of the bone chips at the craniectomy site is associated with satisfactory aesthetic and functional outcome and formation of bone coverage at the operated site.

Chowdhury Forhad

2010-01-01

74

Charcot Spine and Parkinson's Disease  

Science.gov (United States)

Charcot spine is rare condition whose association with Parkinson's disease (PD) has not been reported yet. The authors reported the cases of two patients with PD who developed Charcot spine. Both patients presented with a history of back pain and bilateral radicular leg pain. They had complete clinical and radiological assessment. Lumbar spine was involved in both patients. Clinical features and response to treatment were described. In the first case, circumferential fusion and stabilization were performed on the dislocated vertebral levels. A solid and stable fusion of the spine was obtained with satisfactory clinical outcome. Surgical treatment has been recommended to the other patient. In both cases, no other neurological etiology was found to account for Charcot spine. In conclusion, Charcot spine is associated with several neurological affections but has not previously been reported in association with Parkinson's disease. PMID:25165591

Loriaut, Philippe; Rozenberg, Sylvie; Boyer, Patrick; Dallaudiere, Benjamin; Khiami, Frederic; Sariali, Elhadi; Pascal-Moussellard, Hugues

2014-01-01

75

Patient repositioning and pressure ulcer risk—Monitoring interface pressures of at-risk patients  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Repositioning patients regularly to prevent pressure ulcers and reduce interface pressures is the standard of care, yet prior work has found that standard repositioning does not relieve all areas of at-risk tissue in nondisabled subjects. To determine whether this holds true for high-risk patients, we assessed the effectiveness of routine repositioning in relieving at-risk tissue of the perisacral area using interface pressure mapping. Bedridden patients at risk for pressure ulcer formation (...

Matthew J Peterson, Phd; Nikolaus Gravenstein, Md; Wilhelm K Schwab, Phd; Johannes H Oostrom, Phd; Lawrence J Caruso, Md

2013-01-01

76

The feasibility of repositioning ability as a tool for ergonomic evaluation: effects of chair back inclination and fatigue on head repositioning.  

Science.gov (United States)

Poor posture has been suggested as one of the main factors contributing to the high prevalence of neck pain in video display unit (VDU) users, but no clear association between pain and any particular resting neck posture has been found. Postural awareness of the neck, as indicated by the repositioning accuracy, may therefore be an appropriate measure and potentially useful assessment tool. The objective of this study is to examine whether posture and fatigue affect the head repositioning ability in typical VDU usage. A group of 20 healthy participants reproduced a normal comfortable posture for forward, upright and backward chair back inclinations in random order both before and after fatigue of the upper trapezius muscles. Ten repetitions of the posture were recorded for 2 s each, and the angular and translational deviations from the original head position were measured with regard to the external environment (head in space repositioning) and with regard to the trunk (head on trunk repositioning). Analysis by repeated measures ANOVA showed significant effects and interactions of fatigue and chair back inclination on the repositioning errors in the sagittal plane, which typically showed systematic trends towards certain postures rather than random errors around a mean position. While further work is required to examine the ergonomic impact of impaired repositioning ability, head repositioning is sensitive to ergonomic factors such as seating configuration and fatigue, and may therefore be a useful tool for evaluation of static working postures. PMID:16801232

Wong, T F Y; Chow, D H K; Holmes, A D; Cheung, K M C

2006-07-15

77

MRI of the spine.  

Science.gov (United States)

Experience of more than 250 magnetic resonance (MR) examinations of the spinal cord is reported. MR imaging (MRI) using spin echo technique provides an excellent demonstration of the spine and the spinal cord, especially when appropriate surface coils are used. Consequently, MRI appears to be often the optimal imaging modality to be performed in cases of spinal cord tumors, extramedullar intradural tumoral, epidural lesions, syringo-hydromyelia, spinal cord compression by primary or secondary spinal canal stenosis, and traumatic lesions of the spinal cord. PMID:3635449

Balériaux, D; Deroover, N; Hermanus, N; Segebarth, C

1986-01-01

78

MRI of the spine  

International Nuclear Information System (INIS)

Experience of more than 250 magnetic resonance (MR) examinations of the spinal cord is reported. MR imaging (MRI) using spin echo technique provides an excellent demonstration of the spine and the spinal cord, especially when appropriate surface coils are used. Consequently, MRI appears to be often the optimal imaging modality to be performed in cases of spinal cord tumors, extramedullar intradural tumors, epidural lesions syringo-hydromyelia, spinal cord compression by primary or secondary spinal canal stenosis, and traumatic lesions of the spinal cord. (Auth.)

79

The postoperative spine.  

Science.gov (United States)

Potential complications following spinal surgery include neural compression due to hematoma, recurrent disk herniation, epidural fibrosis, dural tear with pseudomeningocele formation, and infection. Specific complications relate to the use of spinal instrumentation that include incorrectly positioned instrumentation and failure of spinal fusion leading to instrumentation loosening or breakage. To interpret the postoperative imaging correctly, it is necessary to understand the nature of the surgical procedure that has been performed and the normal postoperative appearances. Magnetic resonance imaging is the mainstay in the evaluation of the postoperative spine. Radiographs and computed tomography continue to have a major role in assessing fusion and in the assessment of complications related to instrumentation. PMID:24896745

Rankine, James J

2014-07-01

80

Numerical and experimental analysis of spine’s transpedicular stabilizer  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: The aim of the work was a numerical and experimental analysis of spine’s transpedicular stabilizer on lumbar part of spine. The result of the analysis was determination of displacements of the stabilizers’ elements.Design/methodology/approach: To define numerical characteristic of the lumbar spine – transpedicular spine stabilizer system, the finite element method was applied. Geometrical models of lumbar part of spine and transpedicular stabilizer were discretized by SOLID95 element. The boundary conditions imitating phenomena in real system with appropriate accuracy were established. The experimental analysis was carried out for spine’s transpedicular stabilizers which were implanted on lumbar part of pig spine. The analysis was realized by means of testing machine MTS Insight with the use of videoextensometer. Numerical and experimental analysis were carried out for stabilizer made of stainless steel Cr-Ni-Mo. System was loaded by uniaxial compression with forces from 50 N to 1600 N.Findings: The result of analysis was calculation of relative displacements of the transpedicular stabilizer in a function of the applied loading; F = 700 - 1600 N for numerical model and F = 50 - 1600 N for experimental model.Research limitations/implications: The results of numerical analysis for transpedicular stabilizer obtained by finite element method were used to determine a construction features of the stabilizer, and to select mechanical properties of metallic biomaterial. The calculation of displacements for stabilizer show that the proposed type of stabilizer enables correct stabilization of spine.Practical implications: Both results of numerical and experimental analysis showed correct selection of mechanical properties of metallic biomaterial which were used to made the proposed type of transpedicular stabilizer.Originality/value: Advantageous results of analysis showed that the type of stabilizer may be used in clinical practice.

M. Kiel

2010-07-01

 
 
 
 
81

De novo spine surgery as a predictor of additional spine surgery at the same or distant spine regions  

Science.gov (United States)

Introduction: Degenerative spine disorders are steadily increasing parallel to the aging of the population with considerable impact on cost and productivity. In this paper we study the prevalence and risk factors for multiple spine surgery and its impact on cost. Methods: Data on 1,153 spine surgery inpatients operated between October 2005 and September 2008 (index spine surgery) in regard to the number of previous spine surgeries and location of surgeries (cervical or lumbar) were retrospectively collected. Additionally, prospective follow-up over a period of 2-5 years was conducted. Results: Retrospectively, 365 (31.7%) patients were recurrent spine surgery patients while 788 (68.3%) were de novo spine surgery patients. Nearly half of those with previous spine surgery (51.5%) were on different regions of the spine. There were no significant differences in length of stay or hospital charges except in lumbar decompression and fusion (LDF) patients with multiple interventions on the same region of the spine. Significant differences (P<.05) in length of stay (5.4 days vs. 7.4 days) and hospital charges ($55,477 vs. $74,878) between LDF patients with one previous spine versus those with ?3 previous spine surgeries on the same region were noted. Prospectively, the overall reoperation rate was 10.4%. The risk of additional spine surgery increased from 8.0% in patients with one previous spine surgery (index surgery) to 25.6% in patients with ?4 previous spine surgeries on different regions of the spine (including index surgery). After excluding patients with previous spine surgeries on different regions of the spine, 17.2% of reoperated patients had additional spine surgery on a different spine region. The percentage of additional spine surgery on a distant spine region increased from 14.0% in patients with one spine surgery to 33.0% in patients with two spine surgeries on the same region. However, in patients with three or more spine surgeries on the same spine region there were no interventions on a distant spine region during the follow-up period. Conclusion: De novo spine surgery is associated with an increased incidence of additional spine surgery at the same or distant spine regions. Large prospective studies with extended follow-up periods and multifaceted cost-outcome analysis are needed to refine the appropriateness of spine surgery. PMID:21522488

Walid, M. Sami; Robinson, Joe Sam; Abbara, Moataz; Tolaymat, Abdullah; Robinson, Joe Sam

2011-01-01

82

De novo spine surgery as a predictor of additional spine surgery at the same or distant spine regions  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Degenerative spine disorders are steadily increasing parallel to the aging of the population with considerable impact on cost and productivity. In this paper we study the prevalence and risk factors for multiple spine surgery and its impact on cost. Methods: Data on 1,153 spine surgery inpatients operated between October 2005 and September 2008 (index spine surgery in regard to the number of previous spine surgeries and location of surgeries (cervical or lumbar were retrospectively collected. Additionally, prospective follow-up over a period of 2-5 years was conducted. Results: Retrospectively, 365 (31.7% patients were recurrent spine surgery patients while 788 (68.3% were de novo spine surgery patients. Nearly half of those with previous spine surgery (51.5% were on different regions of the spine. There were no significant differences in length of stay or hospital charges except in lumbar decompression and fusion (LDF patients with multiple interventions on the same region of the spine. Significant differences (P<.05 in length of stay (5.4 days vs. 7.4 days and hospital charges ($55,477 vs. $74,878 between LDF patients with one previous spine versus those with ?3 previous spine surgeries on the same region were noted. Prospectively, the overall reoperation rate was 10.4%. The risk of additional spine surgery increased from 8.0% in patients with one previous spine surgery (index surgery to 25.6% in patients with ?4 previous spine surgeries on different regions of the spine (including index surgery. After excluding patients with previous spine surgeries on different regions of the spine, 17.2% of reoperated patients had additional spine surgery on a different spine region. The percentage of additional spine surgery on a distant spine region increased from 14.0% in patients with one spine surgery to 33.0% in patients with two spine surgeries on the same region. However, in patients with three or more spine surgeries on the same spine region there were no interventions on a distant spine region during the follow-up period. Conclusion: De novo spine surgery is associated with an increased incidence of additional spine surgery at the same or distant spine regions. Large prospective studies with extended follow-up periods and multifaceted cost-outcome analysis are needed to refine the appropriateness of spine surgery.

Tolaymat, Abdullah

2011-01-01

83

Development of transducers for integrated garter spring repositioning system  

International Nuclear Information System (INIS)

In order to reposition the dislocated garter springs in active channels of 235 MW Pressurised Heavy Water Reactors (PHWRs), a tool named as Integrated Garter Spring Repositioning System (INGRES) has been developed. The tool consists of transducers to detect the concentricity between the Pressure Tube (P/T) and Calandria Tube (C/T) and also to detect garter springs in the channel besides different modules for correcting the eccentricity between P/T and C/T and garter spring repositioning. The transducers used in the system namely Concentricity Detection Probe (CDP) and Garter Spring Detection Probe (GSDP) are based on the eddy current techniques. The CDP makes use of four eddy current bobbin probes separated 90 degrees apart in cross sectional plane of channel assembly. The transducer gives output signal in proportional to the air gap between P/T and C/T in two axes (X and Y) which are designed for the purpose. The output of the unit is obtained on the Cathode Ray Oscilloscope (CRO) screen in the form of illuminated dot. The dot position on the CRO screen gives the information about mismatch in concentricity between P/T and C/T of the channel. The GSDP meant for detecting garter springs in PHWR channel uses two sets of primary and secondary coils connected in differential mode. The output signals from the transducers are processed through a signal processing unit devised for the purpose to obtain output from it as a horizontal beam on the CRO screen. The garter spring presence in the channel is indicated by a change in the voltage level of beam and also by audio-visual indication in the form of buzzer and LED illumination on the processing unit. This paper gives general design and development aspects of the CDP and GSDP transducers of the INGRES tool. (author). 3 figs

84

An investigation of a video-based patient repositioning technique  

International Nuclear Information System (INIS)

Purpose: We have investigated a video-based patient repositioning technique designed to use skin features for radiotherapy repositioning. We investigated the feasibility of the clinical application of this system by quantitative evaluation of performance characteristics of the methodology. Methods and Materials: Multiple regions of interest (ROI) were specified in the field of view of video cameras. We used a normalized correlation pattern-matching algorithm to compute the translations of each ROI pattern in a target image. These translations were compared against trial translations using a quadratic cost function for an optimization process in which the patient rotation and translational parameters were calculated. Results: A hierarchical search technique achieved high-speed (compute correlation for 128x128 ROI in 512x512 target image within 0.005 s) and subpixel spatial accuracy (as high as 0.2 pixel). By treating the observed translations as movements of points on the surfaces of a hypothetical cube, we were able to estimate accurately the actual translations and rotations of the test phantoms used in our experiments to less than 1 mm and 0.2 deg. with a standard deviation of 0.3 mm and 0.5 deg. respectively. For human volunteer cases, we estimated the translations and rotations to have an accuracy of 2 mm and 1.2 deg. Conclusion: A personal computer-based video system is suitable for routine patient setup of fractionated conformal radiotherapy. It is expected to achieve high-precision repositioning of the skin surface with high efficiency

85

Orthodontic repositioning of a malposed and dilacerated central incisor.  

Science.gov (United States)

Dilacerated teeth are commonly seen in the maxillary anterior region. They are a cause for concern to both patients as well as parents when such teeth do not erupt or erupt in an unusual position. Careful planning is required while aligning such teeth. Orthodontists often hesitate aligning severely dilacerated teeth due to high chances of failure. A case of a dilacerated and malposed right central incisor in an eleven-year-old male patient is presented here. The tooth was orthodontically repositioned despite its unusual position and severely dilacerated root. PMID:20502091

Hegde, C; Hegde, M; Parajuli, U

2009-01-01

86

[Endoscopic reposition of pylorogastric intussusception in a dog].  

Science.gov (United States)

A 7 month old West Highland White Terrier was presented with anorexia and vomitus since 4 days. On physical examination the dog was depressed, febrile and showed abdominal pain. During abdominal ultrasonographic examination a pylorogastric intussusception was suspected and this was confirmed subsequently by gastroscopy. The invaginated pylorus could be repositioned without complications using the endoscope. The dog recovered completely and without recurrence. A pylorogastric intussusception is a rarely diagnosed cause of an acute abdomen that can be resolved with a minimal invasive procedure. PMID:24867241

Schaffartzik; Titzmann; Glaus; Tschuor

2014-06-01

87

Repositioning of malpositioned or flipped central venous catheters  

International Nuclear Information System (INIS)

Primary misplaced or secondary flipped implanted catheters are located mostly in the right jugular vein. We demonstrate an effective method to replace fix implanted catheters such as Ports, Grochomg or Hickman catheters. Using a femoral venous approach, replacement into the superior vena cava can easily be done with a Sidewinder 1 catheter which is hooked over the misplaced central venous approach. In all our patients the method was successful. The repositioning technique described is simple, fast and has low costs. We can keep sterile conditions and do not need to solve the catheters' fixation. (orig.)

88

Cassini is repositioned and leveled in the PHSF  

Science.gov (United States)

Jet Propulsion Laboratory (JPL) technicians reposition and level the Cassini orbiter in the Payload Hazardous Servicing Facility at KSC in July after stacking the craft's upper equipment module on the propulsion module. A four-year, close-up study of the Saturnian system, the Cassini mission is scheduled for launch from Cape Canaveral Air Station in October 1997. It will take seven years for the spacecraft to reach Saturn. Scientific instruments carried aboard the spacecraft will study Saturn's atmosphere, magnetic field, rings, and several moons. JPL is managing the Cassini project for NASA.

1997-01-01

89

3-D repositioning and differential images of volumetric CT measurements  

International Nuclear Information System (INIS)

In quantitative computed tomography (QCT), time serial measurements are performed to detect a global bone density loss or to identify localized bone density changes. A prerequisite for an unambiguous analysis is the comparison of identical bone volumes. Usually, manual repositioning is too coarse. The authors therefore developed a mathematical procedure that allows matching two three-dimensional image volumes. The algorithm is based on correlation techniques. The procedure has been optimized and applied to computer-tomographic 3-D images of the human knee. It has been tested with both artificially created and in vivo measured image data. Furthermore, typical results of differential images calculated from real bone measurements are presented

90

Lipid dynamics at dendritic spines  

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Full Text Available Dynamic changes in the structure and composition of the membrane protrusions forming dendritic spines underlie memory and learning processes. In recent years a great effort has been made to characterize in detail the protein machinery that controls spine plasticity. However, we know much less about the involvement of lipids, despite being major membrane components and structure determinants. Moreover, protein complexes that regulate spine plasticity depend on specific interactions with membrane lipids for proper function and accurate intracellular signalling. In this review we attempt to gather the far from complete information available on the lipid composition at dendritic spine membranes and on its dynamics. We pay particular attention to the influence that spine lipid dynamism has on glutamate receptors, which are key regulators of synaptic plasticity.

Carlos Gerardo Dotti

2014-08-01

91

Baastrup's disease: The kissing spine.  

Science.gov (United States)

A 67-year-old male presented with a gradually progressive low back pain of 2 years duration. The patient was leading a retired life and there was no history of chronic fever or significant trauma. There was no radiation of pain or any features suggestive of claudication. There was no history of any comorbidity. The pain was aggravated with extension of the spine and relieved with flexion. There was no swelling or neurological deficit, but muscle spasm was present. Radiographs of the spine revealed degenerative changes in the lumbosacral spine, along with articulation of spinous processes at in lumbar spine at all levels level suggestive of Baastrup's disease, commonly known as "kissing spine". Routine blood investigations were within normal limits. The patient was managed conservatively. He was given a week's course of analgesics and muscle relaxants and then started on spinal flexion exercises, with significant improvement being noted at 6 months follow up. PMID:24579072

Singla, Amit; Shankar, Vivek; Mittal, Samarth; Agarwal, Abhinav; Garg, Bhavuk

2014-02-16

92

Fractures of the cervical spine  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in pol [...] ytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

Raphael Martus, Marcon; Alexandre Fogaca, Cristante; William Jacobsen, Teixeira; Douglas Kenji, Narasaki; Reginaldo Perilo, Oliveira; Tarcisio Eloy Pessoa de, Barros.

93

Fractures of the cervical spine  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in pol [...] ytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.

Raphael Martus, Marcon; Alexandre Fogaca, Cristante; William Jacobsen, Teixeira; Douglas Kenji, Narasaki; Reginaldo Perilo, Oliveira; Tarcisio Eloy Pessoa de, Barros.

1455-14-01

94

The spine problem: Finding a function for dendritic spines  

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Full Text Available Why do neurons have dendritic spines? This question— the heart of what Yuste calls “the spine problem”— presupposes that why-questions of this sort have scientific answers: that empirical findings can favor or count against claims about why neurons have spines. Here we show how such questions can receive empirical answers. We construe such why-questions as questions about how spines make a difference to the behavior of some mechanism that we take to be significant. Why-questions are driven fundamentally by the effort to understand how some item, such as the dendritic spine, is situated in the causal structure of the world (the causal nexus. They ask for a filter on that busy world that allows us to see a part’s individual contribution to a mechanism, independent of everything else going on. So understood, answers to why-questions can be assessed by testing the claims these answers make about the causal structure of a mechanism. We distinguish four ways of making a difference to a mechanism (necessary, modulatory, component, background condition, and we sketch their evidential requirements. One consequence of our analysis is that there are many spine problems and that any given spine problem might have many acceptable answers.

Sarah Malanowski

2014-09-01

95

Rescue surgery (surgical repositioning) of impacted lower second molars.  

Science.gov (United States)

The impaction of lower second molars, given that its incidence is 0.03 to 0.21%, is a rare complication in tooth eruption. It has been detected more often in unilateral form than bilateral and is more common in the mandible than in the maxillary. It has a slight predilection for males, and mesial inclination is more usual. A wide variety of therapeutic approaches have been published, basically referring to surgical techniques, independent or complemented by means of orthodontic technical aids, with the aim of placing the tooth in the correct position, and which are encompassed under the concept of surgical rescue. In cases resolved with repositioning of an impacted tooth, prophylactic root extraction has been proposed as obligatory. We present a case of a 12 and a half year old patient referred to the University of Seville due to non-eruption of the left lower second molar. The patient was referred by her orthodontist, who detected the impaction before starting orthodontic treatment. The orthodontist requested that, if it was possible, we did not extract the root of the third molar, because its eruption would be feasible in the future (there would be sufficient space in the arch). The spaces available were measured and we decided to attempt the repositioning of the impacted tooth without extracting the root of the wisdom tooth, which was carried out successfully. PMID:16264380

García-Calderón, Manuel; Torres-Lagares, Daniel; González-Martín, Maribel; Gutiérrez-Pérez, José Luis

2005-01-01

96

Canalith Repositioning Variations for Benign Paroxysmal Positional Vertigo  

Science.gov (United States)

Objective To determine if variations in common treatments for benign paroxysmal positional vertigo (BPPV) affected efficacy. Study Design Prospective, pseudo-randomized study. Setting Out-patient practice in a tertiary care facility Subjects and Methods Patients (n=118) with unilateral BPPV of the posterior canal, including 13 patients with BPPV of the lateral canal were tested at a tertiary care center on one of five interventions: canalith repositioning maneuver (CRP), CRP plus home exercise, modified CRP, CRP for patients with involvement of two semicircular canals, self-CRP home exercise. Self-CRP was also compared to previously published data on efficacy of the Brandt Daroff exercise. Main outcome measures were vertigo intensity and frequency, presence/ absence of Dix-Hallpike responses, Vestibular Disorders Activities of Daily Living Scale (VADL), computerized dynamic posturography. Results Vertigo intensity and frequency and Dix-Hallpike responses decreased significantly and posturography and VADL improved significantly from pre- to post tests. No other significant changes were found. The groups did not differ significantly. Vertigo intensity and frequency were not strongly related at pre-test but were related at post-test. Length of illness and age did not influence the results. Conclusions However the head is moved, as long as it is moved rapidly enough and through the correct planes in space repositioning treatments are likely to be effective. Therefore clinicians have a range of choices in selecting the treatment best suited for each patient’s unique needs. PMID:20723779

Cohen, Helen S.; Sangi-Haghpeykar, Haleh

2010-01-01

97

Rigid spine syndrome  

International Nuclear Information System (INIS)

A 16-year-old male with typical features of rigid spine syndrome orginally reported by Dubowitz in 1970, was studied by x-ray computed tomography (CT), histochemistry and electron-microscopy. A CT scan of the muscles showed characteristic findings of remarkable hypodensities of the cervical multifidus, semispinalis cervicis and capitis, multifidus of the back, erector spinae, long heads of biceps femoris and soleus muscles. Histochemical studies of the left rectus femoris muscle revealed increased variation in fiber diameters with type I fiber atrophy, partial necrosis and fatty degeneration, infiltration of phagocytes and no ragged red fiber. An electron microscopic examination disclosed increased vacuoles and lipid bodies, dilatation of sarcoplasmic reticula, deformed mitochondria and cytoplasmic bodies associated with derangement of myofibrils. The feature of Z band streaming strongly suggested that the cytoplasmic body originated from Z band degeneration. A review of the histopathological findings of the past literatures was also made. (author)

98

Spine injuries in dancers.  

Science.gov (United States)

Care of a dancer calls for a unique balance between athlete and artist. The physician must familiarize himself or herself with dance terminology, common moves, correct technique, and dancer's mentality. The goal is to work intimately with the dancer to care for the injury and, if possible, continue to participate in portions of dance class to limit anxiety and increase compliance to treatment. The spine is the second most injured area of the body in dancers, and many issues stem from poor technique and muscle imbalance. This often leads to hyperlordosis, spondylolysis, spondylolisthesis, lumbar facet sprain, discogenic back pain, and muscle spasm and piriformis syndrome. This article reviews these causes of low back pain with a focus on dance-related presentation and treatment issues. PMID:21228650

Gottschlich, Laura M; Young, Craig C

2011-01-01

99

Trauma of the spine  

International Nuclear Information System (INIS)

Primary reconstructive surgery is assuming increasing importance in the management of fractures of the spine. Analysis of the injury and thus surgical decision-making are greatly facilitated by the diagnostic power of CT and MRI. This volume provides a systemic introduction to the interpretation of CT and MRI images of injuries to the spinal column and the spinal cord, with special emphasis on the assessment or residual stability. Since survey X-rays remain the indispensable first step in radiodiagnosis, the typical appearances of spinal injuries on conventional films are also shown. This will help the reader interpret the CT and MRI images and also reflects the procedure in radiologic practice. The book's classification of spinal fractures, together with the attempt to conclude how the injury happened by analyzing the damage caused, paves the way for individually oriented therapy. (orig.) With 72 figs. in 132 separate illustrations

100

The Effect of Early Canalith Repositioning on Benign Paroxysmal Positional Vertigo on Recurrence  

Science.gov (United States)

Objectives Benign paroxysmal positional vertigo (BPPV) can be treated using a simple repositioning maneuver. This study demonstrates the effects of early repositioning therapy in patients with BPPV, especially with regard to recurrence. Methods We enrolled 138 consecutive patients who had been diagnosed with BPPV in the emergency rooms and ENT out-patient clinics of Chung-Ang University Hospital and Samyook Medical Center from January to June 2009. All patients immediately underwent appropriate canalith repositioning procedures (CRPs) depending on canalith type and location. The CRPs were performed daily until the patient's symptoms were resolved. The patients were classified into two groups according to the duration between symptom onset and initial treatment: less than 24 hours (early repositioning group, n=66) and greater 24 hours (delayed repositioning group, n=72). We prospectively compared the numbers of treatments received and the recurrence rates between the two groups. Results Follow-up periods ranged from 8 to 14 months, 77 cases involved posterior canal BPPV, 48 cases were lateral canal BPPV (of which 20 cases were cupulolithiasis), and 13 cases were multiple canal BPPV. BPPV recurrence was found in a total of 46 patients (33.3%). The necessary numbers of CRPs were 2.3 for the early repositioning group and 2.5 for the late repositioning group, a difference that was not statistically significant (P=0.582). The early repositioning group showed a recurrence rate of 19.7%, and the delayed repositioning group showed a recurrence rate of 45.8% (P=0.002). Conclusion Performing repositioning treatments as soon as possible after symptom onset may be an important factor in the prevention of BPVV recurrence. PMID:21949575

Do, Youn-Kyoung; Kim, Jin; Park, Chong Yoon; Chung, Myung-Hyun; Moon, In Seok

2011-01-01

 
 
 
 
101

Spine revisited: Principles and parlance redefined  

Directory of Open Access Journals (Sweden)

Full Text Available A revised appreciation of the evolution and the nature of bone in general and of vertebrae in particular, allows revisiting the human spine to usher in some new principles and more rational parlance, that embody spine?s phylogeny, ontogeny, anatomy and physiology. Such an approach accords primacy to spine?s soft-tissues, and relegates to its bones a secondary place.

Kothari M

2005-01-01

102

Repositioning maneuver for benign paroxysmal positional vertigo (BPPV).  

Science.gov (United States)

With vertigo, the symptom of unsteadiness is a common presenting complaint and the etiology protean. However, the specific subset of this patient population with benign paroxysmal positional vertigo (BPPV) is more defined. Cupololithiasis and canalithiasis are perhaps the best known and best described pathologic conditions resulting in vertigo. This condition occurs when otoconia from the utricle are displaced into the Posterior semicircular canal-cupula. The abnormal position of the otoconia often results in a pathological condition. The location of displacement is most often in the posterior semicircular canal. A better understanding of the etiology of BPPV has led to a simple and effective particle repositioning maneuver that allows the practitioner to alleviate vertigo symptoms for most patients using a simple manipulation. PMID:9195789

Brooks, J G; Abidin, M R

1997-05-01

103

siRNA Genome Screening Approaches to Therapeutic Drug Repositioning  

Directory of Open Access Journals (Sweden)

Full Text Available Bridging high-throughput screening (HTS with RNA interference (RNAi has allowed for rapid discovery of the molecular basis of many diseases, and identification of potential pathways for developing safe and effective treatments. These features have identified new host gene targets for existing drugs paving the pathway for therapeutic drug repositioning. Using RNAi to discover and help validate new drug targets has also provided a means to filter and prioritize promising therapeutics. This review summarizes these approaches across a spectrum of methods and targets in the host response to pathogens. Particular attention is given to the utility of drug repurposing utilizing the promiscuous nature of some drugs that affect multiple molecules or pathways, and how these biological pathways can be targeted to regulate disease outcome.

Ralph A. Tripp

2013-01-01

104

Remote repositioning of fuel channels in Bruce A reactors  

International Nuclear Information System (INIS)

Due to axial elongation, the fuel channels in Bruce A reactor Units 1, 2 and 3 were approaching the limit of support bearing engagement at the channel free ends. The elongation is induced by fast neutron irradiation of the Zr 2.5 wt% Nb pressure tube material, the rate being in the order of 4 mm per year. By repositioning the elongated fuel channels towards the fixed end, the full amount of bearing engagement at the free end is utilized, providing a further 10 years of normal operation. Described herein is the project which was implemented to execute the shifts on each of the 480 channels per reactor. The project encompassed a full life cycle, from tooling system conception to implementation on the reactor face. Remote operation of dedicated purpose tooling was maximized. (orig.)

105

THE POSSIBILITIES FOR REPOSITIONING OF THE OPATIJA RIVIERA'S TOURISM OFFER  

Directory of Open Access Journals (Sweden)

Full Text Available The competition on the tourist market is getting more harsh, which imposes the need for continuous co-operation of academic and economic community with the objective to get to know the latest wishes and aspirations of increasingly demanding tourists, and improvement of the tourism offer in accordance with their preferences. Maximum efforts must be invested in achieving recognisability and competitive advantages on the international tourist market. The purpose of the paper was to point out the importance of Opatija Riviera as a tourist destination in function of contributing the development of a Croatian tourist product. The goal of the paper was to give the presentation of the importance of researching the satisfaction with the offer of a tourist destination. It is necessary to reposition the current position of the Opatija Riviera on the tourist market and to, through adequate promotion of the tourist destination, increase the tourist turnover.

Ljerka Cerovic

2014-06-01

106

Radiology illustrated. Spine  

International Nuclear Information System (INIS)

Offers a practical approach to image interpretation for spinal disorders. Includes numerous high-quality radiographic images and schematic illustrations. Will serve as a self-learning book covering daily routine cases from the basic to the advanced. Radiology Illustrated: Spine is an up-to-date, superbly illustrated reference in the style of a teaching file that has been designed specifically to be of value in clinical practice. Common, critical, and rare but distinctive spinal disorders are described succinctly with the aid of images highlighting important features and informative schematic illustrations. The first part of the book, on common spinal disorders, is for radiology residents and other clinicians who are embarking on the interpretation of spinal images. A range of key disorders are then presented, including infectious spondylitis, cervical trauma, spinal cord disorders, spinal tumors, congenital disorders, uncommon degenerative disorders, inflammatory arthritides, and vascular malformations. The third part is devoted to rare but clinically significant spinal disorders with characteristic imaging features, and the book closes by presenting practical tips that will assist in the interpretation of confusing cases.

107

Disruption of spine homeostasis causes depression.  

Science.gov (United States)

Depression is one of the most burdensome diseases in the world. Although the exact pathogenesis remains unknown, stress is a well-known risk factor for the development of depression. Recently, stress has been known to induce loss of dendritic spines in neurons. Interestingly, also in human brains, higher levels of anxiety and depression scores are associated with decreased densities of spines in the hippocampus, supporting that the disturbance of spine homeostasis is deeply involved in the pathogenesis of depression. On the other hand, general serotonin vulnerability has been also proposed as a major risk factor in depression, where the paucity of available serotonin is involved in the pathogenesis of depression, indicating that the serotonergic system somehow possesses the ability to regulate spine homeostasis. However, the relationship between spine homeostasis and the serotonergic system is largely unknown. Thus, in this manuscript, I try to find the missing link between spine homeostasis and the serotonergic system. The hypothesis is as follows. First, stress reduces the number of spines. Since spine homeostasis is tightly regulated by the serotonergic system, the spine loss is compensated by activated serotonergic system in normal conditions. However, various factors, such as genetic predispositions and heavy stress, decrease the resilience of spine homeostasis. In such conditions, the serotonergic system cannot compensate spine homeostasis anymore, leading to disrupted spine homeostasis. Finally, disrupted spine homeostasis results in depression. The characteristic point of this hypothesis is that it can monistically explain the pathogenesis of depression, where disturbance of spine homeostasis is the main cause. PMID:23631853

Sato, Kohji

2013-07-01

108

Robotic systems in spine surgery.  

Science.gov (United States)

Surgical robotic systems have been available for almost twenty years. The first surgical robotic systems were designed as supportive systems for laparoscopic approaches in general surgery (the first procedure was a cholecystectomy in 1987). The da Vinci Robotic System is the most common system used for robotic surgery today. This system is widely used in urology, gynecology and other surgical disciplines, and recently there have been initial reports of its use in spine surgery, for transoral access and anterior approaches for lumbar inter-body fusion interventions. SpineAssist, which is widely used in spine surgery, and Renaissance Robotic Systems, which are considered the next generation of robotic systems, are now FDA approved. These robotic systems are designed for use as guidance systems in spine instrumentation, cement augmentations and biopsies. The aim is to increase surgical accuracy while reducing the intra-operative exposure to harmful radiation to the patient and operating team personnel during the intervention. We offer a review of the published literature related to the use of robotic systems in spine surgery and provide information on using robotic systems. PMID:24848165

Onen, Mehmet Resid; Naderi, Sait

2014-01-01

109

Cervical spine injury: tiger attack.  

Science.gov (United States)

Reports of tiger attacks in the United States are rare. This article presents a case of a young woman who was violently attacked by a Siberian tiger and sustained penetrating trauma to the neck, cervical spine, and bilateral lower extremities. This article presents both diagnostic and therapeutic management of patients who may present with similar injuries. Animal bites from large animals are prone to infection in 10% to 20% of cases. Most infections are polymicrobial, with Pasteurella multicida being the most common isolate. Animal bites also mandate consideration of tetanus and rabies prophylaxis. The decision to administer postexposure rabies prophylaxis is dependent on the type of animal involved, whether the exposure was provoked, the local epidemiology of rabies, and the availability of the animal for observation or testing. Assessment of patients with cervical spine injury requires knowledge of possible associated injuries. Evaluation involves assessment of plain radiographs and computed tomography for evaluation of the cervical spine for bony injury. Furthermore, computed angiography is advantageous to noninvasively evaluate carotid or vertebral artery injury at the same setting in patients with deep cervical puncture wounds. Surgical treatment of unstable cervical spine fractures with lateral mass screw and rod fixation has been reported in the literature to have superior biomechanical properties compared to anterior and posterior instrumentation and fusion. In recent clinical studies, the use of lateral mass screws for traumatic injury of the cervical spine has been associated with excellent maintenance of alignment and minimal complications. PMID:19226051

Anderson, Meredith; Utter, Philip; Szatkowski, Jan; Patrick, Todd; Duncan, William; Turner, Norman; Dekutoski, Mark

2008-12-01

110

Development of methods for detecting and repositioning of snug-fitting annulus spacers  

International Nuclear Information System (INIS)

Annulus spacers are used in the fuel channels of the CANDU power reactor to maintain the gap, or annulus space, between the pressure tube and surrounding calandria tube. It is important that the spacers remain close to their installed locations to prevent pressure tube to calandria tube contact and subsequent hydride blister formation. There is currently no means of in-service repositioning for snug-fitting annulus spacers. In addition, it is desirable to have a means to directly detect the location of a snug-fit spacer that does not rely on secondary effects of spacer location. AECL has been working to develop the capability to directly detect and reposition snug-fitting spacers. To date, means to detect and reposition snug-fitting spacers using vibration have been successfully demonstrated in the laboratory and work is continuing towards implementing this technology for field use. This paper presents an overview of the detection and repositioning techniques. (author)

111

Transconjunctival subperiosteal fat reposition for tear trough deformity: pedicled fat redraping versus septal reset.  

Science.gov (United States)

Fat-preserving lower blepharoplasty techniques are increasingly common, but to date there has been insufficient data comparing the results of fat repositioning and septal reset. The authors compared the aesthetic results of the 2 methods using statistical analysis. A total of 120 patients, who had undergone transconjunctival subperiosteal fat repositioning from February 2008 to April 2009, were included. Group 1 (71 patients) underwent fat reposition with pedicled infraorbital fat redraping. Group 2 (49 patients) underwent septal reset to reposition the underlying fat. Documentation of the results with grading (grade 0-III) by 2 surgeons was done, and the results were evaluated for clinical improvement.Septal reset showed statistical significance on grade improvement compared to direct fat manipulation methods in the patients with grade II and grade III deformities. Septal reset also showed a trend for a higher degree of improvement compared to the latter. There were no major postoperative complications. PMID:23722575

Youn, Seungki; Shin, Jong In; Kim, Jeong Tae; Kim, Youn Hwan

2014-11-01

112

[Treating benign paroxysmal positional vertigo with the canalith repositioning maneuver of Epley. Our experience].  

Science.gov (United States)

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common peripheral vestibular disorders. Particle repositioning maneuvers are simple and effective treatments for patients with BPPV. This study included 37 consecutive cases of BPPV treated with the particle repositioning maneuver of Epley. 97% of patients improved and the maneuver was well tolerated. We conclude that Epley Maneuver is safe and effective in the treatment of BPPV. PMID:11526863

Pérez Vázquez, P; Manrique Estrada, C; Muñoz Pinto, C; Baragaño Río, L; Bernardo Corte, M J; Suárez Nieto, C

2001-04-01

113

Degenerative disease of the spine  

International Nuclear Information System (INIS)

With few exceptions, magnetic resonance imaging (MRI) is becoming the modality of choice for the evaluation of degenerative disorders of the entire spine. With the implementation of surface coils and continued refinement and development of new pulse sequences, osseous and soft tissue structures of the spine can now be studied in great detail. The introduction of paramagnetic contrast agents has made it possible to differentiate epidural scar from recurrent disc herniation in the postoperative setting and to discern previously undetected degenerative changes within the intervertebral disc itself. This paper discusses the spectrum of degenerative diseases of the spine, including disc degeneration (intervertebral osteochondrosis), disc herniation, spinal stenosis, spondylosis deformans, and osteoarthritis. A brief description of the MR techniques and strategies used to evaluate these disorders is also

114

Correction of Asian Short Nose with Lower Lateral Cartilage Repositioning and Ear Cartilage Grafting  

Science.gov (United States)

Background: Asians with short nose lack the cartilage needed to extend the length of the nose. A rhinoplasty technique using lower lateral cartilage (LLC) repositioning and ear cartilage grafting allows for sufficient nasal lengthening and nasal tip mobility in the correction of short nose in Asians. Methods: Short nose was classified into 3 subtypes: type I, II, or III. During LLC repositioning, the LLC was separated from surrounding retaining structures, except at the footplate. The LLC was approximated medially and advanced with a Medpor strut. A silicone dorsal implant was inserted to suit the newly projected nasal tip. An ear cartilage onlay graft or ear cartilage extension graft was applied to further project and enhance the nasal tip and columella. Results: Of the 854 primary rhinoplasty procedures performed on Asian patients between January 2008 and December 2011, 295 were performed on patients with short nose. LLC repositioning and ear cartilage onlay grafting were performed on 228 patients. LLC repositioning and ear cartilage extension grafting with or without ear cartilage onlay grafting were performed on 67 patients. Short nasal tip, alar retraction, and columellar retraction were corrected. Wound dehiscence with marginal necrosis occurred in 7 patients. One patient developed nasal infection. Conclusions: LLC repositioning and ear cartilage grafting aid in the correction of short nose in Asians. With LLC repositioning and ear cartilage grafting, the nasal tip can be positioned in accordance with the patient’s anatomic limits. The entire nasal tip and columella can be lengthened, while the tip maintains its mobility.

Kim, Kenneth K.

2013-01-01

115

Patient repositioning and pressure ulcer risk—Monitoring interface pressures of at-risk patients  

Directory of Open Access Journals (Sweden)

Full Text Available Repositioning patients regularly to prevent pressure ulcers and reduce interface pressures is the standard of care, yet prior work has found that standard repositioning does not relieve all areas of at-risk tissue in nondisabled subjects. To determine whether this holds true for high-risk patients, we assessed the effectiveness of routine repositioning in relieving at-risk tissue of the perisacral area using interface pressure mapping. Bedridden patients at risk for pressure ulcer formation (n = 23, Braden score 95% of the observation period. Thirteen participants were observed in three distinct positions (supine, turned left, turned right, and all had specific skin areas (166 +/– 184 cm2 that exceeded pressure thresholds for >95% of the observation period. At-risk patients have skin areas that are likely always at risk throughout their hospital stay despite repositioning. Healthcare providers are unaware of the actual tissue-relieving effectiveness (or lack thereof of their repositioning interventions, which may partially explain why pressure ulcer mitigation strategies are not always successful. Relieving at-risk tissue is a necessary part of pressure ulcer prevention, but the repositioning practice itself needs improvement.

Matthew J. Peterson, PhD

2013-07-01

116

Degenerative disorders of the spine  

International Nuclear Information System (INIS)

Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

117

Degenerative disorders of the spine  

Energy Technology Data Exchange (ETDEWEB)

Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

Gallucci, Massimo; Puglielli, Edoardo; Splendiani, Alessandra [University of L' Aquila, Department of Radiology, L' Aquila (Italy); Pistoia, Francesca; Spacca, Giorgio [S. Salvatore Hospital, Department of Neuroscience, L' Aquila (Italy)

2005-03-01

118

Spine neck plasticity regulates compartmentalization of synapses.  

Science.gov (United States)

Dendritic spines have been proposed to transform synaptic signals through chemical and electrical compartmentalization. However, the quantitative contribution of spine morphology to synapse compartmentalization and its dynamic regulation are still poorly understood. We used time-lapse super-resolution stimulated emission depletion (STED) imaging in combination with fluorescence recovery after photobleaching (FRAP) measurements, two-photon glutamate uncaging, electrophysiology and simulations to investigate the dynamic link between nanoscale anatomy and compartmentalization in live spines of CA1 neurons in mouse brain slices. We report a diversity of spine morphologies that argues against common categorization schemes and establish a close link between compartmentalization and spine morphology, wherein spine neck width is the most critical morphological parameter. We demonstrate that spine necks are plastic structures that become wider and shorter after long-term potentiation. These morphological changes are predicted to lead to a substantial drop in spine head excitatory postsynaptic potential (EPSP) while preserving overall biochemical compartmentalization. PMID:24657968

Tønnesen, Jan; Katona, Gergely; Rózsa, Balázs; Nägerl, U Valentin

2014-05-01

119

Repositioning accuracy of cerebral fractionated stereotactic radiotherapy using CT scanning  

International Nuclear Information System (INIS)

Purpose: To evaluate the accuracy of patient repositioning in fractionated cerebral stereotactic radiotherapy using a Brain Lab stereotactic cranial mask in conjunction with standard dental fixation. Patients and methods: Fifty planning and checking CT scans were performed in 25 patients. The check CT scan was performed before or after one of the three sessions of treatment. Co registration to the planning CT scan was used to assess alignment of the iso centre to the reference markers. The relative position of the P.T.V. with regard to iso centre allowed us to determine its total displacement (3-dimensional vector). Results: Mean iso centre translations (± S.D.) taking into account direction were -0.01 ± 0.7, -0.2 ± 1.3 and 0.07 ± 0.5 mm in medio-lateral, cranio caudal and anteroposterior directions respectively. Mean rotations (±S.D.) were -0.02 ± 0.6, -0.08 ± 0.3 and -0.1 ± 0.3 degree in medio-lateral, cranio caudal and anteroposterior axes respectively. Mean overall P.T.V. displacement was 1.8 ± 1.5 mm. P.T.V. displacement was smaller than 2 and 3 mm in 19/25 and 23/25 patients respectively. Conclusion: The accuracy of patient positioning using a stereotactic cranial mask system is similar to those reported in the literature and shows a satisfactory reproducibility with a standard dental fixation. (authors)

120

Disk repositioning surgery of the temporomandibular joint with bioabsorbable anchor.  

Science.gov (United States)

The most common temporomandibular joint (TMJ) pathologic disease is anterior-medial displacement of the articular disk, which can lead to TMJ-related symptoms.The indication for disk repositioning surgery is irreversible TMJ damage associated with temporomandibular pain. We describe a surgical technique using a preauricular approach with a high condylectomy to reshape the condylar head. The disk is anchored with a bioabsorbable microanchor (Mitek Microfix QuickAnchor Plus 1.3) to the lateral aspect of the condylar head. The anchor is linked with a 3.0 Ethibond absorbable suture to fix the posterolateral side of the disk above the condyle.The aims of this surgery were to alleviate temporomandibular pain, headaches, and neck pain and to restore good jaw mobility. In the long term, we achieved these objectives through restoration of the physiological position and function of the disk and the lower articular compartment.In our opinion, the bioabsorbable anchor is the best choice for this type of surgery because it ensures the stability of the restored disk position and leaves no artifacts in the long term that might impede follow-up with magnetic resonance imaging. PMID:24036782

Spallaccia, Fabrizio; Rivaroli, Andrea; Basile, Emanuela; Cascone, Piero

2013-01-01

 
 
 
 
121

Magnetic resonance of the spine  

International Nuclear Information System (INIS)

This book contains 12 chapters. Three chapters discuss principles of cerebrospinal fluid flow, spinal imaging techniques, and the physical basis and anatomic correlates of signal intensity in the spine. There are chapters on normal anatomy, congenital anomalies, trauma, tumors, infection, demyelinating disease, degenerative disease, vascular conditions, and syringomyelia

122

Radiology of the cervical spine  

International Nuclear Information System (INIS)

The author describes some particularities seen in the abnormal or pathological image of the cervical spine: The osteolysis of the cortical bone in the spinous processes, the 'Y' shaped course of the corporeal veins, the notch in interspinous bursitis, and the main forms of constitutional stenosis of the cervical canal. (orig.)

123

Radiology of the cervical spine  

Energy Technology Data Exchange (ETDEWEB)

The author describes some particularities seen in the abnormal or pathological image of the cervical spine: The osteolysis of the cortical bone in the spinous processes, the 'Y' shaped course of the corporeal veins, the notch in interspinous bursitis, and the main forms of constitutional stenosis of the cervical canal.

Wackenheim, A.

1989-04-01

124

Canalith repositioning maneuver for benign paroxysmal positional vertigo  

Science.gov (United States)

OBJECTIVE To determine whether the canalith repositioning maneuver (CRM) is effective for treating benign paroxysmal positional vertigo when it is used by family physicians in primary care settings. DESIGN Randomized, prospective, double-blind, sham-controlled trial. SETTING An academic family practice in Hamilton, Ont. PARTICIPANTS Eighty-one patients 18 years or older whose dizziness was confirmed by the Dix-Hallpike (DH) vertigo-triggering maneuver and who had no contraindications to the CRM. INTERVENTIONS At the first visit, the intervention group received the CRM and the control group received a sham maneuver. Both groups received the CRM at the second and third visits 1 and 2 weeks later. MAIN OUTCOME MEASURES Negative results of the DH test or self-reported resolution of vertigo after the initial treatment. RESULTS Eighty-one patients were randomized and received the first treatment. After the first treatment, 34.2% of patients in the intervention group and 14.6% of patients in the control group had negative DH test results (relative risk 2.3, 95% confidence interval 1.03 to 5.2, P = .04); and 31.6% of patients in the intervention group and 24.4% of patients in the control group reported resolution of dizziness (relative risk 1.2, 95% confidence interval 0.7 to 1.9, P = .48). One week later, patients in both intervention and control groups received the CRM, and 61.8% and 57.1% of them, respectively, had negative DH test results (P = .81). By week 3, approximately 75% of patients in both groups had improved. CONCLUSION A statistically significant proportion of patients in the CRM group returned to a negative response to the DH maneuver immediately after the first treatment. Family physicians can use the CRM to treat benign paroxysmal positional vertigo and potentially avoid delays in treatment and unnecessary referrals. TRIAL REGISTRATION NUMBER NCT00182273 (ClinicalTrials.gov) PMID:17872784

Munoz, Juan E.; Miklea, Jonel T.; Howard, Michelle; Springate, Russ; Kaczorowski, Janusz

2007-01-01

125

Neutral spine control exercises in rehabilitation after lumbar spine fusion.  

Science.gov (United States)

Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk muscles after LSF was evaluated. Muscle activity was measured by surface electromyography of the rectus abdominis, external oblique, longissimus, and multifidus muscles during 6 exercises in 22 LSF patients (mean age = 59 years; age range = 25-84 years; 50% women). Muscle activity concurrent with trunk flexion and extension during maximal voluntary isometric contraction (MVIC) was used as a reference value. Pain during the effort was assessed with a visual analog scale (VAS). The highest activity in the rectus abdominis muscles was measured during bilateral shoulder extension (51% of MVIC), and in the external oblique, it occurred during unilateral shoulder horizontal adduction (48% of MVIC) and unilateral hip extension (46% of MVIC) exercises. The highest activation of the multifidus and longissimus muscles (60-104%) was measured during bilateral shoulder flexion and modified Roman chair exercises. The mean (SD) self-reported back pain VAS scores during exercises varied from 3 (7) to 16 (26). Neutral spine control exercises activate trunk muscles and cause minimal pain and are therefore feasible exercises for home-based training to improve muscle endurance and postural control after LSF. In addition, the level of muscle activity during bilateral shoulder flexion and modified Roman chair exercises was over 60% of MVIC, justifying their use in training for strength of the trunk extensor muscles. PMID:24343327

Tarnanen, Sami P; Neva, Marko H; Häkkinen, Keijo; Kankaanpää, Markku; Ylinen, Jari; Kraemer, William J; Newton, Robert U; Häkkinen, Arja

2014-07-01

126

Adaptive prostate IGRT combining online re-optimization and re-positioning: a feasibility study  

Energy Technology Data Exchange (ETDEWEB)

In prostate radiation therapy, inter-fractional organ motion/deformation has posed significant challenges on reliable daily dose delivery. To correct for this issue, off-line re-optimization and online re-positioning have been used clinically. In this paper, we propose an adaptive images guided radiation therapy (AIGRT) scheme that combines these two correction methods in an anatomy-driven fashion. The AIGRT process first tries to find a best plan for the daily target from a plan pool, which consists of the original CT plan and all previous re-optimized plans. If successful, the selected plan is used for daily treatment with translational shifts. Otherwise, the AIGRT invokes the re-optimization process of the CT plan for the anatomy of the day, which is afterward added to the plan pool as a candidate for future fractions. The AIGRT scheme is evaluated by comparisons with daily re-optimization and online re-positioning techniques based on daily target coverage, organs at risk (OAR) sparing and implementation efficiency. Simulated treatment courses for 18 patients with re-optimization alone, re-positioning alone and AIGRT shows that AIGRT offers reliable daily target coverage that is highly comparable to daily re-optimization and significantly improves from re-positioning. AIGRT is also seen to provide improved OAR sparing compared to re-positioning. Apart from dosimetric benefits, AIGRT in addition offers an efficient scheme to integrate re-optimization to current re-positioning-based IGRT workflow.

Li Taoran; Zhu Xiaofeng; Lee, W Robert; Vujaskovic, Zeljko; Yin Fangfang; Wu, Q Jackie [Department of Radiation Oncology, Duke University Medical Centre, Durham, NC (United States); Thongphiew, Danthai, E-mail: taoran.li@duke.edu [Department of Radiation Oncology, Brody School of Medicine, East Carolina University, Greenville, NC (United States)

2011-03-07

127

Adaptive prostate IGRT combining online re-optimization and re-positioning: a feasibility study  

Science.gov (United States)

In prostate radiation therapy, inter-fractional organ motion/deformation has posed significant challenges on reliable daily dose delivery. To correct for this issue, off-line re-optimization and online re-positioning have been used clinically. In this paper, we propose an adaptive images guided radiation therapy (AIGRT) scheme that combines these two correction methods in an anatomy-driven fashion. The AIGRT process first tries to find a best plan for the daily target from a plan pool, which consists of the original CT plan and all previous re-optimized plans. If successful, the selected plan is used for daily treatment with translational shifts. Otherwise, the AIGRT invokes the re-optimization process of the CT plan for the anatomy of the day, which is afterward added to the plan pool as a candidate for future fractions. The AIGRT scheme is evaluated by comparisons with daily re-optimization and online re-positioning techniques based on daily target coverage, organs at risk (OAR) sparing and implementation efficiency. Simulated treatment courses for 18 patients with re-optimization alone, re-positioning alone and AIGRT shows that AIGRT offers reliable daily target coverage that is highly comparable to daily re-optimization and significantly improves from re-positioning. AIGRT is also seen to provide improved OAR sparing compared to re-positioning. Apart from dosimetric benefits, AIGRT in addition offers an efficient scheme to integrate re-optimization to current re-positioning-based IGRT workflow.

Li, Taoran; Thongphiew, Danthai; Zhu, Xiaofeng; Lee, W. Robert; Vujaskovic, Zeljko; Yin, Fang-Fang; Wu, Q. Jackie

2011-03-01

128

Detection and repositioning of tight fighting annulus spacers in CANDU® fuel channels  

Energy Technology Data Exchange (ETDEWEB)

The latest generation of CANDU® reactors has been constructed with tight-fitting annulus spacers to maintain the annular gap between the inner pressure tubes and the outer calandria tubes. These spacers cannot be detected and repositioned with the existing Spacer Location and Repositioning (SLAR) process, which is designed to work with loose-fitting annulus spacers. There is currently no established technology to detect and reposition tight-fitting annulus spacers. Atomic Energy of Canada Limited has been performing research and development to locate and move tight-fitting annulus spacers using Modal Detection and Repositioning (MODAR) technology since 2005 and is currently working in collaboration with Candu Energy and Bruce Power on a production system to be deployed for an In-reactor demonstration in the next year. The MODAR technology uses controlled vibrations on a short, isolated length of pressure tube to locate and reposition tight-fitting annulus spacers. MODAR technology will allow the utilities to demonstrate fuel channel integrity to the regulator and obtain approval for additional years of reactor operation. This paper briefly describes the technology and provides an overview of the tool testing and development. (author)

Hersak, G.; Kittmer, A. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada); Goszczynski, J. [Candu Energy Inc., Mississauga, Ontario (Canada); Kazimer, D. [Bruce Power, Tiverton, Ontario (Canada)

2014-06-15

129

Radiation Exposure During Head Repositioning With the Automatic Positioning System for Gamma Knife Radiosurgery  

International Nuclear Information System (INIS)

Purpose: To measure radiation exposure to a patient during head repositioning with the automatic positioning system (APS) for Gamma Knife radiosurgery. Methods and Materials: A 16-cm diameter spherical solid phantom, provided by the manufacturer, was mounted to the APS unit using a custom-made holder. A small-volume ionization chamber (0.07-cm3 volume) was placed at the center of the phantom. We recorded the temporal variation of ionization current during the entire treatment. Measurements were made for 3 test cases and 7 clinical cases. Results: The average transit time between successive shots, during which the APS unit was moving the phantom for repositioning the shot coordinates, was 20.5 s for 9 cases. The average dose rate, which was measured at the center of the phantom and at a point outside the shot location, was 0.36 ± 0.09 cGy/min when the beam output was approximately 3.03 Gy/min for the 18-mm collimator helmet. Hence, the additional intracranial radiation dose during the APS-driven head repositioning between two successive shots (or APS transit dose) was 0.12 ± 0.050 cGy. The APS transit dose was independent of the helmet size and the position of shots within the phantom relative to the measurement point. Conclusion: The head repositioning with the APS system adds a small but not negligible dose to the dose expected for the manual repositioning method

130

Defining value in spine care.  

Science.gov (United States)

Spinal disorders are extremely common, debilitating, and costly to the payer and to society as a whole. The rate and cost of various spinal treatments are increasing at an astonishing rate, but it is unclear whether the resulting quality of spinal care is improving. Rather than focusing solely on quality improvement measures or cost-saving measures, there is a recent emphasis on the value of health care. Defining the value of spine care depends on a standardized, accurate method of measuring outcomes and costs. It is important that the outcomes measured are patient centered and that both the outcomes and costs are measured over time with long-term follow-up. The purpose of this article is to review current methods for measuring outcomes and propose a means by which the value of spine care can be more clearly defined. PMID:19890180

Rihn, Jeffrey A; Berven, Sigurd; Allen, Todd; Phillips, Frank M; Currier, Bradford L; Glassman, Steven D; Nash, David B; Mick, Charles; Crockard, Alan; Albert, Todd J

2009-01-01

131

Primary tumors of the spine.  

Science.gov (United States)

Spinal tumors consist of a large spectrum of various histologic entities. Multiple spinal lesions frequently represent known metastatic disease or lymphoproliferative disease. In solitary lesions primary neoplasms of the spine should be considered. Primary spinal tumors may arise from the spinal cord, the surrounding leptomeninges, or the extradural soft tissues and bony structures. A wide variety of benign neoplasms can involve the spine including enostosis, osteoid osteoma, osteoblastoma, aneurysmal bone cyst, giant cell tumor, and osteochondroma. Common malignant primary neoplasms are chordoma, chondrosarcoma, Ewing sarcoma or primitive neuroectodermal tumor, and osteosarcoma. Although plain radiographs may be useful to characterize some spinal lesions, magnetic resonance imaging is indispensable to determine the extension and the relationship with the spinal canal and nerve roots, and thus determine the plan of management. In this article we review the characteristic imaging features of extradural spinal lesions. PMID:24896744

Orguc, Sebnem; Arkun, Remide

2014-07-01

132

Fetal evaluation of spine dysraphism  

Energy Technology Data Exchange (ETDEWEB)

Spinal dysraphism or neural tube defects (NTD) encompass a heterogeneous group of congenital spinal anomalies that result from the defective closure of the neural tube early in gestation with anomalous development of the caudal cell mass. Advances in ultrasound and MRI have dramatically improved the diagnosis and therapy of spinal dysraphism and caudal spinal anomalies both prenatally and postnatally. Advances in prenatal US including high frequency linear transducers and three dimensional imaging can provide detailed information concerning spinal anomalies. MR imaging is a complementary tool that can further elucidate spine abnormalities as well as associated central nervous system and non-CNS anomalies. Recent studies have suggested that 3-D CT can help further assess fetal spine anomalies in the third trimester. With the advent of fetal therapy including surgery, accurate prenatal diagnosis of open and closed spinal dysraphism becomes critical in appropriate counselling and perinatal management. (orig.)

Bulas, Dorothy [George Washington University Medical Center, Division of Diagnostic Imaging and Radiology, Children' s National Medical Center, Washington, DC (United States)

2010-06-15

133

Thoracic spine CT, diagnostic efficacy  

International Nuclear Information System (INIS)

In 67 patients the diagnostic efficacy of thoracic spine CT was assessed. Diagnoses suspected clinically or by other examination methods could be confirmed by CT in 81 % and excluded in 18 % of cases. In one per cent (one case) the diagnosis, myelopathia vascularis, could not be seen by CT nor by myelography. In 49 cases the results of thoracic spine CT and myelography were compared with each other. CT gave additional information to myelography in 27 % (13/49), but not in 73 % (36/49). In 27 % (18/67) of the whole material CT was able to replace myelography. It seems that CT is useless if myelography is normal, but CT may be useful in tumors, infections and medullary diseases. In traumas CT may replace myelography. (orig.)

134

Heterogeneity of spine bone density  

International Nuclear Information System (INIS)

This short communication investigates how accurate bone density measured in the lumbar spine (L1-L4 or L2-L4) reflects the bone density of vertebrae where many compression fractures occur (T12 and L1). The ability of two dual-energy X-ray absorptiometers (Lunar DPX and Hologic QDR-1000) to determine the bone density of T12 was also investigated. (Author)

135

MRI of the fetal spine  

Energy Technology Data Exchange (ETDEWEB)

Magnetic resonance imaging of the fetal spine is a vital complement to fetal sonographic examination. Assessing the wide spectrum of spinal dysraphism, as well as spinal neoplasia, allows for more correct prenatal diagnoses, patient care planning, and patient counselling. Proper appraisal of the value of experimental procedures, such as fetal myelomeningocoele repair, requires a high level of diagnostic accuracy for the selection and follow-up of appropriate candidates. (orig.)

Simon, Erin M. [Departement of Radiology, Children' s Hospital of Philadelphia, PA (United States)

2004-09-01

136

Repositioning a laterally luxated maxillary central incisor with a vacuum-formed splint: a case report.  

Science.gov (United States)

Splinting is the standard care for stabilizing replanted or repositioned permanent teeth following trauma. Traditionally, semirigid splints are used to stabilize a repositioned tooth, with support provided by adjacent teeth. However, in cases when the adjacent teeth are wide and/or can only provide minimal anchorage and support, it is difficult to fix the luxated tooth to its original position. This case report describes how a clear vacuum-formed splint was used to reposition and stabilize an avulsed maxillary left central incisor. Due to the avulsion, an unerupted canine, and partially erupted premolars, it was difficult to fabricate a traditional splint, hence the creation of the vacuum-formed splint. PMID:24192748

Khandelwal, Vishal; Shigli, Anand L; Nayak, Ullal Anand

2013-01-01

137

Use of Tongue Blade to Reposition Palatally Luxated Tooth due to Trauma: A Novel Technique  

Science.gov (United States)

Abstract Luxational injuries to the permanent anterior teeth in children are a cause of concern. Palatal luxation of maxillary left central incisor with bleeding of gingival sulcus and fracture of maxillary right central incisor involving enamel and dentine in a 9-year- old girl is presented. The dental occlusion was deranged due to the luxation. Management consisted of repositioning of the luxated tooth using tongue blade under local anesthesia and composite build up of the fractured incisor. Tooth was stable in position with intact occlusion and no loss of vitality of pulp with a follow-up of 2 years. Tongue blade can be used as an alternative to forceful manual repositioning of teeth in selected cases. How to cite this article: Sharma A, Hegde AM. Use of Tongue Blade to Reposition Palatally Luxated Tooth due to Trauma: A Novel Technique. Int J Clin Pediatr Dent 2012;5(3):207-208. PMID:25206169

Hegde, Amitha M

2012-01-01

138

Drug repositioning: re-investigating existing drugs for new therapeutic indications.  

Science.gov (United States)

Drug discovery and development is an expensive, time-consuming, and risky enterprise. In order to accelerate the drug development process with reduced risk of failure and relatively lower costs, pharmaceutical companies have adopted drug repositioning as an alternative. This strategy involves exploration of drugs that have already been approved for treatment of other diseases and/or whose targets have already been discovered. Various techniques including data mining, bioinformatics, and usage of novel screening platforms have been used for identification and screening of potential repositioning candidates. However, challenges in clinical trials and intellectual property issues may be encountered during the repositioning process. Nevertheless, such initiatives not only add value to the portfolio of pharmaceutical companies but also provide an opportunity for academia and government laboratories to develop new and innovative uses of existing drugs for infectious and neglected diseases, especially in emerging countries like India. PMID:21654146

Padhy, B M; Gupta, Y K

2011-01-01

139

Fractionated stereotactic irradiation by Cyberknife of choroid melanomas: repositioning validation, closed eyelids  

International Nuclear Information System (INIS)

The fractionated stereotactic radiotherapy by Cyberknife is an option in the treatment of eyes tumors. The advantages of the Cyberknife in the choroid melanomas are in its infra-millimetric precision, to the automated repositioning on the skull bones and to the conformity brought by the stereotaxy. The objective of this study was to validate the quality of repositioning and the immobility of the eyes with closed eyelids. Conclusion: the reproducibility of the eye positioning with closed eyelids seems enough to consider the conservative treatment of choroid melanomas by fractionated stereotactic radiotherapy by Cyberknife without implementation of fiducials nor retrobulbar anaesthesia. (N.C.)

140

Reposition osteotomy for fracture neck of femur - A simplified technique of surgery and assessment of results  

Directory of Open Access Journals (Sweden)

Full Text Available Background : Delayed presentation of femoral neck fracture poses problem of management. Methods: Sixteen patients of fracture neck femur were treated with repositioning osteotomy and osteosynthesis with a 120 o double angle blade plate. Ten patients had Pauwel?s type II and 6 had type III fracture. Results : The average period for fracture healing was 14.87 weeks. No patient developed avascular necrosis. The average duration of follow up was 25 months. A new scoring system has been described. The results were excellent in four; good in nine; satisfactory in two and poor in one case. Conclusion : Reposition osteotomy provides stability and union in femoral neck fractures.

Nath Rajendra

2006-01-01

 
 
 
 
141

Remotely operated tooling systems for axial repositioning of fuel channel assemblies in CANDU power reators  

International Nuclear Information System (INIS)

Remote equipment has been designed and manufactured to perform cutting, axial repositioning and re-welding of the fuel channel assemblies in units 1, 2 and 3 of Ontario Hydro's Bruce A nuclear generating station. The equipment is controlled from outside reactor containment. Operators inside shielded facilities within containment perform installation and interchange of tooling. This project, called Bruce West Shift, has the objective of repositioning 480 fuel channels per reactor in an efficient manner. Expected reactor outage time and radiation exposure are a minimum of 80 days and 400 man-rem respectively. The requirements, design/development and testing of these tooling systems is described

142

Fractionated brain stereotactic radiotherapy: assessment of repositioning precision using a thermoforming mask  

International Nuclear Information System (INIS)

The authors report a study which aimed at assessing the patient repositioning precision obtained with a support system used during a brain fractionated stereotactic radiotherapy and comprising a thermoforming mask (Elektra head mask). The repositioning is assessed by means of scano-graphies and superimposition with the stereotactic frame. A three-dimensional vector has been computed for each patient. The average displacement corresponds to that published in literature. The high quality of the support system allows a non invasive brain stereotactic radiotherapy to be performed which is also comfortable for the patient. Short communication

143

Canal switch after canalith repositioning procedure for benign paroxysmal positional vertigo.  

Science.gov (United States)

Canal switch is a complication following canalith repositioning procedure (CRP) for posterior canal benign paroxysmal positional vertigo (BPPV). Instead of being returned to the utricle, the loose otoconia migrate into the superior or horizontal semicircular canal. Patients remain symptomatic, and treatment can be ineffective unless the switch is recognized and additional repositioning maneuvers directed toward the appropriate semicircular canal are performed. This report provides the first videographic documentation of canal switch involving conversion of unilateral posterior semicircular canal BPPV to geotropic horizontal canalithiasis. PMID:22549695

Lin, Giant C; Basura, Gregory J; Wong, Hiu Tung; Heidenreich, Katherine D

2012-09-01

144

49 CFR 572.19 - Lumbar spine, abdomen and pelvis.  

Science.gov (United States)

...2010-10-01 false Lumbar spine, abdomen and pelvis. 572.19 Section 572.19 Transportation... § 572.19 Lumbar spine, abdomen and pelvis. (a) The lumbar spine, abdomen, and pelvis consist of the part of the torso...

2010-10-01

145

49 CFR 572.9 - Lumbar spine, abdomen, and pelvis.  

Science.gov (United States)

...2010-10-01 false Lumbar spine, abdomen, and pelvis. 572.9 Section 572.9 Transportation... § 572.9 Lumbar spine, abdomen, and pelvis. (a) The lumbar spine, abdomen, and pelvis consist of the assemblies designated...

2010-10-01

146

Repositioning of an intraventricular dislocated aortic valve during transcatheter aortic valve implantation.  

Science.gov (United States)

The case is presented of a 75-year-old man referred for transcatheter aortic valve implantation. During the procedure the prosthetic aortic valve became dislocated into the left ventricle shortly after expansion. The subsequent steps taken to reposition the valve using only materials at hand are described. PMID:25296450

Natour, Ehsan; Douglas, Yvonne L; Jainandunsing, Jayant S; Schurer, Remco A J; van der Werf, Hendrik W; van den Heuvel, Ad F M

2014-05-01

147

Program management for spring location and repositioning (SLAR) operations at Pickering NGS  

International Nuclear Information System (INIS)

In 1988 a major project was planned for Units 5 and 6 of Pickering NGS (Nuclear Generating Station). The project involved remotely locating and repositioning the four spacer (garter) springs separating each pressure tube from the surrounding calandria tube. This paper describes the requirements for SLAR, and the work being undertaken at Pickering NGS to implement the project

148

Three dimensional assessment of repositioning accuracy of fractionated intracranial stereotactic radiotherapy  

International Nuclear Information System (INIS)

It is very important to achieve set-up accuracy of stereotactic radiotherapy. A non-invasive fixation mask device is used for stereotactic radiotherapy (SRT) in our hospital. Especially, fractionated stereotactic irradiation is useful due to less damage on normal tissues, for which the positioning accuracy of the removable non-invasive fixation device is important. We used our original 3-D examination of set-up, and examined the repositioning accuracy of a removable non-invasive fixation device on the coordinates of CT for treatment planning. The subjects were 25 patients who had undergone head SRT. The removable non-invasive fixation mask device used was for the BrainLAB system. The repositioning accuracy of the fixation device was examined using differences in the distance on the X, Y, and Z coordinates in each three points between the treatment planning and repositioning times determined by comparing the relative coordinates. Evaluation was performed using the relative coordinates of the standard and test points. In the 25 patients, an accuracy of the difference in the distance between the treatment planning and repositioning procedures within 2 mm was obtained in 79.1% of the patients using the fixation device. Our original 3-D examination of a set-up accuracy for non-invasive stereotactic irradiation was considered useful for routine treatment with high accuracy. (author)

149

Simulator verification of the accuracy of patient repositioning after virtual simulation. Is physical simulation still needed?  

International Nuclear Information System (INIS)

Purpose: To evaluate the frequency and amount of displacement after repositioning a patient on the physical simulator following virtual simulation. Material and Methods: After laser marking at the CT scanner and virtual simulation, patients were repositioned on the simulator. The isocenter obtained from the calculated table movements was checked by fluorescopically measuring the distances to standardized anatomic landmarks and comparing them to the treatment plan. Results: In 86% of patients, displacements were ? 0.5 cm. There was no significant difference between the supine and prone position, diagnosis categories or CT reconstruction indices. The use of immobilization devices and cranial versus body stem localization did make a significant difference. Rates of exact repositioning were high in brain and head and neck patients and comparatively low in abdominal tumors and breast cancer. Conclusions: Immobilization devices play an important role for the precision of radiotherapy. Whenever precise positioning is possible (e.g., with a head mask), virtual simulation alone might be sufficient. Patients with abdominal and breast tumors, where repositioning precision is often suboptimal, might profit from an additional physical simulation. (orig.)

150

Unraveling the Threads of White Teachers' Conceptions of Caring: Repositioning White Privilege  

Science.gov (United States)

This study explored two White inservice teachers' understandings of Whiteness in relation to privilege and caring. A yearlong professional development set of courses used a multimodal construction of three significant course experiences designed to reposition Whiteness and illuminate White teachers' predisposition to care for their students in…

Pennington, Julie L.; Brock, Cynthia H.; Ndura, Elavie

2012-01-01

151

The AC device for repositioning of garter springs in CANDU reactors  

International Nuclear Information System (INIS)

Displaced garter-spring spacers in CANDU reactors can lead to contact between the pressure tube and the calandria tube, resulting in eventual pressure tube failure. An inductive AC device has been developed to reposition the garter springs. The device operates safely and without any harmful effects on pressure tube integrity

152

Jurisprudence. Repositioning of cables and pipes. Who decides and who pays?  

International Nuclear Information System (INIS)

Underground cables and pipes sometimes need to be repositioned to make room for buildings. Can any exploiter of pipes be obliged to do this. And if this is the case, who should pay for it? Every year these questions are causing new disputes.

153

Optimization of the repositioning of critical assemblies in a nuclear reactor  

International Nuclear Information System (INIS)

It is proposed to optimize the repositioning of fuel assemblies in the core of a reactor. The reactor core is characterized by the smallest eigenvalue associated to the eigenvector of a partial differential equations system. In the first step the discrete variables are replaced by continuous ones and in the second step, the best approach of the optimal configuration obtained is secked

154

Repositioning Secondary School Administration for Quality Assurance in Ekiti State, Nigeria  

Directory of Open Access Journals (Sweden)

Full Text Available This paper discusses the challenges and prospects of repositioning secondary school administration for quality assurance in Ekiti State, Nigeria. In recent time, there had been a radical transformation of the education sector in Ekiti State part of which included the restructuring of the secondary school system. The senior and junior secondary schools were merged together to become a single school under the administration of a school principal. This paper examines the strategies used in repositioning secondary school administration for quality assurance by the state government. It highlights the challenges of repositioning the school administration based on the public outcry and the reactions of the school principals towards this new development. It x- rays the prospects of repositioning secondary school administration for quality assurance in Ekiti State to include high competency of secondary school administrators, removal of dichotomy between senior and junior secondary schools, unity and team work spirit among teachers, centralization of school policies, improved school infrastructures and facilities, and effective supervision of school personnel. The paper recommended among others that the Teaching Service Commission in Ekiti State should always consider performance, competency and years of experience in the appointment of secondary school principals.

Babatope Kolade Oyewole

2013-07-01

155

Development of a criterion for repositioning a relocatable stereotactic frame using depth helmet measurements  

International Nuclear Information System (INIS)

Based on 95% confidence intervals in the normal distribution, a criterion was developed for a relocatable stereotactic frame depth helmet measurement. The method for obtaining such a criterion is described. The criterion states that, if more than two points deviate more than 1.5 mm the frame should be repositioned

156

Pre and post garter spring repositioning ultrasonic inspection of pressure tubes  

International Nuclear Information System (INIS)

This paper present a description of the ultrasonic cracked hydride blister detections system used for pre and post inspection of pressure tubes during garter spring repositioning in CNE (Embalse Nuclear Power Station). Ultrasonic system setup configuration, transducers characteristics, blister detection head, calibration of parameters, operating procedure, records of ultrasonic inspections and evaluation. (author)

157

[The spine and horseback riding].  

Science.gov (United States)

115 horseback riders have undergone clinical and radiologic examinations of the spine. A minimum of 10 years' riding was required. Depending on intensity of training and number of riding hours, the subjects were divided into three groups: roughriders, sport riders and hobby riders. It was striking that of the bare half of cases (51) suffering from lower back, only 8 (about 15%) had had medical treatment and actually been disabled. Moreover, 47% of the riders with lower back pain were painfree in the saddle, i.e. when riding. No causal connection was found between riding and a higher incidence of osteochondrosis in some parts of the vertebral column. In roughriders and partly in sports riders an increased stress on the spine due to prolonged intensive training cannot be ruled out if the higher incidence of pathologic X-ray findings and low back pain in this group is taken into consideration. On the other hand, other factors such as deficiencies and hard work in the past may, especially in roughriders with a rural background, also be responsible. A higher incidence of spondylolisthesis than in the normal population was not found. It is important that riders should possess a strong back and gluteal muscular system in order to avoid early painful spinal decompensation, especially in cases with degenerative alteration and static form anomalies of the spinal column. PMID:1240657

Hördegen, K M

1975-05-24

158

Lateral extracavitary approach to spine  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. This paper describes the lateral extracavitary approach to the lumbar spine using the three­quarter prone position. Owing to unsatisfied results of the posterior approaches to spine in patients with the ventral compressive lesions, many ventral approaches as well as lateral extracavitary approach have been developed. Case Outline. A patient with tumor (chordoma of L3 vertebral body was operated on by means of ventral compression of cauda equina; the tumor had paraspinal propagation. Lateral extracavitary approach was used with a patient in three­quarter prone position, and corpectomy with the anterior stabilisation was performed followed by posterior transpedicular stabilisation through the same approach. Complete tumor removal and excellent neurological improvement were achieved. Conclusion. This approach provides safe ventral decompression of the spinal cord; it also enables the anterior and posterior instrumental stabilisation through the same incision and in the same position during the intervention. The three­quarter prone position allows excellent view of the dural sac.

Iveti? Dražen

2013-01-01

159

Tuberculosis of spine: neurological deficit.  

Science.gov (United States)

The most dreaded neurological complications in TB spine occur in active stage of disease by mechanical compression, instability and inflammation changes, while in healed disease, these occur due to intrinsic changes in spinal cord secondary to internal salient in long standing kyphotic deformity. A judicious combination of conservative therapy and operative decompression when needed should form a comprehensive integrated course of treatment for TB spine with neurological complications. The patients showing relatively preserved cord with evidence of edema/myelitis with predominantly fluid collection in extradural space on MRI resolve on non-operative treatment, while the patients with extradural compression of mixed or granulomatous nature showing entrapment of spinal cord should be undertaken for early surgical decompression. The disease focus should be debrided with removal of pus caseous tissue and sequestra. The viable bone should only be removed to decompress the spinal cord and resultant gap should be bridged by bone graft. The preserved volume of spinal cord with edema/myelitis and wet lesion on MRI usually would show good neural recovery. The spinal cord showing myelomalacia with reduced cord volume and dry lesion likely to show a poor neural recovery. The internal kyphectomy is indicated for paraplegia with healed disease. These cases are bad risk for surgery and neural recovery. The best form of treatment of late onset paraplegia is the prevention of development of severe kyphosis in initial active stage of disease. PMID:22565802

Jain, Anil K; Kumar, Jaswant

2013-06-01

160

Adaptive prostate IGRT combining online re-optimization and re-positioning: a feasibility study  

International Nuclear Information System (INIS)

In prostate radiation therapy, inter-fractional organ motion/deformation has posed significant challenges on reliable daily dose delivery. To correct for this issue, off-line re-optimization and online re-positioning have been used clinically. In this paper, we propose an adaptive images guided radiation therapy (AIGRT) scheme that combines these two correction methods in an anatomy-driven fashion. The AIGRT process first tries to find a best plan for the daily target from a plan pool, which consists of the original CT plan and all previous re-optimized plans. If successful, the selected plan is used for daily treatment with translational shifts. Otherwise, the AIGRT invokes the re-optimization process of the CT plan for the anatomy of the day, which is afterward added to the plan pool as a candidate for future fractions. The AIGRT scheme is evaluated by comparisons with daily re-optimization and online re-positioning techniques based on daily target coverage, organs at risk (OAR) sparing and implementation efficiency. Simulated treatment courses for 18 patients with re-optimization alone, re-positioning alone and AIGRT shows that AIGRT offers reliable daily target coverage that is highly comparable to daily re-optimization and significantly improves from re-positioning. AIGRT is also seen to provide improved OAR sparing compared to re-positioning. Apart from dosimetric benefits, AIGRT in addition offers an efficient scheme to integrate re-optimization to current re-p integrate re-optimization to current re-positioning-based IGRT workflow.

 
 
 
 
161

Ruptured disc after arthroscopic repositioning in the temporomandibular joint: a retrospective magnetic resonance imaging study.  

Science.gov (United States)

Our aim was to explore the incidence of rupture after arthroscopic repositioning of the disc of the temporomandibular joint (TMJ) by reviewing magnetic resonance images (MRI) of the TMJ taken before and after operation, and to investigate correlations retrospectively. We studied 247 patients with anterior disc displacement of the TMJ, and categorised them into 3 groups based on the postoperative MRI. The first group comprised those whose disc ruptured after repositioning, the second those who had a possible rupture of the disc after repositioning, and the third had no rupture of the disc after repositioning. Age, sex, duration of symptoms, maximum incisal mouth opening, whether the anterior disc displacement was unilateral or bilateral, and the Wilkes stage, were included in the analysis. The incidence of rupture (5/247) was 2%. Weak points at the intermediate zone of the disc were found in 4 of the 5 joints. The patients whose discs ruptured were significantly younger than the other 2 groups (p=0.001). There was no statistically significant difference in preoperative duration of symptoms and mouth opening among the groups. The proportions of unilateral and bilateral disc displacement (p=0.047) and Wilkes stage (p=0.027) differed among the 3 groups. The Wilkes stages was significantly more advanced in the ruptured group than in the other 2 groups (p=0.027) with 4/5 being bilateral. The weak point in the intermediate zone of the disc on MRI could be a sign of rupture. Teenagers and young adults with anterior disc displacement without reduction, particularly those in whom it is bilateral, are at a higher risk of a rupture after repositioning of the disc by arthroscopy. PMID:24736122

Li, Hui; Cai, Xieyi; Yang, Chi; Wang, Shaoyi; Huang, Linjian

2014-07-01

162

Novel electromagnetic technique for repositioning of coolant tube spacers in CANDU nuclear reactors  

International Nuclear Information System (INIS)

A novel electromagnetic technique to reposition the coolant tube spacers in the fuel channels of CANDU nuclear reactors was successfully developed in the fall of 1983 at Ontario Hydro Research Division. The need to reposition dislocated spacers in noncommissioned reactors was discovered subsequent to the rupture of a pressure tube in one reactor at the Pickering Nuclear Generator Station in Ontario. A contributing factor to the failure of the tube was the fact that the annular spacers (garter springs), used to maintain the coaxial configuration between the pressure tube and its surrounding calandria tube, had been displaced longitudinally for a number of years. Subsequent to this finding, it was discovered that a number of garter springs in noncommissioned nuclear reactors were displaced due to vibration induced by various sources during the construction stage. Since the garter springs are not directly accessible by mechanical means, extensive dismantling of the fuel channels would have been necessary to reposition the springs in their designated locations. This paper describes a novel method to reposition the garter springs without dismantling the fuel channels. The method consists of exerting a force on the springs in the direction of the required displacement by applying a large electromagnetic impulse (generated by a 200-kJ capacitor bank) to a drive coil inserted into the pressure tube opposite the spacer. The repositioning of displaced garter springs in five new reactors in Ontario has been carried out successfully in 1984. The saving in reactor repair cost, interest charges, and replacement energy cost was on the order of hundreds of millions of dollars. Equally large benefits and savings will be realized if the need to use this technique in commissioned reactors arises

163

Sport injuries of the cervical spine  

International Nuclear Information System (INIS)

The article reports on injuries of the cervical spine occurring during sports activities. An attempt is made to reconstruct the movements which led to the cervical spine injuries in question. In two cases of accidents occuring during bathing, one football accident and a toboggan accident, the injuries concerned point to hyperextension of the cervical spine as cause of the injury. In another football accident and a riding accident, the changes observed allow us to conclude that the movement leading to the injury must have been a hyperflexion. One accident occurring while jumping on the trampolin resulted in an injury of the upper cervical spine pointing to the action of a compressive force on the cervical spine in addition to the force resulting in hyperflexion. (orig.)

164

Postoperative syndrome after spine surgery  

International Nuclear Information System (INIS)

Postoperative syndrome after spine surgery, i.e., symptoms or syndromes caused by complications or procedure-related consequences, is gaining more and more importance. Due to great improvements concerning imaging and operative techniques (microsurgery, instrumentation) the total number of spinal surgeries as well as their related complications are increasing. Procedure-related postoperative complications including neurological deficit syndromes can occur acutely or at a later date. Concerning imaging techniques for postoperative evaluation after spinal surgery there are several modalities available. Their indications depend on complex factors including initial pathology the surgery was performed for, kind of surgical technique (surgical approach, instrumentation), anatomy of the patient as well as the time between onset of symptoms and surgery. In cases of ambiguous findings, the combination of different imaging techniques can be instrumental. (orig.)

165

Interventional spine procedures in athletes.  

Science.gov (United States)

Back pain is common in athletes and a source of missed time from practice and competition. Pain generators include muscle (strain), ligament (myofascial sprain and strain), intervertebral disc (herniation and degeneration), nerve (radiculopathy), joint (facet and sacroiliac (SI) joint), and bones (pars interarticularis defect). The goal of treatment of an athlete with back pain is to relieve symptoms and facilitate safe but rapid return to play with no change in performance. Initial conservative treatment includes relative rest, anti-inflammatory medications, and physical therapy. The use of interventional spine procedures in athletes with back pain has gained popularity as a nonoperative treatment option. Although there is lack of high-quality evidence of these procedures specifically in athletes, this article will discuss the utility of selective nerve root blocks, epidural steroid injections, intradiscal injections, pars interarticularis injection, facet joint interventions (intraarticular injection, medial branch block, and radiofrequency neurotomy), and SI joint interventions (intraarticular injection and radiofrequency neurotomy). PMID:23147023

Petron, David J; Prideaux, Cara C; Likness, Lincoln

2012-01-01

166

Hemangiopericytoma of the cervical spine.  

Science.gov (United States)

A 28-year-old male presented with neck pain and dysesthesias in the right upper limb. On examination, he had a firm, well-defined midline posterior cervical mass discernible on palpation at the mid-cervical level. He had no neurological deficit. Neuroradiology revealed a variegated enhancing cervical mass is arising from C3 lamina. The mass extended into the right extradural space eroding the C3 lamina and posteriorly into the intermuscular plane. The tumor was excised totally. Histopathology of the tumor showed features of hemangiopericytoma (HPC). The patient underwent postoperative radiotherapy. Primary osseous spinal HPC are rare malignant extra-axial tumors that tend to recur and metastasize. Only two cases of primary osseous HPC have been reported earlier to involve the cervical spine. The clinical presentation and management of the present case with a review of the literature is presented. PMID:25210342

Ramdasi, Raghvendra V; Nadkarni, Trimurti D; Goel, Naina A

2014-04-01

167

Role of image-guided patient repositioning and online planning in localized prostate cancer IMRT  

International Nuclear Information System (INIS)

Purpose: To determine the expected benefit of image-guided online replanning over image-guided repositioning of localized prostate cancer intensity-modulated radiotherapy (IMRT). Materials and methods: On 10 to 11 CT scans of each of 10 early-stage prostate cancer patients, the prostate, bladder and rectum are manually segmented. Using a 3-mm PTV margin expansion from the CTV, an IMRT plan is made on the first CT scan of each patient. Online repositioning is simulated by recalculating the IMRT plan from the initial CT scan on the subsequent CT scans of each patient. For online replanning, IMRT is replanned twice on all CT scans, using 0-mm and 3-mm margins. The doses from subsequent CT images of each patient are then deformed to the initial CT anatomy using a mesh-based thin-plate B-spline deformation method and are accumulated for DVH and isodose review. Results: Paired t-tests show that online replanning with 3-mm margins significantly increases the prostate volume receiving the prescribed dose over replanning with 0-mm margins (p-value 0.004); gives marginally better target coverage than repositioning with 3-mm margins(p-value 0.06-0.343), and reduces variations in target coverage over repositioning. Fractional volumes of rectum and bladder receiving 75%, 80%, 85%, 90%, and 95% (V75, V80, V85, V90, and V95) of the prescription dose are evaluated. V90 and V95 values for the rectum are 1.6% and 0.7 % for 3-mm margin replanning and 1% and 0.4 % for 0-mm margin replanning, with p-values of 0.010-0.011. No significant differences between repositioning and replanning with 3-mm margins are found for both the rectum and the bladder. Conclusions: Image-guided replanning using 3-mm margins reduces target coverage variations, and maintains comparable rectum and bladder sparing to patient repositioning in localized prostate cancer IMRT. Marginal reductions in doses to rectum and bladder are possible when planning margins are eliminated in the online replanning scenario. However, further reduction in treatment planning margins is not recommended.

168

Fine structure of synapses on dendritic spines.  

Science.gov (United States)

Camillo Golgi's "Reazione Nera" led to the discovery of dendritic spines, small appendages originating from dendritic shafts. With the advent of electron microscopy (EM) they were identified as sites of synaptic contact. Later it was found that changes in synaptic strength were associated with changes in the shape of dendritic spines. While live-cell imaging was advantageous in monitoring the time course of such changes in spine structure, EM is still the best method for the simultaneous visualization of all cellular components, including actual synaptic contacts, at high resolution. Immunogold labeling for EM reveals the precise localization of molecules in relation to synaptic structures. Previous EM studies of spines and synapses were performed in tissue subjected to aldehyde fixation and dehydration in ethanol, which is associated with protein denaturation and tissue shrinkage. It has remained an issue to what extent fine structural details are preserved when subjecting the tissue to these procedures. In the present review, we report recent studies on the fine structure of spines and synapses using high-pressure freezing (HPF), which avoids protein denaturation by aldehydes and results in an excellent preservation of ultrastructural detail. In these studies, HPF was used to monitor subtle fine-structural changes in spine shape associated with chemically induced long-term potentiation (cLTP) at identified hippocampal mossy fiber synapses. Changes in spine shape result from reorganization of the actin cytoskeleton. We report that cLTP was associated with decreased immunogold labeling for phosphorylated cofilin (p-cofilin), an actin-depolymerizing protein. Phosphorylation of cofilin renders it unable to depolymerize F-actin, which stabilizes the actin cytoskeleton. Decreased levels of p-cofilin, in turn, suggest increased actin turnover, possibly underlying the changes in spine shape associated with cLTP. The findings reviewed here establish HPF as an appropriate method for studying the fine structure and molecular composition of synapses on dendritic spines. PMID:25249945

Frotscher, Michael; Studer, Daniel; Graber, Werner; Chai, Xuejun; Nestel, Sigrun; Zhao, Shanting

2014-01-01

169

Trauma: Conventional radiologic study in spine injury  

International Nuclear Information System (INIS)

This book includes a discussion of the anatomy of the spinal cord and descriptions of methods for tailored radiologic investigation of spine trauma. Most of the text is devoted to the analysis and classification of spinal injury by radiologic signs and mode of injury. The author addresses injury to the entire spine but emphasizes the cervical spine. Plain radiography and conventional tomography are the only imaging methods discussed. The author stresses the active role of the attending radiologist in directing every phase of the x-ray study. Many subtle variations in patient positioning plus beam direction and angulation are described

170

Complication management with minimally invasive spine procedures.  

LENUS (Irish Health Repository)

Spine surgery as we know it has changed dramatically over the past 2 decades. More patients are undergoing minimally invasive procedures. Surgeons are becoming more comfortable with these procedures, and changes in technology have led to several new approaches and products to make surgery safer for patients and improve patient outcomes. As more patients undergo minimally invasive spine surgery, more long-term outcome and complications data have been collected. The authors describe the common complications associated with these minimally invasive surgical procedures and delineate management options for the spine surgeon.

Hussain, Namath S

2012-02-01

171

Computed tomography of the postoperative lumbar spine  

International Nuclear Information System (INIS)

In the postoperative patient ordinary radiographs of the spine generally add very little information, revealing the usual postoperative bone changes and often postoperative narrowing of the intervertebral space. Myelography may sometimes be informative, showing evidence of focal arachnoiditis or a focal defect at the surgical site. However, the latter finding is difficult to interpret. As experience with high-resolution CT scanning of the lumbar spine has been increasing, it is becoming apparent that this noninvasive and easily performed study can give considerably more information about the postoperative spine than any of the other current imaging methods. About 750 patients with previous lumbar laminectomies had CT scanning within a 28 month period

172

Effect of Laminectomy on Stability of Lumbar Spine Effect of Laminectomy on Stability of Lumbar Spine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The paper aims at the presentation of the lumbar spine finite element model used in a study of segmental kinematics including the tissue loading. Lumbar spine FE-model consisting of the three lumbar vertebras, two disc (including annulus and nucleus) and vast variety of ligaments. The primary model objective is its verification by experimental test data obtained from cadaver spine segments. A confirmed model was used for a study of various range of laminectomy effect. On this model we simulat...

Petr Tichy; Zdenek Horak; Jana Sindelarova

2009-01-01

173

Continued root development of a surgically repositioned human incisor tooth germ.  

Science.gov (United States)

Conventional orthodontic traction may not be the treatment of choice in cases of inverted impaction of a maxillary incisor, especially when located near the alveolar crest. Poor prognosis is associated with the limited space for proper root development, resulting in a root too short for normal function and/or a severely dilacerated root interrupting the force-induced positioning. The surgical repositioning of ectopic impacted toothgerm before the development of root could be a valuable alternative choice of treatment before the decision of extraction. In this case report, an impacted immature incisor toothgerm in complete inversion was surgically repositioned using a closed-flap technique in a boy who was 6 years 8 months old. Continued root formation and spontaneous eruption were observed after surgery over the 51-month follow-up period, without pulpal or periodontal complications. PMID:22771411

Kim, Seunghye; Kim, Junhewk; Song, Je Seon; Choi, Hyung-Jun; Choi, Byung-Jai; Kim, Seong-Oh

2013-05-01

174

Performance evaluation of eddy current transducers and associated instrumentation of integrated garter spring repositioning system  

International Nuclear Information System (INIS)

To extend the life of coolant channels of operating Indian Pressurised Heavy Water Reactors (PHWRs) of an early generation, repositioning of dislocated Garter Spring (GS) spacers is necessary. For this purpose a remotely operated system named INtegrated Garter spring REpositioning System (INGRES) has been developed. As a part of this system, eddy current transducers namely Garter Spring Detection Probe (GSDP) and Concentricity Detection Probe (CDP) along with respective signal processor units have been designed and developed. These devices detect GS spacers and eccentricity between Pressure Tube (PT) and Calandria Tube (CT) of the channel respectively. During a recent campaign of INGRES at Madras Atomic Power Station unit-2 (MAPS-2), these transducer systems have fulfilled intended design and operational objectives besides providing additional information regarding channel. These aspects are discussed. (author). 6 figs

175

Repositioning of the lower lateral cartilage in primary cleft nasoplasty: utilization of a modified Tajima technique.  

Science.gov (United States)

Repositioning the lower lateral cartilages during primary cleft nose repair often requires external bolsters to place suspension sutures. We describe a series of primary unilateral cleft nasal repairs using a modified Tajima technique. The cleft-side lower lateral cartilage is suspended to the contralateral upper lateral cartilage using a buried polydioxanone suture passed through a reverse-U incision with a hollow needle. A modified Tajima nasal repair was performed on 13 unilateral cleft patients. The average age was 6.6 months, and average follow-up was 9 months. All 13 patients demonstrated adequate repositioning of the lower lateral cartilage and improved tip symmetry. No postoperative infections, complications, or extruded sutures were observed. This modification to Tajima's technique allows suture placement without bolsters. We anticipate that long-term results will be maintained as well, if not better than other series, as placing a buried polydioxanone stitch avoids the need for suture removal. Continued monitoring will confirm this. PMID:20395793

Rottgers, Stephen Alexander; Jiang, Shao

2010-05-01

176

Percutaneous Transgastric Snaring for Repositioning of a Dislocated Internal Drain from a Pancreatic Pseudocyst  

International Nuclear Information System (INIS)

Pancreatic pseudocysts may occur in up to 10% of patients with acute or chronic pancreatitis. Symptomatic, persistent, and infected pancreatic pseudocysts require interventional therapy. We present the case of a patient with complete dislocation of a double pigtail catheter into an infected pseudocyst and the repositioning of the drainage catheter using a transgastric snaring technique. The combination of CT-guided percutaneous puncture and fluoroscopic snaring permitted minimally invasive management of this rare complication.

177

Serial repositioning of a Guenther tulip retrievable inferior vena cava filter in a pediatric patient  

International Nuclear Information System (INIS)

We report an 11-year-old boy who required inferior vena cava (IVC) filtration for a prolonged period of time. A retrievable IVC filter was placed and repositioned three times, providing a total of 60 days of IVC filtration. The filter was removed when his risk of pulmonary embolus had decreased substantially. This is a relatively uncommon practice in the pediatric population. The technique is presented, and the available literature is reviewed. (orig.)

178

Rational drug repositioning guided by an integrated pharmacological network of protein, disease and drug  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background The process of drug discovery and development is time-consuming and costly, and the probability of success is low. Therefore, there is rising interest in repositioning existing drugs for new medical indications. When successful, this process reduces the risk of failure and costs associated with de novo drug development. However, in many cases, new indications of existing drugs have been found serendipitously. Thus there is a clear need for establi...

2012-01-01

179

Helmet Versus Active Repositioning for Plagiocephaly: A Three-Dimensional Analysis  

DEFF Research Database (Denmark)

BACKGROUND AND PURPOSE: Orthotic helmets and active repositioning are the most common treatments for deformational plagiocephaly (DP). Existing evidence is not sufficient to objectively inform decisions between these options. A three-dimensional (3D), whole-head asymmetry analysis was used to rigorously compare outcomes of these 2 treatment methods. PATIENTS AND METHODS: Whole-head 3D surface scans of 70 infants with DP were captured before and after treatment by using stereophotogrammetric imaging technology. Helmeted (n = 35) and nonhelmeted/actively repositioned (n = 35) infants were matched for severity of initial deformity. Surfaces were spatially registered to a symmetric template, which was deformed to achieve detailed right-to-left point correspondence for every point on the head surface. A ratio-metric asymmetry value was calculated for each point relative to its contralateral counterpart. Maximum and mean asymmetry values were determined. Change in mean and maximum asymmetry with treatment was the basis for group comparison. RESULTS: The helmeted group had a larger reduction than the repositioned group in both maximum (4.0% vs 2.5%; P = .02) and mean asymmetry (0.9% vs 0.5%; P = .02). The greatest difference was localized to the occipital region. CONCLUSIONS: Whole-head 3D asymmetry analysis is capable of rigorously quantifying the relative efficacy of the 2 common treatments of DP. Orthotic helmets provide statistically superior improvement in head symmetry compared with active repositioning immediately after therapy. Additional studies are needed to (1) establish the clinical significance of these quantitative differences in outcome, (2) define what constitutes pathologic head asymmetry, and (3) determine whether superiority of orthotic treatment lasts as the child matures. Pediatrics 2010;126:e936-e945

Darvann, Tron Andre

2010-01-01

180

Repositioning drugs for inflammatory disease – fishing for new anti-inflammatory agents  

Science.gov (United States)

Inflammation is an important and appropriate host response to infection or injury. However, dysregulation of this response, with resulting persistent or inappropriate inflammation, underlies a broad range of pathological processes, from inflammatory dermatoses to type 2 diabetes and cancer. As such, identifying new drugs to suppress inflammation is an area of intense interest. Despite notable successes, there still exists an unmet need for new effective therapeutic approaches to treat inflammation. Traditional drug discovery, including structure-based drug design, have largely fallen short of satisfying this unmet need. With faster development times and reduced safety and pharmacokinetic uncertainty, drug repositioning – the process of finding new uses for existing drugs – is emerging as an alternative strategy to traditional drug design that promises an improved risk-reward trade-off. Using a zebrafish in vivo neutrophil migration assay, we undertook a drug repositioning screen to identify unknown anti-inflammatory activities for known drugs. By interrogating a library of 1280 approved drugs for their ability to suppress the recruitment of neutrophils to tail fin injury, we identified a number of drugs with significant anti-inflammatory activity that have not previously been characterized as general anti-inflammatories. Importantly, we reveal that the ten most potent repositioned drugs from our zebrafish screen displayed conserved anti-inflammatory activity in a mouse model of skin inflammation (atopic dermatitis). This study provides compelling evidence that exploiting the zebrafish as an in vivo drug repositioning platform holds promise as a strategy to reveal new anti-inflammatory activities for existing drugs. PMID:25038060

Hall, Christopher J.; Wicker, Sophie M.; Chien, An-Tzu; Tromp, Alisha; Lawrence, Lisa M.; Sun, Xueying; Krissansen, Geoffrey W.; Crosier, Kathryn E.; Crosier, Philip S.

2014-01-01

 
 
 
 
181

Variables Affecting Canalith Repositioning Maneuver (CRM) Trend for Treating Patients with Benign Paroxysmal Positional Vertigo (BPPV)  

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Background: The purpose of this study was to identify variables affecting outcome in patients with benign paroxysmal positional vertigo (BPPV) treated with canalith repositioning maneuver (CRM). Methods: This interventional study was conducted on 58 patients (14 males, 44 females, mean age 48.12+13.22) referred to the Vertigo Rehabilitation Clinic of the Rehabilitation School of Tehran University of Medical Sciences from 2002 to 2004. All patients were treated with CRM. According to the treat...

Entezari, E.; Sedaei, M.; Naraghi, M.; Hajiabolhassan, F.; Adel Ghahraman, M.; Haddadi Avval, M.; Kamali, P.

2006-01-01

182

Exploiting Drug Repositioning for Discovery of a Novel HIV Combination Therapy ?  

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The development of HIV drugs is an expensive and a lengthy process. In this study, we used drug repositioning, a process whereby a drug approved to treat one condition is used to treat a different condition, to identify clinically approved drugs that have anti-HIV activity. The data presented here show that a combination of two clinically approved drugs, decitabine and gemcitabine, reduced HIV infectivity by 73% at concentrations that had minimal antiviral activity when used individually. Dec...

Clouser, Christine L.; Patterson, Steven E.; Mansky, Louis M.

2010-01-01

183

X-Ray Exam: Cervical Spine  

Science.gov (United States)

... might be needed. Continue Why It's Done A cervical spine X-ray can help find the cause of symptoms such as neck, shoulder, upper back, or arm pain, as well as tingling, numbness, or weakness in ...

184

MR image appearance of the pediatric spine  

International Nuclear Information System (INIS)

This paper compares MR images of the pediatric spine with anatomic sections. Five cadaver spines---including those of three full-term infants, a 3 mo old, and a 10 y old---were imaged with a 1.5-T MR imager and then sectioned with a cryomicrotome in the sagittal plane. The characteristics of the infant spine in anatomic sections are incomplete ossification of the vertebral bodies and relatively little collagen in the intervertebral disks. By 10 y of age, the ossification of the vertebral bodies and neural arch are nearly complete. The relationship and appearance of the ossification centers, hyaline cartilage, nucleus pulposus, basivertebral veins, and the anatomic structures in the neural foramen in the pediatric spines can be differentiated on T1-weighted for T2-weighted images

185

THE SPINE OF THE COSMIC WEB  

International Nuclear Information System (INIS)

We present the SpineWeb framework for the topological analysis of the Cosmic Web and the identification of its walls, filaments, and cluster nodes. Based on the watershed segmentation of the cosmic density field, the SpineWeb method invokes the local adjacency properties of the boundaries between the watershed basins to trace the critical points in the density field and the separatrices defined by them. The separatrices are classified into walls and the spine, the network of filaments and nodes in the matter distribution. Testing the method with a heuristic Voronoi model yields outstanding results. Following the discussion of the test results, we apply the SpineWeb method to a set of cosmological N-body simulations. The latter illustrates the potential for studying the structure and dynamics of the Cosmic Web.

186

Dendritic spine dysgenesis in Rett syndrome  

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Full Text Available Spines are small cytoplasmic extensions of dendrites that form the postsynaptic compartment of the majority of excitatory synapses in the mammalian brain. Alterations in the numerical density, size, and shape of dendritic spines have been correlated with neuronal dysfunction in several neurological and neurodevelopmental disorders associated with intellectual disability, including Rett syndrome (RTT. RTT is a progressive neurodevelopmental disorder associated with intellectual disability that is caused by loss of function mutations in the transcriptional regulator methyl CpG-binding protein 2 (MECP2. Here, we review the evidence demonstrating that principal neurons in RTT individuals and Mecp2-based experimental models exhibit alterations in the number and morphology of dendritic spines. We also discuss the exciting possibility that signaling pathways downstream of brain-derived neurotrophic factor (BDNF, which is transcriptionally regulated by MeCP2, offer promising therapeutic options for modulating dendritic spine development and plasticity in RTT and other MECP2-associated neurodevelopmental disorders.

LucasPozzo-Miller

2014-09-01

187

Magnetic resonance imaging of the lumbar spine  

International Nuclear Information System (INIS)

The author discusses how MRI has become an invaluable diagnostic adjunct to CT in the study of the lumbar spine. MRI provides improved resolution of soft tissue structures, which leads to more accurate diagnosis of degenerative disc disease and lateral nerve root entrapment as well as spinal neoplasm, infection, and hematoma. MRI is the procedure of choice in the study of complicated spine pathology in postoperative patients. CT currently remains the procedure of choice in the study of degenerative disease of the lumbar spine in the nonoperated patient because of its superb bone and soft tissue imaging and its inexpensiveness when compared to MRI. MRI imaging can be expect to improve with software modifications and new imaging techniques. MRI will play an increasingly prominent role in lumbar spine imaging

188

Insertional torque and pullout strength of pedicle screws with or without repositioning: a porcine study.  

Science.gov (United States)

PURPOSE. To evaluate the insertion torque and pullout strength of pedicle screws with or without repositioning. METHODS. 20 fresh porcine lumbar vertebrae of similar size were used. The entry point was at the site just lateral and distal to the superior facet joint of the vertebra, and to a depth of 35 mm. A 6.2-mm-diameter, 35-mm-long pedicle screw was inserted parallel to the superior end plate on one side as control. On the other side, an identical screw was first inserted 10º caudal to the superior end plate, and then repositioned parallel to the superior end plate. The insertional torque and pullout strength were measured. RESULTS. Three of the specimens were excluded owing to pedicle fractures during the pullout test. Repositioned pedicle screws were significantly weaker than controls in terms of the maximum insertional torque (3.20 ± 0.28 vs. 2.04 ± 0.28 Nm, 36% difference, ppolymethyl methacrylate or a screw with a larger diameter should be considered. PMID:25163961

Tan, Chun Ee; Fok, Margaret Woon Man; Luk, Keith Dip Kei; Cheung, Kenneth Man Chee

2014-08-01

189

Temporomandibular joint disc repositioning using bone anchors: an immediate post surgical evaluation by Magnetic Resonance Imaging  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Open joint procedures using bone anchors have shown clinical and radiograph good success, but post surgical disc position has not been documented with MRI imaging. We have designed a modified technique of using two bone anchors and 2 sutures to reposition the articular discs. This MRI study evaluates the post surgical success of this technique to reposition and stabilize the TMJ articular discs. Methods Consecutive 81 patients with unilateral TMJ internal derangement (ID (81 TMJs were treated between December 1, 2003, and December 1, 2006, at the Department of Oral and Maxillofacial Surgery, Ninth Peoples Hospital, Shanghai, Jiao Tong University School of Medicine. All patients were subjected to magnetic resonance imaging before and one to seven days post surgery to determine disc position using the modified bone anchor technique. Results Postoperative MRIs (one to seven days confirm that 77 of 81 joints were identified as excellent results and one joint was considered good for an overall effective rate of 96.3% (78 of 81 joints. Only 3.7% (3 of 81 of the joints were designated as poor results requiring a second open surgery. Conclusions This procedure has provided successful repositioning of the articular discs in unilateral TMJ ID at one to seven days post surgery.

Haddad Majd S

2010-11-01

190

The Comparison of Cervical Repositioning Errors According to Smartphone Addiction Grades  

Science.gov (United States)

[Purpose] The purpose of this study was to compare cervical repositioning errors according to smartphone addiction grades of adults in their 20s. [Subjects and Methods] A survey of smartphone addiction was conducted of 200 adults. Based on the survey results, 30 subjects were chosen to participate in this study, and they were divided into three groups of 10; a Normal Group, a Moderate Addiction Group, and a Severe Addiction Group. After attaching a C-ROM, we measured the cervical repositioning errors of flexion, extension, right lateral flexion and left lateral flexion. [Results] Significant differences in the cervical repositioning errors of flexion, extension, and right and left lateral flexion were found among the Normal Group, Moderate Addiction Group, and Severe Addiction Group. In particular, the Severe Addiction Group showed the largest errors. [Conclusion] The result indicates that as smartphone addiction becomes more severe, a person is more likely to show impaired proprioception, as well as impaired ability to recognize the right posture. Thus, musculoskeletal problems due to smartphone addiction should be resolved through social cognition and intervention, and physical therapeutic education and intervention to educate people about correct postures. PMID:24764641

Lee, JeonHyeong; Seo, KyoChul

2014-01-01

191

The comparison of cervical repositioning errors according to smartphone addiction grades.  

Science.gov (United States)

[Purpose] The purpose of this study was to compare cervical repositioning errors according to smartphone addiction grades of adults in their 20s. [Subjects and Methods] A survey of smartphone addiction was conducted of 200 adults. Based on the survey results, 30 subjects were chosen to participate in this study, and they were divided into three groups of 10; a Normal Group, a Moderate Addiction Group, and a Severe Addiction Group. After attaching a C-ROM, we measured the cervical repositioning errors of flexion, extension, right lateral flexion and left lateral flexion. [Results] Significant differences in the cervical repositioning errors of flexion, extension, and right and left lateral flexion were found among the Normal Group, Moderate Addiction Group, and Severe Addiction Group. In particular, the Severe Addiction Group showed the largest errors. [Conclusion] The result indicates that as smartphone addiction becomes more severe, a person is more likely to show impaired proprioception, as well as impaired ability to recognize the right posture. Thus, musculoskeletal problems due to smartphone addiction should be resolved through social cognition and intervention, and physical therapeutic education and intervention to educate people about correct postures. PMID:24764641

Lee, Jeonhyeong; Seo, Kyochul

2014-04-01

192

Thoracolumbar spine fractures: Is there a problem?  

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Every physician who treats injured patients has a responsibility to detect and appropriately manage thoracolumbar spinal column injuries. Fractures of the thoracolumbar spine are relatively common, so clinicians must give them every consideration both to protect from secondary spinal cord injury and to appreciate the extent of the patient’s injuries. Other extraspinal as well as noncontiguous injuries to the spinal column are frequently present. Unfortunately, thoracolumbar spine fractures ...

Kirkpatrick, Andrew W.; Mckevitt, Elaine

2002-01-01

193

The Spine of the Cosmic Web  

CERN Document Server

We present a new concept, the Spine of the Cosmic Web, for the topological analysis of the Cosmic Web and the identification of its filaments and walls. Based on the watershed segmentation of the cosmic density field, the method invokes the local properties of the regions adjacent to the critical points, which define its separatrices. Our method allows their classification into walls and the spine of filaments and clusters. Tests on a heuristic Voronoi model yielded outstanding results.

Aragon-Calvo, Miguel A; van de Weygaert, Rien; Szalay, Alexander S

2008-01-01

194

Posteroanterior versus anteroposterior lumbar spine radiology.  

Science.gov (United States)

The posteroanterior view of the lumbar spine has important features including radiation protection and image quality; these have been studied by various investigators. Investigators have shown that sensitive tissues receive less radiation dosage in the posteroanterior view of the spine for scoliosis screening and intracranial tomography without altering the image quality. This paper emphasizes the importance of the radiation safety aspect of the posteroanterior view and shows the improvement in shape distortion in the lumbar vertebrae. PMID:2338520

Tsuno, M M; Shu, G J

1990-01-01

195

Posteroanterior versus anteroposterior lumbar spine radiology  

International Nuclear Information System (INIS)

The posteroanterior view of the lumbar spine has important features including radiation protection and image quality; these have been studied by various investigators. Investigators have shown that sensitive tissues receive less radiation dosage in the posteroanterior view of the spine for scoliosis screening and intracranial tomography without altering the image quality. This paper emphasizes the importance of the radiation safety aspect of the posteroanterior view and shows the improvement in shape distortion in the lumbar vertebrae

196

Posteroanterior versus anteroposterior lumbar spine radiology  

Energy Technology Data Exchange (ETDEWEB)

The posteroanterior view of the lumbar spine has important features including radiation protection and image quality; these have been studied by various investigators. Investigators have shown that sensitive tissues receive less radiation dosage in the posteroanterior view of the spine for scoliosis screening and intracranial tomography without altering the image quality. This paper emphasizes the importance of the radiation safety aspect of the posteroanterior view and shows the improvement in shape distortion in the lumbar vertebrae.

Tsuno, M.M.; Shu, G.J. (Cleveland Chiropractic College, Los Angeles, CA (USA))

1990-03-01

197

Vertigo in patients with cervical spine dysfunction  

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To our knowledge, quantitative studies on the significance of disorders of the upper cervical spine as a cause of vertigo or impaired hearing do not exist. We examined the cervical spines of 67 patients who presented with symptoms of dizziness. Prior to the orthopaedic examination, causes of vertigo relating to the field of ENT and neurology had been ruled out. Fifty patients of the above-mentioned group were studied. They followed the outlined treatment protocol with physical therapy and wer...

Galm, R.; Rittmeister, M.; Schmitt, E.

1998-01-01

198

Neuroimaging for spine and spinal cord surgery  

Energy Technology Data Exchange (ETDEWEB)

Recent advances in neuroimaging of the spine and spinal cord are described based upon our clinical experiences with spinal disorders. Preoperative neuroradiological examinations, including magnetic resonance (MR) imaging and computerized tomography (CT) with three-dimensional reconstruction (3D-CT), were retrospectively analyzed in patients with cervical spondylosis or ossification of the posterior longitudinal ligament (130 cases), spinal trauma (43 cases) and intramedullary spinal cord tumors (92 cases). CT scan and 3D-CT were useful in elucidating the spine pathology associated with degenerative and traumatic spine diseases. Visualization of the deformity of the spine or fracture-dislocation of the spinal column with 3D-CT helped to determine the correct surgical treatment. MR imaging was most important in the diagnosis of both spine and spinal cord abnormalities. The axial MR images of the spinal cord were essential in understanding the laterality of the spinal cord compression in spinal column disorders and in determining surgical approaches to the intramedullary lesions. Although non-invasive diagnostic modalities such as MR imaging and CT scans are adequate for deciding which surgical treatment to use in the majority of spine and spinal cord disorders, conventional myelography is still needed in the diagnosis of nerve root compression in some cases of cervical spondylosis. (author)

Koyanagi, Izumi [Hokkaido Neurosurgical Memorial Hospital (Japan); Iwasaki, Yoshinobu; Hida, Kazutoshi

2001-01-01

199

Spine fractures in winter sports.  

Science.gov (United States)

In a 7-year review of 1,447 spine fractures, 202 (14%) were due to sporting or recreational causes, of which 84 (42%) were associated with paralysis. This high incidence catastrophic injury is second only to motor vehicle accidents. Snowmobiling (10%), skiing (5%), tobogganing (5%) and ice hockey (3%) accounted for approximately one-quarter of these injuries. Snowmobile injuries rose steadily over this period, and the main contributing factors were alcohol, poor lighting, young age and inappropriate terrain. The skiing injuries occurred to novices and top class skiers alike, with one-third of those sustaining a fracture having associated paralysis. In view of the terrain and the speeds involved, the figure is unlikely to change. An alarming trend was the subtle increase in cervical fracture due to ice hockey, most of which were compression injuries with the neck in the neutral or slightly flexible position, and secondary to a collision with the boards. Being decked from behind contributed to the impact. The introduction of measures to reduce these injuries is mandatory, since cervical fractures secondary to ice hockey were associated with permanent paralysis in 67% of the cases. There are several points of initial management which require emphasis. PMID:2662325

Reid, D C; Saboe, L

1989-06-01

200

Computed tomography of the spine  

International Nuclear Information System (INIS)

Until the advent of Computed Tomography (CT), axial studies of the spine were limited in the main to gross bony anatomy and to conventional transaxial tomography (TAT). Others studied the upper cervical cord in transverse section during gas myelography and encephalography. The potential role of CT in the evaluation of spinal anatomy and disease was recognized, however, at an early stage in the development of the general purpose CT scanner. CT is not organ specific and therefore provides a uniformly thin (1.5-13 mm) axial section displaying detailed spinal topographical anatomy against a background of paravertebral muscles, vascular structures and body cavity organs. The relationships of the apophyseal joints to the spinal canal and intervertebral foramina are particularly well displayed. The study of neural tissue and pathology within the spinal canal is facilitated by the use of a non-ionic water-soluble contrast medium (viz. metrizamide) in the subarachnoid spaces. The high sensitivity of CT to very small changes in X-ray attenuation permits studies to be continued over several hours. The digital derivation of the sequential CT transaxial sections enables not only interrogation of data and quantitative studies to be made but also makes possible computer-generated reconstructions in other planes

 
 
 
 
201

Unintentional conversion of benign paroxysmal positional vertigo caused by repositioning procedures for canalithiasis: transitional BPPV.  

Science.gov (United States)

BPPV when diagnosed before any repositioning procedure is called primary BPPV. Primary BPPV canalithiasis treatment with repositioning procedures sometimes results in unintentional conversion of BPPV form: transitional BPPV. Objectives were to find transitional BPPV forms, how they influence relative rate of canal involvement and how to be treated. This study is a retrospective case review performed at an ambulatory, tertiary referral center. Participants were 189 consecutive BPPV patients. Main outcome measures were detection of transitional BPPV, outcome of repositioning procedures for transitional canalithiasis BPPV and spontaneous recovery for transitional cupulolithiasis BPPV. Canal distribution of primary BPPV was: posterior canal (Pc): 85.7% (162/189), horizontal canal (Hc): 11.6% (22/189), anterior canal (Ac): 2.6% (5/189); taken together with transitional BPPV it was: Pc: 71.3% (164/230), Hc: 26.5% (61/230), Ac: 2.2% (5/230). Transitional BPPV forms were: Hc canalithiasis 58% (24/41), Hc cupulolithiasis 37% (15/41) and common crux reentry 5% (2/41). Treated with barbecue maneuver transitional Hc canalithiasis cases either resolved in 58% (14/24) or transitioned further to transitional Hc cupulolithiasis in 42% (10/24). In follow-up of transitional Hc cupulolithiasis we confirmed spontaneous recovery in 14/15 cases in less than 2 days. The most frequent transitional BPPV form was Hc canalithiasis so it raises importance of barbecue maneuver treatment. Second most frequent was transitional Hc cupulolithiasis which very quickly spontaneously recovers and does not require any intervention. The rarest found transitional BPPV form was common crux reentry which is treated by Canalith repositioning procedure. Transitional BPPV taken together with primary BPPV may decrease relative rate of Pc BPPV, considerably increase relative rate of Hc BPPV and negligibly influence relative rate of Ac BPPV. Transitional BPPV forms can be produced by repositioning maneuvers (transitional Hc cupulolithiasis) or by the subsequent controlling positional test (transitional Hc canalithiasis and common crux reentry); underlying mechanisms are discussed. PMID:23605245

Babic, Borivoj B; Jesic, Snezana D; Milovanovic, Jovica D; Arsovic, Nenad A

2014-05-01

202

78 FR 65451 - Agency Information Collection (Neck (Cervical Spine) Conditions Disability Benefits Questionnaire...  

Science.gov (United States)

...Spine) Conditions Disability Benefits Questionnaire) Activity Under OMB Review AGENCY...Spine) Conditions Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER...Spine) Conditions Disability Benefits Questionnaire).'' SUPPLEMENTARY...

2013-10-31

203

Effect of Laminectomy on Stability of Lumbar Spine Effect of Laminectomy on Stability of Lumbar Spine  

Directory of Open Access Journals (Sweden)

Full Text Available The paper aims at the presentation of the lumbar spine finite element model used in a study of segmental kinematics including the tissue loading. Lumbar spine FE-model consisting of the three lumbar vertebras, two disc (including annulus and nucleus and vast variety of ligaments. The primary model objective is its verification by experimental test data obtained from cadaver spine segments. A confirmed model was used for a study of various range of laminectomy effect. On this model we simulate a various loading states witch can spine segment arrive at under physiologic conditions (compression, flexion, extension and lateral bending. FE-model could predict the laminectomy impact on the operation approach. The paper aims at the presentation of the lumbar spine finite element model used in a study of segmental kinematics including the tissue loading. Lumbar spine FE-model consisting of the three lumbar vertebras, two disc (including annulus and nucleus and vast variety of ligaments. The primary model objective is its verification by experimental test data obtained from cadaver spine segments. A confirmed model was used for a study of various range of laminectomy effect. On this model we simulate a various loading states witch can spine segment arrive at under physiologic conditions (compression, flexion, extension and lateral bending. FE-model could predict the laminectomy impact on the operation approach.

Petr Tichy

2009-12-01

204

Right thoracic curvature in the normal spine  

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Full Text Available Abstract Background Trunk asymmetry and vertebral rotation, at times observed in the normal spine, resemble the characteristics of adolescent idiopathic scoliosis (AIS. Right thoracic curvature has also been reported in the normal spine. If it is determined that the features of right thoracic side curvature in the normal spine are the same as those observed in AIS, these findings might provide a basis for elucidating the etiology of this condition. For this reason, we investigated right thoracic curvature in the normal spine. Methods For normal spinal measurements, 1,200 patients who underwent a posteroanterior chest radiographs were evaluated. These consisted of 400 children (ages 4-9, 400 adolescents (ages 10-19 and 400 adults (ages 20-29, with each group comprised of both genders. The exclusion criteria were obvious chest and spinal diseases. As side curvature is minimal in normal spines and the range at which curvature is measured is difficult to ascertain, first the typical curvature range in scoliosis patients was determined and then the Cobb angle in normal spines was measured using the same range as the scoliosis curve, from T5 to T12. Right thoracic curvature was given a positive value. The curve pattern was organized in each collective three groups: neutral (from -1 degree to 1 degree, right (> +1 degree, and left ( Results In child group, Cobb angle in left was 120, in neutral was 125 and in right was 155. In adolescent group, Cobb angle in left was 70, in neutral was 114 and in right was 216. In adult group, Cobb angle in left was 46, in neutral was 102 and in right was 252. The curvature pattern shifts to the right side in the adolescent group (p Conclusions Based on standing chest radiographic measurements, a right thoracic curvature was observed in normal spines after adolescence.

Masuda Keigo

2011-01-01

205

Defining the value of spine care.  

Science.gov (United States)

The increased cost and frequency of spine-related procedures, expanding indications, and regional variation in care has led to a shift toward delivery of value-based spine care. In this model, payers show preference for interventions and treatments with proven value and incentivize providers who use such interventions and demonstrate value in their practices. Thus, spine care providers must understand how to determine the value of interventions and treatments. Determining value (ie, cost and quality of care, measured over time) can be challenging in the setting of spine care. Data collection and reporting are complicated by variation in diagnostic coding and surgical techniques. Typically, outcomes in spine care are based on subjective patient-reported measures that are influenced by concomitant orthopaedic, medical, and psychological disease. Health utility is a preferable measure of quality that can be converted into quality-adjusted life years and used in cost-effectiveness analysis. Although no standard currently exists, estimates of cost should include both direct and indirect costs of care over an adequate time horizon. PMID:23818029

Rihn, Jeffrey A; Currier, Bradford L; Phillips, Frank M; Glassman, Steven D; Albert, Todd J

2013-07-01

206

Functional oblique views of the lumbar spine  

International Nuclear Information System (INIS)

The first part of the paper deals with measurements of 152 radiographs. It was found that the conventional views of the lumbar spine in two planes can demonstrate only 49.1% of the articular joints. Oblique views in two planes increase the accuracy to 88.7%. In view of the relatively high accuracy of the oblique views, these were used as the basis for a new functional method for examining the intervertebral joints. For this examination, oblique views of the lumbar spine are taken in the lordotic and kyphotic positions. The position of the patient during the examination is described in detail. In the second part of the paper, the results of measurements of 80 functional examinations are evaluated. Average values for the mobility of individual elements of the lumbar spine have been derived. Finally, the practical value of the new technique is demonstrated. Its special place for subluxations and spondylolyses is stressed. (orig.)

207

Giant cell tumor of upper thoracic spine.  

Science.gov (United States)

Giant cell tumor (GCT) of the spine is a rare benign tumor, but can be aggressive and can exhibit a high local recurrence rate. Furthermore, GCT of the upper thoracic spine may pose diagnostic and management difficulties. Here, we report a rare case of GCT of the upper thoracic spine with soft tissue extension to the spinal canal. The patient was managed by decompressive laminectomy and posterolateral fusion followed by an injection of polymethylmethacrylate into the vertebral lesion. The patient recovered clinically and showed radiological improvement after surgical treatment without tumor recurrence at his last follow-up of postoperative 7 years. We present this unusual case of GCT and include a review of the literature. PMID:24851155

Lee, Chul Gab; Kim, Sung Hoon; Kim, Dong Min; Kim, Seok Won

2014-03-01

208

Congenital block vertebrae in lumbar spine  

Directory of Open Access Journals (Sweden)

Full Text Available A 34-year-old female visited our rheumatology clinic with the complaint of non-inflammatory back pain that usually occurred on bending down and radiated to bilateral lower limbs. A diagnosis of compressive neuropathy was suspected and an initially performed digital X-ray of lumbar spine revealed a rare congenital anomaly termed as ‘Congenital block vertebrae’ in the lumbar spine (Fig 1.Block vertebrae, a congenital anomaly, occurs due to improper segmentation of vertebral column during fetal development. Improper segmentation leads to fusion of adjacent vertebrae through their inter-vertebral disc. The most common site of this deformity is cervical spine and the lumbar vertebral involvement is rare. The disco-vertebral articulation is always involved and depending on the degree of involvement, the presenting complaints could be either neurological due to the compression of nerve roots or scoliosis due to the vertebral deformity.

Ankur Nandan Varshney

2013-05-01

209

49 CFR 572.75 - Lumbar spine, abdomen, and pelvis assembly and test procedure.  

Science.gov (United States)

... false Lumbar spine, abdomen, and pelvis assembly and test procedure. 572...572.75 Lumbar spine, abdomen, and pelvis assembly and test procedure. (a) Lumbar spine, abdomen, and pelvis assembly. The lumbar spine,...

2010-10-01

210

Differential spatial repositioning of activated genes in Biomphalaria glabrata snails infected with Schistosoma mansoni.  

Science.gov (United States)

Schistosomiasis is an infectious disease infecting mammals as the definitive host and fresh water snails as the intermediate host. Understanding the molecular and biochemical relationship between the causative schistosome parasite and its hosts will be key to understanding and ultimately treating and/or eradicating the disease. There is increasing evidence that pathogens that have co-evolved with their hosts can manipulate their hosts' behaviour at various levels to augment an infection. Bacteria, for example, can induce beneficial chromatin remodelling of the host genome. We have previously shown in vitro that Biomphalaria glabrata embryonic cells co-cultured with schistosome miracidia display genes changing their nuclear location and becoming up-regulated. This also happens in vivo in live intact snails, where early exposure to miracidia also elicits non-random repositioning of genes. We reveal differences in the nuclear repositioning between the response of parasite susceptible snails as compared to resistant snails and with normal or live, attenuated parasites. Interestingly, the stress response gene heat shock protein (Hsp) 70 is only repositioned and then up-regulated in susceptible snails with the normal parasite. This movement and change in gene expression seems to be controlled by the parasite. Other differences in the behaviour of genes support the view that some genes are responding to tissue damage, for example the ferritin genes move and are up-regulated whether the snails are either susceptible or resistant and upon exposure to either normal or attenuated parasite. This is the first time host genome reorganisation has been seen in a parasitic host and only the second time for any pathogen. We believe that the parasite elicits a spatio-epigenetic reorganisation of the host genome to induce favourable gene expression for itself and this might represent a fundamental mechanism present in the human host infected with schistosome cercariae as well as in other host-pathogen relationships. PMID:25211244

Arican-Goktas, Halime D; Ittiprasert, Wannaporn; Bridger, Joanna M; Knight, Matty

2014-09-01

211

Temporomandibular Joint Condylar Changes Following Maxillomandibular Advancement and Articular Disc Repositioning  

Science.gov (United States)

Purpose To evaluate condylar changes 1 year after bimaxillary surgical advancement with or without articular disc repositioning using longitudinal quantitative measurements in 3-dimensional (3D) temporomandibular joint (TMJ) models. Methods Twenty-seven patients treated with maxillomandibular advancement (MMA) underwent cone-beam computed tomography before surgery immediately after surgery and at 1-year follow-up. All patients underwent magnetic resonance imaging before surgery to assess disc displacements. Ten patients without disc displacement received MMA only. Seventeen patients with articular disc displacement received MMA with simultaneous TMJ disc repositioning (MMA-Drep). Pre- and postsurgical 3D models were superimposed using a voxel-based registration on the cranial base. Results The location, direction, and magnitude of condylar changes were displayed and quantified by graphic semitransparent overlays and 3D color-coded surface distance maps. Rotational condylar displacements were similar in the 2 groups. Immediately after surgery, condylar translational displacements of at least 1.5 mm occurred in a posterior, superior, or mediolateral direction in patients treated with MMA, whereas patients treated with MMA-Drep presented more marked anterior, inferior, and mediolateral condylar displacements. One year after surgery, more than half the patients in the 2 groups presented condylar resorptive changes of at least 1.5 mm. Patients treated with MMA-Drep presented condylar bone apposition of at least 1.5 mm at the superior surface in 26.4%, the anterior surface in 23.4%, the posterior surface in 29.4%, the medial surface in 5.9%, or the lateral surface in 38.2%, whereas bone apposition was not observed in patients treated with MMA. Conclusions One year after surgery, condylar resorptive changes greater than 1.5 mm were observed in the 2 groups. Articular disc repositioning facilitated bone apposition in localized condylar regions in patients treated with MMA-Drep. PMID:24040949

Goncalves, Joao Roberto; Wolford, Larry Miller; Cassano, Daniel Serra; da Porciuncula, Guilherme; Paniagua, Beatriz; Cevidanes, Lucia Helena

2014-01-01

212

Operations planning for axial repositioning of fuel channel assemblies in Bruce nuclear generating station 'A'  

International Nuclear Information System (INIS)

The operations planning for the repositioning of fuel channel assemblies in Units 1 to 3 of the Bruce Nuclear Generating Station 'A' is presented. The restrictions and limitations of the specialized tooling, equipment and reactor components are discussed in terms of the impact on overall reactor processing strategy. The use of a shifting simulation computer program permitted the the continual revision of daily plans to optimize operations based on the rate of processing for each of two shield cabinets. The procedures and methods of implementing the operations plans are finally presented

213

The AC device for repositioning of garter springs in CANDU reactors  

International Nuclear Information System (INIS)

The AC Device represents the key component which makes the SLAR (Spacer Locating and Repositioning) system function. The AC Device produces a continuous electromagnetic force on the spacer in the axial direction when ac power is applied, without any adverse effects on the channel integrity. The AC Device of LIM (Linear Induction Motor) was proven to be safe and easy to operate in the hostile environment of a commissioned CANDU reactor, and is currently being manufactured by Ontario Hydro Research Division for field implementation of the SLAR program

214

Physics characteristics of a CANDU-600 with repositioned adjuster rods fuelled with MOX or natural uranium  

International Nuclear Information System (INIS)

Repositioning the adjuster rods in 4 axial banks in future CANDU-600 reactors would permit the flexibility of grading the inner and outer banks to achieve optimal flattening of the axial power distribution for any particular fuel. With the 4 banks identical, acceptable axial power profiles can be achieved for both MOX and natural uranium fuels. Future work is to be directed at assessing the impact of lower zone controller and shutoff rod worth in the configuration of reactivity devices considered here, and if necessary, in identifying means of increasing their worth

215

Late Acceptance Hill Climbing for the Liner Shipping Fleet Repositioning Problem  

DEFF Research Database (Denmark)

Late Acceptance Hill Climbing (LAHC) has been shown to be an effective local search method for sev- eral types of optimization problems, such as on certain types of scheduling problems as well as the traveling salesman problem. We apply LAHC to a central prob- lem in the liner shipping industry, the Liner Shipping Fleet Repositioning Problem (LSFRP). The LSFRP in- volves the movement of vessels between routes in a liner shipping network subject to complex costs and timing restrictions. We show that despite LAHC’s promising performance on other problems, it is unable to achieve the performance of simulated annealing on the LSFRP.

Tierney, Kevin

216

Guidelines for use of lumbar spine radiography  

International Nuclear Information System (INIS)

In deciding whether to obtain lumbosacral spine films, the emergency physician must not ask whether a diagnosis can be established, but whether obtaining films will affect management. Low back pain is a considerable problem for society with cost in billions of dollars. Gonadal radiation from lumbosacral radiographs is significant, and thus ordering films should be minimized. Plain radiographs are rarely indicated in otherwise healthy patients 20 to 50 years old with mechanical or root pain on initial presentation. In other patients alternative diagnostic methodologies such as computed tomography may be superior, with less radiation risk. Specific recommendations for emergency radiographic evaluation of the lumbosacral spine are offered.68 references

217

Guidelines for use of lumbar spine radiography  

Energy Technology Data Exchange (ETDEWEB)

In deciding whether to obtain lumbosacral spine films, the emergency physician must not ask whether a diagnosis can be established, but whether obtaining films will affect management. Low back pain is a considerable problem for society with cost in billions of dollars. Gonadal radiation from lumbosacral radiographs is significant, and thus ordering films should be minimized. Plain radiographs are rarely indicated in otherwise healthy patients 20 to 50 years old with mechanical or root pain on initial presentation. In other patients alternative diagnostic methodologies such as computed tomography may be superior, with less radiation risk. Specific recommendations for emergency radiographic evaluation of the lumbosacral spine are offered.68 references.

Kelen, G.D.; Noji, E.K.; Doris, P.E.

1986-03-01

218

Cervical spine fractures and dislocations in children  

International Nuclear Information System (INIS)

A retrospectivce analysis of pediatric admissions over 10 years revealed 29 patients with cervical spine injuries. Eleven patients were below 12 years of age, and 10 of these had injuries involving C1, C2 or the occipitoatlantal articulation. Eighteen patients were between 12 and 16 years of age with injuries distributed throughout the cervical spine similar to injuries in the adult population. Our results suggest that teenagers with suspected cervical injuries are best evaluated by an adult radiographic series including trauma oblique views. In younger patients, careful evaluation of occipitoatlantoaxial alignment and the prevertebral soft tissues is required for diagnosis and selection of additional imaging evaluation. (orig.)

219

Axial loaded MRI of the lumbar spine  

Energy Technology Data Exchange (ETDEWEB)

Magnetic resonance imaging is established as the technique of choice for assessment of degenerative disorders of the lumbar spine. However, it is routinely performed with the patient supine and the hips and knees flexed. The absence of axial loading and lumbar extension results in a maximization of spinal canal dimensions, which may in some cases, result in failure to demonstrate nerve root compression. Attempts have been made to image the lumbar spine in a more physiological state, either by imaging with flexion-extension, in the erect position or by using axial loading. This article reviews the literature relating to the above techniques.

Saifuddin, A. E-mail: asaifuddin@aol.com; Blease, S.; MacSweeney, E

2003-09-01

220

Cervical spine fractures and dislocations in children  

Energy Technology Data Exchange (ETDEWEB)

A retrospectivce analysis of pediatric admissions over 10 years revealed 29 patients with cervical spine injuries. Eleven patients were below 12 years of age, and 10 of these had injuries involving C1, C2 or the occipitoatlantal articulation. Eighteen patients were between 12 and 16 years of age with injuries distributed throughout the cervical spine similar to injuries in the adult population. Our results suggest that teenagers with suspected cervical injuries are best evaluated by an adult radiographic series including trauma oblique views. In younger patients, careful evaluation of occipitoatlantoaxial alignment and the prevertebral soft tissues is required for diagnosis and selection of additional imaging evaluation.

Apple, J.S.; Kirks, D.R.; Merten, D.F.; Martinez, S.

1987-01-01

 
 
 
 
221

Synergy of the human spine in neutral postures  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The neutral position of the spine is the posture most commonly sustained throughout daily activities. Previous investigations of the spine focused mainly on maximal exertions in various symmetric and asymmetric postures. This report proposes a new synergetic approach for analysis of the spine in neutral postures and evaluates its performance. The model consists of passive components, the osteoligamentous spine, and active components, the spinal muscles. The muscle architecture includes 60 mus...

Kiefer, A.; Shirazi-adl, A.; Parnianpour, M.

1998-01-01

222

Sampling issues in quantitative analysis of dendritic spines morphology  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Quantitative analysis of changes in dendritic spine morphology has become an interesting issue in contemporary neuroscience. However, the diversity in dendritic spine population might seriously influence the result of measurements in which their morphology is studied. The detection of differences in spine morphology between control and test group is often compromised by the number of dendritic spines taken for analysis. In order to estimate the impact of d...

Ruszczycki B?a?ej; Szepesi Zsuzsanna; Wilczynski Grzegorz M; Bijata Monika; Kalita Katarzyna; Kaczmarek Leszek; Wlodarczyk Jakub

2012-01-01

223

Glia selectively approach synapses on thin dendritic spines.  

Science.gov (United States)

This paper examines the relationship between the morphological modality of 189 dendritic spines and the surrounding astroglia using full three-dimensional reconstructions of neuropil fragments. An integrative measure of three-dimensional glial coverage confirms that thin spine postsynaptic densities are more tightly surrounded by glia. This distinction suggests that diffusion-dependent synapse-glia communication near 'learning' synapses (associated with thin spines) could be stronger than that near 'memory' synapses (associated with larger spines). PMID:25225105

Medvedev, Nikolai; Popov, Victor; Henneberger, Christian; Kraev, Igor; Rusakov, Dmitri A; Stewart, Michael G

2014-10-19

224

Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam  

Science.gov (United States)

The authors report a 64-year-old man who developed persistent direction fixed nystagmus after a canalith repositioning maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The patient was initially diagnosed with right HC-BPPV given that the Dix-Hallpike test showed geotropic horizontal nystagmus that was more pronounced on the right side, although the roll test did not show any positional nystagmus. The patient was treated with a canalith repositioning maneuver (Lempert maneuver). The next day, the patient experienced a different character of dizziness, and left-beating spontaneous nystagmus regardless of head position was observed. After a forced prolonged left decubitus and frequent head shaking, his symptoms and nystagmus resolved. This condition, referred to as canalith jam, can be a complication after the repositioning maneuver in patients with BPPV. Atypical positional tests suggest that abnormal canal anatomy could be the underlying cause of canalith jam. PMID:24917912

Chang, Young-Soo; Choi, Jeesun

2014-01-01

225

A simple reproducible and time saving method of semi-automatic dendrite spine density estimation compared to manual spine counting  

DEFF Research Database (Denmark)

Estimation of spine number and spine density by manual counting under the assumption that all dendrite protrusions equal spines are often used in studies on neuroplasticity occurring during health, brain diseases, and different experimental paradigms. Manual spine counting is, however, time consuming and biased by inter-observer variation. We present accordingly a quick, reproducible and simple non-stereological semi-automatic spine density estimation method based on the irregularity of the dendrite surface. Using the freeware ImageJ program, microphotographs of Golgi impregnated hippocampal dendrites derived from a previously performed study on the impact of chronic restrained stress were binarized, skeletonized, and the skeleton endings assumed to represent spine positions were counted and the spine densities calculated. The results based on 754 dendrite fragments were compared to manual spine counting of the same dendrite fragments using the Bland-Altman method. The results from both methods were correlated (r=0.79, p

Orlowski, Dariusz; Bjarkam, C R

2012-01-01

226

49 CFR 572.115 - Lumbar spine and pelvis.  

Science.gov (United States)

...2010-10-01 false Lumbar spine and pelvis. 572.115 Section 572.115 Transportation...Male § 572.115 Lumbar spine and pelvis. The specifications and test procedure for the lumbar spine and pelvis are identical to those for the SID...

2010-10-01

227

Confined prostate cancer treated by conformational irradiation with intensity modulation with or without echography repositioning: is the dose received equivalent to the prescribed dose?  

International Nuclear Information System (INIS)

The results suggest it would be possible to dispense a homogenous dose in agreement with the ICRU recommendations, nearer than the forward looking dose when the daily echographic repositioning is applied. This repositioning does not influence significantly the dosimetry for the risk organs. These results will validated in a bigger population. (N.C.)

228

Design and development of compact, durable electromagnetic pulse power coils for repositioning of coolant tube spacers in CANDU nuclear reactors  

International Nuclear Information System (INIS)

In the fall of 1983, a novel electromagnetic technique to reposition the coolant tube spacers (garter springs) in the fuel channels of CANDU nuclear reactors was successfully developed at Ontario Hydro Research Division. This paper describes the design, development and performance of the compact solenoidal coils used to reposition the garter springs. The coils are capable of withstanding oscillatory current pulses having a first peak of 200 kA and can survive several thousand pulses at current levels exceeding 140 kA. The operating criteria and measures introduced to achieve long coil life with a reasonably high repetition rate for discharging the capacitor bank are also discussed

229

Can stimulating massage improve joint repositioning error in patients with knee osteoarthritis?  

DEFF Research Database (Denmark)

PURPOSE: The purpose of this study was to investigate the effect of massage applied to the thigh muscles on joint repositioning error (JRE) in patients suffering from osteoarthritis (OA).We hypothesized that stimulating massage of the muscles around an osteoarthritic knee joint, could improve the neuromuscular function and thereby optimize the positive and minimize the negative performance factors in relation to an exercise program. METHODS: In a cross-over design, 19 patients with knee osteoarthritis, mean age of 73.1 years (SD: 9.4; range 56 to 88 years), recruited from the local department of rheumatology, were randomly allocated to either receive massage and a week later, act as controls or vice versa. The applied massage consisted of stimulating massage of the quadriceps femoris, sartorious, gracilus, and hamstrings muscles for 10 min on the affected leg. Participants had their JRE measured before and immediately after the 10 min massage and control sessions. Data were analyzed by using paired t-test. RESULTS: No significant change in JRE was observed (95% CI: -0.62 degrees to 0.85 degrees, p = 0.738). CONCLUSION: Massage has no effect on the immediate joint repositioning error in patients with knee osteoarthritis, ie, if an improved JRE is important for improving the performance factors when exercising, stimulating massage may not be recommendable to use.

Lund, Hans; Henriksen, Marius

2009-01-01

230

Reposition af næsefrakturer i lokal anæstesi versus generel anæstesi : En retrospektiv patienttilfredshedsundersøgelse  

DEFF Research Database (Denmark)

INTRODUCTION: Nose fractures are the most common among facial fractures. A well-approved treatment of isolated nose fractures is closed reposition under local or general anaesthesia. MATERIALS AND METHODS: This study included 150 patients who were treated with closed reposition for simple and isolated nose fracture at the Otorhinolaryngology Department of Odense University Hospital during the period 1 January 2003 until 31 December 2004. The case records were retrospectively examined and the patients were sent a questionnaire and were offered outpatient follow-up. RESULTS: The most frequent cause of damage was violence. The average interval from trauma to treatment was 4.1 days. 60% of the patients filed cosmetic results equal to or better than before fracturing the nose regardless of the anaesthetic procedure, while 69% of the patients experienced the function of the nose as equal to or better than before. CONCLUSION: The majority of nose fractures are treated under local anaesthesia. A follow-up at least 1 year later found no difference between patient satisfaction of cosmetic and functional results of the nose, regardless of whether they had local or general anaesthesia. In general, the patients were satisfied with the anaesthesia, whether it was local or general Udgivelsesdato: 2007-Jun-11

Kjeldsen, Anette DrØhse

2007-01-01

231

Drug repositioning by applying 'expression profiles' generated by integrating chemical structure similarity and gene semantic similarity.  

Science.gov (United States)

Drug repositioning, also known as drug repurposing or reprofiling, is the process of finding new indications for established drugs. Because drug repositioning can reduce costs and enhance the efficiency of drug development, it is of paramount importance in medical research. Here, we present a systematic computational method to identify potential novel indications for a given drug. This method utilizes some prior knowledge such as 3D drug chemical structure information, drug-target interactions and gene semantic similarity information. Its prediction is based on another form of 'expression profile', which contains scores ranging from -1 to 1, reflecting the consensus response scores (CRSs) between each drug of 965 and 1560 proteins. The CRS integrates chemical structure similarity and gene semantic similarity information. We define the degree of similarity between two drugs as the absolute value of their correlation coefficients. Finally, we establish a drug similarity network (DSN) and obtain 33 modules of drugs with similar modes of action, determining their common indications. Using these modules, we predict new indications for 143 drugs and identify previously unknown indications for 42 drugs without ATC codes. This method overcomes the instability of gene expression profiling derived from experiments due to experimental conditions, and predicts indications for a new compound feasibly, requiring only the 3D structure of the compound. In addition, the high literature validation rate of 71.8% also suggests that our method has the potential to discover novel drug indications for existing drugs. PMID:24603772

Tan, Fujian; Yang, Ruizhi; Xu, Xiaoxue; Chen, Xiujie; Wang, Yunfeng; Ma, Hongzhe; Liu, Xiangqiong; Wu, Xin; Chen, Yuelong; Liu, Lei; Jia, Xiaodong

2014-05-01

232

X-Ray parameters of lumbar spine  

Directory of Open Access Journals (Sweden)

Full Text Available Knowledge of anatomic spinal structures, especially its relation-ship to the functions performed, is necessary to form a correct diagnosis. The anatomical structure of the vertebrae varies de-pending on the level of the spinal segment. Normal anatomical parameters, derived from bone structures of the spine, are roughly determined by X-ray method.This paper presents the results of the survey radiography of the lumbar spine in a straight line and lateral projections in 30 individ-uals without pathology spine, aged 21-60 years with frequently observed lumbar spinal stenosis stenosis. Applying X-ray method there were studied shape, height, and the contours of the vertebral bodies and intervertebral disc in the front (interpedicular and sagittal planes; there were measured dimensions of the lumbar canal and foramen holes in the same planes. Using X-ray method can fully identify the bone parameters of vertebral column. How-ever, the informativity of the method depends on knowledge of radiologist about topographic anatomical features of spine.

Otabek Ablyazov

2012-05-01

233

Primary telangiectatic osteosarcoma of the cervical spine.  

Science.gov (United States)

Telangiectatic osteosarcoma (TOS) is one of the 8 subtypes of osteosarcoma that infrequently affects the spine. The radiopathological features of TOS overlap with those of more benign entities, most commonly the aneurysmal bone cyst), and therefore is a significant diagnostic challenge. It is a rare but well-described entity in the thoracolumbar and sacral spine, and to the authors' knowledge has not been previously reported in the cervical spine. The authors report the case of a 15-year-old boy who presented with a 6-month history of neck pain and torticollis. He underwent preoperative glue embolization followed by a staged subtotal C-5 spondylectomy and posterior fusion for a C-5 vertebral body lytic expansile lesion. Histopathological examination showed the lesion to be TOS. The surgery was followed by adjuvant radiation and chemotherapy with a favorable outcome at the 1-year follow-up. This report reiterates that TOS is an important differential diagnosis for aneurysmal bone cyst and giant-cell tumor of the spine, as its biological behavior and clinical outcome differ from those of these more benign lesions, which it mimics. PMID:22225487

Turel, Mazda K; Joseph, Vivek; Singh, Vandita; Moses, Vinu; Rajshekhar, Vedantam

2012-04-01

234

Infected Ewing?s sarcoma of spine.  

Directory of Open Access Journals (Sweden)

Full Text Available An unusual case of extradural, intraspinal Ewing?s sarcoma with significant extraspinal extension is reported. In view of associated constitutional symptoms, suggestive signs, leucocytosis, elevated ESR and operative findings, the initial diagnosis of Pott?s spine was entertained. The lesion however turned out to be infected Ewing?s sarcoma on histopathology and bacteriological examination.

Kumar R

2000-10-01

235

Thoracic vertebral osteomyelitis following catfish spine impalement.  

Science.gov (United States)

Although rare, thoracic osteomyelitis can occur when toxins from a catfish spine impalement to the hand spread via the blood. This article describes diagnosis and management of this condition in a man who required hospitalization for debilitating back pain that developed 3 weeks after the initial injury. PMID:25343428

Sateren-Zoller, Elizabeth; Sharma, Manish S; Tin, Thiha; Cannella, Dominic M; Chyatte, Douglas

2014-11-01

236

Anterior approaches to the upper thoracic spine  

International Nuclear Information System (INIS)

The upper thoracic spine region is difficult to access from an anterior approach because of the surrounding bones (ribs, sternum and scapulae) and organs (heart, lung and great vessels). The outcomes of 37 consecutive cases with lesions in the upper thoracic spine region (T1-4) were reviewed to study surgical approaches to the upper thoracic spine. We used anterior approaches in 13 cases. A full sternotomy was performed in 6 cases (5 cases ossification of posterior longitudinal ligament (OPLL), 1 case herniated disc), a high thoracotomy was performed in 6 cases (3 cases herniated disc, 2 cases spinal cord tumor, 1 case TB spine), and a partial resection of a unilateral sternoclavicular joint was performed in 1 case. A sternotomy is thought to be useful for OPLL in the T1-3 region, whereas a high thoracotomy is recommended for unilateral anterior lesions and lesions extending below the T3/4 level. Reconstructive CT sagittal images can supply useful anatomical informations for selecting a surgical approach. (author)

237

Cervical spine injury in child abuse: report of two cases  

International Nuclear Information System (INIS)

Pediatric cervical spine injuries have rarely been reported in the setting of child abuse. We report two cases of unsuspected lower cervical spine fracture-dislocation in twin infant girls who had no physical examination findings to suggest cervical spine injury. Classic radio-graphic findings of child abuse were noted at multiple other sites in the axial and appendicular skeleton. Magnetic resonance (MR) imaging proved to be valuable in both the initial evaluation of the extent of cervical spine injury and in following postoperative changes. The unexpected yet devastating findings in these two cases further substantiate the importance of routine evaluation of the cervical spine in cases of suspected child abuse. (orig.)

238

Cervical spine injury in child abuse: report of two cases  

Energy Technology Data Exchange (ETDEWEB)

Pediatric cervical spine injuries have rarely been reported in the setting of child abuse. We report two cases of unsuspected lower cervical spine fracture-dislocation in twin infant girls who had no physical examination findings to suggest cervical spine injury. Classic radio-graphic findings of child abuse were noted at multiple other sites in the axial and appendicular skeleton. Magnetic resonance (MR) imaging proved to be valuable in both the initial evaluation of the extent of cervical spine injury and in following postoperative changes. The unexpected yet devastating findings in these two cases further substantiate the importance of routine evaluation of the cervical spine in cases of suspected child abuse. (orig.)

Rooks, V.J.; Sisler, C.; Burton, B. [Tripler Army Medical Center, Honolulu, HI (United States). Dept. of Radiology

1998-03-01

239

Volumetric quantitative CT of the spine  

International Nuclear Information System (INIS)

The authors have developed a new three-dimensional technique for quantitative CT (QCT) that provides image subtraction as a direct visual and quantitative means of measuring bone mineral density (BMD) changes. Two vertebrae were scanned in contiguous 3-mm sections. An object coordinate system (OCS) was computed for the baseline and follow-up measurements. The OCS specifies the location and orientation of the vertebral body with respect to a global scanner coordinate system. The follow-up measurement was transformed for alignment with the baseline and follow-up measurements were subtracted on a voxel-by-voxel basis. The resulting difference image highlighted zones of unusual BMD changes. Preliminary results from experimental subjects before and after 17 weeks of bed rest suggest that residual repositioning errors are on the order of 1 mm after image transformation

240

Development and validation of a strategic repositioning model for defense and aerospace contractors  

Science.gov (United States)

Strategic repositioning refers to the organized efforts of defense contractors to "reposition" a technology that they have developed for a defense sector customer into a civilian or commercial market. The strategic repositioning model developed here is a structural model: it seeks to isolate the factors that influence choice of strategy, which in turn influences the organization's performance. The model draws from the prior experience of contractors (through interviews and surveys) and companies in other sectors (through a review of the relevant published research). (1) Over all, the model accounted for 55% of the variance in financial performance of the sample and 35% for the underlying population. (2) Key success factors include a rigorous planning process, a target market in the growth (vs. incubation) stage, a priority on market leadership as well as financial return, the ability to operate in an ambiguous business environment, and a relatively short time horizon but strong corporate support. (3) The greatest challenges that a contractor is likely to encounter are understanding his new customers' buying practices, strong competition, and adapting his technology to their needs and price expectations. (4) To address these issues contractors often involve partners in their entry strategy, but partnerships of equals tend to be more difficult to bring off than direct entry strategies. (5) The two major target market categories--government and commercial--present different challenges. Commercial customers are more likely to resist doing business with the contractor, while contractors entering government and other noncommercial markets are more likely to encounter price resistance, low technical sophistication among customers, and difficulties reaching their customer base. (6) Despite these differences across markets, performance is not influenced by the target market category, nor by the type of product or service or the contractor's functional orientation (marketing, technology, or operations). (7) The absence of a difference in performance may be partly due to natural selection. Noncommercial markets tend to attract contractors with more deliberative, consultative, and process-oriented corporate cultures, while commercial markets tend to attract contractors with results-oriented, opportunistic cultures.

Bers, John A.

 
 
 
 
241

Ranked retrieval of segmented nuclei for objective assessment of cancer gene repositioning  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Correct segmentation is critical to many applications within automated microscopy image analysis. Despite the availability of advanced segmentation algorithms, variations in cell morphology, sample preparation, and acquisition settings often lead to segmentation errors. This manuscript introduces a ranked-retrieval approach using logistic regression to automate selection of accurately segmented nuclei from a set of candidate segmentations. The methodology is validated on an application of spatial gene repositioning in breast cancer cell nuclei. Gene repositioning is analyzed in patient tissue sections by labeling sequences with fluorescence in situ hybridization (FISH, followed by measurement of the relative position of each gene from the nuclear center to the nuclear periphery. This technique requires hundreds of well-segmented nuclei per sample to achieve statistical significance. Although the tissue samples in this study contain a surplus of available nuclei, automatic identification of the well-segmented subset remains a challenging task. Results Logistic regression was applied to features extracted from candidate segmented nuclei, including nuclear shape, texture, context, and gene copy number, in order to rank objects according to the likelihood of being an accurately segmented nucleus. The method was demonstrated on a tissue microarray dataset of 43 breast cancer patients, comprising approximately 40,000 imaged nuclei in which the HES5 and FRA2 genes were labeled with FISH probes. Three trained reviewers independently classified nuclei into three classes of segmentation accuracy. In man vs. machine studies, the automated method outperformed the inter-observer agreement between reviewers, as measured by area under the receiver operating characteristic (ROC curve. Robustness of gene position measurements to boundary inaccuracies was demonstrated by comparing 1086 manually and automatically segmented nuclei. Pearson correlation coefficients between the gene position measurements were above 0.9 (p Conclusions Accurate segmentation is necessary to automate quantitative image analysis for applications such as gene repositioning. However, due to heterogeneity within images and across different applications, no segmentation algorithm provides a satisfactory solution. Automated assessment of segmentations by ranked retrieval is capable of reducing or even eliminating the need to select segmented objects by hand and represents a significant improvement over binary classification. The method can be extended to other high-throughput applications requiring accurate detection of cells or nuclei across a range of biomedical applications.

Cukierski William J

2012-09-01

242

Head repositioning errors in normal student volunteers: a possible tool to assess the neck's neuromuscular system  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background A challenge for practitioners using spinal manipulation is identifying when an intervention is required. It has been recognized that joint pain can interfere with the ability to position body parts accurately and that the recent history of muscle contraction can play a part in that interference. In this study, we tested whether repositioning errors could be induced in a normal population by contraction or shortening of the neck muscles. Methods In the experimental protocol, volunteers free of neck problems first found a comfortable neutral head posture with eyes closed. They deconditioned their cervical muscles by moving their heads 5 times in either flexion/extension or lateral flexion and then attempted to return to the same starting position. Two conditioning sequences were interspersed within the task: hold the head in an extended or laterally flexed position for 10 seconds; or hold a 70% maximum voluntary contraction in the same position for 10 seconds. A computer-interfaced electrogoniometer was used to measure head position while a force transducer coupled to an auditory alarm signaled the force of isometric contraction. The difference between the initial and final head orientation was calculated in 3 orthogonal planes. Analysis of variance (1-way ANOVA with a blocking factor (participants was used to detect differences in proprioceptive error among the conditioning sequences while controlling for variation between participants. Results Forty-eight chiropractic students participated: 36 males and 12 females, aged 28.2 ± 4.8 yrs. During the neck extension test, actively contracting the posterior neck muscles evoked an undershoot of the target position by 2.1° (p Conclusion The results suggest that the recent history of cervical paraspinal muscle contraction can influence head repositioning in flexion/extension. To our knowledge this is the first time that muscle mechanical history has been shown to influence proprioceptive accuracy in the necks of humans. This finding may be used to elucidate the mechanism behind repositioning errors seen in people with neck pain and could guide development of a clinical test for involvement of paraspinal muscles in cervical pain and dysfunction.

Gudavalli M Ram

2006-03-01

243

Te Kotahitanga: A Case Study of a Repositioning Approach to Teacher Professional Development for Culturally Responsive Pedagogies  

Science.gov (United States)

This article presents a case study of a unique New Zealand professional development programme, Te Kotahitanga, for mainstream secondary school teachers. Findings discussed are drawn from an independent evaluation of the programme across 22 secondary schools. The professional development approach attempted to reposition the relationship between…

Hynds, Anne; Sleeter, Christine; Hindle, Rawiri; Savage, Catherine; Penetito, Wally; Meyer, Luanna H.

2011-01-01

244

Measurement of repositioning accuracy during fractionated stereotactic radiotherapy for intracranial tumors using noninvasive fixation of BrainLAB radiotherapy equipment  

International Nuclear Information System (INIS)

Purpose: A noninvasive fixation mask device is used for stereotactic radiotherapy (SRT) in our hospital. Fractionated SRT is useful because it results in less damage to normal tissues, for which the positioning accuracy of the removable noninvasive fixation device is important. We examined the repositioning accuracy of a BrainLAB removable noninvasive fixation device on the coordinates of computed tomography (CT) for treatment planning. Methods and Materials: The subjects were 13 patients who had undergone head SRT. The removable noninvasive fixation mask device used was a noninvasive fixation device for the BrainLAB system. The accuracy of the irradiation apparatus was evaluated using Winston-Lutz test film, and the repositioning accuracy of the fixation device was examined using differences in the distance on the X, Y, and Z coordinates between the treatment planning and repositioning times determined by comparing the relative coordinates. The evaluation was performed using the relative coordinates of the standard and test points. Results: The accuracy of the irradiation center with the apparatus was within 0.5 mm. In the 13 patients, the difference in the distance between the treatment planning and repositioning procedures ranged from 0.1 to 2.080 mm, and an accuracy of within 2 mm was obtained in 84.6% of the patients using the fixation device. Conclusion: The BrainLAB noninvasive SRT fixation device was considered useful for routine treatment with high accuracy

245

On the Shoulders of Giants? Global Science, Resource Asymmetries, and Repositioning of Research Universities in China and Russia  

Science.gov (United States)

Chinese and Russian universities are increasingly drawn into center-periphery repositioning, as they compete for symbolic, financial, and intellectual resources locally and globally. However, their strategies on national and institutional linkages differ with regards to the individual scientist's powers in knowledge production. As global…

Oleksiyenko, Anatoly

2014-01-01

246

Remote Sensing  

... Richard Gloaguen Remote Sensing Group, Helmholtz Institute Freiberg, TU Bergakademie Freiberg, Bernhard von-Cotta Str., 2, D-09599 Freiberg,...de/remote-sensing-group E-Mail: r.gloaguen@hzdr.de Interests: earth sciences; remote sensing/photogrammetry; tectonic geomorphology; vegetation physical properties;... Wolfgang Wagner * Research Group Remote Sensing, Department of Geodesy and Geoinformation (GEO), Vienna University of Technology (TU Wien)... Churnside Ocean Remote Sensing Working Group, NOAA Earth System Research Laboratory, CSD3, 325 Broadway, Boulder, Colorado 80305-3328, ...

247

Endoplasmic reticulum Calcium stores in dendritic spines  

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Full Text Available Despite decades of research, the role of calcium stores in dendritic spines structure, function and plasticity is still debated. The reasons for this may have to do with the multitude of overlapping calcium handling machineries in the neuron, including stores, voltage and ligand gated channels, pumps and transporters. Also, different cells in the brain are endowed with calcium stores that are activated by different receptor types, and their differential compartmentalization in dendrites, spines and presynaptic terminals complicates their analysis. In the present review we address several key issues, including the role of calcium stores in synaptic plasticity, their role during development, in stress and in neurodegenerative diseases. Apparently, there is increasing evidence for a crucial role of calcium stores, especially of the ryanodine species, in synaptic plasticity and neuronal survival.

Menahem Segal

2014-07-01

248

Retropharyngeal cold abscess without Pott's spine  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Retropharyngeal abscesses are infections deep in the neck space that can pose an immediate life-threatening emergency, with potential for airway compromise and other catastrophic complications. In adults these abscesses can develop as a result of vertebral pyogenic osteomyelitis, tube Reculosis of t [...] he spine, or external injuries caused by endoscopes or foreign bodies (e.g. fish bones). Tuberculosis of the retropharyngeal space is one of the rare forms of extrapulmonary tuberculosis. Early diagnosis and treatment are necessary to prevent the serious complications of the disease. We present a case of tuberculous retropharyngeal abscess in an adult woman without tuberculosis of the cervical spine who was managed surgically by aspirating the retropharyngeal abscess transorally, together with antituberculosis treatment.

J, Singh; H, Velankar; D, Shinde; N, Chordia; S, Budhwani.

249

Branched standard spines of 3-manifolds  

CERN Document Server

This book provides a unified combinatorial realization of the categroies of (closed, oriented) 3-manifolds, combed 3-manifolds, framed 3-manifolds and spin 3-manifolds. In all four cases the objects of the realization are finite enhanced graphs, and only finitely many local moves have to be taken into account. These realizations are based on the notion of branched standard spine, introduced in the book as a combination of the notion of branched surface with that of standard spine. The book is intended for readers interested in low-dimensional topology, and some familiarity with the basics is assumed. A list of questions, some of which concerning relations with the theory of quantum invariants, is enclosed.

Benedetti, Riccardo

1997-01-01

250

Manifestations of spine infections for RMN  

International Nuclear Information System (INIS)

Instead of demonstrate the utility and benefits of MRI imaging in infectious processes of the spine, 8 patients with lumbar pain affected by spondilodiscitis were studied. T1 SE, T2, SE with and without fat sat and proton density imaging was performed, axial; sagittal and coronal views were obtained. Contrast media was used in 1 Patient. hypointense lesions in T1 and hyperintense lesions in T2 compatible with esponsilodiscitis were observed in every patient. Images with great anatomic detail of bone and soft tissue structures were obtained. MRI is an alternative diagnostic method with multiplanar images and excellent contrast that permits a precise diagnosis in any of the stages of infectious processes of the spine

251

Retropharyngeal cold abscess without Pott's spine.  

Science.gov (United States)

Retropharyngeal abscesses are infections deep in the neck space that can pose an immediate life-threatening emergency, with potential for airway compromise and other catastrophic complications. In adults these abscesses can develop as a result of vertebral pyogenic osteomyelitis, tuberculosis of the spine, or external injuries caused by endoscopes or foreign bodies (e.g. fish bones). Tuberculosis of the retropharyngeal space is one of the rare forms of extrapulmonary tuberculosis. Early diagnosis and treatment are necessary to prevent the serious complications of the disease. We present a case of tuberculous retropharyngeal abscess in an adult woman without tuberculosis of the cervical spine who was managed surgically by aspirating the retropharyngeal abscess transorally, together with antituberculosis treatment. PMID:23217558

Singh, Jyoti; Velankar, Haritosh; Shinde, Devayani; Chordia, Nilesh; Budhwani, Sneha

2012-11-01

252

Development of the Young Spine Questionnaire  

DEFF Research Database (Denmark)

Title Development of the Young Spine Questionnaire Authors & Affiliations Henrik Hein Lauridsen1, Lise Hestbæk1,2 1. Research Unit for Clinical Biomechanics, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Clinical Locomotion Network, Campusvej 55, DK-5230 Odense M, Denmark 2. Nordic Institute of Chiropractic and Clinical Biomechanics, Clinical Locomotion Network, Forskerparken 10A, 5230 Odense M, Denmark Background Back pain in children is common and early onset of back pain has been shown to increase the risk of back pain significantly in adulthood. Therefore preventive efforts must be targeted the young population but research relating to spinal problems in this age group is scarce. Focus has primarily been on the working age population, and therefore specific instruments to measure spinal pain and its consequences, specifically aimed at children and adolescents are absent. The purpose of this study was to develop an instrument for children aged 9-12 years which could fill this gap in the literature. Methods The Young Spine Questionnaire (YSQ) was developed in three phases – the conceptualisation, development and testing phase. We used the conceptual model of Wilson and Cleary (1995) and divided the YSQ into two parts: part one included spinal prevalence estimates (including pictures of spinal area) and part two questions regarding pain, activity restrictions, care seeking behaviour and influence of parental back trouble. During the developing phase we used an iterative process to carefully rephrase existing items used in prior questionnaires such as the Standardised Nordic Questionnaire. To measure pain the “Revised Faces Pain Scale” (rFPS) was included. The testing phase consisted of an iterative method assessing respondent understanding during two pilot tests. In the first pilot test 52 4th grade children filled in the draft version of the YSQ. This was followed by a semi-structured interview two days later designed to obtain the same information ascontained in the YSQ, however, using different semantics and open-ended questions. The revised questionnaire was tested and reviewed a second time at the end of the first pilot test. The second pilot test included 23 children from the 4th grade. It followed similar procedures as the first pilot test but focused mainly on revised versions of the drawings demarcating the spinal areas. Results Agreement between the questionnaire prevalence estimates and the interviews ranged between 83.7% (cervical pain today) and 97.9% (thoracic pain today). Correlations between the rFPS and the interview NRS score ranged between 0.71 (cervical spine) and 0.84 (thoracic spine). Agreement between the questionnaire drawings and the interviews of the upper and lower boundaries of the spinal areas were 91.8% for the cervical spine and 67.4% (lumbar spine) and 63.3% (thoracic spine). This resulted in alterations to the drawings. Lastly, as some questions in the second part of the YSQ had a high prevalence of non-responses, it was decided to change question semantics and response options. Conclusion The Young Spine Questionnaire is a novel self-report measure of spinal pain and its consequences. The items have been tested for understanding of content among target respondents, and the results showed acceptable agreement between questionnaire scores and interview findings. On the basis of these preliminary results we conclude that the YSQ is a feasible and valid instrument to be used in cross-sectional cohort studies of children aged 9 to 12 years.

Lauridsen, Henrik Hein; Hestbæk, Lise

253

Detailed sectional anatomy of the spine  

International Nuclear Information System (INIS)

Morphologic studies on the human spine constitute a special challenge because of the spine's complex topographic anatomy and the intimate relationship between the supporting skeleton and the contiguous soft tissues (muscles, discs, joint capsules) as well as the neurovascular contents of the spinal canal and intervertebral foramina. The improving resolution and multiplanar image reformatting capabilities of modern CT scanners call for accurate anatomic reference material. Such anatomic images should be available without distortion, in natural colors, and in considerable detail. The images should present the anatomy in the correct axial, sagittal, and coronal planes and should also be sufficiently closely spaced so as to follow the thin cuts of modern CT scanners. This chapter details one of several recent attempts to correlate gross anatomy with the images depicted by high-resolution CT. The methods of specimen preparation, sectioning, and photographing have been documented elsewhere

254

Retropharyngeal cold abscess without Pott's spine  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Retropharyngeal abscesses are infections deep in the neck space that can pose an immediate life-threatening emergency, with potential for airway compromise and other catastrophic complications. In adults these abscesses can develop as a result of vertebral pyogenic osteomyelitis, tube Reculosis of t [...] he spine, or external injuries caused by endoscopes or foreign bodies (e.g. fish bones). Tuberculosis of the retropharyngeal space is one of the rare forms of extrapulmonary tuberculosis. Early diagnosis and treatment are necessary to prevent the serious complications of the disease. We present a case of tuberculous retropharyngeal abscess in an adult woman without tuberculosis of the cervical spine who was managed surgically by aspirating the retropharyngeal abscess transorally, together with antituberculosis treatment.

J, Singh; H, Velankar; D, Shinde; N, Chordia; S, Budhwani.

2012-11-01

255

Raziskovalni model strateškega repozicioniranja blagovne znamke = Research Model of Strategic Repositioning of the Brand  

Directory of Open Access Journals (Sweden)

Full Text Available Development of the world food market has, in recent years, been markedby rapid, unexpected and complex changes. The world food industryis operating in an explicitly dynamic environment which demandsconstant adjustments and responses. Good familiarity with consumers,their habits, wishes, and motives for buying a certain product is becomingan increasingly important area and food companies have,therefore, devoted more attention to it. The paper uses case a studyof the brand Perutnina Ptuj to illustrate the importance of action elementsin repositioning a brand in competitive markets. The exampleis illustrated by using a research model of strategic repositioningof a brand. The results of the analysis of competitors, the analysis ofthe brand, the results of qualitative research, and the developmentand testing of possible concepts on international markets have offereda basic starting-point for a new positioning of the brand.

Tina Vukasovi?

2009-09-01

256

Actin-dependent intranuclear repositioning of an active gene locus in vivo.  

Science.gov (United States)

Although bulk chromatin is thought to have limited mobility within the interphase eukaryotic nucleus, directed long-distance chromosome movements are not unknown. Cajal bodies (CBs) are nuclear suborganelles that nonrandomly associate with small nuclear RNA (snRNA) and histone gene loci in human cells during interphase. However, the mechanism responsible for this association is uncertain. In this study, we present an experimental system to probe the dynamic interplay of CBs with a U2 snRNA target gene locus during transcriptional activation in living cells. Simultaneous four-dimensional tracking of CBs and U2 genes reveals that target loci are recruited toward relatively stably positioned CBs by long-range chromosomal motion. In the presence of a dominant-negative mutant of beta-actin, the repositioning of activated U2 genes is markedly inhibited. This supports a model in which nuclear actin is required for these rapid, long-range chromosomal movements. PMID:18070915

Dundr, Miroslav; Ospina, Jason K; Sung, Myong-Hee; John, Sam; Upender, Madhvi; Ried, Thomas; Hager, Gordon L; Matera, A Gregory

2007-12-17

257

Actin-dependent intranuclear repositioning of an active gene locus in vivo  

Science.gov (United States)

Although bulk chromatin is thought to have limited mobility within the interphase eukaryotic nucleus, directed long-distance chromosome movements are not unknown. Cajal bodies (CBs) are nuclear suborganelles that nonrandomly associate with small nuclear RNA (snRNA) and histone gene loci in human cells during interphase. However, the mechanism responsible for this association is uncertain. In this study, we present an experimental system to probe the dynamic interplay of CBs with a U2 snRNA target gene locus during transcriptional activation in living cells. Simultaneous four-dimensional tracking of CBs and U2 genes reveals that target loci are recruited toward relatively stably positioned CBs by long-range chromosomal motion. In the presence of a dominant-negative mutant of ?-actin, the repositioning of activated U2 genes is markedly inhibited. This supports a model in which nuclear actin is required for these rapid, long-range chromosomal movements. PMID:18070915

Dundr, Miroslav; Ospina, Jason K.; Sung, Myong-Hee; John, Sam; Upender, Madhvi; Ried, Thomas; Hager, Gordon L.; Matera, A. Gregory

2007-01-01

258

Subcapital fractures of the fourth and fifth metacarpals treated without splinting and reposition  

DEFF Research Database (Denmark)

The aim of the study was to evaluate the results after treating subcapital fractures in the fourth and fifth metacarpals with immediate mobilisation and without splinting or reduction. We undertook a prospective clinical evaluation of 36 subcapital fractures of the fourth and fifth metacarpals treated with immediate mobilisation and without splinting or reduction during the period 1 January 1990 to 31 December 1992 in the accident and emergency department, Holstebro Central Hospital. After 4 weeks only 4 patients (11%) had restricted movement in the metacarpophalangeal joint (less than 0-80 degrees of movement). The fracture had healed in 33 patients (92%), and 31 of the patients (86%) were completely satisfied. We conclude that subcapital fractures in the fourth and fifth metacarpals can be treated without immobilisation or reposition.

Breddam, M; Hansen, Torben Bæk

1995-01-01

259

Refining Chandra/ACIS Subpixel Event Repositioning Using a Backside Illuminated CCD Model  

CERN Document Server

Subpixel event repositioning (SER) techniques have been demonstrated to significantly improve the already unprecedented spatial resolution of Chandra X-ray imaging with the Advanced CCD Imaging Spectrometer (ACIS). Chandra CCD SER techniques are based on the premise that the impact position of events can be refined, based on the distribution of charge among affected CCD pixels. ACIS SER models proposed thus far are restricted to corner split (3- and 4-pixel) events, and assume that such events take place at the split pixel corners. To improve the event counting statistics, we modified the ACIS SER algorithms to include 2-pixel split events and single pixel events, using refined estimates for photon impact locations. Furthermore, simulations that make use of a high-fidelity CCD model demonstrate that mean photon impact positions for split events are energy dependent, leading to further modification of subpixel event locations, according to event type and energy. Testing on Chandra CCD X-ray observations of the...

Li, J; Prigozhin, G Y; Schulz, N S; Li, Jingqiang; Kastner, Joel H.; Prigozhin, Gregory Y.; Schulz, Norbert S.

2003-01-01

260

Repositioning accuracy of a noninvasive head fixation system for stereotactic radiotherapy  

International Nuclear Information System (INIS)

We report on the repositioning accuracy of patient setup achieved with a noninvasive head fixation device for stereotactic radiotherapy. A custom head mask which attaches to our stereotactic radiosurgery head ring assembly is fabricated for each patient. The position and orientation of a patient in the stereotactic space at the time of treatment are determined from analyzing portal films containing images of radio-opaque spheres embedded in a custom mouthpiece. From analysis of 104 setups of 12 patients, we find that the average distance between the treated isocenter and its mean position is 1.8 mm, and that the standard deviations of the position of the treated isocenter in stereotactic coordinate space about its mean position are less than 1.4 mm in translation in any direction and less than 1 degree of rotation about any axis. copyright 1996 American Association of Physicists in Medicine

 
 
 
 
261

On the Utility of Directional Information for Repositioning Errant Probes in Central Force Optimization  

CERN Document Server

Central Force Optimization is a global search and optimization algorithm that searches a decision space be flying "probes" whose trajectories are deterministically computed using two equations of motion. Because it is possible for a probe to fly outside the domain of feasible solutions, a simple errant probe retrieval method has been used previously that does not include the directional information contained in a probe's acceleration vector. This note investigates the effect of adding directionality to the "repositioning factor" approach. As a general proposition, it appears that doing so does not improve convergence speed or accuracy. In fact, adding directionality to the original errant probe retrieval scheme appears to be highly inadvisable. Nevertheless, there may be alternative probe retrieval schemes that do benefit from directional information, and the results reported here may assist in or encourage their development.

Formato, Richard A

2010-01-01

262

Correction of vertical maxillary excess by superior repositioning of the maxilla.  

Science.gov (United States)

Vertical maxillary excess (VME) is frequently referred to as one variation of maxillo-mandibular discrepancy, which is often identified by excessive display of incisors and gingiva during smiling. This anomaly is corrected surgically by superior maxillary impaction, which can be combined by other procedures such as, anterior maxillary segmental osteotomy to relieve the maxillary protrusion, or mandibular osteotomy in the form of ramus surgery, or subapical osteotomy to correct the maxillary-mandibular relationship, and to obtain functional occlusion. Adjunctive procedures are undertaken to counteract the associated soft tissue changes, and to establish functional and esthetic facial balance. This article subjectively reports the results of superior repositioning of the maxilla in 4 patients with excessive maxillary growth, with or without other skeletal deformities. The remarkable improvements in facial appearance perceived by patients suggest the best value of orthognathic surgery in the correction of VME by means of maxillary impaction osteotomy and other adjunctive procedures. PMID:20563371

Zahrani, Ahmed A

2010-06-01

263

Correction of vertical maxillary excess by superior repositioning of the maxilla.  

Directory of Open Access Journals (Sweden)

Vertical maxillary excess (VME is frequently referred to as one variation of maxillo-mandibular discrepancy, which is often identified by excessive display of incisors and gingiva during smiling. This anomaly is corrected surgically by superior maxillary impaction, which can be combined by other procedures such as, anterior maxillary segmental osteotomy to relieve the maxillary protrusion, or mandibular osteotomy in the form of ramus surgery, or subapical osteotomy to correct the maxillary-mandibular relationship, and to obtain functional occlusion. Adjunctive procedures are undertaken to counteract the associated soft tissue changes, and to establish functional and esthetic facial balance. This article subjectively reports the results of superior repositioning of the maxilla in 4 patients with excessive maxillary growth, with or without other skeletal deformities. The remarkable improvements in facial appearance perceived by patients suggest the best value of orthognathic surgery in the correction of VME by means of maxillary impaction osteotomy and other adjunctive procedures.

Ahmed A. Zahrani

2010-06-01

264

Automatic Thresholding for Frame-Repositioning Using External Tracking in PET Brain Imaging  

DEFF Research Database (Denmark)

Motion correction (MC) in positron emission tomography (PET) brain imaging become of higher importance with increasing scanner resolution. Several motion correction methods have been suggested and so far the Polaris Vicra tracking system has been the preferred one for motion registration. We present an automated algorithm for dividing PET acquisitions into subframes based on the registered head motion to correct for intra-frame motion with the frame repositioning MC method. The method is tested on real patient data (five 11C-SB studies and five 11C-PIB studies) and compared with an image based registration method (AIR). Quantitative evaluation was done using a correlation measure. The study shows that MC improves the correlation of the PET images and that AIR performed slightly better than the Polaris Vicra. We found significant intra-frame motion of 1-5 mm in 9 frames but the correlation was not significantly improved using intra-frame MC.

Olesen, Oline Vinter; Larsen, Rasmus

2010-01-01

265

The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo.  

Science.gov (United States)

The Canalith Repositioning Procedure (CRP) is designed to treat benign paroxysmal positional vertigo (BPPV) through induced out-migration of free-moving pathological densities in the endolymph of a semicircular canal, using timed head maneuvers and applied vibration. This article describes the procedure and its rationale, and reports the results in 30 patients who exhibited the classic nystagmus of BPPV with Hallpike maneuvers. CRP obtained timely resolution of the nystagmus and positional vertigo in 100%. Of these, 10% continued to have atypical symptoms, suggesting concomitant pathology; 30% experienced one or more recurrences, but responded well to retreatment with CRP. These results also support an alternative theory that the densities that impart gravity-sensitivity to a semicircular canal in BPPV are free in the canal, rather than attached to the cupula. CRP offers significant advantages over invasive and other noninvasive treatment modalities in current use. PMID:1408225

Epley, J M

1992-09-01

266

[Injuries of the cervical spine in Switzerland].  

Science.gov (United States)

The post traumatic evaluation of patients after soft tissue injuries of cervical spine is not clear. As objective criteria of the injury are often absent, the judgement in the medical expertise is difficult. 1100 medical records as a representative sample of 11,000 patients with cervical spine injury recorded at the Swiss National Insurance Company during the years 1978-81 were analysed. 320 records were evaluated in detail. Those injured received a questionnaire about their present psychosocial situation, complaints, necessity of treatment and financial compensation. 207 or 65% returned the filled out questionnaire. X-rays verified that 12.6% of all injured had fractures or luxation of the cervical spine, 4.2% of all patients showed fracture combined with spinal cord lesion. In 87.4% only soft tissue injury was described. About the half of the accidents were road accidents, the other half occurred during sport, work etc. 30% of the patients with fracture are receiving financial compensation as a result of working disability, 70% of them are still, i.e. 4-7 years after injury, under medical care. Only 1% of the injured patients without fracture are receiving a financial compensation, while 25% of them do need treatment for their symptoms caused by the accident. The therapeutical procedures range from application of Myotonolytics, pain killers, Infiltrations to Physiotherapy and Manipulation. Almost all of those 25% injured are not in agreement with the decision of the insurance company based upon the medical expertise. 12% of all injured developed, after the accident, psychological symptoms, such as decreased concentration, vitality or productivity, melancholy etc. The discrepancy between the judgement of the insurance company based upon the medical records and the patients complaints also 4-7 years after injury as well as the diversification of therapeutical procedures used in the long term patients career are indicating a necessity of prospective study on cervical spine injury. PMID:3574939

Dvorak, J; Valach, L; Schmid, S

1987-02-01

267

Camptocormia: the bent spine syndrome, an update  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Camptocormia, also referred to as bent spine syndrome (BSS) is defined as an abnormal flexion of the trunk, appearing in standing position, increasing during walking and abating in supine position. BSS was initially considered, especially in wartime, as a psychogenic disorder. It is now recognized that in addition to psychiatric syndromes, many cases of reducible BSS have a somatic origin related to a number of musculo-skeletal or neurological disorders. The majority of BSS of muscular origin...

Lenoir, Thibaut; Guedj, Nathalie; Boulu, Philippe; Guigui, Pierre; Benoist, Michel

2010-01-01

268

Audit of autotransfusion in spine surgery  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A prospective evaluation has been undertaken of 382 patients undergoing reconstructive spine surgery during a thirty-six month period. Acute normovolaemic haemodilution and haemapheresis for blood component sequestration was used in 80 patients in the operating theatre. An average of two units each of freshly collected autologous red cells and fresh plasma together with a therapeutic dose of a plateletpheresis product were prepared for each patient prior to surgical incision. The same supplie...

Shulman, G.; Solanki, D. R.; Nicodemus, C. L.; Flores, I. M.; Hadjipavlou, A. G.

1998-01-01

269

Concomitant lower thoracic spine disc disease in lumbar spine MR imaging studies  

International Nuclear Information System (INIS)

Our objective was to study the coexistence of lower thoracic-spine disc changes in patients with low back pain using a large field of view (FOV) in lumbar spine MR imaging. One hundred fifty patients with low back pain were referred to an MR examination. All patients were studied with a large FOV (27 cm), covering from the coccyx to at least the body of T11. Discs were coded as normal, protrusion, and extrusion (either epiphyseal or intervertebral). The relationship between disc disease and level was established with the Pearson ?2 test. The T11-12 was the most commonly affected level of the lower thoracic spine with 58 disc cases rated as abnormal. Abnormalities of T11-12 and T12-L1 discs were significantly related only to L1-L2 disease (p=0.001 and p=0.004, respectively) but unrelated to other disc disease, patient's gender, and age. No correlation was found between other discs. Magnetic resonance imaging of the lumbar spine can detect a great amount of lower thoracic disease, although its clinical significance remains unknown. A statistically significant relation was found within the thoracolumbar junctional region (T11-L2), reflecting common pathoanatomical changes. The absence of relation with lower lumbar spine discs is probably due to differences in their pathomechanisms. (orig.)

270

Primary spine care services: responding to runaway costs and disappointing outcomes in spine care.  

Science.gov (United States)

Efforts are underway to reform our health care system to improve efficiency, outcomes, patient satisfaction and costs. In no field is this more critical than that of spine- related disorders, where escalating costs combined with decreasing clinical benefits for patients has reached a breaking point. Traditionally, practitioners have grouped together based on their specialty (orthopedics, otolaryn- gology, etc.). There has been a recent movement to restructure health care delivery into a patient-centered model that teams professionals based on their ability to serve specific patient needs. This article introduces a new service line - primary spine care services - led by a new type of professional - the primary spine practitioner (PSP). This new practitioner type requires a refined and focused skill set and ideally functions within an integrated spine care pathway. The challenges and opportunities presented by primary spine care services are discussed. This service line has already been implemented in a variety of settings. [Full text available at http://rimed.org/rimedicaljournal-2014-10.asp, free with no login]. PMID:25271662

Murphy, Donald R

2014-01-01

271

Concomitant lower thoracic spine disc disease in lumbar spine MR imaging studies  

Energy Technology Data Exchange (ETDEWEB)

Our objective was to study the coexistence of lower thoracic-spine disc changes in patients with low back pain using a large field of view (FOV) in lumbar spine MR imaging. One hundred fifty patients with low back pain were referred to an MR examination. All patients were studied with a large FOV (27 cm), covering from the coccyx to at least the body of T11. Discs were coded as normal, protrusion, and extrusion (either epiphyseal or intervertebral). The relationship between disc disease and level was established with the Pearson {chi}{sup 2} test. The T11-12 was the most commonly affected level of the lower thoracic spine with 58 disc cases rated as abnormal. Abnormalities of T11-12 and T12-L1 discs were significantly related only to L1-L2 disease (p=0.001 and p=0.004, respectively) but unrelated to other disc disease, patient's gender, and age. No correlation was found between other discs. Magnetic resonance imaging of the lumbar spine can detect a great amount of lower thoracic disease, although its clinical significance remains unknown. A statistically significant relation was found within the thoracolumbar junctional region (T11-L2), reflecting common pathoanatomical changes. The absence of relation with lower lumbar spine discs is probably due to differences in their pathomechanisms. (orig.)

Arana, Estanislao; Marti-Bonmati, Luis; Dosda, Rosa; Molla, Enrique [Department of Radiology, Quiron Clinic, Avd. Blasco Ibanez, 14, 46010 Valencia (Spain)

2002-11-01

272

Comparison of Coronally Advanced and Semilunar Coronally Repositioned Flap for the Treatment of Gingival Recession  

Science.gov (United States)

Background: Gingival Recession (GR) occurs in population with low oral hygiene levels. Root coverage may be achieved by a number of surgical techniques, including pedicle gingival grafts, free grafts, connective tissue grafts, gtr may also be used. The objective of the present study is to compare the clinical outcomes of the Semilunar Coronally Repositioned Flap (SCRF) and Coronally Advanced Flap (CAF) procedure in the treatment of miller’s class I gingival recession defects in maxillary teeth. Materials and Methods: Twenty systemically healthy patients, with isolated miller’s class 1 gingival recessions, were selected and allocated randomly into two groups, Group I and Group II with 10 patients in each. In Group I, the patients were treated with coronally advanced flap procedure with sling sutures, whereas in Group II, patients were treated with semilunar coronally repositioned flap without sutures. Results: Descriptive statistical analysis has been carried out in the present study. Results on continuous measurements are presented on Mean ± SD. Significance is assessed at 5 % level of significance. Student t-test (two tailed, dependent) has been used to find the significance of study parameters between baseline - 3 months and baseline - 6 months, 90% Confidence interval for mean has been computed. Conclusion: CAF provides consistently better results than SCRF With all other parameters, such as clinical attachment levels, percentage of root coverage and complete root coverage and esthetics were taken into account, caf was found to be superior. In contrary to this, there is significant increase in width of keratinized tissue in scrf group. PMID:25121054

Moka, Leela Rani; M, Srinivas; D, Narasimha swamy; Swarna, Chakrapani; Putcha, Madhusudhan

2014-01-01

273

Recurrent Upside-Down Stomach after Endoscopic Repositioning and Gastropexy Treated by Laparoscopic Surgery  

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Patients with an upside-down stomach usually receive surgical treatment. In high-risk patients, endoscopic repositioning and gastropexy can be performed. However, the risk of recurrence after endoscopic treatment is not known. We treated a case of recurrent upside-down stomach after endoscopic therapy that indicated the limits of endoscopic treatment and risk of recurrence. An 88-year-old woman was treated three times for vomiting in the past. She presented to our hospital with periodic vomiting and an inability to eat, and a diagnosis of upside-down stomach was made. Endoscopic repositioning and gastropexy were performed. The anterior stomach wall was fixed to the abdominal wall in three places as widely as possible. Following treatment, she became symptom-free. Three months later, she was hospitalized again because of a recurrent upside-down stomach. Laparoscopic repair of hernias and gastropexy was performed. Using a laparoscope, two causes of recurrence were found. One cause was that the range of adherence between the stomach and the abdominal wall was narrow (from the antrum only to the lower corpus of stomach), so the upper corpus of stomach was rotated and herniated into the esophageal hiatus. The other cause was adhesion between the omentum and the esophageal hiatus which caused the stomach to rotate and repeatedly become herniated. Although endoscopic treatment for upside-down stomach can be a useful alternative method in high-risk patients, its ability to prevent recurrence is limited. Moreover, a repeated case caused by adhesions has risks of recurrence. PMID:24574947

Toyota, Kazuhiro; Sugawara, Yuji; Hatano, Yu

2014-01-01

274

Rational drug repositioning guided by an integrated pharmacological network of protein, disease and drug  

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Full Text Available Abstract Background The process of drug discovery and development is time-consuming and costly, and the probability of success is low. Therefore, there is rising interest in repositioning existing drugs for new medical indications. When successful, this process reduces the risk of failure and costs associated with de novo drug development. However, in many cases, new indications of existing drugs have been found serendipitously. Thus there is a clear need for establishment of rational methods for drug repositioning. Results In this study, we have established a database we call “PharmDB” which integrates data associated with disease indications, drug development, and associated proteins, and known interactions extracted from various established databases. To explore linkages of known drugs to diseases of interest from within PharmDB, we designed the Shared Neighborhood Scoring (SNS algorithm. And to facilitate exploration of tripartite (Drug-Protein-Disease network, we developed a graphical data visualization software program called phExplorer, which allows us to browse PharmDB data in an interactive and dynamic manner. We validated this knowledge-based tool kit, by identifying a potential application of a hypertension drug, benzthiazide (TBZT, to induce lung cancer cell death. Conclusions By combining PharmDB, an integrated tripartite database, with Shared Neighborhood Scoring (SNS algorithm, we developed a knowledge platform to rationally identify new indications for known FDA approved drugs, which can be customized to specific projects using manual curation. The data in PharmDB is open access and can be easily explored with phExplorer and accessed via BioMart web service (http://www.i-pharm.org/, http://biomart.i-pharm.org/.

Lee Hee

2012-07-01

275

Sampling issues in quantitative analysis of dendritic spines morphology  

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Full Text Available Abstract Background Quantitative analysis of changes in dendritic spine morphology has become an interesting issue in contemporary neuroscience. However, the diversity in dendritic spine population might seriously influence the result of measurements in which their morphology is studied. The detection of differences in spine morphology between control and test group is often compromised by the number of dendritic spines taken for analysis. In order to estimate the impact of dendritic spine diversity we performed Monte Carlo simulations examining various experimental setups and statistical approaches. The confocal images of dendritic spines from hippocampal dissociated cultures have been used to create a set of variables exploited as the simulation resources. Results The tabulated results of simulations given in this article, provide the number of dendritic spines required for the detection of hidden morphological differences between control and test groups in terms of spine head-width, length and area. It turns out that this is the head-width among these three variables, where the changes are most easily detected. Simulation of changes occurring in a subpopulation of spines reveal the strong dependence of detectability on the statistical approach applied. The analysis based on comparison of percentage of spines in subclasses is less sensitive than the direct comparison of relevant variables describing spines morphology. Conclusions We evaluated the sampling aspect and effect of systematic morphological variation on detecting the differences in spine morphology. The results provided here may serve as a guideline in selecting the number of samples to be studied in a planned experiment. Our simulations might be a step towards the development of a standardized method of quantitative comparison of dendritic spines morphology, in which different sources of errors are considered.

Ruszczycki B?a?ej

2012-08-01

276

Perioperative visual loss after spine surgery.  

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Perioperative visual loss (POVL) is an uncommon, but devastating complication that remains primarily associated with spine and cardiac surgery. The incidence and mechanisms of visual loss after surgery remain difficult to determine. According to the American Society of Anesthesiologists Postoperative Visual Loss Registry, the most common causes of POVL in spine procedures are the two different forms of ischemic optic neuropathy: anterior ischemic optic neuropathy and posterior ischemic optic neuropathy, accounting for 89% of the cases. Retinal ischemia, cortical blindness, and posterior reversible encephalopathy are also observed, but in a small minority of cases. A recent multicenter case control study has identified risk factors associated with ischemic optic neuropathy for patients undergoing prone spinal fusion surgery. These include obesity, male sex, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and decreased percent colloid administration. These risk factors are thought to contribute to the elevation of venous pressure and interstitial edema, resulting in damage to the optic nerve by compression of the vessels that feed the optic nerve, venous infarction or direct mechanical compression. This review will expand on these findings as well as the recently updated American Society of Anesthesiologists practice advisory on POVL. There are no effective treatment options for POVL and the diagnosis is often irreversible, so efforts must focus on prevention and risk factor modification. The role of crystalloids versus colloids and the use of ?-2 agonists to decrease intraocular pressure during prone spine surgery will also be discussed as a potential preventative strategy. PMID:24829872

Nickels, Travis J; Manlapaz, Mariel R; Farag, Ehab

2014-04-18

277

Findings in osteosarcoma of the dorsal spine  

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A 60-year-old male had a left pneumonectomy four-and-a-half-years ago to remove a carcinoma of the lung; the surgery was followed by radiation therapy. In September 1997, he complained of back pain. When the back pain was investigated, a malignant tumor was found in the upper dorsal spine. Tumor decompression was performed in November 1997. Pathologic examination confirmed the presence of radiation bone sarcoma and he was treated with postoperative chemotherapy. In April 1998, the patient had another surgery in which three ribs were removed from the upper left chest wall posteriorly and most of the tumor was removed from the left side of the spine. A second surgery was planned to remove tumor from the right side of the spine. An {sup 18}FDG study was requested to determine the extent of the tumor prior to the second operation. It is concluded that adding attenuation correction to the ADAC Solus Molecular Co-incidence Detection (MCD) gamma-camera, markedly improved the quality of the {sup 18}FDG images and the accuracy of the anatomical distribution of uptake

Abdel-Dayem, H. [Saint Vincents Hospital and Medical Centre, New York (United States)

1998-09-01

278

ATLS® and damage control in spine trauma  

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Full Text Available Abstract Substantial inflammatory disturbances following major trauma have been found throughout the posttraumatic course of polytraumatized patients, which was confirmed in experimental models of trauma and in vitro settings. As a consequence, the principle of damage control surgery (DCS has developed over the last two decades and has been successfully introduced in the treatment of severely injured patients. The aim of damage control surgery and orthopaedics (DCO is to limit additional iatrogenic trauma in the vulnerable phase following major injury. Considering traumatic brain and acute lung injury, implants for quick stabilization like external fixators as well as decided surgical approaches with minimized potential for additional surgery-related impairment of the patient's immunologic state have been developed and used widely. It is obvious, that a similar approach should be undertaken in the case of spinal trauma in the polytraumatized patient. Yet, few data on damage control spine surgery are published to so far, controlled trials are missing and spinal injury is addressed only secondarily in the broadly used ATLS® polytrauma algorithm. This article reviews the literature on spine trauma assessment and treatment in the polytrauma setting, gives hints on how to assess the spine trauma patient regarding to the ATLS® protocol and recommendations on therapeutic strategies in spinal injury in the polytraumatized patient.

Gosse Andreas

2009-03-01

279

Intrapartum Ultrasound Assessment of Fetal Spine Position  

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We investigated the role of foetal spine position in the first and second labour stages to determine the probability of OPP detection at birth and the related obstetrical implications. We conducted an observational-longitudinal cohort study on uncomplicated cephalic single foetus pregnant women at term. We evaluated the accuracy of ultrasound in predicting occiput position at birth, influence of fetal spine in occiput position during labour, labour trend, analgesia request, type of delivery, and indication to CS. The accuracy of the foetal spinal position to predict the occiput position at birth was high at the first labour stage. At the second labour stage, CS (40.3%) and operative vaginal deliveries (23.9%) occurred more frequently in OPP than in occiput anterior position (7% and 15.2%, resp.), especially in cases of the posterior spine. In concordant posterior positions labour length was greater than other ones, and analgesia request rate was 64.1% versus 14.7% for all the others. The assessment of spinal position could be useful in obstetrical management and counselling, both before and during labour. The detection of spinal position, more than OPP, is predictive of successful delivery. In concordant posterior positions, the labour length, analgesia request, operative delivery, and caesarean section rate are higher than in the other combination. PMID:25157368

Noventa, Marco; Di Gangi, Stefania; Anis, Omar; Nardelli, Giovanni Battista

2014-01-01

280

Intrapartum ultrasound assessment of fetal spine position.  

Science.gov (United States)

We investigated the role of foetal spine position in the first and second labour stages to determine the probability of OPP detection at birth and the related obstetrical implications. We conducted an observational-longitudinal cohort study on uncomplicated cephalic single foetus pregnant women at term. We evaluated the accuracy of ultrasound in predicting occiput position at birth, influence of fetal spine in occiput position during labour, labour trend, analgesia request, type of delivery, and indication to CS. The accuracy of the foetal spinal position to predict the occiput position at birth was high at the first labour stage. At the second labour stage, CS (40.3%) and operative vaginal deliveries (23.9%) occurred more frequently in OPP than in occiput anterior position (7% and 15.2%, resp.), especially in cases of the posterior spine. In concordant posterior positions labour length was greater than other ones, and analgesia request rate was 64.1% versus 14.7% for all the others. The assessment of spinal position could be useful in obstetrical management and counselling, both before and during labour. The detection of spinal position, more than OPP, is predictive of successful delivery. In concordant posterior positions, the labour length, analgesia request, operative delivery, and caesarean section rate are higher than in the other combination. PMID:25157368

Gizzo, Salvatore; Andrisani, Alessandra; Noventa, Marco; Burul, Giorgia; Di Gangi, Stefania; Anis, Omar; Ancona, Emanuele; D'Antona, Donato; Nardelli, Giovanni Battista; Ambrosini, Guido

2014-01-01

 
 
 
 
281

Efficacy of cervical spine immobilization methods.  

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Cervical spine immobilization devices are widely used to stabilize the cervical spine and prevent neurologic deficits associated with unstable fractures. In order to quantitate their efficacy we measured controlled cervical spine motion in three axes, using six different immobilization methods in 25 volunteers instructed to actively move their necks as much as possible in the directions of flexion, extension, rotation, and lateral bending while lying supine. Control measurements were made with no device and measurements were repeated following immobilization with: soft collar (SC), hard collar (HC), extrication collar (EC), Philadelphia collar (PC), bilateral sandbags joined with 3-inch cloth tape across the forehead (ST), and the combination of sandbags, tape, and the Philadelphia collar (ST/PC). Neck movements were reported in degrees recorded on a hand-held goniometer. There were no significant differences between control and SC measurements except in rotary movement. PC was not significantly better than the other two types of hard collars, except in limiting extension. ST immobilization was significantly better than any of the other four methods used alone, for all four movements. The addition of PC to ST was significantly more effective in reducing extension only. PMID:6864837

Podolsky, S; Baraff, L J; Simon, R R; Hoffman, J R; Larmon, B; Ablon, W

1983-06-01

282

Cervical spine injuries in American football.  

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American football is a high-energy contact sport that places players at risk for cervical spine injuries with potential neurological deficits. Advances in tackling and blocking techniques, rules of the game and medical care of the athlete have been made throughout the past few decades to minimize the risk of cervical injury and improve the management of injuries that do occur. Nonetheless, cervical spine injuries remain a serious concern in the game of American football. Injuries have a wide spectrum of severity. The relatively common 'stinger' is a neuropraxia of a cervical nerve root(s) or brachial plexus and represents a reversible peripheral nerve injury. Less common and more serious an injury, cervical cord neuropraxia is the clinical manifestation of neuropraxia of the cervical spinal cord due to hyperextension, hyperflexion or axial loading. Recent data on American football suggest that approximately 0.2 per 100,000 participants at the high school level and 2 per 100,000 participants at the collegiate level are diagnosed with cervical cord neuropraxia. Characterized by temporary pain, paraesthesias and/or motor weakness in more than one extremity, there is a rapid and complete resolution of symptoms and a normal physical examination within 10 minutes to 48 hours after the initial injury. Stenosis of the spinal canal, whether congenital or acquired, is thought to predispose the athlete to cervical cord neuropraxia. Although quite rare, catastrophic neurological injury is a devastating entity referring to permanent neurological injury or death. The mechanism is most often a forced hyperflexion injury, as occurs when 'spear tackling'. The mean incidence of catastrophic neurological injury over the past 30 years has been approximately 0.5 per 100,000 participants at high school level and 1.5 per 100,000 at the collegiate level. This incidence has decreased significantly when compared with the incidence in the early 1970s. This decrease in the incidence of catastrophic injury is felt to be the result of changes in the rules in the mid-1970s that prohibited the use of the head as the initial contact point when blocking and tackling. Evaluation of patients with suspected cervical spine injury includes a complete neurological examination while on the field or the sidelines. Immobilization on a hard board may also be necessary. The decision to obtain radiographs can be made on the basis of the history and physical examination. Treatment depends on severity of diagnosed injury and can range from an individualized cervical spine rehabilitation programme for a 'stinger' to cervical spine decompression and fusion for more serious bony or ligamentous injury. Still under constant debate is the decision to return to play for the athlete. PMID:19691361

Rihn, Jeffrey A; Anderson, David T; Lamb, Kathleen; Deluca, Peter F; Bata, Ahmed; Marchetto, Paul A; Neves, Nuno; Vaccaro, Alexander R

2009-01-01

283

Subregional, dendritic compartment, and spine subtype specificity in cocaine regulation of dendritic spines in the nucleus accumbens.  

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Numerous studies have found that chronic cocaine increases dendritic spine density of medium spiny neurons in the nucleus accumbens (NAc). Here, we used single-cell microinjections and advanced 3D imaging and analysis techniques to extend these findings in several important ways: by assessing cocaine regulation of dendritic spines in the core versus shell subregions of NAc in the mouse, over a broad time course (4 h, 24 h, or 28 d) of withdrawal from chronic cocaine, and with a particular focus on proximal versus distal dendrites. Our data demonstrate subregion-specific, and in some cases opposite, regulation of spines by cocaine on proximal but not distal dendrites. Notably, all observed density changes were attributable to selective regulation of thin spines. At 4 h after injection, the proximal spine density is unchanged in the core but significantly increased in the shell. At 24 h, the density of proximal dendritic spines is reduced in the core but increased in the shell. Such downregulation of thin spines in the core persists through 28 d of withdrawal, whereas the spine density in the shell returns to baseline levels. Consistent with previous results, dendritic tips exhibited upregulation of dendritic spines after 24 h of withdrawal, an effect localized to the shell. The divergence in regulation of proximal spine density in NAc core versus shell by cocaine correlates with recently reported electrophysiological data from a similar drug administration regimen and might represent a key mediator of changes in the reward circuit that drive aspects of addiction. PMID:22593064

Dumitriu, Dani; Laplant, Quincey; Grossman, Yael S; Dias, Caroline; Janssen, William G; Russo, Scott J; Morrison, John H; Nestler, Eric J

2012-05-16

284

Clinical significance of gas myelography and CT gas myelography of the thoracic spine and the lumbar spine  

International Nuclear Information System (INIS)

Basic and clinical applications relating to air myelography of the cervical spine have already been studied and extensively been used as an adjuvant diagnostic method for diseases of the spine and the spinal cord. However, hardly any application and clinical evaluation have been made concerning gas myelography of the thoracic spine and the lumbar spine. The author examined X-ray findings of 183 cases with diseases of the thoracic spine and the lumbar spine, including contral cases. Gas X-ray photography included simple profile, forehead tomography, sagittal plane, and CT section. Morphological characteristics of normal X-ray pictures of the throacic spine and the lumbar spine were explained from 54 control cases, and all the diameters of the subarachnoidal space from the anterior to the posterior part were measured. X-ray findings were examined on pathological cases, namely 22 cases with diseases of the throacic spine and 107 cases with diseases of the lumbar spine, and as a result these were useful for pathological elucidation of spinal cord tumors, spinal carries, yellow ligament ossification, lumbar spinal canal stenosis, hernia of intervertebral disc, etc. Also, CT gas myelography was excellent in stereoobservation of the spine and the spinal cord in spinal cord tumors, yellow ligament ossification, and spinal canal stenosis. On the other hand, it is not suitable for the diagnoses of intraspinal vascular abnormality, adhesive arachinitis, and running abnormality of the cauda equina nerve and radicle. Gas myelography of the thoracic spine and the lambar spine, is very useful in clinics when experienced techniques are used in photographic conditions, and diagnoses are made, well understanding the characteristics of gas pictures. Thus, its application has been opened to selection of an operative technique, determination of operative ranges, etc. (J.P.N.)

285

Clinical significance of gas myelography and CT gas myelography of the thoracic spine and the lumbar spine  

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Basic and clinical applications relating to air myelography of the cervical spine have already been studied and extensively been used as an adjuvant diagnostic method for diseases of the spine and the spinal cord. However, hardly any application and clinical evaluation have been made concerning gas myelography of the thoracic spine and the lumbar spine. The author examined X-ray findings of 183 cases with diseases of the thoracic spine and the lumbar spine, including contral cases. Gas X-ray photography included simple profile, forehead tomography, sagittal plane, and CT section. Morphological characteristics of normal X-ray pictures of the throacic spine and the lumbar spine were explained from 54 control cases, and all the diameters of the subarachnoidal space from the anterior to the posterior part were measured. X-ray findings were examined on pathological cases, namely 22 cases with diseases of the throacic spine and 107 cases with diseases of the lumbar spine, and as a result these were useful for pathological elucidation of spinal cord tumors, spinal carries, yellow ligament ossification, lumbar spinal canal stenosis, hernia of intervertebral disc, etc. Also, CT gas myelography was excellent in stereo observation of the spine and the spinal cord in spinal cord tumors, yellow ligament ossification, and spinal canal stenosis. On the other hand, it is not suitable for the diagnoses of intraspinal vascular abnormality, adhesive arachinitis, and running abnormality of the cauda equina nerve and radicle. Gas myelography of the thoracic spine and the lambar spine, is very useful in clinics when experienced techniques are used in photographic conditions, and diagnoses are made, well understanding the characteristics of gas pictures. Thus, its application has been opened to selection of an operative technique, determination of operative ranges, etc.

Yoshinaga, Haruhiko (Tokyo Medical Coll. (Japan))

1984-05-01

286

Maladaptive dendritic spine remodeling contributes to diabetic neuropathic pain.  

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Diabetic neuropathic pain imposes a huge burden on individuals and society, and represents a major public health problem. Despite aggressive efforts, diabetic neuropathic pain is generally refractory to available clinical treatments. A structure-function link between maladaptive dendritic spine plasticity and pain has been demonstrated previously in CNS and PNS injury models of neuropathic pain. Here, we reasoned that if dendritic spine remodeling contributes to diabetic neuropathic pain, then (1) the presence of malformed spines should coincide with the development of pain, and (2) disrupting maladaptive spine structure should reduce chronic pain. To determine whether dendritic spine remodeling contributes to neuropathic pain in streptozotocin (STZ)-induced diabetic rats, we analyzed dendritic spine morphology and electrophysiological and behavioral signs of neuropathic pain. Our results show changes in dendritic spine shape, distribution, and shape on wide-dynamic-range (WDR) neurons within lamina IV-V of the dorsal horn in diabetes. These diabetes-induced changes were accompanied by WDR neuron hyperexcitability and decreased pain thresholds at 4 weeks. Treatment with NSC23766 (N(6)-[2-[[4-(diethylamino)-1-methylbutyl]amino]-6-methyl-4-pyrimidinyl]-2-methyl-4,6-quinolinediamine trihydrochloride), a Rac1-specific inhibitor known to interfere with spine plasticity, decreased the presence of malformed spines in diabetes, attenuated neuronal hyperresponsiveness to peripheral stimuli, reduced spontaneous firing activity from WDR neurons, and improved nociceptive mechanical pain thresholds. At 1 week after STZ injection, animals with hyperglycemia with no evidence of pain had few or no changes in spine morphology. These results demonstrate that diabetes-induced maladaptive dendritic spine remodeling has a mechanistic role in neuropathic pain. Molecular pathways that control spine morphogenesis and plasticity may be promising future targets for treatment. PMID:22593049

Tan, Andrew M; Samad, Omar A; Fischer, Tanya Z; Zhao, Peng; Persson, Anna-Karin; Waxman, Stephen G

2012-05-16

287

Posterior transpedicular corpectomy for malignant cervical spine tumors  

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The goal of this study was to assess surgical clinical and radiographic outcomes of using a posterior transpedicular approach (posterolateral) for ventral malignant tumors of the cervical spine. Access to ventral lesions of the cervical spine can be challenging in patients with malignant tumors. Anterior approaches are the gold standard for ventral pathology in the cervical spine, however, there are cases, where a posterior approach is indicated due to multilevel disease, previous radiation, ...

Eleraky, Mohammed; Setzer, Matthias; Vrionis, Frank D.

2010-01-01

288

Clinical development of a failure detection-based online repositioning strategy for prostate IMRT--Experiments, simulation, and dosimetry study  

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Purpose: To implement and evaluate clinic-ready adaptive imaging protocols for online patient repositioning (motion tracking) during prostate IMRT using treatment beam imaging supplemented by minimal, as-needed use of on-board kV. Methods: The authors examine the two-step decision-making strategy: (1) Use cine-MV imaging and online-updated characterization of prostate motion to detect target motion that is potentially beyond a predefined threshold and (2) use paired MV-kV 3D localization to determine overthreshold displacement and, if needed, reposition the patient. Two levels of clinical implementation were evaluated: (1) Field-by-field based motion correction for present-day linacs and (2) instantaneous repositioning for new-generation linacs with capabilities of simultaneous MV-kV imaging and remote automatic couch control during treatment delivery. Experiments were performed on a Varian Trilogy linac in clinical mode using a 4D motion phantom programed with prostate motion trajectories taken from patient data. Dosimetric impact was examined using a 2D ion chamber array. Simulations were done for 536 trajectories from 17 patients. Results: Despite the loss of marker detection efficiency caused by the MLC leaves sometimes obscuring the field at the marker's projected position on the MV imager, the field-by-field correction halved (from 23% to 10%) the mean percentage of time that target displacement exceeded a 3 mm threshold, as compared to no intervention. This was achieved at minimal cost in additional imaging (average of one MV-kV pair per two to three treatment fractions) and with a very small number of repositionings (once every four to five fractions). Also with low kV usage ({approx}2/fraction), the instantaneous repositioning approach reduced overthreshold time by more than 75% (23% to 5%) even with severe MLC blockage as often encountered in current IMRT and could reduce the overthreshold time tenfold (to <2%) if the MLC blockage problem were relieved. The information acquired for repositioning using combined MV-kV images was found to have submillimeter accuracy. Conclusions: This work demonstrated with a current clinical setup that substantial reduction of adverse targeting effects of intrafraction prostate motion can be realized. The proposed adaptive imaging strategy incurs minimal imaging dose to the patient as compared to other stereoscopic imaging techniques.

Liu Wu; Qian Jianguo; Hancock, Steven L.; Xing, Lei; Luxton, Gary [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305-5847 (United States) and Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06510 (United States); Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305-5847 (United States)

2010-10-15

289

Clinical development of a failure detection-based online repositioning strategy for prostate IMRT--Experiments, simulation, and dosimetry study  

International Nuclear Information System (INIS)

Purpose: To implement and evaluate clinic-ready adaptive imaging protocols for online patient repositioning (motion tracking) during prostate IMRT using treatment beam imaging supplemented by minimal, as-needed use of on-board kV. Methods: The authors examine the two-step decision-making strategy: (1) Use cine-MV imaging and online-updated characterization of prostate motion to detect target motion that is potentially beyond a predefined threshold and (2) use paired MV-kV 3D localization to determine overthreshold displacement and, if needed, reposition the patient. Two levels of clinical implementation were evaluated: (1) Field-by-field based motion correction for present-day linacs and (2) instantaneous repositioning for new-generation linacs with capabilities of simultaneous MV-kV imaging and remote automatic couch control during treatment delivery. Experiments were performed on a Varian Trilogy linac in clinical mode using a 4D motion phantom programed with prostate motion trajectories taken from patient data. Dosimetric impact was examined using a 2D ion chamber array. Simulations were done for 536 trajectories from 17 patients. Results: Despite the loss of marker detection efficiency caused by the MLC leaves sometimes obscuring the field at the marker's projected position on the MV imager, the field-by-field correction halved (from 23% to 10%) the mean percentage of time that target displacement exceeded a 3 mm threshold, as compared to no intervention. This was achieved at minimal cost in additional imaging (average of one MV-kV pair per two to three treatment fractions) and with a very small number of repositionings (once every four to five fractions). Also with low kV usage (?2/fraction), the instantaneous repositioning approach reduced overthreshold time by more than 75% (23% to 5%) even with severe MLC blockage as often encountered in current IMRT and could reduce the overthreshold time tenfold (to <2%) if the MLC blockage problem were relieved. The information acquired for repositioning using combined MV-kV images was found to have submillimeter accuracy. Conclusions: This work demonstrated with a current clinical setup that substantial reduction of adverse targeting effects of intrafraction prostate motion can be realized. The proposed adaptive imaging strategy incurs minimal imaging dose to the patient as compared to other stereoscopic imaging techniques.

290

Function of dendritic spines on hippocampal inhibitory neurons.  

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The majority of ?-aminobutyric acid (GABA)ergic interneurons have smooth dendrites with no or only few dendritic spines, but certain types of spiny GABAergic interneurons do actually contain substantial numbers of spines. The explanation for such spines has so far been purely structural: They increase the dendritic surface area and thus provide the opportunity to accommodate larger numbers of synapses. We reasoned that there may be specific functional properties for these spines and therefore, undertook to characterize interneuron spines functionally. We find a remarkable similarity to pyramidal cell spines: They receive excitatory synapses with calcium impermeable ?-amino-3-hydroxy-5-methyl-4 isoxazolepropionic acid (AMPA) and N-methyl-d-aspartate (NMDA) receptors, compartmentalize biochemical signals, and display activity-dependent morphological plasticity. Nevertheless, notable differences in spine density, neck length, and spine-dendrite coupling exist. Thus, dendritic spines on inhibitory interneurons have a number of important functional properties that go substantially beyond simply expanding the dendritic surface area. It therefore seems likely that spiny and aspiny interneurons may have very different roles in neural circuit function and plasticity. PMID:23825320

Scheuss, Volker; Bonhoeffer, Tobias

2014-12-01

291

Spatiotemporal Dynamics of Dendritic Spines in the Living Brain  

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Full Text Available Dendritic spines are ubiquitous postsynaptic sites of most excitatory synapses in the mammalian brain, and thus may serve as structural indicators of functional synapses. Recent works have suggested that neuronal coding of memories may be associated with rapid alterations in spine formation and elimination. Technological advances have enabled researchers to study spine dynamics in vivo during development as well as under various physiological and pathological conditions. We believe that better understanding of the spatiotemporal patterns of spine dynamics will help elucidate the principles of experience-dependent circuit modification and information processing in the living brain.

Yi Zuo

2014-05-01

292

Lumbar spine degenerative disease : effect on bone mineral density measurements in the lumbar spine and femoral neck  

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To determine the effect of degenerative disease of the lumbar spine on bone mineral density in the lumbar spine and femoral neck. We reviewed radiographs and dual energy x-ray absorptiometry scans of the lumbar spine and hip in 305 Caucasian women with suspected osteoporosis. One hundred and eight-six patient remained after excluding women less than 40 years of age (n=18) and those with hip osteoarthritis, scoliosis, lumbar spine fractures, lumbar spinal instrumentation, hip arthroplasty, metabolic bone disease other than osteoporosis, or medications known to influence bone metabolism (n=101). On the basis of lumbar spine radiographs, those with absent/mild degenerative disease were assigned to the control group and those with moderate/severe degenerative disease to the degenerative group. Spine radiographs were evaluated for degenerative disease by two radiologists working independently; discrepant evaluations were resolved by consensus. Lumbar spine and femoral neck bone mineral density was compared between the two groups. Forty-five (24%) of 186 women were assigned to the degenerative group and 141 (76%) to the control group. IN the degenerative group, mean bone mineral density measured 1.075g/cm? in the spine and 0.788g/cm{sup 2} in the femoral neck, while for controls the corresponding figures were 0.989g/cm{sup 2} and 0.765g/cm{sup 2}. Adjusted for age, weight and height by means of analysis of variance, degenerative disease of the lumbar spine was a significant predictor of increased bone mineral density in the spine (p=0.0001) and femoral neck (p=0.0287). Our results indicate a positive relationship between degenerative disease of the lumbar spine and bone mineral density in the lumbar spine and femoral neck, and suggest that degenerative disease in that region, which leads to an intrinsic increase in bone mineral density in the femoral neck, may be a good negative predictor of osteoporotic hip fractures.

Juhng, Seon Kwan [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of); Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon [Wake Forest Univ. School of Medicine, Winston-salem (United States)

2001-04-01

293

Percutaneous spine injection: considerations for improving treatment  

International Nuclear Information System (INIS)

To discuss the causes of treatment failure in percutaneous spine injections for low back pain or radiculopathy by analyzing patients who have experienced negative treatment effect on their first visit and a positive treatment effect on their second visit. The authors reviewed the cases of 24 patients who visited the pain intervention outpatient department in our hospital due to back pain or radiculopathy. All patients reviewed experienced a negative treatment effect following their first spine injection, but a positive treatment effect following the second injection. The dates of the cases range from June 2003 to May 2004. Two radiologists analyzed the possible causes of the negative treatment effect following the first injection therapies by considering clinical aspects as well as reviewing radiological images. The most common condition was the presence of the change in the level of the second selective nerve root block (n=13). In seven cases, the methods for administering the injections were changed to facet block (n=2), midline epidural block (n=1), selective nerve root block (n=3) and caudal epidural block (n=1). In four cases, there were no changes in the methods for administering the injections nor were there any changes in the level of the selective nerve root block between first and second visit. In those cases, after reviewing spot radiographs performed during injection, we attributed the causes of failure of injection therapy to an inappropriate distributionn therapy to an inappropriate distribution of drugs. We can improve the effect of percutaneous spine injections for low back pain or radioculopathy by determining the exact level of perineural root block, trying alternative methods, and insuring a good distribution of the injected drugs

294

Blunt Traumatic Cervical Spine Fractures in Iran  

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Full Text Available Background: Blunt traumatic cervical spine fractures (TCSF are serious injuries which may be associated with considerable mortality and morbidity. We describe the epidemiology of blunt traumatic cervical spine fracture in Iran over a definable time period. Methods: In a cross-sectional study, the data including the distribution of TCSF, demographics, mechanisms, abbreviated injury scale (AIS, spinal cord associated injuries and final outcome of patients, was extracted from the Iranian national trauma registry database in target hospitals in eight major cities of Iran from 1999 to 2004. The Chi square test was used to compare mortality and one-way ANOVA was used to compare ISS amongst the categories of TCSF. Results: TCSF was identified in 120 cases, of these 70.8% were male. Their mean age was 36.6 ± 17.2 years. The overall incidence of TCSF among all trauma patients was 0.7% (95%CI: 0.61% - 0.88%. The TCSF incidence among all spine fractured patients was 19.38% (95%CI: 16.34% - 22.72%. The most common mechanism of TCSF was a motor vehicle collision (66.7%. The overall percentage of in-hospital death for TCSF was 12.6%. There were no statistically significant difference in death and injury severity scores (ISS among TCSF categories (p > 0.05. Spinal cord and root injuries occurred in 34.9% and 2.4% of TCSF, respectively. Conclusions: Preventive strategies need to be developed in order to reduce the number and severity of TCSF in the general Iranian population.

Soheil Saadat

2011-10-01

295

Comparison of two repositioning devices used during radiation therapy for Hodgkin's disease  

International Nuclear Information System (INIS)

Purpose: Reproducible patient positioning is fundamental to the success of fractionated radiation therapy in all patients. In patients with a radio curable disease and a long life expectancy, such as those with Hodgkin's disease, accurate repositioning is crucial to maximize the likelihood of cure and to minimize incidental irradiation of non-target normal tissues. In the late 1980s, we replaced an upper torso positioning cradle with an extended near-total body cradle which also includes the lower torso and thighs. This study was performed to assess the impact of the extended cradle on the reproducibility of patient repositioning during irradiation of Hodgkin's disease. Methods and Materials: Patients treated from 1990-1992 were positioned in the short cradle while those treated from 1992 - 1995 were positioned in the extended cradle. All treatments were delivered via anterior and posterior fields. Treatment areas above and below the diaphragm were considered separately. All fields were simulated and beam-shaping blocks designed on anterior and posterior radiographs. Discrepancies in isocenter placement between the simulation radiographs and subsequent port films were noted by a radiation oncologist and requests for isocenter shifts were indicated. The number, magnitude, and direction of any physician-requested isocenter shifts on port films were retrospectively reviewed. For the purpose of scoring the frequency of isocenter misplacements, when a shift was noted on twisplacements, when a shift was noted on two port films taken during the same treatment session (i.e., a left shift on both an anterior and a posterior port film), it was scored as only one event. A two-tailed chi-square test was used to compare the differences in requested shifts in the two patient groups. Results: The study population consisted of 57 patients (32 short and 25 extended cradle). A total of 815 port films representing 459 isocenter placements were analyzed (288 above and 170 below the diaphragm). When all port films above the diaphragm (mostly mantle fields) are considered, isocenter shifts were requested in 15.6% ((24(154))) of isocenter placements with the upper torso cradle and in 6.7% ((9(134))) of isocenter placements with the extended cradle (p = 0.035). When all port films below the diaphragm (mostly paraaortic/spleen and pelvic fields) are considered, isocenter shifts were requested in 30.1% ((28(93))) of isocenter placements with the upper torso cradle and in 16.7% ((13(78))) of isocenter placements with the extended cradle (p = 0.106). When both treatment sites are combined, isocenter shifts were requested in 21.1% ((52(247))) of isocenter placements with the upper torso cradle and in 10.4% ((22(212))) of isocenter placements when the extended cradle was used (p 0.008). Conclusions: The extended cradle provides superior repositioning of patients undergoing radiation therapy for Hodgkin's disease. Differences observed in setup accuracy in this study underscore the importance of aggressive immobilization of patients with Hodgkin's disease. Increased accuracy of daily setup provides an opportunity to improve the therapeutic ratio both by increased likelihood of tumor control and decreased risk of normal tissue complications

296

Comparison of two repositioning devices used during radiation therapy for Hodgkin's disease  

International Nuclear Information System (INIS)

Purpose: Patients irradiated for Hodgkin's disease are fixed in an immobilization cradle to improve repositioning. In the early 1990s, we changed our cradle system from a 'short' upper torso cradle to an extended near-total body cradle that also includes the lower torso and thighs. In this study, we assess the impact of the extended cradle on the reproducibility of patient repositioning during irradiation of Hodgkin's disease. Methods and Materials: A total of 782 port films of 56 patients treated immediately before and after the change-over were studied to assess positioning reproducibility. Patients treated prior to 1993 were positioned in the short cradle, while those treated 1993 and later were positioned in the extended cradle. All treatment were delivered via anterior and posterior fields and treatment areas above and below the diaphragm were considered separately and together. All treatment fields were simulated and the field shape was designed on anterior and posterior radiographs. Discrepancies in field placement between the simulation radiographs and subsequent port films were noted by a radiation oncologist and requests for position adjustment (both translational and rotational shifts) were noted. The number, magnitude, and direction of any physician-requested position adjustment on port films were retrospectively reviewed. For the purpose of scoring the frequency of field misplacements, when an adjustment was noted on two port films taken during the same treatment session (i.e., a left shift on both an anterior and a posterior port film), it was scored as only one event. A two-tailed chi-square test was used to compare the differences in requested shifts in the two patient groups. Results: The study population consisted of 56 patients (31 short and 25 extended cradle) representing 92 treatment sites. A total of 782 port films representing 450 treatment setups were analyzed (292 above and 158 below the diaphragm). When all port films above the diaphragm (mostly mantle fields) are considered, position adjustments were requested in 13.4% 921 out of 157) of treatment setups with the upper torso cradle and in 5.9% (8 out of 135) of treatment setups with the extended cradle (p = 0.054). When all port films below the diaphragm (mostly paraaortic/spleen and pelvic fields) are considered, position adjustments were requested in 33.8% (27 out of 80) of treatment setups with the upper torso cradle and in 16.7% (13 out of 78) of treatment setups with the extended cradle (p = 0.056). A reduction in the frequency of both translational and rotational adjustments were seen. When both treatment sites are combined, position adjustments were requested in 20.3% (48 out of 237) of treatment setups with the upper torso cradle and in 9.9% (21 out of 213) of treatment setups when the extended cradle was used (p = 0.0086). Conclusions: The extended cradle provides superior repositioning of patients undergoing radiation therapy for Hodgkin's disease. Differences observed in setup accuracy in this study underscore the importance of aggressive immobilization of patients with Hodgkin's disease. Increased accuracy of daily setup may provide an opportunity to improve the therapeutic ratio both by increased likelihood of tumor control and decreased risk of normal tissue complications

297

Enlarged approach to the anterior cervical spine.  

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In this report a new enlarged approach to the anterior cervical spine is presented. A 66-year-old female, having a large C3-C4-C5 chordoma, recurrent after surgery and following radiotherapy, underwent a surgical resection. The approach allows a wide retraction of the nasopharynx, oropharynx and larynx from the midline, only sacrificing the superior laryngeal nerve on one side. Its continuity can be re-established later by adopting the stent in tube technique. The approach we used presents al...

Sartoris, Alberto; Crosetti, Erika; Succo, Giovanni

2001-01-01

298

Synergy of the human spine in neutral postures.  

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The neutral position of the spine is the posture most commonly sustained throughout daily activities. Previous investigations of the spine focused mainly on maximal exertions in various symmetric and asymmetric postures. This report proposes a new synergetic approach for analysis of the spine in neutral postures and evaluates its performance. The model consists of passive components, the osteoligamentous spine, and active components, the spinal muscles. The muscle architecture includes 60 muscles inserting onto both the rib cage and lumbar vertebral bodies. The passive spine is simulated by a finite element model, while kinematic constraints and optimization are used for resolution of a redundant muscle recruitment problem. Although the passive spine alone exhibits little resistance to a vertical load, its load-bearing capacity in neutral posture is significantly enhanced by the muscles, i.e., the passive spine and its muscles must be considered as a synergetic system. The proposed method is used to investigate the response of the spine when the T1 vertebra displaces 40 mm anteriorly and 20 mm posteriorly from its initial position. The sacrum is fixed at all times and the T1 displacements are achieved by the action of muscles. The results suggest that relatively small muscle activations are sufficient to stabilize the spine in neutral posture under the body weight. The results also indicate that muscles attaching onto the rib cage are important for control of the overall spinal posture and maintenance of equilibrium. The muscles inserting onto the lumbar vertebrae are found mainly to enhance the stability of the spine. The proposed method also predicts forces and moments carried by the passive system. Flexion moments ranging from 8000 Nmm to 15,000 Nmm, corresponding to decreases in lordosis of 6 degrees and 7.5 degrees respectively, are found to be carried by the passive spine at the thoracolumbar junction when the T1 vertebra is 40 mm anterior to its initial position. PMID:9883956

Kiefer, A; Shirazi-Adl, A; Parnianpour, M

1998-01-01

299

Assessment of the structural integrity of CANDU Zr-Nb pressure tubes for the fuel channel spacer repositioning operation  

International Nuclear Information System (INIS)

This paper reports on a procedure that has been developed to reposition the garter spring spacers in CANDU fuel channels to extend the life of the Zr-Nb pressure tubes. An assessment was performed of the effects of the spacer repositioning operation on the structural integrity of the Zr-Nb pressure tubes. The allowable root radii of postulated blunt flaws to prevent crack initiation due to fatigue were calculated. Fret marks measured in surveillance tubes removed from Ontario Hydro reactors all met the allowable root radii criterion. The allowable depths of sharp crack-like flaws to prevent fracture initiation were also calculated. The allowable depths of postulated outer surface cracks are within the range of detectability of the on-board inspection system

300

Repositioning the patient: patient organizations, consumerism, and autonomy in Britain during the 1960s and 1970s.  

Science.gov (United States)

This article explores how and why the patient came to be repositioned as a political actor within British health care during the 1960s and 1970s. Focusing on the role played by patient organizations, it is suggested that the repositioning of the patient needs to be seen in the light of growing demands for greater patient autonomy and the application of consumerist principles to health. Examining the activities of two patient groups-the National Association for the Welfare of Children in Hospital (NAWCH) and the Patients Association (PA)-indicates that while such groups undoubtedly placed more emphasis on individual autonomy, collective concerns did not entirely fall away. The voices of patients, as well as the patient, continued to matter within British health care. PMID:23811711

Mold, Alex

2013-01-01

 
 
 
 
301

Jurisprudence. Repositioning of cables and pipes. Who decides and who pays?; Jurisprudentie. Kabels en leidingen verleggen. Wie bepaalt en betaalt?  

Energy Technology Data Exchange (ETDEWEB)

Underground cables and pipes sometimes need to be repositioned to make room for buildings. Can any exploiter of pipes be obliged to do this. And if this is the case, who should pay for it? Every year these questions are causing new disputes. [Dutch] Ondergrondse kabels en leidingen moeten soms worden verlegd om plaats te maken voor bebouwing. Kan een leidingexploitant hiertoe verplicht worden? En zo ja, wie moet dat betalen? Hierover ontstaan jaarlijks geschillen.

Roggenkamp, M. [Brinkhof Advocaten, Amsterdam (Netherlands)

2011-09-15

302

Room-temperature repositioning of individual C60 molecules at Cu steps: Operation of a molecular counting device  

Science.gov (United States)

C60 molecules absorbed on a monoatomic Cu step have been reversibly repositioned at room temperature with the tip of a scanning tunneling microscope by performing controlled displacements along the step direction. We demonstrate the feasibility of building an abacus on the nanometer scale using single molecules as ``counters,'' Cu monoatomic steps as ``rods'' that constrain the molecular motion to one dimension, and the scanning tunneling microscope as an ``actuator'' for counting operations.

Cuberes, M. T.; Schlittler, R. R.; Gimzewski, J. K.

1996-11-01

303

Computer codes used in the repositioning of garter springs in the fuel channels of the Embalse nuclear generation station  

International Nuclear Information System (INIS)

Each of the 380 fuel channels (FC) of the Embalse Nuclear Generation Station (CNE) has 4 garter springs (GS) located between the pressure tube (PT) and the Calandria tube (CT) and distributed along the channel, aiming to avoid the contact PT/CT. Generally, the GS shifts from their design positions, and their actual positions have to be verified within each FC. If necessary, they have to be relocated to avoid PT/CT contact during the service life of the reactor. The localization and repositioning of the GS is performed with the SLARette (Spacer Location And Repositioning tooling) tool, and the decision to carry it out and where, is taken with a Computer Code developed in CNEA named MACACO (MAteriales CAnal COmbustible). This code permits to predict the evolution of the in service deformation of each Fuel Channel, and calculates the necessary operation time till an eventual PT/CT contact. This work presents results obtained with version 98 of the code MACACO and the criteria used in the repositioning of the GS. (author)

304

Technical note: Electrocardiogram electrode repositioning for 320-row coronary CT angiography in patients with regular and recurrent premature ventricular contractions.  

Science.gov (United States)

Arrhythmias can compromise image quality and increase radiation exposure during coronary CT angiography (CTA). However, premature ventricular contractions (PVCs) can occur in a predictable recurrent and regular pattern (ie, bigeminy, trigeminy, quadrigeminy) with post-PVC compensatory pauses. Electrocardiographic (ECG) electrode repositioning can achieve relative amplification of the R waves of PVCs compared with R waves of sinus beats. This technical note describes how simple ECG electrode repositioning, combined with an absolute-delay strategy, facilitated selective R waves of PVC ECG triggering of image acquisition in 6 patients with PVC bigeminy or quadrigeminy at the time of 320-row coronary CTA. All 6 studies were single heartbeat acquisition scans with excellent image quality and a median effective radiation dose of 2.9 mSv (interquartile range, 2.1-3.8 mSv). Standard ECG electrode positions used for 2 patients with PVC bigeminy undergoing coronary CTA were associated with an acquisition over 2 heartbeats and effective radiation doses of 6.8 and 10.3 mSv, respectively. In conclusion, ECG electrode repositioning combined with an absolute-delay strategy for regularly recurring PVCs, such as ventricular bigeminy, facilitates high image quality and lower radiation dose during coronary CTA. This simple and straightforward technique can be considered for all patients with regular and recurrent PVCs undergoing coronary CTA. PMID:24582039

Kondo, Takeshi; Matsutani, Hideyuki; Groarke, John; Takamura, Kazuhisa; Fujimoto, Shinichiro; Rybicki, Frank J; Kumamaru, Kanako K

2014-01-01

305

Automated 4D analysis of dendritic spine morphology: applications to stimulus-induced spine remodeling and pharmacological rescue in a disease model  

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Full Text Available Abstract Uncovering the mechanisms that regulate dendritic spine morphology has been limited, in part, by the lack of efficient and unbiased methods for analyzing spines. Here, we describe an automated 3D spine morphometry method and its application to spine remodeling in live neurons and spine abnormalities in a disease model. We anticipate that this approach will advance studies of synapse structure and function in brain development, plasticity, and disease.

Swanger Sharon A

2011-10-01

306

Ambulatory spine surgery: a survey study.  

Science.gov (United States)

Study Design?Cross-sectional study. Objective?To assess the current practices of spine surgeons performing ambulatory surgery in the United States. Methods?An electronic survey was distributed to members of the International Society for the Advancement of Spine Surgery. Data were initially examined in a univariate manner; variables with a p value?correlation. Surgeons in private practice were more likely to perform ambulatory surgery (94.3%; p?=?0.0176), and nonacademic surgeons were both more likely to invest in ambulatory surgery centers (p?=?0.0024) and perform surgery at least part of the time in a surgery center (p?=?0.0039). Conclusions?Though the numbers were too few to calculate statistical significance, there was a trend toward the performance of high-risk procedures on an ambulatory basis being undertaken by those with investment status in an ambulatory center. It is possible that this plays a role in the decision to perform these procedures in this setting versus that of a hospital, where a patient may have better access to care should a complication arise requiring emergent assessment and treatment by a physician. This decision should divest itself of financial incentives and focus entirely on patient safety. PMID:25083356

Baird, Evan O; Brietzke, Sasha C; Weinberg, Alan D; McAnany, Steven J; Qureshi, Sheeraz A; Cho, Samuel K; Hecht, Andrew C

2014-08-01

307

Radiological manifestations of tuberculosis of the spine  

International Nuclear Information System (INIS)

The classical roentgenographic features of tuberculosis of the spine such as narrowing of the intervertebral disc, collapse of the vertebral bodies, with or without the shadow of a cold abscess, present a specific picture of the actural pathological process. However, the diagnosis of tuberculosis is not confirmed unless proven by biopsy, or the findings of the tubercle bacilius. 120 cases of proven spinal tuberculosis, at Kwangju Christian Hospital during the period from January 1973 through August 1980, were studied and analysed. The results were as follows: 1. The ratio of male to female was 1 : 1.1. The age preference was under 30 years old. 2. The most frequent site of involvement was the lumber spine (44.1%) and next the thoracic (39.2%). 3. The incidence of lytic type was 50.8%, mixed type 36.7%, and scierotic type 12.5%. 4. Associated pulmonary tuberculous lesions were observed in 94 patients (78.3%). 5. The central type, with wedging or collapse of the vertebral body, was more common in the younger age group and the intervertebral articular type in older patients. 6. The incidense of typical radiologic findings were: Collapse of vertebral body (90%), cold abscess (78.3%) and narrowing of intervertebral space (70%). 7. Associated kyphosis was observed in 37 cases (30.8%). Among these 37 cases the range of angulation was between 21 to 40 degrees in 40%

308

Effects of the rib cage on thoracic spine flexibility.  

Science.gov (United States)

Besides protecting the internal organs of the thorax, the rib cage is the site of numerous muscle attachments. It also decreases the overall flexibility of the thoracic spine. This study developed finite element (FE) models of the thoracic spine with and without the rib cage, and the effects of the rib cage on thoracic spine flexibility were determined. The numerical models were validated by comparing the maximum rotation of the models for several loading cases with experimental data in the literature. After adapting the material properties for the discs and ligaments, the calculated maximum rotations differed from the measured median values by less than 1 degrees without the rib cage and by less than 2.5 degrees with it. The rib cage decreased the mean flexibility of the thoracic spine by 23% to 47%, depending on the loading plane. Assuming the ribs to be rigid beams required a corresponding reduction of ligament stiffnesses in order to achieve the same agreement of the maximum rotations with the measured median values. Interconnecting the FE thoracic spine model plus rib cage with the existing detailed FE lumbar spine model improves the simulation of force directions of muscles attached to the rib cage or thoracolumbar spine. In addition, such a model is suitable for determining the effects of lumbar spine implants on spinal balance. PMID:16370149

Sham, M L; Zander, T; Rohlmann, A; Bergmann, G

2005-11-01

309

Rheumatoid arthritis. Radiological changes in the cervical spine.  

Directory of Open Access Journals (Sweden)

Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not statistically significant.

Ahmed A. Al-Boukai

2003-04-01

310

Drug Repositioning and Pharmacophore Identification in the Discovery of Hookworm MIF Inhibitors  

Energy Technology Data Exchange (ETDEWEB)

The screening of bioactive compound libraries can be an effective approach for repositioning FDA-approved drugs or discovering new pharmacophores. Hookworms are blood-feeding, intestinal nematode parasites that infect up to 600 million people worldwide. Vaccination with recombinant Ancylostoma ceylanicum macrophage migration inhibitory factor (rAceMIF) provided partial protection from disease, thus establishing a 'proof-of-concept' for targeting AceMIF to prevent or treat infection. A high-throughput screen (HTS) against rAceMIF identified six AceMIF-specific inhibitors. A nonsteroidal anti-inflammatory drug (NSAID), sodium meclofenamate, could be tested in an animal model to assess the therapeutic efficacy in treating hookworm disease. Furosemide, an FDA-approved diuretic, exhibited submicromolar inhibition of rAceMIF tautomerase activity. Structure-activity relationships of a pharmacophore based on furosemide included one analog that binds similarly to the active site, yet does not inhibit the Na-K-Cl symporter (NKCC1) responsible for diuretic activity.

Y Cho; J Vermeire; J Merkel; L Leng; X Du; R Bucala; M Cappello; E Lolis

2011-12-31

311

Tubular foreign body or stent: safe retrieval or repositioning using the coaxial snare technique  

International Nuclear Information System (INIS)

To evaluate the utility and advantages of the coaxial snare technique in the retrieval of tubular foreign bodies. Using the coaxial snare technique, we attempted to retrieve tubular foreign bodies present in seven patients. The bodies were either stents which were malpositioned or had migrated from their correct position in the vascular system (n=2), a fragmented venous introducer sheath (n=1), fragmented drainage catheters in the biliary tree (n=2), or fractured external drainage catheters in the urinary tract (n=2). After passing a guidewire and/or a dilator through the lumina of these foreign bodies, we introduced a loop snare over the guidewire or dilator, thus capturing and retrieving them. In all cases, it was possible to retrieve or reposition the various items, using a minimum-sized introducer sheath or a tract. No folding was involved. In no case were surgical procedures required, and no complications were encountered. The coaxial snare technique, an application of the loop snare technique, is a useful and safe method for the retrieval of tubular foreign bodies, and one which involves minimal injury to the patient

312

Whole-body MRI using a sliding table and repositioning surface coil approach  

International Nuclear Information System (INIS)

To introduce and assess a new way of performing whole-body magnetic resonance imaging (MRI) using a non-integrated surface coil approach as available on most clinical MRI systems worldwide. Ten consecutive asymptomatic subjects prospectively underwent whole-body MRI for health screening. Whole-body MRI included T1-, T2- and diffusion-weighted sequences, and was performed using a non-integrated surface coil to image four different stations without patient repositioning. The four separately acquired stations were merged, creating seamless coronal whole-body T1-, T2- and diffusion-weighted images. Anatomical alignment, image quality at the boundaries of adjacent stations, and overall image quality of all stations were qualitatively assessed. The average time (±SD) taken to change the surface coil from one station to the next station was 53.8 (±7.1) s. The average total extra examination time ± SD was 2 min 41.4 s (±15.3 s). Anatomical alignment, image quality at the boundaries of adjacent stations, and overall image quality of all stations of T1-, T2- and diffusion-weighted whole-body MRI were overall graded as ''good'' to ''excellent''. This study shows that a time-efficient and high-quality whole-body MRI examination can easily be performed by using a non-integrated sliding surface coil approach. (orig.)

313

A MODIFIED TECHNIQUE OF INFERIOR ALVEOLAR NERVE REPOSITIONING: RESULTS IN 11 PATIENTS  

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Full Text Available Most often in the posterior of the mandible of patients who need implants, the inferior alveolar nerve (IAN is too high to insert the implants, and the surgeons have to reposition IAN. In conventional techniques (to make the windows in the buccal aspect of the mandible removal of the corticocancellous bone may cause weakness of the mandible. Here we present a new technique in which the bone is removed to a lesser extent and the IAN is best protected by the curet. This new technique is called the guard technique. As a primary report, evaluation of 11 patients (who were treated by this technique is reported. There were few complications and IAN function was preserved in all patients. The mean time which the patients had temporary anesthesia was 7.3 days and the mean time that complete function of the nerve was returned was 3.3 months. Meanwhile the surgeon should also make an effort to make surgery and osteotomy far from the IAN. Most of the surgeons always avoid involving the IAN in a mandibular surgery; therefore, sometimes, they have to replace the IAN. Primary results of the new technique are promising.

H. Mahmood-Hashemi

2006-08-01

314

THE RE-POSITIONING OF COLONIAL SPACES IN A GLOBALIZING METROPOLITAN The Case of Jakarta  

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Full Text Available This article is dealing with the position of colonial space in a globalizing Metropolitan. Starting with the idea that Colonial space is a materialization of colonial system of production, It will investigate how are these colonial spaces responding to their actual context, with different system of production, needs and demands. Firstly, it will start by defining what is colonial space then it will continue by classifying colonial spaces based on their role in the colonial system of production, then grouping them based on their positions in the actual context either as built heritage or institutional heritage. It will be analysed based on two layers of analysis namely, economic and socio-cultural. By doing so it is expected that we could discover problems and potentials related to these spaces that could help reposition these spaces in their actual context and to some extent elaborate them in general urban strategic planning. Abstract in Bahasa Indonesia : Artikel ini membahas tentang posisi ruang kolonial di dalam konteks metropolitan. Berangkat dari ide dasar bahwa ruang kolonial adalah materialisasi dari system produksi kolonial, artikel akan membahas bagaimana posisi ruang kolonial di dalam konteks yang aktual, dimana kolonialisme telah berakhir dan sistem produksi telah berubah seiring dengannya. Kata kunci: Kolonial, Warisan Budaya, Sistim produksi.

Devisari Tunas

2004-01-01

315

Repositioning the use of the Bible towards a mission-oriented theological education  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english It is an undeniable fact that mission remains the cardinal essence of the Church. However, in Africa and in Nigeria, the Church seems to have lost focus regarding the main reason for its existence, namely mission. One of the factors responsible for this may be the form of theological education in vo [...] gue. In view of this anomaly, this paper reflects on how the study of the Bible, which serves as the primary basis for theological education in some institutions, can be repositioned to enhance a mission-oriented theological education. The importance of proper interpretation of the Bible in enhancing missions can be premised on the fact that a sound biblical hermeneutics is prerequisite to the formulation of an effective and functional theology of missions. If our theology of mission is faulty, the practice cannot be anything but flawed. In view of this, the paper explores ways in which the Bible can be meaningfully studied in order to promote a mission-oriented theological education.

Adekunle O., Dada.

316

Posture and re-positioning considerations of a complete torso topographic analysis system for assessing scoliosis  

Science.gov (United States)

The influence of posture and re-positioning (sway and breathing) on the accuracy of a torso imaging system for assessing scoliosis was evaluated. The system comprised of a rotating positioning platform and one or two laser digitizers. It required four partial-scans taken at 90 ° intervals over 10 seconds to generate two complete torso scans. Its accuracy was previously determined to be 1.1+/-0.9mm. Ten evenly spaced cross-sections obtained from forty scans of five volunteers in four postures (free-standing, holding side supports, holding front supports and with their hands on their shoulders) were used to assess the variability due to posture. Twenty cross-sections from twenty scans of two volunteers holding side supports were used to assess the variability due to positioning. The variability due to posture was less than 4mm at each cross-section for all volunteers. Variability due to sway ranged from 0-3.5mm while that due to breathing ranged from 0-3mm for both volunteers. Holding side supports was the best posture. Taking the four shots within 10 seconds was optimal. As major torso features that are indicative of scoliosis are larger than 4mm in size, the system could be used in obtaining complete torso images used in assessing and managing scoliosis.

Ajemba, Peter O.; Durdle, Nelson G.; Hill, Doug L.; Raso, V. J.

2006-02-01

317

From periphery to the centre: towards repositioning churches for a meaningful contribution to public health care  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english The role of communities in health care has gained prominence in the last few years. Churches as community structures have been identified as instrumental in health-care delivery. Whilst it is widely acknowledged that churches provide important health services, particularly in countries where there a [...] re poorly-developed health sectors, the role of churches in health care is poorly understood and often overlooked. This article discusses some causes of this lacuna and makes suggestions for repositioning churches for a meaningful contribution to health care. Firstly, the article provides a context by reviewing literature on the church and health care. Secondly, it clarifies the nature of interventions and the competencies of churches. Thirdly, it discusses the operational meaning of church and churches for assessing health-care contributions. Fourthly, it explores the health-care models that are discerned in church and health-care literature. Fifthly, it discusses the contribution of churches within a multidisciplinary health team. Sixthly, it proposes an appropriate motivation that should drive churches to be involved in health care and the ecclesiological design that underpins such health care interventions.

Vhumani, Magezi.

318

Refining Chandra/ACIS Subpixel Event Repositioning Using a Backside-illuminated CCD Model  

Science.gov (United States)

Subpixel event repositioning (SER) techniques have been demonstrated to significantly improve the already unprecedented spatial resolution of Chandra X-ray imaging with the Advanced CCD Imaging Spectrometer (ACIS). Chandra CCD SER techniques are based on the premise that the impact position of events can be refined, based on the distribution of charge among affected CCD pixels. ACIS SER models proposed thus far are restricted to corner split (3 and 4 pixel) events and assume that such events take place at the split-pixel corners. To improve the event-counting statistics, we modified the ACIS SER algorithms to include 2 pixel split events and single-pixel events, using refined estimates for photon impact locations. Furthermore, simulations that make use of a high-fidelity backside-illuminated (BI) CCD model demonstrate that mean photon impact positions for split events are energy dependent, leading to further modification of subpixel event locations according to event type and energy, for BI ACIS devices. Testing on Chandra CCD X-ray observations of the Orion Nebula Cluster indicates that these modified SER algorithms further improve the spatial resolution of Chandra/ACIS, to the extent that the spreading in the spatial distribution of photons is dominated by the high-resolution mirror assembly, rather than by ACIS pixelization.

Li, Jingqiang; Kastner, Joel H.; Prigozhin, Gregory Y.; Schulz, Norbert S.

2003-06-01

319

Alveolar nerve repositioning with rescue implants for management of previous treatment. A clinical report.  

Science.gov (United States)

The goal of modern implant dentistry is to return patients to oral health in a rapid and predictable fashion, following a diagnostically driven treatment plan. If only a limited number of implants can be placed, or some fail and the prosthetic phase of implant dentistry is chosen to complete the patient's treatment, the final outcome may result in partial patient satisfaction and is commonly referred to as a "compromise." Previous All-on-4 implant treatment for the patient presented here resulted in a compromise, with an inadequate support system for the mandibular prosthesis and a maxillary complete denture with poor esthetics. The patient was unable to function adequately and also was disappointed with the resulting appearance. Correction of the compromised treatment consisted of bilateral inferior alveolar nerve elevation and repositioning without bone removal for lateral transposition, to gain room for rescue implants for a totally implant-supported and stabilized prosthesis. Treatment time to return the patient to satisfactory comfort, function, facial esthetics, and speech was approximately 2 weeks. The definitive mandibular prosthesis was designed for total implant support and stability with patient retrievability. Adequate space between the mandibular bar system and the soft tissue created a high water bridge effect for self-cleansing. Following a short interim mandibular healing period, the maxillary sinuses were bilaterally grafted to compensate for bone inadequacies and deficiencies for future maxillary implant reconstruction. PMID:23924033

Amet, Edward M; Uehlein, Chris

2013-12-01

320

Variables Affecting Canalith Repositioning Maneuver (CRM Trend for Treating Patients with Benign Paroxysmal Positional Vertigo (BPPV  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The purpose of this study was to identify variables affecting outcome in patients with benign paroxysmal positional vertigo (BPPV treated with canalith repositioning maneuver (CRM. Methods: This interventional study was conducted on 58 patients (14 males, 44 females, mean age 48.12+13.22 referred to the Vertigo Rehabilitation Clinic of the Rehabilitation School of Tehran University of Medical Sciences from 2002 to 2004. All patients were treated with CRM. According to the treatment efficacy the patients were allocated in three groups: completely treated, partially treated, and not treated. The effect of factors including age, sex, etiology, duration of BPPV, unilateral or bilateral disease, number of maneuvers, and number of sessions on outcome in patients was evaluated. Results: Forty-nine patients (84.5% were completely cured. Age, sex, etiology, and duration did not significantly affect the treatment outcome. Unilateral BPPV can be treated significantly better than bilateral BPPV. Forty-seven patients who were completely treated needed 1 session and thirty-seven of them required 2 maneuvers. Conclusion: CRM is significantly effective for BPPV treatment. Treating unilateral BPPV is expected to be easier. As most of the patients will be cured by 1 or 2 maneuvers or in 1 session, patients who required more sessions or more maneuvers may not be completely treated.

E. Entezari

2006-07-01

 
 
 
 
321

Emergency MRI of the spine and spinal cord  

International Nuclear Information System (INIS)

Out of 137 cases concerning the spine and spine cord, the authors demonstrate that MRI is nowadays fully integrated in urgency investigations. In all cord compression suspiscions and in spine trauma investigations, it's place is found. Coil and software improvements allow to put CT and MR scanning delays on a line. This study underlines the necessity of being equipped with non magnetic life support systems allowing management of very fragile patients. In traumas, MR provides the lesion's authentification, it's type, it's unique localisation or not, and therefore an early functional prognosis. The discovery of spine cord involving lesions in neoplasic conditions allows to follow a therapeutic strateging for maintaining the motor function. In the end, the authors discuss about practical utility of MR in scubadiving decompression accidents. No lesion of the spine cord has been demonstrated in 25 patients, probably because of technical insufficiency. (authors). 42 refs., 5 tabs., 8 figs

322

Neurofibromin is the major ras inactivator in dendritic spines.  

Science.gov (United States)

In dendritic spines, Ras plays a critical role in synaptic plasticity but its regulation mechanism is not fully understood. Here, using a fluorescence resonance energy transfer/fluorescence lifetime imaging microscopy-based Ras imaging technique in combination with 2-photon glutamate uncaging, we show that neurofibromin, in which loss-of-function mutations cause Neurofibromatosis Type 1 (NF1), contributes to the majority (?90%) of Ras inactivation in dendritic spines of pyramidal neurons in the CA1 region of the rat hippocampus. Loss of neurofibromin causes sustained Ras activation in spines, which leads to impairment of spine structural plasticity and loss of spines in an activity-dependent manner. Therefore, deregulation of postsynaptic Ras signaling may explain, at least in part, learning disabilities associated with NF1. PMID:24431436

Oliveira, Ana F; Yasuda, Ryohei

2014-01-15

323

Flexible Robotic Spine Actuated by Shape Memory Alloy  

Directory of Open Access Journals (Sweden)

Full Text Available A flexible robotic spine actuated by shape memory alloy (SMA can achieve both bending motion and impact absorption, which will allow robots to realize a variety of postures. In this paper, the robotic spine is designed and simplified into a multi-segment dynamic model based on several verified assumptions. The SMA wire is modelled using the Seelecke-Muller-Acenbach theory. An iterative algorithm is developed to address the external forces distributed along the spine and compute the spine’s bending angle. Based on the dynamic model, we improve the simulation structure and search algorithm to achieve good efficiency and stable solutions. Experiments are conducted to verify the simulation and the results fit the simulation prediction well, with error of less than five degrees. Design optimization with our simulation tool based on several parameters is also discussed in this paper.

Shiquan Wang

2014-04-01

324

Glucose Sensing  

CERN Document Server

Topics in Fluorescence Spectroscopy, Glucose Sensing is the eleventh volume in the popular series Topics in Fluorescence Spectroscopy, edited by Drs. Chris D. Geddes and Joseph R. Lakowicz. This volume incorporates authoritative analytical fluorescence-based glucose sensing reviews specialized enough to be attractive to professional researchers, yet also appealing to the wider audience of scientists in related disciplines of fluorescence. Glucose Sensing is an essential reference for any lab working in the analytical fluorescence glucose sensing field. All academics, bench scientists, and industry professionals wishing to take advantage of the latest and greatest in the continuously emerging field of glucose sensing, and diabetes care & management, will find this volume an invaluable resource. Topics in Fluorescence Spectroscopy Volume 11, Glucose Sensing Chapters include: Implantable Sensors for Interstitial Fluid Smart Tattoo Glucose Sensors Optical Enzyme-based Glucose Biosensors Plasmonic Glucose Sens...

Geddes, Chris D

2006-01-01

325

Effect of spine motion on mobility in quadruped running  

Science.gov (United States)

Most of current running quadruped robots have similar construction: a stiff body and four compliant legs. Many researches have indicated that the stiff body without spine motion is a main factor in limitation of robots' mobility. Therefore, investigating spine motion is very important to build robots with better mobility. A planar quadruped robot is designed based on cheetahs' morphology. There is a spinal driving joint in the body of the robot. When the spinal driving joint acts, the robot has spine motion; otherwise, the robot has not spine motion. Six group prototype experiments with the robot are carried out to study the effect of spine motion on mobility. In each group, there are two comparative experiments: the spinal driving joint acts in one experiment but does not in the other experiment. The results of the prototype experiments indicate that the average speeds of the robot with spine motion are 8.7%-15.9% larger than those of the robot without spine motion. Furthermore, a simplified sagittal plane model of quadruped mammals is introduced. The simplified model also has a spinal driving joint. Using a similar process as the prototype experiments, six group simulation experiments with the simplified model are conducted. The results of the simulation experiments show that the maximum rear leg horizontal thrusts of the simplified mode with spine motion are 68.2%-71.3% larger than those of the simplified mode without spine motion. Hence, it is found that spine motion can increase the average running speed and the intrinsic reason of speed increase is the improvement of the maximum rear leg horizontal thrust.

Chen, Dongliang; Liu, Qi; Dong, Litao; Wang, Hong; Zhang, Qun

2014-08-01

326

Cooperative aquatic sensing using the telesupervised adaptive ocean sensor fleet  

Science.gov (United States)

Earth science research must bridge the gap between the atmosphere and the ocean to foster understanding of Earth's climate and ecology. Typical ocean sensing is done with satellites or in situ buoys and research ships which are slow to reposition. Cloud cover inhibits study of localized transient phenomena such as Harmful Algal Blooms (HAB). A fleet of extended-deployment surface autonomous vehicles will enable in situ study of characteristics of HAB, coastal pollutants, and related phenomena. We have developed a multiplatform telesupervision architecture that supports adaptive reconfiguration based on environmental sensor inputs. Our system allows the autonomous repositioning of smart sensors for HAB study by networking a fleet of NOAA OASIS (Ocean Atmosphere Sensor Integration System) surface autonomous vehicles. In situ measurements intelligently modify the search for areas of high concentration. Inference Grid and complementary information-theoretic techniques support sensor fusion and analysis. Telesupervision supports sliding autonomy from high-level mission tasking, through vehicle and data monitoring, to teleoperation when direct human interaction is appropriate. This paper reports on experimental results from multi-platform tests conducted in the Chesapeake Bay and in Pittsburgh, Pennsylvania waters using OASIS platforms, autonomous kayaks, and multiple simulated platforms to conduct cooperative sensing of chlorophyll-a and water quality.

Dolan, John M.; Podnar, Gregg W.; Stancliff, Stephen; Low, Kian Hsiang; Elfes, Alberto; Higinbotham, John; Hosler, Jeffrey; Moisan, Tiffany; Moisan, John

2009-09-01

327

Subregional, dendritic compartment, and spine subtype specificity in cocaine-regulation of dendritic spines in the nucleus accumbens  

Science.gov (United States)

Numerous studies have found that chronic cocaine increases dendritic spine density of medium spiny neurons in the nucleus accumbens (NAc). Here, we employed single cell microinjections and advanced 3D imaging and analysis techniques to extend these findings in several important ways: by assessing cocaine regulation of dendritic spines in the core versus shell subregions of NAc in the mouse, over a broad time course (4 hours, 24 hours, or 28 days) of withdrawal from chronic cocaine, and with a particular focus on proximal versus distal dendrites. Our data demonstrate subregion-specific, and in some cases opposite, regulation of spines by cocaine on proximal but not distal dendrites. Notably, all observed density changes were attributable to selective regulation of thin spines. At 4 hours post-injection, the proximal spine density is unchanged in the core but significantly increased in the shell. At 24 hours, the density of proximal dendritic spines is reduced in the core but increased in the shell. Such down-regulation of thin spines in the core persists through 28 days of withdrawal, while the spine density in the shell returns to baseline levels. Consistent with previous results, dendritic tips exhibited up-regulation of dendritic spines after 24 hours of withdrawal, an effect localized to the shell. The divergence in regulation of proximal spine density in NAc core versus shell by cocaine correlates with recently reported electrophysiological data from a similar drug administration regimen and might represent a key mediator of changes in the reward circuit that drive aspects of addiction. PMID:22593064

Dumitriu, Dani; LaPlant, Quincey; Grossman, Yael S.; Dias, Caroline; Janssen, William G.; Russo, Scott J.; Morrison, John H.; Nestler, Eric J.

2012-01-01

328

MR imaging evaluation of congenital spine anomalies  

International Nuclear Information System (INIS)

Over a 2-year period, 135 patients between the ages of 1 week and 18 years were examined with MR imaging for possible congenital anomalies of the spine and spinal cord. Tethered cords with various other associated pathologies such as lipomas and myelomeningoceles were found in 36 patients. The remaining abnormal examinations consisted of syrinxes, Chiari malformations, diastematomyelia, and conus masses. In 55 patients the studies were interpreted as normal. Of these, three were subsequently shown by surgery of myelography to be abnormal. The first had a thickened filum with a small epidermoid, the second a thickened filum, and the third, with only sagittal images, a diastematomyelia. Children presenting with symptoms highly suspicious for congenital abnormalities but with a normal MR study in multiple planes may still require further evaluation with myelography. Multiplanar MR examination in most instances will be a sufficient evaluation for congenital anomalies

329

Herpes myelitis after thoracic spine surgery.  

Science.gov (United States)

Herpes simplex or herpes zoster reactivation after spinal surgery is rarely reported. This case report and review of the literature describes patients in whom this reactivation occurs to clarify the diagnosis and management. In addition to reporting their case, the authors reviewed case reports and series published between 1980 and 2012 found through a PubMed search. Herpes reactivation is generally confined to a vesicular rash that can be treated with acyclovir. However, occasional dissemination has occurred and has led to myelitis or encephalitis. Atypical presentations led to delays in diagnosis, delayed treatment, and poor neurological outcome. While rare, herpes simplex or herpes zoster reactivation is a complication of spine surgery that must be considered in the face of new-onset focal neurological symptoms in a dermatome pattern without a structural cause, even without a rash. PMID:23452248

Anderson, Mark Daniel; Tummala, Sudhakar

2013-05-01

330

Nuclear magnetic resonance imaging of the spine  

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Forty subjects were examined to determine the accuracy and clinical usefulness of nuclear magnetic resonance (NMR) examination of the spine. The NMR images were compared with plain radiographs, high-resolution computed tomograms, and myelograms. The study included 15 patients with normal spinal cord anatomy and 25 patients whose pathological conditions included canal stenosis, herniated discs, metastatic tumors, primary cord tumor, trauma, Chiari malformations, syringomyelia, and developmental disorders. Saturation recovery images were best in differentiating between soft tissue and cerebrospinal fluid. NMR was excellent for the evaluation of the foramen magnum region and is presently the modality of choice for the diagnosis of syringomyelia and Chiari malformation. NMR was accurate in diagnosing spinal cord trauma and spinal canal block.

Modic, M.T.; Weinstein, M.A.; Pavlicek, W.; Starnes, D.L.; Duchesneau, P.M.; Boumphrey, F.; Hardy, R.J. Jr.

1984-01-01

331

Nuclear magnetic resonance imaging of the spine  

International Nuclear Information System (INIS)

Forty subjects were examined to determine the accuracy and clinical usefulness of nuclear magnetic resonance (NMR) examination of the spine. The NMR images were compared with plain radiographs, high-resolution computed tomograms, and myelograms. The study included 15 patients with normal spinal cord anatomy and 25 patients whose pathological conditions included canal stenosis, herniated discs, metastatic tumors, primary cord tumor, trauma, Chiari malformations, syringomyelia, and developmental disorders. Saturation recovery images were best in differentiating between soft tissue and cerebrospinal fluid. NMR was excellent for the evaluation of the foramen magnum region and is presently the modality of choice for the diagnosis of syringomyelia and Chiari malformation. NMR was accurate in diagnosing spinal cord trauma and spinal canal block

332

[Spondylarthrosis of the cervical spine. Therapy].  

Science.gov (United States)

Chronic neck pain is often associated with spondylarthrosis, whereby segments C4/C5 (C: cervical) are most frequently affected. Spondylarthrosis can be the sole complaint, but it is associated with a degenerative cascade of the spine. The umbrella term for neck pain is the so-called cervical syndrome, which can be differentiated into segmental dysfunction and/or morphological changes of the intervertebral discs and small joints of the vertebral column. Conservative therapy modalities include physical therapy, subcutaneous application of local anesthetics, muscle, nerve and facet joint injections in addition to adequate analgesic and muscle relaxant therapy. If surgery is required, various techniques via dorsal and ventral approaches, depending on the clinic and morphologic changes, can be applied. PMID:23989596

Radl, R; Leixner, G; Stihsen, C; Windhager, R

2013-09-01

333

Spondylitis of thoracic spine: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction Spondylitis is a rare bone and joint infection. It is a disease with long clinical history. Often, it is difficult to recognise symptoms at a proper time, and, due to the complex clinical outcome of spondylitis, a clinician may think about other problems in the body. Case Outline A case report of a 59-year-old male patient with thoracic spine spondylitis is presented, formerly treated as pulmonary thromboembolism with pericarditis. Only after neurological disorder such as paraplegia and orthopaedic consultative examination, real diagnosis was established. After that, the patient was hospitalized and operated on. Conclusion A therapeutic approach to spondylitis is based on surgery, antibiotic drugs and symptomatic therapy. Due to the frequent occurrence of neurologic disorders, therapy could be prolonged and uncertain. .

Timotijevi? Sla?an

2008-01-01

334

Dendritic spine pathology in neuropsychiatric disorders.  

Science.gov (United States)

Substantial progress has been made toward understanding the genetic architecture, cellular substrates, brain circuits and endophenotypic profiles of neuropsychiatric disorders, including autism spectrum disorders (ASD), schizophrenia and Alzheimer's disease. Recent evidence implicates spiny synapses as important substrates of pathogenesis in these disorders. Although synaptic perturbations are not the only alterations relevant for these diseases, understanding the molecular underpinnings of spine pathology may provide insight into their etiologies and may reveal new drug targets. Here we discuss recent neuropathological, genetic, molecular and animal model studies that implicate structural alterations at spiny synapses in the pathogenesis of major neurological disorders, focusing on ASD, schizophrenia and Alzheimer's disease as representatives of these categories across different ages of onset. We stress the importance of reverse translation, collaborative and multidisciplinary approaches, and the study of the spatio-temporal roles of disease molecules in the context of synaptic regulatory pathways and neuronal circuits that underlie disease endophenotypes. PMID:21346746

Penzes, Peter; Cahill, Michael E; Jones, Kelly A; VanLeeuwen, Jon-Eric; Woolfrey, Kevin M

2011-03-01

335

Cervical spine instability in rheumatoid arthritis.  

Science.gov (United States)

Rheumatoid arthritis (RA) is the most common inflammatory disease of the cervical spine (CS). After hands and feet, CS is the most commonly involved segment, being present in more than half of the patients with RA. Especially in the CS, RA may cause degeneration of ligaments, leading to laxity, instability and subluxation of the vertebral bodies. This is often asymptomatic or symptoms are erroneously attributed to peripheral manifestations. Otherwise, this may cause compression of spinal cord (SC) and medulla oblongata leading to severe neurologic deficits and even sudden death. Owing to its potentially debilitating and life-threatening sequelae, inevitable progression once neurologic deficits occur and the poor medical condition of afflicted patients, CS involvement remains a priority in the diagnosis and its treatment will remain a challenge. The surgical approach aims a solid fixation of the upper cervical spine, giving stability, preventing neurologic deterioration and injury to the SC, leading to improved neurologic function, vascular integrity and maintenance of sagittal balance. The recent advances in surgical techniques, complete understanding of the anatomy and precise preoperative evaluation led to safer and more effective procedures that have decreased complication rates. Based on the fact that when a patient becomes myelopathic the rate of long-term mortality increases and the chance of neurologic recovery decreases, many authors agree that early surgical intervention, before the onset of neurologic deficits, gives a more satisfactory outcome. However, the timing when a prophylactic stabilization should occur is poorly defined, and so, patients with radiographic instability but without evidence of neurologic deficit are still the most difficult to manage. PMID:23807394

da Côrte, Filipa Camacho; Neves, Nuno

2014-07-01

336

Infections of the spine; Infektionen der Wirbelsaeule  

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Diagnosis of infectious disease of the spine in an early stage ist difficult. Conventional X-ray examinations, often used as a basic screening study, will show the characteristic narrowing of the intervertebral disc space and the osteolytic and sclerotic changes in the adjointing vertebra only after two to eight weeks. Magnetic resonance imaging (MRI) has a sensitivity equivalent to bone scintigraphy and, due to its superior delineation of anatomic details, MRI has become the method of choice not only for the assessment of location, extent, and associated lesions in infectious bone disease, but also in the diagnosis of intradural infections including myelitis. MRI examination in the assessment of a successful therapy or osteomyelitis of the spine aims for the detection of regression of bone marrow edema, reappearance of fatty marrow, and less pronounced contrast enhancement. Computed tomography (CT) is mainly used for image-guided biopsy to obtain specimen for microbiologic culture or for the placement of a percutaneous drainage. (orig.) [Deutsch] Die Diagnostik entzuendlicher Erkrankungen der Wirbelsaeule und des Spinalkanals in den Fruehstadien ist schwierig. Die als Einstiegsdiagnostik eingesetzte Nativroentgenaufnahme zeigt bei der Spondylitis fruehestens 2 bis 8 Wochen nach Infektion die charakteristische Hoehenminderung des Zwischenwirbelraums, die von lytischen und sklerotischen Veraenderungen der benachbarten Wirbelkoerper begleitet wird. Die Magnetresonanztomographie (MRT) ist heute aufgrund ihrer der Szintigraphie vergleichbar hohen Sensitivitaet und ihrer ueberlegenen anatomischen Detailaufloesung Untersuchungsmethode der Wahl nicht nur zur Beurteilung von Lage, Groesse und Umgebungsreaktion entzuendlicher Knochenprozesse, sondern auch bei der Diagnostik intraduraler Infektionen einschliesslich der Myelitis. Parameter zur Beurteilung einer erfolgreichen Therapie von Wirbelsaeulenosteomyelitiden in der MRT sind die Rueckbildung des Knochenmarkoedems, die Fettmarkkonversion und der Rueckgang der Kontrastmittelanfaerbung. Das Hauptanwendungsgebiet der Computertomographie ist bei schon diagnostiziertem Krankheitsbild die Biopsie zum Erregernachweis und gegebenenfalls therapeutisch die gezielte Plazierung einer Drainage. (orig.)

Heindel, W. [Koeln Univ. (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Lanfermann, H. [Koeln Univ. (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Du Mesnil, R. [Koeln Univ. (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik; Fischbach, R. [Koeln Univ. (Germany). Inst. und Poliklinik fuer Radiologische Diagnostik

1996-11-01

337

Introduction: minimally invasive spine surgery video supplement.  

Science.gov (United States)

This video supplement of Neurosurgery Focus is devoted to minimally invasive spine surgery. Minimally invasive spine surgery has gained popularity amongst patients and physicians over the past decade because it has been shown in select instances to lower blood loss and reduce length of hospital stay for appropriately selected candidates. This supplement includes videos from many of the leaders in the field. Pioneers like Frank LaMarca, Paul Park, Cheerag Upadhyaya, Juan Uribe, and Mike Wang have all sent in videos depicting minimally invasive spinal deformity surgery options. The supplement also includes videos from several different countries, demonstrating how widespread and nuanced minimally invasive spinal procedures have become. Drs. Barbagallo, Certo, Sciacca, and Albanese from Italy; Drs. Gragnaniello and Seex from Australia; and Drs. Liao, Wu, Huang, Wang, Chang, Cheng, and Shih from Taiwan have all sent in nuanced surgical videos that will be of interest to many viewers. I personally enjoyed viewing videos on lumbar degenerative disease surgery depicting unique surgical nuances to treat common problems. Dr. Beejal Amin, Dr. Harel Deutsch, Dr. Daniel Lu, and Dr. Adam Kanter have each submitted videos depicting lumbar decompression and/or fusion for lumbar degenerative stenosis and spondylosis. This supplement also included videos depicting the minimally invasive treatment of uncommon spinal pathologies as well. Videos from Dr. Fred Geisler, Dr. John O'Toole, and Dr. Noel Perin covered topics as varied as sacroiliac joint dysfunction, spinal arteriovenous malformations, and sympathetic chain surgery. I hope that you enjoy this issue of Neurosurgical Focus devoted to videos depicting the surgical nuances of minimally invasive spinal surgery. This video supplement has international appeal, and it has been an honor to be a guest editor on this superb supplement. PMID:23829838

Mummaneni, Praveen V

2013-07-01

338

Biomechanical response of the lumbar spine in dynamic compression.  

Science.gov (United States)

The purpose of this study was to investigate the biomechanical properties of the human lumbar spine subjected to dynamic compression. A series of six experiments using the lumbar spines from four human cadavers was performed. The first two tests utilized the entire lumbar spine while the remaining four tests used lumbar functional joints to separate the differences in stability. A high rate material testing machine was used to produce the dynamic compression at a displacement rate of 1 m/s. Custom mounting plates were developed to ensure proper anatomical position of the lumbar spine sections. Both tests with the whole lumbar spines resulted in compression fractures at T12 due to combined axial loads of 5009 N and 5911 N and bending moments of 237 Nm and 165 Nm respectively. These failures occurred as the spine behaved in first order buckling which resulted in concentrated loading and bending of the anterior aspects of the vertebral bodies. All tests with functional units resulted in endplate fractures and recorded substantially higher axial loads between 11,203 N and 13,065 N and substantially lower bending moments between 47 Nm and 88 Nm. The results indicate that the mechanical stability of the lumbar spine is critical component in relation to the tolerable compressive loads. PMID:16817654

Duma, Stefan M; Kemper, Andrew R; McNeely, David M; Brolinson, P Gunnar; Matsuoka, Fumio

2006-01-01

339

Testosterone modulation of dendritic spines of somatosensory cortical pyramidal neurons.  

Science.gov (United States)

Brain structures and functions are increasingly recognized to be directly affected by gonadal hormones, which classically determine reproductive functions and sexual phenotypes. In this regard, we found recently that ovariectomy trimmed the dendritic spines of female rat primary somatosensory cortical neurons and estradiol supplement reversed it. Here, we investigated whether in the male androgen also has a cortical modulatory effect. The dendritic arbors and spines of rat somatosensory cortical pyramidal neurons were studied following intracellular dye injection and three-dimensional reconstruction. Dendritic spines, but not length, of the layers III and V pyramidal neurons were found reduced at 2 weeks and rebounded slightly at 4 weeks and further at 8 and 24 weeks following castration, which, however, remained significantly fewer than those of the intact animals. Two weeks of osmotic pump-delivered testosterone treatment to animals castrated for 4 weeks replenished serum testosterone and reversed the densities of dendritic spines on these neurons to control animal levels. Androgen receptor appears to mediate this effect as its antagonist flutamide reduced the dendritic spines of normal adult rats while causing a mild feedback surge of serum testosterone. On the other hand, blocking the conversion of testosterone to estrogen with the aromatase inhibitor anastrozole failed to alter the dendritic spine densities in male adult rats. In conclusion, these results support our hypothesis that testosterone acts directly on the androgen receptor in males to modulate the dendritic spines of somatosensory cortical output neurons. PMID:23340667

Chen, Jeng-Rung; Wang, Tsyr-Jiuan; Lim, Seh-Hong; Wang, Yueh-Jan; Tseng, Guo-Fang

2013-11-01

340

MRI features of hydatid disease of the spine  

International Nuclear Information System (INIS)

Objective: To analyze the typical MRI findings and to evaluate the value of MRI in the diagnosis of hydatid disease of the spine. Methods: This retrospective study consisted of 16 patients with hydatidosis of the spine evaluated with MRI. All patients had surgery with histological diagnosis. MR myelography (MRM) was done in 4 eases, contrast-enhanced scan in 2 cases and perfusion weighted imaging (PWI) in 1 case. X-ray was performed in 8 cases and CT in 5 cases. Results: All 16 cases were diagnosed as hydatid disease with multicysts. Hydatid disease involved thoracic spine in 5 cases, lumbar spine in 4 cases, sacrum in 3 eases, lumbosacral spine in 2 cases and a combination of thoracic, lumbar spine and sacrum in 2 cases. MR imaging showed bone destruction with wedge shaped compression of single or multiple vertebra. The lesions were round in contour with different sizes and involved the bony spinal canal, appendix of vertebra and neighboring soft tissues. Cystic lesions with multiple daughter cysts demonstrated long T1 and long T2 abnormal signal intensity on MR imaging. On T2-weighted images, a hypointense rim was seen. Cystic lesions were better seen on T2 SPIR and MRM. Mild contrast enhancement of these lesions were seen. A single case showed iso-perfusion on PWI. Conclusions: MRI can demonstrate hydatid cysts in vertebra, spinal canal, paravertebral and neighboring soft tissue. MRI is a valuable tool in the diagnosis and treatment planning of hydatid disease of the spine. (authors)

 
 
 
 
341

The talon removable head frame system for stereotactic radiosurgery/radiotherapy: measurement of the repositioning accuracy  

International Nuclear Information System (INIS)

Purpose: To present the TALON removable head frame system as an immobilization device for single-fraction intensity-modulated stereotactic radiosurgery (IMRS) and fractionated stereotactic intensity-modulated radiotherapy (FS-IMRT); and to evaluate the repositioning accuracy by measurement of anatomic landmark coordinates in repeated computed tomography (CT) examinations. Methods and materials: Nine patients treated by fractionated stereotactic intensity-modulated radiotherapy underwent repeated CTs during their treatment courses. We evaluated anatomic landmark coordinates in a total of 26 repeat CT data sets and respective x, y, and z shifts relative to their positions in the nine treatment-planning reference CTs. An iterative optimization algorithm was employed using a root mean square scoring function to determine the best-fit orientation of subsequent sets of anatomic landmark measurements relative to the original image set. This allowed for the calculation of the x, y, and z components of translation of the target isocenter for each repeat CT. In addition to absolute target isocenter translation, the magnitude (sum vector) of isocenter motion and the patient/target rotation about the three principal axes were calculated. Results: Anatomic landmark analysis over a treatment course of 6 weeks revealed a mean target isocenter translation of 0.95±0.55, 0.58±0.46, and 0.51±0.38 mm in x, y, and z directions, respectively. The mean magnitude of isocenter translation was 1.38±0.48 mm. The 95% confidence interval ([CI], mean translation plus two standard deviations) for repeated isocenter setup accuracy over the 6-week period was 2.34 mm. Average rotations about the x, y, and z axes were 0.41±0.36, 0.29±0.25, and 0.18±0.15 degrees, respectively. Analysis of the accuracy of the first repeated setup control, representative of single-fraction stereotactic radiosurgery situations, resulted in a mean target isocenter translation in the x, y, and z directions of 0.52±0.38, 0.56±0.30, and 0.46±0.25 mm, respectively. The mean magnitude of isocenter translation was 0.99±0.28 mm. The 95% confidence interval for these radiosurgery situations was 1.55 mm. Average rotations at first repeated setup control about the x, y, and z axes were 0.24±0.19, 0.19±0.17, and 0.19±0.12 degrees, respectively. Conclusion: The TALON relocatable head frame was seen to be well suited for immobilization and repositioning of single-fraction stereotactic radiosurgery treatments. Because of its unique removable design, the system was also seen to provide excellent repeat immobilization and alignment for fractionated stereotactic applications. The exceptional accuracy for the single-fraction stereotactic radiosurgical application of the system was seen to deteriorate only slightly over a 6-week fractionated stereotactic treatment course

342

Lumbar position sense acuity during an electrical shock stressor  

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Full Text Available Abstract Background Optimal motor control of the spine depends on proprioceptive input as a prerequisite for co-ordination and the stability of the spine. Muscle spindles are known to play an important role in proprioception. Animal experiments suggest that an increase in sympathetic outflow can depress muscle spindle sensitivity. As the muscle spindle may be influenced by sympathetic modulation, we hypothesized that a state of high sympathetic activity as during mental stress would affect the proprioceptive output from the muscle spindles in the back muscles leading to alterations in proprioception and position sense acuity. The aim was to investigate the effect of mental stress, in this study the response to an electrical shock stressor, on position sense acuity in the rotational axis of the lumbar spine. Methods Passive and active position sense acuity in the rotational plane of the lumbar spine was investigated in the presence and absence of an electrical shock stressor in 14 healthy participants. An electrical shock-threat stressor lasting for approximately 12 minutes was used as imposed stressor to build up a strong anticipatory arousal: The participants were told that they were going to receive 8 painful electrical shocks however the participants never received the shocks. To quantify the level of physiological arousal and the level of sympathetic outflow continuous beat-to-beat changes in heart rate (beats*min-1 and systolic, diastolic and mean arterial blood pressure (mmHg were measured. To quantify position sense acuity absolute error (AE expressed in degrees was measured. Two-way analysis of variance with repeated measurements (subjects as random factor and treatments as fixed factors was used to compare the different treatments. Results Significant increases were observed in systolic blood pressure, diastolic blood pressure, and heart rate during the stress sessions indicating elevated sympathetic activity (15, 14 and 10%, respectively. Despite pronounced changes in the sympathetic activity and subjective experiences of stress no changes were found in position sense acuity in the rotational plane of the lumbar spine in the presence of the electrical shock stressor compared to the control period. Conclusion The present findings indicate that position sense acuity in the rotational plane of the spine was unaffected by the electrical shock stressor.

Fallentin Nils

2005-07-01

343

The relationship between PSD-95 clustering and spine stability in vivo.  

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The appearance and disappearance of dendritic spines, accompanied by synapse formation and elimination may underlie the experience-dependent reorganization of cortical circuits. The exact temporal relationship between spine and synapse formation in vivo remains unclear, as does the extent to which synapse formation enhances the stability of newly formed spines and whether transient spines produce synapses. We used in utero electroporation of DsRedExpress- and eGFP-tagged postsynaptic density protein 95 (PSD-95) to investigate the relationship between spine and PSD stability in mouse neocortical L2/3 pyramidal cells in vivo. Similar to previous studies, spines and synapses appeared and disappeared, even in naive animals. Cytosolic spine volumes and PSD-95-eGFP levels in spines covaried over time, suggesting that the strength of many individual synapses continuously changes in the adult neocortex. The minority of newly formed spines acquired PSD-95-eGFP puncta. Spines that failed to acquire a PSD rarely survived for more than a day. Although PSD-95-eGFP accumulation was associated with increased spine lifetimes, most new spines with a PSD did not convert into persistent spines. This indicates that transient spines may serve to produce short-lived synaptic contacts. Persistent spines that were destined to disappear showed, on average, reduced PSD-95-eGFP levels well before the actual pruning event. Altogether, our data indicate that the PSD size relates to spine stability in vivo. PMID:24501349

Cane, Michele; Maco, Bohumil; Knott, Graham; Holtmaat, Anthony

2014-02-01

344

The Relationship of SmokingOpioidAntidepressant Use and History of Spine Surgery  

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Full Text Available Introduction: In a recent paper, smoking was shown to be an independent predictor of longterm continued opioid use in spine patients (Krebs et al. 2010. In this paper, we study the interaction of smoking with opioid and antidepressant use and the relationship with prior spine surgery and future spine surgery. Methods: Data on smoking, opioid and antidepressant use were retrospectively collected from 758 spine surgery inpatients [lumbar microdiskectomy (LMD, anterior cervical decompression and fusion (ACDF and lumbar decompression and fusion (LDF]. Interaction with history of previous spine surgery and return for additional spine surgery was studied. Followup ranged from one to four years. Results: Significant correlation was detected between smoking and opioid use and between opioid and antidepressant use. History of previous spine surgery correlated with antidepressant use and return for additional spine surgery. Additional spine surgery correlated with opioid use and history of previous spine surgery. Smoking LMD patients on both opioids and antidepressants and smoking ACDF patients on antidepressants who have a history of prior spine surgery were more likely to return for additional spine surgery. However, in the LDF group, smoking patients on antidepressants without previous spine surgery were more likely to come for another spine surgery. Conclusion: Smokingantidepressantopioid use could be predictive of return for additional spine surgery during the followup years especially if a history of prior spine surgery was reported. Further research is needed on the implications of such an association.

Walid Mohammad

2010-08-01

345

Evaluation of Multi Canister Overpack (MCO) Handling Machine Uplift Restraint for a Seismic Event During Repositioning Operations  

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Insertion of the Multi-Canister Overpack (MCO) assemblies into the Canister Storage Building (CSB) storage tubes involves the use of the MCO Handling Machine (MHM). During MCO storage tube insertion operations, inadvertent movement of the MHM is prevented by engaging seismic restraints (''active restraints'') located adjacent to both the bridge and trolley wheels. During MHM repositioning operations, the active restraints are not engaged. When the active seismic restraints are not engaged, the only functioning seismic restraints are non-engageable (''passive'') wheel uplift restraints which function only if the wheel uplift is sufficient to close the nominal 0.5-inch gap at the uplift restraint interface. The MHM was designed and analyzed in accordance with ASME NOG-1-1995. The ALSTHOM seismic analysis reported seismic loads on the MHM uplift restraints and EDERER performed corresponding structural calculations to demonstrate structural adequacy of the seismic uplift restraint hardware. The ALSTHOM and EDERER calculations were performed for a parked MHM with the active seismic restraints engaged, resulting in uplift restraint loading only in the vertical direction. In support of development of the CSB Safety Analysis Report (SAR), an evaluation of the MHM seismic response was requested for the case where the active seismic restraints are not engaged. If a seismic event occurs during MHM repositioning operations, a moving contact at a seismic uplift restraint would introduce a friction load on the restraint in the direction of the movement. These potential horizontal friction loads on the uplift restraints were not included in the existing restraint hardware design calculations. One of the purposes of the current evaluation is to address the structural adequacy of the MHM seismic uplift restraints with the addition of the horizontal friction associated with MHM repositioning movements.

SWENSON, C.E.

2000-05-15

346

Treatment of Degenerative Diseases of the Spine by Physiotherapy.  

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Three methods of treating degenerative diseases of the spine by physiotherapy are reviewed. Specific examples involving patients are discussed which demonstrate the effectiveness of different heat, physiotherapy, and exercise treatments. The uses of physi...

W. Koch, A. Lynn

1985-01-01

347

Anterior cervical spine fusion: struts, plugs, and plates  

International Nuclear Information System (INIS)

Bone grafting in the cervical spine is an expanding and rapidly changing area. Its success depends on the presence of bone formation, bone incorporation, and ongoing adaptive remodeling to mechanical loads. The evaluation of anterior cervical spine grafts requires a basic understanding of bone graft physiology, its clinical applications, and its postoperative appearances. The roles of routine radiography, polydirectional tomography, computed tomography, and magnetic resonance imaging in the assessment and follow-up of the postoperatively grafted cervical spine will be discussed. The main focus on this paper is to review current surgical procedures utilized for stabilizing the cervica spine as well as to discuss the radiologist's role in the imaging of this region. (orig.)

348

Viscous dissipation in 3D spine reconnection solutions  

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Aims: We consider the influence of viscous dissipation on "spine" reconnection solutions in coronal plasmas. It is known from 2D and 3D "fan" reconnection studies that viscous losses can be important. We extend these arguments to 3D "spine" reconnection solutions. Methods: Steady 3D spine reconnection models were constructed by time relaxation of the governing visco-resistive MHD equations. Scaling laws were derived that compare the relative importance of viscous and resistive damping. Results: It is shown that viscous dissipation in spine reconnection models can dominate resistive damping by many orders of magnitude. A similar conclusion, but with less severe implications, applies to current sheet "fan" solutions. These findings are not sensitive to whether classical or Braginskii viscosity is employed.

Craig, I. J. D.; Lopez, N.

2013-12-01

349

Mef2 promotes spine elimination in absence of ?-catenin.  

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?-Catenin is a component of the cadherin-catenin cell adhesion complex and its loss has been implicated in the mental retardation associated with the Cri du chat syndrome. We have previously demonstrated that loss of ?-catenin in a murine model during development results in excessive spine and synaptic density and function. In order to examine the role of potential molecules that might cooperate with ?-catenin to regulate spine density, we focused on Mef2. Our data demonstrate that while loss of ?-catenin does not alter the expression levels of endogenous Mef2, expression of Mef2 in neurons that are knocked down for ?-catenin promotes spine elimination. These results establish a molecular mechanism by which excessive spines in the absence of ?-catenin may be eliminated and may point toward pharmacological therapy for the Cri du chat syndrome. PMID:23328440

Yuan, Yang; Singh, Dipika; Arikkath, Jyothi

2013-03-01

350

The effect of laryngoscopy of different cervical spine immobilisation techniques.  

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Fifty patients underwent laryngoscopy with two different cervical spine immobilisation techniques. First the cervical spine was immobilised in a rigid collar with tape across the forehead and sandbags on either side of the neck, then with an assistant providing manual in-line immobilisation. Finally, patients underwent laryngoscopy in the routine intubating position. In 56% of patients the view of the larynx improved by one grade and in 10% the view improved by two grades when manual immobilisation was substituted for the collar, tape and sandbags (p sandbags compared to 22% of patients undergoing in-line manual immobilisation (p < 0.001). Mouth opening was significantly reduced when patients were wearing cervical collars and this was the main factor contributing to the increased difficulty of laryngoscopy in this particular form of cervical spine immobilisation. It is recommended that manual in-line immobilisation should be the method of choice for cervical spine stabilisation during tracheal intubation. PMID:7802175

Heath, K J

1994-10-01

351

Tuberculosis of the spine radiological imaging. Case report  

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Skeletal tuberculosis constitutes 1-3% of all cases of tuberculosis and involves the spine in up to 50% of cases, most commonly the thoracolumbar spine. The purpose of this article is to review the case of a 47-year-old man who complained of back pain, weakness of muscles and weight loss. He was examined with conventional anteriorposterior and lateral X-rays of thoracic spine, computed tomography (CT) and magnetic resonance imaging. Radiological imaging suggested tubercolosis of the spine. The authors present the imaging procedures applied to diagnose this case. Conventional radiography was used as the first basic examination. Computed tomography (CT) and magnetic resonance imaging (MR) were used as complementary methods. The final diagnosis was based on a biopsy of the bone. The definite diagnosis is required to adequate treatment. In some cases surgical treatment is used. (author)

352

Strain sensing  

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The three most generally used practical methods of strain sensing are discussed. These methods are brittle coatings, photoelastic coatings, and resistance strain gages. The physical principles of each method are reviewed.

King, R. R.; Kusenberger, F. N.

1973-01-01

353

Strategic positioning and repositioning of oil companies in the upstream business: understanding the historical evolution of firms' strategic behavior  

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This is the second article of a series whose objective is to use the analytical framework proposed by Michael Porter, from the University of Harvard, to study the global oil competition game and the competitive advantages of oil companies. The paper focuses on the historical changes in the positioning and behavior of various actors in the upstream oil industry. The authors start by describing the main oil actors and their initial strategic positioning before 1973. Then, the changes and the firm's strategic repositioning during the oil crisis in the 1970's and 1980's are analyzed. (author)

354

Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl  

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Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

355

Villonodular synovitis (PVNS) of the spine  

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To describe the imaging features of spinal pigmented villonodular synovitis (PVNS). We retrospectively reviewed 15 cases of pathologically proven spinal PVNS. Patient demographics and clinical presentation were reviewed. Radiologic studies were evaluated by consensus of two musculoskeletal radiologists for spinal location, spinal segments affected, lesion center, detection of facet origin and intrinsic characteristics on radiography (n =11), myelography (n =7), CT (n =6) and MR imaging (n =6). Women (64%) were more commonly affected than men (36%) with an average age of 28 years. Clinical symptoms were pain (45%), neurologic (9%) or both (36%). Lesions most frequently affected the cervical spine (53%) followed by the thoracic (27%) and lumbar regions (20%). The majority of lesions (93%) were centered in the posterior elements with frequent involvement of the pedicle (67%), neural foramina (73%), lamina (67%) and facets (93%). No lesions showed calcification. Determination of a facet origin by imaging was dependent on imaging modality and lesion size. A facet origin could be determined in 45% of cases by radiography vs 67% of patients by CT (n=6) and MR (n=6). Large lesions (greater than 3 cm in at least one dimension) obscured the facet origin in all cases with CT and/or MR imaging (44%,n=4). Small lesions (less than 3 cm in any dimension) demonstrated an obvious facet origin in all cases by CT and/or MR imaging (56%,n=5). Low-to-intermediate signal intensity was seen in all cases on T2-weighted MR images resulting from hemosiderin deposition with ''blooming effect'' in one case with gradient echo MR images. PVNS of the spine is rare. Large lesions obscure the facet origin and simulate an aggressive intraosseous neoplasm. Patient age, a solitary noncystic lesion centered in the posterior elements, lack of mineralization and low-to-intermediate signal intensity on all MR pulse sequences may suggest the diagnosis in these cases. Small lesions demonstrate a facet origin on CT or MR imaging. This limits differential considerations to synovial-based lesions and additional features of a solitary focus, lack of underlying disease or systemic arthropathy, no calcification as well as low-to-intermediate signal intensity on all MR images should allow spinal PVNS to be suggested as the likely diagnosis. (orig.)

356

Villonodular synovitis (PVNS) of the spine  

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To describe the imaging features of spinal pigmented villonodular synovitis (PVNS). We retrospectively reviewed 15 cases of pathologically proven spinal PVNS. Patient demographics and clinical presentation were reviewed. Radiologic studies were evaluated by consensus of two musculoskeletal radiologists for spinal location, spinal segments affected, lesion center, detection of facet origin and intrinsic characteristics on radiography (n =11), myelography (n =7), CT (n =6) and MR imaging (n =6). Women (64%) were more commonly affected than men (36%) with an average age of 28 years. Clinical symptoms were pain (45%), neurologic (9%) or both (36%). Lesions most frequently affected the cervical spine (53%) followed by the thoracic (27%) and lumbar regions (20%). The majority of lesions (93%) were centered in the posterior elements with frequent involvement of the pedicle (67%), neural foramina (73%), lamina (67%) and facets (93%). No lesions showed calcification. Determination of a facet origin by imaging was dependent on imaging modality and lesion size. A facet origin could be determined in 45% of cases by radiography vs 67% of patients by CT (n=6) and MR (n=6). Large lesions (greater than 3 cm in at least one dimension) obscured the facet origin in all cases with CT and/or MR imaging (44%,n=4). Small lesions (less than 3 cm in any dimension) demonstrated an obvious facet origin in all cases by CT and/or MR imaging (56%,n=5). Low-to-intermediate signal intensity was seen in all cases on T2-weighted MR images resulting from hemosiderin deposition with ''blooming effect'' in one case with gradient echo MR images. PVNS of the spine is rare. Large lesions obscure the facet origin and simulate an aggressive intraosseous neoplasm. Patient age, a solitary noncystic lesion centered in the posterior elements, lack of mineralization and low-to-intermediate signal intensity on all MR pulse sequences may suggest the diagnosis in these cases. Small lesions demonstrate a facet origin on CT or MR imaging. This limits differential considerations to synovial-based lesions and additional features of a solitary focus, lack of underlying disease or systemic arthropathy, no calcification as well as low-to-intermediate signal intensity on all MR images should allow spinal PVNS to be suggested as the likely diagnosis. (orig.)

Motamedi, Kambiz [Armed Forces Institute of Pathology, Department of Radiologic Pathology, Washington, DC (United States); David Geffen School of Medicine at UCLA, Department of Radiology (Section of Musculoskeletal Radiology), 200 UCLA Medical Plaza, Suite 165-59, Los Angeles, CA (United States); Murphey, Mark D. [Armed Forces Institute of Pathology, Department of Radiologic Pathology, Washington, DC (United States); Uniformed Services University of Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD (United States); University of Maryland School of Medicine, Department of Radiology, Baltimore, MD (United States); Fetsch, John F.; Furlong, Mary A. [Armed Forces Institute of Pathology, Department of Soft Tissue Pathology, Washington, DC (United States); Vinh, Tinhoa N.; Sweet, Donald E. [Armed Forces Institute of Pathology, Department of Orthopedic Pathology, Washington, DC (United States); Laskin, William B. [Northwestern Memorial Hospital, Department of Surgical Pathology, Chicago, IL (United States)

2005-04-01

357

Stability of the human spine in neutral postures  

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The present study aimed to identify some of the mechanisms affecting spinal compressive load-bearing capacity in neutral postures. Two spinal geometries were employed in the evaluation of the stabilizing mechanisms of the spine in standing neutral postures. Large-displacement finite-element models were used for parametric studies of the effect of load distribution, initial geometry, and pelvic rotation on the compression stability of the spine. The role of muscles in stabilization of the spin...

Kiefer, A.; Parnianpour, M.; Shirazi-adl, A.

1997-01-01

358

Primary Dural Repair in Minimally Invasive Spine Surgery  

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We describe an effective surgical technique in primary repair of the spinal dura during minimally invasive spine surgery (MISS). Objective. Minimally invasive spine surgery includes the treatment of intradural lesions, and proper closure of the dura is necessary. However, primary dural closure can be difficult due to the restricted space of MIS retractors and the availability of appropriate surgical instrumentation. Methods. We describe the use of a needle already used in the pediatric neuros...

Haque, Raqeeb M.; Hashmi, Sohaib Z.; Omar Uddin; Ogden, Alfred T.

2013-01-01

359

Muscular contributions to dynamic dorsoventral lumbar spine stiffness  

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Spinal musculature plays a major role in spine stability, but its importance to spinal stiffness is poorly understood. We studied the effects of graded trunk muscle stimulation on the in vivo dynamic dorsoventral (DV) lumbar spine stiffness of 15 adolescent Merino sheep. Constant voltage supramaximal electrical stimulation was administered to the L3–L4 interspinous space of the multifidus muscles using four stimulation frequencies (2.5, 5, 10, and 20 Hz). Dynamic stiffness was quantified a...

Keller, Tony S.; Colloca, Christopher J.; Harrison, Deed E.; Moore, Robert J.; Gunzburg, Robert

2007-01-01

360

Chondrosarcoma of the spine: A rare case with unusual presentation  

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Full Text Available Abstract Chondrosarcoma is the third most common primary malignancy of bone, affecting primarily the pelvic and shoulder girdles and being extremely rare in the spine. Herein, we present a case of a 65-year-old woman with a rare chondrosarcoma of the spine, who presented with clinical symptoms from the lung metastasis. The neoplasm was grade II and exhibited overexpression of the p53 tumor suppressor protein. The latter has been associated with a high propensity for distant metastases.

Charalabopoulos Konstantinos

2006-10-01

 
 
 
 
361

The schizophrenia susceptibility gene dysbindin regulates dendritic spine dynamics.  

Science.gov (United States)

Dysbindin is a schizophrenia susceptibility gene required for the development of dendritic spines. The expression of dysbindin proteins is decreased in the brains of schizophrenia patients, and neurons in mice carrying a deletion in the dysbindin gene have fewer dendritic spines. Hence, dysbindin might contribute to the spine pathology of schizophrenia, which manifests as a decrease in the number of dendritic spines. The development of dendritic spines is a dynamic process involving formation, retraction, and transformation of dendritic protrusions. It has yet to be determined whether dysbindin regulates the dynamics of dendritic protrusions. Here we address this question using time-lapse imaging in hippocampal neurons. Our results show that dysbindin is required to stabilize dendritic protrusions. In dysbindin-null neurons, dendritic protrusions are hyperactive in formation, retraction, and conversion between different types of protrusions. We further show that CaMKII? is required for the stabilization of mushroom/thin spines, and that the hyperactivity of dendritic protrusions in dysbindin-null neurons is attributed in part to decreased CaMKII? activity resulting from increased inhibition of CaMKII? by Abi1. These findings elucidate the function of dysbindin in the dynamic morphogenesis of dendritic protrusions, and reveal the essential roles of dysbindin and CaMKII? in the stabilization of dendritic protrusions during neuronal development. PMID:25297099

Jia, Jie-Min; Hu, Zhonghua; Nordman, Jacob; Li, Zheng

2014-10-01

362

Spine fractures in falling accidents: analysis of multidetector CT findings  

International Nuclear Information System (INIS)

The purpose of the present study was to assess incidence, fracture type, and location of spine fractures due to falls. All emergency room CT requests during a time period of 26 months were reviewed retrospectively. Patients who had fallen or jumped and were initially examined with multidetector CT (MDCT) were included. The MDCT studies were evaluated by two radiologists for trauma location, fracture type, and multiple level involvement. A total of 237 patients (184 males, 53 female, age range 16-86 years, mean age 42 years) met the inclusion criteria. A total of 203 vertebral fractures were seen in 127 patients. Burst fracture (n=78) was the most frequent type of trauma, usually located in the thoracolumbar junction (50%). Also, compression fracture (n=52) was most common in the thoracolumbar junction (39%). Posterior column fracture (n=52) was most frequently detected in the cervical spine (40%). Multiple-level spine fractures were seen in 41 (32%) of the injured patients, of which 12 (29%) had fractures at noncontinuous levels. With increasing height the overall incidence of fractures increased, and burst fractures and multiple level spine fractures became more frequent. Age had no effect on fracture type or location. Spine fractures due to falls are common. Burst fracture is the most common fracture type and most frequently seen in the thoracolumbar junction. Multiple-level fractures were seen in 32% of the cases, of which 29% were seen at noncontinuous levels. Serious spine fractures are seen in all falling height and age groups. (orig.)

363

Rheumatoid arthritis: Radiological changes in the cervical spine  

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Objective was to describe the radiographic cervical spine changes in rheumatoid arthritis patients.Forty-nine patients (37 females and 12 males ) diagnosed with rheumatoid arthritis at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between June 1998 and December 2000, were studied for their radiographic cervical spine changes . Their mean age at disease onset was 41.4+ 13.4 years (range of 18-73)and mean duration of disease was 9.1+-6.28 years (range of 2-34). Their demographic data including rheumatoid factor status was obtained. Standard conventional radiographs cervical spine were obtained to study the cervical spine changes. Cervical radiographic changes were found in 34 patients (27 females and 7 males) 10 had subluxation (7 with atlanto-axial subluxation,2 with sub-axial subluxation,and one with lateral subluxation ). No vertical impaction was seen. Erosion of odontoid process was seen in one patient .All were rheumatoid seropositive Cervical spine changes in patients with rheumatoid arthritis are common, in particular subluxation in the upper cervical spine. Our study showed somewhat lesser prevalence of these changes. These were clinically correlated with disease duration, female sex, and rheumatoid factor, but were not clinically significant. (author)

364

History of spine surgery in older obese patients  

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Full Text Available Goal: To study the interaction of obesity and age in patients with multiple spine surgeries. Methods: Data on the body mass index (BMI of 956 patients were collected and classified into four groups: non-obese (BMI <30 kg/m2, obese-class I (BMI ?30 kg/m2, obese-class II (BMI ?35 kg/m2 and obese-class III (BMI ?40 kg/m2. Patients' age was categorized into the following age groups: ?40, 41–65 and ?66. T-test and Chi-square test were applied using SPSS v16. Results: In lumbar patients aged ?66 years with previous spine surgery, the average number of previous spine surgeries significantly increased with increasing obesity from 1.4 in nonobese patients to 1.7, 2.5 and 3.5 in obese class I, II and III patients.In lumbar decompression and fusion patients aged ?66 years with previous spine surgery, the average number of previous spine surgeries signifi-cantly increased with increasing obesity from 1.7 in nonobese patients to 1.6, 2.0 and 3.5 in obese class I, II and III patients. A similar trend was noted in lumbar microdiskectomy patients aged ?66 years but it was statistically nonsignificant due probably to small numbers. Conclusion: Obesity is associated with an increased number of previous spine surgeries in patients over 65 years of age undergoing lumbar surgery.

Zaytseva, Nadezhda

2011-01-01

365

Spine fractures in falling accidents: analysis of multidetector CT findings  

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The purpose of the present study was to assess incidence, fracture type, and location of spine fractures due to falls. All emergency room CT requests during a time period of 26 months were reviewed retrospectively. Patients who had fallen or jumped and were initially examined with multidetector CT (MDCT) were included. The MDCT studies were evaluated by two radiologists for trauma location, fracture type, and multiple level involvement. A total of 237 patients (184 males, 53 female, age range 16-86 years, mean age 42 years) met the inclusion criteria. A total of 203 vertebral fractures were seen in 127 patients. Burst fracture (n=78) was the most frequent type of trauma, usually located in the thoracolumbar junction (50%). Also, compression fracture (n=52) was most common in the thoracolumbar junction (39%). Posterior column fracture (n=52) was most frequently detected in the cervical spine (40%). Multiple-level spine fractures were seen in 41 (32%) of the injured patients, of which 12 (29%) had fractures at noncontinuous levels. With increasing height the overall incidence of fractures increased, and burst fractures and multiple level spine fractures became more frequent. Age had no effect on fracture type or location. Spine fractures due to falls are common. Burst fracture is the most common fracture type and most frequently seen in the thoracolumbar junction. Multiple-level fractures were seen in 32% of the cases, of which 29% were seen at noncontinuous levels. Serious spine fractures are seen in all falling height and age groups. (orig.)

Bensch, Frank V.; Kiuru, Martti J.; Koivikko, Mika P.; Koskinen, Seppo K. [Department of Radiology, Toeoeloe Trauma Center, Helsinki University Central Hospital, Topeliuksenkatu 5, 00029, Helsinki (Finland)

2004-04-01

366

Spine Stereotactic Body Radiotherapy Utilizing Cone-Beam CT Image-Guidance With a Robotic Couch: Intrafraction Motion Analysis Accounting for all Six Degrees of Freedom  

International Nuclear Information System (INIS)

Purpose: To evaluate the residual setup error and intrafraction motion following kilovoltage cone-beam CT (CBCT) image guidance, for immobilized spine stereotactic body radiotherapy (SBRT) patients, with positioning corrected for in all six degrees of freedom. Methods and Materials: Analysis is based on 42 consecutive patients (48 thoracic and/or lumbar metastases) treated with a total of 106 fractions and 307 image registrations. Following initial setup, a CBCT was acquired for patient alignment and a pretreatment CBCT taken to verify shifts and determine the residual setup error, followed by a midtreatment and posttreatment CBCT image. For 13 single-fraction SBRT patients, two midtreatment CBCT images were obtained. Initially, a 1.5-mm and 1° tolerance was used to reposition the patient following couch shifts which was subsequently reduced to 1 mm and 1° degree after the first 10 patients. Results: Small positioning errors after the initial CBCT setup were observed, with 90% occurring within 1 mm and 97% within 1°. In analyzing the impact of the time interval for verification imaging (10 ± 3 min) and subsequent image acquisitions (17 ± 4 min), the residual setup error was not significantly different (p > 0.05). A significant difference (p = 0.04) in the average three-dimensional intrafraction positional deviations favoring a more strict tolerance in translation (1 mm vs. 1.5 mm) was observed. The absolute intrafraction motion averaged over all patients and all n averaged over all patients and all directions along x, y, and z axis (± SD) were 0.7 ± 0.5 mm and 0.5 ± 0.4 mm for the 1.5 mm and 1 mm tolerance, respectively. Based on a 1-mm and 1° correction threshold, the target was localized to within 1.2 mm and 0.9° with 95% confidence. Conclusion: Near-rigid body immobilization, intrafraction CBCT imaging approximately every 15–20 min, and strict repositioning thresholds in six degrees of freedom yields minimal intrafraction motion allowing for safe spine SBRT delivery.

367

[Evaluation and optimization of an image-subtraction method for the analysis of the repositioning accuracy of female patients with breast cancer].  

Science.gov (United States)

To analyze the repositioning accuracy in female patients with breast carcinoma, two different setups of an image-subtraction system (Positioning System FIVE) were devised using different numbers and alignments of lasers. The applicability of the system was tested for repositioning of the breast in normal volunteers. Horizontal translations as well as breathing-related movements in the vertical direction were measured. The mean repositioning accuracy was found to be 2.9 mm for the first setup and 1.5 mm for a second, optimized setup. For this second setup, a gating function was implemented which evaluates the position of the breast twelve times per second. The simulation of a gated treatment showed that the breathing-related displacement of the breast can be reduced to 45-70% of the displacement without gating. This implies a significant improvement of the positioning accuracy. PMID:16171041

Hub, Martina; Liebler, Thorsten; Sanner, Christian; Barthold-Bess, Simone; Schlegel, Wolfgang; Lübbert, Ulrich

2005-01-01

368

Evaluation and optimization of an image-subtraction method for the analysis of the repositioning accuracy of female patients with breast cancer  

International Nuclear Information System (INIS)

To analyze the repositioning accuracy in female patients with breast carcinoma, two different setups of an image-subtraction system (Positioning System FIVE) were devised using different numbers and alignments of lasers. The applicability of the system was tested for repositioning of the breast in normal volunteers. Horizontal translations as well as breathing-related movements in the vertical direction were measured. The mean repositioning accuracy was found to be 2.9 mm for the first setup and 1.5 mm for a second, optimized setup. For this second setup, a gating function was implemented which evaluates the position of the breast twelve times per second. The simulation of a gated treatment showed that the breathing-related displacement of the breast can be reduced to 45-70% of the displacement without gating. This implies a significant improvement of the positioning accuracy. (orig.)

369

Dosimetric implications of changes in patient repositioning and organ motion in conformal radiotherapy for prostate cancer  

International Nuclear Information System (INIS)

Purpose: To assess the influence of patient repositioning and organ motion on dose distribution within the prostate and the seminal vesicles (clinical target volume, (CTV)). Material and methods: Nine patients were simulated and treated in the supine position, with an empty bladder, and without immobilization devices. While on treatment, patients underwent weekly pelvic computed tomography (CT) scans under conditions identical to those at simulation. Patients were aligned using lasers on anterior and lateral skin tattoos, onto which lead markers were placed. After each CT scan (n=53) the CTV was redefined by contouring, and a new isocenter was obtained. A six-field technique was used. The field margins around the CTV were 20 mm in the cranio-caudal axis, and 13 mm in the other axes, except in the lateral fields where a 10 mm posterior margin was used. Dose-volume histograms (DVHs) for each organ were compared with those determined at simulation, using the notion of the proportional change in the area under the CTV-DVH curve resulting from a change in treatment plan (cDVH). Results: The reproducibility of the dose distribution was good for the prostate (%cDVH, mean±SD: -0.97±2.11%) and less than optimal for the seminal vesicles (%cDVH, mean±SD: -4.66±10.45%). When correlating prostate %cDVH variations with displacements of the isocenter in the Y axis (antero-posterior) the %cDVH exceeded (-)5% in only two dosimetries, both with an isocenter shift of >10 mm. For the seminal vesicles, however, ten out of 53 dosimetries showed a %cDVH exceeding (-) 5%. In nine of these ten dose distribution studies the posterior shift of the isocenter exceeded 8 mm. Conclusions: Precise targeting of prostate radiotherapy is primarily dependent on careful daily set-up and on random changes in rectal geometry. Margins no less than 10 mm around the prostate and at least 15 mm around the seminal vesicles are probably necessary to insure adequate target coverage with a six-field technique

370

Adjacent segment disease after cervical spine fusion.  

Science.gov (United States)

Anterior cervical diskectomy and fusion is one of the most common cervical spine procedures. Although it is usually successful in relieving the symptoms of radiculopathy and myelopathy, the subsequent development of clinically significant disk disease at levels adjacent to the fusion is a matter of concern. Adjacent segment cervical disease occurs in approximately 3% of patients; the incidence is expected to increase to more than 25% of patients within the first 10 years after the index fusion procedure. The disease is well described in the literature, and significant basic science and clinical research has been conducted. Nonetheless, the cause of the disease is a matter of debate. A combination of factors probably contributes to its development, including the increased biomechanical stress placed on the disk space adjacent to a fusion and the natural history of cervical spondylosis in patients known to have such pathology. Clinical and biomechanical data are available to support each of these claims. Symptomatic disk disease adjacent to a cervical fusion is a significant clinical problem, and, therefore, motion-sparing technology has been developed to reduce its incidence. Two cervical disk replacement systems are currently approved by the US Food and Drug Administration for the treatment of symptomatic cervical spondylosis. PMID:19385583

Rihn, Jeffrey A; Lawrence, James; Gates, Charley; Harris, Eric; Hilibrand, Alan S

2009-01-01

371

Incidence of venous thromboembolism after spine surgery  

International Nuclear Information System (INIS)

g/mL were followed up. The incidence of symptomatic PE was significantly higher in Group A than in Group B (8/541, 1.5% vs. 3/1,434, 0.2%). In 3 patients in Group B, PE developed within 1 week postoperatively and D-dimer values at onset were ?10 ?g/mL. In the 100 cases examined by contrast-enhanced computed tomography (CT), asymptomatic PE and VTE were detected in 18 and 19%, respectively. The D-dimer level 1 week after surgery was ?10 ?g/mL in 105 of 841 patients; however, none of these patients had clinically symptomatic VTE for at least 3 months postoperatively. Mechanical prophylaxis and early ambulation may be effective in reducing the incidence of symptomatic PE after spine surgery. Asymptomatic PE developed in 18% of patients who received mechanical prophylaxis, but the incidence of symptomatic PE was only 0.2%. Prompt diagnosis and treatment are required for patients who develop symptomatic PE. (author)

372

Instrumentation of the paediatric cervical spine  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english BACKGROUND: Paediatric cervical fusion surgery is challenging. Traditional techniques such as external stabilisation, onlay fusions and wiring techniques resulted in unsatisfactory outcomes due to inferior biomechanical stability. METHODS: A retrospective review was performed of paediatric patients [...] who underwent instrumented cervical fusion surgery under 16 years of age. Fusion rates, blood loss, levels fused, theatre time, technique and complications were assessed. RESULTS: An average of 2.5 levels was fused, with an estimated blood loss of 428 ml and surgical duration of 159 min. Anterior procedures had an average of one level fused with blood loss of 117 ml and surgical duration of 98 min. Posterior procedures had an average number of 1.9 levels fused, blood loss of 306 ml and surgical time of 131 min. Combined procedures had an average of 5.5 levels fused, blood loss 810 ml and surgical duration of 241 min. Four surgery-related complications were encountered. These consisted of dural leaks and wound sepsis which were all treated effectively. All patients achieved radiological fusion. CONCLUSION: The use of modern segmental spinal instrumentation in the paediatric cervical spine is a viable option. Although the study sample was small we are able to demonstrate that no major surgical complications were encountered due to the use of adult cervical spinal instrumentation techniques in the paediatric group.

RN, Dunn; AH, Botha.

2014-01-01

373

Repair of the spondylolysis in lumbar spine  

International Nuclear Information System (INIS)

The objective is to present the surgical experience in the repair of the spondylolysis in lumbar spine. Background: Spodylolysis is an important cause of low back pain in young adults and is responsible for high grade of incapacity. Classically, patients with surgical indications with Spondylolysis have been treated with vertebral arthrodesis arthrodesis, with the following functional lost of the intervened segment and biomechanical overload of the upper contiguous segment. There are not previous reports about repairing of lysis in national literature and international references in this technique are scarce. Materials and methods: Eight patients within 2002-2004 were operated, a direct repairing of the lyses by in situ, fusion and interfragmental osteosynthesis with AO 3.5 mm titanium cortical screws with autogenous bone grafts was achieved. The casuistic was analyzed depending on clinical presentation, consolidation, mobility and vitality of the disc in imaginology studies. Results: During the follow-up a firm fusion in all cases, mobility and vitality preservation of the L5-S1 intervertebral disc was detected. There was neither infection nor neurological deficit. Recommendations: Repairing of spondylolysis in lumbar column, in young symptomatic patients without or with mild lystesis (grade I) and without associated disc damage, is a safe surgical technique

374

A repositioning technique for counting induced fission tracks in muscovite external detectors in single-grain dating of minerals with low and inhomogeneous uranium concentrations  

International Nuclear Information System (INIS)

In fission-track dating with the external detector method, an exact match between the grain area scanned for fossil tracks and the area of the external detector scanned for induced tracks is often difficult to achieve. In the simple repositioning-technique proposed here, the muscovite external detector is repositioned track-side down on the grain mount after etching the induced tracks. The fossil tracks are counted by focussing on the grain surface through the external detector. The positioning precision allows track to track matching, and is useful for methodical research and dating of low-uranium and sediment samples, containing a mixture of high- and low-uranium grains

375

A cost-outcome analysis of Image-Guided Patient Repositioning in the radiation treatment of cancer of the prostate  

International Nuclear Information System (INIS)

Background and purpose: With Image-Guided Radiation Therapy (IGRT) rapidly gaining acceptance in the clinic it is timely to commence an assessment of its potential outcome benefit versus costs. Materials and methods: Using Activity-Based Costing we have calculated the incremental cost of adding Image-Guided Patient Repositioning (IGPR), a significant component of IGRT, to both Intensity-Modulated Radiation Therapy (IMRT) and Three-Dimensional Conformal Radiation Therapy (3DCRT) for prostate cancer. The dosimetric outcome benefit resulting from the implementation of IGPR is estimated from a publication describing the improvement in set-up accuracy using each of four correction protocols. In our study outcome is quantified using a metric based on the Equivalent Uniform Dose. Our discussion is limited to image-guided corrective translations of the patient and does not specifically address margin reduction, rotations, organ deformation or major equipment failure modes, all of which are significant additional justifications for implementing an IGRT program. Results: Image guidance used solely for translational patient repositioning for prostate cancer adds costs with relatively little improvement in dosimetric quality. Full exploitation of the potential of IGRT, particularly through margin reduction, can be expected to result in a reduction in the cost-outcome ratios reported here. Conclusions: IMRT benefits more than 3DCRT from IGPR with the Weekly Shrinking Action Level PR with the Weekly Shrinking Action Level approach yielding the lowest cost-outcome ratio.

376

Repositioning of Barcelona’s Image in the Light of a Redefinition of the Urban Tourism Planning Model  

Directory of Open Access Journals (Sweden)

Full Text Available Barcelona’s city tourism model over the last fifteen years has chalked up many successes in terms of soaring tourist numbers, overnight stays, cruise liner passengers, hotel beds and visits to priced sights. Growth in city breaks has soared to the point where Barcelona has become one of Europe’s most visited cities. But this growth has come at a heavy price: mass tourism, concentration in certain neighbourhoods, competition for space between tourists and residents, lack of adequate inter-modal transport. All of these problems threaten Barcelona’s competitive position. The paper reviews the city’s competitiveness, comparing Barcelona to ten other European cities. Starting out from a qualitative analysis of internal players and a Delphi Study with external players, we find thecity’s tourism model needs correcting. We also identify the vectors and most important factors for achieving this repositioning. The vectors reinforce the competitiveness concerning the model’s sustainability, integrated management and governance, and client orientation. The proposed strategic repositioning will allow Barcelona to continue competing with Europe’s main cities.

Josep-Francesc Valls

2013-01-01

377

Structural dynamics of dendritic spines: molecular composition, geometry and functional regulation.  

Science.gov (United States)

The development of dendritic spines with specific geometry and membrane composition is critical for proper synaptic function. Specific spine membrane architecture, sub-spine microdomains and spine head and neck geometry allow for well-coordinated and compartmentalized signaling, disruption of which could lead to various neurological diseases. Research from neuronal cell culture, brain slices and direct in vivo imaging indicates that dendritic spine development is a dynamic process which includes transition from small dendritic filopodia through a series of structural refinements to elaborate spines of various morphologies. Despite intensive research, the precise coordination of this morphological transition, the changes in molecular composition, and the relation of spines of various morphologies to function remain a central enigma in the development of functional neuronal circuits. Here, we review research so far and aim to provide insight into the key events that drive structural change during transition from immature filopodia to fully functional spines and the relevance of spine geometry to function. PMID:24915021

Ebrahimi, Saman; Okabe, Shigeo

2014-10-01

378

To Sense or Not To Sense  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A longer sensing time improves the sensing performance; however, with a fixed frame size, the longer sensing time will reduce the allowable data transmission time of the secondary user (SU). In this paper, we try to address the tradeoff between sensing the primary channel for $\\tau$ seconds of the time slot proceeded by randomly accessing it and randomly accessing primary channel without sensing to avoid wasting $\\tau$ seconds in sensing. The SU senses primary channel to exp...

Shafie, Ahmed El

2012-01-01

379

Vertebral position alters paraspinal muscle spindle responsiveness in the feline spine: effect of positioning duration.  

Science.gov (United States)

Proprioceptive information from paraspinal tissues including muscle contributes to neuromuscular control of the vertebral column. We investigated whether the history of a vertebra's position can affect signalling from paraspinal muscle spindles. Single unit recordings were obtained from muscle spindle afferents in the L6 dorsal roots of 30 Nembutal-anaesthetized cats. Each afferent's receptive field was in the intact muscles of the low back. The L6 vertebra was controlled using a displacement-controlled feedback motor and was held in each of three different conditioning positions for durations of 0, 2, 4, 6 and 8 s. Conditioning positions (1.0-2.2 mm dorsal and ventral relative to an intermediate position) were based upon the displacement that loaded the L6 vertebra to 50-60% of the cat's body weight. Following conditioning positions that stretched (hold-long) and shortened (hold-short) the spindle, the vertebra was repositioned identically and muscle spindle discharge at rest and to movement was compared with conditioning at the intermediate position. Hold-short conditioning augmented mean resting spindle discharge by +4.1 to +6.2 impulses s(-1); however, the duration of hold-short did not significantly affect this increase (F(4,145) = 0.49, P = 0.74). The increase was maintained at the beginning of vertebral movement but quickly returned to baseline. Conversely, hold-long conditioning significantly diminished mean resting spindle discharge by -2.0 to -16.1 impulses s(-1) (F(4,145) = 11.23, P positioning history were fully developed within 2 s of conditioning. In addition, 2 s or greater of hold-long conditioning significantly diminished spindle discharge to vertebral movement by -5.7 to -10.0 impulses s(-1) (F(4,145) = 11.0, P positioning history may be a mechanism whereby spinal biomechanics interacts with the spine's proprioceptive system to produce acute effects on neuromuscular control of the vertebral column. PMID:16210357

Ge, Weiqing; Long, Cynthia R; Pickar, Joel G

2005-12-01

380

Comparison of Three Prehospital Cervical Spine Protocols for Missed Injuries  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: We wanted to compare 3 existing emergency medical services (EMS immobilization protocols: the Prehospital Trauma Life Support (PHTLS, mechanism-based; the Domeier protocol (parallels the National Emergency X-Radiography Utilization Study [NEXUS] criteria; and the Hankins’ criteria (immobilization for patients 65 years, those with altered consciousness, focal neurologic deficit, distracting injury, or midline or paraspinal tenderness.To determine the proportion of patients who would require cervical immobilization per protocol and the number of missed cervical spine injuries, had each protocol been followed with 100% compliance. Methods: This was a cross-sectional study of patients ?18 years transported by EMS post-traumatic mechanism to an inner city emergency department. Demographic and clinical/historical data obtained by physicians were recorded prior to radiologic imaging. Medical record review ascertained cervical spine injuries. Both physicians and EMS were blinded to the objective of the study. Results: Of 498 participants, 58% were male and mean age was 48 years. The following participants would have required cervical spine immobilization based on the respective protocol: PHTLS, 95.4% (95% CI: 93.1-96.9%; Domeier, 68.7% (95% CI: 64.5-72.6%; Hankins, 81.5% (95% CI: 77.9-84.7%. There were 18 cervical spine injuries: 12 vertebral fractures, 2 subluxations/dislocations and 4 spinal cord injuries. Compliance with each of the 3 protocols would have led to appropriate cervical spine immobilization of all injured patients. In practice, 2 injuries were missed when the PHTLS criteria were mis-applied. Conclusion: Although physician-determined presence of cervical spine immobilization criteria cannot be generalized to the findings obtained by EMS personnel, our findings suggest that the mechanism-based PHTLS criteria may result in unnecessary cervical spine immobilization without apparent benefit to injured patients. PHTLS criteria may also be more difficult to implement due to the subjective interpretation of the severity of the mechanism, leading to non-compliance and missed injury.

Rick Hong

2014-07-01

 
 
 
 
381

Outpatient surgery in the cervical spine: is it safe?  

Science.gov (United States)

Study Design?Systematic review. Study Rationale?As the length of stay after cervical spine surgery has decreased substantially, the feasibility and safety of outpatient cervical spine surgery come into question. Although minimal length of stay is a targeted metric for quality and costs for medical centers, the safety of outpatient cervical spine surgery has not been clearly defined. Objective?The objective of this article is to evaluate the safety of inpatient versus outpatient surgery in the cervical spine for adult patients with symptomatic or asymptomatic degenerative disc disease. Methods?A systematic review of the literature was undertaken for articles published through February 19, 2014. Electronic databases and the bibliographies of key articles were searched to identify comparative studies evaluating the safety of inpatient versus outpatient surgery in the cervical spine. Spinal cord stimulation, spinal injections, and diagnostic procedures were excluded. Two independent reviewers assessed the strength of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, and disagreements were resolved by consensus. Results?Five studies that met the inclusion criteria were identified. One study reported low risk of hematoma (0% of outpatients and 1.6% of inpatients). Two studies reported on mortality and both reported no deaths in either group following surgery. Dysphagia risks ranged from 0 to 10% of outpatients and 1.6 to 5% of inpatients, and infection risks ranged from 0 to 1% of outpatients and 2 to 2.8% of inpatients. One study reported that no (0) outpatients were readmitted to the hospital due to a complication, compared with four inpatients (7%). The overall strength of evidence was insufficient for all safety outcomes examined. Conclusion?Though the studies in our systematic review did not suggest an increased risk of complication with outpatient cervical spine surgery, the strength of evidence to make a recommendation was insufficient. Further study is needed to more clearly define the role of outpatient cervical spine surgery. PMID:25278884

Lee, Michael J; Kalfas, Iain; Holmer, Haley; Skelly, Andrea

2014-10-01

382

Stereotactic radiosurgery for metastatic spine tumors.  

Science.gov (United States)

Spinal metastases invariably affect the majority of patients with cancer. Many will develop symptoms related to pain and disability from epidural spinal cord compression as well as pathologic fracture of the vertebrae. With the emergence of targeted systemic therapies and a better understanding of cancer biology, patients are living longer with bony metastases. This poses particular challenges, as palliation of pain and maintenance of local tumor control are paramount to quality of life and overall functional independence for these patients. Stereotactic radiosurgery (SRS) has emerged as a potent primary standalone and adjuvant treatment option for spinal metastases. To date, the primary indications for SRS include 1) upfront standalone treatment for painful bony metastases in the oligometastatic patient, 2) standalone or post-operative treatment following progression or recurrence of local disease despite previous conventional external beam radiation therapy (cEBRT), and 3) following surgery during which epidural disease is decompressed and the spine stabilized when indicated. SRS has demonstrated a significant advantage over cEBRT for tumors traditionally regarded as relatively radioresistant such as sarcoma, melanoma, renal cell carcinoma, non-small cell lung cancer and colon carcinoma.9 The radiobiological advantage of increased tumoricidal dose delivery and spinal cord dose sparing in SRS have made this a powerful treatment alternative to cEBRT particularly within the context of re-irradiation. Given the limitations of spinal cord dose constraints, surgery is still the first-line therapy in patients with high-grade epidural spinal cord compression (ESCC). Epidural compression can be treated with SRS, however this risks radiation-induced myelopathy and challenges the safety of effective dose delivery at the dural margin.11 With increasing dose, radiation-induced vertebral fracture is the most serious and prevalent side effect of SRS.53 An overview of SRS, including the most common indications, complications, and outcomes for spinal metastases are presented here. PMID:24614791

Chan, N K; Abdullah, K G; Lubelski, D; Steinmetz, M P; Benzel, E C; Shin, J H; Mroz, T E

2014-03-01

383

Intra- and interday reliability of spine rasterstereography.  

Science.gov (United States)

To determine intra- and interday reliability of spine rasterstereographic system Formetric 4D with and without reflective markers. Twenty-six healthy volunteers (M group) had two markers placed in correspondence of vertebra prominens and intergluteal cleft, and 24 volunteers (NM group) were assessed without markers. All participants were analyzed two times in the same day and one time on a separate day. Trunk length, kyphotic angle, lordotic angle, pelvic inclination, kyphotic and lordotic apex, right and left lateral deviation, flèche cervicale and lombaire, trunk imbalance, pelvic tilt, inflection point, rotation correction, right and left surface rotation, pelvic torsion, and trunk torsion were measured. Intraclass correlation coefficient (ICC) and Cronbach Alpha (C ? ) were calculated. In M group, for intra-, interday, and overall evaluations, the higher reliability coefficients were 0.971, 0.963, and 0.958 (ICC) and 0.987, 0.983, and 0.985 (C ? ) for trunk length, kyphotic angle, and lordotic apex, respectively; while in NM group, they were 0.978, 0.982, and 0.972 and 0.989, 0.991, and 0.991 for trunk length. In M group, the lower values were 0.598, 0.515, and 0.534 (ICC) and 0.742, 0.682, and 0.784 (C ? ) for trunk and pelvic torsion and in NM group 0.561, 0.537, and 0.461 and 0.731, 0.695, and 0.729 for left lateral deviation. The reliability of most parameters was excellent. PMID:23819119

Guidetti, Laura; Bonavolontà, Valerio; Tito, Alessandro; Reis, Victor M; Gallotta, Maria Chiara; Baldari, Carlo

2013-01-01

384

Camptocormia: the bent spine syndrome, an update.  

Science.gov (United States)

Camptocormia, also referred to as bent spine syndrome (BSS) is defined as an abnormal flexion of the trunk, appearing in standing position, increasing during walking and abating in supine position. BSS was initially considered, especially in wartime, as a psychogenic disorder. It is now recognized that in addition to psychiatric syndromes, many cases of reducible BSS have a somatic origin related to a number of musculo-skeletal or neurological disorders. The majority of BSS of muscular origin is related to a primary idiopathic axial myopathy of late onset, appearing progressively in elderly patients. Diagnosis of axial myopathy first described by Laroche et al. is based upon CT/MRI examination demonstrating massive fatty infiltration of paravertebral muscles. The non-specific histological aspect includes an extensive endomysial fibrosis and fat tissue with irregular degenerated fibers. Weakness of the paravertebral muscles can be secondary to a wide variety of diseases generating diffuse pathologic changes in the muscular tissue. BSS can be the predominant and sometimes revealing symptom of a more generalized muscular disorder. Causes of secondary BSS are numerous. They must be carefully assessed and ruled out before considering the diagnosis of primary axial myopathy. The principal etiologies include on the one hand inflammatory myopathies, muscular dystrophies of late onset, myotonic myopathies, endocrine and metabolic myopathies, and on the other hand neurological disorders, principally Parkinson's disease. Camptocormia in Parkinsonism is caused by axial dystonia, which is the hallmark of Parkinson's disease. There is no specific pharmacologic treatment for primary axial myopathy. General activity, walking with a cane, physiotherapy, and exercises should be encouraged. Treatment of secondary forms of BSS is dependent upon the variety of the disorder generating the muscular pathology. Pharmacologic and general management of camptocormia in Parkinson's disease merge with that of Parkinsonism. Levodopa treatment, usually active on tumor rigidity and akinesia, has poor or negative effect on BSS. PMID:20300781

Lenoir, Thibaut; Guedj, Nathalie; Boulu, Philippe; Guigui, Pierre; Benoist, Michel

2010-08-01

385

Camptocormia: the bent spine syndrome, an update  

Science.gov (United States)

Camptocormia, also referred to as bent spine syndrome (BSS) is defined as an abnormal flexion of the trunk, appearing in standing position, increasing during walking and abating in supine position. BSS was initially considered, especially in wartime, as a psychogenic disorder. It is now recognized that in addition to psychiatric syndromes, many cases of reducible BSS have a somatic origin related to a number of musculo-skeletal or neurological disorders. The majority of BSS of muscular origin is related to a primary idiopathic axial myopathy of late onset, appearing progressively in elderly patients. Diagnosis of axial myopathy first described by Laroche et al. is based upon CT/MRI examination demonstrating massive fatty infiltration of paravertebral muscles. The non-specific histological aspect includes an extensive endomysial fibrosis and fat tissue with irregular degenerated fibers. Weakness of the paravertebral muscles can be secondary to a wide variety of diseases generating diffuse pathologic changes in the muscular tissue. BSS can be the predominant and sometimes revealing symptom of a more generalized muscular disorder. Causes of secondary BSS are numerous. They must be carefully assessed and ruled out before considering the diagnosis of primary axial myopathy. The principal etiologies include on the one hand inflammatory myopathies, muscular dystrophies of late onset, myotonic myopathies, endocrine and metabolic myopathies, and on the other hand neurological disorders, principally Parkinson’s disease. Camptocormia in Parkinsonism is caused by axial dystonia, which is the hallmark of Parkinson’s disease. There is no specific pharmacologic treatment for primary axial myopathy. General activity, walking with a cane, physiotherapy, and exercises should be encouraged. Treatment of secondary forms of BSS is dependent upon the variety of the disorder generating the muscular pathology. Pharmacologic and general management of camptocormia in Parkinson’s disease merge with that of Parkinsonism. Levodopa treatment, usually active on tumor rigidity and akinesia, has poor or negative effect on BSS. PMID:20300781

Lenoir, Thibaut; Boulu, Philippe; Guigui, Pierre; Benoist, Michel

2010-01-01

386

Diagnostic value of high resolutional computed tomography of spine  

International Nuclear Information System (INIS)

Non-enhanced high resolution computed tomography provide clear visualization of soft tissue in the canal and bony details of spine, particularly of the lumbar spine. We observed 70 cases of spine CT using GE CT/T 8800 scanner during the period from Dec. 1982 to Sep. 1983 at Jeonbug National University Hospital. The results were as follows: 1. The sex distribution of cases were 55 males and 15 females : age was from 17 years to 67 years; sites were 11 cervical spine, 5 thoracic spine and 54 lumbosacral spine. 2. CT diagnosis showed 44 cases of lumbar disc herniation, 7 cases of degenerative disease, 3 cases of spine fracture and each 1 cases of cord tumor, metastatic tumor, spontaneous epidural hemorrhage, epidural abscess, spine tbc., meningocele with diastematomyelia. 3. Sites of herniated nucleus pulposus were 34 cases (59.6%) between L4-5 interspace and 20 cases (35.1%) between L5-S1 interspace. 13 cases (29.5%) of lumbar disc herniation disclosed multiple lesions. Location of herniation were central type in 28 cases(49.1%), right-central type in 12 cases(21.2%), left-central type in 11 cases (19.2%) and far lateral type in 6 cases(10.5%). 4. CT findings of herniated nucleus pulposus were as follows : focal protrusion of posterior disc margin and obliteration of anterior epidural fat in all cases, dural sac indentation in 26 cases(45.6%), soft tissue mass in epidural fat in 21 cases(36.8%), displacement or compression of nerve root sheath in 12 cases(21%). 5. Multiplanar reformatted images and Blink mode provide more effective evaluation about definite level and longitudinal dimension of lesion, such as obscure disc herniation, spine fracture, cord tumor and epidural abscess. 6. Non-enhanced and enhanced high resolutional computed tomography were effectively useful in demonstrating compression or displacement of spinal cord and nerve root, examing congenital anomaly such as meningocele and primary or metastatic spinal lesions

387

Comparison of online IGRT techniques for prostate IMRT treatment: Adaptive vs repositioning correction  

International Nuclear Information System (INIS)

This study compares three online image guidance techniques (IGRT) for prostate IMRT treatment: bony-anatomy matching, soft-tissue matching, and online replanning. Six prostate IMRT patients were studied. Five daily CBCT scans from the first week were acquired for each patient to provide representative ''snapshots'' of anatomical variations during the course of treatment. Initial IMRT plans were designed for each patient with seven coplanar 15 MV beams on a Eclipse treatment planning system. Two plans were created, one with a PTV margin of 10 mm and another with a 5 mm PTV margin. Based on these plans, the delivered dose distributions to each CBCT anatomy was evaluated to compare bony-anatomy matching, soft-tissue matching, and online replanning. Matching based on bony anatomy was evaluated using the 10 mm PTV margin (''bone10''). Soft-tissue matching was evaluated using both the 10 mm (''soft10'') and 5 mm (''soft5'') PTV margins. Online reoptimization was evaluated using the 5 mm PTV margin (''adapt''). The replanning process utilized the original dose distribution as the basis and linear goal programming techniques for reoptimization. The reoptimized plans were finished in less than 2 min for all cases. Using each IGRT technique, the delivered dose distribution was evaluated on all 30 CBCT scans (6 patientsx5CBCT/patient). The mean minimum dose (in percentage of prescription dose) to the CTV over five treatment fractions were in the ranges of 99%-100%(SD=0.1%-0.8%), 65%-98%(SD=0.4%-19.5%), 87%-99%(SD=0.7%-23.3%), and 95%-99%(SD=0.4%-10.4%) for the adapt, bone10, soft5, and soft10 techniques, respectively. Compared to patient position correction techniques, the online reoptimization technique also showed improvement in OAR sparing when organ motion/deformations were large. For bladder, the adapt technique had the best (minimum) D90, D50, and D30 values for 24, 17, and 15 fractions out of 30 total fractions, while it also had the best D90, D50, and D30 values for the rectum for 25, 16, and 19 fractions, respectively. For cases where the adapt plans did not score the best for OAR sparing, the gains of the OAR sparing in the repositioning-based plans were accompanied by an underdosage in the target volume. To further evaluate the fast online replanning technique, a gold-standard plan (''new'' plan) was generated for each CBCT anatomy on the Eclipse treatment planning system. The OAR sparing from the online replanning technique was compared to the new plan. The differences in D90, D50, and D30 of the OARs between the adapt and the new plans were less than 5% in 3 patients and were between 5% and 10% for the remaining three. In summary, all IGRT techniques could be sufficient to correct simple geometrical variations. However, when a high degree of deformation or differential organ position displacement occurs, the online reoptimization technique is feasible with less than 2 min optimization time and provides improvements in both CTV coverage and OAR sparing over the position correction techniques. For these cases, the reoptimization technique can be a highly valuable online IGRT tool to correct daily treatment uncertainties, especially when hypofractionation scheme is applied and daily correction, rather than averaging over many fractions, is required to match the original plan.

388

Remote Sensing  

Science.gov (United States)

Collection of seven classroom activities that focus on mapping and navigation. Topics include: sensory remote sensing; maps and globes; coded signals; satellite imagery resolution; color imagery; visible and infrared imagery; sea turtle tracking; and locating the Titanic. Each activity provides list of materials needed, background information, and procedure.

389

Making Sense  

Science.gov (United States)

In this article, the author provides a self-portrait of his intellectual life. He states that overall his approach to teaching and researching is about "making sense" where inadequate or incongruous conceptions fall into place or are transformed so they are congruous and adequate. In his teaching the author applies the methods of philosophy to…

Golding, Clinton

2009-01-01

390

Stability of the human spine in neutral postures.  

Science.gov (United States)

The present study aimed to identify some of the mechanisms affecting spinal compressive load-bearing capacity in neutral postures. Two spinal geometries were employed in the evaluation of the stabilizing mechanisms of the spine in standing neutral postures. Large-displacement finite-element models were used for parametric studies of the effect of load distribution, initial geometry, and pelvic rotation on the compression stability of the spine. The role of muscles in stabilization of the spine was also investigated using a unique muscle model based on kinematic conditions. The model with a realistic load configuration supported the largest compression load. The compressive load-bearing capacity of the passive thoracolumbar spine was found to be significantly enhanced by pelvic rotation and minimal muscular forces. Pelvic rotation and muscle forces were sensitive to the initial positioning of T1 and the spinal curvatures. To sustain the physiological gravity load, the lordotic angle increased as observed in standing postures. These predictions are in good agreement with in vitro and in vivo observations. The load-bearing potential of the ligamentous spine in compression is substantially increased by controlling its deformation modes through minimal exertion of selected muscles and rotation of the pelvis. PMID:9093827

Kiefer, A; Shirazi-Adl, A; Parnianpour, M

1997-01-01

391

Musical representation of dendritic spine distribution: a new exploratory tool.  

Science.gov (United States)

Dendritic spines are small protrusions along the dendrites of many types of neurons in the central nervous system and represent the major target of excitatory synapses. For this reason, numerous anatomical, physiological and computational studies have focused on these structures. In the cerebral cortex the most abundant and characteristic neuronal type are pyramidal cells (about 85 % of all neurons) and their dendritic spines are the main postsynaptic target of excitatory glutamatergic synapses. Thus, our understanding of the synaptic organization of the cerebral cortex largely depends on the knowledge regarding synaptic inputs to dendritic spines of pyramidal cells. Much of the structural data on dendritic spines produced by modern neuroscience involves the quantitative analysis of image stacks from light and electron microscopy, using standard statistical and mathematical tools and software developed to this end. Here, we present a new method with musical feedback for exploring dendritic spine morphology and distribution patterns in pyramidal neurons. We demonstrate that audio analysis of spiny dendrites with apparently similar morphology may "sound" quite different, revealing anatomical substrates that are not apparent from simple visual inspection. These morphological/music translations may serve as a guide for further mathematical analysis of the design of the pyramidal neurons and of spiny dendrites in general. PMID:24395057

Toharia, Pablo; Morales, Juan; de Juan, Octavio; Fernaud, Isabel; Rodríguez, Angel; DeFelipe, Javier

2014-04-01

392

Prevention of spine deforimities in adoloscents due to inaduquate posture  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. The spine deformities tend to increase, and in 90% of children they change the quality of life. The aim of this study was to determine the percents of spinal deformity in our population of adolescents, and long bad posture in and out of school as a factor for its increase. Material and methods. The study included 124 adolescents attending High Musical School in Bitola and Skopje, who underwent four standard spine tests and an interview. Results. According to the test 3, 50% of the examined adolescents in Bitola and 69% in Skopje had the postural spine deformity, the average being 59.5%. The results obtained by the questionnaire showed that 50% of adolescents did not have any physical activity out of school, the longest daily activity, lasting four hours, in 48% of the examinees was practising their musical instruments; 40% of the examinees spent two hours watching TV or using the computer, whereas 18% did not use any of them at all. Conclusion. The bad spine posture tends to deteriorate in adolescents and the factor influencing this result should be established by studies aimed at determining the effects of physical activity on reducing such deformities, since the specific type of their education induces the risk of developing pain and early degenerative changes of the spine, which are predominant in the professionals.

Lazovi? Milica

2010-01-01

393

Diagnosis of cervical spine fractures with multislice helical CT  

International Nuclear Information System (INIS)

Purpose: It is the aim of this study to investigate the efficiency of multislice helical CT for the diagnosis of cervical spine fractures. The advantages of this technique are demonstrated by case reports. Material and Methods: The entire cervical spine or selected vertebral bodies of 66 patients with cervical spine fractures known from preceding plain films were scanned with a multislice helical CT. The CT-scans were obtained with a slice thickness of 1,25 mm and with two different pitches (0,75 or 1,5) and table speeds (3,75 or 7,5 mm/rot.). Additionally, sagittal and coronal reformations were performed. Results: The mean scantime for the cervical spine was 13 seconds. High quality sagittal and coronal reformations were obtained from axial images within a few minutes. Fractures of the dens (n = 17) and of the vertebral body of C3-C7 (n = 12) occured predominantly. Conclusion: Multislice helical CT is an effective tool to diagnose fractures of the cervical spine rapidly and exactly. (orig.)

394

Cervical spine trauma: Radiologic manifestations and imaging algorithms  

International Nuclear Information System (INIS)

Cervical spine trauma is very critical injury that is incurred most frequently in automobile accidents, mining incidents, and war. Injuries of the cervical spine produce neurologic damage in approximately 40% of cases, whereas injuries of the thoracolumbar junction produce neurologic damage in 4% and injuries of the thoracic spine do so in 10%. Radiology has a fundamental role in the recognition and follow-up of patients. Radiologists should be quite familiar with the imaging algorithms and various radiologic manifestations of cervical spine injuries. In this paper, techniques of examining severely injured patients as well as those with slight or questionable injuries are demonstrated. Indications and limitations of various diagnostic procedures (plain film radiography, tomography, CT, and MR imaging) are discussed. A systematic plan for the study of the cervical spine with an emphasis on joints, bones, ligaments and soft tissues (JO-B-LI-ST) is introduced. Mechanisms of injury and the stability or instability of the injuries are presented. Plain radiography as well as other imaging modalities are used to demonstrate the most important forms of injuries at various levels. Follow-up of some of the treated cases is shown. The late complications of spinal cord damage in closed injuries and open wounds (urinary stones, myositis, ossificans, contractures, fractures, disuse atrophy, and bone infections) are presented at the end

395

EFFECT OF DIFFERENT LEVELS OF LOCALIZED MUSCLE FATIGUE ON KNEE POSITION SENSE  

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Full Text Available There is little information available regarding how proprioceptive abilities decline as the amount of exertion increases during exercise. The purpose of this study was to determine the role of different levels of fatigue on knee joint position sense. A repeated measures design was used to examine changes in active joint reposition sense (AJRS prior to and following three levels of fatigue. Eighteen participants performed knee extension and flexion isokinetic exercise until torque output was 90%, 70%, or 50% of the peak hamstring torque for three consecutive repetitions. Active joint reposition sense at 15, 30, or 45 degrees was tested following the isokinetic exercise session. Following testing of the first independent measure, participants were given a 20 minute rest period. Testing procedures were repeated for two more exercise sessions following the other levels of fatigue. Testing of each AJRS test angle was conducted on three separate days with 48 hours between test days. Significant main effect for fatigue was indicated (p = 0.001. Pairwise comparisons indicated a significant difference between the pre-test and following 90% of peak hamstring torque (p = 0.02 and between the pre-test and following 50% of peak hamstring torque (p = 0.02. Fatigue has long been theorized to be a contributing factor in decreased proprioceptive acuity, and therefore a contributing factor to joint injury. The findings of the present study indicate that fatigue may have an effect on proprioception following mild and maximum fatigue.

William S. Gear

2011-12-01

396

Repositioning and Leaving In Situ the Central Venous Catheter During Percutaneous Treatment of Associated Superior Vena Cava Syndrome: A Report of Eight Cases  

International Nuclear Information System (INIS)

Purpose: To describe a combined procedure of repositioning and leaving in situ a central venous catheter followed by immediate percutaneous treatment of associated superior vena cava syndrome (SVCS). Methods: Eight patients are presented who have central venous catheter-associated SVCS (n = 6 Hickman catheters, n = 2 Port-a-cath) caused by central vein stenosis (n = 4) or concomitant thrombosis (n = 4). With the use of a vascular snare introduced via the transcubital or transjugular approach, the tip of the central venous catheter could be engaged, and repositioned after deployment of a stent in the innominate or superior vena cava. Results: In all patients it was technically feasible to reposition the central venous catheter and treat the SVCS at the same time. In one patient flipping of the Hickman catheter in its original position provoked dislocation of the released Palmaz stent, which could be positioned in the right common iliac vein. Conclusion: Repositioning of a central venous catheter just before and after stent deployment in SVCS is technically feasible and a better alternative than preprocedural removal of the vascular access

397

Maniobra de reposición canalítica para el tratamiento del vértigo postural paroxístico benigno / Canalith reposition procedure for the treatment of benign paroxysmal positional vertigo  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Background: Paroxysmal positional vertigo is a frequent and handicapping disease. Aim: To assess the effectiveness of physical therapies using particle reposition procedures in the treatment of paroxysmal positional vertigo. Patients and methods: Fifty nine patients (13 male) with paroxysmal positio [...] nal vertigo were studied. Clinical data was gathered, the affected channel was identified. In the same session, the corresponding canalith reposition procedure was performed (Epley maneuver for posterior channel and Lempert maneuver for lateral channel) and the immediate response was recorded. Results: Twenty seven percent of patients had recurring episodes of vertigo and 60% had more than two weeks of evolution. In 49% of patients, vertigo was considered idiopathic and in 92%, the posterior channel was affected. One patient had a combined lesion of posterior and lateral channels and two patients had isolated lateral channel lesions. Seventy percent of patients recovered after two sessions of canalith reposition procedure. Conclusions: Canalith reposition maneuvers were highly effective for the treatment of paroxysmal positional vertigo. (Rev Méd Chile 2000; 128: 619-26).

Viviana, Valenzuela P; Pilar, Neira M; Juan, Viada L.

398

Modeling the Effects of Moisture-Related Skin-Support Friction on the Risk for Superficial Pressure Ulcers during Patient Repositioning in Bed  

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Full Text Available Patient repositioning when the skin is moist e.g. due to sweat or urine may cause skin breakdown since wetness increases the skin-support coefficient of friction (COF and hence also the shear stresses that are generated in the skin when the patient is being moved. This everyday hospital scenario was never studied systematically however. The aim of this study was to simulate such interactions using a biomechanical computational model which is the first of its kind, in order to quantitatively describe the effects of repositioning on the pathomechanics of moisture-related tissue damage. We designed a finite element model to analyze skin stresses under a weight-bearing bony prominence while this region of interest slides frictionally over the support surface, as occurs during repositioning. Our results show, expectedly, that maximal effective stresses in the skin increase as the moisture-contents-related COF between the skin and the mattress rises. Interestingly however, the rise in stresses for a wet interface became more prominent when the skin tissue was stiffer - which represented aging or diabetes. This finding demonstrates how the aged/diabetic skin is more fragile than a young-adult skin when repositioning in a moist environment. The modeling used herein can now be extended to test effects of different moisturizers, creams, lubricants or possibly other interventions at the skin-support interface for testing their potential in protecting the skin from superficial pressure ulcers in a standard, objective and quantitative manner.

AmitGefen

2013-10-01

399

Dendritic spine heterogeneity and calcium dynamics in basolateral amygdala principal neurons.  

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Glutamatergic synapses on pyramidal neurons are formed on dendritic spines where glutamate activates ionotropic receptors, and calcium influx via N-methyl-d-aspartate receptors leads to a localized rise in spine calcium that is critical for the induction of synaptic plasticity. In the basolateral amygdala, activation of metabotropic receptors is also required for synaptic plasticity and amygdala-dependent learning. Here, using acute brain slices from rats, we show that, in basolateral amygdala principal neurons, high-frequency synaptic stimulation activates metabotropic glutamate receptors and raises spine calcium by releasing calcium from inositol trisphosphate-sensitive calcium stores. This spine calcium release is unevenly distributed, being present in proximal spines, but largely absent in more distal spines. Activation of metabotropic receptors also generated calcium waves that differentially invaded spines as they propagated toward the soma. Dendritic wave invasion was dependent on diffusional coupling between the spine and parent dendrite which was determined by spine neck length, with waves preferentially invading spines with short necks. Spine calcium is a critical trigger for the induction of synaptic plasticity, and our findings suggest that calcium release from inositol trisphosphate-sensitive calcium stores may modulate homosynaptic plasticity through store-release in the spine head, and heterosynaptic plasticity of unstimulated inputs via dendritic calcium wave invasion of the spine head. PMID:24944224

Power, John M; Sah, Pankaj

2014-10-01

400

Activity-dependent dendritic spine neck changes are correlated with synaptic strength.  

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Most excitatory inputs in the mammalian brain are made on dendritic spines, rather than on dendritic shafts. Spines compartmentalize calcium, and this biochemical isolation can underlie input-specific synaptic plasticity, providing a raison d'etre for spines. However, recent results indicate that the spine can experience a membrane potential different from that in the parent dendrite, as though the spine neck electrically isolated the spine. Here we use two-photon calcium imaging of mouse neocortical pyramidal neurons to analyze the correlation between the morphologies of spines activated under minimal synaptic stimulation and the excitatory postsynaptic potentials they generate. We find that excitatory postsynaptic potential amplitudes are inversely correlated with spine neck lengths. Furthermore, a spike timing-dependent plasticity protocol, in which two-photon glutamate uncaging over a spine is paired with postsynaptic spikes, produces rapid shrinkage of the spine neck and concomitant increases in the amplitude of the evoked spine potentials. Using numerical simulations, we explore the parameter regimes for the spine neck resistance and synaptic conductance changes necessary to explain our observations. Our data, directly correlating synaptic and morphological plasticity, imply that long-necked spines have small or negligible somatic voltage contributions, but that, upon synaptic stimulation paired with postsynaptic activity, they can shorten their necks and increase synaptic efficacy, thus changing the input/output gain of pyramidal neurons. PMID:24982196

Araya, Roberto; Vogels, Tim P; Yuste, Rafael

2014-07-15

 
 
 
 
401

Recurrent spine surgery patients in hospital administrative database  

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Introduction: Hospital patient databases are typically used by administrative staff to estimate loss-profit ratios and to help with the allocation of hospital resources. These databases can also be very useful in following rehospitalization. This paper studies the recurrence of spine surgery patients in our hospital population based on administrative data analysis. Methods: Hospital data on 4,958 spine surgery patients operated between 2002 and 2009 were retrospectively reviewed. After sorting the cohort per ascending discharge date, the patient official name, consisting of first, middle and last names, was used as the variable determining duplicate cases in the SPSS statistical program, designating the first case in each group as primary. Yearly recurrence rate and change in procedure distribution were studied. In addition, hospital charges and length of stay were compared using the Wilcoxon-Mann-Whitney test. Results: Of 4,958 spine surgery patients 364 (7.3%) were categorized as duplicate cases by SPSS. The number of primary cases from which duplicate cases emerged was 327 meaning that some patients had more than two spine surgeries. Among primary patients (N=3