Sample records for caudal spinal stump

  1. Somatostatin in the caudal spinal cord

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    Schrøder, H D


    The distribution of somatostatin in the rat spinal cord was studied immunohistochemically with particular reference to the localization in the caudal centers that innervate the pelvic organs. For detailed studies of the laminar distribution of somatostatin the combination of immunohistochemistry...... was particularly low in the motoneuron neuropil. However, a dense somatostatin network was found in the sixth lumbar segment in relation to the neurons in Onuf's nucleus X complex, the nucleus that innervates the small pelvic muscles including the striated sphincters. It is concluded that somatostatin, besides...

  2. Ependymal variations in the caudal spinal cord. (United States)

    Stoltenburg-Didinger, G; Bienentreu, R


    The lumbosacral spinal cord including the cauda equina was examined in 100 unselected autopsied cases of infants dying at or near term. A striking finding in 10% of these cases was the occurrence of bilateral collections of ependymal cells lying in rows on the surface of the lumbosacral cord. In another 25% the central canal was forked or duplicate. These foci were not associated with evidence of defective neural tube closure or spina bifida; the central canal was of normal length. There was no relationship between the ependymal structures and systemic clinical or pathological findings. The pathogenesis and significance of these lesions is unclear. Our observations suggest that they occur regularly and are not associated with neurological disturbances. The relationship of the ependymal cell collections to ependymomas of the caudal spinal cord is open to speculation.

  3. [Caudal and spinal anesthesia in sub-umbilical surgery in children. Apropos of 1875 cases]. (United States)

    Aguemon, A R; Terrier, G; Lansade, A; Favereau, J P; Nathan, N; Feiss, P


    Caudal and spinal anaesthesia are two techniques widely used in European children. The aim of this retrospective study was to evaluate the applicability of this practice in developing countries. The study concerned 1875 children, 1 day to 17 years old. isobaric 0.5% bupivacaine was used for spinal anaesthesia (n = 730) and mixture a of 1% lidocaine-0.25% bupivacaine with epinephrine 1/200,000 for caudal anaesthesia (n = 1,145). Spinal anaesthesia was performed in neonates and infants (< 3 years) and caudal anaesthesia in children (aged 14 days to 17 years) undergoing urological and lower extremity surgery. No variation of heart rate, blood pressure or blood oxygen saturation (SpO2) were observed during surgery. Failure of the technique was less than 1%. These two regional anaesthesia techniques are easy to perform and are inexpensive. This is advantageous for developing countries.

  4. Early neurogenesis during caudal spinal cord regeneration in adult Gekko japonicus. (United States)

    Zhou, Youlang; Xu, Qing; Li, Donghui; Zhao, Lijuan; Wang, Yongjun; Liu, Mei; Gu, Xiaosong; Liu, Yan


    Gekko japonicus undergoes dramatic changes in the caudal spinal cord after tail amputation. The amputation induces cell proliferation in the caudal ependymal tube. We performed hematoxylin and eosin staining at different time points in the regeneration process to investigate the morphological characterization of the regenerated appendages. The central canal extended to the blastema post-amputation and the cartilage and muscle tissue appeared 3 weeks after injury. We performed the bromodeoxyuridine (BrdU) incorporation assay to detect proliferating cells during the regeneration process. BrdU positive cells were detected in the peri-central canal. Furthermore, nestin and neuron-specific enolase (NSE) immunocytochemistry were applied to detect neural stem/progenitor cells and neurons. Two weeks after injury, nestin-positive cells undergoing proliferation were located outside of the ependymal tube, and NSE positive cells appeared after 3 weeks of amputation. These data suggest that neurogenesis is an early event during caudal spinal cord regeneration in gecko.

  5. The spinal cord ependymal region: a stem cell niche in the caudal central nervous system. (United States)

    Hugnot, Jean Philippe; Franzen, Rachelle


    In the brain, specific signalling pathways localized in highly organized regions called niches, allow the persistence of a pool of stem and progenitor cells that generate new neurons and glial cells in adulthood. Much less is known on the spinal cord central canal niche where a sustained adult neurogenesis is not observed. Here we review our current knowledge of this caudal niche in normal and pathological situations. Far from being a simple layer of homogenous cells, this region is composed of several cell types localized at specific locations, expressing characteristic markers and with different morphologies and functions. We further report on a screen of online gene-expression databases to better define this spinal cord niche. Several genes were found to be preferentially expressed within or around the central canal region (Bmp6, CXCR4, Gdf10, Fzd3, Mdk, Nrtn, Rbp1, Shh, Sox4, Wnt7a) some of which by specific cellular subtypes. In depth characterization of the spinal cord niche constitutes a framework to make the most out of this endogenous cell pool in spinal cord disorders.

  6. Anatomical mechanism of spontaneous recovery in regions caudal to thoracic spinal cord injury lesions in rats (United States)

    Li, Lu-sheng; Yu, Hao; Raynald, Raynald; Wang, Xiao-dong; Dai, Guang-hui; Cheng, Hong-bin; Liu, Xue-bin


    Background The nerve fibre circuits around a lesion play a major role in the spontaneous recovery process after spinal cord hemisection in rats. The aim of the present study was to answer the following question: in the re-control process, do all spinal cord nerves below the lesion site participate, or do the spinal cord nerves of only one vertebral segment have a role in repair? Methods First we made a T7 spinal cord hemisection in 50 rats. Eight weeks later, they were divided into three groups based on distinct second operations at T7: ipsilateral hemisection operation, contralateral hemisection, or transection. We then tested recovery of hindlimbs for another eight weeks. The first step was to confirm the lesion had role or not in the spontaneous recovery process. Secondly, we performed T7 spinal cord hemisections in 125 rats. Eight weeks later, we performed a second single hemisection on the ipsilateral side at T8–T12 and then tested hindlimb recovery for another six weeks. Results In the first part, the Basso, Beattie, Bresnahan (BBB) scores and the electrophysiology tests of both hindlimbs weren’t significantly different after the second hemisection of the ipsilateral side. In the second part, the closer the second hemisection was to T12, the more substantial the resulting impairment in BBB score tests and prolonged latency periods. Conclusions The nerve regeneration from the lesion area after hemisection has no effect on spontaneous recovery of the spinal cord. Repair is carried out by all vertebrae caudal and ipsilateral to the lesion, with T12 being most important. PMID:28097067

  7. Success rates and complications of awake caudal versus spinal block in preterm infants undergoing inguinal hernia repair: A prospective study

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    Mahin Seyedhejazi


    Full Text Available Background: Inguinal hernia is a common disease in preterm infants necessitating surgical repair. Despite the increased risk of postoperative apnea in preterm infants, the procedure was conventionally performed under general anesthesia. Recently, regional anesthesia approaches, including spinal and caudal blocks have been proposed as safe and efficient alternative anesthesia methods in this group of patients. The current study evaluates awake caudal and spinal blocks in preterm infants undergoing inguinal hernia repair. Materials and Methods: In a randomized clinical trial, 66 neonates and infants (weight <5 kg undergoing inguinal hernia repair were recruited in Tabriz Teaching Children Hospital during a 12-month period. They were randomly divided into two equal groups; receiving either caudal block by 1 ml/kg of 0.25% bupivacaine plus 20 μg adrenaline (group C or spinal block by 1 mg/kg of 0.5% bupivacaine plus 20 μg adrenaline (group S. Vital signs and pain scores were documented during operation and thereafter up to 24 h after operation. Results: Decrease in heart rate and systolic blood pressure was significantly higher in group C throughout the study period (P < 0.05. The mean recovery time was significantly higher in group S (27.3 ± 5.5 min vs. 21.8 ± 9.3 min; P = 0.03. Postoperative need for analgesia was significantly more frequent in group S (75.8% vs. 36.4%; P = 0.001. Failure in anesthesia was significantly higher in group S (24.4% vs. 6.1%; P = 0.04. Conclusion: More appropriate success rate, duration of recovery and postoperative need of analgesics could contribute to caudal block being a superior anesthesia technique compared to spinal anesthesia in awaked preterm infants undergoing inguinal hernia repair.

  8. Orofacial inflammatory pain affects the expression of MT1 and NADPH-d in rat caudal spinal trigeminal nucleus and trigeminal ganglion

    Institute of Scientific and Technical Information of China (English)

    Fang Huang; Hongwen He; Wenguo Fan; Yongliang Liu; Hongyu Zhou; Bin Cheng


    Very little is known about the role of melatonin in the trigeminal system, including the function of melatonin receptor 1. In the present study, adult rats were injected with formaldehyde into the right vibrissae pad to establish a model of orofacial inflammatory pain. The distribution of melatonin re-ceptor 1 and nicotinamide adenine dinucleotide phosphate diaphorase in the caudal spinal minal nucleus and trigeminal ganglion was determined with immunohistochemistry and mistry. The results show that there are significant differences in melatonin receptor 1 expression and nicotinamide adenine dinucleotide phosphate diaphorase expression in the trigeminal ganglia and caudal spinal nucleus during the early stage of orofacial inflammatory pain. Our findings sug-gest that when melatonin receptor 1 expression in the caudal spinal nucleus is significantly reduced, melatonin’s regulatory effect on pain is attenuated.

  9. Weight-bearing locomotion in the developing opossum, Monodelphis domestica following spinal transection: remodeling of neuronal circuits caudal to lesion.

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    Benjamin J Wheaton

    Full Text Available Complete spinal transection in the mature nervous system is typically followed by minimal axonal repair, extensive motor paralysis and loss of sensory functions caudal to the injury. In contrast, the immature nervous system has greater capacity for repair, a phenomenon sometimes called the infant lesion effect. This study investigates spinal injuries early in development using the marsupial opossum Monodelphis domestica whose young are born very immature, allowing access to developmental stages only accessible in utero in eutherian mammals. Spinal cords of Monodelphis pups were completely transected in the lower thoracic region, T10, on postnatal-day (P7 or P28 and the animals grew to adulthood. In P7-injured animals regrown supraspinal and propriospinal axons through the injury site were demonstrated using retrograde axonal labelling. These animals recovered near-normal coordinated overground locomotion, but with altered gait characteristics including foot placement phase lags. In P28-injured animals no axonal regrowth through the injury site could be demonstrated yet they were able to perform weight-supporting hindlimb stepping overground and on the treadmill. When placed in an environment of reduced sensory feedback (swimming P7-injured animals swam using their hindlimbs, suggesting that the axons that grew across the lesion made functional connections; P28-injured animals swam using their forelimbs only, suggesting that their overground hindlimb movements were reflex-dependent and thus likely to be generated locally in the lumbar spinal cord. Modifications to propriospinal circuitry in P7- and P28-injured opossums were demonstrated by changes in the number of fluorescently labelled neurons detected in the lumbar cord following tracer studies and changes in the balance of excitatory, inhibitory and neuromodulatory neurotransmitter receptors' gene expression shown by qRT-PCR. These results are discussed in the context of studies indicating

  10. Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results

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    Lee, Joon Woo; Myung, Jae Sung; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seong Nam, Gyeongi-do (Korea); Park, Kun Woo; Yeom, Jin S. [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Seong Nam, Gyeongi-do (Korea); Kim, Ki-Jeong; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Seong Nam, Gyeongi-do (Korea)


    To evaluate the short-term and long-term effects of fluoroscopically guided caudal epidural steroid injection (ESI) for the management of degenerative lumbar spinal stenosis (DLSS) and to analyze outcome predictors. All patients who underwent caudal ESI in 2006 for DLSS were included in the study. Response was based on chart documentation (aggravated, no change, slightly improved, much improved, no pain). In June 2009 telephone interviews were conducted, using formatted questions including the North American Spine Society (NASS) patient satisfaction scale. For short-term and long-term effects, age difference was evaluated by the Mann-Whitney U test, and gender, duration of symptoms, level of DLSS, spondylolisthesis, and previous operations were evaluated by Fisher's exact test. Two hundred and sixteen patients (male: female = 75:141; mean age 69.2 years; range 48{proportional_to}91 years) were included in the study. Improvements (slightly improved, much improved, no pain) were seen in 185 patients (85.6%) after an initial caudal ESI and in 189 patients (87.5%) after a series of caudal ESIs. Half of the patients (89/179, 49.8%) replied positively to the NASS patient satisfaction scale (1 or 2). There were no significant outcome predictors for either the short-term or the long-term responses. Fluoroscopically guided caudal ESI was effective for the management of DLSS (especially central canal stenosis) with excellent short-term and good long-term results, without significant outcome predictors. (orig.)

  11. Phosphorylation of Dpsyl2 (CRMP2) and Dpsyl3 (CRMP4) is required for positioning of caudal primary motor neurons in the zebrafish spinal cord. (United States)

    Morimura, Rii; Nozawa, Keisuke; Tanaka, Hideomi; Ohshima, Toshio


    Dpysls (CRMPs) that were initially identified as mediator proteins of Semaphorin3a (Sema3a) signaling are involved in neuronal polarity and axon elongation in cultured neurons. Previous studies have shown that knockdown of neuropilin1a, one of the sema3a receptors, exhibited ectopic primary motor neurons (PMNs) outside of the spinal cord in zebrafish. However, downstream molecules of sema3a signaling involved in the positioning of motor neurons are largely unknown. Here, we addressed the role of Dpysl2 (CRMP2) and Dpysl3 (CRMP4) in the positioning of PMNs in the zebrafish spinal cord. We found that the knockdown of dpysls by antisense morpholino oligonucleotides (AMO) causes abnormal positioning of caudal primary (CaP) motor neurons outside the spinal cord. The knockdown of cdk5 and dyrk2 by AMO also caused similar phenotype in the positioning of CaP motor neurons, and this phenotype was rescued by co-injection of phosphorylation-mimic type dpysl2 mRNA. These results suggest that the phosphorylation of Dpysl2 and Dpysl3 by Cdk5 and Dyrk2 is required for correct positioning of CaP motor neurons in the zebrafish spinal cord.

  12. Productivity and costs of stump rake and stump harvester

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    Jouhiaho, A.; Rieppo, K.; Mutikainen, A. (TTS Research, Rajamaeki (Finland)), e-mail:, e-mail:, e-mail:


    The cost-effectiveness of the two most common stump extraction equipment used in Finland was investigated in the work study: stump rake and stump harvester. The productivity of stump extraction with the stump rake was on average 12,7 m3 / effective hour and with the stump harvester 12,0 m3 /effective hour. Soil preparation performed during the stump extraction decreased the productivity of stump extraction by 1,9-3,1 m3 / effective hour. Considering the work methods adapted by the drivers, the different revolutions of the engines (RPM) used in the excavators and speed of movement, it is not possible to draw a general conclusion that there would be differences in productivity between stump extraction methods at issue. Even though the acquisition price of the stump harvester was almost double that of the acquisition price of the stump rake with bucket tilt mechanism, the operating costs of the stump harvester were lower due to its lower fuel consumption. The hourly operating costs of the stump rake were 4 per cent or EUR 2,0 / hour higher than the operating costs of the stump harvester. Due to the 6 per cent higher productivity of the stump rake, the unit cost of the stump rake was 2 per cent or EUR 0,09 / m3 lower than that of the stump harvester. (orig.)

  13. Origin and neurochemical properties of bulbospinal neurons projecting to the rat lumbar spinal cord via the medal longitudinal fasciculus and caudal ventrolateral medulla

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    Zilli eHuma


    Full Text Available Bulbospinal systems (BS originate from various regions of the brainstem and influence spinal neurons by classical synaptic and modulatory mechanisms. Our aim was to determine the brainstem locations of cells of origin of BS pathways passing through the medial longitudinal fasciculus (MLF and the caudal ventrolateral medulla (CVLM. We also examined the transmitter content of spinal terminations of the CVLM pathway. Six adult rats received Fluorogold (FG injections to the right intermediate grey matter of the lumbar cord (L1-L2 and the b-subunit of cholera toxin (CTb was injected either into the MLF or the right CVLM (3 animals each. Double-labelled cells were identified within brainstem structures with confocal microscopy and mapped onto brainstem diagrams. An additional 3 rats were injected with CTb in the CVLM to label axon terminals in the lumbar spinal cord. Double-labelled cells projecting via the MLF or CVLM were found principally in reticular regions of the medulla and pons but small numbers of cells were also located within the midbrain. CVLM projections to the lumbar cord were almost exclusively ipsilateral and concentrated within the intermediate grey matter. Most (62% of terminals were immunoreactive for the vesicular glutamate transporter 2 while 23% contained the vesicular GABA transporter. The inhibitory subpopulation was glycinergic, GABAergic or contained both transmitters. The proportions of excitatory and inhibitory axons projecting via the CVLM to the lumbar cord are similar to those projecting via the MLF. Unlike the MLF pathway, CVLM projections are predominantly ipsilateral and concentrated within intermediate grey but do not extend into motor nuclei or laminia VIII. Terminations of the CVLM pathway are located in a region of the grey matter that is rich in premotor interneurons; thus its primary function may be to coordinate activity of premotor networks.

  14. Carotid Stump Syndrome

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    Lara Toufic Dakhoul MD


    Full Text Available Objectives. To highlight the case of a patient with multiple transient ischemic attacks and visual disturbances diagnosed with carotid stump syndrome and managed with endovascular approach. Case Presentation. We present the case of a carotid stump syndrome in an elderly patient found to have moderate left internal carotid artery stenosis in response to an advertisement for carotid screening. After a medical therapeutic approach and a close follow-up, transient ischemic attacks recurred. Computed tomographic angiography showed an occlusion of the left internal carotid artery and the presence of moderate stenosis in the right internal carotid artery, which was treated by endovascular stenting and balloon insertion. One month later, the patient presented with visual disturbances due to the left carotid stump and severe stenosis of the left external carotid artery that was reapproached by endovascular stenting. Conclusion. Considerations should be given to the carotid stump syndrome as a source of emboli for ischemic strokes, and vascular assessment could be used to detect and treat this syndrome.

  15. MRI determination of the vertebral termination of the dural sac tip in a South African population: clinical significance during spinal irradiation and caudal anaesthesia

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    A Cilliers


    Full Text Available Abstract Knowing where the dural sac (DS ends is important, especially when placing the portal fields during craniospinal irradiation (CSI and performing caudal anesthesia. The purpose of this investigation was to determine the level of termination of the DS in relation to the spine in a group of South African patients using magnetic resonance imaging (MRI. We retrospectively reviewed the lumbosacral MR Imaging of 309 patients in each case identifying the tip of the DS. This level was recorded in relation to the adjacent vertebral body i.e. upper-, middle- and lower third and adjacent intervertebral disc. The overall mean of the DS position was at the middle third of S2. A notable percentage (13.9% of patients had a DS level lower than the lower third of S2 and (15.2% patients had a DS level higher than the S1-S2 intervertebral disc. This study failed to demonstrate a difference in the DS termination level, compared to the levels reported in various international studies; nor is there a statistical difference between gender, race and age. Our study shows that routine placement of the portal field at the lower border of S2 adequately treats the majority of CSI patients. However some patients (13.9% will be undertreated and some patients (15.2% will be overradiated. Using spinal MRI to establish the lower border of the CSI portal field will however benefit patients by ensuring adequate coverage of the entire neuroaxis as well as minimizing late gonadal toxicity due to overradiation.

  16. Connections between EM2-containing terminals and GABA/μ-opioid receptor co-expressing neurons in the rat spinal trigeminal caudal nucleus (United States)

    Li, Meng-Ying; Wu, Zhen-Yu; Lu, Ya-Cheng; Yin, Jun-Bin; Wang, Jian; Zhang, Ting; Dong, Yu-Lin; Wang, Feng


    Endomorphin-2 (EM2) demonstrates a potent antinociceptive effect via the μ-opioid receptor (MOR). To provide morphological evidence for the pain control effect of EM2, the synaptic connections between EM2-immunoreactive (IR) axonal terminals and γ-amino butyric acid (GABA)/MOR co-expressing neurons in lamina II of the spinal trigeminal caudal nucleus (Vc) were investigated in the rat. Dense EM2-, MOR- and GABA-IR fibers and terminals were mainly observed in lamina II of the Vc. Within lamina II, GABA- and MOR-neuronal cell bodies were also encountered. The results of immunofluorescent histochemical triple-staining showed that approximately 14.2 or 18.9% of GABA-IR or MOR-IR neurons also showed MOR- or GABA-immunopositive staining in lamina II; approximately 45.2 and 36.1% of the GABA-IR and MOR-IR neurons, respectively, expressed FOS protein in their nuclei induced by injecting formalin into the left lower lip of the mouth. Most of the GABA/MOR, GABA/FOS, and MOR/FOS double-labeled neurons made close contacts with EM2-IR fibers and terminals. Immuno-electron microscopy confirmed that the EM2-IR terminals formed synapses with GABA-IR or MOR-IR dendritic processes and neuronal cell bodies in lamina II of the Vc. These results suggest that EM2 might participate in pain transmission and modulation by binding to MOR-IR and GABAergic inhibitory interneuron in lamina II of the Vc to exert inhibitory effect on the excitatory interneuron in lamina II and projection neurons in laminae I and III. PMID:25386121

  17. Caudal Regression Syndrome

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    Karim Hardani*


    Full Text Available A 10-month-old baby presented with developmental delay. He had flaccid paralysis on physical examination.An MRI of the spine revealed malformation of the ninth and tenth thoracic vertebral bodies with complete agenesis of the rest of the spine down that level. The thoracic spinal cord ends at the level of the fifth thoracic vertebra with agenesis of the posterior arches of the eighth, ninth and tenth thoracic vertebral bodies. The roots of the cauda equina appear tightened down and backward and ended into a subdermal fibrous fatty tissue at the level of the ninth and tenth thoracic vertebral bodies (closed meningocele. These findings are consistent with caudal regression syndrome.

  18. Stump Appendicitis: A Clinical Enigma. (United States)

    Çiftci, F; Abdurrahman, I; Tatar, Z


    Appendectomy is one of the most frequently performed operations. Stump appendicitis, as a postoperative complication of appendectomy, is inflammation of the remnant residue when an incomplete excision occurs. We present a patient with stump appendicitis who had been operated on, laparoscopically, for acute appendicitis 6 months before. The patient was diagnosed with acute appendicitis, underwent surgery, and was discharged on postoperative day 3 without complications. Stump appendicitis is a rare cause of acute abdominal disease but should be considered in the differential diagnosis. Ultrasonography is helpful in the diagnosis.

  19. Stump problems in traumatic amputation. (United States)

    Hirai, M; Tokuhiro, A; Takechi, H


    Stump problems in amputations resulting from employment related injuries were investigated in 397 cases in the Chugoku and Shikoku districts of Japan between 1987 and 1991. Ninety-seven patients (24%) had stump problems which interfered the prosthetic fitting. Stump problems of the upper extremity were seen in about 9% (17 amputees), two thirds of which were skin troubles. Stump problems of the lower extremity were seen in about 37% (80 amputees). Certain complaints were associated with specific methods of amputation; abnormal keratosis in Syme's amputation, equinus deformity in Chopart's amputation, reduced muscle power in above the knee (A/K) amputation and joint dysfunction in below the knee (B/K) amputation. Adequate prosthetic fitting was achieved by the modification of the socket and alignment in almost all amputees with stump problems. In only two cases, Chopart's amputation required subsequent Syme's amputation due to equinus deformity with abnormal keratosis. In almost every case, stump problems are avoidable by means of surgeons' deliberate evaluation of the affected limb and adequate choice of the amputation level.

  20. Spinal and epidural anesthesia (United States)

    ... you epidural or spinal anesthesia is called an anesthesiologist. First, the area of your back where the ... Chan VWS. Spinal, epidural, and caudal anesthesia. In: Miller RD, ed. Miller's Anesthesia . 8th ed. Philadelphia, PA: ...

  1. The stump and the prosthesis. (United States)

    Day, H J


    In performing amputations the surgeon must bear in mind the biomechanical and other constraints of the prosthesis likely to be fitted and, so far as possible, should fashion the stump accordingly. The various types of prosthesis and their features are discussed in relation to amputations of the lower and upper limbs at all levels.

  2. Disrafias vertebro-medulares caudais: formas intra-sacras Caudal spinal cord disraphism: intra-sacral forms. Report of 4 cases

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    Pedro M. Sampaio


    Full Text Available Os autores abordam a gênese das disrafias vértebro-medulares caudais, e se atêm aos divertículos meníngeos intra-sacros. Encontraram na literatura pertinente, descrição de 24 casos e acrescentaram 4 de sua experiência. A incontinencia urinaria foi sintoma proeminente e o resultado cirúrgico compensador. O diagnóstico foi firmado por mielografia.The mean theories of the sacral spinal dysraphisms are reviwed and 4 cases of "meningeal intrasacral diverticulum" are reported. The authors prefer this term to the more common "intrasacral occult meningocele". The proeminent symptom in their cases was late vesical incontinence, which disappeared after surgery. In the pertinent litterature 24 similar cases were described till now.

  3. Caudal ropivacaine in infants

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    Hansen, Tom Giedsing; Ilett, K F; Reid, C;


    Ropivacaine is a new long-acting amino-amide local anesthetic. However, there are no data on its use in infants. In the current study, the authors investigated the pharmacokinetics of caudal ropivacaine in 30 infants younger than 12 months....

  4. Spinal Cord Stimulation

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    Meier, Kaare


    pain after failed back surgery syndrome (FBSS)(4), pain due to peripheral nerve injury, stump pain(5), peripheral vascular disease(6) and diabetic neuropathy(7,8); whereas phantom pain(9), postherpetic neuralgia(10), chronic visceral pain(11), and pain after partial spinal cord injury(12) remain more...

  5. Stump sensibility in children with upper limb reduction deficiency

    NARCIS (Netherlands)

    Reinkingh, Marianne; Reinders-Messelink, Heleen A.; Dijkstra, Pieter U.; Maathuis, Karel G. B.; van der Sluis, Corry K.


    Objectives: To compare stump sensibility in children with upper limb reduction deficiency with sensibility of the unaffected arm and hand. In addition, to evaluate the associations between stump sensibility, stump length and activity level. Design: Cross-sectional study. Subjects: Children and young

  6. Caudales ecológicos



    En respuesta al aumento de la conciencia ambiental a escala mundial, se ha desarrollado lo que se puede denominar una nueva ciencia que se encarga de estudiar los caudales necesarios para mantener un hábitat deseado, es decir los denominados caudales ecológicos. En el presente artículo se expone una breve recopilación bibliográfica sobre la evolución de éste nuevo concepto, al igual que de las metodologías más importantes desarrolladas hasta la fecha, junto con las técnicas usadas en Es...

  7. Overlapping Features of Caudal Regression Syndrome and VACTERL Complex in a Neonate

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    Lubna Ijaz


    Full Text Available Caudal regression syndrome (CRS is characterized by a group of heterogeneous anomalies involving the distal spinal cord and vertebral column, genitourinary system, hind gut and limbs. The malformation may range from minor anomalies of spine and spinal cord to the extreme, the sirenomelia. Various authors pointed out an overlap of spectrum of anomalies in CRS and VACTERL (vertebral, anorectal, cardiac, tracheo-esophageal, renal and limb anomalies complex.

  8. Occurrence patterns of lichens on stumps in young managed forests.

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    Måns Svensson

    Full Text Available The increasing demand for forest-derived bio-fuel may decrease the amount of dead wood and hence also the amount of available substrate for saproxylic ( = dead-wood dependent organisms. Cut stumps constitute a large portion of dead wood in managed boreal forests. The lichen flora of such stumps has received little interest. Therefore, we investigated which lichens that occur on stumps in young (4-19 years, managed forests and analyzed how species richness and occurrence of individual species were related to stump and stand characteristics. We performed lichen inventories of 576 Norway spruce stumps in 48 forest stands in two study areas in Central Sweden, recording in total 77 lichen species. Of these, 14 were obligately lignicolous, while the remaining were generalists that also grow on bark, soil or rocks. We tested the effect of characteristics reflecting successional stage, microclimate, substrate patch size, and the species pool in the surrounding area on (1 total lichen species richness, (2 species richness of obligately lignicolous lichens and (3 the occurrence of four obligately lignicolous lichen species. The most important variables were stump age, with more species on old stumps, and study area, with similar total species richness but differences in occupancy for individual species. Responses for total lichen species richness and species richness of obligately lignicolous lichens were overall similar, indicating similar ecological requirements of these two groups. Our results indicate that species richness measurements serve as poor proxies for the responses of individual, obligately lignicolous lichen species.

  9. Occurrence patterns of lichens on stumps in young managed forests. (United States)

    Svensson, Måns; Dahlberg, Anders; Ranius, Thomas; Thor, Göran


    The increasing demand for forest-derived bio-fuel may decrease the amount of dead wood and hence also the amount of available substrate for saproxylic ( = dead-wood dependent) organisms. Cut stumps constitute a large portion of dead wood in managed boreal forests. The lichen flora of such stumps has received little interest. Therefore, we investigated which lichens that occur on stumps in young (4-19 years), managed forests and analyzed how species richness and occurrence of individual species were related to stump and stand characteristics. We performed lichen inventories of 576 Norway spruce stumps in 48 forest stands in two study areas in Central Sweden, recording in total 77 lichen species. Of these, 14 were obligately lignicolous, while the remaining were generalists that also grow on bark, soil or rocks. We tested the effect of characteristics reflecting successional stage, microclimate, substrate patch size, and the species pool in the surrounding area on (1) total lichen species richness, (2) species richness of obligately lignicolous lichens and (3) the occurrence of four obligately lignicolous lichen species. The most important variables were stump age, with more species on old stumps, and study area, with similar total species richness but differences in occupancy for individual species. Responses for total lichen species richness and species richness of obligately lignicolous lichens were overall similar, indicating similar ecological requirements of these two groups. Our results indicate that species richness measurements serve as poor proxies for the responses of individual, obligately lignicolous lichen species.

  10. Human neural stem cells promote corticospinal axons regeneration and synapse reformation in injured spinal cord of rats

    Institute of Scientific and Technical Information of China (English)

    LIANG Peng; JIN Lian-hong; LIANG Tao; LIU En-zhong; ZHAO Shi-guang


    Background Axonal regeneration in lesioned mammalian central nervous system is abortive, and this causes permanent disabilities in individuals with spinal cord injuries. This paper studied the action of neural stem cell (NSC) in promoting corticospinal axons regeneration and synapse reformation in rats with injured spinal cord.Methods NSCs were isolated from the cortical tissue of spontaneous aborted human fetuses in accordance with the ethical request. The cells were discarded from the NSC culture to acquire NSC-conditioned medium. Sixty adult Wistar rats were randomly divided into four groups (n=15 in each): NSC graft, NSC medium, graft control and medium control groups. Microsurgical transection of the spinal cord was performed in all the rats at the T11. The NSC graft group received stereotaxic injections of NSCs suspension into both the spinal cord stumps immediately after transection; graft control group received DMEM injection. In NSC medium group,NSC-conditioned medium was administered into the spinal cord every week; NSC culture medium was administered to the medium control group. Hindlimb motor function was assessed using the BBB Locomotor Rating Scale. Regeneration of biotin dextran amine (BDA) labeled corticospinal tract was assessed. Differentiation of NSCs and the expression of synaptophysin at the distal end of the injured spinal cord were observed under a confocal microscope. Group comparisons of behavioral data were analyzed with ANOVA.Results NSCs transplantation resulted in extensive growth of corticospinal axons and locomotor recovery in adult rats after complete spinal cord transection, the mean BBB scores reached 12.5 in NSC graft group and 2.5 in graft control group (P< 0.05). There was also significant difference in BBB score between the NSC medium (11.7) and medium control groups (3.7, P< 0.05). BDA traces regenerated fibers sprouted across the lesion site and entered the caudal part of the spinal cord. Synaptophysin expression

  11. Tinea corporis on the stump leg with Trichophyton rubrum infection

    Directory of Open Access Journals (Sweden)

    Xin Ran


    Full Text Available We report a case of tinea corporis on amputated leg stump caused by Trichophyton rubrum. The patient, a 54-year-old male, experienced a serious traffic accident, resulted his right leg amputated 3 years ago. Since then prosthesis was fitted and protective equipment of silicone stocking was worn for the stump. He consulted with circular, patchy and scaly erythemas with itching on his right below knee amputation stump for 2 months. The diagnoses of tinea corporis on the stump was made based on a positive KOH direct microscopic examination, morphologic characteristics and sequencing of the internal transcribed spacers (ITS 1 and 4, confirmed that the isolate from the scales was T. rubrum. The patient was cured with oral terbinafine and topical naftifine-ketaconazole cream following 2% ketaconazole shampoo wash for 3 weeks. Long times using prosthesis together with protective equipment of silicone stocking, leading to the local environment of airtight and humid within the prosthesis favors T. rubrum infection of the stump could be considered as the precipitating factors.

  12. Comparison of two stump-lifting heads in final felling Norway spruce stand

    Energy Technology Data Exchange (ETDEWEB)

    Karha, K.


    The use of stump and root wood chips has increased very rapidly in the 21st century in Finland: in the year 2000, the total consumption of stump wood chips for energy generation was 10 GWh, while in 2010 it was approximately 2 TWh. Metsaeteho Oy and TTS Research evaluated two stump-lifting devices for the lifting of Norway spruce (Picea abies) stumps. The productivity and costs of stump lifting were determined. There was one base machine with one operator in the time study. When lifting stumps with a diameter of 30 cm, the effective hour productivity of stump lifting was 11.2 m{sup 3} solid over bark (sob)/E0 (4.8 ton{sub D}/E{sub 0}) without site preparation using a Vaekevae Stump Processor, and when lifting spruce stumps with a diameter of 40 cm, the productivity was 14.9 m{sup 3} sob/E{sub 0} (6.5 tonD/E0). When the site preparation (mounding) was integrated into lifting work, the stump-lifting productivity decreased 21-27%. The stump-lifting productivity of the other lifting head (Jarvinen) was lower than that of the Vaekevae Stump Processor. Some development suggestions for the Jarvinen lifting head were presented and discussed. The cost calculations showed that stump-lifting costs are extremely high when stump diameter is less than 20 cm. Therefore, the study recommended a change in the current stump-harvesting guidelines of Finland: The study suggested that all the stumps with a diameter less than 20 cm should be left on the harvesting site. (orig.)

  13. Fentanyl, dexmedetomidine, dexamethasone as adjuvant to local anesthetics in caudal analgesia in pediatrics: A comparative study

    Directory of Open Access Journals (Sweden)

    Elham M. El-Feky


    Conclusion: Both caudal dexmedetomidine and caudal dexamethasone added to local anesthetics are good alternatives in prolongation of postoperative analgesia compared to caudal local anesthetic alone or added to caudal fentanyl. Also they showed less side effects compared to caudal fentanyl.

  14. Caudal bupivacaine supplemented with caudal or intravenous clonidine in children undergoing hypospadias repair

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Henneberg, Steen Winther; Walther-Larsen, Søren;


    Clonidine is used increasingly in paediatric anaesthetic practice to prolong the duration of action of caudal block with a local anaesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and i.v. clonidine on postoperat...

  15. Relation of Stump Length with Various Gait Parameters in Trans-tibial Amputee

    Directory of Open Access Journals (Sweden)

    Koyel Majumdar


    Full Text Available The purpose of this paper is evaluating the impact of stump length of unilateral below knee amputees (BKA on different gait parameters. Nine unilateral BKA were chosen and divided into three groups comprising patients with short, medium, and long stump length. Each of them underwent gait analysis test by Computer Dynography (CDG system to measure the gait parameters. It was found that the ground reaction force is higher in the patients with medium stump length whereas the velocity, step length both for the prosthetic and sound limb and cadence were high in longer stump length. Statistical analysis shows a significant difference (p<0.05 between the gait parameters of BKA with medium and longer stump length. The patients with longer stump length were more efficient than medium and short stump patients as they consumed comparatively lesser energy while walking with self-selected velocity and conventional (Solid ankle cushioned heel SACH foot.

  16. Stereotactic body radiation therapy for patients with recurrent pancreatic adenocarcinoma at the abdominal lymph nodes or postoperative stump including pancreatic stump and other stump

    Directory of Open Access Journals (Sweden)

    Zeng XL


    Full Text Available Xian-Liang Zeng,* Huan-Huan Wang,* Mao-Bin Meng, Zhi-Qiang Wu, Yong-Chun Song, Hong-Qing Zhuang, Dong Qian, Feng-Tong Li, Lu-Jun Zhao, Zhi-Yong Yuan, Ping Wang Department of Radiation Oncology, Tianjin’s Clinical Research Center for Cancer and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, People’s Republic of China *These authors contributed equally to this work Background and aim: The aim of this study is to evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT using CyberKnife in the treatment of patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery. Patients and methods: Between October 1, 2006 and May 1, 2015, patients with recurrent pancreatic adenocarcinoma at the abdominal lymph node or stump after surgery were enrolled and treated with SBRT at our hospital. The primary end point was local control rate after SBRT. Secondary end points were overall survival, time to symptom alleviation, and toxicity, assessed using the Common Terminology Criteria for Adverse Events version 4.0. Results: Twenty-four patients with 24 lesions (17 abdominal lymph nodes and seven stumps were treated with SBRT, of which five patients presented with abdominal lymph nodes and synchronous metastases in the liver and lung. The 6-, 12-, and 24-month actuarial local control rates were 95.2%, 83.8%, and 62.1%, respectively. For the entire cohort, the median overall survival from diagnosis and SBRT was 28.9 and 12.2 months, respectively. Symptom alleviation was observed in eleven of 14 patients (78.6% within a median of 8 days (range, 1–14 days after SBRT. Nine patients (37.5% experienced Common Terminology Criteria for Adverse Events version 4.0 grade 1–2 acute toxicities; one patient experienced grade 3 acute toxicity due to thrombocytopenia. Conclusion: SBRT is a safe and

  17. Modeling spinal cord biomechanics (United States)

    Luna, Carlos; Shah, Sameer; Cohen, Avis; Aranda-Espinoza, Helim


    Regeneration after spinal cord injury is a serious health issue and there is no treatment for ailing patients. To understand regeneration of the spinal cord we used a system where regeneration occurs naturally, such as the lamprey. In this work, we analyzed the stress response of the spinal cord to tensile loading and obtained the mechanical properties of the cord both in vitro and in vivo. Physiological measurements showed that the spinal cord is pre-stressed to a strain of 10%, and during sinusoidal swimming, there is a local strain of 5% concentrated evenly at the mid-body and caudal sections. We found that the mechanical properties are homogeneous along the body and independent of the meninges. The mechanical behavior of the spinal cord can be characterized by a non-linear viscoelastic model, described by a modulus of 20 KPa for strains up to 15% and a modulus of 0.5 MPa for strains above 15%, in agreement with experimental data. However, this model does not offer a full understanding of the behavior of the spinal cord fibers. Using polymer physics we developed a model that relates the stress response as a function of the number of fibers.

  18. Analysis of environmentally friendly harvesting systems for integrated stump fuel and roundwood production

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Simon [Swedish Univ. of Agricultural Sciences, Dept. of Forest Resource Management, Umeaa (Sweden)], e-mail:


    Tree stumps could potentially make a significant contribution to the transition from reliance on foreign fossil to renewable domestic energy sources in Sweden, but harvesting them can have unintended negative environmental consequences, largely due to ground disturbance. One way to reduce the ground disturbance is to only harvest the central part of the stump, but this is not profitable using current systems. A possible solution is to integrate stump-centre and roundwood harvests. In the presented study the work, productivity and costs of a conventional, separate stem and stump harvesting system were compared in simulations to an integrated system for simultaneously harvesting stem and stump centre. The conventional system involves use of a harvester, a forwarder, a stump harvester and a stump forwarder, while the integrated system consists of a feller-puller that fells trees with the stump centre attached, a processor and a forwarder. The results indicate that integrated harvests could produce stump wood more cheaply than the current stump harvesting system at sites dominated by trees with breast height diameters exceeding 200 mm, which includes about 80% of the clear-cutting sites in Sweden. The study is not yet complete, the results are thus preliminary and require further validation, but such integrated supply systems are promising and warrant further research.

  19. Spinal dysraphism: MR imaging rationale. (United States)

    Rossi, A; Cama, A; Piatelli, G; Ravegnani, M; Biancheri, R; Tortori-Donati, P


    Spinal cord development occurs through the three consecutive periods of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal cord malformations derive from defects in these early embryonic stages, and are collectively called spinal dysraphisms. Spinal dysraphisms may be categorized clinically into open and closed, based on whether the abnormal nervous tissue is exposed to the environment or covered by skin. Open spinal dysraphisms include myelomeningocele and other rare abnormalities such as myelocele, hemimyelomeningocele, and hemimyelocele, and are always associated with a Chiari II malformation. Closed spinal dysraphisms are further divided into two subsets based on whether a subcutaneous mass is present in the low back. Closed spinal dysraphisms with mass comprise lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category involves abnormal notochordal development, either in the form of failed midline integration (ranging from complete dorsal enteric fistula to neurenteric cysts and diastematomyelia) or of segmental agenesis (caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging is the imaging modality of choice for evaluation of this complex group of disorders.

  20. Stump appendicitis is a rare delayed complication of appendectomy: A case report

    Institute of Scientific and Technical Information of China (English)

    Mehmet Uludag; Adnan Isgor; Muzaffer Basak


    Stump appendicitis is an acute inflammation of the residual appendix and one of the rare complications after appendectomy. Paying attention to the possibility of stump appendicitis in patients with right lower abdominal pain after appendectomy can prevent the delay of diagnosis and treatment. In patients with stump appendicitis,CT scan not only assists in making an accurate preoperative diagnosis but also excludes other etiologies. We report a 47-year old man with preoperatively diagnosed stump appendicitis by CT, who underwent an open appendectomy 20 years ago.

  1. A Rare Case: Appendectomy After Connected Stump Appendicitis Perforation of the Cecum

    Directory of Open Access Journals (Sweden)

    Berke Manoglu


    Full Text Available Stump appendicitis is a rare complication after appendectomy . Stump appendicitis made of incomplete appendectomy after a rest appendix tissue develops as a result of the inflammation. Admitted to the emergency department with acute abdomen and a history of appendectomy in patients with a history of current pain in the right lower quadrant , especially that of the patient must be evaluated in terms of stump appendicitis. The fact that the earlier story appendectomy patients , causing a delay in diagnosis and increasing the morbidity Cecal perforation was offered an advanced case of delayed depending on the stump appendicitis in this article.

  2. Chemical composition of decomposing stumps in successive rotation of Chinese fir (Cunninghamia lanceolata (Lamb.) Hook.) plantations

    Institute of Scientific and Technical Information of China (English)

    HUANG Zhiqun; XU Zhihong; BOYD Sue; WILLIAMS David


    Decomposition of stumps in successive rotation of Chinese fir (Cunninghamia lanceolata (Lamb.) Hook.) plantations was studied using a chronosequence approach. The results showed that decomposition rate constant of Chinese fir stump was 0.02695 as calculated from Olson's model. The N content of stump increased during the first two-year decomposition. When the dead stump C/N ratio was 463.2 ± 27.3, the stumps started to release N. The pattern of P release was similar to that for N. However, K content of stumps showed a consistent declining trend over time during the whole decomposition. 13C nuclear magnetic resonance spectroscopy with cross polarization and magic-angle spinning (13C CPMAS-NMR) was used to analyse organic carbon (C) components in decomposing stumps. The 13C CPMAS-NMR spectra of stumps displayed that stump was dominated by cellulose and hemicellulose. The spectra also showed the accumulation of intensity in alkyl C, aromatic C, and carboxyl C spectral regions, which was expected as the labile cellulose and hemicellulose components in O-alkyl C spectral region were selectively decomposed first.

  3. Case of spontaneous tubal stump pregnancy after adnexectomy

    Institute of Scientific and Technical Information of China (English)

    Konrad Futyma; Andrzej Wr ´obel; Aleksandra Filipczak; Tomasz Rechberger


    Ectopic pregnancy is a significant problem in women of childbearing potential and affects up to 2%of them. The most common ectopic pregnancy localization is the ampullary area of the Fallopian tube. Patient with spontaneous ectopic pregnancy located in the tubal stump after an ipsilateral adnexectomy performed with a laparotomy due to mucinous cystadenoma was operated by laparoscopy. Remnant of Fallopian tube with ectopic pregnancy was removed. The most important lecture from this case is when adnexectomy or salpingectomy is per-formed, it should be done in the isthmic part, without leaving any remnant.

  4. Case of spontaneous tubal stump pregnancy after adnexectomy

    Directory of Open Access Journals (Sweden)

    Konrad Futyma


    Full Text Available Ectopic pregnancy is a significant problem in women of childbearing potential and affects up to 2% of them. The most common ectopic pregnancy localization is the ampullary area of the Fallopian tube. Patient with spontaneous ectopic pregnancy located in the tubal stump after an ipsilateral adnexectomy performed with a laparotomy due to mucinous cystadenoma was operated by laparoscopy. Remnant of Fallopian tube with ectopic pregnancy was removed. The most important lecture from this case is when adnexectomy or salpingectomy is performed, it should be done in the isthmic part, without leaving any remnant.


    Directory of Open Access Journals (Sweden)

    Satyendra S


    Full Text Available In the Urological surgery, the most commonly performed procedure in Transurethral Resection of Prostate. Most of these patients are elderly above the age of 60 years with various systemic problems. The common problem includes cardiovascular disorder, chronic obstructive pulmonary diseases and various old age problems. These patients present as a challenge to anaesthesiologists because they are high risk patients for endoscopic surgeries. Various worker since many years tried different type of anesthesia procedure. The regional techniques have been proved to be safe and less risky. It includes spinal, lumbar epidural, combined spinal epidural and caudal epidural. The caudal epidural block have been used by many workers for TURP in elderly patients since so many years. The Present study includes 50 patients of ASA grade I, II, III including cardiovascular problem, COPD, and other spinal deformities, scheduled for TURP. After pre anesthetic checkup and through investigation, caudal epidural block were given by standard technique. Observation and results were recorded by observing the onset and duration of analgesia, level of block, any side effects. The changes in pulse rate, blood pressure, SPO 2 , ECG were closely monitored throughout the procedure. The observation showed that 60% of patients having co - existing diseases and most of them having chronic Hypertension (30%, onset of analgesia was 10 - 15 mins in 30 patients. Motor blockade by modified bromage scale was observed and found that 45 patients ( 90% has MBS - O. There were no significant changes observed in PR, BP, R/R, ECG and SPO 2 throughout the procedure in all patients. Response to total procedure was found excellent in 40 patients ( 80%. There were no significant complication observed in maximum number of patients. Only 5 patients had complained of nausea and vomiting, which was successfully treated by antiemetics

  6. Systematization, distribution and territory of the caudal cerebral artery on the brain's surface of the turkey (Meleagris gallopavo

    Directory of Open Access Journals (Sweden)

    Amarílis Díaz de Carvalho


    Full Text Available Thirty Meleagris gallopavo heads with their neck segments were used. Animals were contained and euthanized with the association of mebezonium iodide, embutramide and tetracaine hydrochloride (T 61, Intervet by intravenous injection. The arterial system was rinsed with cold saline solution (15°C, with 5000IU heparin and filled with red-colored latex. The samples were fixed in 20% formaldehyde for seven days. The brains were removed with a segment of cervical spinal cord and after, the dura-mater was removed and the arteries dissected. The cerebral carotid arteries, after the intercarotid anastomosis, were projected around the hypophysis, until they reached the tuber cinereum and divided into their terminal branches, the caudal branch and the rostral branch. The rostral branch was projected rostrolateralwards and gave off, in sequence, two collateral branches, the caudal cerebral and the middle cerebral arteries and the terminal branch was as cerebroethmoidal artery. The caudal cerebral artery of one antimere formed the interhemispheric artery, which gave off dorsal hemispheric branches to the convex surface of both antimeres. Its dorsal tectal mesencephalic branch, of only one antimere, originated the dorsal cerebellar artery. In the interior of the cerebral transverse fissure, after the origin of the dorsal tectal mesencephalic artery, the caudal cerebral artery emitted occipital hemispheric branches, pineal branches and medial hemispheric branches, on both antimeres. The caudal cerebral artery's territory comprehended the entire surface of the dorsal hemioptic lobe, the rostral surface of the cerebellum, the diencephalic structures, the caudal pole and the medial surface of the cerebral hemisphere and in the convex surface, the sagittal eminence except for its most rostral third. Due to the asymmetry found in the caudal cerebral arteries' ramifications, the models were classified into three types and their respective subtypes.

  7. Short-term responses of decomposers and vegetation to stump removal

    Energy Technology Data Exchange (ETDEWEB)

    Kataja-aho, S.


    Stump removal has become a common practice to produce raw material for bioenergy production. It was hypothesized that stump removal is an extensive and more intense disturbance for forest ecosystems (soil decomposer organisms and vegetation) compared to traditional site preparation after clear cutting. Therefore, the effects of stump harvesting on forest soil decomposers, vegetation and nutrient dynamics in undisturbed patches of the forest soil and in exposed mineral soil were compared to the effects of the traditional site preparation method, mounding. Nematodes and enchytraeids were the only decomposer groups that were directly affected (negatively) by the stump removal. Regardless of the treatment, the abundances of most of the decomposer groups were consistently lower in the exposed mineral soil than in the intact forest soil. There was 2-3 times more exposed mineral soil in stump removal sites compared to mounding sites. When this was taken into account, the decomposer community was negatively affected by the stump removal at the forest stand level. However, the greater soil disturbance at the stump harvesting sites enhanced CO{sub 2} production, net nitrogen mineralisation and nitrification. The increased N availability and the changes in microclimate due to the disturbance probably explained the vegetation increase at the stump harvested sites. Planted Norway spruce seedlings grew faster during the first two growing periods at the stump removal sites than at the mounding sites. The seedlings had high and similar ectomycorrhizal colonization rate in both treatments. In the short-term, it is probably not the resources removed in the stumps themselves, but the degree and amount of soil disturbance during the stump harvesting procedure that affects the decomposer community and its function in the clear-felled stands. (orig.)


    Institute of Scientific and Technical Information of China (English)

    ZHANG Xi; SU Yu-min; WANG Zhao-li


    This article presents a comprehensive study of the effects of the caudal fin shape on the propulsion performance of a eandal fin in harmonic heaving and pitching.A numerical simulation based on an unsteady panel method was carried out to analyze the hydrodynamic performance of flapping caudal fins of three shapes (the whale caudal fin with the largest projected area, the dolphin caudal fin with the median projected area, and the tuna caudal fin with the smallest projected area).Then, a series of hydrodynamic experiments for three caudal fin shapes were performed.Both computational and experimental results indicate that the tuna caudal fin produces the highest efficiency.However the mean thrust coefficient of the tuna caudal fin is the smallest.It is found that although the mean thrust coefficient for the tuna caudal fin is not large, the input power of the tuna caudal fin is also quite small.So the tuna caudal fin achieves a high efficiency.

  9. Bamboo stumps as mosquito larval habitats in Darjeeling Himalayas,India:A spatial scale analysis

    Institute of Scientific and Technical Information of China (English)

    Gautam Aditya; Rakesh Tamang; Dipendra Sharma; Francis Subba; Goutam K.Saha


    Bamboo stumps can be a congenial breeding habitat of the mosquitoes.In view of this,a preliminary assessment of the dipteran immatures inhabiting the stumps of bamboo groves in the Darjeeling Himalayas was carried out at a spatial scale.Of the 104 stumps of Dendrocalamus hamiltoni surveyed,70 were found to host immatures of three dipteran species,the mosquitoes Aedes aegypti and Culex quinquefasciatus and the midges Chironomus varying densities.Though the stumps varied in diameter,in each stump on average 12.1 immatures were found.The abundance of the immatures was positively correlated with the diameter of the stumps (r = +0.382;P < 0.001) but negatively with the pH of the water present in the stumps (r = -0.336;P < 0.01).The coefficient of association was found to be +8.4 for the Ae.aegypti and Chironomus immatures,while in the rest of the species pair the association seemed to be independent.Thus it can be concluded that the stumps in the bamboo groves of Darjeeling Himalayas provides a favourable habitat for the mosquito and chironomid immatures.

  10. Variation in Measurements of Transtibial Stump Model Volume A Comparison of Five Methods

    NARCIS (Netherlands)

    Bolt, A.; de Boer-Wilzing, V. G.; Geertzen, J. H. B.; Emmelot, C. H.; Baars, E. C. T.; Dijkstra, P. U.


    Objective: To determine the right moment for fitting the first prosthesis, it is necessary to know when the volume of the stump has stabilized. The aim of this study is to analyze variation in measurements of transtibial stump model volumes using the water immersion method, the Design TT system, the

  11. A patient with donning-related stump wounds : A case report

    NARCIS (Netherlands)

    Baars, E. C. T.; Geertzen, J. H. B.


    A patient suffering from diabetes and a trans-tibial amputation presented with stump wounds caused by improper donning of the liner. His diminished hand function resulted in improper donning, with air being trapped between the liner and stump. This caused blisters on the skin after loading the prost

  12. Imaging in spine and spinal cord malformations. (United States)

    Rossi, Andrea; Biancheri, Roberta; Cama, Armando; Piatelli, Gianluca; Ravegnani, Marcello; Tortori-Donati, Paolo


    Spinal and spinal cord malformations are collectively named spinal dysraphisms. They arise from defects occurring in the early embryological stages of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal dysraphisms are categorized into open spinal dysraphisms (OSDs), in which there is exposure of abnormal nervous tissues through a skin defect, and closed spinal dysraphisms (CSD), in which there is a continuous skin coverage to the underlying malformation. Open spinal dysraphisms basically include myelomeningocele and other rare abnormalities such as myelocele and hemimyelo(meningo)cele. Closed spinal dysraphisms are further categorized based on the association with low-back subcutaneous masses. Closed spinal dysraphisms with mass are represented by lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category further comprises defects of midline notochordal integration (basically represented by diastematomyelia) and defects of segmental notochordal formation (represented by caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging (MRI) is the preferred modality for imaging these complex abnormalities. The use of the aforementioned classification scheme is greatly helpful to make the diagnosis.

  13. Imaging in spine and spinal cord malformations

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Andrea E-mail:; Biancheri, Roberta; Cama, Armando; Piatelli, Gianluca; Ravegnani, Marcello; Tortori-Donati, Paolo


    Spinal and spinal cord malformations are collectively named spinal dysraphisms. They arise from defects occurring in the early embryological stages of gastrulation (weeks 2-3), primary neurulation (weeks 3-4), and secondary neurulation (weeks 5-6). Spinal dysraphisms are categorized into open spinal dysraphisms (OSDs), in which there is exposure of abnormal nervous tissues through a skin defect, and closed spinal dysraphisms (CSD), in which there is a continuous skin coverage to the underlying malformation. Open spinal dysraphisms basically include myelomeningocele and other rare abnormalities such as myelocele and hemimyelo(meningo)cele. Closed spinal dysraphisms are further categorized based on the association with low-back subcutaneous masses. Closed spinal dysraphisms with mass are represented by lipomyelocele, lipomyelomeningocele, meningocele, and myelocystocele. Closed spinal dysraphisms without mass comprise simple dysraphic states (tight filum terminale, filar and intradural lipomas, persistent terminal ventricle, and dermal sinuses) and complex dysraphic states. The latter category further comprises defects of midline notochordal integration (basically represented by diastematomyelia) and defects of segmental notochordal formation (represented by caudal agenesis and spinal segmental dysgenesis). Magnetic resonance imaging (MRI) is the preferred modality for imaging these complex abnormalities. The use of the aforementioned classification scheme is greatly helpful to make the diagnosis.

  14. Proteomic analysis of zebrafish caudal fin regeneration. (United States)

    Saxena, Sandeep; Singh, Sachin K; Lakshmi, Mula G Meena; Meghah, Vuppalapaty; Bhatti, Bhawna; Swamy, Cherukuvada V Brahmendra; Sundaram, Curam S; Idris, Mohammed M


    The epimorphic regeneration of zebrafish caudal fin is rapid and complete. We have analyzed the biomechanism of zebrafish caudal fin regeneration at various time points based on differential proteomics approaches. The spectrum of proteome changes caused by regeneration were analyzed among controls (0 h) and 1, 12, 24, 48, and 72 h postamputation involving quantitative differential proteomics analysis based on two-dimensional gel electrophoresis matrix-assisted laser desorption/ionization and differential in-gel electrophoresis Orbitrap analysis. A total of 96 proteins were found differentially regulated between the control nonregenerating and regenerating tissues of different time points for having at least 1.5-fold changes. 90 proteins were identified as differentially regulated for regeneration based on differential in-gel electrophoresis analysis between the control and regenerating tissues. 35 proteins were characterized for its expression in all of the five regenerating time points against the control samples. The proteins identified and associated with regeneration were found to be directly allied with various molecular, biological, and cellular functions. Based on network pathway analysis, the identified proteome data set for regeneration was majorly associated in maintaining cellular structure and architecture. Also the proteins were found associated for the cytoskeleton remodeling pathway and cellular immune defense mechanism. The major proteins that were found differentially regulated during zebrafish caudal fin regeneration includes keratin and its 10 isoforms, cofilin 2, annexin a1, skeletal α1 actin, and structural proteins. Annexin A1 was found to be exclusively undergoing phosphorylation during regeneration. The obtained differential proteome and the direct association of the various proteins might lead to a new understanding of the regeneration mechanism.

  15. Multiple Neuromas Cause Painful "Jumping Stump" in a Transfemoral Amputee: A Case Report. (United States)

    Buntragulpoontawee, Montana; Pattamapaspong, Nuttaya; Tongprasert, Siam


    Painful "jumping stump" is an uncommon but very disturbing complication postamputation. This condition is one of the movement disorder entities resulting from peripheral nerve pathology, often known as "peripherally induced movement disorders." Previously case reports have been written about painful and nonpainful incidence of "jumping stump"; however, only the earliest "jumping stump" article in 1852 suspected that neuromas might influence the involuntary movement. In this study, we describe a 38-year-old man with bilateral transfemoral amputee who suffered from painful "jumping stump" with multiple neuromas confirmed by imaging. He was treated successfully by ultrasound-guided phenol injection into the sciatic neuroma stalks. The pathophysiology of jumping stump and its possible association with neuroma are briefly discussed.

  16. The anatomy and histology of caudal autotomy and regeneration in lizards. (United States)

    Gilbert, Emily A B; Payne, Samantha L; Vickaryous, Matthew K


    Abstract Caudal autotomy-the ability to self-detach the tail-is a dramatic adaptation common to many structural-grade lizards. For most species, tail loss is followed by the equally dramatic phenomenon of tail regeneration. Here we review the anatomy and histology of caudal autotomy and regeneration in lizards, drawing heavily from research published over the past 2 decades. The autotomous tail is characterized by various structural adaptations, which act to minimize blood loss and trauma to adjacent tissues. The early phase of wound healing involves a leukocytic response but limited inflammation. Reepithelialization via a specialized wound epithelium is not only critical for scar-free healing but also necessary for subsequent tissue patterning and regenerative outgrowth. Regeneration begins with the formation of the blastema, a mass of proliferating mesenchymal-like cells. As the blastema expands, it is invaded by blood vessels and the spinal cord. Whereas the replacement tail outwardly resembles the original appendage, it differs in several notable respects, including the tissue composition and organization of the skeleton, muscular system, and spinal cord. Increasingly, the lizard tail is being recognized among biomedical scientists as an important model for the study of wound healing and multitissue restoration.

  17. Analysis of the Caudal Vortices Evolvement around Flapping Foil

    Institute of Scientific and Technical Information of China (English)

    Wang Zhi-dong; Zhang Xiao-qing; Su Yu-min; Xu Yu-ru


    The viscous flow field around two-dimensional flapping (heaving and pitching) foils was numerically computed. The structural characteristics of caudal vortices were investigated and the contour curves at different phase angles were obtained.The relationships between the structural characteristics of the vortices and the force acting on the foil and between the widths of the caudal vortex street and of the caudal flow field were analyzed. A method to determine the shedding frequency of the vortices was proposed.

  18. Fuel quality of Norway spruce stumps - influence of harvesting technique and storage method

    Energy Technology Data Exchange (ETDEWEB)

    Anerud, Erik; Jirjis, Raida (Dept. of Energy and Technology, Swedish Univ. of Agricultural Science, Uppsala (Sweden))


    The interest in using stump biomass as a biofuel has recently increased in Sweden. The uneven consumption of wood fuel during the year creates a need for storage. This study examined the properties of stump biomass and how they vary at two sites in Sweden depending on harvesting technique, storage method and storage period. Norway spruce stumps, extracted using three different stump harvesting heads (Pallari, Rotary Cutter and Aalto), were stored in windrows or heaps. After 3 months, stumps stored in heaps were gathered into windrows. The fuel quality parameters moisture content (MC), ash content (AC) and calorific value (CV) were evaluated on five occasions in the period May 2008 - September 2009. After 16 months of storage, the MC in all treatments had decreased to <25% (wet basis). Average AC decreased from 3.8% to around 1% (dry basis), whereas CV marginally increased. Stumps split during harvesting dried better than those harvested in one piece. The influence of storage method was minimal, although initial storage in heaps allowed better drying in the stumps harvested in one piece. In general, fuel quality improved in all treatments after storage

  19. Modeling stump biomass of stands using harvester measurements for adaptive energy wood procurement systems

    Energy Technology Data Exchange (ETDEWEB)

    Vesa, Lauri [ForestCalc Consulting Oy Ltd., 80230 Joensuu (Finland); Palander, Teijo [School of Forest Sciences, University of Eastern Finland, 80100 Joensuu (Finland)


    The value and volumes of industrial stump fuel supply are increasing for energy production. Accurate estimates of aboveground and belowground biomass of trees are important when estimating the potential of stumps as a bioenergy source. In this study two stump biomass equations were adapted and tested using them as calibrated stump biomass models computed as the cumulative sum by a local stand. In addition, variables derived from stem measurements of the forest harvester data were examined to predict stump biomass of a stand by applying regression analysis. The true stump yield (dry weight) was used as the reference data in the study. Both biomass models performed well (adjusted R{sup 2} {proportional_to} 0.84) and no advance was found in using other stem dimensions as independent variables in the model. The stand-level model can be used in innovative stump biomass prediction tools for increasing efficiency of energy wood procurement planning to stands within a certain area. In practice, wood procurement managers would need to adapt developed system and decide whether the degree of accuracy/precision provided by the models is acceptable in their local stand harvesting conditions. (author)

  20. [Suggesting the Significance of Pericardial Fat Pad in Bronchial Stump Fistula]. (United States)

    Fukuoka, Tomoki; Sano, Masaaki; Tominaga, Nasa; Sanada, Shotaro; Uno, Yasuo; Oya, Hisaharu; Nishi, Tetsuo; Koshikawa, Katsumi


    Bronchial stump fistula is a post-operative complication with poor outcome after pulmonary lobectomy. In order to prevent this complication, the bronchial stump is covered with pericardial fat tissue in our hospital. The case was 58 year old male who received adjuvant chemotherapy after sigmoidectomy for sigmoid colon cancer. As he developed multiple pulmonary metastases, 48 courses of chemotherapy were performed. The lesions had been localized at the right lower lobe, and neither increase in the size of these lesions nor development of other lesions were observed. Hence, an operation was performed. After right lower lobectomy, the bronchial stump was covered with the pericardial fat tissue. Three months after the operation, he developed pneumothorax, and bubbles were detected inside the fat. The pneumothorax was cured conservatively, and the bubbles disappeared spontaneously after 10 months. It is rare that the patient with bubbles in the covering tissue observed for a long time is cured conservatively, suggesting the significance of the stump pad.

  1. Effect of protein synthesis inhibitors on the trophic action of the nerve stump. (United States)

    Komatsu, K; Higashimori, E; Uchida, K; Satoh, S


    We report that protein synthesis inhibitors exert an inhibitory effect on the trophic action of the nerve stump. The sciatic nerve innervating the extensor digitorum longus muscles of mice was cut either as close to, or as far from, the muscle as possible. Denervation changes in the muscle were evaluated using the resting membrane potential and dose-response curves obtained by plotting acetylcholine-induced contractures. Actinomycin D (2 micrograms/kg, i.p.), ethidium bromide (10 micrograms/kg, i.p.), cycloheximide (1 or 5 mg/kg, i.p.), or chloramphenicol (100 mg/kg, p.o.) administration was immediately after neurotomy and continued daily until the day preceding muscle removal. Although denervation changes occurred significantly later in muscles with a long rather than a short nerve stump, the administrated antibiotics, excluding cycloheximide, accelerated the manifestation of denervation changes in muscles with long nerve stumps without affecting those in muscles with short nerve stumps.

  2. Stump treatment against Heterobasidion annosum - Techniques and biological effect in practical forestry

    Energy Technology Data Exchange (ETDEWEB)

    Thor, M. [SkogForsk, Uppsala (Sweden)


    This thesis summarises and discusses results from two studies on mechanized stump treatment to control the root rot fungus Heterobasidion annosum (Fr.) Bref. In Sweden, stump treatment is at present carried out with two chemical compounds, urea and disodium octaborate tetrahydrate (DOT), and a biological control agent, Phlebiopsis gigantea (Fr.) Juel. The first study investigated the H. annosum colonization of Norway spruce (Picea abies (L.) Karst) stumps following mechanized thinning and stump treatment with the three control agents mentioned. The stumps were treated in the summer and were compared with untreated stumps, cut in the summer and winter, respectively. Experimental plots were established in 12 first thinning stands of Norway spruce. Six to seven weeks after thinning and treatment, sample discs were collected (N=1246) and examined for presence of H. annosum. Stump treatment with any of the control agents reduced the colonized stump area 6-7 weeks after thinning by 88-98% as compared with untreated stumps cut in the summer. The effects of the different treatments differed neither from each other nor from the effect of winter thinning. The variation between the stands was considerable, but mechanized stump treatment provided as good protection as manual treatment against H. annosum infections. Study II examined the survival of P. gigantea oidiospores in aqueous suspension when exposed to high temperature or pressure, which are potential problems in mechanized application. In the laboratory, temperatures of 20, 30 or 35 deg C did not affect the survival. The spores could withstand 40 deg C for a short period, but died at 60 deg C. Pressure of up to 2 200 kPa for 24 h did not affect P. gigantea spore germination. In the field, temperatures of the working suspension (10{sup 7} spores I{sup -1}) was assessed during practical operations. Spore viability was maintained through the applicator system. As long as the prescriptions are followed up to the time of

  3. Gastric stump mucosa: is there a risk for carcinoma?

    Directory of Open Access Journals (Sweden)



    Full Text Available Background - Patients who underwent partial gastric resections are at an increased risk for the development of cancer in the gastric remnant. Aim - To assess the long-term patients who underwent surgical treatment for peptic ulcer disease through endoscopic and pathologic evaluation of the gastric stump mucosal alterations. Patients and Methods - Between 1987 and 1990, 154 patients (mean = 20.4 years after gastrectomy were evaluated by upper digestive endoscopy with multiple biopsies and pathological examination. Results - Endoscopic alterations were present in 111 patients (72.1%. The commonest pathologic alterations were foveolar hyperplasia, intestinal metaplasia and cystic dilation. Severe dysplasia was noted in two (1.25% and carcinoma in 13 (8.4% of the cases. In four patients (3.8% the endoscopic findings did not show any evidence of tumors, however they were detected due to multiple biopsies and histologic studies. Conclusions - Surveillance of these patients with endoscopy and multiple biopsies may provide the means to diagnose tumors at an early stage, but the cost benefit ratio of surveillance requires further study.

  4. High-resolution MRI of intact and transected rat spinal cord. (United States)

    Fraidakis, M; Klason, T; Cheng, H; Olson, L; Spenger, C


    Spinal cord transection at midthoracic level leads to an immediate loss of hindlimb motor function as well as to a progressive degeneration of descending and ascending spinal cord pathways. Thoracic spinal cord in unlesioned control rats and in rats 2 to 6 months after complete midthoracic transection were imaged in vivo using an ultrahigh-field (4.7 T) magnetic resonance spectrometer. High-resolution spin-echo and inversion-recovery pulse sequences were employed. In addition, the apparent diffusion coefficients (ADCs) in longitudinal and transverse directions of the spinal cord were determined. Anatomical MRI findings were confirmed in histological spinal cord tissue preparations. In healthy spinal cord, gray and white matter were easily discerned in proton density-weighted images. An infield resolution of max. 76 micrometers per pixel was achieved. In animals with chronic spinal cord transection changes in gray-white matter structure and contrast were observed toward the cut end. The spinal cord stumps showed a tapering off. This coincided with changes in the longitudinal/transverse ADC ratio. Fluid-filled cysts were found in most cases at the distal end of the rostral stump. The gap between the stumps contained richly vascularized scar tissue. Additional pathologic changes included intramedullary microcysts, vertebral dislocations, and in one animal compression of the spinal cord. In conclusion, MRI was found to be a useful method for in vivo investigation of anatomical and physiological changes following spinal cord transection and to estimate the degree of neural degeneration. In addition, MRI allows the description of the accurate extension of fluid spaces (e.g., cysts) and of water diffusion characteristics which cannot be achieved by other means in vivo.

  5. Stumps of Eucalyptus globulus as a source of antioxidant and antimicrobial polyphenols. (United States)

    Luís, Ângelo; Neiva, Duarte; Pereira, Helena; Gominho, Jorge; Domingues, Fernanda; Duarte, Ana Paula


    These past years have seen an enormous development of the area of natural antioxidants and antimicrobials. Eucalyptus globulus is widely cultivated in subtropical and Mediterranean regions in intensive short rotation coppice plantations. In the Portuguese context, E. globulus is the third species in terms of forest area. The stump is the basal part of the tree, including the near-the-ground stem portion and the woody roots that remain after stem felling. The purpose of this work was to study the phytochemical profile and to evaluate the antioxidant and antimicrobial properties of several crude stump wood and stump bark extracts of E. globulus, comparing it with similar extracts of E. globulus wood (industrial chips). The results showed the presence of high concentrations of total phenolic compounds (>200 mg GAE/g extract) and flavonoids (>10 mg QE/g extract) in E. globulus stump extracts. Generally the stump wood extracts stands out from the other ones, presenting the highest percentages of inhibition of linoleic acid oxidation. It was also possible to conclude that the extracts were more active against Gram-positive bacteria, presenting low MIC values. This study thus provides information supporting the economic valorization of E. globulus stump wood.


    Directory of Open Access Journals (Sweden)



    Full Text Available PURPOSE: The objectives of this study were to compare the effects of caudal dexmedetomidine combined with Ropivacaine to provide postoperative analgesia in children and also to establish its safety in the pediatric patients. METHODS: In a randomized, prospective, parallel group, double-blinded study, 80 children of 1 year to 6years posted for lower abdominal surgeries were recruited and allocated into two groups: Group RD (n=40 received 0.25% Ropivacaine 1 ml/kg with dexmedetomidine2 μg/kg, making the volume to 0.5 ml and Group R (n=40 received 0.25% Ropivacaine1 ml/kg + 0.5 ml normal saline. Induction of anesthesia was achieved with Inj. Ketamine 2mg/kg + Inj. Succinylcholine 2mg/kg. Intubated with appropriate-sized Endotracheal tube and caudal block was performed in all patients. Maintained with 66% nitrous oxide in Oxygen and isoflurane 0.2-0.4%.Post-operative pain assessed with FLACC score. RESULTS: The duration of postoperative analgesia recorded a mean of 339 minutes (5.6hrs ± 2.4 hrs. in Group R compared with 884 minutes (14.7 hrs. ±5hrs in Group RD, with a p value of <0.001. Group RD patients achieved a statistically significant higher FLACC score compared with Group RD patients. The peri-operative hemodynamics were stable among both the groups. CONCLUSION: Caudal dexmedetomidine (2 μg/kg with 0.25%Ropivacaine (1 ml/kg for pediatric lower abdominal surgeries provides significant postoperative pain relief and better quality of sleep and a prolonged duration of arousable sedation.

  7. Effect of Stump Length on Postural Steadiness During Quiet Stance in Unilateral Trans-Tibial Amputee

    Directory of Open Access Journals (Sweden)

    P. Lenka


    Full Text Available Although force platform based Center of pressure (COP measures of postural steadiness have been used to test the diagnostic significance of various cerebellar and labyrinthine lesions, but very few literature are available on amputees. The aim of this work is to measure the effect of stump length of Trance-Tibial amputee on postural steadiness during quiet stance. The COP variation, which is the major determinant of stability, has been evaluated. Twenty transtibial amputee patients (age: 34±9.57 years participated in this study. Among them, ten patients were having stump length of (19.33±2.04 cm and ten patients were having stump length of (9.2±0.91 cm. Postural stability is evaluated considering following factors like, AP range, ML range, RMS distance, mean distance, sway velocity, sway area and mean power frequency. The result shows that the mean value of all the measure parameters are having higher values in case of patients having shorter stump length than there counterpart. Therefore, it is concluded that transtibial amputee with longer stump length has better postural steadiness.

  8. Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography. (United States)

    Omoto, Shusaku; Hasegawa, Yuki; Sakai, Kenichiro; Matsuno, Hiromasa; Arai, Ayumi; Terasawa, Yuka; Mitsumura, Hidetaka; Iguchi, Yasuyuki


    Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy.

  9. Tethered spinal cord syndrome with symptomatic onset in adulthood

    Institute of Scientific and Technical Information of China (English)

    HE Shi-sheng; ZHAO Ying-chuan; SHI Zhi-cai; LI Ming; HOU Tie-sheng; ZHANG Ye; WU Yun-gang


    @@ Tethered spinal cord syndrome(TCS)is a condition of overstretching or compression of the caudal part of the spinal cord caused by various spinal lesions,such as a tight filum terminale or an intraspinal lipoma.~(1-9) Though it is a well-recognized cause of neurological deterioration in childhood,its symptomatic onset in adulthood is uncommon.~(10-23) Eleven cases of TCS are presented here.In addition,their related clinical features,surgical procedures and outcomes are investigated.

  10. Serotonin Promotes Development and Regeneration of Spinal Motor Neurons in Zebrafish. (United States)

    Barreiro-Iglesias, Antón; Mysiak, Karolina S; Scott, Angela L; Reimer, Michell M; Yang, Yujie; Becker, Catherina G; Becker, Thomas


    In contrast to mammals, zebrafish regenerate spinal motor neurons. During regeneration, developmental signals are re-deployed. Here, we show that, during development, diffuse serotonin promotes spinal motor neuron generation from pMN progenitor cells, leaving interneuron numbers unchanged. Pharmacological manipulations and receptor knockdown indicate that serotonin acts at least in part via 5-HT1A receptors. In adults, serotonin is supplied to the spinal cord mainly (90%) by descending axons from the brain. After a spinal lesion, serotonergic axons degenerate caudal to the lesion but sprout rostral to it. Toxin-mediated ablation of serotonergic axons also rostral to the lesion impaired regeneration of motor neurons only there. Conversely, intraperitoneal serotonin injections doubled numbers of new motor neurons and proliferating pMN-like progenitors caudal to the lesion. Regeneration of spinal-intrinsic serotonergic interneurons was unaltered by these manipulations. Hence, serotonin selectively promotes the development and adult regeneration of motor neurons in zebrafish.

  11. Relationship between socket pressure and EMG of two muscles in trans-femoral stumps during gait. (United States)

    Hong, Jung Hwa; Mun, Mu Seong


    The biomechanical interaction between the leg stump and the prosthetic socket is critical in achieving close-to-normal ambulation. Although many investigations have been performed to understand the biomechanics of trans-tibial sockets, few studies have measured the socket interface pressure for transfemoral amputees. Furthermore, no report has examined how the residual muscle activities in the transfemoral stump affect the socket interface pressure characteristics during gait. In this study, an experimental method was developed to measure the trans-femoral socket interface pressures and EMG of muscles in the stumps of two trans-femoral amputees. Also, the measurement of three-dimensional prosthetic locomotion was synchronized to understand detailed socket biomechanics. Based on the experimental results, a significant correlation (P socket-interface pressure changes during ambulation.

  12. Glenohumeral interposition of rotator cuff stumps: a rare complication of traumatic rotator cuff tear

    Directory of Open Access Journals (Sweden)

    Paulo Moraes Agnollitto


    Full Text Available Abstract The present report describes a case where typical findings of traumatic glenohumeral interposition of rotator cuff stumps were surgically confirmed. This condition is a rare complication of shoulder trauma. Generally, it occurs in high-energy trauma, frequently in association with glenohumeral joint dislocation. Radiography demonstrated increased joint space, internal rotation of the humerus and coracoid process fracture. In addition to the mentioned findings, magnetic resonance imaging showed massive rotator cuff tear with interposition of the supraspinatus, infraspinatus and subscapularis stumps within the glenohumeral joint. Surgical treatment was performed confirming the injury and the rotator cuff stumps interposition. It is important that radiologists and orthopedic surgeons become familiar with this entity which, because of its rarity, might be neglected in cases of shoulder trauma.

  13. Characterization of Scots pine stump-root biomass as feed-stock for gasification. (United States)

    Eriksson, Daniel; Weiland, Fredrik; Hedman, Henry; Stenberg, Martin; Öhrman, Olov; Lestander, Torbjörn A; Bergsten, Urban; Öhman, Marcus


    The main objective was to explore the potential for gasifying Scots pine stump-root biomass (SRB). Washed thin roots, coarse roots, stump heartwood and stump sapwood were characterized (solid wood, milling and powder characteristics) before and during industrial processing. Non-slagging gasification of the SRB fuels and a reference stem wood was successful, and the gasification parameters (synthesis gas and bottom ash characteristics) were similar. However, the heartwood fuel had high levels of extractives (≈19%) compared to the other fuels (2-8%) and thereby ≈16% higher energy contents but caused disturbances during milling, storage, feeding and gasification. SRB fuels could be sorted automatically according to their extractives and moisture contents using near-infrared spectroscopy, and their amounts and quality in forests can be predicted using routinely collected stand data, biomass functions and drill core analyses. Thus, SRB gasification has great potential and the proposed characterizations exploit it.

  14. Glenohumeral interposition of rotator cuff stumps: a rare complication of traumatic rotator cuff tear* (United States)

    Agnollitto, Paulo Moraes; Chu, Marcio Wen King; Lorenzato, Mario Muller; Zatiti, Salomão Chade Assan; Nogueira-Barbosa, Marcello Henrique


    The present report describes a case where typical findings of traumatic glenohumeral interposition of rotator cuff stumps were surgically confirmed. This condition is a rare complication of shoulder trauma. Generally, it occurs in high-energy trauma, frequently in association with glenohumeral joint dislocation. Radiography demonstrated increased joint space, internal rotation of the humerus and coracoid process fracture. In addition to the mentioned findings, magnetic resonance imaging showed massive rotator cuff tear with interposition of the supraspinatus, infraspinatus and subscapularis stumps within the glenohumeral joint. Surgical treatment was performed confirming the injury and the rotator cuff stumps interposition. It is important that radiologists and orthopedic surgeons become familiar with this entity which, because of its rarity, might be neglected in cases of shoulder trauma. PMID:26929462

  15. The appendiceal stump closure during laparoscopy: historical, surgical, and future perspectives. (United States)

    Gomes, Carlos Augusto; Nunes, Tarcizo Afonso; Soares, Cleber; Gomes, Camila Couto


    During a laparoscopic appendectomy, the closure of the appendiceal stump is an important step because of postoperative complications from its inappropriate management. The development of life-threatening events such as stercoral fistulas, postoperative peritonitis, and sepsis is feared and unwanted. The tactical modification of the appendiceal stump closure with a single endoligature, replacing the invaginating suture, adjusted very well to laparoscopic appendectomy, and nowadays is the procedure of choice, whenever possible. Among the alternatives that do not make use of an invaginating suture, studies advocate the use of an endostapler, endoligature (endo-loop), metal clips, bipolar endocoagulation, and polymeric clips. All alternatives have advantages and disadvantages against the different clinical stages of acute appendicitis, and it should be noted that the different forms of appendiceal stump closure have never been assessed in prospective randomized studies. Knowledge about and appropriate use of all of them are important for a safe and more cost-effective procedure.

  16. Spinal cord projections to the cerebellum in the mouse. (United States)

    Sengul, Gulgun; Fu, YuHong; Yu, You; Paxinos, George


    The projections from the spinal cord to the cerebellar cortex were studied using retrograde neuronal tracers. Thus far, no study has shown the detailed topographic mapping of the projections from the spinal neuron clusters to the cerebellar cortex regions for experimental animals, and there are no studies for the mouse. Tracers Fluoro-Gold and cholera toxin B were injected into circumscribed regions of the cerebellar cortex, and retrogradely labeled spinal cord neurons were mapped throughout the spinal cord. Spinal projections to the cerebellar cortex were mainly from five neuronal columns--central cervical nucleus, dorsal nucleus, lumbar and sacral precerebellar nuclei, and lumbar border precerebellar cells--and from scattered neurons located in the deep dorsal horn and laminae 6-8. The spinocerebellar projections to the cortex were mainly to the vermis. All five precerebellar cell columns projected to both anterior and posterior parts of the cerebellar cortex. Results of this study provide an amendment to the known rostral and caudal boundaries of the precerebellar cell columns in the mouse. Scattered precerebellar neurons in the most caudal deep dorsal horn and laminae 6-8 projected exclusively to the anterior part of the cerebellar cortex. In this study, no labeled spinal neurons were found to project to the lobules 6 and 7 of the cerebellar vermis, the flocculus, and the paraflocculus. Spinocerebellar neurons were located bilaterally, but the majority of the projections were contralateral for the central cervical nucleus, and ipsilateral for the remaining spinal precerebellar neuronal clusters.

  17. Stump entrapment of the anterior cruciate ligament in late childhood and adolescence

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, Arthur B.; Laor, Tal; Zbojniewicz, Andrew M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)


    Displacement of a portion of the torn anterior cruciate ligament (ACL) into the intercondylar notch can cause a focal fibrotic reaction similar to that seen following ACL reconstruction. This displacement, which can result in locking or limitation of knee extension, is termed stump entrapment and is described in adult MR imaging literature. We present a pictorial essay of the etiology and appearance of stump entrapment on MR imaging of the knee in an older child and adolescents and review the significance of this finding. (orig.)

  18. Spinal infections. (United States)

    Tay, Bobby K-B; Deckey, Jeffrey; Hu, Serena S


    Spinal infections can occur in a variety of clinical situations. Their presentation ranges from the infant with diskitis who is unwilling to crawl or walk to the adult who develops an infection after a spinal procedure. The most common types of spinal infections are hematogenous bacterial or fungal infections, pediatric diskitis, epidural abscess, and postoperative infections. Prompt and accurate diagnosis of spinal infections, the cornerstone of treatment, requires a high index of suspicion in at-risk patients and the appropriate evaluation to identify the organism and determine the extent of infection. Neurologic function and spinal stability also should be carefully evaluated. The goals of therapy should include eradicating the infection, relieving pain, preserving or restoring neurologic function, improving nutrition, and maintaining spinal stability.

  19. Spinal brucellosis. (United States)

    Tali, E Turgut; Koc, A Murat; Oner, A Yusuf


    Spinal involvement in human brucellosis is a common condition and a significant cause of morbidity and mortality, particularly in endemic areas, because it is often associated with therapeutic failure. Most chronic brucellosis cases are the result of inadequate treatment of the initial episode. Recognition of spinal brucellosis is challenging. Early diagnosis is important to ensure proper treatment and decrease morbidity and mortality. Radiologic evaluation has gained importance in diagnosis and treatment planning, including interventional procedures and monitoring of all spinal infections.

  20. Spinal Stenosis (United States)

    ... Pharyngitis, Adenitis Syndrome (Juvenile) Polymyalgia Rheumatica Psoriatic Arthritis Raynaud's Phenomenon Reactive Arthritis Rheumatoid Arthritis Scleroderma Sjogren's Syndrome Spinal Stenosis Spondyloarthritis Systemic Lupus Erythematosus (Juvenile) Takayasu's ...

  1. Expression and cellular distribution of ubiquitin in response to injury in the developing spinal cord of Monodelphis domestica

    DEFF Research Database (Denmark)

    Noor, Natassya M; Møllgård, Kjeld; Wheaton, Benjamin J;


    Ubiquitin, an 8.5 kDa protein associated with the proteasome degradation pathway has been recently identified as differentially expressed in segment of cord caudal to site of injury in developing spinal cord. Here we describe ubiquitin expression and cellular distribution in spinal cord up to pos...... changes in ubiquitin expression and cellular distribution in development and response to spinal injury suggest an intricate regulatory system that modulates these responses which, when better understood, may lead to potential therapeutic targets....

  2. A mechanical microconnector system for restoration of tissue continuity and long-term drug application into the injured spinal cord. (United States)

    Brazda, Nicole; Voss, Christian; Estrada, Veronica; Lodin, Homaira; Weinrich, Nils; Seide, Klaus; Müller, Jörg; Müller, Hans W


    Complete transection of the spinal cord leaves a gap of several mm which fills with fibrous scar tissue. Several approaches in rodent models have used tubes, foams, matrices or tissue implants to bridge this gap. Here, we describe a mechanical microconnector system (mMS) to re-adjust the retracted spinal cord stumps. The mMS is a multi-channel system of polymethylmethacrylate (PMMA), designed to fit into the spinal cord tissue gap after transection, with an outlet tubing system to apply negative pressure to the mMS thus sucking the spinal cord stumps into the honeycomb-structured holes. The stumps adhere to the microstructure of the mMS walls and remain in the mMS after removal of the vacuum. We show that the mMS preserves tissue integrity and allows axonal regrowth at 2, 5 and 19 weeks post lesion with no adverse tissue effects like in-bleeding or cyst formation. Preliminary assessment of locomotor function in the open field suggested beneficial effects of the mMS. Additional inner micro-channels enable local substance delivery into the lesion center via an attached osmotic minipump. We suggest that the mMS is a suitable device to adapt and stabilize the injured spinal cord after surgical resection of scar tissue (e.g., for chronic patients) or traumatic injuries with large tissue and bone damages.

  3. Systematization, description and territory of the caudal cerebral artery of the brain in broad-snouted Caiman (Caiman latirostris

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    Lygia Almeida


    Full Text Available Thirty heads with the neck segment of Caiman latirostris were used. The animals were provided from a creation center called Mister Caiman, under the authorization of the Brazilian Institute of Environment and Renewable Natural Resources (Ibama. Animals were sacrificed according to the slaughtering routine of the abattoir, and the heads were sectioned at the level of the third cervical vertebra. The arterial system was washed with cold saline solution, with drainage through jugular veins. Subsequently, the system was filled with red colored latex injection. Pieces were than fixed in 20% formaldehyde, for seven days. The brains were removed, with a spinal cord segment, the duramater removed and the arteries dissected. At the level of the hypophysis, the internal carotid artery gave off a rostral branch, and a short caudal branch, continuing, naturally, as the caudal cerebral artery. This artery projected laterodorsalwards and, as it overpassed the optic tract, gave off its I (the first central branch. Penetrated in the cerebral transverse fissure, emitting the diencephalic artery and next its II (second central branch. Still inside the fissure, originated occipital hemispheric branches and a pineal branch. Emerged from the cerebral transverse fissure, over the occipital pole of the cerebral hemisphere. Projected rostralwards, sagital to the cerebral longitudinal fissure, as interhemispheric artery. This artery gave off medial and convex hemispheric branches to the respective surfaces of the cerebral hemispheres, anastomosed with its contralateral homologous, forming the common ethmoidal artery. This artery entered the fissure between the olfactory peduncles, emerging ventrally and dividing into ethmoidal arteries, right and left, which progressed towards the nasal cavities, vascularizing them. The territory of the caudal cerebral artery included the most caudal area of the base of the cerebral hemisphere, its convex surface, the olfactory

  4. Visuospatial properties of caudal area 7b in Macaca fascicularis

    Institute of Scientific and Technical Information of China (English)

    Hui-Hui JIANG; Ying-Zhou HU; Jian-Hong WANG; Yuan-Ye MA; Xin-Tian HU


    To proceed from sensation to movement,integration and transformation of information from different senses and reference frames are required.Several brain areas are involved in this transformation process,but previous neuroanatomical and neurophysiological studies have implicated the caudal area 7b as one particular component of this transformation system.In this study,we present the first quantitative report on the spatial coding properties of caudal area 7b.The results showed that neurons in this area had intermediate component characteristics in the transformation system; the area contained bimodal neurons,and neurons in this area encode spatial information using a hybrid reference frame.These results provide evidence that caudal area 7b may belong to the reference frame transformation system,thus contributing to our general understanding of the transformation system.

  5. Invagination of the hernial sac stump. Technique for repair of inguinal hernia. (United States)

    Shafik, A


    A technique for repair of indirect inguinal hernia is presented. The hernial sac stump is invaginated in an attempt to secure high ligation of the sac and obliterate any residual peritoneal diverticulum. Four hundred forty-two patients were operated on. The technique consists essentially of division of the internal spermatic fascial tube at the neck as well as embedding of the sac stump by purse-string sutures in a narrow neck of Lembert sutures in a wide neck. The defect in the fascia transversalis is closed over the stump. Three hundred eighty-one patients were followed up 2 to 15 years, with a recurrence rate of 1.6 percent. The concept that in indirect hernia the problem involves the sac rather than the defect is put forward. Recurrence results essentially from the existence of a handmade sac rather than an improperly repaired defect. The role of invagination of the sac in securing complete excision of the sac and proper closure of the defect is discussed. In initiating recurrence, the part played by the redundant peritoneum deep to the internal ring is emphasized. Changes in the dynamics of intraabdominal tension induced by stump embedding are explained.

  6. Effects of covering highland banana stumps with soil on banana weevil Cosmopolites sordidus (Coleoptera: Curculionidae) oviposition

    NARCIS (Netherlands)

    Masanza, M.; Gold, C.S.; Huis, van A.; Ragama, P.E.


    The effect of covering post-harvest banana stumps with soil on banana weevil Cosmopolites sordidus (Germar) oviposition levels was investigated at three locations, Sendusu, Kawanda Agricultural Research Institute (KARI) and Ntungamo district of southwestern Uganda. In the first experiment ovipositio

  7. The neuroma-like structure of the long-time severed and isolated nerve stumps

    Directory of Open Access Journals (Sweden)

    Eros Abrantes Erhart


    Full Text Available The long-time severed and isolated intermediate and distal nerve segments, maintained undisturbed in their connective tissue bed, completely separated from each other and from the proximal stump, are repopulated by nerve-fibres which origin is still unknown. The extremities of such nerve segments present complex nervous nodules capped by fibrous tissue, neuroma-like structures.

  8. Skin problems of the stump and hand function in lower limb amputees : A historic cohort study

    NARCIS (Netherlands)

    Baars, E. C. T.; Dijkstra, P. U.; Geertzen, J. H. B.


    The aim of this study was to investigate the relationship between liner-related skin problems of the stump in patients with a lower limb amputation and impaired hand function. Sixty patients who were treated in a rehabilitation hospital from 1998-2006 were included in an historic cohort study. Data

  9. Microclimate buffering of winter temperatures by pine stumps in a temperate forest (United States)

    Walczyńska, Aleksandra; Kapusta, Paweł


    In the presented study we evaluated the role of wood in buffering its inhabitants against winter temperatures. We followed the microscale temperature patterns inside and outside decaying pine stumps during two winter periods. We analyzed the data by extracting the minimum, maximum and mean temperatures for the episodes of snow, frost or no frost. We compared the temperature variation by applying an absolute values calculation (=modulus) for the subsequent measurements. Finally, we tested the buffering effect of the horizontal depth inside the stumps by comparing the pattern for 5 and 15 cm depths. The results show that (1) the minimum temperature was significantly higher inside than outside the stumps, while temperature variation tended to be larger outside than inside, (2) the dynamics of temperature varied between weather episodes, i.e. the periods characterized by the presence/absence of snow and of frost, (3) the minimum temperature inside the stumps increased with the horizontal depth, while temperature variation decreased. The results presented are the first truly microclimatic data on wood buffering and they are important for the understanding of the possible effects of climate change on the thermal relationships at the microscale.

  10. Carbon and nitrogen pools and mineralization rates in boreal forest soil after stump harvesting (United States)

    Kaarakka, Lilli; Hyvönen, Riitta; Strömgren, Monika; Palviainen, Marjo; Persson, Tryggve; Olsson, Bengt A.; Helmisaari, Heljä-Sisko


    The use of forest-derived biomass has steadily increased in the Finland and Sweden during the past decades. Thus, more intensive forest management practices are becoming more common in the region, such as whole-tree harvesting, both above- and belowground. Stump harvesting causes a direct removal of carbon (C) in the form of biomass from the stand and can cause extensive soil disturbance, which in turn can result in increased C mineralization. In this study, the effects of stump harvesting on soil C and nitrogen (N) mineralization, and soil surface disturbance were studied at two different clear-felled Norway spruce (Picea abies) stands in Central Finland. The treatments were conventional stem-only harvesting combined with mounding (WTH) and stump harvesting (i.e. complete tree harvesting) combined with mounding (WTH+S). Logging residues were removed from all study sites. Soil samples down to a depth of 20 cm were systematically collected from the different soil disturbance surfaces (undisturbed soil, the mounds and the pits) 12-13 years after final harvest. Soil samples were incubated in the laboratory to determine the C and N mineralization rates. In addition, total C and N pools were estimated for each disturbance class and soil layer. Soil C and N pools were lower following stump harvesting, however, no statistically significant treatment effect was detected. Instead, C mineralization responses to treatment intensity was site-specific. C/N-ratio and organic matter content were significantly affected by harvest intensity. The observed changes in C and N pools appear to be related to the intrinsic variation of the surface disturbance and soil characteristics, and harvesting per se, rather than treatment intensity. Long-term studies are however needed to draw long-term conclusions whether stump harvesting significantly changes soil C and nutrient dynamics.


    Institute of Scientific and Technical Information of China (English)

    Chen Keneng; Yang Guoliang; Xie Wei; Hu Minbo; Feng Ruiqing; Shi Xiaotian


    Objective: Traditional method of closing bronchial stumps after lobectomy was whole layer suture by hand or by stapler. Little is known about the ligated bronchial stump following lobectomy. To evaluate the characteristics of ligation method for closing bronchial stumps. Methods: In this study 90 lobectomies on 15 mongrel dogs and 75 bronchial stump models on fresh cadaver bronchus were performed. Multivariables comparison experimental studies were made on the results of three different closing methods: simple ligation,manual suture and stapling. Results: In the ligation group, the operation time was significantly shortened (P<0.01). The depth of stump cavity between ligation group and suture group was of no difference significantly (P>0.05). The resistance against intrabronchial pressure was greater in the ligation group than in the suture group (P<0.01). Pathological studies illustrated earlier healing of mucosal membrane with milder inflammatory reactions.In clinical practice, 121 lobectomies were successfully performed with simple ligation of the stumps.Conclusion: Simple ligation is a safe, reliable, simple, and applicable method for closing bronchial stump following lobectomies.

  12. Spinal myoclonus resembling belly dance. (United States)

    Kono, I; Ueda, Y; Araki, K; Nakajima, K; Shibasaki, H


    A 63-year-old man presented with an 11-month history of progressive myoclonus in the right abdominal wall. Administration of clonazepam reduced the frequency and amplitude. When the therapy was discontinued, the frequency and amplitude of the myoclonus increased, and synchronous and weak myoclonus also was observed in the left abdomen. The trunk was twisted just after the appearance of the abdominal myoclonus associated with myoclonic jerks spreading from the rostral to caudal paraspinal muscles. Later in the clinical course, the myoclonus became stimulus sensitive and was induced by tendon tap given anywhere on the body, with the latency ranging from 50 to 150 ms irrespective of the sites of tapping. Myoclonus seen in the abdominal wall was segmental and considered to be of spinal origin. The reflex myoclonus had a 150-ms refractory period. It can be postulated that increased excitability of anterior horn cells at a certain segment might make a spino-bulbo-spinal reflex manifest at the corresponding segment. This myoclonus is considered to be a new form of spinal reflex myoclonus, because the abdominal myoclonic jerk seems to trigger another myoclonic jerk involving the paraspinal muscles.

  13. Responses of primate caudal parabrachial nucleus and Kolliker-fuse nucleus neurons to whole body rotation (United States)

    Balaban, Carey D.; McGee, David M.; Zhou, Jianxun; Scudder, Charles A.


    The caudal aspect of the parabrachial (PBN) and Kolliker-Fuse (KF) nuclei receive vestibular nuclear and visceral afferent information and are connected reciprocally with the spinal cord, hypothalamus, amygdala, and limbic cortex. Hence, they may be important sites of vestibulo-visceral integration, particularly for the development of affective responses to gravitoinertial challenges. Extracellular recordings were made from caudal PBN cells in three alert, adult female Macaca nemestrina through an implanted chamber. Sinusoidal and position trapezoid angular whole body rotation was delivered in yaw, roll, pitch, and vertical semicircular canal planes. Sites were confirmed histologically. Units that responded during rotation were located in lateral and medial PBN and KF caudal to the trochlear nerve at sites that were confirmed anatomically to receive superior vestibular nucleus afferents. Responses to whole-body angular rotation were modeled as a sum of three signals: angular velocity, a leaky integration of angular velocity, and vertical position. All neurons displayed angular velocity and integrated angular velocity sensitivity, but only 60% of the neurons were position-sensitive. These responses to vertical rotation could display symmetric, asymmetric, or fully rectified cosinusoidal spatial tuning about a best orientation in different cells. The spatial properties of velocity and integrated velocity and position responses were independent for all position-sensitive neurons; the angular velocity and integrated angular velocity signals showed independent spatial tuning in the position-insensitive neurons. Individual units showed one of three different orientations of their excitatory axis of velocity rotation sensitivity: vertical-plane-only responses, positive elevation responses (vertical plane plus ipsilateral yaw), and negative elevation axis responses (vertical plane plus negative yaw). The interactions between the velocity and integrated velocity components

  14. Calcaneal fillet flap: a new osteocutaneous free tissue transfer for emergency salvage of traumatic below-knee amputation stumps. (United States)

    Januszkiewicz, J S; Mehrotra, O N; Brown, G E


    Traumatic below-knee amputations do not always leave enough soft tissue of bone with which to fashion a stump of sufficient length and durability to support a prosthesis. Composite free flaps can often be harvested from the amputated limb to provide immediate one-stage stump salvage and to preserve knee function. We report a new technique to increase stump length by incorporating the calcaneus into a foot fillet flap as a vascularized bone transfer. The calcaneal fillet flap is a useful addition to the inventory of available composite flaps. It is recommended for knee joint salvage when there is less than 11 cm of tibial remnant length.

  15. Ontogenetic scaling of caudal fin shape in Squalus acanthias (Chondrichthyes, Elasmobranchii): a geometric morphometric analysis with implications for caudal fin functional morphology. (United States)

    Reiss, Katie L; Bonnan, Matthew F


    The shark heterocercal caudal fin and its contribution to locomotion are of interest to biologists and paleontologists. Current hydrodynamic data show that the stiff dorsal lobe leads the ventral lobe, both lobes of the tail are synchronized during propulsion, and tail shape reflects its overall locomotor function. Given the difficulties surrounding the analysis of shark caudal fins in vivo, little is known about changes in tail shape related to ontogeny and sex in sharks. A quantifiable analysis of caudal fin shape may provide an acceptable proxy for inferring gross functional morphology where direct testing is difficult or impossible. We examined ontogenetic and sex-related shape changes in the caudal fins of 115 Squalus acanthias museum specimens, to test the hypothesis that significant shape changes in the caudal fin shape occur with increasing size and between the sexes. Using linear and geometric morphometrics, we examined caudal shape changes within the context of current hydrodynamic models. We found no statistically significant linear or shape difference between sexes, and near-isometric scaling trends for caudal dimensions. These results suggest that lift and thrust increase linearly with size and caudal span. Thin-plate splines results showed a significant allometric shape change associated with size and caudal span: the dorsal lobe elongates and narrows, whereas the ventral lobe broadens and expands ventrally. Our data suggest a combination of caudal fin morphology with other body morphology aspects, would refine, and better elucidate the hydrodynamic factors (if any) that underlie the significant shape changes we report here for S. acanthias.

  16. Spinal Stenosis (United States)

    ... lower part of the body. It resembles a “horse’s tail” ( cauda equina in Latin). What Causes Spinal ... of the spine fails, it usually places increased stress on other parts of the spine. For example, ...

  17. Spinal Hemangiomas

    Directory of Open Access Journals (Sweden)

    I.A. Norkin


    Full Text Available The given article considers the modern view on etiology, pathogenesis, classifications, clinical picture, diagnosis and treatment of spinal hemangiomas. Advantages of vertebroplasty over the other techniques of treatment of studied pathology are presented

  18. Spinal Hemangiomas


    I.A. Norkin; S.V. Likhachev; A.Yu. Chomartov; A.I. Norkin; D.M. Puchinian


    The given article considers the modern view on etiology, pathogenesis, classifications, clinical picture, diagnosis and treatment of spinal hemangiomas. Advantages of vertebroplasty over the other techniques of treatment of studied pathology are presented

  19. Spinal Infections (United States)

    ... infections may occur following surgery or spontaneously in patients with certain risk factors. Risk factors for spinal infections include poor nutrition, immune suppression, human immunodeficiency virus (HIV) infection, cancer, diabetes and obesity. Surgical risk factors ...

  20. Spinal Stenosis (United States)

    ... risk. Diseases such as arthritis and scoliosis can cause spinal stenosis, too. Symptoms might appear gradually or not at all. They include Pain in your neck or back Numbness, weakness, cramping, or pain in ...

  1. Spinal cord decompression reduces rat neural cell apoptosis secondary to spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Kan XU; Qi-xin CHEN; Fang-cai LI; Wei-shan CHEN; Min LIN; Qiong-hua WET


    Objective: To determine whether spinal cord decompression plays a role in neural cell apoptosis after spinal cord injury. Study design: We used an animal model of compressive spinal cord injury with incomplete paraparesis to evaluate neural cell apoptosis after decompression. Apoptosis and cellular damage were assessed by staining with terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate nick-end labelling (TUNEL) and immunostaining for caspase-3, Bcl-2 and Bax. Methods: Experiments were conducted in male Spragne-Dawley rats (n=78) weighing 300-400 g. The spinal cord was compressed posteriorly at T10 level using a custom-made screw for 6 h, 24 h or continuously, followed by decompression by removal of the screw. The rats were sacrificed on Day 1 or 3 or in Week 1 or 4 post-decompression. The spinal cord was removed en bloc and examined at lesion site, rostral site and caudal site (7.5 mm away from the lesion). Results: The numbers of TUNEL-positive cells were significantly lower at the site of decompression on Day l, and also at the rostral and caudal sites between Day 3 and Week 4 post-decompression, compared with the persistently compressed group. The numbers of cells between Day 1 and Week 4 were immunoreactive to caspase-3 and B-cell lymphoma-2 (Bcl-2)-associated X-protein (Bax), but not to Bcl-2, correlated with those of TUNEL-positive cells. Conclusion: Our results suggest that decompression reduces neural cell apoptosis following spinal cord injury.

  2. FDG uptake at the bronchial stump after curative lobectomy for non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Keyzer, Caroline; Corbusier, Florence; Kyratzi, Eirini; Gevenois, Pierre Alain [Universite libre de Bruxelles, Department of Radiology, Hopital Erasme, Brussels (Belgium); Sokolow, Youri [Universite libre de Bruxelles, Department of Thoracic Surgery, Hopital Erasme, Brussels (Belgium); Goldman, Serge [Universite libre de Bruxelles, Department of Nuclear Medicine, Hopital Erasme, Brussels (Belgium)


    Focal areas of FDG uptake may occur at the bronchial stump following curative lobectomy for non-small-cell lung carcinoma (NSCLC), even in the absence of suspicious CT changes. The purpose of our study was to investigate the significance of such PET/CT findings. FDG-PET/CT scans performed in 54 patients after lobectomy for NSCLC were reviewed. The presence of focal areas of FDG uptake at the bronchial stump, associated CT abnormalities, SUVmax, and normalized SUV (SUVnorm = SUVmax/mean liver SUV) were recorded. Final diagnosis was based on biopsy or imaging follow-up. Focal areas of FDG uptake at the bronchial stump were detected in 30 patients (56 %). Mean SUVmax was 4.0 ± 1.9 (range; 2.2-12.1) and mean SUVnorm was 1.8 ± 0.8 (range; 0.9-4.5). Biopsy showed recurrence in two patients. In these patients, SUVnorm was respectively 4.4 and 4.5 (with SUVmax of 8.8 and 12.1), whereas SUVnorm was lower than 4.0 in those without recurrence, with mean SUVnorm of 1.6 ± 0.5 (range; 0.9-3.4) and mean SUVmax of 3.6 ± 0.9 (range; 2.2-5.8). The CT component of the PET/CT revealed ill-defined peribronchial soft tissue opacity only in both patients with recurrence. FDG uptake at the bronchial stump is a frequent finding after pulmonary lobectomy. Moderate levels of FDG uptake (i.e., SUVnorm < 4.0) without corresponding abnormal CT findings might be a dual criterion for diagnosing benign post-surgical changes. (orig.)

  3. A Clinical Perspective and Definition of Spinal Cord Injury. (United States)

    Kretzer, Ryan M


    Spinal cord injury (SCI) can be complete or incomplete. The level of injury in SCI is defined as the most caudal segment with motor function rated at greater than or equal to 3/5, with pain and temperature preserved. The standard neurological classification of SCI provided by the American Spinal Injury Association (ASIA) assigns grades from ASIA A (complete SCI) through ASIA E (normal sensory/motor), with B, C, and D representing varying degrees of injury between these extremes. The most common causes of SCI include trauma (motor vehicle accidents, sports, violence, falls), degenerative spinal disease, vascular injury (anterior spinal artery syndrome, epidural hematoma), tumor, infection (epidural abscess), and demyelinating processes (). (SDC Figure 1, is included in full-text article.).

  4. Greenhouse gas balance of harvesting stumps and logging residues for energy in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Lindholm, Eva-Lotta; Hansson, Per-Anders (Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala (Sweden)), E-mail:; Stendahl, Johan (Department of Soil and Environment, Swedish University of Agricultural Sciences, Uppsala (Sweden)); Berg, Staffan (Forestry Research Institute of Sweden, Uppsala Science Park, Uppsala (Sweden))


    In this case study, forest fuel procurement chains of stumps and logging residues were evaluated using a Life Cycle Assessment perspective. Direct emissions from combustion were not included, but soil organic carbon change was included as changes in carbon stocks in litter and soil. The results showed that primary forest biomass for energy has a climate impact which is time dependent. However, in long-time perspectives, there are large greenhouse gas (GHG) savings. In a short term (20 years), there were no GHG savings when natural gas or coal was replaced. This is due to the fact that the harvest lead to decreased input of organic matter to the soil which is compared to a reference where biomass are left to decompose. The reduction in soil organic carbon may have been underestimated in the stump harvest systems studied, as the effect of soil disturbance per se was not included. Important factors when assessing GHG balance of forest fuels, besides the time horizon used, were site productivity, geographical position and forest fuel resource (stumps or logging residues). When assessing the greenhouse gas savings, efficiency of the end-use, allocation method between heat and power and type of fossil fuel replaced were also important

  5. MR epidurography: distribution of injectate at caudal epidural injection

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Darra T. [Cappagh National Orthopedic Hospital, Dublin 11 (Ireland); St Paul' s Hospital, Department of Radiology, Vancouver, BC (Canada); Kavanagh, Eoin C.; Moynagh, Michael R.; Eustace, Stephen [Cappagh National Orthopedic Hospital, Dublin 11 (Ireland); Mater Misericordiae University Hospital, Dublin 7 (Ireland); Poynton, Ashley; Chan, Vikki O. [Cappagh National Orthopedic Hospital, Dublin 11 (Ireland)


    To (a) evaluate the feasibility of MR epidurography (MRE) and (b) assess the distribution of injectate using two different volumes at caudal epidural steroid injection. Twenty patients who were referred with symptomatic low back pain for caudal epidural steroid injection were assigned to have either 10 ml (9/20) or 20 ml (11/20) of injectate administered. Gadolinium was included in the injection. The patients proceeded to MRI where sagittal and coronal T1-weighted fat-saturated sequences were acquired and reviewed in the mid-sagittal and right and left parasagittal views at the level of the exit foramina. Gadolinium was observed at or above the L3/4 disc level in all 11 patients who received 20 ml (100 %), compared with only five of nine patients who received 10 ml (56 %). Injectate was seen to the L4 nerve root level in all 11 patients who received 20 ml (100 %) but only four out of nine patients who received 10 ml (44 %), not even reaching the L5 nerve root level in four further of these nine patients (44 %). Overall, there was a trend to visualize gadolinium at higher levels of the epidural space with higher volumes injected. Firstly, MR epidurography is a safe technique that allows excellent visualization of the distribution of gadolinium in the epidural space following injection via the caudal hiatus. Secondly, a volume of 10 ml is unlikely to treat L5/S1 disease in almost half of patients at caudal epidural steroid injection and at least 20 ml of injectate is likely required for any medication to reach the desired level. (orig.)

  6. Anatomical Study of Sacral Hiatus for Caudal Epidural Block

    Directory of Open Access Journals (Sweden)

    Dhananjay S Patil


    Full Text Available Introduction: Anatomy of the sacral hiatus is having clinical importance during caudal epidural block. Present study is aimed at determining anatomy of sacrum specially sacral hiatus for caudal epidural block, with the help of morphometric measurements of the sacrum in relation to sacral hiatus in dry sacral bones. Material & method: Total 103 complete and undamaged adult, dry sacral bones were measured with Vernier caliper (accuracy 0.1 mm and anatomical measurements were obtained. Results: Three bones were excluded because of total posterior closure defect. Agenesis of the sacral hiatus was detected in three sacral bones. Right and left superolateral sacral crests of the sacrum were taken as two points on dorsal surface of sacrum (forming the base of a triangle because posterior superior iliac spines impose on the superolateral sacral crests. The distance between the two superolateral sacral crests (base of a triangle, the distances between the right and left superolateral sacral crest and the sacral apex were on average 60.61(SD 6.71, 61.95 (11.71 and 61.4 (11.98 mm respectively.. Summary: An equilateral triangle formed between the apex of the sacral hiatus and right and left superolateral sacral crests. This equilateral triangle will help in determining the location of the sacral hiatus during caudal epidural block. [National J of Med Res 2012; 2(3.000: 272-275

  7. Numerical Study on Hydrodynamic Performance of Bionic Caudal Fin

    Directory of Open Access Journals (Sweden)

    Kai Zhou


    Full Text Available In this work, numerical simulations are conducted to reveal the hydrodynamic mechanism of caudal fin propulsion. In the modeling of a bionic caudal fin, a universal kinematics model with three degrees of freedom is adopted and the flexible deformation in the spanwise direction is considered. Navier-Stokes equations are used to solve the unsteady fluid flow and dynamic mesh method is applied to track the locomotion. The force coefficients, torque coefficient, and flow field characteristics are extracted and analyzed. Then the thrust efficiency is calculated. In order to verify validity and feasibility of the algorithm, hydrodynamic performance of flapping foil is analyzed. The present results of flapping foil compare well with those in experimental researches. After that, the influences of amplitude of angle of attack, amplitude of heave motion, Strouhal number, and spanwise flexibility are analyzed. The results show that, the performance can be improved by adjusting the motion and flexibility parameters. The spanwise flexibility of caudal fin can increase thrust force with high propulsive efficiency.

  8. Acetylcarnitine hydrolase activity in bovine caudal epididymal spermatozoa

    Energy Technology Data Exchange (ETDEWEB)

    Bruns, K.; Foster, R.A.; Casillas, E.R.


    Recently, the authors identified mM concentrations of acetylcarnitine in epidiymal fluids and have investigated the metabolism of acetylcarnitine by bovine and hamster caudal epididymal spermatozoa. (1-/sup 14/C)acetyl-L-carnitine is oxidized to /sup 14/CO/sub 2/ by washed, intact hamster and bovine sperm at maximal rates of 8.4 and 15.2 nmol/hr/10/sup 7/ cells respectively. Conversely, the carnitine moiety of acetyl-L-(/sup 3/H-methyl)carnitine is not accumulated by sperm under similar conditions. Hydrolysis of (/sup 3/H)acetyl-L-carnitine and competition of uptake of (/sup 3/H)acetate by unlabeled acetate was demonstrated in incubations of intact cells of both species. The amount of (/sup 3/H)acetate accumulated in the incubation medium is time-dependent and also depends on the concentration of unlabeled acetate. A partial solubilization of acetylcarnitine hydrolase activity from washed, intact bovine caudal epididymal spermatozoa in buffer or 0.01% Triton X-100 is observed. There is an enrichment of acetylcarnitine hydrolase activity in purified plasma membranes from bovine caudal epididymal spermatozoa when compared to the activity present in broken cell preparations or other cellular fractions. The results suggest that acetylcarnitine is a substrate for spermatozoa as they traverse the epididymis.

  9. Growth Hormone (GH) and Rehabilitation Promoted Distal Innervation in a Child Affected by Caudal Regression Syndrome. (United States)

    Devesa, Jesús; Alonso, Alba; López, Natalia; García, José; Puell, Carlos I; Pablos, Tamara; Devesa, Pablo


    Caudal regression syndrome (CRS) is a malformation occurring during the fetal period and mainly characterized by an incomplete development of the spinal cord (SC), which is often accompanied by other developmental anomalies. We studied a 9-month old child with CRS who presented interruption of the SC at the L2-L3 level, sacral agenesis, a lack of innervation of the inferior limbs (flaccid paraplegia), and neurogenic bladder and bowel. Given the known positive effects of growth hormone (GH) on neural stem cells (NSCs), we treated him with GH and rehabilitation, trying to induce recovery from the aforementioned sequelae. The Gross Motor Function Test (GMFM)-88 test score was 12.31%. After a blood analysis, GH treatment (0.3 mg/day, 5 days/week, during 3 months and then 15 days without GH) and rehabilitation commenced. This protocol was followed for 5 years, the last GH dose being 1 mg/day. Blood analysis and physical exams were performed every 3 months initially and then every 6 months. Six months after commencing the treatment the GMFM-88 score increased to 39.48%. Responses to sensitive stimuli appeared in most of the territories explored; 18 months later sensitive innervation was complete and the patient moved all muscles over the knees and controlled his sphincters. Three years later he began to walk with crutches, there was plantar flexion, and the GMFM-88 score was 78.48%. In summary, GH plus rehabilitation may be useful for innervating distal areas below the level of the incomplete spinal cord in CRS. It is likely that GH acted on the ependymal SC NSCs, as the hormone does in the neurogenic niches of the brain, and rehabilitation helped to achieve practically full functionality.

  10. Growth Hormone (GH) and Rehabilitation Promoted Distal Innervation in a Child Affected by Caudal Regression Syndrome (United States)

    Devesa, Jesús; Alonso, Alba; López, Natalia; García, José; Puell, Carlos I.; Pablos, Tamara; Devesa, Pablo


    Caudal regression syndrome (CRS) is a malformation occurring during the fetal period and mainly characterized by an incomplete development of the spinal cord (SC), which is often accompanied by other developmental anomalies. We studied a 9-month old child with CRS who presented interruption of the SC at the L2–L3 level, sacral agenesis, a lack of innervation of the inferior limbs (flaccid paraplegia), and neurogenic bladder and bowel. Given the known positive effects of growth hormone (GH) on neural stem cells (NSCs), we treated him with GH and rehabilitation, trying to induce recovery from the aforementioned sequelae. The Gross Motor Function Test (GMFM)-88 test score was 12.31%. After a blood analysis, GH treatment (0.3 mg/day, 5 days/week, during 3 months and then 15 days without GH) and rehabilitation commenced. This protocol was followed for 5 years, the last GH dose being 1 mg/day. Blood analysis and physical exams were performed every 3 months initially and then every 6 months. Six months after commencing the treatment the GMFM-88 score increased to 39.48%. Responses to sensitive stimuli appeared in most of the territories explored; 18 months later sensitive innervation was complete and the patient moved all muscles over the knees and controlled his sphincters. Three years later he began to walk with crutches, there was plantar flexion, and the GMFM-88 score was 78.48%. In summary, GH plus rehabilitation may be useful for innervating distal areas below the level of the incomplete spinal cord in CRS. It is likely that GH acted on the ependymal SC NSCs, as the hormone does in the neurogenic niches of the brain, and rehabilitation helped to achieve practically full functionality. PMID:28124993

  11. Electroacupuncture promotes the proliferation of endogenous neural stem cells and oligodendrocytes in the injured spinal cord of adult rats

    Institute of Scientific and Technical Information of China (English)

    Haiying Wu; Min Hu; Dekai Yuan; Yunhui Wang; Jing Wang; Tao Li; Chuanyun Qian


    A contusive model of spinal cord injury at spinal segment T8-9 was established in rats. Huantiao (GB30) and Huatuojiaji (Ex-B05) were punctured with needles, and endogenous neural stem cells were labeled with 5-bromo-2'-deoxyuridine (BrdU) and NG2. Double immunofluorescence staining showed that electroacupuncture markedly increased the numbers of BrdU+/NG2+ cells at spinal cord tissue 15 mm away from the injury center in the rostral and caudal directions. The results suggest that electroacupuncture promotes the proliferation of endogenous neural stem cells and oligodendrocytes in rats with spinal cord injury.

  12. Experimental study on regeneration of ascending tract after spinal cord injury with predegenerated peripheral nerve graft and NGF infusion

    Institute of Scientific and Technical Information of China (English)


    Objective:To explore the effects of predegenerated peripheral nerve graft (PPNG) combined with nerve growth factor (NGF) infusion on ascending sensory tract regeneration after spinal cord injury.Methods: Fifty female SD rats were randomly divided into 5 groups. Group A was treated with PPNG and NGF infusion, group B with PPNG, group C with NGF infusion, group D and group E were blank and normal control, respectively. Horseradish peroxidase-labled (HRP) tracing method was employed to evaluate the regeneration of injured nerves after 8 weeks. The extent of regeneration in and beyond the nerve graft was determined by counting the number of HRP-labeled fibers intersecting imaginary lines perpendicular to the axis of the graft and cord. For the sake of convenience, according to the relation of the PNG and spinal cord, 6 model zones were divided, including caudal of spinal cord, caudal transition zone, caudal zone in graft, rostral zone in graft, rostral transition zone and rostral of spinal cord. Results: On the transverse section of caudal zone in graft, rostral zone in graft, rostral transition zone, the fibers in group A were significantly higher than that in group B and C (P<0.05). Conclusion: PPNG combined with NGF may significantly promote the regeneration of ascending long tract after spinal cord injury. The regenerative fibers can penetrate the 2 graft-host interface scars.

  13. Comparison between the intravenous and caudal routes of sufentanil in children undergoing orchidopexy and further evaluation of the association of caudal adrenaline and neostigmine

    Directory of Open Access Journals (Sweden)

    Gabriela Rocha Lauretti


    Full Text Available Background: The aim of this study was to compare the intravenous (IV and caudal routes of administration of sufentanil for children undergoing orchidopexy and also to evaluate the effects on addition of caudal adrenaline and neostigmine. Materials and Methods: Sixty patients scheduled for orchidopexy were divided into the following groups: 1 Group IVSu received IV 0.5 μg/kg sufentanil and caudal saline; 2 Group CSu received caudal 0.5 μg/kg sufentanil and IV saline; 3 Group CSuAdr received caudal sufentanil plus adrenaline 5 μg/ml (1:200,000 and IV saline; 4 Group CSuNeo received caudal sufentanil plus neostigmine, and IV saline; and 5 Group CSuNeoAdr received caudal sufentanil plus neostigmine plus adrenaline, and IV saline. Heart rate and mean blood pressure >15% was treated with increasing isoflurane concentration. Consumption of isoflurane, side effects, quality of sleep, time to first administration of analgesic, and number of doses of 24-h rescue analgesic were recorded. Results: Groups were demographically similar. Isoflurane consumption showed the following association: Group IVSu = Group CSuNeo = Group CSuNeoAdr Group CSuNeo = Group CSuNeoAdr (P < 0.005. Incidence of adverse effects was similar among groups. Conclusion: Caudal sufentanil alone was no better than when administered in the IV route, and would just be justified by the association of neostigmine, but not adrenaline. Neostigmine association resulted in better perioperative analgesia.

  14. Heavy metals in the spinal cord of normal rats and of animals treated with chelating agents

    DEFF Research Database (Denmark)

    Schrøder, H D; Fjerdingstad, E; Danscher, G


    The amounts of zinc, copper, and lead in the rat spinal cord were determined by means of flameless atomic absorption spectrophotometry. Zinc was present in a concentration about 100 p.p.m. (dry weight), copper in a concentration about 5 p.p.m., and lead in slightly more than 1 p.p.m. Analysis...... of various levels along the cranio-caudal axis of the rat spinal cord revealed differences in the heavy metal content. The Timm sulfide silver staining method has demonstrated that metals in the spinal cord have a distinct regional distribution. To obtain a differentiation between the stainable metals...

  15. La oficina del regante y la medida de caudales



    En la actualidad tanto en las zonas con sistemas de riego presurizado como en las de riegos tradicionales, se está apreciando un gran interés en la mejora de los propios sistemas de riego y de la gestión del agua. Esto genera una gran demanda de información tecnológica por parte de los agricultores. Una parte importante de esta información incluye el conocimiento de los caudales que circulan en las redes de distribución de agua de las Comunidades de Regantes. El Departamento de Agr...




    Lasenfermedades)del)tracto)urinario)caudal)ETUC(en)perros)son)un)conjunto)de) enfermedades)que)afectan)a)la)vejiga,)uretra)y)próstata)siendo)los)signos)clínicos)más) comunes) la)estranguria,)polaquiuria,)disuria)y)hematuria.)Las)ETUC)más)comunes)en) los) perros) son) la) urolitiasis,) la) infección) del) tracto) urinario,) las) alteraciones) de) la) micción,) las)enfermedades)de) la)próstata,) las)neoplasias,) las)alteraciones)anatómicas) congénitas)y)los)traumatismos.)En)Méxic...

  17. Effects of season and urea treatment on infection of stumps of Picea abies by Heterobasidion annosum in stands on former arable land

    Energy Technology Data Exchange (ETDEWEB)

    Brandtberg, P.O. [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Ecology and Environmental Research; Johansson, Martin [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Forest Mycology and Pathology; Seeger, P. [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Statistics


    Between 1986 and 1990, a series of thinnings were made in previously unthinned first rotation stands on former arable land located in the southern half of Sweden. The aim was to evaluate the effects of season and urea treatment on the frequency of infection of stumps of Norway spruce (Picea abies (L.) Karst.) by the root-rot fungus Heterobasidion annosum (Fr.) Bref. Untreated stumps, resulting from 60 thinnings (22-100 stumps each, altogether ca 3000 stumps) made at different times of year, were investigated 3-24 months after cutting to determine whether they were infected with H. annosum. On average only 2% of the stumps from thinnings made in November-February were infected, whereas the incidence of infection among stumps thinned in June-July was 34%. Two methods of treating stumps with urea to prevent stump infection by H. annosum after thinning were evaluated in terms of effectiveness. The freshly cut stumps were treated with a 20% urea solution, transformed to a gel by adding 0.2% carboxymethyl cellulose, or with a 30% urea solution. On average, the reduction in infection rate obtained was 62% with the first method and 85% with the latter. In a separate study involving a concentration series of urea, there was a considerable drop in protection efficiency, from 89% to 58%, when the concentration was decreased from 30% to 15%. 38 refs, 3 figs, 1 tab

  18. Treatment of stump complications after above-knee amputation using negative-pressure wound therapy

    Directory of Open Access Journals (Sweden)

    Babić Srđan


    Full Text Available Introduction. The stump wound complications after above-knee amputation lead to other problems, such as prolonged rehabilitation, delayed prosthetic restoration, the increase in total treatment cost and high mortality rates. Objective. To evaluate the safety and outcomes of negative-pressure wound therapy (NPWT using Vacuum-Assisted Closure (VACR therapy in patients with stump complication after above-knee amputation (AKA. Methods. From January 2011 to July 2014, AKA was performed in 137 patients at the University Cardiovascular Clinic. Nineteen (12.4% of these patients (mean age 69.3 Ѓ} 9.2 years were treated with NPWT. The following variables were recorded: wound healing and hospitalization time, rate of NPWT treatment failure, and mortality. Results. AKA was performed in 17 (89.5% patients after the vascular or endovascular procedures had been exhausted, while urgent AKA was performed in two (10.5% patients due to uncontrolled infection. The time before NPWT application was 3.1 Ѓ} 1.9 days and the duration of the NPWT use ranged from 15 to 54 days (mean 27.95 Ѓ} 12.1 days. During NPWT treatment, operative debridement was performed in 12 patients. All the patients were kept on culture-directed intravenous antibiotics. The average hospital length of stay was 34.7 days (range 21-77 days. There were four (20.9% failures during the treatment which required secondary amputation. During the treatment, one (5.3% patient died due to multi-organ failure after 27 days. Conclusions. The use of NPWT therapy in the treatment of AKA stump complication is a safe and effective procedure associated with low risk and positive outcome in terms of wound healing time and further complications.

  19. Congenital segmental spinal muscular atrophy: a case report. (United States)

    Savaş, Tülin; Erol, Ilknur; Özkale, Yasemin; Saygi, Semra


    Spinal muscular atrophies are genetic disorders in which anterior horn cells in the spinal cord and motor nuclei of the brainstem are progressively lost. We present a patient with arthrogryposis due to congenital spinal muscular atrophy predominantly affecting the upper limbs. Spinal muscular atrophies with onset at birth may be a cause of arthrogryposis. Localized forms of neurogenic arthrogryposis have been divided into cervical and caudal forms. Our case is similar to the cases described by Hageman et al (J Neurol Neurosurg Psychiatry 1993;56:365-368): severe symmetric lower motor neuron deficit in the upper extremities at the time of birth, no history of injury to the cervical spinal cord or the brachial plexus during delivery, and severe muscle wasting suggesting chronic denervation in utero. Because there was improvement of our patient's situation, her disease was also possibly nonprogressive and sporadic. To our knowledge, this is the first reported case of a Turkish patient with congenital cervical spinal muscular atrophy. Congenital cervical spinal muscular atrophy affecting predominantly the upper limbs is a relatively rare form of motor neuron disease and should be considered in the differential diagnosis of infants with congenital contractures and severe muscle weakness by wasting mainly confined to the upper limbs.

  20. [Prostatic Stromal Tumors of Uncertain Malignant Potential (STUMP): definition, pathology, prognosis and management]. (United States)

    Michaud, S; Moreau, A; Braud, G; Renaudin, K; Branchereau, J; Bouchot, O; Rigaud, J


    Prostatic Stromal Tumors of Uncertain Malignant Potential (STUMP) are rare tumor of the prostate of mesenchymal origin, accounting, with sarcoma for 0.1-0.2% of all malignant prostatic tumours. They however require to be individualized, to differentiate it from a benign prostatic hyperplasia or a sarcoma of the prostate. The therapeutic management should be made keeping in mind the risk of degeneration towards a malignant shape. Although the appropriate treatment is unknown, radical prostatectomy seem to be the treatment of reference, especially for young patient or for extensive lesion.

  1. Zebrafish Caudal Haematopoietic Embryonic Stromal Tissue (CHEST) Cells Support Haematopoiesis (United States)

    Wolf, Anja; Aggio, Julian; Campbell, Clyde; Wright, Francis; Marquez, Gabriel; Traver, David; Stachura, David L.


    Haematopoiesis is an essential process in early vertebrate development that occurs in different distinct spatial locations in the embryo that shift over time. These different sites have distinct functions: in some anatomical locations specific hematopoietic stem and progenitor cells (HSPCs) are generated de novo. In others, HSPCs expand. HSPCs differentiate and renew in other locations, ensuring homeostatic maintenance. These niches primarily control haematopoiesis through a combination of cell-to-cell signalling and cytokine secretion that elicit unique biological effects in progenitors. To understand the molecular signals generated by these niches, we report the generation of caudal hematopoietic embryonic stromal tissue (CHEST) cells from 72-hours post fertilization (hpf) caudal hematopoietic tissue (CHT), the site of embryonic HSPC expansion in fish. CHEST cells are a primary cell line with perivascular endothelial properties that expand hematopoietic cells in vitro. Morphological and transcript analysis of these cultures indicates lymphoid, myeloid, and erythroid differentiation, indicating that CHEST cells are a useful tool for identifying molecular signals critical for HSPC proliferation and differentiation in the zebrafish. These findings permit comparison with other temporally and spatially distinct haematopoietic-supportive zebrafish niches, as well as with mammalian haematopoietic-supportive cells to further the understanding of the evolution of the vertebrate hematopoietic system. PMID:28300168

  2. Histomorphometry of Trabecular Bone of Caudal Vertebrae During Rat Pregnancy

    Directory of Open Access Journals (Sweden)

    S.M. Shahtaheri


    Full Text Available Pregnancy make demands upon maternal calcium hemeostasis and the extent to which the maternal bone mass is effected remains uncertain. Recently changes in the bone mass during human pregnancy have been associated also with the transformation of the cancellous architecture and the bone surface available for exchange. These jistomorphometrical structural changes were examined further in an animal model. Using uniparous laboratory rats fed at libitum, the histomorphometry of cancellous bone was compared in undecalcified of caudal vertebrae. Between 3 and 6 sections (8 m were analysed by an automated trabecular analysis system (TAS which measures a comprehensive range of structural variables including the trabecular separation, number, connectivity and width. There was an early stimulation of bone formation that was indicated by generation of thicker and interconnected trabeculae. However in caudal vertebrae, there were architectural changes in cancellous bone commencing with a significant increase in the trabecular separation. ‌‌ It was concluded that strengthens the cancellous component of the maternal skeleton possibly to counter increased load and to facilitate mineral mobilisation in maternal/neonate exchange during the subsequent lactation period.

  3. Evaluation of caudal epidural anesthesia efficacy by measurement of feet skin temperature in children

    Directory of Open Access Journals (Sweden)

    M. Yu. Kurochkin


    Full Text Available Caudal epidural anesthesia in children is not performed in pure form, but only in combination with superficial general anesthesia. Therefore, a search for reliable evaluation criteria of the caudal epidural block onset in children remains actual. Aim. To evaluate effectiveness of caudal epidural anesthesia efficacy by measurement of feet skin temperature in children. Methods and results. We investigated feet skin temperature before the caudal blockade by bupivacaine and after 15–20 minutes in 30 children. The control group included 20 children who underwent total intravenous anesthesia. The study showed that feet skin temperature after caudal blockade significantly increased from 30,1±0,15°C to 33,0±0,1°C (10% and in the control group it did not change significantly. Conclusion. Thus, feet skin thermometry may be considered to be a reliable non-invasive method for assessing the onset of the caudal block.

  4. Investigation of Fish Caudal Fin Locomotion Using a Bio-inspired Robotic Model


    Ziyu Ren; Kainan Hu; Tianmiao Wang; Li Wen


    Due to its advantages of realizing repeatable experiments, collecting data and isolating key factors, the bio-robotic model is becoming increasingly important in the study of biomechanics. The caudal fin of fish has long been understood to be central to propulsion performance, yet its contribution to manoeuverability, especially for homocercal caudal fin, has not been studied in depth. In the research outlined in this paper, we designed and fabricated a robotic caudal fin to mimic the morphol...

  5. Learning about Spinal Muscular Atrophy (United States)

    ... News Release Fischbeck Group Learning About Spinal Muscular Atrophy What is spinal muscular atrophy? What are the ... for Spinal Muscular Atrophy What is spinal muscular atrophy? Spinal muscular atrophy is a group of inherited ...

  6. Spinal Cord Contusion

    Institute of Scientific and Technical Information of China (English)

    Gong Ju; Jian Wang; Yazhou Wang; Xianghui Zhao


    Spinal cord injury is a major cause of disability with devastating neurological outcomes and lim-ited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

  7. Acquired lumbar spinal stenosis. (United States)

    Deasy, JoAnn


    Lumbar spinal stenosis is the most frequent reason for spinal surgery in patients over age 65 years. In this condition, narrowing of the lumbar spinal canal and nerve root canals leads to painful, debilitating compression of spinal nerves and blood vessels. As the population ages, an increasing number of patients will be diagnosed and treated for lumbar spinal stenosis by primary care providers. This article reviews the pathophysiology, diagnosis, and management of lumbar spinal stenosis in adults over age 50 years.

  8. Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

    Institute of Scientific and Technical Information of China (English)

    LI Yong-dong; HAN Xin-wei; WU Gang; LI Ming-hua


    Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula (BSF). Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types (A and B) of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7(87.5%) of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple,safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. (J Intervent Radiol, 2007, 16: 253-257)[ Key words ] Fistula, pulmonary; Bronchialpleural fistula; Stents and prostheses; Computed tomography

  9. Stump Invagination Versus Simple Ligation in Open Appendicectomy: A Systematic Review and Meta-Analysis. (United States)

    Qian, Daohai; He, Zhigang; Hua, Jie; Song, Zhenshun


    The aim of this meta-analysis was to compare the superiority of stump closure between stump invagination (SI) and simple ligation (SL) during open appendicectomy (OA). The literature searching was conducted in MEDLINE, EMBASE, the Cochrane Library, and . Available data was extracted by 3 independent reviewers. The clinical outcomes were analyzed by meta-analytic software to compare the difference between 2 methods during OA. The pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were obtained by using fixed effect model. Eleven randomized controlled trials (RCTs) were finally included in this study involving 2634 patients. Postoperative pyrexia and infections were similar between SL and SI groups, respectively, but the former group had a shorter operative time (WMD: 8.72; 95% CI: 6.87-10.56; P < 0.00001); less incidence of postoperative ileus (WMD: 2.02; 95% CI: 1.36-3.01; P = 0.0005); and quicker postoperative recovery (WMD: 0.30; 95% CI: 0.11-0.48; P = 0.002). The above results were based on 5, 11, 4, 11, and 9 articles, respectively. The clinical results revealed that SL was significantly superior to SI. SL should be suggested during OA.

  10. [Pain syndromes following amputation. Analysis of 100 affected patients with chronic stump and phantom pain]. (United States)

    Wörz, R; Wörz, E


    One hundred amputees (m = 95, f = 5) with a pain syndrome were analysed. In 80 patients post-amputation pain of the lower, in 20 of the upper, extremities presented. Thirty-two patients suffered bouts of pain, 68 constant pain of various types. The most commonly cited type of pain in the patients with intermittent pain was lancinating, in the case of constant pain a burning sensation. In some patients pain occurred immediately after the loss of the limb, in others not until several years, or even decades, later. Forty per cent of our patients indicated that the incidence and intensity of the pain increased with time. Neurological, orthopedic and internistic causes of stump or phantom pain have been described. In 72% of the patients with constant pain and in 34% of those suffering from bouts of pain, an algogenic psychosyndrome had developed. Complications and late sequelae of amputations are of considerable significance for the development and intensity of stump and phantom pain.

  11. Axonal sprouting of a brainstem-spinal pathway after estrogen administration in the adult female rhesus monkey

    NARCIS (Netherlands)

    Vanderhorst, VGJM; Terasawa, E; Ralston, HJ


    The nucleus retroambiguus (NRA) is located in the caudal medulla oblongata and contains premotor neurons that project to motoneuronal cell groups in the brainstem and spinal cord. NRA projections to the lumbosacral cord are species specific and might be involved in mating behavior. In the female cat

  12. The effects of slash and stump removal on productivity and quality of forest regeneration operations-preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Saarinen, Veli-Matti [Finnish Forest Research Institute, Suonenjoki Research Station, FIN-77600 Suonenjoki (Finland)


    The object of this study was to survey the effects of slash and stump removal on work productivity and work quality, as well as on the technology of forest regeneration operations. Site preparation and planting were studied in different conditions. Slash and stump treatments 'removal' and 'no removal' were established at each site. Time studies were made during site preparation and planting. The quality of mounding and planting was analysed by measurements of the seedlings. After slash removal, the increase of work productivity (E{sub 0}) in mechanized planting was 18 per cent with a Bracke planting machine and 0 per cent with an Ecoplanter planting machine. The quality of mechanized planting was slightly improved by slash removal. After slash removal, the productivity (E{sub 0}) of excavator-mounted mounders was 22 per cent higher with a mounding blade and 53 per cent higher with a ditching bucket. The quality of mounding was the same for both slash treatments. The productivity (E{sub 0}) of three forwarder-mounted mounders was 5 per cent lower after slash removal, but at the same time the quality of the mounding was much better. In combined stump extraction and mounding, the time consumption of the mounding phase was about 40 per cent lower than for separate mounding after stump removal. The results show that slash and stump removal will improve work productivity and quality when using mechanized mounding and planting methods. In addition after slash and/or stump removal it may be possible and cost-effective to use new planting and site preparation methods based on forwarder-mounted mounders. (author)

  13. The Mass Loss and Humification of Stumps and Roots in Masson Pine Plantations Based on Log File Records. (United States)

    Zhou, Jiao; Wu, Fuzhong; Yang, Wanqin; Tan, Bo; Xu, Zhenfeng; Zhang, Jian; Duan, Fei; Liu, Hui; Justine, Meta Francis


    Stumps account for a large proportion of coarse woody debris in managed forests, but their decay dynamics are poorly understood. The loss of mass and the degree of humification of the above-ground woody debris, below-ground woody debris, bark and root system (R1, 10 mm ≥ diameter > 0 mm; R2, 25 mm ≥ diameter >10 mm; 100 mm ≥ R3 > 25 mm; R4 > 100 mm) of Masson pine (Pinus massoniana) stump systems were evaluated in southwestern China in a chronosequence of plantations cut 1-15 years prior to the study. The results indicated that above-ground woody debris decomposed more quickly than below-ground woody debris and bark, whereas the degree of humification followed the opposite trend. Compared with one-year stumps, the mass losses of 15-year stump systems were 60.4% for above-ground woody debris, 42.1% for below-ground woody debris, 47.3% for bark, 69.9% for R1, 47.3% for R2, 51.0% for R3, and 83.2% for R4. In contrast, below-ground woody debris showed a greater degree of humification compared with other components in the stump system. Among the root system, fine roots (R1, diameter ≤ 10 mm) had the largest k value (0.09), whereas the decay rate of coarser roots (R2, R3, R4; diameter > 10 mm) increased with increasing root diameter. However, coarse roots showed a larger degree of humification (0.2-0.6) than fine roots (0.3-0.4). These results suggest that below-ground woody debris and coarse roots may display a higher degree of humification, showing greater short-term contributions to overall humification when compared with the other components in the stump system.

  14. Incidental detection of a pseudoaneurysm at an amputation stump in a Tc-99m HMPAO labeled leukocyte scan

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)


    A 20-year-old man underwent a Tc-99m HMPAO labeled leukocyte scan for the evaluation of an infection at the stump of an AK amputation, which was conducted due to an open communicated fracture of the left lower leg. Blood-flow and blood-pool images demonstrated a pseudoaneurysm with a focus of intense activity medial to the stump, and centered within a large photopenic defect by surrounding hematoma. Delayed image obtained at 3 hours post-injection showed persistent intense and slight increased activity. Contrast angiography confirmed the presence of a pseudoaneurysm arising from a branch of the left superficial femoral artery.

  15. Effectiveness of caudal septal extension graft application in endonasal septoplasty

    Directory of Open Access Journals (Sweden)

    Yunus Karadavut

    Full Text Available Abstract Introduction Septal deviation is a common disease seen in daily otorhinolaryngology practice and septoplasty is a commonly performed surgical procedure. Caudal septum deviation is also a challenging pathology for ear, nose, and throat specialists. Many techniques are defined for caudal septal deviation. Objective To evaluate the effectiveness of caudal septal extension graft (CSEG application in patients who underwent endonasal septoplasty for a short and deviated nasal septum. Methods Forty patients with nasal septal deviation, short nasal septum, and weak nasal tip support who underwent endonasal septoplasty with or without CSEG placement between August 2012 and June 2013 were enrolled in this study. Twenty patients underwent endonasal septoplasty with CSEG placement. The rest of the group, who rejected auricular or costal cartilage harvest for CSEG placement, underwent only endonasal septoplasty without any additional intervention. Using the Nasal Obstruction Symptom Evaluation (NOSE and Rhinoplasty Outcome Evaluation (ROE questionnaires, pre- and post-operative acoustic rhinometer measurements were evaluated to assess the effect of CESG placement on nasal obstruction. Results In the control group, preoperative and postoperative minimal cross-sectional areas (MCA1 were 0.44 ± 0.10 cm2 and 0.60 ± 0.11 cm2, respectively (p < 0.001. In the study group, pre- and postoperative MCA1 values were 0.45 ± 0.16 cm2 and 0.67 ± 0.16 cm2, respectively (p < 0.01. In the control group, the nasal cavity volume (VOL1 value was 1.71 ± 0.21 mL preoperatively and 1.94 ± 0.17 mL postoperatively (p < 0.001. In the study group, pre- and postoperative VOL1s were 1.72 ± 0.15 mL and 1.97 ± 0.12 mL, respectively (p < 0.001. Statistical analysis of postoperative MCA1 and VOL1 values in the study and the control groups could not detect any significant intergroup difference (p = 0.093 and 0.432, respectively. In the study group, mean nasolabial angles were

  16. [The crooked nose: correction of dorsal and caudal septal deviations]. (United States)

    Foda, H M T


    The deviated nose represents a complex cosmetic and functional problem. Septal surgery plays a central role in the successful management of the externally deviated nose. This study included 800 patients seeking rhinoplasty to correct external nasal deviations; 71% of these suffered from variable degrees of nasal obstruction. Septal surgery was necessary in 736 (92%) patients, not only to improve breathing, but also to achieve a straight, symmetric external nose. A graduated surgical approach was adopted to allow correction of the dorsal and caudal deviations of the nasal septum without weakening its structural support to the nasal dorsum or nasal tip. The approach depended on full mobilization of deviated cartilage, followed by straightening of the cartilage and its fixation in the corrected position by using bony splinting grafts through an external rhinoplasty approach.

  17. Termination of vestibulospinal fibers arising from the spinal vestibular nucleus in the mouse spinal cord. (United States)

    Liang, H; Bácskai, T; Paxinos, G


    The present study investigated the vestibulospinal system which originates from the spinal vestibular nucleus (SpVe) with both retrograde and anterograde tracer injections. We found that fluoro-gold (FG) labeled neurons were found bilaterally with a contralateral predominance after FG injections into the upper lumbar cord. Anterogradely labeled fibers from the rostral SpVe traveled in the medial part of the ventral funiculus ipsilaterally and the dorsolateral funiculus bilaterally in the cervical cord. They mainly terminated in laminae 5-8, and 10 of the ipsilateral spinal cord. The contralateral side had fewer fibers and they were found in laminae 6-8, and 10. In the thoracic cord, fibers were also found to terminate in bilateral intermediolateral columns. In the lumbar and lower cord, fibers were mainly found in the dorsolateral funiculus bilaterally and they terminated predominantly in laminae 3-7 contralaterally. Anterogradely labeled fibers from the caudal SpVe did not travel in the medial part of the ventral funiculus but in the dorsolateral funiculus bilaterally. They mainly terminated in laminae 3-8 and 10 contralaterally. The present study is the first to describe the termination of vestibulospinal fibers arising from the SpVe in the spinal cord. It will lay the anatomical foundation for those who investigate the physiological role of vestibulospinal fibers and potentially target these fibers during rehabilitation after stroke, spinal cord injury, or vestibular organ injury.

  18. Awake caudal anesthesia for inguinal hernia operations: successful use in low birth weight neonates. (United States)

    Geze, S; Imamoğlu, M; Cekic, B


    Neonates with inguinal hernia face a relatively high risk of incarcerated hernia and bowel obstruction and this therefore requires surgical treatment. Complications following general anesthesia even for minor surgery are more common in low birth weight neonates than in term neonates. Caudal epidural anesthesia without adjunct general anesthesia has been recommended for neonates to reduce the risk of postoperative complications. The successful application of awake caudal anesthesia with levobupivacaine for inguinal hernia repair in 15 low birth weight neonates is reported. Single dose caudal epidural anesthesia was administered for inguinal hernia surgery to avoid complications associated with general anesthesia. Caudal block was performed with 2.5 mg/kg body weight (BW) levobupivacaine. Caudal anesthesia can be recommended as an effective technique for avoiding postoperative anesthetic complications in low birth weight neonates.

  19. The 5-year survival following the marginal resection of a primary leiomyosarcoma of the distal femur and a stump fracture. (United States)

    Plath, J; Gurk, S; Strophal, G; Johnson, M; Jansson, V


    In this case, we present a 5-year follow-up of a 3-fault-affected primary leiomyosarcoma of the distal femur (spontaneous fracture treated by osteosynthesis; marginal resection; stump fracture after adequate trauma) with an extended local recurrence but without metastasis.

  20. Computer simulation of flow and mixing at the duodenal stump after gastric resection

    Institute of Scientific and Technical Information of China (English)

    Nenad Filipovic; Aleksandar Cvetkovic; Velibor Isailovic; Zoran Matovic; Mirko Rosic; Milos Kojic


    AIM: To investigate the flow and mixing at the duodenal stump after gastric resection, a computersimulation was implemented.METHODS: Using the finite element method, two different Billroth ? procedure cases (A and B) were modeled. Case A was defined with a shorter and almost straight duodenal section, while case B has a much longer and curved duodenal section. Velocity,pressure and food concentration distribution were determined and the numerical results were compared with experimental observations.RESULTS: The pressure distribution obtained by numerical simulation was in the range of the recorded experimental results. Case A had a more favorable pressure distribution in comparison with case B.However, case B had better performance in terms of food transport because of more continual fooddistribution,as well as better emptying of the duodenal section.

  1. Physical rehabilitation of patients with amputation stump of thigh because of trauma

    Directory of Open Access Journals (Sweden)

    Efremova O.V.


    Full Text Available The article is exposition essence of problem of renewal of ability to work of a problem of restoration after amputation at the hip. The analysis of the standard program of the standard in traumatology programs of physical rehabilitation of patients after amputation and presents the results of the developed physical rehabilitation of patients with amputating the thigh stumps due to injury. The authors propose to use the means of physical rehabilitation in accordance with the flow dynamics of the reparative processes after amputation and clinical features of injury. All this contributes to the development of compensatory own human capabilities, resulting in remission. Since these funds most physiological, their correct application does not cause complications.

  2. Apendicitis del muñón apendicular Appendicitis of the appendicular stump

    Directory of Open Access Journals (Sweden)

    María Carolina Berrogain


    Full Text Available La apendicitis del muñón es una entidad rara, caracterizada por un proceso inflamatorio del remanente apendicular luego de una apendicectomía incompleta. Los signos y síntomas no difieren de una apendicitis aguda. Al no ser una patología usualmente pensada como posible diagnóstico diferencial del abdomen agudo inflamatorio, tiene mayor riesgo de complicaciones y morbi-mortalidad. Los métodos seccionales de diagnósticos por imágenes resultan muy beneficiosos para definir el diagnóstico. La ultrasonografía (US y tomografía computada (TC demuestran signos similares a los observados en cuadros habituales de inflamación aguda del apéndice cecal. Se presentan dos casos de apendicitis del muñón, uno de ellos recibió tratamiento quirúrgico y el otro tratamiento médico.Stump appendicitis is a rare entity characterized by inflammation of the appendiceal remanent after incomplete appendectomy. Signs and symptoms do not differ from acute appendicitis. As it is not a condition usually considered as a potential differential diagnosis of acute inflammatory abdomen, it has higher risks of complications and morbidity and mortality. Imaging methods are highly useful to define the diagnosis. Ultrasound (US and Computed Tomography (CT show signs similar to those found in standard cases of acute appendicitis. Two cases of stump appendicitis are reponed: one managed with surgical treatment and the other with medical treatment.

  3. Spinal pain

    Energy Technology Data Exchange (ETDEWEB)

    Izzo, R., E-mail: [Neuroradiology Department, A. Cardarelli Hospital, Naples (Italy); Popolizio, T., E-mail: [Radiology Department, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Fg) (Italy); D’Aprile, P., E-mail: [Neuroradiology Department, San Paolo Hospital, Bari (Italy); Muto, M., E-mail: [Neuroradiology Department, A. Cardarelli Hospital, Napoli (Italy)


    Highlights: • Purpose of this review is to address the current concepts on the pathophysiology of discogenic, radicular, facet and dysfunctional spinal pain, focusing on the role of the imaging in the diagnostic setting, to potentially address a correct approach also to minimally invasive interventional techniques. • Special attention will be given to the discogenic pain, actually considered as the most frequent cause of chronic low back pain. • The correct distinction between referred pain and radicular pain contributes to give a more correct approach to spinal pain. • The pathogenesis of chronic pain renders this pain a true pathology requiring a specific management. - Abstract: The spinal pain, and expecially the low back pain (LBP), represents the second cause for a medical consultation in primary care setting and a leading cause of disability worldwide [1]. LBP is more often idiopathic. It has as most frequent cause the internal disc disruption (IDD) and is referred to as discogenic pain. IDD refers to annular fissures, disc collapse and mechanical failure, with no significant modification of external disc shape, with or without endplates changes. IDD is described as a separate clinical entity in respect to disc herniation, segmental instability and degenerative disc desease (DDD). The radicular pain has as most frequent causes a disc herniation and a canal stenosis. Both discogenic and radicular pain also have either a mechanical and an inflammatory genesis. For to be richly innervated, facet joints can be a direct source of pain, while for their degenerative changes cause compression of nerve roots in lateral recesses and in the neural foramina. Degenerative instability is a common and often misdiagnosed cause of axial and radicular pain, being also a frequent indication for surgery. Acute pain tends to extinguish along with its cause, but the setting of complex processes of peripheral and central sensitization may influence its evolution in chronic

  4. Intraspinal microstimulation A novel technique for the functional recovery of spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Hua Zhang; Liqun Feng; Yuping Wang


    Nonspecific neuronal activity elicited by intraspinal microstimulation in the intermediate and ventral gray matter of thoracic spinal segments caudal to a complete spinal cord transection significantly increased the rat hindlimb Basso,Beattie,Bresnahan locomotor score by activating the central pattern generator located in the lumbar spinal cord.However,the best region for intraspinal microstimulation is unclear.Using an incomplete spinal cord injury model at T8,we compared the use of intraspinal microstimulation to activate the spinal cord in rats with a spontaneous recovery group.The intraspinal microstimulation group recovered sooner and showed three kinds of movement: the left hindlimb,the left hindlimb toes,and the paraspinal muscles and tails.These had different microstimulation thresholds.There was mild hyperplasia of the astrocytes surrounding the tips of the microelectrodes and slight inflammatory reactions nearby.These results indicate that implantation of microelectrodes was relatively safe and induced minimal damage to the lumbar-sacral spinal cord.Intraspinal microstimulation in the lumbar sacral spinal cord may improve leg movements after spinal cord injury.Non-specific intraspinal microstimulation may be a novel technique for the recovery of spinal cord injuries.

  5. Spinal infections

    Energy Technology Data Exchange (ETDEWEB)

    Tali, E. Turgut E-mail:


    Spinal infections can be thought of as a spectrum of disease comprising spondylitis, discitis, spondylodiscitis, pyogenic facet arthropathy, epidural infections, meningitis, polyradiculopathy and myelitis. Radiological evaluations have gained importance in the diagnosis, treatment planning, treatment and treatment monitoring of the spinal infections. Conventional radiographs are usually the initial imaging study. The sensitivity and specificity of the plain radiographs are very low. The sensitivity of CT is higher while it lacks of specificity. Conventional CT has played minor role for the diagnosis of early spondylitis and disc space infection and for follow-up, researches are going on the value of MDCT. MRI is as sensitive, specific and accurate as combined nuclear medicine studies and the method of choice for the spondylitis. Low signal areas of the vertebral body, loss of definition of the end plates and interruption of the cortical continuity, destruction of the cortical margins are typical on T1WI whereas high signal of affected areas of the vertebral body and disc is typical on T2WI. Contrast is mandatory and increases conspicuity, specificity, and observer confidence in the diagnosis and facilitates the treatment planning. Contrast enhancement is the earliest sign and pathognomonic in the acute inflammatory episode and even in the subtle infection then persists to a varying degree for several weeks or months. The outcome of the treatment is influenced by the type of infection and by the degree of neurologic compromise before treatment. There is an increasing move away from surgical intervention towards conservative therapy, percutaneous drainage of abscess or both. It is therefore critical to monitor treatment response, particularly in the immuno-deficient population.

  6. Evaluation of Anesthesia Profile in Pediatric Patients after Inguinal Hernia Repair with Caudal Block or Local Wound Infiltration

    Directory of Open Access Journals (Sweden)

    Aleksandra Gavrilovska-Brzanov


    CONCLUSIONS: Between children undergoing inguinal hernia repair, local wound infiltration insures safety and satisfactory analgesia for surgery. Compared to caudal block it is not overwhelming. Caudal block provides longer analgesia, however complications are rather common.

  7. Response Function of the Crayfish Caudal Photoreceptor to Hydrodynamic Stimuli (United States)

    Breite, Sally; Bahar, Sonya; Neiman, Alexander; Moss, Frank


    In its abdominal 6th ganglion the crayfish houses 2 light-sensitive neurons (caudal photoreceptors, or CPRs). It is known that these neurons work in tandem with a mechanosensory system of tiny hairs spread across the tailfan, which make synaptic contact with the photoreceptors. A stochastic resonance effect has been shown in this system in which light enhances the transduction of a weak, periodic mechanosensory (hydrodynamic) stimulus. It is not known, however, whether an optimal response from the CPR is induced by a single sine wave cycle or some other waveform. We have experimentally investigated this favorable waveform by driving a tailfan preparation with mechanical 10 Hz correlated Ornstein-Uhlenbeck noise and calculating the response function from the spike-triggered average of the applied noise waveform. We will discuss differences in the shape of the optimal waveform under dark and light conditions, as well as what seems to be a noticeable difference in the magnitude of the animals' response to a noisy stimulus in comparison with a periodic stimulus.

  8. Transcriptional Profiling of Caudal Fin Regeneration in Zebrafish

    Directory of Open Access Journals (Sweden)

    Michael Schebesta


    Full Text Available Regeneration of severed limbs in adult animals is restricted to urodele amphibians. Mammals, including humans, have very limited regenerative capabilities and even with proper treatment, only the tips of our digits can grow back. Teleost fish can regenerate amputated fins, the evolutionary ancestors of limbs. To elucidate the principles of limb-fin regeneration, we performed an Affymetrix microarray screen on regenerating caudal fins 12, 24, 48, and 72 h post amputation. Approximately 15,000 zebrafish transcripts were analyzed, identifying 829 transcripts as differentially expressed during regeneration. Of those, 563 were up-regulated and 266 were down-regulated. We constructed a comprehensive database containing expression data, functional assignment, and background information from the literature for each differentially expressed transcript. In order to validate our findings, we employed three approaches: (1 microarray expression analysis of genes previously implicated in fin regeneration, (2 RT-PCR analysis of genes newly identified as differentially expressed during regeneration, and (3 in situ hybridization of the up-regulated genes bambi, dlx5A, and her6. Moreover, we show that Smad 1/5/8 proteins, effector molecules of Bmp signaling, are phosphorylated during fin regeneration. Taken together, we provide a comprehensive database of fin regeneration that will serve as an important tool for understanding the molecular mechanisms of regeneration.

  9. [The choice of drugs for caudal anaesthesia in children. An overview]. (United States)

    Marhofer, P; Koinig, H; Kapral, S


    Caudal anaesthesia is the most frequently used regional technique in paediatric anaesthesia. Caudal in combination with general anaesthesia is usually performed in healthy children (i.e. for herniotomy or hypospadias). Therefore every complication of this method is a catastrophe, even when the incidence of these complications is very low. Some of the documented complications of caudal anaesthesia in children are caused by the local anaesthetic solutions and/or by additives. Thus, the choice of substances for paediatric caudal blocks should minimize the risk associated with the substances used for this indication. Over the last decades the standard was bupivacaine but because of serious cardiovascular and central-nervous toxicity following inadvertent intravascular injection of bupivacaine during caudal puncture, the less toxic ropivacaine should be favoured for this indication. A huge number of clinical studies have proven the clinical effectiveness and safety of ropivacaine also for this indication. In addition, levobupivacaine, the L-enantiomere of bupivacaine, will also be an interesting local anaesthetic in the future for paediatric caudal anaesthesia. By using additives to local anaesthetics better analgesic properties should be obtained. Following an exact review of the literature, only clonidine and S(+)-ketamine are useful additives to local anaesthetics in paediatric caudal anaesthesia.

  10. Numerical simulation and experimental research of a flexible caudal fin by piezoelectric fiber composite

    Directory of Open Access Journals (Sweden)

    Yuan-Lin Guan


    Full Text Available A flexible caudal fin made of the macro fiber composites and the carbon fiber orthotropic composite was investigated by the numerical simulations and the experiments. First, a three-dimensional numerical simulation procedure was adopted to research the torsion propulsion mode of the caudal fin and the impact of the water for the structural torsion frequency of the caudal fin. Then, a two-dimensional unsteady fluid computational method was used to analyze the hydrodynamic performance with the periodic swing of the caudal fin on the torsion mode. Based on the simulation results, the flow field was demonstrated and discussed. The interaction between the caudal fin and the water was explained. Finally, the laser vibrometer system was built to verify the torsion propulsion mode. Meanwhile, the application of the caudal fin was realized on the torsion propulsion, and the measured system was established to demonstrate the performance of the caudal fin. The established simulation procedures and experimental methods in this study may provide guidance to the fins made of the composite materials during the structural design and the investigation of the flow field characteristics with the movement of the fins.

  11. Robust, accurate and fast automatic segmentation of the spinal cord. (United States)

    De Leener, Benjamin; Kadoury, Samuel; Cohen-Adad, Julien


    Spinal cord segmentation provides measures of atrophy and facilitates group analysis via inter-subject correspondence. Automatizing this procedure enables studies with large throughput and minimizes user bias. Although several automatic segmentation methods exist, they are often restricted in terms of image contrast and field-of-view. This paper presents a new automatic segmentation method (PropSeg) optimized for robustness, accuracy and speed. The algorithm is based on the propagation of a deformable model and is divided into three parts: firstly, an initialization step detects the spinal cord position and orientation using a circular Hough transform on multiple axial slices rostral and caudal to the starting plane and builds an initial elliptical tubular mesh. Secondly, a low-resolution deformable model is propagated along the spinal cord. To deal with highly variable contrast levels between the spinal cord and the cerebrospinal fluid, the deformation is coupled with a local contrast-to-noise adaptation at each iteration. Thirdly, a refinement process and a global deformation are applied on the propagated mesh to provide an accurate segmentation of the spinal cord. Validation was performed in 15 healthy subjects and two patients with spinal cord injury, using T1- and T2-weighted images of the entire spinal cord and on multiecho T2*-weighted images. Our method was compared against manual segmentation and against an active surface method. Results show high precision for all the MR sequences. Dice coefficients were 0.9 for the T1- and T2-weighted cohorts and 0.86 for the T2*-weighted images. The proposed method runs in less than 1min on a normal computer and can be used to quantify morphological features such as cross-sectional area along the whole spinal cord.

  12. Origin of a Non-Clarke's Column Division of the Dorsal Spinocerebellar Tract and the Role of Caudal Proprioceptive Neurons in Motor Function. (United States)

    Yuengert, Rachel; Hori, Kei; Kibodeaux, Erin E; McClellan, Jacob X; Morales, Justin E; Huang, Teng-Wei P; Neul, Jeffrey L; Lai, Helen C


    Proprioception, the sense of limb and body position, is essential for generating proper movement. Unconscious proprioceptive information travels through cerebellar-projecting neurons in the spinal cord and medulla. The progenitor domain defined by the basic-helix-loop-helix (bHLH) transcription factor, ATOH1, has been implicated in forming these cerebellar-projecting neurons; however, their precise contribution to proprioceptive tracts and motor behavior is unknown. Significantly, we demonstrate that Atoh1-lineage neurons in the spinal cord reside outside Clarke's column (CC), a main contributor of neurons relaying hindlimb proprioception, despite giving rise to the anatomical and functional correlate of CC in the medulla, the external cuneate nucleus (ECu), which mediates forelimb proprioception. Elimination of caudal Atoh1-lineages results in mice with relatively normal locomotion but unable to perform coordinated motor tasks. Altogether, we reveal that proprioceptive nuclei in the spinal cord and medulla develop from more than one progenitor source, suggesting an avenue to uncover distinct proprioceptive functions.

  13. Pyogenic spinal osteomyelitis: a review of 61 cases. (United States)

    Silverthorn, K G; Gillespie, W J


    The presentation and outcome of 61 cases of nontuberculous spinal osteomyelitis were reviewed. Although the commonest presentation was subacute, with back pain predominating, 10% had septicaemia and 7% paraperesis or paraplegia. Most infections were caudal to the fourth thoracic vertebra. One third were associated with preceding urinary, respiratory, dental or abdominal sepsis. Staphylococcus aureus was the infecting organism in 85% of isolates. Delay in diagnosis was frequent. There were four deaths, and seven individuals remained severely disabled: outcome was otherwise satisfactory. An algorithm for the investigation and management of this uncommon but serious condition is proposed.

  14. [Horner syndrome following combined spinal-epidural anesthesia]. (United States)

    Karaca, Ömer; Kumaş Solak, Sezen; Demirgan, Serdar; Bademci, Mehmet


    Horner syndrome is rarely observed in connection with epidural anesthesia. It is characterized by ptosis, enophthalmos, miosis, anisocoria, and conjunctival hyperemia in the affected eye, as well as anhydrosis and flushing on the affected side of the face. It is usually a complication spontaneously resolved without permanent neurological deficits. Intraoral anesthesia; stellate ganglion, cervical or brachial plexus blocks; thoracic, lumbar or caudal epidural anesthesia, and intrapleural analgesia are the main causes for Horner syndrome related to anesthesia. Among other causes of Horner syndrome are head and neck surgery, trauma, and puncture of internal jugular vein. The present case of unilateral Horner syndrome appeared in the aortobifemoral bypass after lumbar spinal- epidural anesthesia.

  15. Caudal Duplication Syndrome: the Vital Role of a Multidisciplinary Approach and Staged Correction. (United States)

    Samuk, Inbal; Levitt, Marc; Dlugy, Elena; Kravarusic, Dragan; Ben-Meir, David; Rajz, Gustavo; Konen, Osnat; Freud, Enrique


    Caudal duplication syndrome is a rare entity that describes the association between congenital anomalies involving caudal structures and may have a wide spectrum of clinical manifestations. A full-term male presented with combination of anomalies including anorectal malformation, duplication of the colon and lower urinary tract, split of the lower spine, and lipomyelomeningocele with tethering of the cord. We report this exceptional case of caudal duplication syndrome with special emphasis on surgical strategy and approach combining all disciplines involved. The purpose of this report is to present the pathology, assessment, and management strategy of this complex case.

  16. Spinal cord central canal of the German shepherd dog: morphological, histological, and ultrastructural considerations. (United States)

    Marín-García, P; González-Soriano, J; Martinez-Sainz, P; Contreras-Rodríguez, J; Del Corral-Gros, C; Rodríguez-Veiga, E


    This study deals with some macroscopical, microscopical, and ultrastructural aspects of the spinal cord central canal of the German shepherd dog. The caudal end of the spinal cord is constituted by the conus medullaris, which may extend to the first sacral vertebra, the terminal ventricle, and the filum terminale. The latter structure is considered as internum (second to third sacral vertebrae) or externum (fifth caudal vertebra), according to its relation to the dura mater. Occasionally, there is a second anchorage which is close to the level of the sixth caudal vertebra. The central canal is surrounded by a ciliated ependymal epithelium, which differs depending upon the levels. The most caudal part of the filum terminale bears a columnar ciliated ependymal epithelium surrounded by two layers of glia and pia mater, which separate the central canal from the subarachnoid space. Microfil injections show a communication between the cavity and the subarachnoid space, as the plastic is able to pass through the ependymal epithelium. At the level of the terminal ventricle there are real separations of the ependymal epithelium, which seem to connect the lumen of the spinal canal with the subarachnoid space. These structures probably constitute one of the drainage pathways of the cerebrospinal fluid. The diameter of the central canal is related to the age of the animal. However, even in very old animals the spinal cord central canal reaches the tip of the filum terminale and remains patent until death. At the ultrastructural level the ependymal cells present villi, located on cytoplasmic projections, cilia, dense mitochondria, and oval nuclei.

  17. Unusual magnetic resonance characteristics of a cerebellopontine angle epidermoid cyst with upper cervical spinal canal extension. (United States)

    Teo, Beng-Tiong; Lin, Chao-chun; Chiou, Tsung-Lang; Chen, Shang-Chi; Yen, Pao-Sheng


    We present a 27-year-old woman with an epidermoid cyst at the cerebellopontine (CP) angle with caudal extension into the upper cervical spinal canal. The lesion showed unusual hyperintensity on T1-weighted images, and hypointensity on T2-weighted images. We used microneurosurgical techniques for tumour dissection and excision. To our knowledge, this is the fifth example in Index Medicus/MEDLINE of histopathologically proven CP angle epidermoid with cervical spine extension.

  18. Major vault protein promotes locomotor recovery and regeneration after spinal cord injury in adult zebrafish. (United States)

    Pan, Hong-Chao; Lin, Jin-Fei; Ma, Li-Ping; Shen, Yan-Qin; Schachner, Melitta


    In contrast to mammals, adult zebrafish recover locomotor functions after spinal cord injury (SCI), in part due to axonal regrowth and regeneration permissivity of the central nervous system. Upregulation of major vault protein (MVP) expression after spinal cord injury in the brainstem of the adult zebrafish prompted us to probe for its contribution to recovery after SCI. MVP is a multifunctional protein expressed not only in many types of tumours but also in the nervous system, where its importance for regeneration is, however, unclear. Using an established zebrafish SCI model, we found that MVP mRNA and protein expression levels were increased in ependymal cells in the spinal cord caudal to the lesion site at 6 and 11 days after SCI. Double immunolabelling showed that MVP was co-localised with Islet-1 or tyrosine hydroxylase around the central canal of the spinal cord in sham-injured control fish and injured fish 11 days after surgery. MVP co-localised with the neural stem cell marker nestin in ependymal cells after injury. By using an in vivo morpholino-based knock-down approach, we found that the distance moved by MVP morpholino-treated fish was reduced at 4, 5 and 6 weeks after SCI when compared to fish treated with standard control morpholino. Knock-down of MVP resulted in reduced regrowth of axons from brainstem neurons into the spinal cord caudal to the lesion site. These results indicate that MVP supports locomotor recovery and axonal regrowth after SCI in adult zebrafish.

  19. Spinal Cord Dysfunction (SCD) (United States)

    Department of Veterans Affairs — The Spinal Cord Dysfunction (SCD) module supports the maintenance of local and national registries for the tracking of patients with spinal cord injury and disease...

  20. Tethered Spinal Cord Syndrome (United States)

    ... roots may be cut to relieve pain. In adults, surgery to free (detether) the spinal cord can reduce the size ... is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord ...

  1. Extradural spinal meningioma: MRI

    Energy Technology Data Exchange (ETDEWEB)

    Sato, N. [Department of Diagnostic Radiology, Yale University School of Medicine, P. O. Box 20 8042, New Haven, CT 06520-8042 (United States); Sze, G. [Department of Diagnostic Radiology, Yale University School of Medicine, P. O. Box 20 8042, New Haven, CT 06520-8042 (United States)


    We report a case of extradural spinal meningioma with pathologically proven features of malignant transformation. The MRI findings of extradural spinal meningioma and differences in the findings from intradural meningiomas are discussed. (orig.). With 1 fig.

  2. Spinal cord abscess (United States)

    ... drugs The infection often begins in the bone ( osteomyelitis ). The bone infection may cause an epidural abscess ... Boils Cerebral spinal fluid (CSF) collection Epidural abscess Osteomyelitis Pulmonary tuberculosis Sepsis Spinal cord trauma Swelling Review ...

  3. Spinal Muscular Atrophy (United States)

    Spinal muscular atrophy (SMA) is a genetic disease that attacks nerve cells, called motor neurons, in the spinal cord. These cells communicate with your voluntary muscles - the ones you can control, like in your ...

  4. Upregulation of S100A4 after spinal cord transection in adult rats

    Institute of Scientific and Technical Information of China (English)

    Kai-hua ZHANG; Shu HAN; Pei-hua LU; Xiao-ming XU


    AIM: To investigate whether spinal cord transection induces changes of gene expression of S 100A4 protein.METHODS: In a spinal cord transection model, S 100A4 expression and cellular localization were examined using cDNA microarray, Northern blot, immunohistochemistry, and immunofluorescence double-labeling methods.RESULTS: There was very limited S 100A4 mRNA expression in the control spinal cord. However, S 100A4 mRNA expression was increased significantly in both the rostral and caudal spinal cord segments adjacent to the injury site.Specifically, S100A4 gene expression was substantially increased at d 2, peaked at d 7 and d 14, and remained high up to 28 d post-injury. During its peak expression, S100A4 protein was localized in astrocytes of the spinal cord within 5 mm from the site of spinal transection. CONCLUSION: Spinal cord transection induces prolonged S 100A4 expression at both mRNA and protein levels in areas close to the injury site. Increased expression of S100A4 in astrocytes after spinal cord transection may indicate that this molecule may play a role in astrocytic responses to injury.

  5. Minimally Invasive Drainage of a Post-Laminectomy Subfascial Seroma with Cervical Spinal Cord Compression. (United States)

    Kitshoff, Adriaan Mynhardt; Van Goethem, Bart; Cornelis, Ine; Combes, Anais; Dvm, Ingeborgh Polis; Gielen, Ingrid; Vandekerckhove, Peter; de Rooster, Hilde


    A 14 mo old female neutered Doberman pinscher was evaluated for difficulty in rising, a wide based stance, pelvic limb gait abnormalities, and cervical pain of 2 mo duration. Neurologic examination revealed pelvic limb ataxia and cervical spinal hyperesthesia. Spinal reflexes and cranial nerve examination were normal. The pathology was localized to the C1-C5 or C6-T2 spinal cord segments. Computed tomography (CT) findings indicated bony proliferation of the caudal articular processes of C6 and the cranial articular processes of C7, resulting in bilateral dorsolateral spinal cord compression that was more pronounced on the left side. A limited dorsal laminectomy was performed at C6-C7. Due to progressive neurological deterioration, follow-up CT examination was performed 4 days postoperatively. At the level of the laminectomy defect, a subfacial seroma had developed, entering the spinal canal and causing significant spinal cord compression. Under ultrasonographic guidance a closed-suction wound catheter was placed. Drainage of the seroma successfully relieved its compressive effects on the spinal cord and the patient's neurological status improved. CT was a valuable tool in assessing spinal cord compression as a result of a postoperative subfascial seroma. Minimally invasive application of a wound catheter can be successfully used to manage this condition.

  6. Neuromodulation of evoked muscle potentials induced by epidural spinal-cord stimulation in paralyzed individuals. (United States)

    Sayenko, Dimitry G; Angeli, Claudia; Harkema, Susan J; Edgerton, V Reggie; Gerasimenko, Yury P


    Epidural stimulation (ES) of the lumbosacral spinal cord has been used to facilitate standing and voluntary movement after clinically motor-complete spinal-cord injury. It seems of importance to examine how the epidurally evoked potentials are modulated in the spinal circuitry and projected to various motor pools. We hypothesized that chronically implanted electrode arrays over the lumbosacral spinal cord can be used to assess functionally spinal circuitry linked to specific motor pools. The purpose of this study was to investigate the functional and topographic organization of compound evoked potentials induced by the stimulation. Three individuals with complete motor paralysis of the lower limbs participated in the study. The evoked potentials to epidural spinal stimulation were investigated after surgery in a supine position and in one participant, during both supine and standing, with body weight load of 60%. The stimulation was delivered with intensity from 0.5 to 10 V at a frequency of 2 Hz. Recruitment curves of evoked potentials in knee and ankle muscles were collected at three localized and two wide-field stimulation configurations. Epidural electrical stimulation of rostral and caudal areas of lumbar spinal cord resulted in a selective topographical recruitment of proximal and distal leg muscles, as revealed by both magnitude and thresholds of the evoked potentials. ES activated both afferent and efferent pathways. The components of neural pathways that can mediate motor-evoked potentials were highly dependent on the stimulation parameters and sensory conditions, suggesting a weight-bearing-induced reorganization of the spinal circuitries.

  7. Reverse Anterolateral Thigh Flap to Revise a Below-knee Amputation Stump at the Mid-tibial Level

    Directory of Open Access Journals (Sweden)

    Parviz Lionel Sadigh, MB ChB


    Full Text Available Summary: The reconstruction of defects around the knee often poses a challenge due to the limited availability of local soft tissues. Indeed, this same problem is encountered when attempting to revise a below-knee amputation stump. Moreover, due to a paucity of recipient vessels in those who have undergone previous amputation secondary to trauma, free-flap reconstruction is often challenging and not always successful. We report a case of a reverse anterolateral thigh (ALT flap used to revise a long below-knee amputation stump. Previous reports in the literature attest to the versatility of the reverse ALT to cover defects around the knee and proximal tibia, but to our knowledge, this is the first report of a reverse ALT reaching to the mid-tibial level.

  8. In vivo dynamic compression has less detrimental effect than static compression on newly formed bone of a rat caudal vertebra (United States)

    Benoit, A.; Mustafy, T.; Londono, I.; Grimard, G.; Aubin, C-E.; Villemure, I.


    Fusionless devices are currently designed to treat spinal deformities such as scoliosis by the application of a controlled mechanical loading. Growth modulation by dynamic compression was shown to preserve soft tissues. The objective of this in vivo study was to characterize the effect of static vs. dynamic loading on the bone formed during growth modulation. Controlled compression was applied during 15 days on the 7th caudal vertebra (Cd7) of rats during growth spurt. The load was sustained in the “static” group and sinusoidally oscillating in the “dynamic” group. The effect of surgery and of the device was investigated using control and sham (operated on but no load applied) groups. A high resolution CT-scan of Cd7 was acquired at days 2, 8 and 15 of compression. Growth rates, histomorphometric parameters and mineral density of the newly formed bone were quantified and compared. Static and dynamic loadings significantly reduced the growth rate by 20% compared to the sham group. Dynamic loading preserved newly formed bone histomorphometry and mineral density whereas static loading induced thicker (+31%) and more mineralized (+12%) trabeculae. A significant sham effect was observed. Growth modulation by dynamic compression constitutes a promising way to develop new treatment for skeletal deformities. PMID:27609036

  9. Proximal ulnar stump stability after using the pronator quadratus muscle transfer combined with the Suavé-Kapandji procedure in rheumatoid wrist. (United States)

    Uerpairojkit, Chairoj; Leechavengvongs, Somsak; Malungpaishorpe, Kanchai; Witoonchart, Kiat; Buddhavibul, Panai


    The pronator quadratus muscle transfer combined with the Sauvé-Kapandji procedure was used to treat the distal radioulnar joint disorder in ten rheumatoid wrists for prevention against instability of the proximal ulnar stump. All patients were female with a mean age of 46.6 years. The mean follow-up time was 24.2 months. Postoperatively, supination increased in all patients with a mean of 50 degrees. Pain decreased significantly and none complained of prominence of the proximal ulnar stump in normal pronated position and during a tight grip. The wrist radiographs of both coronal and sagittal planes in normal and stress fisting views were used to evaluate the postoperative static and physiologic loaded stability of the proximal ulnar stump. It had shown this procedure provided good static proximal ulnar stump stability in both coronal and sagittal planes. However, in physiologic loaded condition, it was able to provide stability only in the sagittal plane.

  10. Plasma concentrations and pharmacokinetics of bupivacaine with and without adrenaline following caudal anaesthesia in infants

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Morton, N S; Cullen, P M


    The aim of this study was to determine whether the use of adrenaline 1/400000 added to 0.25% bupivacaine significantly delays the systemic absorption of the drug from the caudal epidural space in young infants.......The aim of this study was to determine whether the use of adrenaline 1/400000 added to 0.25% bupivacaine significantly delays the systemic absorption of the drug from the caudal epidural space in young infants....

  11. Investigation of Fish Caudal Fin Locomotion Using a Bio-inspired Robotic Model

    Directory of Open Access Journals (Sweden)

    Ziyu Ren


    Full Text Available Due to its advantages of realizing repeatable experiments, collecting data and isolating key factors, the bio-robotic model is becoming increasingly important in the study of biomechanics. The caudal fin of fish has long been understood to be central to propulsion performance, yet its contribution to manoeuverability, especially for homocercal caudal fin, has not been studied in depth. In the research outlined in this paper, we designed and fabricated a robotic caudal fin to mimic the morphology and the three-dimensional (3D locomotion of the tail of the Bluegill Sunfish (Lepomis macrochirus. We applied heave and pitch motions to the robot to model the movement of the caudal peduncle of its biological counterpart. Force measurements and 2D and 3D digital particle image velocimetry were then conducted under different movement patterns and flow speeds. From the force data, we found the addition of the 3D caudal fin locomotion significantly enhanced the lift force magnitude. The phase difference between the caudal fin ray and peduncle motion was a key factor in simultaneously controlling the thrust and lift. The increased flow speed had a negative impact on the generation of lift force. From the average 2D velocity field, we observed that the vortex wake directed water both axially and vertically, and formed a jet like structure with notable wake velocity. The 3D instantaneous velocity field at 0.6 T indicated the 3D motion of the caudal fin may result in asymmetry wake flow patterns relative to the mid-sagittal plane and change the heading direction of the shedding vortexes. Based on these results, we hypothesized that live fish may actively tune the movement between the caudal fin rays and the peduncle to change the wake structure behind the tail and hence obtain different thrust and lift forces, which contributes to its high manoeuvrability.

  12. Formulación iterativa de un modelo de transferencia lluvia bruta-caudal


    Revilla Cortezón, José Antonio; Luceño Vázquez, Alberto; Liaño Herrera, Andrés; Sainz Borda, José Ángel; Díez-Cascón Sagrado, Joaquín


    RESUMEN. En este artículo se presenta un modelo de transferencia lluvia -caudal, cuyo ajuste se efectúa mediante técnicas de regresión múltiple y cuya base conceptual se establece mediante la dependencia que el caudal medio, en un momento determinado, debe tener con la lluvia bruta precipitada en él y en períodos anteriores.

  13. Spinal Cord Diseases (United States)

    ... damages the vertebrae or other parts of the spine, this can also injure the spinal cord. Other spinal cord problems include Tumors Infections such as meningitis and polio Inflammatory diseases Autoimmune diseases Degenerative diseases such as amyotrophic lateral sclerosis and spinal ...

  14. Spinal Cord Injuries (United States)

    ... forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or ... down on the nerve parts that carry signals. Spinal cord injuries can be complete or incomplete. With a complete ...

  15. Spinal Muscular Atrophy (SMA) (United States)

    ... Your 1- to 2-Year-Old Spinal Muscular Atrophy (SMA) KidsHealth > For Parents > Spinal Muscular Atrophy (SMA) A A A What's in this article? ... Outlook en español Atrofia muscular espinal Spinal muscular atrophy, or SMA, is an inherited condition that causes ...

  16. The Effect of Autologous Platelet-Rich Plasma on Bronchial Stump Tissue Granulation after Pneumonectomy: Experimental Study


    Eleftherios Spartalis; Periklis Tomos; Petros Konofaos; Grigorios Karagkiouzis; Georgia Levidou; Nikolaos Kavantzas; Alkistis Pantopoulou; Othon Michail; Despina Perrea; Gregory Kouraklis


    Objectives. Recent advances in perioperative management, antibiotics, and surgical materials, including mechanical staplers, have decreased the operative risk of pulmonary resection. However, bronchopleural fistula can still occur in some instances, the occurrence often being lethal. This study investigated whether platelet-rich plasma (PRP) promotes granulation of the bronchial stump after pneumonectomy. Methods. Ten pigs were randomized into two groups: (A) control or non-PRP group (pneumon...

  17. [The endo-exo prosthesis for patients with a problematic amputation stump]. (United States)

    Frölke, Jan Paul M; van de Meent, Henk


    Following lower limb amputation, quality of life is highly related to the ability to use a prosthetic limb. The conventional way to attach a prosthetic limb to the body is with a socket. Many patients experience serious discomfort wearing a conventional prosthesis because of pain, instability during walking, pressure sores, bad smell or skin irritation. In addition, sitting is uncomfortable and pelvic and lower back pain due to unstable gait is often seen in these patients. The main disadvantage of the current prosthesis is the attachment of a rigid prosthesis socket to a soft and variable body. The socket must fit tightly for stability during walking but should also be comfortable for sitting. The implantation of an osseointegrated, intramedullary, transcutaneously conducted prosthesis is a new procedure for attaching a limb prosthesis to the human body without the disadvantages of the conventional prosthesis. The intramedullary prosthesis is designed with a rough surface resembling cancellous bone to enable a secure solid integration with the long bone. We treated two patients with this new prosthesis, a 44-year-old man after a transfemoral amputation, and a 32-year-old woman after a lower leg amputation; both amputations were necessary because of trauma. Those two patients are now, more than one year after the operation, showing excellent functional results without infectious complications. We assume that endo-exo prosthesis may be a promising option for selected patients unable to use a conventional prosthesis because of a problematic amputation stump.

  18. The regenerating antler blastema: the derivative of stem cells resident in a pedicle stump. (United States)

    Li, Chunyi; Chu, Wenhui


    Antlers of the deer are the only mammalian organs that can fully grow back once lost from their pedicles, hence offer the only opportunity to learn how nature has bestowed mammalian epimorphic regeneration. Investigations have demonstrated that it is the proliferation and differentiation of pedicle periosteal cells (PPCs), but not dedifferentiation of the local differentiated cells, that give rise to the antler blastema. PPCs express key embryonic stem cell markers and can be induced to differentiate into multiple cell lineages, so are termed antler stem cells. Further research has found that PPCs can initiate antler regeneration only when they have interacted with cells of the pedicle skin. Histologically, the process of early antler regeneration resembles that of healing of a mouse leg stump wound. However what sets these two apart is the difference in proliferation potential between the PPCs and the periosteal cells of the long bone. We believe that if we can impart a greater proliferation potential to the long bone periosteal cells, we might be able to achieve the dream of regenerating limbs in mammals.

  19. Cranial and caudal mesenteric arteries of the paca (Cuniculus paca, L. 1766

    Directory of Open Access Journals (Sweden)

    Isabela Cristina de Souza Marques


    Full Text Available The paca (Cuniculus paca, Linnaeus, 1766 is a medium-sized rodent that occurs in Brazil; however, there is little information regarding its morphology. The goal of this study was to describe the origin and branching of the cranial and caudal mesenteric arteries of this rodent in order to contribute to comparative anatomy studies. Ten animals (males and females were used. After death, their thoracic inlet was opened between the fourth and sixth ribs to expose the thoracic aorta, which was cannulated caudally. A stained, neoprene latex solution was then injected, in order to fill the arterial system, and the preparations were fixed in a 10% aqueous formalin solution for over 72h. The fixed specimens were dissected to identify the cranial and caudal mesenteric arteries. The cranial mesenteric artery started at the abdominal aorta, caudally to the celiac artery, and originated in the following arterial branches: caudal pancreatic duodenal, pancreatic, jejunal, ileum colic and cecal. The origin of the caudal mesenteric artery occurred next to the end of abdominal aorta and this vessel issued the left colic artery and cranial rectal artery from which the sigmoid arteries initiated. It was found that there was little difference in the branching pattern of the arteries compared to other rodents and domestic mammals.

  20. The evaluation of upper leg traction in lateral position for pediatric caudal block

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    Mahin Seyedhejazi


    Full Text Available Purpose: A well-functioning caudal block is an excellent adjunct to general anesthesia, but misplaced injection results in poor analgesia as well as possibility of serious morbidity. Therefore, the purpose of this study was to evaluate the effectiveness of leg traction on success rate of caudal block in lateral position in children. Methods: Two hundred children, age 2 months to 6 years, ASA I and II, who underwent lower abdominal surgeries were randomized in prospective controlled clinical trial study in two groups. After induction of General anesthesia, the caudal block was performed in the lateral position with upper leg traction (L-T- or with the standard position (S-P (leg flexed 90΀. Hemodynamicchanges, movement of lower extremity in response to surgical stimulus were evaluated. Results: There was no significant difference in caudal block′s success rate between two groups at first attempt (P=0.25. In group (S-P the procedure was successful in 60% of cases at first attempt, 25% at second,10% at third attempt and 5% failure of caudal block, whereas in the first group it was 75%, 20%, 1% and 4% of cases respectively. There were no significant differences in heart rate and blood pressure changes between two groups (P>0.05. Conclusion: The success rate of pediatric caudal block in upper leg traction did not differ from that of the standard position.

  1. The untold story of the caudal skeleton in the electric eel (ostariophysi: gymnotiformes: electrophorus.

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    Carlos David de Santana

    Full Text Available Alternative hypotheses had been advanced as to the components forming the elongate fin coursing along the ventral margin of much of the body and tail from behind the abdominal region to the posterior margin of the tail in the Electric Eel, Electrophorus electricus. Although the original species description indicated that this fin was a composite of the caudal fin plus the elongate anal fin characteristic of other genera of the Gymnotiformes, subsequent researchers proposed that the posterior region of the fin was formed by the extension of the anal fin posteriorly to the tip of the tail, thereby forming a "false caudal fin." Examination of ontogenetic series of the genus reveal that Electrophorus possesses a true caudal fin formed of a terminal centrum, hypural plate and a low number of caudal-fin rays. The confluence of the two fins is proposed as an additional autapomorphy for the genus. Under all alternative proposed hypotheses of relationships within the order Gymnotiformes, the presence of a caudal fin in Electrophorus optimized as being independent of the occurence of the morphologically equivalent structure in the Apteronotidae. Possible functional advantages to the presence of a caudal fin in the genus are discussed.

  2. Spinal epidural hematoma; Spinales epidurales Haematom

    Energy Technology Data Exchange (ETDEWEB)

    Papanagiotou, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)


    Spinal epidural hematoma is an accumulation of blood in the potential space between the dura and bone. On unenhanced computed tomography epidural hemorrhage appears as a high-density spinal canal mass with variable cord compression. Magnetic resonance imaging is the modality of choice for evaluating spinal epidural hematoma and can demonstrate the extent of the hematoma and degree of cord compression. When treated surgically the outcome depends on the extent of preoperative neurological deficits and on the operative timing interval. (orig.) [German] Das spinale epidurale Haematom ist eine Blutansammlung zwischen Dura und Knochen. Die klinische Praesentation ist aehnlich dem akuten Bandscheibenvorfall, die Symptomatik ist allerdings in der Regel progredient. In der CT stellt sich ein frisches Haematom hyperdens dar. Die MRT ist die Methode der Wahl zur Diagnose spinaler epiduraler Haematome und kann die Ausdehnung sowie auch das Ausmass der Kompression darstellen. Die wichtigste Differenzialdiagnose vom epiduralen Haematom ist das epidurale Empyem. (orig.)

  3. Ultrasound-guided alcohol neurolysis and radiofrequency ablation of painful stump neuroma: effective treatments for post-amputation pain (United States)

    Zhang, Xin; Xu, Yongming; Zhou, Jin; Pu, Shaofeng; Lv, Yingying; Chen, Yueping; Du, Dongping


    Background Post-amputation pain (PAP) is highly prevalent after limb amputation, and stump neuromas play a key role in the generation of the pain. Presently, PAP refractory to medical management is frequently treated with minimally invasive procedures guided by ultrasound, such as alcohol neurolysis and radiofrequency ablation (RFA). Objective To record the immediate and long-term efficacy of alcohol neurolysis and RFA. We first used alcohol neurolysis and then, when necessary, we performed RFA on PAP patients. Study design Prospective case series. Setting Pain management center. Methods Thirteen subjects were treated with ultrasound-guided procedures. Results All patients were treated with neurolysis using alcohol solutions guided by ultrasound. Seven (54%) of 13 subjects achieved pain relief after 1–3 alcohol injection treatments. The remaining 6 subjects obtained pain relief after receiving 2 administrations of ultrasound-guided RFA. After a 6-month follow-up evaluation period, pain quantities were also assessed. Both stump pain (including intermittent sharp pain and continuous burning pain) and phantom pain were relieved. The frequency of intermittent sharp pain was decreased, and no complications were noted during the observation. Conclusion The use of ultrasound guidance for alcohol injection and RFA of painful stump neuromas is a simple, radiation-free, safe, and effective procedure that provides sustained pain relief in PAP patients. In this case series, RFA was found to be an effective alternative to alcohol injection. PMID:28223839

  4. [Lower limb stump reconstruction with a functional calcaneo-plantar unit free flap. A series of 16 cases]. (United States)

    Malikov, S; Dubert, T; Koupatadze, D; Nabokov, V; Polosov, R


    The main objective of surgery, once amputation is inevitable, is to preserve a functional stump. This report describes the immediate reconstruction of 16 leg stumps in children by transfer of a functional calcaneo-plantar unit. Of these, 3 were thigh and 13 were lower leg reconstructions. Amputation was performed for tumor in 4 cases, and was due to accidents in the remaining twelve. The main technical features of flap preparation are preservation of the calcaneum branch and attachment of the heel skin to the greater tuberosity of the calcaneum. One case resulted in failure due to vascular thrombosis. The other 15 cases resulted in bone consolidation after an average of 45 days, sensitive protection by 70 days, and very good trophic and protective results. The provision of good distal pressure area encourages overall development of the child. There was no morbidity at the donor site, and because there is no major muscle mass in the distal fragment, the overall risk is very low compared to that of total proximal leg replantation. The transfer of functional calcaneo-plantar tissue as a single unit is the best strategy for one-step restoration of good distal support area for the stump. All surgeons liable to perform leg amputations should be aware of this technical approach.

  5. The effect of autologous platelet-rich plasma on bronchial stump tissue granulation after pneumonectomy: experimental study. (United States)

    Spartalis, Eleftherios; Tomos, Periklis; Konofaos, Petros; Karagkiouzis, Grigorios; Levidou, Georgia; Kavantzas, Nikolaos; Pantopoulou, Alkistis; Michail, Othon; Perrea, Despina; Kouraklis, Gregory


    Objectives. Recent advances in perioperative management, antibiotics, and surgical materials, including mechanical staplers, have decreased the operative risk of pulmonary resection. However, bronchopleural fistula can still occur in some instances, the occurrence often being lethal. This study investigated whether platelet-rich plasma (PRP) promotes granulation of the bronchial stump after pneumonectomy. Methods. Ten pigs were randomized into two groups: (A) control or non-PRP group (pneumonectomy) and (B) PRP group (pneumonectomy and PRP application). PRP was obtained by spinning down the animal's own blood and collecting the buffy coat containing platelets and white blood cells. Results. Increased platelet concentration triggered the healing process. The percentage of granulation tissue formed at the stumps was significantly higher in the PRP group of animals. This observation was confirmed when statistical analysis using Mann-Whitney U test was performed (P = 0.0268). Conclusions. PRP is easily produced with minimal basic equipment and is useful in accelerating granulation of the bronchial stump, although the timing and optimum number of applications in humans require further study. Autologous PRP is a safe, feasible, and reliable new healing promoter with potential therapeutic effects.

  6. Short-term effects of thinning, clear-cutting and stump harvesting on methane exchange in a boreal forest

    Directory of Open Access Journals (Sweden)

    E. Sundqvist


    Full Text Available Forest management practices can alter soil conditions, affecting the consumption and production processes that control soil methane (CH4 exchange. We studied the short-term effects of thinning, clear-cutting and stump harvesting on the CH4 exchange between soil and atmosphere at a boreal forest site in central Sweden, using an undisturbed plot as the control. Chambers in combination with a high precision laser gas analyser were used for continuous measurements. Both the undisturbed plot and the thinned plot were net sinks of CH4, whereas the clear-cut plot and the stump harvested plot were net CH4 sources. The CH4 uptake at the thinned plot was reduced in comparison to the undisturbed plot. The shift from sink to source at the clear-cut and stump harvested plots was probably due to a rise of the water table and an increase in soil moisture, leading to lower gas diffusivity and more reduced conditions which favour CH4 production by archea. Reduced evapotranspiration after harvesting leads to wetter soils, decreased CH4 consumption and increased CH4 production, and should be accounted for in the CH4 budget of managed forests.

  7. The capability of fiber Bragg grating sensors to measure amputees' trans-tibial stump/socket interface pressures. (United States)

    Al-Fakih, Ebrahim A; Osman, Noor Azuan Abu; Eshraghi, Arezoo; Adikan, Faisal Rafiq Mahamd


    This study presents the first investigation into the capability of fiber Bragg grating (FBG) sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s) were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee's Patellar Tendon (PT) bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.

  8. The Capability of Fiber Bragg Grating Sensors to Measure Amputees’ Trans-Tibial Stump/Socket Interface Pressures

    Directory of Open Access Journals (Sweden)

    Faisal Rafiq Mahamd Adikan


    Full Text Available This study presents the first investigation into the capability of fiber Bragg grating (FBG sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee’s Patellar Tendon (PT bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.

  9. Rostrocaudal distribution of motoneurones and variation in ventral horn area within a segment of the feline thoracic spinal cord

    DEFF Research Database (Denmark)

    Meehan, Claire Francesca; Ford, Tim W; Road, Jeremy D;


    Retrograde transport of horseradish peroxidase, applied to cut peripheral nerves, was used to determine the rostrocaudal distribution of motoneurones supplying different branches of the ventral ramus for a single mid- or caudal thoracic segment in the cat. The motoneurones occupied a length...... of spinal cord equal to the segmental length but displaced rostrally from the segment as defined by the dorsal roots, with the number of motoneurones per unit length of cord higher in the rostral part of a segment (close to the entry of the most rostral dorsal root) than in the caudal part. The cross......-sectional area of the ventral horn showed a rostrocaudal variation that closely paralleled the motoneurone distribution. The ratio between the number of motoneurones per unit length in the caudal and rostral regions of a segment (0.70) was similar to the ratio previously reported for the strength of functional...

  10. Distribution of networks generating and coordinating locomotor activity in the neonatal rat spinal cord in vitro: a lesion study

    DEFF Research Database (Denmark)

    Kjaerulff, O; Kiehn, O


    The isolated spinal cord of the newborn rat contains networks that are able to create a patterned motor output resembling normal locomotor movements. In this study, we sought to localize the regions of primary importance for rhythm and pattern generation using specific mechanical lesions. We used...... ventral root recordings to monitor neuronal activity and tested the ability of various isolated parts of the caudal thoraciclumbar cord to generate rhythmic bursting in a combination of 5-HT and NMDA. In addition, pathways mediating left/right and rostrocaudal burst alternation were localized. We found...... decreased in the caudal direction, but the rhythm-generating network was found to be distributed over the entire lumbar region and to extend into the caudal thoracic region. The pathways mediating left/ right alternation exist primarily in the ventral commissure. As with the rhythmogenic ability...

  11. Comparing caudal and penile nerve blockade using bupivacaine in hypospadias repair surgeries in children

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    Mahin Seyedhejazi


    Full Text Available Background: Caudal anaesthesia is recommended for most surgical procedures of the lower part of the body, mainly below the umbilicus. It has been well established that a dorsal penile nerve block immediately after surgery decreases postoperative pain in children undergoing hypospadias repair. This study aimed to compare caudal or penile nerve block using bupivacaine in postoperative pain control in hypospadias repair in children. Patients and Methods: After local ethical committee approval and obtaining informed parental consent, 85 American society of Anesthesiologists status I and II patients, aged 6 months to 6 years old, undergoing hypospadias repair, were prospectively enrolled in this study. The patients were randomly divided into the following two groups: Caudal block was performed in 44 and penile block was performed in 41 patients. Cardiorespiratory systems data, analgesic requirement and complications were compared between the groups. Results: There were statistically significant haemodynamic (blood pressureand heart rate alteration during operation in each group (P<0.01. The haemodynamic parameters were stable during operation in successful blocks in both groups. Caudal block success rate is 97.7%, whereas in penile block is 92.6%. Nineteen of 43 patients (44% in caudal group and 29 of 41 patients (70% in penile group received analgesia in the postoperative period and this difference was significant between the two groups (P = 0.025. Conclusions: Without ultrasonography and with blind block, with anatomic landmarks only, the caudal block success rate is high and if there is no contraindication for caudal block, it is the best choice in children under 6 years old (or 25 kg for hypospadias repai.

  12. Eletrophysiological study of the caudal nerve on developing rats Estudo eletrofisiológico do nervo caudal em ratos em desenvolvimento

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    Juliana Netto Maia


    Full Text Available PURPOSE: To non-invasively study the sensory nerve conduction of the caudal nerve of normal developing rats. METHODS: Twenty normal Wistar male rats served as subjects. Caudal nerve conduction studies were performed at 60 days from birth and weekly at end of six consecutive weeks. The caudal nerve was stimulated distally and nerve potentials were recorded proximally on the animal's tail using common "alligator" clips as surface electrodes. RESULTS: The amplitude and the conduction velocity of the caudal nerve sensory action potential increased linearly from 29±6 µV to 85±13 µV and from 34±3 m/s to 44±4 m/s, respectively, between the 8th and the 15th week of life. The equations of linear regressions were as followed: Amplitude (µV = 8.1 × weeks - 34 (R² = 0.99 and NCV (m/s = 1.2 × weeks + 25 (R² = 0.86. CONCLUSIONS: It was possible to study non-invasively the sensitive conduction of the caudal nerve of normal developing rats and describe reference values. The technique and data may be used as animal model in physiological and pathological studies.OBJETIVO: Estudar de forma não invasiva a condução nervosa sensitiva do nervo caudal em ratos normais em desenvolvimento. MÉTODOS: Vinte ratos machos Wistar foram utilizados. A conducão nervosa foi realizada a partir dos 60 dias, semanal durante seis semanas consecutivas. O nervo caudal foi estimulado distalmente, os potenciais foram registrados proximalmente na cauda do animal usando garras comum do tipo "jacaré" como eletrodos de superficie. RESULTADOS: A amplitude do potencial de ação de nervo sensitivo a velocidade de condução nervosa do nervo caudal cresceu linearmente de 29 ± 6 µV para 85 ± 13 µV e de 34 ± 3 m/s para 44 ± 4 m/s, respectivamente, entre a 8º e a 15º semana da vida do animal. As equações de regressão linear foram as seguintes: Amplitude (µV = 8,1 × semanas - 34 (R² = 0,99 e velocidade de conducao nervosa (m/s = 1,2 × semanas + 25 (R² = 0

  13. The spinal cord of the common marmoset (Callithrix jacchus). (United States)

    Watson, Charles; Sengul, Gulgun; Tanaka, Ikuko; Rusznak, Zoltan; Tokuno, Hironobu


    The marmoset spinal cord possesses all the characteristic features of a typical mammalian spinal cord, but with some interesting variation in the levels of origin of the limb nerves. In our study Nissl and ChAT sections of the each segment of the spinal cord in two marmosets (Ma5 and Ma8), we found that the spinal cord can be functionally and anatomically divided into six regions: the prebrachial region (C1 to C3); the brachial region (C4 to C8) - segments supplying the upper limb; the post-brachial region (T1 to L1) - containing the sympathetic outflow, and supplying the hypaxial muscles of the body wall; the crural region (L2 to L5) - segments supplying the lower limb; the postcrural region (L6) - containing the parasympathetic outflow; and the caudal region (L7 to Co4) - supplying the tail. In the rat, mouse, and rhesus monkey, the prebrachial region consists of segments C1 to C4 (with the phrenic nucleus located at the C4 segment), and the brachial region extends from C5 to T1 inclusive. The prefixing of the upper limb outflow in these two marmosets mirrors the finding in the literature that a large C4 contribution to the brachial plexus is common in humans.

  14. Expression of adrenomedullin in rats after spinal cord injury and intervention effect of recombinant human erythropoietin (United States)

    Zhao, Liang; Jing, Yu; Qu, Lin; Meng, Xiangwei; Cao, Yang; Tan, Huibing


    The expression of adrenomedullin (ADM) in injured tissue of rat spinal cord was observed and the effect of recombinant human erythropoietin was analyzed. A total of 45 Sprague-Dawley rats were selected and divided into 3 equal groups including, a sham-operation group in which rats received an excision of vertebral plate; a spinal cord injury model group and a recombinant human erythropoietin group in which rats with spinal cord injury received a caudal vein injection of 300 units recombinant human erythropoietin after injury. Hematoxylin and eosin staining was performed to observe the spinal cord injury conditions. Immunohistochemical staining was performed to observe the expression of ADM. Pathologic changes in the group of recombinant human erythropoietin at various times were significantly less severe than those in the group of spinal cord injury model. The expression of ADM was increased particularly in the group of recombinant human erythropoietin (P<0.01). The improved Tarlov scores of the group of spinal cord injury model and the group of recombinant human erythropoietin were lower than those of the sham-operation group at 3, 6 and 9 days (P<0.01). Thus, the recombinant human erythropoietin is capable of alleviating the secondary injury of spinal cord. One of the mechanisms may be achieved by promoting the increase of ADM expression. PMID:28101163

  15. Hydrodynamic Performance of an Undulatory Robot: Functional Roles of the Body and Caudal Fin Locomotion

    Directory of Open Access Journals (Sweden)

    Li Wen


    Full Text Available Both body undulation and caudal fin flapping play essential locomotive roles while a fish is swimming, but how these two affect the swimming performance and hydrodynamics of fish individually is yet to be known. We implemented a biomimetic robotic fish that travel along a servo towing system, which can be regarded as “treadmill” of the model. Hydrodynamics was studied as a function of the principal kinetic parameters of the undulatory body and caudal fin of the model in a self‐propelled condition, under which the time‐averaged measured axial net force becomes zero. Thrust efficiency was estimated from two‐dimensional digital particle image velocimetry (DPIV measurements in the horizontal and mid‐caudal fin plane. The Single‐Row Reverse Karman wake (2S is commonly observed in many previous studies of live fish swimming. However, we show that a Double‐Row Two‐Paired vortices (2P wake was generated by the robotic model for most kinetic parameter combinations. Interestingly, the 2S wake emerged within the results of a narrow range of robotic caudal fin pitch angles (0≤θ≤10°, occurring concurrently with enhanced thrust efficiency. We also show that, compared with the effect of body wavelength (λ, the wake structure behind the robotic swimmer is more sensitive to the Strouhal number (St and caudal fin pitch angle (θ.

  16. International Spinal Cord Injury

    DEFF Research Database (Denmark)

    Dvorak, M F; Itshayek, E; Fehlings, M G;


    of the completion of the intervention or surgical closure; (6) Surgical procedure-open reduction, (7) Surgical procedure-direct decompression of neural elements, and (8 and 9) Surgical procedure-stabilization and fusion (spinal segment number and level). All variables are coded using numbers or characters. Each...... spinal intervention and procedure is coded (variables 1 through 7) and the spinal segment level is described (variables 8 and 9). Sample clinical cases were developed to illustrate how to complete it. CONCLUSION: The International SCI Spinal Interventions and Surgical Procedures Basic Data Set......STUDY DESIGN: Survey of expert opinion, feedback and final consensus. OBJECTIVE: To describe the development and the variables included in the International Spinal Cord Injury (SCI) Spinal Interventions and Surgical Procedures Basic Data set. SETTING: International working group. METHODS...

  17. The influence of coughing on cerebrospinal fluid pressure in an in vitro syringomyelia model with spinal subarachnoid space stenosis

    Directory of Open Access Journals (Sweden)

    Martin Bryn A


    Full Text Available Abstract Background The influence of coughing, on the biomechanical environment in the spinal subarachnoid space (SAS in the presence of a cerebrospinal fluid flow stenosis, is thought to be an important etiological factor in craniospinal disorders, including syringomyelia (SM, Chiari I malformation, and hydrocephalus. The aim of this study was to investigate SAS and syrinx pressures during simulated coughing using in vitro models and to provide information for the understanding of the craniospinal fluid system dynamics to help develop better computational models. Methods Four in vitro models were constructed to be simplified representations of: 1 non-communicating SM with spinal SAS stenosis; 2 non-communicating SM due to spinal SAS stenosis with a distensible spinal column; 3 non-communicating SM post surgical removal of a spinal SAS stenosis; and 4 a spinal SAS stenosis due to spinal trauma. All of the models had a flexible spinal cord. To simulate coughing conditions, an abrupt CSF pressure pulse (~ 5 ms was imposed at the caudal end of the spinal SAS by a computer-controlled pump. Pressure measurements were obtained at 4 cm intervals along the spinal SAS and syrinx using catheter tip transducers. Results Pressure measurements during a simulated cough, showed that removal of the stenosis was a key factor in reducing pressure gradients in the spinal SAS. The presence of a stenosis resulted in a caudocranial pressure drop in the SAS, whereas pressure within the syrinx cavity varied little caudocranially. A stenosis in the SAS caused the syrinx to balloon outward at the rostral end and be compressed at the caudal end. A >90% SAS stenosis did not result in a significant Venturi effect. Increasing compliance of the spinal column reduced forces acting on the spinal cord. The presence of a syrinx in the cord when there was a stenosis in the SAS, reduced pressure forces in the SAS. Longitudinal pressure dissociation acted to suck fluid and tissue

  18. Prenatal diagnosis of caudal dysplasia sequence associated with undiagnosed type I diabetes. (United States)

    Palacios-Marqués, Ana; Oliver, Cecilia; Martín-Bayón, Tina; Martinez-Escoriza, Juan Carlos


    Caudal regression or caudal dysplasia sequence (CDS) is a rare congenital malformation, which includes a wide spectrum of musculoskeletal abnormalities involving the lumbosacral spine, pelvis and lower limbs. It can be associated to visceral defects in various degrees. Maternal diabetes, genetic predisposition and vascular hypoperfusion have been suggested as possible causative factors. Women with diabetes who are dependent on insulin are 200-400 times more likely to have a child with caudal regression, making CDS the most characteristic fetal abnormality of diabetic embryopathy. Prenatal diagnosis is possible by ultrasonographic examination. The sonographic findings include abrupt interruption of the lumbar spine and 'Buddha or frog position' of the lower limbs. MRI has demonstrated the level of the vertebral anomalies as well as the associated abnormalities and this is crucial because the prognosis of this condition depends on the severity of the lesion and the presence of associated disorders.

  19. Comparative study of caudal bupivacaine versus bupivacaine with tramadol for postoperative analgesia in paediatric cancer patients

    Institute of Scientific and Technical Information of China (English)

    Mohammed Hegazy; Ayman A. Ghoneim


    Objective: Caudal epidural analgesia has become very common analgesic technique in paediatric surgery. Add-ing tramadol to bupivacaine for caudal injection prolongs duration of analgesia with minimal side effects. The aim of the study was to investigate the different effects of caudal bupivacaine versus bupivacaine with thamadol for postoperative analgesia in paediatric cancer patients. Methods: A prospective randomized controlled trial was conducted over 40 paediatric cancer pa-tients who were recruited from Children Cancer Hospital of Egypt (57357 Hospital). Patients were randomized into 2 groups: bupivacaine group (group B, 20 patients) to receive single shot caudal block of 1 mL/kg 0.1875% bupivacaine; tramadol group (group T, 20 patients) prepared as group B with the addition of 1 mg/kg caudal tramadol. Results: The mean duration of analgesia was significantly longer among group T than group B [(24 ± 13.7) hours versus (7 ± 3.7) hours respectively with P = 0.001]. Group T showed a significantly lower mean FLACC score than group B (2.2 ± 0.9 versus 3.6 ± 0.6 with P = 0.002). The difference in FLACC score was comparable on arrival, and after 2 and 4 hours. At 8 and 12 hours the group B recorded significantly higher scores (P = 0.002 and 0.0001 respectively). There were no significant differences between the groups as regards sedation score [the median in both groups was 1 (0–1) with P value = o.8]. No one developed facial flush or pruritis. Conclusion: Caudal injection of low dose tramadol 1 mg/kg with bupivacaine 0.1875% is proved to be effective, long standing technique for postoperative analgesia in major paediatric cancer surgery and almost devoid of side effect.

  20. Cardiocirculatory intraoperative assessment during single-shot caudal anaesthesia in children: comparison between levobupivacaine and ropivacaine

    Directory of Open Access Journals (Sweden)

    A. Gentili


    Full Text Available Background: Caudal block with levobupivacaine or ropivacaine is the most commonly used regional anaesthesia in children. Methods: The aim of study was to compare the cardiocirculatory profile induced in two matched groups of young patients, submitted to caudal anaesthesia with levobupivacaine or ropivacaine for an elective subumbilical surgery. Sixty children were enrolled: thirty received levopubivacaine 0.25% and thirty ropivacaine 0.2%. Intraoperative heart rate (HR, systolic blood pressure (SBP, diastolic blood pressure (DBP were monitored at following times: Ta0 (after anaesthesia induction, Ta1 (after caudal anaesthesia, Ta2 (five minutes later, Ta3 (ten minutes later, Ts1 (at surgical incision, Ts2, Ts3, Ts4, Ts5 (every 10 minutes during surgery, Taw (at the awakening. Results: In both groups the cardiocirculatory trend remained within normal ranges at all times considered, demonstrating the safety of the method with both drugs. Both groups showed a similar trend at the different monitoring times: low decrease in HR, SBP and DBP after caudal block, slight increase in parameters after skin incision, slight decrease during surgery, increase at awakening. Regarding SBP and DBP, the levobupivacaine group children generally showed higher levels compared to the ropivacaine group, especially for DBP. Conclusions: Paediatric caudal anaesthesia is an effective method with an very infrequent complication rate. Possible hypotheses for differing haemodynamic behaviour could include a stronger vasoconstriction reflex of innervated areas during caudal anaesthesia with levobupivacaine and a lower levobupivacaine induced block of the sympathetic fibers, related to different pharmacokinetic profile of low concentrations of the local anaesthetics used in paediatric epidural space.

  1. Adenocarcinoma arising from vaginal stump: unusual vaginal carcinogenesis 7 years after hysterectomy due to cervical intraepithelial neoplasia. (United States)

    Shibata, Takashi; Ikura, Yoshihiro; Iwai, Yasuhiro; Tokuda, Hisato; Cho, Yuka; Morimoto, Noriyuki; Nakago, Satoshi; Oishi, Tetsuya


    Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation.

  2. Neurovascular calcaneo-cutaneus pedicle graft for stump capping in congenital pseudarthrosis of the tibia: preliminary report of a new technique. (United States)

    Weber, Michael


    The operative treatment of congenital pseudarthrosis of the tibia, especially when associated with neurofibromatosis type I (Recklinghausen's disease), often leads to failure. Frequently, regardless of the type of deformity, multiple operative procedures end in the amputation of the affected limb. Soft tissue coverage of the amputation stump may confront the surgeon with new problems. Secondary perforation of the soft tissue envelope of the stump owing to terminal overgrowth is not a rare complication. A new technique of stump capping is demonstrated in a 10-year-old boy and a 14-year old girl, both with congenital pseudarthrosis of the tibia of the right leg and neurofibromatosis. During this procedure, a radical resection of the pseudarthrotic tissue is performed although all neurovascular structures supplying the calcaneus are carefully maintained (Arteria, vena et nervus tibialis posterior et peronealis). Subsequently, the tibia and fibula are inserted into the calcaneus. This construct is stabilized with two crossed Kirschner wires. Afterwards, the skin of the lower limb and the hindfoot are sutured together covering the neurovascular bundles, which are arranged in a loop-like fashion. The documented active range of motion was similar to that of the unaffected knee joint. Twelve weeks after operation in both patients, full weight bearing was achieved with a lower-leg prosthesis. This new procedure leads to a durable, full weight-bearing stump with complete sensitive innervation without the risk of future soft tissue perforation caused by the growing bone. The stump fits with an end-bearing lower-leg prosthesis.

  3. Global gene expression analysis of rodent motor neurons following spinal cord injury associates molecular mechanisms with development of post-injury spasticity

    DEFF Research Database (Denmark)

    Wienecke, Jacob; Westerdahl, Ann-Charlotte; Hultborn, Hans;


    of endogenous plateau potentials in motor neurons and the development of spasticity after spinalization. To unravel the molecular mechanisms underlying the increased excitability of motor neurons and the return of plateau potentials below a spinal cord injury we investigated changes in gene expression......Spinal cord injury leads to severe problems involving impaired motor, sensory and autonomic functions. After spinal injury there is an initial phase of hypo-reflexia followed by hyper-reflexia, often referred to as spasticity. Previous studies have suggested a relationship between the reappearance...... in this cell population. We adopted a rat tail-spasticity model with a caudal spinal transection that causes a progressive development of spasticity from its onset after two to three weeks until two months post injury. Gene expression changes of fluorescently identified tail motor neurons were studied 21...

  4. Glioblastoma with spinal seeding

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrai, N.; Fazeny-Doerner, B.; Marosi, C. [Clinical Div. of Oncology, Dept. of Medicine I, Univ. of Vienna (Austria); Czech, T. [Dept. of Neurosurgery, Univ. of Vienna (Austria); Diekmann, K. [Dept. of Radiooncology, Univ. of Vienna (Austria); Birner, P.; Hainfellner, J.A. [Clinical Inst. for Neurology, Univ. of Vienna (Austria); Prayer, D. [Dept. of Neuroradiology, Univ. of Vienna (Austria)


    Background: extracranial seeding of glioblastoma multiforme (GBM) is very rare and its development depends on several factors. This case report describes two patients suffering from GBM with spinal seeding. In both cases, the anatomic localization of the primary tumor close to the cerebrospinal fluid (CSF) was the main factor for spinal seeding. Case reports: two patients with GBM and spinal seeding are presented. After diagnosis of spinal seeding, both patients were highly symptomatic from their spinal lesions. Case 1 experienced severe pain requiring opiates, and case 2 had paresis of lower limbs as well as urinary retention/incontinence. Both patients were treated with spinal radiation therapy. Nevertheless, they died 3 months after diagnosis of spinal seeding. Results: in both patients the diagnosis of spinal seeding was made at the time of cranial recurrence. Both tumors showed close contact to the CSF initially. Even though the patients underwent intensive treatment, it was not possible to keep them in a symptom-free state. Conclusion: because of short survival periods, patients deserve optimal pain management and dedicated palliative care. (orig.)

  5. Spinal arteriography: a primer

    Institute of Scientific and Technical Information of China (English)

    David A KUMPE


    Spinal arteriography is an esoteric procedure that is seldom performed by peripheral interventionalists. This presentation is intended to outline some of the essential points that the interventionalist performing the procedure should be aware of, especially about spinal dural arteriovenous fistulae (SDAVF).

  6. Spinal pain in adolescents

    DEFF Research Database (Denmark)

    Aartun, Ellen; Hartvigsen, Jan; Wedderkopp, Niels


    BACKGROUND: The severity and course of spinal pain is poorly understood in adolescents. The study aimed to determine the prevalence and two-year incidence, as well as the course, frequency, and intensity of pain in the neck, mid back, and low back (spinal pain). METHODS: This study was a school...

  7. Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy

    Directory of Open Access Journals (Sweden)

    Konstantinos Blouhos


    Full Text Available When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula.

  8. Stump-harvest in Sweden : from an environmental impact assessment study to recommendations and an adaptive forest management approach from the Swedish Forest Agency

    Energy Technology Data Exchange (ETDEWEB)

    Egnell, G. [Swedish Univ. of Agricultural Sciences, Umea (Sweden). Faculty of Forestry, Dept. of Forest Ecology and Management


    Sweden is increasingly relying on the production of energy from its forest stocks, and its domestic annual bioenergy market is expanding rapidly. An environmental impact assessment study was conducted to determine the loss of biodiversity through the loss of coarse woody debris; soil damage; methyl mercury releases in surface waters; fine material and organic matter on surface waters; the greenhouse gas (GHG) balance; aesthetics; and side and stand productivity. The aim of the study was to determine the potential impact of tree stump harvesting in Swedish forests. The study showed that moderate stump-harvesting of between 5 and 10 per cent of the annual final cut areas will not have a significant impact on suitable stands. Results of the study will be used to provide recommendations for stand level restrictions where stump-harvesting is practiced.

  9. Human spinal motor control

    DEFF Research Database (Denmark)

    Nielsen, Jens Bo


    interneurons and exert a direct (willful) muscle control with the aid of a context-dependent integration of somatosensory and visual information at cortical level. However, spinal networks also play an important role. Sensory feedback through spinal circuitries is integrated with central motor commands...... and contributes importantly to the muscle activity underlying voluntary movements. Regulation of spinal interneurons is used to switch between motor states such as locomotion (reciprocal innervation) and stance (coactivation pattern). Cortical regulation of presynaptic inhibition of sensory afferents may focus...... the central motor command by opening or closing sensory feedback pathways. In the future, human studies of spinal motor control, in close collaboration with animal studies on the molecular biology of the spinal cord, will continue to document the neural basis for human behavior. Expected final online...

  10. Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

    Institute of Scientific and Technical Information of China (English)


    AIM: To identify risk factors related to pancreatic fistula in patients undergoing distal pancreatectomy (DP) and to determine the effectiveness of using a stapled and a sutured closed of pancreatic stump.METHODS: Sixty-four patients underwent DP during a 10-year period. Information regarding diagnosis,operative details, and perioperative morbidity or mortality was collected. Eight risk factors were examined.RESULTS: Indications for DP included primary pancreatic disease (n = 38, 59%) and non-pancreatic malignancy (n = 26, 41%). Postoperative mortality and morbidity rates were 1.5% and 37% respectively; one patient died due to sepsis and two patients required a reoperation due to postoperative bleeding. Pancreatic fistula was developed in 14 patients (22%); 4 of fistulas were classified as Grade A, 9 as Grade B and only 1 as Grade C. Incidence of pancreatic fistula rate was significantly associated with four risk factors: pathology,use of prophylactic octreotide therapy, concomitant splenectomy, and texture of pancreatic parenchyma.The role that technique (either stapler or suture) of pancreatic stump closure plays in the development of pancreatic leak remains unclear.CONCLUSION: The pancreatic fistula rate after DP is 22%. This is reduced for patients with non-pancreatic malignancy, fibrotic pancreatic tissue, postoperative prophylactic octreotide therapy and concomitant splenectomy.

  11. Fungal Transformation of Tree Stumps into a Suitable Resource for Xylophagous Beetles via Changes in Elemental Ratios

    Directory of Open Access Journals (Sweden)

    Michał Filipiak


    Full Text Available The elements present in dead pine stumps inhabited by larvae of wood-boring beetles (Stictoleptura rubra, Arhopalus rusticus and Chalcophora mariana were analyzed over the initial (first 5 years; a chronosequence stages of wood decay. The quantities of N, P, K, Ca, Mg, Fe, Zn, Mn, Cu and Na (but not S increased with increases in the content of ergosterol (used as a proxy for the amount of fungal tissue. In fact, the amounts of P, N, K, Fe and Cu presented marked increases. These findings show that fungi stoichiometrically rearrange dead wood by importing externally occurring nutrients to decaying stumps. During the first years of wood decay, the ratios of C to other elements decrease substantially, but differently, for various elements, whereas the N:Fe, N:Cu, N:P and N:K ratios remain relatively stable. Therefore, the stoichiometric mismatch between xylophages and their food is greatly reduced. By changing the nutritional stoichiometry of dead wood, fungi create a nutritional niche for wood-eaters, and these changes enable the development of xylophages.

  12. Agency over a phantom limb and electromyographic activity on the stump depend on visuomotor synchrony: a case study

    Directory of Open Access Journals (Sweden)

    Shu eImaizumi


    Full Text Available Most patients, post-amputation, report the experience of a phantom limb. Some even sense voluntary movements when viewing a mirror image of the intact limb superimposed onto the phantom limb. While delayed visual feedback of an action is known to reduce a sense of agency, the effect of delayed visual feedback on phantom motor sensation (i.e., sense of controlling a phantom limb has not been examined. Using a video-projection system, we examined the effect of delayed visual feedback on phantom motor sensation in an upper-limb amputee (male; left upper-limb amputation. He was instructed to view mirrored video images of his intact hand clasping and unclasping during a phantom limb movement. He then rated the intensity of the phantom motor sensation. Three types of hand movement images were presented as follows: synchronous, asynchronous with a 250-ms delay, and asynchronous with a 500-ms delay. Results showed that phantom motor sensation decreased when the image was delayed by 250 and 500 ms. However, when we instructed the patient to adjust the phase of phantom limb movement to that of the image with a 500-ms delay, phantom motor sensation increased. There was also a positive correlation between intensity of phantom motor sensation and electromyographic activity on deltoids at the patient’s stump. These results suggest that phantom motor sensation and electromyographic activity on the stump depend on visuomotor synchrony and top-down effects.

  13. The Lateglacial and Postglacial vegetation history of the northwestern limits of Beringia, based on pollen, stomate and tree stump evidence (United States)

    Pisaric, M. F. J.; MacDonald, G. M.; Velichko, A. A.; Cwynar, L. C.


    In order to reconstruct the Late- and Postglacial vegetation history of the northwestern edge of Beringia, a sediment core was collected from a lake north of the present treeline along the lower Lena River of northeastern Siberia, and analysed for fossil pollen and stomates. In addition, fossil tree stumps were collected in the vicinity of the lake. Eight radiocarbon dates indicate that the lake sediment record spans at least the past 12,300 yr BP. The early vegetation at this site was dominated by herb and shrub tundra. Possible evidence of Younger Dryas cooling, consisting of a decrease in shrub birch and increases in grass and herbaceous plants, occurs between 11,000 and 10,000 yr BP. Forests, dominated by Larix dahurica and including Picea obovata, extended northward to the site between 8500 and 3500 yr BP. There is an agreement between the pollen, stomate and tree stump evidence for this advance. The modern vegetation of shrub tundra was established after 3500 yr BP.

  14. Exploring the Use of Non-Image-Based Ultrasound to Detect the Position of the Residual Femur within a Stump (United States)

    Chong, Sook-Yee; Röhrle, Oliver


    A satisfactorily fitted socket interacts dynamically with the stump in order to support body weight, transmit load effectively, enhance dynamic stability, and enable the control and stabilization of the residual limb. The internal dynamics occurring within a socket is important in determining optimal fit. Many measurement and imaging techniques, such as X-rays, have been utilized to investigate the movement of the residual femur within the stump during gait. However, due to associated health risks and costs, none of the current techniques have been extended to clinical prosthetics. The use of B-mode ultrasound has been suggested as a safe and cheap alternative, and has been utilized in previous studies to monitor the motion of the femur. However, the need to create a duplicate socket and time-consuming analysis of the images were obstacles to the system being applied clinically. This study aims to gauge the effectiveness of a non-image based ultrasound system. Here, we determined errors expected from the measurements. Accuracy errors of 2.9 mm to 8.4 mm and reproducibility measurements within a standard deviation of 3.9 mm are reported. We also estimated errors up to 14.4 mm in in-vivo measurements. We think there is potential in developing this technique, and we hope to reduce some technical difficulties such that it can, one day, be easily incorporated into prosthetic fitting. PMID:27764120

  15. Agency over a phantom limb and electromyographic activity on the stump depend on visuomotor synchrony: a case study. (United States)

    Imaizumi, Shu; Asai, Tomohisa; Kanayama, Noriaki; Kawamura, Mitsuru; Koyama, Shinichi


    Most patients, post-amputation, report the experience of a phantom limb. Some even sense voluntary movements when viewing a mirror image of the intact limb superimposed onto the phantom limb. While delayed visual feedback of an action is known to reduce a sense of agency, the effect of delayed visual feedback on phantom motor sensation (i.e., sense of controlling a phantom limb) has not been examined. Using a video-projection system, we examined the effect of delayed visual feedback on phantom motor sensation in an upper-limb amputee (male; left upper-limb amputation). He was instructed to view mirrored video images of his intact hand clasping and unclasping during a phantom limb movement. He then rated the intensity of the phantom motor sensation. Three types of hand movement images were presented as follows: synchronous, asynchronous with a 250-ms delay, and asynchronous with a 500-ms delay. Results showed that phantom motor sensation decreased when the image was delayed by 250 and 500 ms. However, when we instructed the patient to adjust the phase of phantom limb movement to that of the image with a 500-ms delay, phantom motor sensation increased. There was also a positive correlation between intensity of phantom motor sensation and electromyographic (EMG) activity on deltoids at the patient's stump. These results suggest that phantom motor sensation and EMG activity on the stump depend on visuomotor synchrony and top-down effects.

  16. Dorsal border periaqueductal gray neurons project to the area directly adjacent to the central canal ependyma of the C4-T8 spinal cord in the cat. (United States)

    Mouton, L J; Kerstens, L; Van der Want, J; Holstege, G


    In a previous study horseradish peroxidase (HRP) injections in the upper thoracic and cervical spinal cord revealed some faintly labeled small neurons at the dorsal border of the periaqueductal gray (PAG). The present light microscopic and electronmicroscopic tracing study describes the precise location of these dorsal border PAG-spinal neurons and their terminal organization. Wheat germ agglutinin-conjugated HRP (WGA-HRP) injections into cervical and upper thoracic spinal segments resulted in several hundreds of small retrogradely labeled neurons at the dorsal border of the ipsilateral caudal PAG. These neurons were not found after injections in more caudal segments. WGA-HRP injections in the dorsal border PAG region surprisingly resulted in anterogradely labeled fibers terminating in the area dorsally and laterally adjoining the central canal ependyma of the C4-T8 spinal cord. No anterogradely labeled fibers were found more caudal in the spinal cord. The labeled fibers found in the upper cervical cord were not located in the area immediately adjoining the ependymal layer of the central canal, but in the lateral part of laminae VI, VII and VIII and in area X bilaterally. Electronmicroscopic results of one case show that the dorsal border PAG-spinal neurons terminate in the neuropil of the subependymal area and in the vicinity of the basal membranes of capillaries located laterally to the central canal. The terminal profiles contain electron-lucent and densecored vesicles, suggesting a heterogeneity of possible transmitters. A striking observation was the lack of synaptic contacts, suggesting nonsynaptic release from the profiles. The function of the dorsal border PAG-spinal projection is unknown, but considering the termination pattern of the dorsal border PAG neurons on the capillaries the intriguing similarity between this projection system and the hypothalamohypophysial system is discussed.

  17. Edaravone combined with Schwann cell transplantation may repair spinal cord injury in rats

    Directory of Open Access Journals (Sweden)

    Shu-quan Zhang


    Full Text Available Edaravone has been shown to delay neuronal apoptosis, thereby improving nerve function and the microenvironment after spinal cord injury. Edaravone can provide a favorable environment for the treatment of spinal cord injury using Schwann cell transplantation. This study used rat models of complete spinal cord transection at T 9. Six hours later, Schwann cells were transplanted in the head and tail ends of the injury site. Simultaneously, edaravone was injected through the caudal vein. Eight weeks later, the PKH-26-labeled Schwann cells had survived and migrated to the center of the spinal cord injury region in rats after combined treatment with edaravone and Schwann cells. Moreover, the number of PKH-26-labeled Schwann cells in the rat spinal cord was more than that in rats undergoing Schwann cell transplantation alone or rats without any treatment. Horseradish peroxidase retrograde tracing revealed that the number of horseradish peroxidase-positive nerve fibers was greater in rats treated with edaravone combined withSchwann cells than in rats with Schwann cell transplantation alone. The results demonstrated that lower extremity motor function and neurophysiological function were better in rats treated with edaravone and Schwann cells than in rats with Schwann cell transplantation only. These data confirmed that Schwann cell transplantation combined with edaravone injection promoted the regeneration of nerve fibers of rats with spinal cord injury and improved neurological function.

  18. Effect of caudal epidural steroid or saline injection in chronic lumbar radiculopathy: multicentre, blinded, randomised controlled trial

    DEFF Research Database (Denmark)

    Iversen, Trond; Solberg, Tore K; Romner, Bertil;


    To assess the efficacy of caudal epidural steroid or saline injection in chronic lumbar radiculopathy in the short (6 weeks), intermediate (12 weeks), and long term (52 weeks).......To assess the efficacy of caudal epidural steroid or saline injection in chronic lumbar radiculopathy in the short (6 weeks), intermediate (12 weeks), and long term (52 weeks)....

  19. Rostral and caudal prefrontal contribution to creativity: A meta-analysis of functional imaging data

    Directory of Open Access Journals (Sweden)

    Gil eGonen-Yaacovi


    Full Text Available Creativity is of central importance for human civilization, yet its neurocognitive bases are poorly understood. The aim of the present study was to integrate existing functional imaging data by using the meta-analysis approach. We reviewed 34 functional imaging studies that reported activation foci during tasks assumed to engage creative thinking in healthy adults. A coordinate-based meta-analysis using Activation Likelihood Estimation (ALE first showed a set of predominantly left-hemispheric regions shared by the various creativity tasks examined. These regions included the caudal lateral prefrontal cortex (PFC, the medial and lateral rostral PFC, and the inferior parietal and posterior temporal cortices. Further analyses showed that tasks involving the combination of remote information (combination tasks activated more anterior areas of the lateral PFC than tasks involving the free generation of unusual responses (unusual generation tasks, although both types of tasks shared caudal prefrontal areas. In addition, verbal and non-verbal tasks involved the same regions in the left caudal prefrontal, temporal, and parietal areas, but also distinct domain-oriented areas. Taken together, these findings suggest that several frontal and parieto-temporal regions may support cognitive processes shared by diverse creativity tasks, and that some regions may be specialized for distinct types of processes. In particular, the lateral PFC appeared to be organized along a rostro-caudal axis, with rostral regions involved in combining ideas creatively and more posterior regions involved in freely generating novel ideas.

  20. Two cases of the caudal duplication anomaly including a discordant monozygotic twin

    NARCIS (Netherlands)

    Kroes, HY; Takahashi, M; Zijlstra, RJ; Baert, JALL; Kooi, KA; Hofstra, RMW; van Essen, AJ


    We present two unrelated patients with various duplications in the caudal region. One patient presented with a duplication of the distal spine from L4, left double ureter, duplication of the vagina and cervix, and duplication of the distal colon. The second patient was diagnosed with a duplication o

  1. GATA-3 is involved in the development of serotonergic neurons in the caudal raphe nuclei

    NARCIS (Netherlands)

    J. van der Wees (Jacqueline); A. Karis (Alar); E. Goedknegt; M. Rutteman; F.G. Grosveld (Frank); J.H. van Doorninck (Hikke); C.I. de Zeeuw (Chris)


    textabstractAbstract The GATA-3 transcription factor shows a specific and restricted expression pattern in the developing and adult mouse brain. In the present study we investigated the role of GATA-3 in the caudal raphe system, which is known to operate as a modulator of motor activity. We demonst

  2. Caudal regulates the spatiotemporal dynamics of pair-rule waves in Tribolium.

    Directory of Open Access Journals (Sweden)

    Ezzat El-Sherif


    Full Text Available In the short-germ beetle Tribolium castaneum, waves of pair-rule gene expression propagate from the posterior end of the embryo towards the anterior and eventually freeze into stable stripes, partitioning the anterior-posterior axis into segments. Similar waves in vertebrates are assumed to arise due to the modulation of a molecular clock by a posterior-to-anterior frequency gradient. However, neither a molecular candidate nor a functional role has been identified to date for such a frequency gradient, either in vertebrates or elsewhere. Here we provide evidence that the posterior gradient of Tc-caudal expression regulates the oscillation frequency of pair-rule gene expression in Tribolium. We show this by analyzing the spatiotemporal dynamics of Tc-even-skipped expression in strong and mild knockdown of Tc-caudal, and by correlating the extension, level and slope of the Tc-caudal expression gradient to the spatiotemporal dynamics of Tc-even-skipped expression in wild type as well as in different RNAi knockdowns of Tc-caudal regulators. Further, we show that besides its absolute importance for stripe generation in the static phase of the Tribolium blastoderm, a frequency gradient might serve as a buffer against noise during axis elongation phase in Tribolium as well as vertebrates. Our results highlight the role of frequency gradients in pattern formation.

  3. Allometric growth rate of the spinal cord in relation to the vertebral column during prenatal life in male and female goats (Capra hircus). (United States)

    Ghazi, S M; Ranjbar, R; Khaksary Mahabady, M


    Total and regional allometric growth rates and termination sites of the spinal cord related to the respective vertebra were studied in 36 goat fetuses, from the Ahvaz slaughterhouse. These specimens were assigned to 3 groups, group 1 (CRL 10-20 cm), group 2 (CRL 21-30 cm), and group 3 (CRL 31-40 cm), each consisting of 6 male and 6 female fetuses. Observations in all 3 groups revealed that although the growth of the vertebral column was greater than that of the spinal cord, the difference in growth was not constant throughout the spine. While in cervical and thoracic regions the growth rate of the spinal cord in relation to the vertebral column was almost isometric, in the caudal part of the spine there was marked decline in growth of the spinal cord compared to the respective regions of the vertebral column. Craniocaudally, the allometric growth rate became drastically negative. There was no significant difference (P>0.05) between males and females. Except in thoracic region, all other regions showed significant differences (P0.05). As a consequence of the negative allometric growth of the spinal cord in relation to the vertebral column in the caudal part of the spine, the conus medullaris was displaced from S4-S5 in group 1 to S2 in group 3. No significant difference (P>0.05) between male and female fetuses concerning the termination of the spinal cord was found.

  4. Stabilization of the Proximal Ulnar Stump after the Darrach or Sauvé-Kapandji Procedure by Using the Extensor Carpi Ulnaris Tendon


    Chu, Po-Jung; Lee, Hung-Maan; Hung, Sheng-Tsai; Shih, Jui-Tien


    The Darrach and Sauvé-Kapandji procedures are considered to be useful treatment options for distal radioulnar joint disorders. Postoperative instability of the proximal ulnar stump and radioulnar convergence, however, may cause further symptoms. From October 1999 to May 2002, a total of 19 wrists in 15 men and four women, with an average age of 48.3 years, were treated by stabilizing the proximal ulnar stump with a half-slip of the extensor carpi ulnaris tendon using modified Darrach and Sauv...

  5. A comparative study of the modified Sauvé-Kapandji procedure for rheumatoid wrist with and without stabilization of the proximal ulnar stump. (United States)

    Kawabata, A; Egi, T; Hashimoto, H; Masada, K; Saito, S


    We compared the clinical and radiological results of the modified Sauvé-Kapandji procedure for 41 of 86 operated rheumatoid wrists with (n=22) and without (n=19) stabilization of the proximal ulnar stump with a slip of half the extensor carpi ulnaris tendon. Gender, age, and follow-up period were similar in the two groups. We found no difference clinically or on radiographs between the two groups other than better early postoperative pain relief in those stabilized. Stabilization of the proximal ulnar stump may not be necessary in the modified Sauvé-Kapandji procedure for rheumatoid wrists.

  6. Effect of an Artificial Caudal Fin on the Performance of a Biomimetic Fish Robot Propelled by Piezoelectric Actuators

    Institute of Scientific and Technical Information of China (English)


    This paper addresses the design of a biomimetic fish robot actuated by piezoceramic actuators and the effect of artificial caudal fins on the fish robot's performance. The limited bending displacement produced by a lightweight piezocomposite actuator was amplified and transformed into a large tail beat motion by means of a linkage system. Caudal fins that mimic the shape of a mackerel fin were fabricated for the purpose of examining the effect of caudal fin characteristics on thrust production at an operating frequency range. The thickness distribution of a real mackerel's fin was measured and used to design artificial caudal fins. The thrust performance of the biomimetic fish robot propelled by fins of various thicknesses was examined in terms of the Strouhal number, the Froude number, the Reynolds number, and the power consumption. For the same fin area and aspect ratio, an artificial caudal fin with a distributed thickness shows the best forward speed and the least power consumption.

  7. Double insurance transfacetal screws for lumbar spinal stabilization

    Directory of Open Access Journals (Sweden)

    Atul Goel


    Full Text Available Aim: The authors report experience with 14 cases where two screws or ′′double insurance′′ screws were used for transfacetal fixation of each joint for stabilization of the lumbar spinal segment. The anatomical subtleties of the technique of insertion of screws are elaborated. Materials and Methods: During the period March 2011 to June 2014, 14 patients having lumbar spinal segmental instability related to lumbar canal stenosis were treated by insertion of two screws into each articular assembly by transfacetal technique. After a wide surgical exposure, the articular cartilage was denuded and bone chips were impacted into the joint cavity. For screw insertion in an appropriate angulation, the spinous process was sectioned at its base. The screws (2.8 mm in diameter and 18 mm in length were inserted into the substance of the medial or inferior articular facet of the rostral vertebra via the lateral limit of the lamina approximately 6-8 mm away from the edge of the articular cavity. The screws were inserted 3 mm below the superior edge and 5 mm above the inferior edge of the medial (inferior facets and directed laterally and traversed through the articular cavity into the lateral (superior articular facet of the caudal vertebra toward and into the region of junction of base of transverse process and of the pedicle. During the period of follow-up all treated spinal levels showed firm bone fusion. There was no complication related to insertion of the screws. There was no incidence of screw misplacement, displacementor implant rejection. Conclusions: Screw insertion into the firm and largely cortical bones of facets of lumbar spine can provide robust fixation and firm stabilization of the spinal segment. The large size of the facets provides an opportunity to insert two screws at each spinal segment. The firm and cortical bone material and absence on any neural or vascular structure in the course of the screw traverse provides strength and

  8. Neostigmine does not prolong the duration of analgesia produced by caudal bupivacaine in children undergoing urethroplasty

    Directory of Open Access Journals (Sweden)

    Bhardwaj N


    Full Text Available Context : Neostigmine extends the duration of analgesia produced by caudal bupivacaine in children. Aims : To study the effect of different doses of caudal neostigmine on the duration of postoperative analgesia. Settings and Design : A randomized, double-blind study was conducted in 120 boys aged 1-12 years undergoing urethroplasty under combined general and caudal anesthesia. Materials and Methods : Children were administered 1.875 mg/kg bupivacaine alone (Group B, or with 2, 3 or 4 µg/kg of neostigmine (groups BN 2 , BN 3 or BN 4 respectively as caudal drug (0.75 ml/kg. Children with a pain score of 4 or more (OPS and NRS postoperatively were administered rescue analgesic. Time to first analgesic and the number of analgesic doses administered in the 24h were recorded. Statistical Analysis : Parametric data were analyzed using ANOVA. Kaplan-Meier survival curves for the time to first analgesic administration were plotted and compared using log rank analysis. Chi-square test was used to analyze the incidence data. Results : The median [IQR] time to first analgesic in Group B (540 [240-1441] min was similar to that in Groups BN 2 (450 [240-720], BN 3 (600 [360-1020] and BN 4 (990 [420-1441]. Significantly more patients in Groups B (9 [34.6%] and BN 4 (13 [44.8%] required no supplemental analgesic for 24h than those in Groups BN 2 and BN 3 (4 [13.8%] and 4 [13.3%]. The number of analgesic doses required in 24h in the four groups was similar. Conclusion : Addition of neostigmine to 1.875 mg/kg of caudal bupivacaine did not prolong the analgesia following urethroplasty in children.

  9. Clinical evaluation and treatment of stumps in amputees injured in Wenchuan earthquake%地震后截肢患者残肢的临床评定和康复治疗

    Institute of Scientific and Technical Information of China (English)

    武继祥; 刘宏亮; 周贤丽; 刘青山; 汪琴; 尹清; 余洪俊; 吴宗耀


    Objective To analyze the feature and cause of stumps of amputees after Wenchuan earthquake,and study the effects of rehabilitation treatment for stumps.Methods Fifty-two cases with stump limbs post-amputation were evaluated,including stump skin status,stump shape,stump length,stump swelling,range of motion (ROM)of joint and strength of stump,and were treated with physical therapy,stump moulding and kinesiotherapy.Results The incidences of stump ulcer,stump swelling,conical stump,short stump and limitation of ROM of joint in all 52 cases were 76%,73%,34%,40%and 42%respectively.After rehabilitation treatment stump ulcers healed,stump swelling eliminated;stump shape,ROM of joint and muscle strength improved obviously.All poor stumps could be fit with the prosthetic limb and get good function.Conclusion The incidences of poor stump limb post·amputation after earthquake were high.Rehabilitation treatment can improve the stump condition.Early comprehensive rehabilitative intervention after amputation is important for fitting the prosthetic limb tO the stump.%目的 分析地震致截肢患者残肢的特点和原因、观察康复治疗的效果.方法 从残端皮肤情况、残肢形态、残肢长度、残肢肿胀、残肢关节活动度和残肢肌力等方面对52条残肢进行评定,并进行物理治疗、残肢塑形和运动治疗.结果 52条残肢中,残端有溃疡或窦道、残肢肿胀、圆锥形残肢和短残肢分别占76%、73%、34%和40%,残肢关节活动受限者占42%,所有患者残肢肌力明显减退.经康复治疗后,残肢无肿胀、溃疡或窦道完全愈合,残肢形状、关节活动度和肌力明显改善,已达到假肢装配条件,均装配假肢,并获得良好的功能.结论 地震后截肢不良残肢发生率高,综合康复治疗能明显改善残肢条件,早期康复治疗对促进患者康复,安装假肢具有重要意义.

  10. Glycine uptake by lamprey spinal neurons demonstrated by light microscopic autoradiography

    Energy Technology Data Exchange (ETDEWEB)

    Sheridan, P.H.; Youngs, L.J.; Krieger, N.R.; Selzer, M.E.


    We have mapped the neuronal uptake of 3H-glycine in the spinal cords of large larval sea lampreys: Petromyzon marinus. Spinal cords were incubated in 10(-6) M 3H-glycine for 15 minutes. They were rinsed in lamprey solution, fixed in phosphate-buffered 2% glutaraldehyde, and washed in phosphate buffer. They were then sectioned with a cryostat at 16-m thickness or dehydrated, embedded in Epon, and sectioned at 1-4 micron. Sections were coated with a photographic emulsion and maintained at 4 degrees C for 1-7 days. By sectioning horizontally, it was possible to obtain complete serial reconstructions of up to 1.5-mm lengths of cord in 100-150 sections. The outlines of labelled cells were traced with a Nikon drawing attachment. For one Epon-embedded spinal cord sectioned at 4 micron, tracings were superimposed to form complete maps for 0.6-1.5-mm lengths in three representative regions of cord: rostral (gill region), caudal (dorsal fin region), and midsection. The labelled neurons were small (5-10-micron diameter) cells distributed throughout the central gray columns. They numbered 22 cells per hemisegment in the rostral region, 33 in the midsection, and 43 in the caudal region. None of the previously identified cell types were labelled, including lateral interneurons, edge cells, giant interneurons, dorsal cells, and Mueller and Mauthner axons.

  11. Spinal Cord Injury Map (United States)

    ... Videos by Topic and Question Videos by Family Relationship Videos by Experts Resources The Short List Government Programs Family and Caregiver Support Financial Help Active Lifestyle Advocacy Employment and Education Adaptive Technology Recent Medical Research Good Things to Read Spinal ...

  12. Spinal Cord Injury 101 (United States)

    ... Videos by Topic and Question Videos by Family Relationship Videos by Experts Resources The Short List Government Programs Family and Caregiver Support Financial Help Active Lifestyle Advocacy Employment and Education Adaptive Technology Recent Medical Research Good Things to Read Spinal ...

  13. Spinal Cord Injury (United States)

    ... indicated by a total lack of sensory and motor function below the level of injury. People who survive a spinal cord injury will most likely have medical complications such as chronic pain and bladder and bowel ...

  14. Extradural Spinal Arachnoid Cysts

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available A 14-year-old boy with multiple spinal arachnoid cysts and paraplegia, and 37 similar cases in the literature are reviewed by neurosurgeons and radiologist at Univ of Sao Paulo, Brazil.

  15. Spinal curves (image) (United States)

    There are four natural curves in the spinal column. The cervical, thoracic, lumbar, and sacral curvature. The curves, along with the intervertebral disks, help to absorb and distribute stresses that occur from everyday activities such as walking or from ...

  16. Undirected compensatory plasticity contributes to neuronal dysfunction after severe spinal cord injury. (United States)

    Beauparlant, Janine; van den Brand, Rubia; Barraud, Quentin; Friedli, Lucia; Musienko, Pavel; Dietz, Volker; Courtine, Grégoire


    Severe spinal cord injury in humans leads to a progressive neuronal dysfunction in the chronic stage of the injury. This dysfunction is characterized by premature exhaustion of muscle activity during assisted locomotion, which is associated with the emergence of abnormal reflex responses. Here, we hypothesize that undirected compensatory plasticity within neural systems caudal to a severe spinal cord injury contributes to the development of neuronal dysfunction in the chronic stage of the injury. We evaluated alterations in functional, electrophysiological and neuromorphological properties of lumbosacral circuitries in adult rats with a staggered thoracic hemisection injury. In the chronic stage of the injury, rats exhibited significant neuronal dysfunction, which was characterized by co-activation of antagonistic muscles, exhaustion of locomotor muscle activity, and deterioration of electrochemically-enabled gait patterns. As observed in humans, neuronal dysfunction was associated with the emergence of abnormal, long-latency reflex responses in leg muscles. Analyses of circuit, fibre and synapse density in segments caudal to the spinal cord injury revealed an extensive, lamina-specific remodelling of neuronal networks in response to the interruption of supraspinal input. These plastic changes restored a near-normal level of synaptic input within denervated spinal segments in the chronic stage of injury. Syndromic analysis uncovered significant correlations between the development of neuronal dysfunction, emergence of abnormal reflexes, and anatomical remodelling of lumbosacral circuitries. Together, these results suggest that spinal neurons deprived of supraspinal input strive to re-establish their synaptic environment. However, this undirected compensatory plasticity forms aberrant neuronal circuits, which may engage inappropriate combinations of sensorimotor networks during gait execution.

  17. Characterization of sulfur deposition over the period of industrialization in Japan using sulfur isotope ratio in Japanese cedar tree rings taken from stumps. (United States)

    Ishida, Takuya; Tayasu, Ichiro; Takenaka, Chisato


    We characterized the sulfur deposition history over the period of industrialization in Japan based on the sulfur isotope ratio (δ(34)S) in tree rings of Japanese cedar (Cryptomeria japonica D. Don) stumps. We analyzed and compared δ(34)S values in the rings from two types of disk samples from 170-year-old stumps that had been cut 5 years earlier (older forest stand) and from 40-year-old living trees (younger forest stand) in order to confirm the validity of using stump disks for δ(34)S analysis. No differences in δ(34)S values by age were found between the sample types, indicating that stump disks can be used for δ(34)S analysis. The δ(34)S profile in tree rings was significantly correlated with anthropogenic SO2 emissions in Japan (r = -0.76, p tree rings serve as a record of anthropogenic sulfur emissions. In addition, the values did not change largely from pre-industrialization to the 1940s (+4.2 to +6.1‰). The values before the 1940s are expected to reflect the background sulfur conditions in Japan and, thus, disks containing rings formed before the 1940s contain information about the natural environmental sulfur, which is useful for biogeochemical studies.

  18. Pregnancy and birth after intracytoplasmic sperm injection with normal testicular spermatozoa in a patient with azoospermia and tail stump epididymal sperm

    Directory of Open Access Journals (Sweden)

    Betina B. Povlsen


    Full Text Available Main findings: An intriguing yet perplexing case report of a successful pregnancy and live birth with intracytoplasmic sperm injection using normal testicular sperm, after the finding of azoospermia in the semen analysis and discovering only tail stump abnormal sperm in the epididymis. Case hypothesis: A tail stump sperm defect of genetic origin was suspected. However, after obtaining normal testicular sperm we concluded that obstructive azoospermia, either idiopathic or secondary to multiple minor genital trauma was the plausible scenario. This has rendered the search of previous reports on a similar condition, but none was found. However, it has raised scientific thoughts for future research. Promising future implications: The importance of reporting this case is to alert urologists performing sperm retrieval that healthy and morphologically normal sperm may be found in the testis of azoospermic men with 100% tail stump epididymal sperm. Retrieval of normal testicular sperm obviates the need of a more complex investigation, including sperm electron microscopy. It also offers the possibility of utilizing such gametes for sperm injections rather than abnormal tail stump sperm that may be associated with a poor reproductive outcome.

  19. Stabilization of the proximal ulnar stump after the Darrach or Sauvé-Kapandji procedure by using the extensor carpi ulnaris tendon. (United States)

    Chu, Po-Jung; Lee, Hung-Maan; Hung, Sheng-Tsai; Shih, Jui-Tien


    The Darrach and Sauvé-Kapandji procedures are considered to be useful treatment options for distal radioulnar joint disorders. Postoperative instability of the proximal ulnar stump and radioulnar convergence, however, may cause further symptoms. From October 1999 to May 2002, a total of 19 wrists in 15 men and four women, with an average age of 48.3 years, were treated by stabilizing the proximal ulnar stump with a half-slip of the extensor carpi ulnaris tendon using modified Darrach and Sauvé-Kapandji procedures. The average follow-up period was 77 months (range, 62 to 91 months). No patient complained of symptoms due to instability of the proximal ulnar stump. Grip strength improved in all wrists after surgery. Postoperative X-rays, including loading X-rays, showed improved alignment in both coronal and lateral planes. We concluded that stabilization of the proximal ulnar stump with ECU tenodesis is an effective procedure for treating distal radioulnar joint disorder after the Darrach and Sauvé-Kapandji procedures.

  20. Effect of slash and stump removal on soil preparation and planting; Hakkuutaehteiden ja kantojen korjuun vaikutus maanmuokkaukseen ja metsaenviljelyyn - PUUT32

    Energy Technology Data Exchange (ETDEWEB)

    Saarinen, V.-M.; Harstela, P. [Finnish Forest Research Institute, Suonenjoki (Finland)


    The object of this study was to survey the effects of slash and stump removal on work productivity, work quality and technology of forest regeneration operations. Site preparation and planting were studied in test areas with and without slash or/and stump removal in different conditions. Work studies were done during site preparation and planting. The quality of mounding and planting was analysed by measurements of the seedlings. After slash removal, the increase of work productivity (E0) in mechanized planting was on average 18 per cent with Braecke and on average 0 per cent with Ecoplanter. The quality of mechanized planting was slightly better after slash removal. The productivity (E0) of excavator-mounted mounders was after slash removal on average about 22 per cent higher with mounding blade and 53 per cent higher with ditching bucket. The quality of mounding was at the same level in both slash treatments. The productivity of three forwarder-mounted mounders (E0) was on average 5 per cent lower after slash removal, but the quality of mounding was much better. In combined stump extraction and mounding the time consumption of mounding phase was on average 40 per cent lower than separate mounding after stump removal. (orig.)


    Institute of Scientific and Technical Information of China (English)


    Objective To explore the mechanism of neurotropism in peripheral nerve regeneration by assessing the bioactivity of regeneration microcircumstance on motoneurons. Methods The motor branch of femoral nerve to quadriceps was incised and the distal stump was sutured with one-end silicone chamber. The nerve regeneration chamber fluids from distal motor nerve stumps ( motor branch of femoral nerve ) ( MD-NR- CF) was collected 7d post-operatively, and with the same method, nerve regeneration conditioned fluids from distal stumps nerve stumps ( saphenous nerve) ( SD-NRCF) was collected. The dissociated rat's motoneurons were co-cultured with MD-NRCF, SD-NRCF, basic fibroblast growth factor (b-FGF) and serum-free medium for 72h respectively and then were photographed under phase-contrast microscope. The longest neurites and cell- body areas of motoneurons from each group were measured by cell image processing computer system. MTT col- orimetric assay was also used to measure cell activation. Results The cells of MD-NRCF group had signifi- cantly longer neurites than the other 3 groups, and their activation was also superior to those of the other groups. Conclusion These results indicate that MD-NRCF has more significant neurite-promoting and neu- robiological effects on motoneuron than SD-NRCF and b-FGF.

  2. [Effects of a series of food substances on motor and emptying function of the gastric stump and diverting intestinal loop after stomach resection and truncal vagotomy]. (United States)

    Loranskaia, T I; Khoromskiĭ, L N; Benedikt, V V


    Altogether 253 patients operated on for peptic ulcer were examined for the action of 30 foods on motor and evacuatory function of the gastric stump and efferent intestinal loop. 213 patients were subjected to gastric resection after Hofmeister-Finsterer and 40 patients to antrum resection and truncal vagotomy. Proceeding from the action on motor function of the gastric stump and efferent intestinal loop the foods were distributed into three groups: with a stimulation, inhibitory of weak effects on the function. The first group included beef and fish broths, boiled meat, rye bread, cabbage, tomato, apple, cherry and black currant juices, rhubarb infusion, fresh kefir, carrot and pumpkin purees. The group of foods producing an inhibitory action comprised milk and milk whey, cottage cheese, sugar, butter, sunflower oil, lard, rice and oat decoctions, mashed potatoes and potato juice, buckwheat porridge and semolina, wheat bread, raw eggs, and honey. The action of the same foods was found to be different as regards the effect on the gastric stump and efferent intestinal loop, on tonic and contractile functions of the organs. The dietetic management of patients undergoing gastric operations should be carried out on a strictly individualized basis with allowance made for the functions of the gastric stump and intestinal loop and for the action of foods on the organs.

  3. Comparison and Efficacy of LigaSure and Rubber Band Ligature in Closing the Inflamed Cecal Stump in a Rat Model of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Chun-Chieh Yeh


    Full Text Available Safety of either LigaSure or rubber band in closing inflamed appendiceal stump in acute appendicitis has been less investigated. In this study, cecal ligation followed by resecting inflamed cecum was performed to mimic appendectomy in a rat model of acute appendicitis. Rats were sacrificed immediately (Group A and 7 days (Group B after cecal resection, respectively. The cecal stumps were closed by silk ligature (S, 5 mm LigaSure (L, or rubber band (R. Seven days after cecal resection, the LigaSure (BL and silk subgroups (BS had significantly less intra-abdominal adhesion and better laparotomy wound healing than rubber band subgroup (BR. The initial bursting pressure at cecal stump was comparable among the three methods; along with tissue healing process, both BL and BS provided a higher bursting pressure than BR 7 days after appendectomy. BL subgroup had more abundant hydroxyproline deposition than BS and BR subgroup. Furthermore, serum TNF-α in BR group kept persistently increasing along with time after cecal resection. Thus, the finding that LigaSure but not rubber band is safe in sealing off the inflamed cecal stump in rat model of acute appendicitis suggests the possibility of applying LigaSure for appendectomy via single port procedure or natural orifice transluminal endoscopic surgery (NOTES.

  4. Tegaserod, a small compound mimetic of polysialic acid, promotes functional recovery after spinal cord injury in mice. (United States)

    Pan, H-C; Shen, Y-Q; Loers, G; Jakovcevski, I; Schachner, M


    In a previous study, we have shown that the small organic compound tegaserod, a drug approved for clinical application in an unrelated condition, is a mimic of the regeneration-beneficial glycan polysialic acid (PSA) in a mouse model of femoral nerve injury. Several independent observations have shown positive effects of PSA and its mimetic peptides in different paradigms of injury of the central and peripheral mammalian nervous systems. Since small organic compounds generally have advantages over metabolically rapidly degraded glycans and the proteolytically vulnerable mimetic peptides, a screen for a small PSA mimetic compound was successfully carried out, and the identified molecule proved to be beneficial in neurite outgrowth in vitro, independent of its originally described function as a 5-HT4 receptor agonist. In the present study, a mouse spinal cord compression device was used to elicit severe compression injury. We show that tegaserod promotes hindlimb motor function at 6 weeks after spinal cord injury compared to the control group receiving vehicle only. Immunohistology of the spinal cord rostral and caudal to the lesion site showed increased numbers of neurons, and a reduced area and intensity of glial fibrillary acidic protein immunoreactivity. Quantification of regrowth/sprouting of axons immunoreactive for tyrosine hydroxylase and serotonin showed increased axonal density rostral and caudal to the injury site in the ventral horns of mice treated with tegaserod. The combined observations suggest that tegaserod has the potential for treatment of spinal cord injuries in higher vertebrates.

  5. Spinal dysraphism: MRI evaluation

    Directory of Open Access Journals (Sweden)



    Conclusion: Thus we conclude that Spinal dysraphism were common in young females, with commonest anomaly being vertebral anomaly (Spina bifida, commonest location is lumbar region, Diastematomyelia common in young aged female. Magnetic resonance imaging is an accurate, noninvasive, safe and advanced modality for evaluation of the congenital spinal disorders and help in better management of these patients with prompt and accurate diagnosis. [Int J Res Med Sci 2015; 3(8.000: 1937-1941

  6. CT myelography characteristics of spinal dysraphism in a young mixed breed dog Características de mielografía con TC de una disrafia espinal en un perro mestizo joven

    Directory of Open Access Journals (Sweden)

    M Gómez


    Full Text Available Spinal dysraphism is a congenital defect of the vertebral column and spinal cord secondary to imperfect closure of the caudal neuropore of the developing neural tube. This report describes computed tomographic myelography (Myelo-CT characteristics of spina bifida occulta, spinal cord aplasia/hypoplasia and split cord malformation type II (diplomyelia in the caudal lumbar area of a 2 month old mixed breed dog.La disrafia espinal es un defecto congénito de la columna vertebral y la médula espinal secundaria a un cierre imperfecto del neuroporo caudal del tubo neural en desarrollo. Este reporte describe las características observadas en una mielografía por tomografía computarizada (mielo-TC de una espina bífida oculta, aplasia/hipoplasia segmentaria de médula espinal y duplicación de médula espinal tipo II (diplomielia en el segmento lumbar caudal de un perro mestizo de dos meses de edad.

  7. The distribution of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) in the medulla oblongata, spinal cord, cranial and spinal nerves of frog, Microhyla ornata. (United States)

    Jadhao, Arun G; Biswas, Saikat P; Bhoyar, Rahul C; Pinelli, Claudia


    Nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) enzymatic activity has been reported in few amphibian species. In this study, we report its unusual localization in the medulla oblongata, spinal cord, cranial nerves, spinal nerves, and ganglions of the frog, Microhyla ornata. In the rhombencephalon, at the level of facial and vagus nerves, the NADPH-d labeling was noted in the nucleus of the abducent and facial nerves, dorsal nucleus of the vestibulocochlear nerve, the nucleus of hypoglossus nerve, dorsal and lateral column nucleus, the nucleus of the solitary tract, the dorsal field of spinal grey, the lateral and medial motor fields of spinal grey and radix ventralis and dorsalis (2-10). Many ependymal cells around the lining of the fourth ventricle, both facial and vagus nerves and dorsal root ganglion, were intensely labeled with NADPH-d. Most strikingly the NADPH-d activity was seen in small and large sized motoneurons in both medial and lateral motor neuron columns on the right and left sides of the brain. This is the largest stained group observed from the caudal rhombencephalon up to the level of radix dorsalis 10 in the spinal cord. The neurons were either oval or elongated in shape with long processes and showed significant variation in the nuclear and cellular diameter. A massive NADPH-d activity in the medulla oblongata, spinal cord, and spinal nerves implied an important role of this enzyme in the neuronal signaling as well as in the modulation of motor functions in the peripheral nervous systems of the amphibians.

  8. Caudal shif ting of hepatic vein anastomosis inright liver living donor liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Sheung Tat Fan


    BACKGROUND: In right liver living donor liver trans-plantation, hepatic venous anastomosis is performed using the recipient's right hepatic vein oriifce. There may be situations that the portal vein is short or the right liver graft is small, leading to dififculty in portal vein, hepatic artery or duct-to-duct anastomosis. METHODS: The recipient's right hepatic vein oriifce is closed partially for 2 cm at the cranial end or totally, and a new venotomy is made caudal to the right hepatic vein oriifce. Hepatic vein anastomosis is performed with the new venotomy. RESULTS: The distance between the liver graft hilum and hepatoduodenal ligament is reduced. Portal vein, hepatic artery and biliary anastomosis could be performed without tension or conduit. CONCLUSION: Caudal shifting of hepatic vein anasto-mosis facilitates implantation of a right liver living donor graft.

  9. Caudal Elbow Luxation in a Dog Managed by Temporary Transarticular External Skeletal Fixation

    Directory of Open Access Journals (Sweden)

    K. Hamilton


    Full Text Available This case report details a caudal unilateral traumatic elbow luxation in a 4-year-old male neutered Labrador following a road traffic trauma. This is a highly unusual injury in the dog. The pathogenesis and successful treatment by closed reduction followed by stabilisation with a temporary transarticular external skeletal fixator are discussed. The dog was assessed at 4 weeks and 6 months after surgery. Findings at 6 months after treatment demonstrated a normal gait with no pain or crepitation. A mild amount of soft tissue thickening around the elbow was noted. The range of motion of the elbow was limited to 45 degrees of flexion and 150 degrees of extension. This is the first case of a traumatic caudal luxation of the elbow in a dog described in the English veterinary literature and the first report of successful management of an elbow luxation in a dog by closed reduction and temporary transarticular fixation.

  10. The quality of cryopreserved sperm collected from feline caudal epididymides stored at room temperature. (United States)

    Toyonaga, Mari; Kaihara, Aya; Tsutsui, Toshihiko


    On the assumption that animals of wild feline species died in the field, caudal epididymal sperm were cryopreserved following storage of the feline epididymides at 20°C for 0-24 hr, and their qualities were observed. Compared to the qualities at 0 hr, no significant differences were noted following 12 hr of storage at 20°C. On comparison of the qualities between caudal sperm cryopreserved after 24 hr storage at 4°C and after 12 hr at 20°C followed by 12 hr storage at 4°C, no significant differences were noted. These findings suggest that the cryopreserved sperm collected from epididymides of dead animals might be useful for artificial insemination if cryopreservation was performed within 12 hr exposure to ambient temperature.

  11. Caudal block and emergence delirium in pediatric patients: Is it analgesia or sedation?

    Directory of Open Access Journals (Sweden)

    Aparna Sinha


    Full Text Available Background: Emergence delirium (ED although a short-lived and self-limiting phenomenon, makes a child prone to injury in the immediate postoperative period and hence is a cause of concern not only to the pediatric anesthesiologist, surgeons, and post anesthesia care unit staff but also amongst parents. Additional medication to quieten the child offsets the potential benefits of rapid emergence and delays recovery in day care settings. There is conflicting evidence of influence of analgesia and sedation following anesthesia on emergence agitation. We hypothesized that an anesthetic technique which improves analgesia and prolongs emergence time will reduce the incidence of ED. We selected ketamine as adjuvant to caudal block for this purpose. Methods: This randomized, double blind prospective study was performed in 150 premedicated children ASA I, II, aged 2 to 8 years who were randomly assigned to either group B (caudal with bupivacaine, BK (bupivacaine and ketamine, or NC (no caudal, soon after LMA placement. Recovery characteristics and complications were recorded. Results: Emergence time, duration of pain relief, and Pediatric Anesthesia Emergence Delirium (PAED scores were significantly higher in the NC group (P<0.05. Duration of analgesia and emergence time were significantly more in group BK than groups B and NC. However, the discharge readiness was comparable between all groups. No patient in BK group required to be given any medication to treat ED. Conclusion: Emergence time as well as duration of analgesia have significant influence on incidence of emergence delirium. Ketamine, as caudal adjuvant is a promising agent to protect against ED in children, following sevoflurane anesthesia.

  12. Organ and effective dose coefficients for cranial and caudal irradiation geometries: photons. (United States)

    Veinot, K G; Eckerman, K F; Hertel, N E


    With the introduction of new recommendations of the International Commission on Radiological Protection (ICRP) in Publication 103, the methodology for determining the protection quantity, effective dose, has been modified. The modifications include changes to the defined organs and tissues, the associated tissue weighting factors, radiation weighting factors and the introduction of reference sex-specific computational phantoms. Computations of equivalent doses in organs and tissues are now performed in both the male and female phantoms and the sex-averaged values used to determine the effective dose. Dose coefficients based on the ICRP 103 recommendations were reported in ICRP Publication 116, the revision of ICRP Publication 74 and ICRU Publication 57. The coefficients were determined for the following irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right and left lateral (RLAT and LLAT), rotational (ROT) and isotropic (ISO). In this work, the methodology of ICRP Publication 116 was used to compute dose coefficients for photon irradiation of the body with parallel beams directed upward from below the feet (caudal) and directed downward from above the head (cranial). These geometries may be encountered in the workplace from personnel standing on contaminated surfaces or volumes and from overhead sources. Calculations of organ and tissue kerma and absorbed doses for caudal and cranial exposures to photons ranging in energy from 10 keV to 10 GeV have been performed using the MCNP6.1 radiation transport code and the adult reference phantoms of ICRP Publication 110. As with calculations reported in ICRP 116, the effects of charged-particle transport are evident when compared with values obtained by using the kerma approximation. At lower energies the effective dose per particle fluence for cranial and caudal exposures is less than AP orientations while above ∼30 MeV the cranial and caudal values are greater.

  13. Caudal Elbow Luxation in a Dog Managed by Temporary Transarticular External Skeletal Fixation


    Hamilton, K.; Langley-Hobbs, S.; Warren-Smith, C.; Parsons, K


    This case report details a caudal unilateral traumatic elbow luxation in a 4-year-old male neutered Labrador following a road traffic trauma. This is a highly unusual injury in the dog. The pathogenesis and successful treatment by closed reduction followed by stabilisation with a temporary transarticular external skeletal fixator are discussed. The dog was assessed at 4 weeks and 6 months after surgery. Findings at 6 months after treatment demonstrated a normal gait with no pain or crepitatio...

  14. Congenital spinal malformations; Kongenitale spinale Malformationen

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    Ertl-Wagner, B.B.; Reiser, M.F. [Klinikum Grosshadern, Ludwig-Maximilians-Univ. Muenchen (Germany). Inst. fuer Klinische Radiologie


    Congenital spinal malformations form a complex and heterogeneous group of disorders whose pathogenesis is best explained embryologically. Radiologically, it is important to formulate a diagnosis when the disorder first becomes symptomatic. However, it is also crucial to detect complications of the disorder or of the respective therapeutic interventions in the further course of the disease such as hydromyelia or re-tethering after repair of a meningomyelocele. Moreover, once a congenital spinal malformation is diagnosed, associated malformations should be sought after. A possible syndromal classification such as in OEIS- or VACTERL-syndromes should also be considered. (orig.) [German] Kongenitale spinale Malformationen stellen eine komplexe Gruppe an Stoerungen dar, deren Genese sich am einfachsten aus der Embryologie heraus erklaeren laesst. Bei der klinisch-radiologischen Begutachtung ist zunaechst ihre korrekte Klassifikation im Rahmen der Erstdiagnose wichtig. Im weiteren Verlauf ist es jedoch zudem entscheidend, moegliche Komplikationen wie beispielsweise eine Hydromyelie oder ein Wiederanheften des Myelons nach Operation einer Spina bifida aperta zu erkennen. Zudem sollte bei der Diagnosestellung einer kongenitalen spinalen Malformation immer auch auf assoziierte Fehlbildungen, wie z.B. die Diastematomyelie oder das intraspinale Lipom bei der Spina bifida aperta, sowie auf eine moegliche syndromale Einordnung wie beispielsweise beim OEIS-oder VACTERL-Syndrom geachtet werden. (orig.)


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    Full Text Available BACKGROUND: Caudal analgesia has been successfully used in paediatric patients since 1933. Ropivacaine a stereo isomer of Bupivacaine was used to increase duration of analgesia. The present study is designed to compare clonidine and dexmedetomidine as adjuvants to Ropivacaine in caudal block in children. METHODS: A total of 60 patients of 3 - 10 years age, either sex, ASA I/II posted for infraumblical surgeries under GA with caudal analgesia were randomly allocated to receive 0.2% ropivacaine plain@1ml/kg+normal saline (1ml, 0.2% ropivacaine @1ml/kg+clonidine 1microg/kg (1ml, 0.2% ropivacaine @1ml/kg+dexmedetomidine 1microg/kg(1ml. The children were monitored postoperatively for duration of analgesia, sedation score and postoperative complications if any. RESULTS: Duration of analgesia was maximum in Group - III (Ropivacaine+ Dexmedetomidine – 14hrs., 12hrs. I n Group - II (Ropivacaine+Clonidine and 6 - 8 hrs. I n Group - I (Ropivacaine Plain. Children were more sedated in early postoperative period in Group - II & III as compared to Group - I. CONCLUSION : Duration of analgesia was prolonged in Group - II & III, the same group children were more sedated and calm in postoperative period.

  16. Efficacy of two doses of tramadol versus bupivacaine in perioperative caudal analgesia in adult hemorrhoidectomy (United States)

    Farag, Hanan M.; Esmat, Ibrahim M.


    Background: The study was conducted to evaluate the perioperative analgesic efficacy of the two doses of caudally administered tramadol versus bupivacaine in adult hemorrhoidectomy. Patients and Methods: A total of 90 patients, aged 20-50 years, undergoing hemorrhoidectomy were randomly scheduled to receive bupivacaine 0.25% in 20 ml (Group B; n = 30), tramadol 1 mg/kg in 20 ml (Group T1; n = 30), tramadol 2 mg/kg in 20 ml (Group T2; n = 30) through caudal route after induction of general anesthesia. Postoperative pain was assessed every hour until the visual analog scale was 6, which is 1st time for rescue analgesia. Postoperative sedation, hemodynamic changes, serum cortisol, and epinephrine levels and incidence of side effects were also evaluated. Results: Duration of analgesia was longer in Group T2 (20 [1.14] h] compared with the Group B (7 [1.2] h) or Group T1 (12 [0.75] h); all P < 0.001. There were no significant hemodynamic changes. There were not incidences of side effects. Conclusion: Caudal tramadol 2 mg/kg provided a longer duration of postoperative analgesia with rapid onset and no incidence of complications or adverse effects in adult hemorrhoidectomy. PMID:27051362

  17. Simplified three-dimensional model provides anatomical insights in lizards' caudal autotomy as printed illustration

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    Full Text Available Lizards' caudal autotomy is a complex and vastly employed antipredator mechanism, with thorough anatomic adaptations involved. Due to its diminished size and intricate structures, vertebral anatomy is hard to be clearly conveyed to students and researchers of other areas. Three-dimensional models are prodigious tools in unveiling anatomical nuances. Some of the techniques used to create them can produce irregular and complicated forms, which despite being very accurate, lack didactical uniformity and simplicity. Since both are considered fundamental characteristics for comprehension, a simplified model could be the key to improve learning. The model here presented depicts the caudal osteology of Tropidurus itambere, and was designed to be concise, in order to be easily assimilated, yet complete, not to compromise the informative aspect. The creation process requires only basic skills in manipulating polygons in 3D modeling softwares, in addition to the appropriate knowledge of the structure to be modeled. As reference for the modeling, we used microscopic observation and a photograph database of the caudal structures. This way, no advanced laboratory equipment was needed and all biological materials were preserved for future research. Therefore, we propose a wider usage of simplified 3D models both in the classroom and as illustrations for scientific publications.

  18. Effects of Caudal Elevation on Testicular Function in Rats: Separation of Effects on Spermatogenesis and Steroidogenesis (United States)

    Deaver, D. R.; Amann, R. P.; Hammerstedt, R. H.; Ball, R.; Veeramachaneni, D. N. R.; Musacchia, X. J.


    A variety of biologic processes are perturbed when exposed to microgravity (space flight) for more than 7 days, including testicular function. Suspension of rats in a special harness (caudal elevation) to induce thoracic pooling of blood fluids and remove the support function of the hind limbs is used to mimic, on earth, the effects of microgravity encountered during space flight. Typically, this induces cryptorchidism in male rats. Three experiments were conducted to differentiate the effects of caudal elevation (30 deg angle) and anatomic location of testes on spermatogenesis and steroidogenesis. Rats were subjected to caudal elevation for 7 days using either a tail harness or a whole-body harness. Testes of rats fell into the abdominal cavity when a tail harness was used, but ligation of the iguinal canal prevented this repositioning. For rats with abdominal testes, testicular weight was reduced (P less than 0.05) and histology of testes was abnormal; the number of spermatids per gram parenchyma was lower (P less than 0.05) in tail-suspended rats compared with control rats.

  19. A caudal proliferating growth center contributes to both poles of the forming heart tube. (United States)

    van den Berg, Gert; Abu-Issa, Radwan; de Boer, Bouke A; Hutson, Mary R; de Boer, Piet A J; Soufan, Alexandre T; Ruijter, Jan M; Kirby, Margaret L; van den Hoff, Maurice J B; Moorman, Antoon F M


    Recent studies have shown that the primary heart tube continues to grow by addition of cells from the coelomic wall. This growth occurs concomitantly with embryonic folding and formation of the coelomic cavity, making early heart formation morphologically complex. A scarcity of data on localized growth parameters further hampers the understanding of cardiac growth. Therefore, we investigated local proliferation during early heart formation. Firstly, we determined the cell cycle length of primary myocardium of the early heart tube to be 5.5 days, showing that this myocardium is nonproliferating and implying that initial heart formation occurs solely by addition of cells. In line with this, we show that the heart tube rapidly lengthens at its inflow by differentiation of recently divided precursor cells. To track the origin of these cells, we made quantitative 3D reconstructions of proliferation in the forming heart tube and the mesoderm of its flanking coelomic walls. These reconstructions show a single, albeit bilateral, center of rapid proliferation in the caudomedial pericardial back wall. This center expresses Islet1. Cell tracing showed that cells from this caudal growth center, besides feeding into the venous pole of the heart, also move cranially via the dorsal pericardial mesoderm and differentiate into myocardium at the arterial pole. Inhibition of caudal proliferation impairs the formation of both the atria and the right ventricle. These data show how a proliferating growth center in the caudal coelomic wall elongates the heart tube at both its venous and arterial pole, providing a morphological mechanism for early heart formation.

  20. Caudal pneumaticity and pneumatic hiatuses in the sauropod dinosaurs Giraffatitan and Apatosaurus. (United States)

    Wedel, Mathew J; Taylor, Michael P


    Skeletal pneumaticity is found in the presacral vertebrae of most sauropod dinosaurs, but pneumaticity is much less common in the vertebrae of the tail. We describe previously unrecognized pneumatic fossae in the mid-caudal vertebrae of specimens of Giraffatitan and Apatosaurus. In both taxa, the most distal pneumatic vertebrae are separated from other pneumatic vertebrae by sequences of three to seven apneumatic vertebrae. Caudal pneumaticity is not prominent in most individuals of either of these taxa, and its unpredictable development means that it may be more widespread than previously recognised within Sauropoda and elsewhere in Saurischia. The erratic patterns of caudal pneumatization in Giraffatitan and Apatosaurus, including the pneumatic hiatuses, show that pneumatic diverticula were more broadly distributed in the bodies of the living animals than are their traces in the skeleton. Together with recently published evidence of cryptic diverticula--those that leave few or no skeletal traces--in basal sauropodomorphs and in pterosaurs, this is further evidence that pneumatic diverticula were widespread in ornithodirans, both across phylogeny and throughout anatomy.


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    Juan David Cadavid


    Full Text Available Se aplica un modelo estocástico bilineal, el cual inicialmente es propuesto para análisis de retornos financieros y otros sistemas complejos combinando la alta no linealidad y multiplicidad del ruido. Este modelo, por su carácter aleatorio, no tiene componente determinística que permita considerar la persistencia de los caudales en una aplicación a la Hidrología. Por lo tanto, se propone el acoplamiento entre la parte determinística de un modelo autorregresivo de orden 2 y el modelo estocástico bilineal como componente aleatorio, y se obtiene un modelo autorregresivo bilineal (MAB. El MAB se empleó para la predicción de caudales en ventanas de 3, 6 y 12 meses en 12 ríos de Colombia de diferentes regiones del país. El MAB tiene una estructura simple y muestra una mejora sustancial en la disminución de los errores para los caudales máximos y mínimos en el período de validación respecto de los modelos estocásticos tradicionales.

  2. Functional Connectivity of the Caudal Anterior Cingulate Cortex Is Decreased in Autism. (United States)

    Zhou, Yuanyue; Shi, Lijuan; Cui, Xilong; Wang, Suhong; Luo, Xuerong


    The anterior cingulate cortex (ACC) is frequently reported to have functionally distinct sub-regions that play key roles in different intrinsic networks. However, the contribution of the ACC, which is connected to several cortical areas and the limbic system, to autism is not clearly understood, although it may be involved in dysfunctions across several distinct but related functional domains. By comparing resting-state fMRI data from persons with autism and healthy controls, we sought to identify the abnormalities in the functional connectivity (FC) of ACC sub-regions in autism. The analyses found autism-related reductions in FC between the left caudal ACC and the right rolandic operculum, insula, postcentral gyrus, superior temporal gyrus, and the middle temporal gyrus. The FC (z-scores) between the left caudal ACC and the right insula was negatively correlated with the Stereotyped Behaviors and Restricted Interests scores of the autism group. These findings suggest that the caudal ACC is recruited selectively in the pathomechanism of autism.

  3. Megaesophagus in Friesian horses associated with muscular hypertrophy of the caudal esophagus. (United States)

    Komine, M; Langohr, I M; Kiupel, M


    Friesian horses have a perceived high rate of congenital or hereditary diseases, including megaesophagus, that may lead to choke and death. A retrospective study was performed to determine the prevalence and pathologic characteristics of esophageal disease in 852 horses, including 17 Friesians, that had been necropsied over a 6-year period at the Diagnostic Center for Population and Animal Health. Forty-two horses had grossly described esophageal lesions (25 muscular hypertrophy, 7 hemorrhage, 6 megaesophagus, 4 erosion/ulceration, 3 obstruction, 2 tears, 2 secondary neoplasms, 2 lymphoid patches, 1 thin wall, 1 esophagitis). Some of these lesions occurred concurrently in the same horse. Ten of these horses died or were euthanatized because of severe esophageal disease (6 megaesophagus causing tears in 2 horses, 3 esophageal obstruction with food bolus, and 1 esophagitis). All 6 horses with megaesophagus were Friesians. No cause for megaesophagus was noted in the necropsy reports; however, 5 of these 6 Friesians had marked caudal esophageal muscular hypertrophy (wall thickness: 1.9 ± 0.3 cm). Microscopic review of the esophagus of these Friesians confirmed smooth muscle hypertrophy, with no obvious fibrosis, degeneration, or loss of myenteric plexi. Unlike the Friesians, the 4 non-Friesian horses with severe esophageal disease had esophageal obstruction with an intraluminal food bolus or severe esophagitis. None had caudal esophageal muscular hypertrophy. It is concluded that in comparison to other horse breeds, Friesians have a higher prevalence of severe esophageal disease, specifically megaesophagus, that is commonly associated with marked caudal muscular hypertrophy.

  4. Caudal migration and proliferation of renal progenitors regulates early nephron segment size in zebrafish (United States)

    Naylor, Richard W.; Dodd, Rachel C.; Davidson, Alan J.


    The nephron is the functional unit of the kidney and is divided into distinct proximal and distal segments. The factors determining nephron segment size are not fully understood. In zebrafish, the embryonic kidney has long been thought to differentiate in situ into two proximal tubule segments and two distal tubule segments (distal early; DE, and distal late; DL) with little involvement of cell movement. Here, we overturn this notion by performing lineage-labelling experiments that reveal extensive caudal movement of the proximal and DE segments and a concomitant compaction of the DL segment as it fuses with the cloaca. Laser-mediated severing of the tubule, such that the DE and DL are disconnected or that the DL and cloaca do not fuse, results in a reduction in tubule cell proliferation and significantly shortens the DE segment while the caudal movement of the DL is unaffected. These results suggest that the DL mechanically pulls the more proximal segments, thereby driving both their caudal extension and their proliferation. Together, these data provide new insights into early nephron morphogenesis and demonstrate the importance of cell movement and proliferation in determining initial nephron segment size. PMID:27759103

  5. Postoperative analgesia in children: A comparison of three different doses of caudal epidural morphine

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    Neha Baduni


    Full Text Available Background and Aims: Caudal epidural block is the most commonly used neuraxial block in children. Morphine has been used as a caudal additive for more than three decades. The aim of our study was to evaluate the efficacy and duration of analgesia of three different doses of caudal epidural morphine (CEM, and to find out the incidence of side effects. Material and Methods: This study was conducted on 75 patients of American Society of Anesthesiologists grades I and II, aged 2-12 years, undergoing lower abdominal and urogenital surgeries. Patients were randomly allocated to one of the three groups according to the dose of morphine. Group I received 30 μg/kg, group II 50 μg/kg, and group III 70 μg/kg. Heart rate, blood pressure, oxygen saturation, electrocardiogram, pain score, sedation score, duration of analgesia, and side-effects were noted. Results: The mean duration of analgesia was 8.63 h in group I, 13.36 h in group II and 19.19 h in group III. Respiratory depression was noted in three patients in group III. One patient in group I had itching. One patient each in groups I, II, and III had nausea/vomiting. Conclusion: CEM significantly prolongs the duration of analgesia, though with a higher dose the risk of respiratory depression should always be kept in mind.

  6. Postoperative Analgesia in Children- Comparative Study between Caudal Bupivacaine and Bupivacaine plus Tramadol

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    Meena Doda


    Full Text Available Thirty children, ASAI-II, aged between 2yrs-5yrs, undergoing sub umbilical operation (inguinal and penile surgery were selected for this double blind study. They were randomly divided in two groups, group Aand group B. Group A(n15 received 0.25%bupivacaine -1 and Group B (n=15 received 0.25% bupivaeaine -1 and tramadol -1 as single shot caudal block. Postoperative pain was assessed by a modified TPPPS (Toddler-Preschool Postoperative Pain Scale and analgesic given only when the score was more than 3. In the first 24 hrs it was observed that the mean duration of time interval between the caudal block and first dose of analgesic was significantly long(9. lhrs in Group B as compared to Group A (6.3hrs which was much shorter(p< 0.01.There was no significant haemodynamie changes, motor weakness or respiratory depression in both groups. This study con-cluded that addition of tramadol -1 to caudal 0.25% bupivacaine -1 significantly prolong the duration of postoperative analgesia in children withoutprodueing much adverse effects.

  7. Postoperative analgesia in children when using clonidine in addition to fentanyl with bupivacaine given caudally. (United States)

    Jarraya, Anouar; Elleuch, Sahar; Zouari, Jawhar; Smaoui, Mohamed; Laabidi, Sofiene; Kolsi, Kamel


    The aim of the study was to evaluate the efficacy of clonidine in association with fentanyl as an additive to bupivacaine 0.25% given via single shot caudal epidural in pediatric patients for postoperative pain relief. In the present prospective randomized double blind study, 40 children of ASA-I-II aged 1-5 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg and clonidine 1μg/kg (group I) or bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg (group II). Caudal block was performed after the induction of general anesthesia. Postoperatively patients were observed for analgesia, sedation, hemodynamic parameters, and side effects or complications. Both the groups were similar with respect to patient and various block characteristics. Heart rate and blood pressure were not different in 2 groups. Significantly prolonged duration of post-operative analgesia was observed in group I (Pbupivacaine in single shot caudal epidural in children may provide better and longer analgesia after infraumblical surgical procedures.

  8. Serotonergic neurons in the caudal raphe nuclei discharge in association with activity of masticatory muscles

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    Ribeiro-do-Valle L.E.


    Full Text Available There is a dense serotonergic projection from nucleus raphe pallidus and nucleus raphe obscurus to the trigeminal motor nucleus and serotonin exerts a strong facilitatory action on the trigeminal motoneurons. Some serotonergic neurons in these caudal raphe nuclei increase their discharge during feeding. The objective of the present study was to investigate the possibility that the activity of these serotonergic neurons is related to activity of masticatory muscles. Cats were implanted with microelectrodes and gross electrodes. Caudal raphe single neuron activity, electrocorticographic activity, and splenius, digastric and masseter electromyographic activities were recorded during active behaviors (feeding and grooming, during quiet waking and during sleep. Seven presumed serotonergic neurons were identified. These neurons showed a long duration action potential (>2.0 ms, and discharged slowly (2-7 Hz and very regularly (interspike interval coefficient of variation <0.3 during quiet waking. The activity of these neurons decreased remarkably during fast wave sleep (78-100%. Six of these neurons showed tonic changes in their activity positively related to digastric and/or masseter muscle activity but not to splenius muscle activity during waking. These data are consistent with the hypothesis that serotonergic neurons in the caudal raphe nuclei play an important role in the control of jaw movements

  9. Neuroprotective Effect of Ulinastatin on Spinal Cord Ischemia-Reperfusion Injury in Rabbits

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    Bingbing Liu


    Full Text Available Ulinastatin (UTI, a trypsin inhibitor, is isolated and purified from human urine and has been shown to exert protective effect on myocardial ischemia reperfusion injury in patients. The present study was aimed at investigating the effect of ulinastatin on neurologic functions after spinal cord ischemia reperfusion injury and the underlying mechanism. The spinal cord IR model was achieved by occluding the aorta just caudal to the left renal artery with a bulldog clamp. The drugs were administered immediately after the clamp was removed. The animals were terminated 48 hours after reperfusion. Neuronal function was evaluated with the Tarlov Scoring System. Spinal cord segments between L2 and L5 were harvested for pathological and biochemical analysis. Ulinastatin administration significantly improved postischemic neurologic function with concomitant reduction of apoptotic cell death. In addition, ulinastatin treatment increased SOD activity and decreased MDA content in the spinal cord tissue. Also, ulinastatin treatment suppressed the protein expressions of Bax and caspase-3 but enhanced Bcl-2 protein expression. These results suggest that ulinastatin significantly attenuates spinal cord ischemia-reperfusion injury and improves postischemic neuronal function and that this protection might be attributable to its antioxidant and antiapoptotic properties.

  10. Electrophysiological functional recovery in a rat model of spinal cord hemisection injury following bone marrow-derived mesenchymal stem cell transplantation under hypothermia

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    Dong Wang; Jianjun Zhang


    Following successful establishment of a rat model of spinal cord hemisection injury by resecting right spinal cord tissues, bone marrow stem cells were transplanted into the spinal cord lesions via the caudal vein while maintaining rectal temperature at 34 ± 0.5°C for 6 hours (mild hypothermia). Hematoxylin-eosin staining showed that astrocytes gathered around the injury site and formed scars at 4 weeks post-transplantation. Compared with rats transplanted with bone marrow stem cells under normal temperature, rats transplanted with bone marrow stem cells under hypothermia showed increased numbers of proliferating cells (bromodeoxyuridine-positive cells), better recovery of somatosensory-evoked and motor-evoked potentials, greater Basso, Beattie, and Bresnahan locomotor rating scores, and an increased degree of angle in the incline plate test. These findings suggested that hypothermia combined with bone marrow mesenchymal stem cells transplantation effectively promoted electrical conduction and nerve functional repair in a rat model of spinal cord hemisection injury.

  11. Imaging in spinal trauma

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    Goethem, J.W.M. van [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium); Algemeen Ziekenhuis Maria Middelares, Department of Radiology, Sint-Niklaas (Belgium); Maes, Menno; Oezsarlak, Oezkan; Hauwe, Luc van den; Parizel, Paul M. [Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium, Department of Radiology, Edegem (Belgium)


    Because it may cause paralysis, injury to the spine is one of the most feared traumas, and spinal cord injury is a major cause of disability. In the USA approximately 10,000 traumatic cervical spine fractures and 4000 traumatic thoracolumbar fractures are diagnosed each year. Although the number of individuals sustaining paralysis is far less than those with moderate or severe brain injury, the socioeconomic costs are significant. Since most of the spinal trauma patients survive their injuries, almost one out of 1000 inhabitants in the USA are currently being cared for partial or complete paralysis. Little controversy exists regarding the need for accurate and emergent imaging assessment of the traumatized spine in order to evaluate spinal stability and integrity of neural elements. Because clinicians fear missing occult spine injuries, they obtain radiographs for nearly all patients who present with blunt trauma. We are influenced on one side by fear of litigation and the possible devastating medical, psychologic and financial consequences of cervical spine injury, and on the other side by pressure to reduce health care costs. A set of clinical and/or anamnestic criteria, however, can be very useful in identifying patients who have an extremely low probability of injury and who consequently have no need for imaging studies. Multidetector (or multislice) computed tomography (MDCT) is the preferred primary imaging modality in blunt spinal trauma patients who do need imaging. Not only is CT more accurate in diagnosing spinal injury, it also reduces imaging time and patient manipulation. Evidence-based research has established that MDCT improves patient outcome and saves money in comparison to plain film. This review discusses the use, advantages and disadvantages of the different imaging techniques used in spinal trauma patients and the criteria used in selecting patients who do not need imaging. Finally an overview of different types of spinal injuries is given

  12. Ultrasound guided TAP block versus ultrasound guided caudal block for pain relief in children undergoing lower abdominal surgeries

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    Wafaa Mohamed Alsadek


    Conclusion: TAP block and caudal block under ultrasound guidance proved to be safe with no recorded complications either intra or postoperatively. Patient and parent satisfaction was markedly observed in case of TAP block.

  13. Effect of nalbuphine as an adjuvant on levobupivacaine induced caudal analgesia in children undergoing surgical procedures, controlled randomized double blinded

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    Riham Hussein Saleh


    Conclusion: Caudal epidural nalbuphine is safe in pediatric surgeries including the lower half of the body and effectively reduces postoperative pain. However it may cause early postoperative sedation, yet without respiratory depression.

  14. Spinal canal stenosis; Spinalkanalstenose

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    Papanagiotou, P.; Boutchakova, M. [Klinikum Bremen-Mitte/Bremen-Ost, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Bremen (Germany)


    Spinal stenosis is a narrowing of the spinal canal by a combination of bone and soft tissues, which can lead to mechanical compression of spinal nerve roots or the dural sac. The lumbal spinal compression of these nerve roots can be symptomatic, resulting in weakness, reflex alterations, gait disturbances, bowel or bladder dysfunction, motor and sensory changes, radicular pain or atypical leg pain and neurogenic claudication. The anatomical presence of spinal canal stenosis is confirmed radiologically with computerized tomography, myelography or magnetic resonance imaging and play a decisive role in optimal patient-oriented therapy decision-making. (orig.) [German] Die Spinalkanalstenose ist eine umschriebene, knoechern-ligamentaer bedingte Einengung des Spinalkanals, die zur Kompression der Nervenwurzeln oder des Duralsacks fuehren kann. Die lumbale Spinalkanalstenose manifestiert sich klinisch als Komplex aus Rueckenschmerzen sowie sensiblen und motorischen neurologischen Ausfaellen, die in der Regel belastungsabhaengig sind (Claudicatio spinalis). Die bildgebende Diagnostik mittels Magnetresonanztomographie, Computertomographie und Myelographie spielt eine entscheidende Rolle bei der optimalen patientenbezogenen Therapieentscheidung. (orig.)

  15. Nkx2.2 and Nkx2.9 are the key regulators to determine cell fate of branchial and visceral motor neurons in caudal hindbrain. (United States)

    Jarrar, Wassan; Dias, Jose M; Ericson, Johan; Arnold, Hans-Henning; Holz, Andreas


    Cranial motor nerves in vertebrates are comprised of the three principal subtypes of branchial, visceral, and somatic motor neurons, which develop in typical patterns along the anteroposterior and dorsoventral axes of hindbrain. Here we demonstrate that the formation of branchial and visceral motor neurons critically depends on the transcription factors Nkx2.2 and Nkx2.9, which together determine the cell fate of neuronal progenitor cells. Disruption of both genes in mouse embryos results in complete loss of the vagal and spinal accessory motor nerves, and partial loss of the facial and glossopharyngeal motor nerves, while the purely somatic hypoglossal and abducens motor nerves are not diminished. Cell lineage analysis in a genetically marked mouse line reveals that alterations of cranial nerves in Nkx2.2; Nkx2.9 double-deficient mouse embryos result from changes of cell fate in neuronal progenitor cells. As a consequence progenitors of branchiovisceral motor neurons in the ventral p3 domain of hindbrain are transformed to somatic motor neurons, which use ventral exit points to send axon trajectories to their targets. Cell fate transformation is limited to the caudal hindbrain, as the trigeminal nerve is not affected in double-mutant embryos suggesting that Nkx2.2 and Nkx2.9 proteins play no role in the development of branchiovisceral motor neurons in hindbrain rostral to rhombomere 4.

  16. A differential synaptic input to the motor nuclei of triceps surae from the caudal and lateral cutaneous sural nerves. (United States)

    LaBella, L A; Kehler, J P; McCrea, D A


    1. Postsynaptic potentials (PSPs) were recorded in 115 triceps surae motoneurons of 10 chloralose-anesthetized adult cats (spinal cord intact), upon electrical stimulation of the caudal and lateral cutaneous sural nerve branches (CCS and LCS, respectively). 2. With twice threshold (2T) stimulation of CCS, excitatory PSPs (EPSPs) were the predominant effect in 95% of all medial gastrocnemius (MG) motoneurons tested (min. central latency 1.5 ms; mean 2.4 ms). In only a few MG cells was the EPSP followed by an inhibitory postsynaptic potential (IPSP) and in only one cell was an IPSP the sole effect. Increasing the stimulus intensity to 5T tended to enhance both the later EPSP and IPSP components, with less change in the amplitude or latency of the earliest EPSPs. 3. In lateral gastrocnemius (LG) and soleus (SOL) motoneurons, 2T CCS stimulation led to either inhibition or no potential change in the majority of cells tested: EPSPs were the predominant effect in only 15 and 30% of LG and SOL cells, respectively (min. central latency 2.5 ms; mean 3.0 ms) and rarely occurred without subsequent inhibition. Again, increasing the stimulus intensity to 5T had more of an effect on later rather than earlier PSP components. 4. A predominance of depolarization in MG motoneurons but not in SOL motoneurons is in agreement with previous findings that CCS excitation is more powerful in "fast type" triceps surae motoneurons. However, the strong predominance of hyperpolarizing effects of CCS stimulation in the present LG population is evidence that such an organization does not transcend triceps surae motor nuclei as a whole. 5. Postsynaptic effects of LCS stimulation at 2T were frequently weak or absent but increasing the stimulus intensity to 5T produced predominant inhibition in 71% of all triceps surae motoneurons studied (n = 107). Of the few cells which did receive excitation from this nerve, most were MG, a few were SOL, and none were LG. These EPSPs occurred more frequently at 5

  17. Enhanced noradrenergic axon regeneration into schwann cell-filled PVDF-TrFE conduits after complete spinal cord transection. (United States)

    Lee, Yee-Shuan; Wu, Siliang; Arinzeh, Treena Livingston; Bunge, Mary Bartlett


    Schwann cell (SC) transplantation has been utilized for spinal cord repair and demonstrated to be a promising therapeutic strategy. In this study, we investigated the feasibility of combining SC transplantation with novel conduits to bridge the completely transected adult rat spinal cord. This is the first and initial study to evaluate the potential of using a fibrous piezoelectric polyvinylidene fluoride trifluoroethylene (PVDF-TrFE) conduit with SCs for spinal cord repair. PVDF-TrFE has been shown to enhance neurite growth in vitro and peripheral nerve repair in vivo. In this study, SCs adhered and proliferated when seeded onto PVDF-TrFE scaffolds in vitro. SCs and PVDF-TrFE conduits, consisting of random or aligned fibrous inner walls, were transplanted into transected rat spinal cords for 3 weeks to examine early repair. Glial fibrillary acidic protein (GFAP)(+) astrocyte processes and GFP (green fluorescent protein)-SCs were interdigitated at both rostral and caudal spinal cord/SC transplant interfaces in both types of conduits, indicative of permissivity to axon growth. More noradrenergic/DβH(+) (dopamine-beta-hydroxylase) brainstem axons regenerated across the transplant when greater numbers of GFAP(+) astrocyte processes were present. Aligned conduits promoted extension of DβH(+) axons and GFAP(+) processes farther into the transplant than random conduits. Sensory CGRP(+) (calcitonin gene-related peptide) axons were present at the caudal interface. Blood vessels formed throughout the transplant in both conduits. This study demonstrates that PVDF-TrFE conduits harboring SCs are promising for spinal cord repair and deserve further investigation. Biotechnol. Bioeng. 2017;114: 444-456. © 2016 Wiley Periodicals, Inc.

  18. The Relationships Between Diameter Stump Height (d0.30) and Diameter Breast Height (d1.30) for Scotch Pine (Pinus sylvestris (L.)) in West Black Sea RegionThe Relationships Between Diameter Stump Height (d0.30) and Diameter Breast Height (d1.30) for Scotc


    ŞENYURT, Muammer


    In this study, it is proposed to determine the relationship between the diameter at stump height (d0.3) and diameter breast height (d1.30) for Scotch Pine (Pinus sylvestris (L.)) in West Black Sea Region including Kastamonu, Bolu and Ankara forest regional offices. For this purpose, 101 temporary sample plots were obtained and 1111 tree measurements for stump height (d0.3) and diameter breast height (d1.3) were carried out. The different regression models were selected and compared to some ...

  19. Comparison of Postoperative Analgesic Efficacy of Penile Block, Caudal Block and Intravenous Paracetamol for Circumcision: A prospective Randomized Study


    Ahmet Hakan Haliloglu; Mehmet Ilker Gokce; Semih Tangal; Mehmet Salih Boga; Hakan Tapar; Ebru Aladag


    Purpose To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision. Materials and Methods In this prospective randomized study a total of 159 patients underwent circumcision under general anesthesia at urology clinic of Ufuk University Faculty of Medicine and Sorgun State Hospital between May 2012 and September 2012. The patients were randomized to three groups to receive penile block (Group 1), caudal blo...

  20. Spinal cord swelling and candidiasis

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    Ho, K.; Gronseth, G.; Aldrich, M.; Williams, A.


    Fusiform swelling of the spinal cord was noted myelographically in a patient with Hodgkin's disease. Autopsy revealed that the swelling was caused by Candida infection of the spinal cord. It is suggested that fungal infection be included in the differential diagnosis of spinal cord swelling in the immunosuppressed cancer patient.

  1. Spinal actinomycosis: A rare disease

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    Dua Rakesh


    Full Text Available Actinomycosis is an indolent, slowly progressive infection caused by Actinomyces species. Of human actinomycosis, the spinal form is rare and actinomycosis-related spinal neurological deficit is uncommon. We report two cases with cervical and dorsal actinomycosis and one of them with spinal neurological deficit.

  2. Intramedullary spinal melanocytoma

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    Meic H. Schmidt


    Full Text Available Meningeal melanocytoma is a benign lesion arising from leptomeningeal melanocytes that at times can mimic its malignant counterpart, melanoma. Lesions of the spine usually occur in extramedullary locations and present with spinal cord compression symptoms. Because most reported spinal cases occur in the thoracic region, these symptoms usually include lower extremity weakness or numbness. The authors present a case of primary intrame­dullary spinal meningeal melanocytoma presenting with bilateral lower extremity symptoms in which the patient had no known supratentorial primary lesions. Gross total surgical resection allowed for full recovery, but early recurrence of tumor was detected on close follow-up monitoring, allowing for elective local radiation without loss of neurological function. Case reports of such tumors discuss different treatment strategies, but just as important is the close follow-up monitoring in these patients even after gross total surgical resection, since these tumors can recur.

  3. [Spinal cord infarction]. (United States)

    Naumann, N; Shariat, K; Ulmer, S; Stippich, C; Ahlhelm, F J


    Infarction of the spinal cord can cause a variety of symptoms and neurological deficits because of the complex vascular supply of the myelon. The most common leading symptom is distal paresis ranging from paraparesis to tetraplegia caused by arterial ischemia or infarction of the myelon. Venous infarction, however, cannot always be distinguished from arterial infarction based on the symptoms alone.Modern imaging techniques, such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) assist in preoperative planning of aortic operations to reliably identify not only the most important vascular structure supplying the spinal cord, the artery of Adamkiewicz, but also other pathologies such as tumors or infectious disorders. In contrast to CT, MRI can reliably depict infarction of the spinal cord.

  4. Cerebrospinal fluid dynamics at the lumbosacral level in patients with spinal stenosis: A pilot study. (United States)

    Chun, Se-Woong; Lee, Hack-Jin; Nam, Koong-Ho; Sohn, Chul-Ho; Kim, Kwang Dong; Jeong, Eun-Jin; Chung, Sun G; Kim, Keewon; Kim, Dong-Joo


    Spinal stenosis is a common degenerative condition. However, how neurogenic claudication develops has not been clearly elucidated. Moreover, cerebrospinal fluid physiology at the lumbosacral level has not received adequate attention. This study was conducted to compare cerebrospinal fluid hydrodynamics at the lumbosacral spinal level between patients with spinal stenosis and healthy controls. Twelve subjects (four patients and eight healthy controls; 25-77 years old; seven males) underwent phase-contrast magnetic resonance imaging to quantify cerebrospinal fluid dynamics. The cerebrospinal fluid flow velocities were measured at the L2 and S1 levels. All subjects were evaluated at rest and after walking (to provoke neurogenic claudication in the patients). The caudal peak flow velocity in the sacral spine (-0.25 ± 0.28 cm/s) was attenuated compared to that in the lumbar spine (-0.93 ± 0.46 cm/s) in both patients and controls. The lumbar caudal peak flow velocity was slower in patients (-0.65 ± 0.22 cm/s) than controls (-1.07 ± 0.49 cm/s) and this difference became more pronounced after walking (-0.66 ± 0.37 cm/s in patients, -1.35 ± 0.52 cm/s in controls; p = 0.028). The sacral cerebrospinal fluid flow after walking was barely detectable in patients (caudal peak flow velocity: -0.09 ± 0.03 cm/s). Cerebrospinal fluid dynamics in the lumbosacral spine were more attenuated in patients with spinal stenosis than healthy controls. After walking, the patients experiencing claudication did not exhibit an increase in the cerebrospinal fluid flow rate as the controls did. Altered cerebrospinal fluid dynamics may partially explain the pathophysiology of spinal stenosis. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:104-112, 2017.

  5. Effects of long-term FK506 administration on functional and histopathological outcome after spinal cord injury in adult rat. (United States)

    Saganová, Kamila; Orendácová, Judita; Sulla, Igor; Filipcík, Peter; Cízková, Dása; Vanický, Ivo


    FK506 (tacrolimus), a potent immunosuppressive drug primarily used for reduction of allograft rejection in organ transplantation, also offers neuroprotection after central nervous system injury. FK506-mediated immunosuppression and neuroprotection may occur through different mechanisms that could affect neurological recovery and the severity of spinal lesions where cells transplantation therapy is combined with FK506 application. We assessed effects of long-term FK506 administration using the same dose regiment (1 mg/kg/day for 6 weeks) as is used in spinal cord transplantation studies following a balloon-compression induced spinal cord injury (SCI). Body weight and locomotor recovery quantified by the BBB (Basso-Beattie-Bresnehan) locomotor rating scale were evaluated for up to 42 days post-injury. The area of the preserved spinal cord tissue within a 13 mm segment of the spinal cord (lesion epicenter and 6 mm rostral-caudal) was examined histologically. The results showed no significant effects of FK506 on spinal cord tissue sparing or improvement of locomotor recovery. However, body weight fell significantly (P < 0.05) with FK506 treatment when compared with placebo from day 7 until sacrifice. In our experimental design, long-term FK506 treatment did not affect the parameters of outcome following balloon-compression SCI in the rat; however, multiple effects of FK506 should be taken into account when evaluating the outcomes in transplantation studies.

  6. Role of endogenous Schwann cells in tissue repair after spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    Shu-xin Zhang; Fengfa Huang; Mary Gates; Eric G. Holmberg


    Schwann cells are glial cells of peripheral nervous system, responsible for axonal myelination and ensheathing, as well as tissue repair following a peripheral nervous system injury. They are one of several cell types that are widely studied and most commonly used for cell transplantation to treat spinal cord injury, due to their intrinsic characteristics including the ability to secrete a variety of neurotrophic factors. This mini review summarizes the recent findings of endogenous Schwann cells after spinal cord injury and discusses their role in tissue repair and axonal regeneration. After spinal cord injury, numerous endogenous Schwann cells migrate into the lesion site from the nerve roots, involving in the construction of newly formed repaired tissue and axonal myelination. These invading Schwann cells also can move a long distance away from the injury site both rostrally and caudally. In addition, Schwann cells can be induced to migrate by minimal insults (such as scar ablation) within the spinal cord and integrate with astrocytes under certain circumstances. More importantly, the host Schwann cells can be induced to migrate into spinal cord by transplantation of different cell types, such as exogenous Schwann cells, olfactory ensheathing cells, and bone marrow-derived stromal stem cells. Migration of endogenous Schwann cells following spinal cord injury is a common natural phenomenon found both in animal and human, and the myelination by Schwann cells has been examined effective in signal conduction electrophysiologically. Therefore, if the inherent properties of endogenous Schwann cells could be developed and utilized, it would offer a new avenue for the restoration of injured spinal cord.

  7. Maladaptive spinal plasticity opposes spinal learning and recovery in spinal cord injury

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    Adam R Ferguson


    Full Text Available Synaptic plasticity within the spinal cord has great potential to facilitate recovery of function after spinal cord injury (SCI. Spinal plasticity can be induced in an activity-dependent manner even without input from the brain after complete SCI. The mechanistic basis for these effects is provided by research demonstrating that spinal synapses have many of the same plasticity mechanisms that are known to underlie learning and memory in the brain. In addition, the lumbar spinal cord can sustain several forms of learning and memory, including limb-position training. However, not all spinal plasticity promotes recovery of function. Central sensitization of nociceptive (pain pathways in the spinal cord may emerge with certain patterns of activity, demonstrating that plasticity within the spinal cord may contribute to maladaptive pain states. In this review we discuss interactions between adaptive and maladaptive forms of activity-dependent plasticity in the spinal cord. The literature demonstrates that activity-dependent plasticity within the spinal cord must be carefully tuned to promote adaptive spinal training. Stimulation that is delivered in a limb position-dependent manner or on a fixed interval can induce adaptive plasticity that promotes future spinal cord learning and reduces nociceptive hyper-reactivity. On the other hand, stimulation that is delivered in an unsynchronized fashion, such as randomized electrical stimulation or peripheral skin injuries, can generate maladaptive spinal plasticity that undermines future spinal cord learning, reduces recovery of locomotor function, and promotes nociceptive hyper-reactivity after spinal cord injury. We review these basic phenomena, discuss the cellular and molecular mechanisms, and discuss implications of these findings for improved rehabilitative therapies after spinal cord injury.

  8. Prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    Lyu Jima; Hao Xuezhi; Hui Zhouguang; Liang Jun; Zhou Zongmei; Feng Qinfu; Xiao Zefen


    Background The prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer (NSCLC) remains unclear.This study intends to identify the prognostic factors and to optimize treatments for these patients under update conditions.Methods The data of 124 NSCLC patients who underwent R1-resection at the bronchial stump was reviewed.There were 41 patients in the surgery group (S),21 in the postoperative radiotherapy (PORT) group (S+R),30 in the postoperative chemotherapy (POCT) group (S+C),and 32 in the PORT plus POCT group (S+R+C).The constitute proportion in different groups was tested using the X2 method,univariate analysis was performed using the Kaplan-Meier and log-rank method,and multivariate analysis was done using the Cox hazard regression with entry factors including age,sex,pathological type and stage,classification of the residual disease,and treatment procedure.The process was performed stepwise backward with a maximum iteration of 20 and an entry possibility of 0.05 as well as an excluded possibility of 0.10 at each step.Results In univariate analysis,survival was more favorable for patients with squamous cell carcinoma,early pathological T or N stage,and chemotherapy or radiotherapy.There was no significant difference in the survival for patients with different types of the residual disease,except for the difference between patients with carcinoma in situ and lymphangiosis carcinomatosa (P=0.030).The survival for patients receiving chemoradiotherapy was superior to that for those undergoing surgery alone (P=0.016).In multivariate analysis,the pathological type (HR 2.51,95% CI 1.59 to 3.96,P=0.000),pathological T (HR 1.29,95% CI 1.04 to 1.60,P=-0.021) or N stage (HR 2.04,95% CI 1.40 to 2.98,P=0.000),and chemotherapy (HR 0.24,95% CI 0.13 to 0.43,P=0.000) were independent prognostic factors.Conclusion Patients with squamous cell carcinoma,early pathological T or N stage,or receiving chemotherapy had a more favorable


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    Full Text Available CONTEXT: Various adjuvants such as opioids or α2 agonists are being used to improve the quality and duration of caudal analgesia with local anesthetics. Dexmedetomidine a α2 agonist is used frequently in adult patients to enhance the local anesthetic effect. However there is little literature regarding its effectiveness in pediatric caudal analgesia. The objective of this study was to assess the efficacy of dexmedetomidine when used as an adjuvant to bupivacaine in increasing the duration of caudal analgesia. AIM: The aim of this study was to investigate the effect of adding Dexmedetomidine to caudal Bupivacaine and observe the effect on the duration of analgesia in the post-operative period. SETTINGS AND DESIGN: One year hospital based Double Blind Randomized Controlled Trial. METHODS AND MATERIAL: Sixty children, aged 1-6 years, undergoing lower abdominal surgeries were included in this prospective randomized double-blind study. The patients were randomly divided into two groups: Group I received Bupivacaine (0.25% 1ml/kg plus 1 ml of normal saline in the caudal epidural space. Group II was administered Bupivacaine (0.25% 1ml/ with Dexmedetomidine 2 mcg/ ml diluted to 1 ml of normal saline in the caudal epidural space. All anesthetic and surgical techniques were standardized. Heart rate, blood pressure, oxygen saturation, respiratory rate were monitored continuously. Surgery was started 10-15 minutes after the injection and confirming adequacy of caudal block. Duration of analgesia was assessed using FLACC scale (Face, Legs, Activity, Cry, Consolability scale. The time from administration of caudal anesthesia to the first time the FLACC score equal or greater than 4 was considered as the duration of caudal analgesia. Paracetamol suppository was used as rescue analgesia with a loading dose of 40mg/kg. STATISTICAL ANALYSIS: Mann-Whitney test and Student ‘t’test was used to compare the data obtained in the two groups. RESULTS: The

  10. A case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery. (United States)

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong


    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was accomplished with a nonisland pedicled foot fillet flap. Various foot fillet flaps may be used acutely as a free or an island pedicled flap, but dissection of the vascular pedicle may be difficult in a chronically inflamed wound because of inflammation and adhesions to surrounding tissue. The nonisland pedicled foot fillet flap may be considered as a useful option for treatment of a chronically inflamed stump wound after below-knee amputation.

  11. Fiabilidad técnica del bloqueo caudal guiado con ecografía

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    A. Mendiola de la Osa


    Full Text Available Introducción: el bloqueo-infiltración caudal es una técnica utilizada en las unidades de dolor para tratar el dolor de origen radicular lumbosacro. Esta técnica se ha realizado clásicamente mediante referencias anatómicas o guiado mediante fluoroscopia. Se presenta la realización de la técnica eco-guiada y las complicaciones surgidas tras la realización de la misma. Material y métodos: estudio observacional descriptivo en el que se estudiaron las complicaciones de la técnica. Se realizaron 126 procedimientos en pacientes adultos de ambos sexos. Procedimiento: se localizó el hiato sacro mediante ecografía y se insertó una aguja de Touhy 18 G en el espacio epidural caudal perforando el ligamento sacro-coccígeo. Resultados: no surgieron complicaciones graves en ninguno de los pacientes. No hubo casos de mala ventana ecográfica por lo que se pudo realizar la técnica en todos los enfermos programados. Conclusión: debido a la ausencia de complicaciones la realización de la técnica eco-guiada es una alternativa segura y fiable a la técnica guiada con fluoroscopia. Mediante esta técnica se evita la exposición de radiaciones ionizantes. Además el bloqueo caudal eco-guiado no necesita del uso de contrastes yodados y permite transportar el ecógrafo a la cabecera del enfermo en caso de ser necesario.

  12. A rostro-caudal gradient of structured sequence processing in the left inferior frontal gyrus. (United States)

    Uddén, Julia; Bahlmann, Jörg


    In this paper, we present two novel perspectives on the function of the left inferior frontal gyrus (LIFG). First, a structured sequence processing perspective facilitates the search for functional segregation within the LIFG and provides a way to express common aspects across cognitive domains including language, music and action. Converging evidence from functional magnetic resonance imaging and transcranial magnetic stimulation studies suggests that the LIFG is engaged in sequential processing in artificial grammar learning, independently of particular stimulus features of the elements (whether letters, syllables or shapes are used to build up sequences). The LIFG has been repeatedly linked to processing of artificial grammars across all different grammars tested, whether they include non-adjacent dependencies or mere adjacent dependencies. Second, we apply the sequence processing perspective to understand how the functional segregation of semantics, syntax and phonology in the LIFG can be integrated in the general organization of the lateral prefrontal cortex (PFC). Recently, it was proposed that the functional organization of the lateral PFC follows a rostro-caudal gradient, such that more abstract processing in cognitive control is subserved by more rostral regions of the lateral PFC. We explore the literature from the viewpoint that functional segregation within the LIFG can be embedded in a general rostro-caudal abstraction gradient in the lateral PFC. If the lateral PFC follows a rostro-caudal abstraction gradient, then this predicts that the LIFG follows the same principles, but this prediction has not yet been tested or explored in the LIFG literature. Integration might provide further insights into the functional architecture of the LIFG and the lateral PFC.

  13. Effects of dexmedetomidine added to caudal ropivacaine in paediatric lower abdominal surgeries

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    Vijay G Anand


    Full Text Available Purpose: The objectives of this study were to compare the effects of caudal dexmedetomidine combined with ropivacaine to provide postoperative analgesia in children and also to establish its safety in the paediatric population. Methods: In a randomised, prospective, parallel group, double-blinded study, 60 children were recruited and allocated into two groups: Group RD (n=30 received 0.25% ropivacaine 1 ml/kg with dexmedetomidine 2 μg/kg, making the volume to 0.5 ml and Group R (n=30 received 0.25% ropivacaine 1 ml/kg + 0.5 ml normal saline. Induction of anaesthesia was achieved with 50% N 2 O and 8% sevoflurane in oxygen in spontaneous ventilation. An appropriate-sized LMA was then inserted and a caudal block performed in all patients. Behaviour during emergence was rated with a 4-point scale, sedation with Ramsay′s sedation scale, and pain assessed with face, legs, activity, cry, consolability (FLACC pain score. Results: The duration of postoperative analgesia recorded a median of 5.5 hours in Group R compared with 14.5 hours in Group RD, with a P value of <0.001. Group R patients achieved a statistically significant higher FLACC score compared with Group RD patients. The difference between the means of mean sedation score, emergence behaviour score, mean emergence time was statistically highly significant (P<0.001. The peri-operative haemodynamics were stable among both the groups. Conclusion: Caudal dexmedetomidine (2 μg/kg with 0.25% ropivacaine (1 ml/kg for paediatric lower abdominal surgeries achieved significant postoperative pain relief that resulted in a better quality of sleep and a prolonged duration of arousable sedation and produced less incidence of emergence agitation following sevoflurane anaesthesia.

  14. Tuning in caudal fastigial nucleus units during natural and galvanic labyrinth stimulation. (United States)

    Schlosser, H G; Guldin, W O; Grüsser, O J


    Neurons of the caudal fastigial nucleus were investigated by means of single unit recordings. Natural vestibular stimuli were applied as well as galvanic labyrinth polarization. One-third of the neurons showed a convergence of vertical and horizontal canals. More than 80% of the neurons responded to polarization of both the ipsilateral and contralateral canals (binaural responders). Most neurons had a limited response range. Two classes of neurons could be distinguished: up to 1 Hz responders and up to 10 Hz responders. In addition a group of fastigial cells showed a tuning within a small range of frequencies (sharp-tuning responders).

  15. Use of CO2 laser as an adjunctive treatment for caudal stomatitis in a cat. (United States)

    Lewis, John R; Tsugawa, Anson J; Reiter, Alexander M


    Lasers have become a popular tool in veterinary practice, particularly the carbon dioxide (CO2) laser. In humans, the CO2 laser is used most commonly in oral and maxillofacial soft tissue surgery due to its favorable interactions with oral soft tissues. Other types of lasers are better suited for use on hard tissues such as enamel and dentin. This article reviews the history of laser use, physics of laser-tissue interaction, delivery systems, and laser types used in dentistry and oral surgery. This is followed by a case report describing the use of CO2 laser as an adjunctive treatment for therapy of refractory caudal stomatitis in a cat.

  16. Morphometric study of sacral hiatus in adult human Egyptian sacra: Their significance in caudal epidural anesthesia

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    Mohamed S Mustafa


    Full Text Available Background: The reliability and success of caudal epidural anesthesia depends on anatomic variations of sacral hiatus (SH as observed by various authors. SH is an important landmark during caudal epidural block (CEB.The purpose of the present study was to clarify the morphometric characteristics of the SH in human Egyptian dry sacra and pelvic radiographs and identification of nearest ony landmarks to permit correct and uncomplicated caudal epidural accesses. Methods: The present study was done on 46 human adult Egyptian dry sacra. The maximum height, midventral curved length, and maximum breadth of each sacrum were measured and sacral and curvature indices were calculated. According to sacral indices, sacra were divided into 2 groups (22 male and 24 female sacra. SH was evaluated in each sacrum according to its shape, level of its apex, and base according to sacral and coccygeal vertebrae, length, anteroposterior (AP diameter at its apex, and transverse width at its base. Linear distances were measured between the apex of SH and second sacral foramina, right and left superolateral sacral crests. The distance between the 2 superolateral sacral crests also was measured. Results: The most common types of SH were the inverted U and inverted V (in male and inverted V and dumbbell shaped (in female. Absent SH was observed in male group only. The most common location of SH apex was at the level of S4 in all groups of dry sacra and S3 in all groups of lumbosacral spine radiographs, whereas S5 was the common level of its base. The mean SH length, transverse width of its base, and AP diameter of its apex were 2.1±0.80, 1.7±0.26, and 0.48±0.19 cm. Female sacra showed narrower SH apex than male. The distance between the S2 foramen and the apex of the SH was 4.1±1.14, 3.67±1.21, and 4.48±1.01 cm in total, female and male sacra, respectively. Conclusion: Sacrum and SH showed morphometric variations in adult Egyptians. The equilateral triangle is an


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    Full Text Available BACKGROUND: The addition of clonidine as an adjuvant has allowed the use of lower concentration of the local anaesthetic for achieving the same level of anaesthesia but with the prolonged duration of analgesia which increases the margin of safety and reduces the inci dence of unwanted motor blockades. With these facts in mind we undertook the study to compare the analgesic properties of 0.25% ropivacaine with the addition of clonidine (1 μ g/kg to that of ropivacaine 0.25% following caudal administration in children. ME THODS: After approval from ethical committee 60 children of age 1 - 10 yrs of ASA grade I or II undergoing elective sub umbilical surgeries were selected for the study. We gave caudal bloc k with 0.25% ropivacaine 1ml/kg +1ml normal saline for group R or 0.25% ropivacaine 1ml/kg + clonidine 1microgram/kg+1ml normal saline to make volume 1ml for group C. To perform caudal block all patient received IV injection glycopyrolate - 0.01mg/kg, IV injection midazolam - 0.1mg/kg and IV Injection ketamine - 1mg/kg. Hemodynam ic parameters were observed before, during and after the surgical procedure. Quality of surgical anesthesia & requirement of supplemental midazolam/ketamine were also noted. Duration of Post - operative analgesia, pain scores, level of sedation and side effe cts if any were looked for and duly recorded. RESULT: Duration of analgesia in group R was 6.45±0.52 hrs. and in group C was 13.01±0.89hrs i.e. significantly prolonged in group C (P<0.0001. Post - operative pain score and sedation score were also significan tly better in group C (P<0.0001. The quality of surgical analgesia was also significantly excellent in group C. Other vital parameters were not statistically significant in both the groups. CONCLUSION: Ropivacaine (0.25% with clonidine (1μg/kg in caudal block showed prolong duration of analgesia as well as better quality of surgical anaesthesia than plain ropivacaine (0.25% in pediatric patients without any

  18. Microarray analysis in caudal medulla of cattle orally challenged with bovine spongiform encephalopathy. (United States)

    Almeida, L M; Basu, U; Williams, J L; Moore, S S; Guan, L L


    Bovine spongiform encephalopathy (BSE) is a fatal disorder in cattle characterized by progressive neurodegeneration of the central nervous system. We investigated the molecular mechanisms involved in neurodegeneration during prion infection through the identification of genes that are differentially expressed (DE) between experimentally infected and non-challenged cattle. Gene expression of caudal medulla from control and orally infected animals was compared by microarray analysis using 24,000 bovine oligonucleotides representing 16,846 different genes to identify DE genes associated with BSE disease. In total, 182 DE genes were identified between normal and BSE-infected tissues (>2.0-fold change, P bovine species.

  19. In vivo longitudinal Myelin Water Imaging in rat spinal cord following dorsal column transection injury. (United States)

    Kozlowski, Piotr; Rosicka, Paulina; Liu, Jie; Yung, Andrew C; Tetzlaff, Wolfram


    Longitudinal Myelin Water Imaging was carried out in vivo to characterize white matter damage following dorsal column transection (DC Tx) injury at the lumbar level L1 of rat spinal cords. A transmit-receive implantable coil system was used to acquire multiple spin-echo (MSE) quantitative T2 data from the lumbar spinal cords of 16 rats at one week pre-injury as well as 3 and 8weeks post-injury (117 microns in-plane resolution and 1.5mm slice thickness). In addition, ex vivo MSE and DTI data were acquired from cords fixed and excised at 3 or 8weeks post injury using a solenoid coil. The MSE data were used to generate Myelin Water Fractions (MWFs) as a surrogate measure of myelin content, while DTI data were acquired to study damage to the axons. Myelin damage was assessed histologically with Eriochrome cyanine (EC) and Myelin Basic Protein in degenerated myelin (dgen-MBP) staining, and axonal damage was assessed by neurofilament-H in combination with neuron specific beta-III-tubulin (NF/Tub) staining. These MRI and histological measures of injury were studied in the dorsal column at 5mm cranial and 5mm caudal to injury epicenter. MWF increased significantly at 3weeks post-injury at both the cranial and caudal sites, relative to baseline. The values on the cranial side of injury returned to baseline at 8weeks post-injury but remained elevated on the caudal side. This trend was found in both in vivo and ex vivo data. This MWF increase was likely due to the presence of myelin debris, which were cleared by 8 weeks on the cranial, but not the caudal, side. Both EC and dgen-MBP stains displayed similar trends. MWF showed significant correlation with EC staining (R=0.63, p=0.005 in vivo and R=0.74, p=0.0001 ex vivo). MWF also correlated strongly with the dgen-MBP stain, but only on the cranial side (R=0.64, p=0.05 in vivo; R=0.63, p=0.038 ex vivo). This study demonstrates that longitudinal MWI in vivo can accurately characterize white matter damage in DC Tx model of injury

  20. Normal nerve-fibres in the distal segment of nerves completely separated from the proximal stump for more than six months

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    Eros Abrantes Erhart


    Full Text Available Our experimental and histopathological findings of normal nerve-fibres in the distal and intermediate segments of nerves completely separated from the proximal stump for more than six months differs from those of previous observers, and the application of our observations in surgical reconstruction of about one hundred human nerves, chiefly from the upper limb, has resulted in appreciably great degrees of success in most cases.

  1. A Case of Nonisland Pedicled Foot Fillet Flap for Below-Knee Amputation Stump Wound: Treatment Option for Compartment Syndrome after Fibular Free Flap Surgery


    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong


    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was ...

  2. Comparison the effect of stump closure by endoclips versus endoloop on the duration of surgery and complications in patients under laparoscopic appendectomy: A randomized clinical trial (United States)

    Sadat-Safavi, Seyed Abas; Nasiri, Shirzad; Shojaiefard, Abolfazl; Jafari, Mehdi; Abdehgah, Ali Ghorbani; Notash, Aidin Yghoobi; Soroush, Ahmadreza


    Background: Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, or other techniques. In this study, the effect of stump closure on duration of surgery and complications by endoclips was compared with endoloop in patients under laparoscopic appendectomy. The study was carried out as a prospective randomized clinical trial between 2013 and 2015 in Shariati Hospital of Tehran. Materials and Methods: Seventy-six patients under laparoscopic appendectomy were enrolled and randomly assigned to receive either endoclips or endoloop for stump closure. The results in terms of the operating time, length of hospital stay, and the complications were compared and analyzed between two groups. After collecting the essential data by using a checklist and examination of patients, the data were analyzed with SPSS. Results: The mean age was 23.13 ± 5.07 years and 44.7% of the patients were male. Moreover, in this study, it was seen that the mean duration of surgery was 23.2 min versus 21.5 min in endoloop and endoclips groups, respectively (P = 0.021). There was no difference between hospital stay among two groups (P > 0.05). Furthermore, the complications were same in two groups (P > 0.05). Conclusion: The effect of stump closure with endoloop versus endoclips is not different for complications, but the duration of surgery was shorter in endoclips method. Both methods could be used based on the opinion of the surgeon without expecting a statistically significant difference in the results. PMID:28163733

  3. Morphological study of Schwann cells remyelination in contused spinal cord of rats

    Institute of Scientific and Technical Information of China (English)

    LI Yue; ZHANG Lu; ZHANG Jie-yuan; LIU Zheng; DUAN Zhao-xia; LI Bing-cang


    Objective:To study the role and effect of Schwann cells (SCs) remyelination in contused spinal cord.Methods:Green fluorescence protein expressing-SCs were transplanted into the epicenter,rostral and caudal tissues of the injury site at 1 week after the spinal cords were contused.At 6 weeks,the spinal cords were removed for cryosections,semithin sections and ultrathin sections,and then immunocytochemical staining of myelin basic protein (MBP),P0 protein (P0) and S 100 protein (S100) was carried out on the cryosections.Qualitative and semiquantitative analyses were performed on the cryosections and semithin sections.Ultrastructure ofmyelinated fibers was observed on the ultrathin sections under electron microscope.Results:Transplanted SCs and myelinated fibers immunocytochemically labeled by MBP,P0 as well as S100 distributed in whole injured area.The quantity of myelinated fibers labeled by the three myelin proteins showed no statistical difference,however,which was significantly larger than that of controls.On the semithin sections,the experimental group demonstrated more myelinated fibers in the injured area than the controls,but the fibers had smaller diameter and thinner myelin sheath under electron microscope.Conclusion:SCs can promote regeneration of injured nerve fibers and enhance remyelination,which may be histological basis of SCs-mediated functional repair of injured spinal cords.

  4. Identification of QTL for dorso-caudal chronic pleuritis in 12 crossbred porcine families. (United States)

    Gregersen, V R; Sørensen, K K; Christensen, O F; Busch, M E; Vingborg, R K K; Velander, I H; Lund, M S; Bendixen, C


    Pleuropneumonia is a major problem in pig production. At the time of slaughter, chronic pleuritis (CP) developed from pleuropneumonia is a common finding, and breeding for a reduced incidence of CP using marker-assisted selection (MAS) would be advantageous. Before applying MAS, quantitative trait loci (QTL) or markers associated with the prevalence of CP should be identified. In this study, 7470 pigs from crosses between 12 Danish Duroc boars and 604 sows (Danish Landrace × Danish Large White) were evaluated for CP located on the dorso-caudal part of the lungs. Quantitative trait loci were identified within boar families using both a Binomial logistic regression method and a chi-square test of association. Significant QTL for CP were detected on Sus scrofa chromosomes (SSC) 2, 8, 12, 13, 14 and 18 using both methods. One QTL on SSC 8 was also detected across families. For the QTL identified within families, the odds-ratio of having CP was approximately twice as high for the unfavourable allele compared to the favourable one. These QTL and closely linked markers show promise for the development of gene-specific markers associated with a reduced incidence of CP located on the dorso-caudal part of the lungs.

  5. Development of the caudal exoskeleton of the pliomerid trilobite Hintzeia plicamarginis new species (United States)

    Simpson, A.G.; Hughes, N.C.; Kopaska-Merkel, D. C.; Ludvigsen, R.


    The later juvenile ontogeny of the caudal plate of the early Ordovician pliomerid trilobite Hintzeia plicamarginis new species likely comprised an initial phase during which the rate of appearance of new segments subterminally exceeded that of segment release into the thorax, a short phase of constant segment numbers, and a later phase during which release occurred but in which no new segments appeared. A distinct terminal region became manifest in the second phase. During the second and third phases growth coefficients for individual segments were about 1.1-1.2 per instar. Although the shapes of segments varied during growth, the pattern of ontogenetic shape change appears to have been broadly similar among segments. This suggests an homonomous trunk segment morphology regardless of thoracic or caudal identity in maturity. These results imply that control of trunk exoskeletal segment appearance and articulation were decoupled in this trilobite, and that the terminal region had a distinct mature morphology. H. plicamarginis is described as a new species. ?? Blackwell Publishing, Inc.

  6. Caudal duplication syndrome: imaging evaluation of a rare entity in an adult patient

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    Tianshen Hu, BS


    Full Text Available Several theories have been put forth to explain the complex yet symmetrical malformations and the myriad of clinical presentations of caudal duplication syndrome. Hereby, reported case is a 28-year-old female, gravida 2 para 2, with congenital caudal malformation who has undergone partial reconstructive surgeries in infancy to connect her 2 colons. She presented with recurrent left lower abdominal pain associated with nausea, vomiting, and subsequent feculent anal discharge. Imaging reveals duplication of the urinary bladder, urethra, and colon with with cloacal malformations and fistulae from the left-sided cloaca, uterus didelphys with separate cervices and vaginal canals, right-sided aortic arch and descending thoracic aorta, and dysraphic midline sacrococcygeal defect. Hydronephrosis of the left kidney with left hydroureter and inflammation of one of the colons were suspected to be the cause of the patient’s acute complaints. She improved symptomatically over the course of her hospitalization stay with conservative treatments. The management for this syndrome is individualized and may include surgical intervention to fuse or excise the duplicated organs.

  7. Medial prefrontal depressor response: involvement of the rostral and caudal ventrolateral medulla in the rat. (United States)

    Owens, N C; Verberne, A J


    The importance of neurones of the caudal and rostral ventrolateral medulla (CVLM and RVLM, respectively) in mediation of the medial prefrontal cortex depressor response was studied in halothane-anaesthetised rats. Blockade of GABA(A) receptors in the RVLM produced by microinjection of bicuculline (50 nl, 2 mM, n = 6) resulted in reversal of the depressor (-9.5 +/- 1.2 mm Hg) and lumbar sympathetic (-6.5 +/- 5.7 units) responses to pressor (+7.8 +/- 3.5 mm Hg) and sympathoexcitatory (+19.3 +/- 12.5 units) responses and simultaneous blockade of baroreceptor reflex-mediated sympathoinhibition. Baroreflex blockade was reflected by a significant reduction in the gain (slope of the blood pressure vs. lumbar sympathetic nerve discharge regression line) of the reflex. Microinjection of the excitatory amino acid antagonist kynurenic acid (100 nl, 50 mM, n = 6) into the CVLM blocked the baroreflex and significantly reduced the depressor (-9.6 +/- 0.4 to -6.9 +/- 0.6 mm Hg) and lumbar sympathetic (-4.0 +/- 2.1 to 2.9 +/- 1.9 units) responses to medial prefrontal cortex stimulation. These results support the hypothesis that the medial prefrontal cortex depressor response is mediated by a pathway which converges at the level of the RVLM and which is only partly dependent on an excitatory input to caudal ventrolateral medullary neurones.

  8. Caudal epidural analgesia using lidocaine alone or in combination with ketamine in dromedary camels (Camelus dromedarius

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    Omid Azari


    Full Text Available This study was performed to investigate the analgesic effect of lidocaine and a combination of lidocaine and ketamine following epidural administration in dromedary camels. Ten 12–18-month-old camels were randomly divided into two equal groups. In group L, the animals received 2% lidocaine (0.22 mg/kg and in group LK the animals received a mixture of 10% ketamine (1 mg/kg and 2% lidocaine (0.22 mg/kg administered into the first intercoccygeal (Co1–Co2 epidural space while standing. Onset time and duration of caudal analgesia, sedation level and ataxia were recorded after drug administration. Data were analysed by U Mann-Whitney tests and significance was taken as p < 0.05. The results showed that epidural lidocaine and co-administration of lidocaine and ketamine produced complete analgesia in the tail, anus and perineum. Epidural administration of the lidocaine-ketamine mixture resulted in mild to moderate sedation, whilst the animals that received epidural lidocaine alone were alert and nervous during the study. Ataxia was observed in all test subjects and was slightly more severe in camels that received the lidocaine-ketamine mixture. It was concluded that epidural administration of lidocaine plus ketamine resulted in longer caudal analgesia in standing conscious dromedary camels compared with the effect of administering lidocaine alone.


    Institute of Scientific and Technical Information of China (English)

    ZHANG Xi; SU Yu-min; WANG Zhao-li


    A comprehensive numerical simulation of the hydrodynamic performance of a caudal fin with unsymmetric flapping motion is carried out.The unsymmetrical motion is induced by adding a pitch bias or a heave bias.A numerical simulation program based on the unsteady panel method is developed to simulate the hydrodynamics of an unsymmetrical flapping caudal fin.A CFD code based on Navier-Stokes equations is used to analyze the flow field.Computational results of both the panel method and the CFD method indicate that the hydrodynamics are greatly affected by the pitch bias and the heave bias.The mean lateral force coefficient is not zero as in contrast with the symmetrical flapping motion.By increasing the pitch bias angle,the mean thrust force coefficient is reduced rapidly.By adding a heave bias,the hydrodynamic coefficients are separated as two parts:in one part,the amplitude is the heave amplitude plus the bias and in the other part,it is the heave amplitude minus the bias.Analysis of the flow field shows that the vortex distribution is not symmetrical,which generates the non-zero mean lateral force coefficient.

  10. Efficacy of clonidine as an adjuvant to bupivacaine for caudal analgesia in children undergoing sub-umbilical surgery

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    Aruna Parameswari


    Full Text Available Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. We evaluated the efficacy of clonidine added to bupivacaine in prolonging the analgesia produced by caudal bupivacaine in children undergoing sub-umbilical surgery. One hundred children, age one to three years, undergoing sub-umbilical surgery, were prospectively randomized to one of two groups: caudal analgesia with 1 ml/kg of 0.25% bupivacaine in normal saline (Group A or caudal analgesia with 1 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group B. Post-operative pain was assessed for 24 hours using the FLACC scale. The mean duration of analgesia was significantly longer in Group B (593.4 ± 423.3 min than in Group A (288.7 ± 259.1 min; P < 0.05. The pain score assessed using FLACC scale was compared between the two groups, and children in Group B had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group B. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects.

  11. Sirenomelia phenotype in bmp7;shh compound mutants: a novel experimental model for studies of caudal body malformations.

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    Carlos Garrido-Allepuz

    Full Text Available Sirenomelia is a severe congenital malformation of the lower body characterized by the fusion of the legs into a single lower limb. This striking external phenotype consistently associates severe visceral abnormalities, most commonly of the kidneys, intestine, and genitalia that generally make the condition lethal. Although the causes of sirenomelia remain unknown, clinical studies have yielded two major hypotheses: i a primary defect in the generation of caudal mesoderm, ii a primary vascular defect that leaves the caudal part of the embryo hypoperfused. Interestingly, Sirenomelia has been shown to have a genetic basis in mice, and although it has been considered a sporadic condition in humans, recently some possible familial cases have been reported. Here, we report that the removal of one or both functional alleles of Shh from the Bmp7-null background leads to a sirenomelia phenotype that faithfully replicates the constellation of external and internal malformations, typical of the human condition. These mutants represent an invaluable model in which we have analyzed the pathogenesis of sirenomelia. We show that the signaling defect predominantly impacts the morphogenesis of the hindgut and the development of the caudal end of the dorsal aortas. The deficient formation of ventral midline structures, including the interlimb mesoderm caudal to the umbilicus, leads to the approximation and merging of the hindlimb fields. Our study provides new insights for the understanding of the mechanisms resulting in caudal body malformations, including sirenomelia.

  12. Dinosaur speed demon: the caudal musculature of Carnotaurus sastrei and implications for the evolution of South American abelisaurids.

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    W Scott Persons

    Full Text Available In the South American abelisaurids Carnotaurus sastrei, Aucasaurus garridoi, and, to a lesser extent Skorpiovenator bustingorryi, the anterior caudal ribs project at a high dorsolateral inclination and have interlocking lateral tips. This unique morphology facilitated the expansion of the caudal hypaxial musculature at the expense of the epaxial musculature. Distinct ridges on the ventrolateral surfaces of the caudal ribs of Aucasaurus garridoi are interpreted as attachment scars from the intra caudofemoralis/ilio-ischiocaudalis septa, and confirm that the M. caudofemoralis of advanced South American abelisaurids originated from a portion of the caudal ribs. Digital muscle models indicate that, relative to its overall body size, Carnotaurus sastrei had a substantially larger M. caudofemoralis than any other theropod yet studied. In most non-avian theropods, as in many extant sauropsids, the M. caudofemoralis served as the primary femoral retractor muscle during the locomotive power stroke. This large investment in the M. caudofemoralis suggests that Carnotaurus sastrei had the potential for great cursorial abilities, particularly short-burst sprinting. However, the tightly interlocking morphology of the anterior caudal vertebrae implies a reduced ability to make tight turns. Examination of these vertebral traits in evolutionary context reveals a progressive sequence of increasing caudofemoral mass and tail rigidity among the Abelisauridae of South America.

  13. Differential diagnoses of spinal tumors; Differenzialdiagnose spinaler Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)


    A wide variety of degenerative, inflammatory and vascular diseases can resemble the clinical presentation and imaging findings of spinal tumors. This article provides an overview of the most frequent diseases which are important to recognize for diagnostic imaging of the spine. (orig.) [German] Eine Vielzahl degenerativer, entzuendlicher und vaskulaerer Erkrankungen kann das klinische Bild und radiologische Befunde spinaler Tumoren imitieren. Dieser Artikel dient der Uebersicht ueber die haeufigsten dieser Erkrankungen, deren Kenntnis wichtig fuer die spinale Bildgebung ist. (orig.)

  14. Imaging of Spinal Metastatic Disease

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    Lubdha M. Shah


    Full Text Available Metastases to the spine can involve the bone, epidural space, leptomeninges, and spinal cord. The spine is the third most common site for metastatic disease, following the lung and the liver. Approximately 60–70% of patients with systemic cancer will have spinal metastasis. Materials/Methods. This is a review of the imaging techniques and typical imaging appearances of spinal metastatic disease. Conclusions. Awareness of the different manifestations of spinal metastatic disease is essential as the spine is the most common site of osseous metastatic disease. Imaging modalities have complimentary roles in the evaluation of spinal metastatic disease. CT best delineates osseous integrity, while MRI is better at assessing soft tissue involvement. Physiologic properties, particularly in treated disease, can be evaluated with other imaging modalities such as FDG PET and advanced MRI sequences. Imaging plays a fundamental role in not only diagnosis but also treatment planning of spinal metastatic disease.

  15. Transverse myelitis following spinal anesthesia

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    Jha Sanjeev


    Full Text Available Spinal anesthesia is widely used during surgical procedures. It is generally safe and the frequency of severe, permanent neurological complications associated with it has been reported to be extremely low. We report a patient, who developed paraplegia following spinal anesthesia. A 29-year-old male was referred with acute, flaccid, sensory motor paraplegia, with bladder and bowel involvement. He developed this immediately after an operation for inguinal hernia under spinal anesthesia. Spinal magnetic resonance imaging revealed hemorrhagic myelitis in the conus at D12. He was referred after he did not respond to intravenous methylprednisolone for 10 days. This case brings up the difficulty encountered in determination of the interspace used for spinal anesthesia and the potential for traumatic injury to the spinal cord. It also demonstrates the tragic outcome after a clinician violates some important, standard and established guidelines.

  16. Spinal brucellosis: a review

    Energy Technology Data Exchange (ETDEWEB)

    Chelli Bouaziz, Mouna; Ladeb, Mohamed Fethi; Chakroun, Mohamed; Chaabane, Skander [Institut M T Kassab d' orthopedie, Department of Radiology, Ksar Said (Tunisia)


    Brucellosis is a zoonosis of worldwide distribution, relatively frequent in Mediterranean countries and in the Middle East. It is a systemic infection, caused by facultative intra-cellular bacteria of the genus Brucella, that can involve many organs and tissues. The spine is the most common site of musculoskeletal involvement, followed by the sacroiliac joints. The aim of this study was to assess the clinical, biological and imaging features of spinal brucellosis. (orig.)

  17. Spontaneous spinal epidural abscess.

    LENUS (Irish Health Repository)

    Ellanti, P


    Spinal epidural abscess is an uncommon entity, the frequency of which is increasing. They occur spontaneously or as a complication of intervention. The classical triad of fever, back pain and neurological symptoms are not always present. High index of suspicion is key to diagnosis. Any delay in diagnosis and treatment can have significant neurological consequences. We present the case of a previously well man with a one month history of back pain resulting from an epidural abscess.

  18. Aspergillus spinal epidural abscess

    Energy Technology Data Exchange (ETDEWEB)

    Byrd, B.F. III (Vanderbilt Univ. School of Medicine, Nashville, TN); Weiner, M.H.; McGee, Z.A.


    A spinal epidural abscess developed in a renal transplant recipient; results of a serum radioimmunoassay for Aspergillus antigen were positive. Laminectomy disclosed an abscess of the L4-5 interspace and L-5 vertebral body that contained hyphal forms and from which Aspergillus species was cultured. Serum Aspergillus antigen radioimmunoassay may be a valuable, specific early diagnostic test when systemic aspergillosis is a consideration in an immunosuppressed host.

  19. Two spinal arachnoid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Puijlaert, J.B.C.M.; Vielvoye, G.J.; Dulken, H. van


    Two cases of spinal arachnoid cysts are reported. One is extradurally located, the other intradurally. The first is only documented with myelography, the second also by subsequent CT scanning. Some clinical and diagnostic aspects of the lesion are discussed. The aim of this report is to add two new cases to the literature and to emphasize the role of high-resolution CT scanning in the diagnosis of these lesions.

  20. When two equals three: developmental osteology and homology of the caudal skeleton in carangid fishes (Perciformes: Carangidae). (United States)

    Hilton, Eric J; Johnson, G David


    Ontogeny often provides the most compelling evidence for primary homology in evolutionary developmental studies and is critical to interpreting complex structures in a phylogenetic context. As an example of this, we document the ontogenetic development of the caudal skeleton of Caranx crysos by examining a series of cleared and stained larval and postlarval specimens. By studying ontogeny, we are able to more accurately identify some elements of the adult caudal skeleton than is possible when studying the adult stage alone. The presence of two epurals has been used as a synapomorphy of Caranginae (homoplastically present in the scomberoidine genera Scomberoides and Oligoplites). Here we find that three epurals (ep) are present in larvae and small postlarval juveniles (i.e.,osteology of the caudal skeleton of carangoid fishes generally and emphasize the power and importance of ontogeny in the identification of primary homology.

  1. Pain following spinal cord injury



    The aims of this thesis were to assess and characterise nociceptive and neuropathic pain, the use of pharmacological and non-pharmacological pain treatment, and the influence of pain on the quality of sleep in a population following spinal cord injury (SCI). This thesis is divided into five separate studies: I. Pain in a Swedish spinal cord injury population. II. Gender related differences in pain in spinal cord injured individuals. III. Use of analgesic drugs in indi...

  2. [Information analysis of spinal ganglia]. (United States)

    Lobko, P I; Kovaleva, D V; Kovalchuk, I E; Pivchenko, P G; Rudenok, V V; Davydova, L A


    Information parameters (entropia and redundancy) of cervical and thoracic spinal ganglia of albino rat foetuses, mature animals (cat and dog) and human subjects were analysed. Information characteristics of spinal ganglia were shown to be level-specified and to depend on their functional peculiarities. Information parameters of thoracic spinal ganglia of man and different animals are specie specified and may be used in assessment of morphological structures as information systems.

  3. Spinal sensory circuits in motion



    International audience; The role of sensory feedback in shaping locomotion has been long debated. Recent advances in genetics and behavior analysis revealed the importance of proprioceptive pathways in spinal circuits. The mechanisms underlying peripheral mechanosensation enabled to unravel the networks that feedback to spinal circuits in order to modulate locomotion. Sensory inputs to the vertebrate spinal cord were long thought to originate from the periphery. Recent studies challenge this ...

  4. SDF1 in the dorsal corticospinal tract promotes CXCR4+ cell migration after spinal cord injury

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    Jung Hosung


    Full Text Available Abstract Background Stromal cell-derived factor-1 (SDF1 and its major signaling receptor, CXCR4, were initially described in the immune system; however, they are also expressed in the nervous system, including the spinal cord. After spinal cord injury, the blood brain barrier is compromised, opening the way for chemokine signaling between these two systems. These experiments clarified prior contradictory findings on normal expression of SDF1 and CXCR4 as well as examined the resulting spinal cord responses resulting from this signaling. Methods These experiments examined the expression and function of SDF1 and CXCR4 in the normal and injured adult mouse spinal cord primarily using CXCR4-EGFP and SDF1-EGFP transgenic reporter mice. Results In the uninjured spinal cord, SDF1 was expressed in the dorsal corticospinal tract (dCST as well as the meninges, whereas CXCR4 was found only in ependymal cells surrounding the central canal. After spinal cord injury (SCI, the pattern of SDF1 expression did not change rostral to the lesion but it disappeared from the degenerating dCST caudally. By contrast, CXCR4 expression changed dramatically after SCI. In addition to the CXCR4+ cells in the ependymal layer, numerous CXCR4+ cells appeared in the peripheral white matter and in the dorsal white matter localized between the dorsal corticospinal tract and the gray matter rostral to the lesion site. The non-ependymal CXCR4+ cells were found to be NG2+ and CD11b+ macrophages that presumably infiltrated through the broken blood-brain barrier. One population of macrophages appeared to be migrating towards the dCST that contains SDF1 rostral to the injury but not towards the caudal dCST in which SDF1 is no longer present. A second population of the CXCR4+ macrophages was present near the SDF1-expressing meningeal cells. Conclusions These observations suggest that attraction of CXCR4+ macrophages is part of a programmed response to injury and that modulation of the

  5. A comparative study of the effect of caudal dexmedetomidine versus morphine added to bupivacaine in pediatric infra-umbilical surgery

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    Hossam A El Shamaa


    Full Text Available Background: One of the most commonly used regional anesthetic techniques in pediatric surgeries is the caudal epidural block. Its main disadvantage remains the short duration of action. Hence, different additives have been used. Dexmedetomidine is a potent as well as highly selective α2 adrenergic receptor agonist. The aim of this randomized, double-blinded, study was to compare the duration of postoperative analgesia of caudal dexmedetomidine versus morphine in combination with bupivacaine in pediatric patients undergoing lower abdominal or perineal surgery. Patients and Methods: A total of 50 pediatric patients 1-5 years old The American Society of Anesthesiologists status I, II scheduled for lower abdominal and perineal surgeries were included in the study. The patients were enrolled into 2 equal groups: Group A patients (n = 25 received dexmedetomidine with bupivacaine while Group B patients (n = 25 received morphine with bupivacaine. Patients were placed in a supine position then inhalational general anesthesia was induced, and laryngeal mask airway (LMA was placed. Patients were then given caudal epidural analgesia. By the end of surgery reversal of muscle relaxation was done and the LMA was removed. Post-operatively, the sedation as well as pain score were observed and recorded. Results: The current study showed that minor complications were recorded in the post-anesthesia care unit; in addition, significantly longer periods of analgesia and sedation were detected in Group A. However, no significant differences in demographic data, as well as in the duration of surgery, and the time of emergence from anesthesia and patient condition during recovery were detected. Conclusion: The present study suggested that use of dexmedetomidine, during single dose injection, as an additive to the local anesthetic bupivacaine in caudal epidural analgesia prolongs the duration of post-operative analgesia following lower abdominal as well as perineal

  6. Linking bone development on the caudal aspect of the distal phalanx with lameness during life. (United States)

    Newsome, R; Green, M J; Bell, N J; Chagunda, M G G; Mason, C S; Rutland, C S; Sturrock, C J; Whay, H R; Huxley, J N


    Claw horn disruption lesions (CHDL; sole hemorrhage, sole ulcer, and white line disease) cause a large proportion of lameness in dairy cattle, yet their etiopathogenesis remains poorly understood. Untreated CHDL may be associated with damage to the internal anatomy of the foot, including to the caudal aspect of the distal phalanx upon which bone developments have been reported with age and with sole ulcers at slaughter. The primary aim of this study was to assess whether bone development was associated with poor locomotion and occurrence of CHDL during a cow's life. A retrospective cohort study imaged 282 hind claws from 72 Holstein-Friesian dairy cows culled from a research herd using X-ray micro-computed tomography (μ-CT; resolution: 0.11mm). Four measures of bone development were taken from the caudal aspect of each distal phalanx, in caudal, ventral, and dorsal directions, and combined within each claw. Cow-level variables were constructed to quantify the average bone development on all hind feet (BD-Ave) and bone development on the most severely affected claw (BD-Max). Weekly locomotion scores (1-5 scale) were available from first calving. The variables BD-Ave and BD-Max were used as outcomes in linear regression models; the explanatory variables included locomotion score during life, age, binary variables denoting lifetime occurrence of CHDL and of infectious causes of lameness, and other cow variables. Both BD-Max and BD-Ave increased with age, CHDL occurrence, and an increasing proportion of locomotion scores at which a cow was lame (score 4 or 5). The models estimated that BD-Max would be 9.8mm (SE 3.9) greater in cows that had been lame at >50% of scores within the 12mo before slaughter (compared with cows that had been assigned no lame scores during the same period), or 7.0mm (SE 2.2) greater if the cow had been treated for a CHDL during life (compared with cows that had not). Additionally, histology demonstrated that new bone development was osteoma


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND: Caudal epidural is one of the most popular reliable & safe technique mainly used for intra and post-op analgesia in pediatric patients undergoing infra umbilical surgeries. To prolong the duration of analgesia various adjuvants like epinephrine, opioids, ketamine, midazolam, tramadol, clonidine, were added to local anesthetic. The aim of this study was to evaluate the clinical efficacy and safety of CAUDAL administration of plain Ropivacaine 0.2% (1miligram/kilogram body weight with and without dexmedetomedine (2 microgram/kilogram body weight in children undergoing infraumbilical surgeries; in terms of quality of surgical anesthesia and the duration of post-operative analgesia.

  8. Histology of the rectus abdominis muscle in rats subjected to cranial and caudal devascularization Histologia do músculo reto do abdome de ratos submetidos à desvascularização cranial e caudal

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    Walder Costa


    Full Text Available PURPOSE: To investigate the microscopic changes in the rectus abdominis muscle in rats subjected to five delay procedure. METHODS: 30 male holtzmann rats, weighting between 250 and 350 grams, were used. The animals were divided into five groups (n=6: A - cranial section of the right muscle; B - caudal section of the right muscle; C - craniocaudal section of the right muscle; D - cranial section reflecting the right muscle in the craniocaudal direction; E - caudal section reflecting the right muscle in the caudocranial direction. On the seventh day after surgery, a resection of the cranial and caudal fragments of the right and left muscles, respectively, was performed for microscopic analysis. Histological alterations were quantified and the right and left (control muscle fragments compared. Fisher's exact test was used for statistical purposes with a significance level of 5%. RESULTS: The comparison between right and left muscles showed statistically significant differences in group A - inflammatory infiltrate in the cranial fragment (p=0.015; in group C - inflammatory infiltrate (p=0.000 and necrosis (p=0.015 in the caudal fragment; and in group E - edema in the caudal fragment (p=0.000. No significant alterations were noted in groups B and D. CONCLUSIONS: Irrigation exclusively through the perforating muscle vessels is inappropriate; irrigation exclusively through the cranial pedicle causes milder, insignificant histological alterations, when compared with irrigation exclusively through the caudal pedicle; irrigation exclusively through the caudal pedicle causes more pronounced, but still insignificant, histological alterations when compared with other forms of devascularization.OBJETIVO: Investigar as alterações microscópicas no músculo reto do abdome de ratos submetidos a cinco técnicas de autonomização. MÉTODOS: Utilizaram-se 30 ratos machos Holtzmann, pesando entre 250 e 350 gramas. Os animais foram distribuídos em cinco grupos (n

  9. 神经断端肌肉内埋入法治疗汶川地震截肢伤员痛性神经瘤%Treatment of painful stump neuroma by resection and nerve stump implantation into muscle in twelve Wenchuan earthquake amputees

    Institute of Scientific and Technical Information of China (English)

    何纯青; 赵正恩; 许猛; 张立海; 柳现飞; 唐佩福


    目的:探讨神经断端肌肉内埋入法治疗地震伤截肢残端痛性神经瘤的临床疗效.方法:应用神经断端肌肉内埋入法治疗汶川地震伤截肢伤员痛性神经瘤12例27处,观察术后症状、体征及患肢功能改变情况.结果:12例全部获随访12~26个月,平均16个月.随访时患者主诉肢体残端疼痛和触电感消失;局部无压痛、叩击痛和Tinel征,残端软组织内未触及硬性结节或包块;患肢功能较术前明显改善.结论:采用神经断端肌肉内埋入法治疗地震伤截肢残端痛性神经瘤,可减轻痛苦,疗效确切.%Objective To investigate the clinical efficacy of a painful stump neuroma treatment by resection and nerve stump implantation into muscle in treating Wenchuan earthquake amputees. Methods In 12 Wenchuan earthquake amputees (27 painful neuromas), painful neuroma underwent resection and implantation into the nearby muscle. Changes of symptoms and limb function were observed. Results All the cases were followed up for 12 -26 months with an average of 16 months. It was shown that limb stump pain and “electric -shock” sensation disappeared without any local tenderness, percussion tenderness or Tinel sign. The soft tissue nodule or mass of limb stump disappeared. Limb function improved, compared with preoperative evaluation. Conclusions Pesection and nerve stump implantation into muscle is a feasible and effective method for treatment of painful stump neuroma after amputation.

  10. Medicolegal cases for spinal epidural hematoma and spinal epidural abscess. (United States)

    French, Keisha L; Daniels, Eldra W; Ahn, Uri M; Ahn, Nicholas U


    Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider. The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control. All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases.

  11. Poly-lactic acid and agarose gelatin play an active role in the recovery of spinal cord injury

    Institute of Scientific and Technical Information of China (English)


    Objective To investigate the role of poly-lactic acid and agarose gelatin in promoting the functional recovery of the injured spinal cord. Methods Poly-lactic acid (PLA) or agarose was embedded in the space between two stumps of the hemisectioned spinal cord. Immunohistochemistry was used to show astroglia proliferation and the infiltration of RhoA-positive cells. Locomotor activity recovery was evaluated by testing the function of hindlimbs. Results Astroglias and RhoA labeled non-neuronal cells accumulated in the area adjacent to the implant, while the number of RhoA-positive cells was decreased dramatically in the absence of implant. Animals implanted with agarose gelatin recovered more quickly than those with PLA, concomitant with a higher survival rate of the neurons. Conclusion Both PLA and agarose gelatin benefited the recovery of spinal cord after injury by providing a scaffold for astroglia processes. Modulation of the rigidity, pore size and inner structure of PLA and agarose gelatin might make these biodegradable materials more effective in the regeneration of the central nervous system (CNS).

  12. Electrode alignment of transverse tripoles using a percutaneous triple-lead approach in spinal cord stimulation (United States)

    Sankarasubramanian, V.; Buitenweg, J. R.; Holsheimer, J.; Veltink, P.


    The aim of this modeling study is to determine the influence of electrode alignment of transverse tripoles on the paresthesia coverage of the pain area in spinal cord stimulation, using a percutaneous triple-lead approach. Transverse tripoles, comprising a central cathode and two lateral anodes, were modeled on the low-thoracic vertebral region (T10-T12) using percutaneous triple-lead configurations, with the center lead on the spinal cord midline. The triple leads were oriented both aligned and staggered. In the staggered configuration, the anodes were offset either caudally (caudally staggered) or rostrally (rostrally staggered) with respect to the midline cathode. The transverse tripolar field steering with the aligned and staggered configurations enabled the estimation of dorsal column fiber thresholds (IDC) and dorsal root fiber thresholds (IDR) at various anodal current ratios. IDC and IDR were considerably higher for the aligned transverse tripoles as compared to the staggered transverse tripoles. The aligned transverse tripoles facilitated deeper penetration into the medial dorsal columns (DCs). The staggered transverse tripoles always enabled broad and bilateral DC activation, at the expense of mediolateral steerability. The largest DC recruited area was obtained with the rostrally staggered transverse tripole. Transverse tripolar geometries, using percutaneous leads, allow for selective targeting of either medial or lateral DC fibers, if and only if the transverse tripole is aligned. Steering of anodal currents between the lateral leads of the staggered transverse tripoles cannot target medially confined populations of DC fibers in the spinal cord. An aligned transverse tripolar configuration is strongly recommended, because of its ability to provide more post-operative flexibility than other configurations.

  13. BDNF promotes connections of corticospinal neurons onto spared descending interneurons in spinal cord injured rats. (United States)

    Vavrek, R; Girgis, J; Tetzlaff, W; Hiebert, G W; Fouad, K


    Although regeneration of injured axons is inhibited within the adult CNS, moderate recovery can be found in patients and animals with incomplete spinal cord injury (SCI). This can be partly attributed to sprouting of spared and injured axons, rostral and caudal to the lesion, respectively. Recently, it has been reported that following a thoracic SCI such sprouting can result in indirect reconnections of the lesioned axons to caudal targets via propriospinal interneurons (PrI). Here, we attempted to further promote this spontaneous repair mechanism by applying the neurotrophic factor BDNF (brain-derived neurotrophic factor), in the vicinity of the cell bodies of lesioned corticospinal neurons or NT-3, intrathecally to the cervical spinal cord. We performed a dorsal over-hemisection at the thoracic spinal cord sparing only the left ventrolateral quadrant. This type of lesion did not promote sprouting of injured corticospinal axons or re-routing via commissural PrI. Also, in rats that received NT-3 at the cervical enlargement, no increase in sprouting was found. However, animals receiving BDNF at the cell bodies of lesioned corticospinal neurons showed a significant increase in collateral sprouting and in the number of contacts with PrI. This was not observed when BDNF was administered to unlesioned animals. Although no statistical difference in the horizontal ladder walking was found between the groups, the increase in collateral sprouting and in the number of contacts correlated with the functional recovery. Hence, cell body treatment can promote plasticity of the injured CNS and may be a valuable treatment approach in conjunction with local regeneration promoting strategies.

  14. Effect of Age, Adernaline and Operation Site on Duration of Caudal Analgesia in Paediatric Patients

    Directory of Open Access Journals (Sweden)

    Kharirat Mohd., Yasir,G.A.Mir


    Full Text Available The effect ofage, operative site and addition of 1: 200,000 adrenaline to bupivacaine was evaluatedon the duration ofpost operative analgesia after caudal block in 200 children between the age groupof 1 year to 14 years. Anaesthesia was induced and maintained on Halothane/N20I02• After thiscaudal block was performed with 0.5 mllkg of0.25% bupivacaine in one group of 100 Children andwith 0.25% bupivacaine with adrenaline 1 : 200,000 in another 100 children. The duration of postoperative analgesia was noted to be significantly longer in young children, in children having penoscrotaloperations and when adrenaline was added to bupivacaine. Conclusion was drawn that durationofpost-operative analgesia depended upon age, site and addition of adrenaline to bupivacaine.

  15. Caudal epidural analgesia using lidocaine alone or in combination with ketamine in dromedary camels Camelus dromedarius. (United States)

    Azari, Omid; Molaei, Mohammad M; Ehsani, Amir H


    This study was performed to investigate the analgesic effect of lidocaine and a combination of lidocaine and ketamine following epidural administration in dromedary camels. Ten 12-18-month-old camels were randomly divided into two equal groups. In group L, the animals received 2% lidocaine (0.22 mg/kg) and in group LK the animals received a mixture of 10% ketamine (1 mg/kg) and 2% lidocaine (0.22 mg/kg) administered into the first intercoccygeal (Co1-Co2) epidural space while standing. Onset time and duration of caudal analgesia, sedation level and ataxia were recorded after drug administration. Data were analysed by U Mann-Whitney tests and significance was taken as p dromedary camels compared with the effect of administering lidocaine alone.

  16. Corticotrigeminal Projections from the Insular Cortex to the Trigeminal Caudal Subnucleus Regulate Orofacial Pain after Nerve Injury via Extracellular Signal-Regulated Kinase Activation in Insular Cortex Neurons. (United States)

    Wang, Jian; Li, Zhi-Hua; Feng, Ban; Zhang, Ting; Zhang, Han; Li, Hui; Chen, Tao; Cui, Jing; Zang, Wei-Dong; Li, Yun-Qing


    Cortical neuroplasticity alterations are implicated in the pathophysiology of chronic orofacial pain. However, the relationship between critical cortex excitability and orofacial pain maintenance has not been fully elucidated. We recently demonstrated a top-down corticospinal descending pain modulation pathway from the anterior cingulate cortex (ACC) to the spinal dorsal horn that could directly regulate nociceptive transmission. Thus, we aimed to investigate possible corticotrigeminal connections that directly influence orofacial nociception in rats. Infraorbital nerve chronic constriction injury (IoN-CCI) induced significant orofacial nociceptive behaviors as well as pain-related negative emotions such as anxiety/depression in rats. By combining retrograde and anterograde tract tracing, we found powerful evidence that the trigeminal caudal subnucleus (Vc), especially the superficial laminae (I/II), received direct descending projections from granular and dysgranular parts of the insular cortex (IC). Extracellular signal-regulated kinase (ERK), an important signaling molecule involved in neuroplasticity, was significantly activated in the IC following IoN-CCI. Moreover, in IC slices from IoN-CCI rats, U0126, an inhibitor of ERK activation, decreased both the amplitude and the frequency of spontaneous excitatory postsynaptic currents (sEPSCs) and reduced the paired-pulse ratio (PPR) of Vc-projecting neurons. Additionally, U0126 also reduced the number of action potentials in the Vc-projecting neurons. Finally, intra-IC infusion of U0126 obviously decreased Fos expression in the Vc, accompanied by the alleviation of both nociceptive behavior and negative emotions. Thus, the corticotrigeminal descending pathway from the IC to the Vc could directly regulate orofacial pain, and ERK deactivation in the IC could effectively alleviate neuropathic pain as well as pain-related negative emotions in IoN-CCI rats, probably through this top-down pathway. These findings may help

  17. Metals and organochlorine pesticides in caudal scutes of crocodiles from Belize and Costa Rica. (United States)

    Rainwater, Thomas R; Wu, Ted H; Finger, Adam G; Cañas, Jaclyn E; Yu, Lu; Reynolds, Kevin D; Coimbatore, Gopal; Barr, Brady; Platt, Steven G; Cobb, George P; Anderson, Todd A; McMurry, Scott T


    Despite high animal diversity in the Neotropics and the largely unregulated use and disposal of pesticides and industrial chemicals in Central America, few data exist regarding accumulation of environmental contaminants in Central American wildlife. In this study we examined accumulation of metals and organochlorine (OC) pesticides in caudal scutes of crocodiles from Belize and Costa Rica. Scutes from Morelet's crocodiles (Crocodylus moreletii) from two sites in northern Belize were analyzed for metals, and scutes from American crocodiles (C. acutus) from one site in Costa Rica were analyzed for metals and OC pesticides. All scutes (n=25; one scute from each of 25 individuals) contained multiple contaminants. Mercury was the predominant metal detected, occurring in all scutes examined from both species. Other metals detected include cadmium, copper, lead, and zinc. American crocodile scutes from Costa Rica contained multiple OC pesticides, including endrin, methoxychlor, p,p'-DDE, and p,p'-DDT, all of which occurred in 100% of scutes analyzed (n=6). Mean metal and OC concentrations varied in relation to those previously reported in crocodilian scutes from other localities in North, Central, and South America. OC concentrations in American crocodile scutes were generally higher than those previously reported for other Costa Rican wildlife. Currently, caudal scutes may serve as general, non-lethal indicators of contaminant accumulation in crocodilians and their areas of occurrence. However, a better understanding of the relationships between pollutant concentrations in scutes, internal tissues, and environmental matrices at sample collection sites are needed to improve the utility of scutes in future ecotoxicological investigations.

  18. β-catenin regulates Pax3 and Cdx2 for caudal neural tube closure and elongation. (United States)

    Zhao, Tianyu; Gan, Qini; Stokes, Arjun; Lassiter, Rhonda N T; Wang, Yongping; Chan, Jason; Han, Jane X; Pleasure, David E; Epstein, Jonathan A; Zhou, Chengji J


    Non-canonical Wnt/planar cell polarity (PCP) signaling plays a primary role in the convergent extension that drives neural tube closure and body axis elongation. PCP signaling gene mutations cause severe neural tube defects (NTDs). However, the role of canonical Wnt/β-catenin signaling in neural tube closure and NTDs remains poorly understood. This study shows that conditional gene targeting of β-catenin in the dorsal neural folds of mouse embryos represses the expression of the homeobox-containing genes Pax3 and Cdx2 at the dorsal posterior neuropore (PNP), and subsequently diminishes the expression of the Wnt/β-catenin signaling target genes T, Tbx6 and Fgf8 at the tail bud, leading to spina bifida aperta, caudal axis bending and tail truncation. We demonstrate that Pax3 and Cdx2 are novel downstream targets of Wnt/β-catenin signaling. Transgenic activation of Pax3 cDNA can rescue the closure defect in the β-catenin mutants, suggesting that Pax3 is a key downstream effector of β-catenin signaling in the PNP closure process. Cdx2 is known to be crucial in posterior axis elongation and in neural tube closure. We found that Cdx2 expression is also repressed in the dorsal PNPs of Pax3-null embryos. However, the ectopically activated Pax3 in the β-catenin mutants cannot restore Cdx2 mRNA in the dorsal PNP, suggesting that the presence of both β-catenin and Pax3 is required for regional Cdx2 expression. Thus, β-catenin signaling is required for caudal neural tube closure and elongation, acting through the transcriptional regulation of key target genes in the PNP.

  19. Metals and organochlorine pesticides in caudal scutes of crocodiles from Belize and Costa Rica

    Energy Technology Data Exchange (ETDEWEB)

    Rainwater, Thomas R. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States)]. E-mail:; Wu, Ted H. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); Finger, Adam G. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); Canas, Jaclyn E. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); Yu Lu [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); Reynolds, Kevin D. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); Coimbatore, Gopal [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); Barr, Brady [National Geographic Channel, 1145 17th St. NW Washington, DC 20036 (United States); Platt, Steven G. [Department of Biology, Box C-64, Sul Ross State University, Alpine, TX 79832 (United States); Cobb, George P. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); Anderson, Todd A. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States); McMurry, Scott T. [Institute of Environmental and Human Health, Department of Environmental Toxicology, Texas Tech University, Lubbock, TX 79409 (United States)


    Despite high animal diversity in the Neotropics and the largely unregulated use and disposal of pesticides and industrial chemicals in Central America, few data exist regarding accumulation of environmental contaminants in Central American wildlife. In this study we examined accumulation of metals and organochlorine (OC) pesticides in caudal scutes of crocodiles from Belize and Costa Rica. Scutes from Morelet's crocodiles (Crocodylus moreletii) from two sites in northern Belize were analyzed for metals, and scutes from American crocodiles (C. acutus) from one site in Costa Rica were analyzed for metals and OC pesticides. All scutes (n = 25; one scute from each of 25 individuals) contained multiple contaminants. Mercury was the predominant metal detected, occurring in all scutes examined from both species. Other metals detected include cadmium, copper, lead, and zinc. American crocodile scutes from Costa Rica contained multiple OC pesticides, including endrin, methoxychlor, p,p'-DDE, and p,p'-DDT, all of which occurred in 100% of scutes analyzed (n = 6). Mean metal and OC concentrations varied in relation to those previously reported in crocodilian scutes from other localities in North, Central, and South America. OC concentrations in American crocodile scutes were generally higher than those previously reported for other Costa Rican wildlife. Currently, caudal scutes may serve as general, non-lethal indicators of contaminant accumulation in crocodilians and their areas of occurrence. However, a better understanding of the relationships between pollutant concentrations in scutes, internal tissues, and environmental matrices at sample collection sites are needed to improve the utility of scutes in future ecotoxicological investigations.

  20. Biomarkers in spinal cord injury.

    NARCIS (Netherlands)

    Pouw, M.H.; Hosman, A.J.F.; Middendorp, J.J. van; Verbeek, M.M.; Vos, P.E.; Meent, H. van de


    STUDY DESIGN: Literature review. OBJECTIVES: In traumatic spinal cord injury (SCI), much effort has been put into the evaluation of SCI severity and the prediction of recovery potential. An accurate prediction of the initial damage of the spinal cord that differentiates between the severities of SCI

  1. Surgical Treatment of a Patient with Human Tail and Multiple Abnormalities of the Spinal Cord and Column

    Directory of Open Access Journals (Sweden)

    Chunquan Cai


    Full Text Available The dorsal cutaneous appendage, or so-called human tail, is often considered to be a cutaneous marker of underlying occult dysraphism. The authors present a case of human tail occurring in a 9-month-old infant with multiple abnormalities of the spinal cord and spine. Examination revealed unremarkable except for a caudal appendage and a dark pigmentation area in the low back. Neuroradiological scans revealed cleft vertebrae and bifid ribbon, split cord malformations, block vertebrae, and hemivertebra. Surgical excision of the tail and untethering the spinal cord by removal of the septum were performed. The infant had an uneventful postoperative period and was unchanged neurologically for 18 months of followup. To our knowledge, no similar case reports exist in the literature. The specific features in a rare case with a human tail treated surgically are discussed in light of the available literature.

  2. Morphological and electrophysiological evidence for regeneration of transected spinal cord fibers and restoration of motor functions in adult rats

    Institute of Scientific and Technical Information of China (English)


    After 2/3 transection of the right ninth thoracic spinal cord of an adult rat, a chitosan tube seeded with L-poly-lysine was implanted between the rostral and caudal end of the lesioned cord. Twelve months after the operation, regeneration of myelinated and non-myelinated axons and new blood vessels were observed along the wall of the chitosan tube implanted under an electron microscope. Somatosensory evoked potentials (SEP) could be consistently recorded from the left somatosensory cortex following electrical stimulation of the right hind limb, while transcranial magnetic stimulation of the left motor cortex could also evoke motor activity from the right hind limb. The present result suggests that implanted chitosan tube might be useful in regeneration of injured nerve fibers of the spinal cord resulting in a long-term restoration of motor functions.

  3. In vitro and in vivo responses of saccular and caudal nucleus neurons in the grassfrog (Rana temporaria)

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, J; Walkowiak, W


    We present results from in vitro and in vivo studies of response properties of neurons in the saccular and caudal nuclei in the frog. In the in vitro studies the saccular nerve of the isolated brain was stimulated with electrical pulses. In the in vivo experiments, the neurons were stimulated by ...


    Directory of Open Access Journals (Sweden)

    Dilip Kumar


    Full Text Available Caudal epidural analgesia with bupivacaine is common in paediatric anaesthesia for providing intra and postoperative analgesia. But duration of analgesia even with bupivacaine; long acting anaesthetic is short only 4-6hrs. Hence, several adjuvants have been tried to prolong the duration of action of bupivacaine. We evaluated the efficacy of clonidine added to bupivacaine in prolonging the analgesic effect provided by caudal bupivacaine in children undergoing infra-umbilical surgery. Forty children, aged one to seven years, American Society of Anaesthesiologists (ASA Grade I/II, undergoing infra-umbilical surgery, were included in prospective randomized double blind study to one of two groups: caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine in normal saline (Group A or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group B. Post-operative pain was assessed for 24 hours using the Objective Pain Scale (OPS. The mean duration of analgesia was significantly longer in Group B (10.2 Hrs. than in Group A (4.2 1Hrs; P0.05. The requirement of rescue medicine was lesser in Group B. Clonidine as an adjunct to bupivacaine prolongs the post-operative pain relief in children and is safe compared to bupivacaine alone in paediatric infra umbilical surgeries.

  5. Pitch Variability in Patients with Parkinson's Disease: Effects of Deep Brain Stimulation of Caudal Zona Incerta and Subthalamic Nucleus (United States)

    Karlsson, Fredrik; Olofsson, Katarina; Blomstedt, Patric; Linder, Jan; van Doorn, Jan


    Purpose: The purpose of the present study was to examine the effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the caudal zona incerta (cZi) pitch characteristics of connected speech in patients with Parkinson's disease (PD). Method: The authors evaluated 16 patients preoperatively and 12 months after DBS surgery. Eight…

  6. Noradrenergic inhibitory modulation in the caudal commissural NTS of the pressor response to chemoreflex activation in awake rats. (United States)

    Silva de Oliveira, Luciana C; Bonagamba, Leni G H; Machado, Benedito H


    In the present study we evaluated the possible modulatory role of noradrenaline on the neurotransmission of the peripheral chemoreflex afferents in the caudal commissural NTS of awake rats. To reach this goal we performed a dose-response curve to microinjection of increasing dose of noradrenaline into the caudal commissural NTS of awake rats and then the threshold dose, which produces minor changes in the baseline mean arterial pressure, was selected to be used in the chemoreflex experiment. The peripheral chemoreflex was activated with KCN before and after bilateral microinjections of noradrenaline (5 nMol/50 nL, threshold dose) into the NTS. The data show that microinjection of noradrenaline into the caudal NTS produced a significant reduction in the pressor response to the chemoreflex 30 s after the injection when compared to the control response (30+/-6 vs. 49+/-3 mm Hg) but no significant changes in the bradycardic response. The data indicate that noradrenaline in the caudal commissural NTS of awake rats may play an important inhibitory neuromodulatory role on the processing of the pressor/sympathoexcitatory component of the chemoreflex.

  7. Retraining the injured spinal cord (United States)

    Edgerton, V. R.; Leon, R. D.; Harkema, S. J.; Hodgson, J. A.; London, N.; Reinkensmeyer, D. J.; Roy, R. R.; Talmadge, R. J.; Tillakaratne, N. J.; Timoszyk, W.; Tobin, A.


    The present review presents a series of concepts that may be useful in developing rehabilitative strategies to enhance recovery of posture and locomotion following spinal cord injury. First, the loss of supraspinal input results in a marked change in the functional efficacy of the remaining synapses and neurons of intraspinal and peripheral afferent (dorsal root ganglion) origin. Second, following a complete transection the lumbrosacral spinal cord can recover greater levels of motor performance if it has been exposed to the afferent and intraspinal activation patterns that are associated with standing and stepping. Third, the spinal cord can more readily reacquire the ability to stand and step following spinal cord transection with repetitive exposure to standing and stepping. Fourth, robotic assistive devices can be used to guide the kinematics of the limbs and thus expose the spinal cord to the new normal activity patterns associated with a particular motor task following spinal cord injury. In addition, such robotic assistive devices can provide immediate quantification of the limb kinematics. Fifth, the behavioural and physiological effects of spinal cord transection are reflected in adaptations in most, if not all, neurotransmitter systems in the lumbosacral spinal cord. Evidence is presented that both the GABAergic and glycinergic inhibitory systems are up-regulated following complete spinal cord transection and that step training results in some aspects of these transmitter systems being down-regulated towards control levels. These concepts and observations demonstrate that (a) the spinal cord can interpret complex afferent information and generate the appropriate motor task; and (b) motor ability can be defined to a large degree by training.

  8. Different phase delays of peripheral input to primate motor cortex and spinal cord promote cancellation at physiological tremor frequencies. (United States)

    Koželj, Saša; Baker, Stuart N


    Neurons in the spinal cord and motor cortex (M1) are partially phase-locked to cycles of physiological tremor, but with opposite phases. Convergence of spinal and cortical activity onto motoneurons may thus produce phase cancellation and a reduction in tremor amplitude. The mechanisms underlying this phase difference are unknown. We investigated coherence between spinal and M1 activity with sensory input. In two anesthetized monkeys, we electrically stimulated the medial, ulnar, deep radial, and superficial radial nerves; stimuli were timed as independent Poisson processes (rate 10 Hz). Single units were recorded from M1 (147 cells) or cervical spinal cord (61 cells). Ninety M1 cells were antidromically identified as pyramidal tract neurons (PTNs); M1 neurons were additionally classified according to M1 subdivision (rostral/caudal, M1r/c). Spike-stimulus coherence analysis revealed significant coupling over a broad range of frequencies, with the strongest coherence at <50 Hz. Delays implied by the slope of the coherence phase-frequency relationship were greater than the response onset latency, reflecting the importance of late response components for the transmission of oscillatory inputs. The spike-stimulus coherence phase over the 6-13 Hz physiological tremor band differed significantly between M1 and spinal cells (phase differences relative to the cord of 2.72 ± 0.29 and 1.72 ± 0.37 radians for PTNs from M1c and M1r, respectively). We conclude that different phases of the response to peripheral input could partially underlie antiphase M1 and spinal cord activity during motor behavior. The coordinated action of spinal and cortical feedback will act to reduce tremulous oscillations, possibly improving the overall stability and precision of motor control.

  9. Spatial and temporal activation of spinal glial cells: role of gliopathy in central neuropathic pain following spinal cord injury in rats. (United States)

    Gwak, Young S; Kang, Jonghoon; Unabia, Geda C; Hulsebosch, Claire E


    In the spinal cord, neuron and glial cells actively interact and contribute to neurofunction. Surprisingly, both cell types have similar receptors, transporters and ion channels and also produce similar neurotransmitters and cytokines. The neuroanatomical and neurochemical similarities work synergistically to maintain physiological homeostasis in the normal spinal cord. However, in trauma or disease states, spinal glia become activated, dorsal horn neurons become hyperexcitable contributing to sensitized neuronal-glial circuits. The maladaptive spinal circuits directly affect synaptic excitability, including activation of intracellular downstream cascades that result in enhanced evoked and spontaneous activity in dorsal horn neurons with the result that abnormal pain syndromes develop. Recent literature reported that spinal cord injury produces glial activation in the dorsal horn; however, the majority of glial activation studies after SCI have focused on transient and/or acute time points, from a few hours to 1 month, and peri-lesion sites, a few millimeters rostral and caudal to the lesion site. In addition, thoracic spinal cord injury produces activation of astrocytes and microglia that contributes to dorsal horn neuronal hyperexcitability and central neuropathic pain in above-level, at-level and below-level segments remote from the lesion in the spinal cord. The cellular and molecular events of glial activation are not simple events, rather they are the consequence of a combination of several neurochemical and neurophysiological changes following SCI. The ionic imbalances, neuroinflammation and alterations of cell cycle proteins after SCI are predominant components for neuroanatomical and neurochemical changes that result in glial activation. More importantly, SCI induced release of glutamate, proinflammatory cytokines, ATP, reactive oxygen species (ROS) and neurotrophic factors trigger activation of postsynaptic neuron and glial cells via their own receptors


    Directory of Open Access Journals (Sweden)

    Mukhergee G. S


    Full Text Available BACKGROUND Spinal stenosis is one of the most common conditions in the elderly. It is defined as a narrowing of the spinal canal. The term stenosis is derived from the Greek word for narrow, which is “Stenos”. The first description of this condition is attributed to Antoine portal in 1803. Verbiest is credited with coining the term spinal stenosis and the associated narrowing of the spinal canal as its potential cause. [1-10] Kirkaldy–Willis subsequently described the degenerative cascade in the lumbar spine as the cause for the altered anatomy and pathophysiology in spinal stenosis. [11-15] If compression does not occur, the canal should be described as narrow but not stenotic. Some studies defined lumbar spinal stenosis as a “narrowing of the osteoligamentous vertebral canal and/or the intervertebral foramina causing compression of the thecal sac and/or the caudal nerve roots; at a single vertebral level, narrowing may affect the whole canal or part of it” (Postacchini 1983. This definition distinguished between disc herniation and stenosis. [16] . The most common type of spinal stenosis is caused by degenerative arthritis of the spine. Hypertrophy and ossification of the posterior longitudinal ligament which usually are confined to the cervical spine, and diffuse idiopathic skeletal hyperostosis (DISH syndrome also may result in an acquired form of spinal stenosis. Congenital forms caused by disorders such as achondroplasia and dysplastic spondylolisthesis are much less common. Congenital spinal stenosis usually is central and is evident or imaging studies. Idiopathic congenital narrowing usually involves the anteroposterior dimension of the canal secondary to short pedicles; the patient otherwise is normal. In contrast, in achondroplasia, the canal is narrowed in the anteroposterior plane owing to shortened pedicles and in lateral dimension because of diminished interpedicular distance. Acquired forms of spinal stenosis usually are

  11. Recovering missing data: estimating position and size of caudal vertebrae in Staurikosaurus pricei Colbert, 1970

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    Orlando N. Grillo


    Full Text Available Missing data is a common problem in paleontology. It makes it difficult to reconstruct extinct taxa accurately and restrains the inclusion of some taxa on comparative and biomechanical studies. Particularly, estimating the position of vertebrae on incomplete series is often non-empirical and does not allow precise estimation of missing parts. In this work we present a method for calculating the position of preserved middle sequences of caudal vertebrae in the saurischian dinosaur Staurikosaurus pricei, based on the length and height of preserved anterior and posterior caudal vertebral centra. Regression equations were used to estimate these dimensions for middle vertebrae and, consequently, to assess the position of the preserved middle sequences. It also allowed estimating these dimensions for non-preserved vertebrae. Results indicate that the preserved caudal vertebrae of Staurikosaurus may correspond to positions 1-3, 5, 7, 14-19/15-20, 24-25/25-26, and 29-47, and that at least 25 vertebrae had transverse processes. Total length of the tail was estimated in 134 cm and total body length was 220-225 cm.Dados lacunares são um problema comum na paleontologia. Eles dificultam a reconstrução acurada de táxons extintos e limitam a inclusão de alguns táxons em estudos comparativose biomecânicos. Particularmente, estimar a posição de vértebras em séries incompletas tem sido feito com base em métodos não empíricos que não permitem estimar corretamente as partes ausentes. Neste trabalho apresentamos uma metodologia que permite estimar a posição de sequências médias preservadas de vértebras caudais no dinossauro saurísquio Staurikosaurus pricei, com base no comprimento e altura dos centros das vértebras anteriores e posteriores preservadas. Equações de regressão foram usadas para estimar essas dimensões para as vértebras médias e, consequentemente, para posicionar as sequências médias preservadas e para estimar o tamanho das

  12. Pathological changes in the white matter after spinal contusion injury in the rat.

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    C Joakim Ek

    Full Text Available It has been shown previously that after spinal cord injury, the loss of grey matter is relatively faster than loss of white matter suggesting interventions to save white matter tracts offer better therapeutic possibilities. Loss of white matter in and around the injury site is believed to be the main underlying cause for the subsequent loss of neurological functions. In this study we used a series of techniques, including estimations of the number of axons with pathology, immunohistochemistry and mapping of distribution of pathological axons, to better understand the temporal and spatial pathological events in white matter following contusion injury to the rat spinal cord. There was an initial rapid loss of axons with no detectable further loss beyond 1 week after injury. Immunoreactivity for CNPase indicated that changes to oligodendrocytes are rapid, extending to several millimetres away from injury site and preceding much of the axonal loss, giving early prediction of the final volume of white matter that survived. It seems that in juvenile rats the myelination of axons in white matter tracts continues for some time, which has an important bearing on interpretation of our, and previous, studies. The amount of myelin debris and axon pathology progressively decreased with time but could still be observed at 10 weeks after injury, especially at more distant rostral and caudal levels from the injury site. This study provides new methods to assess injuries to spinal cord and indicates that early interventions are needed for the successful sparing of white matter tracts following injury.

  13. Projections from the lateral vestibular nucleus to the spinal cord in the mouse. (United States)

    Liang, Huazheng; Bácskai, Timea; Watson, Charles; Paxinos, George


    The present study investigated the projections from the lateral vestibular nucleus (LVe) to the spinal cord using retrograde and anterograde tracers. Retrogradely labeled neurons were found after fluoro-gold injections into both the cervical and lumbar cord, with a smaller number of labeled neurons seen after lumbar cord injections. Labeled neurons in the LVe were found in clusters at caudal levels of the nucleus, and a small gap separated these clusters from labeled neurons in the spinal vestibular nucleus (SpVe). In the anterograde study, BDA-labeled fiber tracts were found in both the ventral and ventrolateral funiculi on the ipsilateral side. These fibers terminated in laminae 6-9. Some fibers were continuous with boutons in contact with motor neurons in both the medial and lateral motor neuron columns. In the lumbar and sacral segments, some collaterals from the ipsilateral vestibulospinal tracts were found on the contralateral side, and these fibers mainly terminated in laminae 6-8. The present study reveals for the first time the fiber terminations of the lateral vestibular nucleus in the mouse spinal cord and therefore enhances future functional studies of the vestibulospinal system.

  14. Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification

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    Tortori-Donati, P.; Rossi, A. [Dept. of Paediatric Neuroradiology, G. Gaslini Children' s Research Hospital, Genova (Italy); Cama, A. [Dept. of Paediatric Neurosurgery, G. Gaslini Children' s Research Hospital, Genova (Italy)


    Our purpose was to review the neuroradiological features of spinal dysraphism and to correlate them with clinical findings and up-to-date embryological theory. We also aimed to formulate a working classification which might prove useful in clinical practice. We reviewed series of 986 children referred to our Spina Bifida Centre in the past 24 years. There were 353 children with open spinal (OSD) and 633 with closed (skin-covered) spinal (CSD) dysraphism. By far the most common open abnormality was myelomeningocele, and all patients with OSD had a Chiari II malformation. CSD was categorised clinically, depending on the presence of a subcutaneous mass in the back. CSD with a mass mainly consisted of lipomas with dural defects and meningoceles, and accounted for 18.8 % of CSD. CSD without a mass were simple (tight filum terminale, intradural lipoma) or complex (split cord malformations, caudal regression). Our suggested classification is easy to use and to remember and takes into account clinical and MRI features; we have found it useful and reliable when making a preoperative neuroradiological diagnosis in clinical practice. (orig.)

  15. Formation of body appendages during caudal regeneration in Platynereis dumerilii: adaptation of conserved molecular toolsets

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    Jan Grimmel


    Full Text Available Abstract Background Platynereis and other polychaete annelids with homonomous segmentation are regarded to closely resemble ancestral forms of bilateria. The head region comprises the prostomium, the peristomium, a variable number of cephalized body segments and several appendages, like cirri, antennae and palps. The trunk of such polychaetes shows numerous, nearly identical segments. Each segment bears a parapodium with species-specific morphology on either side. The posterior end of the trunk features a segment proliferation zone and a terminal pygidium with the anus and anal cirri. The removal of a substantial part of the posterior trunk is by no means lethal. Cells at the site of injury dedifferentiate and proliferate forming a blastema to regenerate both the pygidium and the proliferation zone. The pygidium forms new anal cirri, and the proliferation zone generates new segments at a rapid pace. The formation of body appendages like the cirri and the segmental parapodia can thus be studied in the caudal regenerate of Platynereis within only a few days. Results The development of body appendages in Platynereis is regulated by a network of genes common to polychaetes but also shared by distant taxa. We isolated DNA sequences from P. dumerilii of five genes known to be involved in appendage formation within other groups: Meis/homothorax, Pbx1/extradenticle, Dlx/Distal-less, decapentaplegic and specific protein 1/buttonhead. Analyses of expression patterns during caudal regeneration by in situ hybridization reveal striking similarities related to expression in arthropods and vertebrates. All genes exhibit transient expression during differentiation and growth of segments. As was shown previously in other phyla Pdu-Meis/hth and Pdu-Pbx1/exd are co-expressed, although the expression is not limited to the proximal part of the parapodia. Pdu-Dll is prominent in parapodia but upregulated in the anal cirri. No direct dependence concerning Pdu-Dll and

  16. Postembryonic morphology in epsilonematidae, with a discussion on the variability of caudal gland outlets. (United States)

    Raes, Maarten; Decraemer, Wilfrida; Vanreusel, Ann


    intergeneric variability. The variability in the number and orientation of caudal gland outlets among different nematode taxa is discussed. The presence of separate outlets for the caudal glands seems to be widespread within the family Epsilonematidae and has also been observed in various other, unrelated taxa of free-living aquatic nematodes, although their arrangement in Epsilonematidae is opposite. This aberrant arrangement is probably related to the aberrant locomotory pattern in this family.


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    M. Karami


    Full Text Available In this study to determine whether spine stiffness is predictive of clinical results after lumbar spinal fusion for spinal stenosis, a total of 78 patients were measured intraoperatively with Kocher clamp manual distraction technique to determine motion segment stiffness then spinal fusion was performed for any loose segment. ‎Statistical analysis revealed that stiffness measurement correlate with clinical results of surgery. During a minimum of 2 years follow up after surgery, patients who had loose motion segment before or after decompression and were fused had the same level of satisfaction with surgical results as patients without loose segments and fusion. ‎We concluded that intraoperative spinal stiffness measurement provide a good indicator to spine fusion after lumbar canal stenosis ‎surgery.


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    Supriya De


    Full Text Available INTRODUCTION: Pain is an unpleasant sensory and emotional experience. . Adequate pain relief reduces the stress response and pain relief through epidural route. Caudal epidural analgesia is very commonly practiced technique in children with levobupivacaine. Rectal administration of diclofenac in children is safe and convenient route and su s tained action of this drug provides analgesia in early and late post - operative period. AIMS: The aim of the study is to compare post - operative analgesic effect of rectal diclofenac with caudal levobupivacaine. MATERIALS AND METHODS : Hundred children were a llocated randomly in two groups in equal numbers using generated randomisation chart. All the patients underwent general anaesthesia. At the conclusion of surgery group A (n=50 received caudal injection of 1ml/kg of 0.25% levobupivacaine. The patients we re put left lateral and 23 gauge 25 mm long , short bevelled needle was used for this purpose. Group B (N=50 received a suppository of diclofenac sodium 2.5mg/kg. All anaesthesia , caudal block and suppository insertion was performed by the same anaesthet ist. No information on the method of analgesia or the study group to which the children belong was given to the ward nurse for post - operative observation. Syr. Paracetamol was as post - operative rescue analgesic as 15 mg/kg orally. The ward nurse assessed pain according to the observer pain scale. Assessment was undertaken in four occasions , 1 , 3 and 6 hours post operatively and overnight. If the patient were comfortable without any complain , they were discharged in the in following morning after completion of 24 hours. RESULT AND ANALYSIS: Statistical analysis of the data for pain and use of post - operative analgesic was done by chi - square test analysis with yati’s correction. Intergroup comparision of parametricv data were made by using student un paired t test. P<0.05 was considered to be significant.100 patients were grouped as Group C

  19. [Osteological development of the vertebral column and caudal complex of Lujanus guttatus (Perciformes: Lutjanidae) larvae under rearing conditions]. (United States)

    Rodríguez-Ibarra, Luz Estela; Abdo-de la Parra, María Isabel; Aguilar-Zárate, Gabriela; Valasco-Blanco, Gabriela; Ibarra-Castro, Leonardo


    The spotted rose snapper (Lutjanus guttatus) is an important commercial species in Mexico with good culture potential. The osteological study at early stages in this species is an important tool to confirm normal bone structure and for the detection of malformations that may occur during early development. This study was carried out in order to evaluate and describe the normal osteological development of the vertebral column and caudal complex of this species grown under controlled conditions. For this, a total of 540 larvae of L. guttatus, between 2.1 and 17.5 mm of total length (TL), were cultured during 36 days; culture conditions were 28 degrees C, 5.74 mg/L oxygen and 32.2 ups salinity with standard feeding rates. To detect growth changes, a sample of 15 organisms was daily taken from day one until day 36 of post-hatch (DPH). Samples were processed following standard techniques of clearing, and cartilage (alcian blue) and bone staining (alizarin red). Results showed that the vertebral column is composed of ten vertebrae in the abdominal region, and 14 vertebrae including the urostyle in the caudal region. The development of the axial skeleton starts with the neural arches and haemal arches at 3.8 mm TL. Caudal elements such as the hypurals and parahypural began to develop at 4.1 mm TL. Pre-flexion and flexion of the notochord and the formation of all hypurals were observed between 5.3 and 5.8 mm TL. Ossification of the vertebrae in the abdominal region and in some neural arches initiated at 9.5mm TL. In the caudal region, all the neural and haemal arches ossified at 10.2 mm TL. All the abdominal vertebrae and their respective neural arches and parapophyses ossified at 11.2 mm TL, while the elements of the caudal complex that ossified were the hypurals, parahypurals and modified haemal spines. All caudal fm rays, 12 neural spines and 3 haemal arches were ossified by 15.5 mm. The complete ossification process of this specie under laboratory culture conditions

  20. Sobre remisión de caudales en las fragatas "Gloria" y "Santa Agueda" 1794

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    de Historia Social y de la Cultura Anuario Colombiano


    Full Text Available Es copia de su original y remitida por los Ministros de RealHacienda de la Plaza de Cartagena, De que certifico. Santa fe, 19de diciembre de 1794.Razón General para el Exmo. señor Secretario de Estado ydel Despacho Universal de Hacienda de los caudales que Oficiales Reales de Cartagena de Indias y de las Cajas Reales de su cargo remiten registrados en las dos Fragatas de Guerra, a saber, en la "Santa Agueda", del mando del Capitán de Fragata don Marcelo Espinola, y de que es Maestre don Alejandro de Lanas, y la titulada "Gloria", del mando del Capitán de Navío don Miguel Goycochea, y de que es Maestre don Luis Muñoz, que todo se ha de entregar al señor Presidente Juez de Arribadas del Puerto de Cádiz, para que desde allí les de su respectivo destino, en la forma siguiente. 

  1. Role of annexin gene and its regulation during zebrafish caudal fin regeneration. (United States)

    Saxena, Sandeep; Purushothaman, Sruthi; Meghah, Vuppalapaty; Bhatti, Bhawna; Poruri, Akhila; Meena Lakshmi, Mula G; Sarath Babu, Nukala; Narasimha Murthy, Ch Lakshmi; Mandal, Komal K; Kumar, Arvind; Idris, Mohammed M


    The molecular mechanism of epimorphic regeneration is elusive due to its complexity and limitation in mammals. Epigenetic regulatory mechanisms play a crucial role in development and regeneration. This investigation attempted to reveal the role of epigenetic regulatory mechanisms, such as histone H3 and H4 lysine acetylation and methylation during zebrafish caudal fin regeneration. It was intriguing to observe that H3K9,14 acetylation, H4K20 trimethylation, H3K4 trimethylation and H3K9 dimethylation along with their respective regulatory genes, such as GCN5, SETd8b, SETD7/9, and SUV39h1, were differentially regulated in the regenerating fin at various time points of post-amputation. Annexin genes have been associated with regeneration; this study reveals the significant up-regulation of ANXA2a and ANXA2b transcripts and their protein products during the regeneration process. Chromatin immunoprecipitation and PCR analysis of the regulatory regions of the ANXA2a and ANXA2b genes demonstrated the ability to repress two histone methylations, H3K27me3 and H4K20me3, in transcriptional regulation during regeneration. It is hypothesized that this novel insight into the diverse epigenetic mechanisms that play a critical role during the regeneration process may help to strategize the translational efforts, in addition to identifying the molecules involved in vertebrate regeneration.

  2. Caudal regression syndrome (sirenomelia and its pathogenesis correlation: a case report

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    Vanadondi Usha Rani


    Full Text Available Congenital anomaly characterized by an abnormal development of caudal region of the body with different degrees of fusion of lower extremities, bears resemblance of Sirenomelia or mermaid of Greek Mythology. This type of deformity is also known as Symmelia, Symposia, Sympus, Uromelia and Monopodia. It is associated with the single umbilical artery. It is associated with severe malformations of urogenital i.e. renal agenesis and absence of both internal and external genitalia. The aim of this study is to present, a rare congenital malformation Sirenomelia. In this context, we report a case of Sirenomelia illustrating the prenatal sonographic and pathological features. In our study 25 years old primigravida gave birth to still born full term baby, sex could not be identified. The specimen was collected from private nursing home at Ongole, no relevant history of consanguineous marriage or tobacco smoking or drugs taking etc. Fetal USG, X-ray and CT were taken after birth. Fetal autopsy was done; the gonad, thymus and umbilical cord were sent to histopathological examination. The etiopathogenesis and characteristic features of Sirenomelia were discussed with the findings and review of the literature. [Int J Res Med Sci 2015; 3(11.000: 3406-3411

  3. Modeling the Behavior of Red Blood Cells within the Caudal Vein Plexus of Zebrafish (United States)

    Djukic, Tijana R.; Karthik, Swapna; Saveljic, Igor; Djonov, Valentin; Filipovic, Nenad


    Due to the important biological role of red blood cells (RBCs) in vertebrates, the analysis of reshaping and dynamics of RBCs motion is a critical issue in physiology and biomechanics. In this paper the behavior of RBCs within the immature capillary plexus during embryonic development of zebrafish has been analyzed. Relying on the fact that zebrafish embryos are small and optically transparent, it is possible to image the blood flow. In this way the anatomy of blood vessels is monitored along with the circulation throughout their development. Numerical simulations were performed using a specific numerical model that combines fluid flow simulation, modeling of the interaction of individual RBCs immersed in blood plasma with the surrounding fluid and modeling the deformation of individual cells. The results of numerical simulations are in accordance with the in vivo observed region of interest within the caudal vein plexus of the zebrafish embryo. Good agreement of results demonstrates the capabilities of the developed numerical model to predict and analyze the motion and deformation of RBCs in complex geometries. The proposed model (methodology) will help to elucidate different rheological and hematological related pathologies and finally to design better treatment strategies. PMID:27774070

  4. Post-operative pain relief in children following caudal bupivacaine and buprenorphine--a comparative study.

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    Anilkumar T


    Full Text Available Eighty-five paediatric patients (age range: 6 mths-12yrs undergoing lower abdominal surgery were studied for post-operative pain relief following either caudal bupivacaine (GpI: n = 43 or buprenorphine (GpII: n = 42. Bupivacaine was administered as 0.5ml/kg body weight of 0.25% solution and buprenorphine as 4 micrograms/ml and volume of 0.5 ml/Kg body weight in normal saline. Post-operatively pain was graded on a 4-point scale and behaviour on a 5-point scale. Any post-operative complications and need for additional analgesia were also noted. Bupivacaine provided good pain relief in the early post-operative hours but buprenorphine provided pain relief lasting for 24 hrs or more post-operatively. Post-operative behaviour of 10 patients receiving buprenorphine was graded as cheerful as compared to 2 from bupivacaine group. Till the end of observation period (i.e. 8 hr post-operatively, majority of patients receiving buprenorphine remained cheerful.

  5. Evolutionary multiobjective design of a flexible caudal fin for robotic fish. (United States)

    Clark, Anthony J; Tan, Xiaobo; McKinley, Philip K


    Robotic fish accomplish swimming by deforming their bodies or other fin-like appendages. As an emerging class of embedded computing system, robotic fish are anticipated to play an important role in environmental monitoring, inspection of underwater structures, tracking of hazardous wastes and oil spills, and the study of live fish behaviors. While integration of flexible materials (into the fins and/or body) holds the promise of improved swimming performance (in terms of both speed and maneuverability) for these robots, such components also introduce significant design challenges due to the complex material mechanics and hydrodynamic interactions. The problem is further exacerbated by the need for the robots to meet multiple objectives (e.g., both speed and energy efficiency). In this paper, we propose an evolutionary multiobjective optimization approach to the design and control of a robotic fish with a flexible caudal fin. Specifically, we use the NSGA-II algorithm to investigate morphological and control parameter values that optimize swimming speed and power usage. Several evolved fin designs are validated experimentally with a small robotic fish, where fins of different stiffness values and sizes are printed with a multi-material 3D printer. Experimental results confirm the effectiveness of the proposed design approach in balancing the two competing objectives.

  6. Origins and distributions of the cranial and caudal mesenteric arteries in fetuses of wild boars (Sus scrofa scrofa, Linnaeus – 1758

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    Tharlianne Alici Martins de Souza


    Full Text Available The anatomical behavior of the cranial and caudal mesenteric arteries was studied in 21 wild boars fetuses, female and male, in which one injected, through the thoracic aorta, a Neoprene Latex “450” solution, stained with a specific pigment and, then, they were fixed in a 10% formaldehyde solution. The analysis of results allowed one to state that the cranial mesenteric artery originated from the abdominal aorta, caudal to the celiac artery, issuing right and left adrenal branches, pancreatic, and the caudal pancreaticduodenal, jejunal, middle and right colic, and ileo-ceco-colic arteries. The caudal mesenteric artery originated from the abdominal aorta, from its caudal third, issuing the left colic and the cranial rectal arteries. Anastomoses were found between jejunal, left colic and cranial rectal, and left and middle colic arteries. In the three species, the cranial and caudal mesenteric, caudal pancreatic-duodenal, jejunal, right and middle colic, and ileo-cecocolic arteries showed similar vascular patterns, whereas the differences with regard to emission of branches or isolated emergence or emergence in common trunk didn’t change the blood supply.

  7. Effect of intravenous transplantation of bone marrow mesenchymal stem cells on neurotransmitters and synapsins in rats with spinal cord injury

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    Shaoqiang Chen; Bilian Wu; Jianhua Lin


    Bone marrow mesenchymal stem cells were isolated,purified and cultured in vitro by Percoll density gradient centrifugation combined with the cell adherence method.Passages 3-5 bone marrow mesenchymal stem cells were transplanted into rats with traumatic spinal cord injury via the caudal vein.Basso-Beattie-Bresnahan scores indicate that neurological function of experimental rats was significantly improved over transplantation time (1-5 weeks).Expressions of choline acetyltransferase,glutamic acid decarboxylase and synapsins in the damaged spinal cord of rats was significantly increased after transplantation,determined by immunofluorescence staining and laser confocal scanning microscopy.Bone marrow mesenchymal stem cells that had migrated into the damaged area of rats in the experimental group began to express choline acetyltransferase,glutamic acid decarboxylase and synapsins,3 weeks after transplantation.The Basso-Beattie-Bresnahan scores positively correlated with expression of choline acetyltransferase and synapsins.Experimental findings indicate that intravenously transplanted bone marrow mesenchymal stem cells traverse into the damaged spinal cord of rats,promote expression of choline acetyltransferase,glutamic acid decarboxylase and synapsins,and improve nerve function in rats with spinal cord injury.

  8. Risser sign: the value of the lateral spinal radiograph to assess the excursion of the iliac apophysis. (United States)

    Kotwicki, T


    The course of the ossification of the iliac apophysis is considered in adolescent patients with idiopathic scoliosis, under the name of the Risser sign, to determine the remaining spinal growth. Although the iliac crest develops in the three-dimensional space as a complex structure, the iliac apophysis ossification has been assessed only on a one plane frontal spinal radiograph. This study points out the usefulness of the lateral radiograph for the visualization of the whole iliac crest, especially the posterior region which otherwise cannot be observed. Two young female pelvis specimen were examined with anatomical measurements and radiography. Lateral spinal radiographs of 201 girls were analyzed for the iliac apophysis excursion. The measures of the width of the iliac bone beneath the iliac crest revealed one anterior and one posterior thick regions, coupled with an intermediate thin region. The regions of the maximal thickness corresponded to the earliest appearance of the apophysis ossification (Risser 1), while the thin part of the iliac bone corresponded to late appearance of the apophysis ossification (Risser 3-4). The ossification of the posterior part of the crest was best visualized with the lateral radiograph, which was exclusive in showing the posterior superior iliac spine region. On the frontal spinal radiograph the end of the course of the apophysis (Risser 3-4) is usually searched at the level of the sacroiliac joint, while in reality this point was found to be situated more caudal, and accessible for observation on the lateral radiograph.

  9. Relationship between Spinal Cord Volume and Spinal Cord Injury due to Spinal Shortening.

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    Feng Qiu

    Full Text Available Vertebral column resection is associated with a risk of spinal cord injury. In the present study, using a goat model, we aimed to investigate the relationship between changes in spinal cord volume and spinal cord injury due to spinal shortening, and to quantify the spinal cord volume per 1-mm height in order to clarify a safe limit for shortening. Vertebral column resection was performed at T10 in 10 goats. The spinal cord was shortened until the somatosensory-evoked potential was decreased by 50% from the baseline amplitude or delayed by 10% relative to the baseline peak latency. A wake-up test was performed, and the goats were observed for two days postoperatively. Magnetic resonance imaging was used to measure the spinal cord volume, T10 height, disc height, osteotomy segment height, and spinal segment height pre- and postoperatively. Two of the 10 goats were excluded, and hence, only data from eight goats were analyzed. The somatosensory-evoked potential of these eight goats demonstrated meaningful changes. With regard to neurologic function, five and three goats were classified as Tarlov grades 5 and 4 at two days postoperatively. The mean shortening distance was 23.6 ± 1.51 mm, which correlated with the d-value (post-pre of the spinal cord volume per 1-mm height of the osteotomy segment (r = 0.95, p < 0.001 and with the height of the T10 body (r = 0.79, p = 0.02. The mean d-value (post-pre of the spinal cord volume per 1-mm height of the osteotomy segment was 142.87 ± 0.59 mm3 (range, 142.19-143.67 mm3. The limit for shortening was approximately 106% of the vertebral height. The mean volumes of the osteotomy and spinal segments did not significantly change after surgery (t = 0.310, p = 0.765 and t = 1.241, p = 0.255, respectively. Thus, our results indicate that the safe limit for shortening can be calculated using the change in spinal cord volume per 1-mm height.

  10. Spinal and Intracranial Epidural Abscess

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    J Gordon Millichap


    Full Text Available Presentation, epidemiology, diagnosis and treatment of spinal epidural abscess (SEA and intracranial epidural abscess (ICEA are reviewed by researchers at The John's Hopkins University School of Medicine, Baltimore, MD, and Universidad de Santander, Columbia.

  11. Depression and Spinal Cord Injury (United States)

    ... About Us Patient Care Resources Information & Education SCI Empowerment Project Projects & Research FAQ © 2017 University of Washington ... Ave., Seattle WA 98104 Spinal Cord Injury Clinic nurses: 206-744-5862 University of Washington Medical Center ...

  12. Substituição dos ligamentos cruzados cranial e caudal em cães por duplo implante de polipropileno Replacement of the cranial and caudal cruciate ligaments in dogs by double t polypropylene implant

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    Daniel Curvello de Mendonça Müller


    Full Text Available O objetivo deste trabalho é salientar uma alternativa eficaz no tratamento da ruptura dos ligamentos cruzados cranial e caudal de cães, sem associação de imobilização externa. Foram atendidos seis animais portadores de ruptura de ambos os ligamentos cruzados. Optou-se pela correção cirúrgica intracapsular, utilizando-se dois implantes sintéticos de polipropileno, para a estabilização da articulação. Os pacientes retornaram ao apoio completo do membro em 11,8±3,5 dias e não mantiveram instabilidade articular, após 0, 30 e 90 dias de avaliação clínica pós-operatória. Aos 90 dias após a cirurgia, não se percebeu claudicação nos pacientes avaliados. Concluiu-se que a técnica utilizada promoveu total estabilidade articular na ausência dos ligamentos cruzados cranial e caudal.The objective of this study is to point out an effective alternative in the treatment of the cranial and caudal cruciate ligaments rupture in dogs, with no association of external immobilization. Six dogs with rupture of both cruciate ligaments were included in the present study. Stifle joint was surgically stabilized by an intracapsular technique, using two polypropylene synthetic implants. The animals returned to full member support in 11.8±3.5 days and did not sustain any joint instability degree after 0, 30 and 90 days of clinical evaluation after surgery. At 90 days after surgery, it became apparent lameness in any of the six patients. It was concluded that the technique employed caused total joint stability in the absence of caudal and cranial cruciate ligaments.

  13. Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

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    Michael Y. Wang


    Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

  14. Decreased MHC I expression in IFN gamma mutant mice alters synaptic elimination in the spinal cord after peripheral injury

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    Victório Sheila CS


    Full Text Available Abstract Background The histocompatibility complex (MHC class I expression in the central nervous system (CNS regulates synaptic plasticity events during development and adult life. Its upregulation may be associated with events such as axotomy, cytokine exposition and changes in neuron electrical activity. Since IFNγ is a potent inducer of the MHC I expression, the present work investigated the importance of this pro-inflammatory cytokine in the synaptic elimination process in the spinal cord, as well as the motor recovery of IFN−/−, following peripheral injury. Methods The lumbar spinal cords of C57BL/6J (wild type and IFNγ−/− (mutant mice, subjected to unilateral sciatic nerve transection, were removed and processed for immunohistochemistry and real time RT-PCR, while the sciatic nerves from animals subjected to unilateral crush, were submitted to immunohistochemistry and electron microscopy for counting of the axons. Gait recovery was monitored using the Cat Walk system. Newborn mice astrocyte primary cultures were established in order to study the astrocytic respose in the absence of the IFNγ expression. Results IFNγ−/− mutant mice showed a decreased expression of MHC I and β2-microglobulin mRNA coupled with reduced synaptophysin immunolabelling in the lesioned spinal cord segment. Following unilateral nerve transection, the Iba-1 (ionized calcium binding adaptor molecule 1 and glial fibrillary acid protein (GFAP reactivities increased equally in both strains. In vitro, the astrocytes demonstrated similar GFAP levels, but the proliferation rate was higher in the wild type mice. In the crushed nerves (distal stump, neurofilaments and p75NTR immunolabeling were upregulated in the mutant mice as compared to the wild type and an improvement in locomotor recovery was observed. Conclusion The present results show that a lack of IFNγ affects the MHC I expression and the synaptic elimination process in the spinal cord. Such

  15. Spinal syringomyelia following subarachnoid hemorrhage. (United States)

    Nakanishi, Kinya; Uchiyama, Takuya; Nakano, Naoki; Fukawa, Norihito; Yamada, Kimito; Yabuuchi, Tomonari; Kato, Amami


    Subarachnoid blood has been reported as a cause of chronic spinal arachnoiditis. Although syringomyelia has been thought to be caused by spinal arachnoiditis, reports of syringomyelia following aneurysmal subarachnoid hemorrhage (SAH) are very rare. We describe two patients with syringomyelia associated with chronic spinal arachnoiditis following SAH. From January 2001 to December 2010, 198 patients with aneurysmal SAH were treated at Kinki University School of Medicine. Two of the 198 patients had syringomyelia following aneurysmal SAH; thus the rate of syringomyelia associated with aneurysmal SAH was 1.0%. Patient 1 was a 54-year-old woman who presented with back pain, back numbness and gait disturbance 20 months after SAH. Her MRI revealed syringomyelia of the spinal cord from C2 to T10. She underwent shunting of the syrinx to the subarachnoid space. Patient 2 was a 49-year-old man, who was admitted to the hospital with headache, diplopia, hoarseness, dysphagia and ataxia five months after SAH. MRI revealed syringomyelia from the medulla oblongata to C6, and an enlargement of the lateral and fourth ventricles. After foramen magnum decompression and C1 laminectomy, a fourth ventricle-subarachnoid shunt was placed by insertion of a catheter. Spinal arachnoiditis and spinal syringomyelia are rare but important chronic complications after SAH.




    En el presente artículo de revisión se consolidó información sobre el Régimen de Caudal Ecológico, al constituirse en una herramienta de gestión en la conservación de la Biota Acuática. De esta manera, se considera relevante informar a la comunidad académica y actores de gestión, sobre la importancia de la gestión del recurso hídrico, el análisis de conceptos sobre el caudal ambiental y ecológico, la descripción de las diferentes metodologías que permiten su determinación y la normatividad am...

  17. Imaging corticospinal tract connectivity in injured rat spinal cord using manganese-enhanced MRI

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    Bilgen Mehmet


    Full Text Available Abstract Background Manganese-enhanced MRI (MEI offers a novel neuroimaging modality to trace corticospinal tract (CST in live animals. This paper expands this capability further and tests the utility of MEI to image axonal fiber connectivity in CST of injured spinal cord (SC. Methods A rat was injured at the thoracic T4 level of the SC. The CST was labeled with manganese (Mn injected intracortically at two weeks post injury. Next day, the injured SC was imaged using MEI and diffusion tensor imaging (DTI modalities. Results In vivo MEI data obtained from cervical SC confirmed that CST was successfully labeled with Mn. Ex vivo MEI data obtained from excised SC depicted Mn labeling of the CST in SC sections caudal to the lesion, which meant that Mn was transported through the injury, possibly mediated by viable CST fibers present at the injury site. Examining the ex vivo data from the injury epicenter closely revealed a thin strip of signal enhancement located ventrally between the dorsal horns. This enhancement was presumably associated with the Mn accumulation in these intact fibers projecting caudally as part of the CST. Additional measurements with DTI supported this view. Conclusion Combining these preliminary results collectively demonstrated the feasibility of imaging fiber connectivity in experimentally injured SC using MEI. This approach may play important role in future investigations aimed at understanding the neuroplasticity in experimental SCI research.

  18. Development of regional specificity of spinal and medullary dorsal horn neurons

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    Yu-Feng Xie; Xing-Hong Jiang; Barry J Sessle; Xian-Min Yu


    Extensive studies have focused on the development and regionalization of neurons in the central nervous system(CNS). Many genes, which play crucial roles in the development of CNS neurons, have been identified. By using the technique "direct reprogramming", neurons can be produced from multiple cell sources such as fibroblasts. However, understanding the region-specific regulation of neurons in the CNS is still one of the biggest challenges in the research field of neuroscience. Neurons located in the trigeminal subnucleus caudalis(Vc) and in the spinal dorsal horn(SDH) play crucial roles in pain and sensorimotor functions in the orofacial and other somatic body regions, respectively. Anatomically, Vc represents the most caudal component of the trigeminal system, and is contiguous with SDH. This review is focused on recent data dealing with the regional specificity involved in the development of neurons in Vc and SDH.

  19. Caudal Nucleus Accumbens Core Is Critical in the Regulation of Cue-Elicited Approach-Avoidance Decisions (United States)

    Hamel, Laurie; Thangarasa, Tharshika; Samadi, Osai


    The nucleus accumbens (NAc) is thought to be a site of integration of positively and negatively valenced information and action selection. Functional differentiation in valence processing has previously been found along the rostrocaudal axis of the shell region of the NAc in assessments of unconditioned motivation. Given that the core region of the NAc has been implicated in the elicitation of motivated behavior in response to conditioned cues, we sought to assess the role of caudal, intermediate, and rostral sites within this subregion in cue-elicited approach-avoidance decisions. Rats were trained to associate visuo-tactile cues with appetitive, aversive, and neutral outcomes. Following the successful acquisition of the cue-outcome associations, rats received microinfusions of GABAA and GABAB receptor agonists (muscimol/baclofen) or saline into the caudal, intermediate, or rostral NAc core and were then exposed to a superimposition of appetitively and aversively valenced cues versus neutral cues in a “conflict test,” as well as to the appetitive versus neutral cues, and aversive cues versus neutral cues, in separate conditioned preference/avoidance tests. Disruption of activity in the intermediate to caudal parts of the NAc core resulted in a robust avoidance bias in response to motivationally conflicting cues, as well as a potentiated avoidance of aversive cues as compared with control animals, coupled with an attenuated conditioned preference for the appetitive cue. These results suggest that the caudal NAc core may have the capacity to exert bidirectional control over appetitively and aversively motivated responses to valence signals. PMID:28275709

  20. Comparison of preemptive intravenous paracetamol and caudal block in terms of analgesic and hemodynamic parameters in children

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    Serbülent Gökhan Beyaz


    Full Text Available Objectives: Paracetamol has a widespread use for feverand symptomatic relief of pain in children. The aim ofthis study was to compare analgesic effects of preemptiveintravenous (i.v. paracetamol, and caudal block withlevobupivacaine.Materials and methods: A total of 60 children with ASAI-II physical status, aged 5-15 years and undergoing inguinalhernia repair, were randomly allocated to threegroups so that each group contained 20 patients. Group Pchildren received i.v. 15mg/kg paracetamol. Group C receivedonly caudal block with levobupivacaine, and GroupPC received both i.v. paracetamol, and caudal block withlevobupivacaine. Pain level assessed by modified EasternOntario Children’s Hospital pain scale (mCHEOPs,sedation status by Ramsey sedation scale at postoperative5, 15, 30 min and 1,3, and 6th hours.Results: No significant differences were found in age,gender distribution, body weight, ASA status, type andduration of surgery between three groups (p>0.05. Althoughsignificant difference were found in mCHEOPsscores within groups by repeated measures, no differenceof pain scores was observed between three groups(p>0.05. There were no significant differences in the hemodynamicparameters (heart rate, blood pressure bothwithin groups and between groups (p>0.05.Conclusions: Preemptive intravenous paracetamol hadsimilar analgesic effects compared with caudal block withlevobupivacaine with regard to postoperative pain scoresin children undergoing inguinal hernia repair. No hemodynamicor other adverse effects were observed withintravenous paracetamol. J Clin Exp Invest 2012; 3(2:202-208

  1. Comparative Analysis of Gastrointestinal Microbiota Between Normal and Caudal-Related Homeobox 2 (Cdx2) Transgenic Mice


    Sakamoto, Hirotsugu; Asahara, Takashi; Chonan, Osamu; Yuki, Norikatsu; Mutoh, Hiroyuki; Hayashi, Shunji; Yamamoto, Hironori; Sugano, Kentaro


    Background/Aims Caudal-related homeobox 2 (Cdx2) is expressed in the human intestinal metaplastic mucosa and induces intestinal metaplastic mucosa in the Cdx2 transgenic mouse stomach. Atrophic gastritis and intestinal metaplasia commonly lead to gastric achlorhydria, which predisposes the stomach to bacterial overgrowth. In the present study, we determined the differences in gut microbiota between normal and Cdx2 transgenic mice, using quantitative reverse transcription-polymerase chain reac...


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    Full Text Available BACKGROUND: Addition of clonidine to ropivacaine (0.2% can potentially enhance analgesia without producing prolonged motor blockade. The aim of the study was to compare the post - operative pain relieving quality of ropivacaine (0.2% and clonidine mixture to that of p lain ropivacaine (0.2% following caudal block in children’s. OBJECTIVE: In this study I examined the quality, post - operative analgesia and haemodynamics effects in children when clonidine is added to ropivacaine for urogenital surgeries in caudal anaesthe sia. MATERIAL AND METHODS: In this clinical trial, 30 children’s aged 1 - 10 years who were candidates for elective urogenital surgeries were studied. Induction and maintenance of anaesthesia were achieved using propofol, sevoflurane and nitrous oxide. Child ren were randomly divided into 2 groups in double blind fashion, and were given caudal block with 0.2% ropivacaine (1ml/kg alone and ropivacaine plus clonidine 2mcg/kg. Haemodynamic parameters were observed before, during and after the surgical procedure. Post - operative analgesia evaluated using FLACC score and sedation was assessed using Ramsey sedation scale. Paracetamol was given orally for cases with FLACC score 4 or more. RESULTS: Duration of analgesia was found to be significantly longer in the group given ropivacaine plus clonidine. CONCLUSIONS: I concluded that addition of clonidine to ropivacaine prolongs the duration of post - operative analgesia without any respiratory or heamodynamic side - effects.

  3. Lhx2 and Lhx9 determine neuronal differentiation and compartition in the caudal forebrain by regulating Wnt signaling.

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    Daniela Peukert


    Full Text Available Initial axial patterning of the neural tube into forebrain, midbrain, and hindbrain primordia occurs during gastrulation. After this patterning phase, further diversification within the brain is thought to proceed largely independently in the different primordia. However, mechanisms that maintain the demarcation of brain subdivisions at later stages are poorly understood. In the alar plate of the caudal forebrain there are two principal units, the thalamus and the pretectum, each of which is a developmental compartment. Here we show that proper neuronal differentiation of the thalamus requires Lhx2 and Lhx9 function. In Lhx2/Lhx9-deficient zebrafish embryos the differentiation process is blocked and the dorsally adjacent Wnt positive epithalamus expands into the thalamus. This leads to an upregulation of Wnt signaling in the caudal forebrain. Lack of Lhx2/Lhx9 function as well as increased Wnt signaling alter the expression of the thalamus specific cell adhesion factor pcdh10b and lead subsequently to a striking anterior-posterior disorganization of the caudal forebrain. We therefore suggest that after initial neural tube patterning, neurogenesis within a brain compartment influences the integrity of the neuronal progenitor pool and border formation of a neuromeric compartment.

  4. Comparison of Postoperative Analgesic Efficacy of Penile Block, Caudal Block and Intravenous Paracetamol for Circumcision: A prospective Randomized Study

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    Ahmet Hakan Haliloglu


    Full Text Available Purpose To evaluate the postoperative analgesic efficacy of penile block, caudal block and intravenous paracetamol administration following circumcision. Materials and Methods In this prospective randomized study a total of 159 patients underwent circumcision under general anesthesia at urology clinic of Ufuk University Faculty of Medicine and Sorgun State Hospital between May 2012 and September 2012. The patients were randomized to three groups to receive penile block (Group 1, caudal block (Group 2 and intravenous paracetamol administration (group 3. Pain measurement of the patients was done via CHEOPS scoring system at 30,60,120 and 180 minutes postoperatively and compared. Statistical tests were performed with a conventional statistics program and statistical significance was set at a p value of < 0.05. Results The mean age of the patients was 5.7 years. Patients in group 1 had significantly lower pain score at 30 minutes compared to other two groups. At 60 minutes groups 1 and 2 had significantly lower score compared to group 3. At 120 and 180 minutes no difference between the groups was observed. No significant major complications were observed in all 3 groups. Conclusion Penile block and caudal block provide similar pain scores and painless postoperative periods after circumcision under general anesthesia. Intravenous paracetamol is insufficient at the early postoperative period. The three procedures were shown to be safe for analgesia following circumcision.

  5. Radionuclide imaging of spinal infections

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    Gemmel, Filip [Ghent Maria-Middelares, General Hospital, Division of Nuclear Medicine, Ghent (Belgium); Medical Center Leeuwarden (MCL), Division of Nuclear Medicine, Henri Dunantweg 2, Postbus 888, Leeuwarden (Netherlands); Dumarey, Nicolas [Universite Libre de Bruxelles, Hopital Erasme, Division of Nuclear Medicine, Brussels (Belgium); Palestro, Christopher J. [Long Island Jewish Medical Center, Division of Nuclear Medicine, Long Island, NY (United States)


    The diagnosis of spinal infection, with or without implants, has been a challenge for physicians for many years. Spinal infections are now being recognised more frequently, owing to aging of the population and the increasing use of spinal-fusion surgery. The diagnosis in many cases is delayed, and this may result in permanent neurological damage or even death. Laboratory evidence of infection is variable. Conventional radiography and radionuclide bone imaging lack both sensitivity and specificity. Neither in vitro labelled leucocyte scintigraphy nor {sup 99m}Tc-anti-granulocyte antibody scintigraphy is especially useful, because of the frequency with which spinal infection presents as a non-specific photopenic area on these tests. Sequential bone/gallium imaging and {sup 67}Ga-SPECT are currently the radionuclide procedures of choice for spinal osteomyelitis, but these tests lack specificity, suffer from poor spatial resolution and require several days to complete. [{sup 18}F]Fluoro-2-deoxy-D-glucose (FDG) PET is a promising technique for diagnosing spinal infection, and has several potential advantages over conventional radionuclide tests. The study is sensitive and is completed in a single session, and image quality is superior to that obtained with single-photon emitting tracers. The specificity of FDG-PET may also be superior to that of conventional tracers because degenerative bone disease and fractures usually do not produce intense FDG uptake; moreover, spinal implants do not affect FDG imaging. However, FDG-PET images have to be read with caution in patients with instrumented spinal-fusion surgery since non-specific accumulation of FDG around the fusion material is not uncommon. In the future, PET-CT will likely provide more precise localisation of abnormalities. FDG-PET may prove to be useful for monitoring response to treatment in patients with spinal osteomyelitis. Other tracers for diagnosing spinal osteomyelitis are also under investigation, including

  6. The effect of inflammation on sympathetic nerve mediated contractions in rat isolated caudal artery. (United States)

    Fotso Soh, Jocelyn; Strong, Hilary R; Daneshtalab, Noriko; Tabrizchi, Reza


    Chronic inflammatory process(es) contributes to changes in vascular function in a variety of diseases. Sympathetic nerve-mediated responses in blood vessels play a pivotal role in regular physiological functions. We tested the hypothesis that sympathetic neuro-effector function will be altered as consequence of inflammatory state. Sympathetic nerve-mediated contractions and alpha adrenergic receptor expressions were evaluated in isolated caudal arteries of rats treated with saline and Complete Freund's adjuvant (CFA). While CFA-treated animals had significantly higher plasma levels of tumor necrosis factor-alpha compared to saline, blood pressure remained unchanged. Immunofluorescence revealed increased expression of ionized calcium adapter binding molecule-1 in the adventitia of blood vessels from CFA-treated animals compared to saline. In isolated arteries, electrical field stimulations between 1.25 and 40Hz resulted in frequency-dependent contractions that wasabolished by tetrodotoxin. Neurogenic contractions from CFA groups were significantly greater than saline. While the presence of alpha1-adrenoceptor antagonist (prazosin) significantly inhibited contractions at lower frequencies of stimulation (1.25-5Hz) in isolated arteries of CFA-treated rats compared to controls, alpha2-adrenoceptor antagonist (rauwolscine) had modest effects. Inhibition of neuronal reuptake by cocaine comparably enhanced field-stimulated responses in vessels of experimental and control animals. Immunofluorescence revealed a difference in expression of alpha1- and alpha2-adrenoceptors in the endothelium of blood vessels of CFA compared to saline controls. Collectively, our observations lend support to enhanced neurogenic contractions in blood vessels of inflamed animals possibly attributing to alterations in responsiveness and/or distribution of post-junctional alpha1-adrenoceptors.

  7. Caudal topographic nucleus isthmi and the rostral nontopographic nucleus isthmi in the turtle, Pseudemys scripta. (United States)

    Sereno, M I; Ulinski, P S


    Isthmotectal projections in turtles were examined by making serial section reconstructions of axonal and dendritic arborizations that were anterogradely or retrogradely filled with HRP. Two prominent tectal-recipient isthmic nuclei--the caudal magnocellular nucleus isthmi (Imc) and the rostral magnocellular nucleus isthmi (Imr)--exhibited strikingly different patterns of organization. Imc cells have flattened, bipolar dendritic fields that cover a few percent of the area of the cell plate constituting the nucleus and they project topographically to the ipsilateral tectum without local axon branches. The topography was examined explicitly at the single-cell level by using cases with two injections at widely separated tectal loci. Each Imc axon terminates as a compact swarm of several thousand boutons placed mainly in the upper central gray and superficial gray layers. One Imc terminal spans less that 1% of the tectal surface. Imr cells, by contrast, have large, sparsely branched dendritic fields overlapped by local axon collaterals while distally, their axons nontopographically innervate not only the deeper layers of the ipsilateral tectum but also ipsilateral Imc. Imr receives a nontopographic tectal input that contrasts with the topographic tectal input to Imc. Previous work on nucleus isthmi emphasized the role of the contralateral isthmotectal projection (which originates from a third isthmic nucleus in turtles) in mediating binocular interactions in the tectum. The present results on the two different but overlapping ipsilateral tecto-isthmo-tectal circuits set up by Imc and Imr are discussed in the light of physiological evidence for selective attention effects and local-global interactions in the tectum.

  8. Zebrafish Caudal Fin Angiogenesis Assay-Advanced Quantitative Assessment Including 3-Way Correlative Microscopy.

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    Ruslan Hlushchuk

    Full Text Available Researchers evaluating angiomodulating compounds as a part of scientific projects or pre-clinical studies are often confronted with limitations of applied animal models. The rough and insufficient early-stage compound assessment without reliable quantification of the vascular response counts, at least partially, to the low transition rate to clinics.To establish an advanced, rapid and cost-effective angiogenesis assay for the precise and sensitive assessment of angiomodulating compounds using zebrafish caudal fin regeneration. It should provide information regarding the angiogenic mechanisms involved and should include qualitative and quantitative data of drug effects in a non-biased and time-efficient way.Basic vascular parameters (total regenerated area, vascular projection area, contour length, vessel area density were extracted from in vivo fluorescence microscopy images using a stereological approach. Skeletonization of the vasculature by our custom-made software Skelios provided additional parameters including "graph energy" and "distance to farthest node". The latter gave important insights into the complexity, connectivity and maturation status of the regenerating vascular network. The employment of a reference point (vascular parameters prior amputation is unique for the model and crucial for a proper assessment. Additionally, the assay provides exceptional possibilities for correlative microscopy by combining in vivo-imaging and morphological investigation of the area of interest. The 3-way correlative microscopy links the dynamic changes in vivo with their structural substrate at the subcellular level.The improved zebrafish fin regeneration model with advanced quantitative analysis and optional 3-way correlative morphology is a promising in vivo angiogenesis assay, well-suitable for basic research and preclinical investigations.

  9. Ultrasound guided single injection caudal epidural anesthesia of isobaric bupivacaine with/without dexamethasone for geriatric patients undergoing total hip replacement surgery

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    H.A. El Gendy


    Conclusion: Adding dexamethasone with isobaric bupivacaine caudal anesthesia prolongs the duration of postoperative analgesia and decreased postoperative analgesic requirement in geriatric patients undergoing total hip replacement surgery in comparison isobaric bupivacaine alone.

  10. Topographic maps of human motor cortex in normal and pathological conditions: mirror movements, amputations and spinal cord injuries. (United States)

    Cohen, L G; Bandinelli, S; Topka, H R; Fuhr, P; Roth, B J; Hallett, M


    We studied motor evoked potentials to transcranial magnetic stimulation in patients with unilateral upper limb amputations, complete T10-T12 spinal cord transection, and congenital mirror movements and in controls. Different muscles in the trunk and upper and lower extremities were evaluated at rest. In controls, muscles could be activated with stimulation of regions several centimeters wide. These areas overlapped extensively when muscles studied were from the same limb and shifted positions abruptly when muscles were from different limbs. Distal muscles were easier to activate than proximal muscles and normally evidenced exclusively a contralateral representation. Congenital defects in motor control in patients with mirror movements resulted in marked derangement of the map of outputs of distal hand muscles with enlarged and ipsilateral representations. Peripheral lesions, either acquired (amputations) or congenital (congenital absence of a limb), resulted in plastic reorganization of motor outputs targeting muscles immediately proximal to the stump. Central nervous system lesions (i.e., spinal cord injury producing paraplegia) also resulted in enlargement of the map of outputs targeting muscles proximal to the lesion. These results indicate that magnetic stimulation is a useful non-invasive tool for exploring plastic changes in human motor pathways following different types of injury.

  11. Effects of Lumbosacral Spinal Cord Epidural Stimulation for Standing after Chronic Complete Paralysis in Humans.

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    Enrico Rejc

    Full Text Available Sensory and motor complete spinal cord injury (SCI has been considered functionally complete resulting in permanent paralysis with no recovery of voluntary movement, standing or walking. Previous findings demonstrated that lumbosacral spinal cord epidural stimulation can activate the spinal neural networks in one individual with motor complete, but sensory incomplete SCI, who achieved full body weight-bearing standing with independent knee extension, minimal self-assistance for balance and minimal external assistance for facilitating hip extension. In this study, we showed that two clinically sensory and motor complete participants were able to stand over-ground bearing full body-weight without any external assistance, using their hands to assist balance. The two clinically motor complete, but sensory incomplete participants also used minimal external assistance for hip extension. Standing with the least amount of assistance was achieved with individual-specific stimulation parameters, which promoted overall continuous EMG patterns in the lower limbs' muscles. Stimulation parameters optimized for one individual resulted in poor standing and additional need of external assistance for hip and knee extension in the other participants. During sitting, little or negligible EMG activity of lower limb muscles was induced by epidural stimulation, showing that the weight-bearing related sensory information was needed to generate sufficient EMG patterns to effectively support full weight-bearing standing. In general, electrode configurations with cathodes selected in the caudal region of the array at relatively higher frequencies (25-60 Hz resulted in the more effective EMG patterns for standing. These results show that human spinal circuitry can generate motor patterns effective for standing in the absence of functional supraspinal connections; however the appropriate selection of stimulation parameters is critical.

  12. The Role of the Serotonergic System in Locomotor Recovery after Spinal Cord Injury

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    Mousumi eGhosh


    Full Text Available Serotonin (5-HT, a monoamine neurotransmitter synthesized in various populations of brainstem neurons, plays an important role in modulating the activity of spinal networks involved in vertebrate locomotion. Following spinal cord injury (SCI there is a disruption of descending serotonergic projections to spinal motor areas, which results in a subsequent depletion in 5-HT, the dysregulation of serotonin transporters as well as the elevated expression, super-sensitivity and/or constitutive auto-activation of specific serotonin receptors. These changes in the serotonergic system can produce varying degrees of locomotor dysfunction through to paralysis. To date, various approaches targeting the different components of the serotonergic system have been employed to restore limb coordination and improve locomotor function in experimental models of SCI. These strategies have included pharmacological modulation of serotonergic receptors, through the administration of specific 5-HT receptor agonists, or by elevating the serotonin precursor 5-hydroxytryptophan, which produces a global activation of all classes of 5-HT receptors. Stimulation of these receptors leads to the activation of the locomotor central pattern generator (CPG below the site of injury to facilitate or improve the quality and frequency of movements, particularly when used in concert with the activation of other monoaminergic systems or coupled with electrical stimulation. Another approach has been to employ cell therapeutics to replace the loss of descending serotonergic input to the CPG, either through transplanted fetal brainstem 5-HT neurons at the site of injury that can supply 5-HT to below the level of the lesion or by other cell types to provide a substrate at the lesion for encouraging serotonergic axon regrowth across the lesion to the caudal spinal cord for restoring locomotion.

  13. Response of ependymal progenitors to spinal cord injury or enhanced physical activity in adult rat. (United States)

    Cizkova, Dasa; Nagyova, Miriam; Slovinska, Lucia; Novotna, Ivana; Radonak, Jozef; Cizek, Milan; Mechirova, Eva; Tomori, Zoltan; Hlucilova, Jana; Motlik, Jan; Sulla, Igor; Vanicky, Ivo


    Ependymal cells (EC) in the spinal cord central canal (CC) are believed to be responsible for the postnatal neurogenesis following pathological or stimulatory conditions. In this study, we have analyzed the proliferation of the CC ependymal progenitors in adult rats processed to compression SCI or enhanced physical activity. To label dividing cells, a single daily injection of Bromo-deoxyuridine (BrdU) was administered over a 14-day-survival period. Systematic quantification of BrdU-positive ependymal progenitors was performed by using stereological principles of systematic, random sampling, and optical Dissector software. The number of proliferating BrdU-labeled EC increased gradually with the time of survival after both paradigms, spinal cord injury, or increased physical activity. In the spinal cord injury group, we have found 4.9-fold (4 days), 7.1-fold (7 days), 4.9-fold (10 days), and 5.6-fold (14 days) increase of proliferating EC in the rostro-caudal regions, 4 mm away from the epicenter. In the second group subjected to enhanced physical activity by running wheel, we have observed 2.1-2.6 fold increase of dividing EC in the thoracic spinal cord segments at 4 and 7 days, but no significant progression at 10-14 days. Nestin was rapidly induced in the ependymal cells of the CC by 2-4 days and expression decreased by 7-14 days post-injury. Double immunohistochemistry showed that dividing cells adjacent to CC expressed astrocytic (GFAP, S100beta) or nestin markers at 14 days. These data demonstrate that SCI or enhanced physical activity in adult rats induces an endogenous ependymal cell response leading to increased proliferation and differentiation primarily into macroglia or cells with nestin phenotype.

  14. ω-conotoxin MVIIA intralesional injection in spinal cord injury in rats

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    Karen Maciel de Oliveira


    Full Text Available This study aimed to investigate the neuroprotective effect of ω-conotoxin MVIIA (MVIIA intralesional application in rats submitted to spinal cord injury. Male Wistar rats, weighing 300g±23.4, were distributed in five groups: negative control (SHAM, placebo (PLA, 5μM MVIIA, 10μM MVIIA and 20μM MVIIA MVIIA. After laminectomy of the 12th thoracic vertebra (SHAM, the PLA, 5μM MVIIA, 10μM MVIIA and 20μM MVIIA groups were subjected to acute compressive spinal cord trauma for five minutes, and then five minutes later, the animals received specific treatment in a standard total volume of 2µL, by intralesional route, using sterile PBS as placebo. Locomotor activity was assayed using Basso Beattie Bresnahan (BBB scale to show the patterning of SCI. With 48 hours of injury, the animals were euthanized, the liquor sample was collected in atlantooccipital space, and also the spinal segment, including the epicenter and caudal region to injury. Assays were performed for mitochondrial viability, serum glutamate, production of reactive oxygen species (ROS and lipid peroxidation (LP were performed. The study design was randomized and the data submitted to ANOVA and comparison of means by SNK test, and data from BBB scale were evaluated using Kruskal-Wallis test (P<0.05. There was no significant difference between groups in BBB scores. The MVIIA did not promote decrease in the levels of glutamate, ROS, LP, and did not preserve the mitochondria in the intralesional application five minutes after spinal cord injury in rats.

  15. Electrical stimulation modulates injury potentials in rats after spinal cord injury*

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    Guanghao Zhang; Xiaolin Huo; Aihua Wang; Changzhe Wu; Cheng Zhang; Jinzhu Bai


    An injury potential is the direct current potential difference between the site of spinal cord injury and the healthy nerves. Its initial amplitude is a significant indicator of the severity of spinal cord injury, and many cations, such as sodium and calcium, account for the major portion of injury potentials. This injury potential, as wel as injury current, can be modulated by direct current field stimulation;however, the appropriate parameters of the electrical field are hard to define. In this paper, injury potential is used as a parameter to adjust the intensity of electrical stimulation. Injury potential could be modulated to slightly above 0 mV (as the anode-centered group) by placing the anodes at the site of the injured spinal cord and the cathodes at the rostral and caudal sections, or around-70 mV, which is resting membrane potential (as the cathode-centered group) by reversing the polarity of electrodes in the anode-centered group. In addition, rats receiving no electrical stimulation were used as the control group. Results showed that the absolute value of the injury potentials acquired after 30 minutes of electrical stimulation was higher than the control group rats and much lower than the initial absolute value, whether the anodes or the cathodes were placed at the site of injury. This phenomenon il ustrates that by changing the polarity of the electrical field, electrical stimulation can effectively modulate the injury potentials in rats after spinal cord injury. This is also beneficial for the spontaneous repair of the cel membrane and the reduction of cation influx.

  16. Effects of Lumbosacral Spinal Cord Epidural Stimulation for Standing after Chronic Complete Paralysis in Humans. (United States)

    Rejc, Enrico; Angeli, Claudia; Harkema, Susan


    Sensory and motor complete spinal cord injury (SCI) has been considered functionally complete resulting in permanent paralysis with no recovery of voluntary movement, standing or walking. Previous findings demonstrated that lumbosacral spinal cord epidural stimulation can activate the spinal neural networks in one individual with motor complete, but sensory incomplete SCI, who achieved full body weight-bearing standing with independent knee extension, minimal self-assistance for balance and minimal external assistance for facilitating hip extension. In this study, we showed that two clinically sensory and motor complete participants were able to stand over-ground bearing full body-weight without any external assistance, using their hands to assist balance. The two clinically motor complete, but sensory incomplete participants also used minimal external assistance for hip extension. Standing with the least amount of assistance was achieved with individual-specific stimulation parameters, which promoted overall continuous EMG patterns in the lower limbs' muscles. Stimulation parameters optimized for one individual resulted in poor standing and additional need of external assistance for hip and knee extension in the other participants. During sitting, little or negligible EMG activity of lower limb muscles was induced by epidural stimulation, showing that the weight-bearing related sensory information was needed to generate sufficient EMG patterns to effectively support full weight-bearing standing. In general, electrode configurations with cathodes selected in the caudal region of the array at relatively higher frequencies (25-60 Hz) resulted in the more effective EMG patterns for standing. These results show that human spinal circuitry can generate motor patterns effective for standing in the absence of functional supraspinal connections; however the appropriate selection of stimulation parameters is critical.

  17. A case of acute spinal intradural hematoma due to spinal anesthesia

    Institute of Scientific and Technical Information of China (English)

    Josu M Avecillas-Chasn; Jordi A Matias-Guiu; Gustavo Gomez; Javier Saceda-Gutierrez


    Spinal intradural hematoma is a rare complication of diagnostic lumbar puncture or spinal anesthesia. This complication could be overlooked with devastating neurological consequences due to a delay in diagnosis. Here, we reported a case of a patient with a lumbar spinal intradural hematoma as a result of a difficult spinal anesthesia.

  18. In situ ∼2.0 Ma trees discovered as fossil rooted stumps, lowermost Bed I, Olduvai Gorge, Tanzania. (United States)

    Habermann, Jörg M; Stanistreet, Ian G; Stollhofen, Harald; Albert, Rosa M; Bamford, Marion K; Pante, Michael C; Njau, Jackson K; Masao, Fidelis T


    The discovery of fossil rooted tree stumps in lowermost Lower Bed I from the western Olduvai Basin, Tanzania, age-bracketed by the Naabi Ignimbrite (2.038 ± 0.005 Ma) and Tuff IA (1.88 ± 0.05 Ma), provides the first direct, in situ, and to date oldest evidence of living trees at Olduvai Gorge. The tree relicts occur in an interval dominated by low-viscosity mass flow and braided fluvial sediments, deposited at the toe of a largely Ngorongoro Volcano-sourced volcaniclastic fan apron that comprised a widely spaced network of ephemeral braided streams draining northward into the Olduvai Basin. Preservation of the trees occurred through their engulfment by mass flows, post-mortem mold formation resulting from differential decay of woody tissues, and subsequent fluvially-related sediment infill, calcite precipitation, and cast formation. Rhizolith preservation was triggered by the interaction of root-induced organic and inorganic processes to form rhizocretionary calcareous root casts. Phytolith analyses were carried out to complete the paleoenvironmental reconstruction. They imply a pronounced seasonality and indicate a wooded landscape with grasses, shrubs, and sedges growing nearby, comparable to the low, open riverine woodland (unit 4c) along the Garusi River and tributaries in the Laetoli area. Among the tree stump cluster were found outsized lithic clasts and those consisting of quartzite were identified as Oldowan stone tool artifacts. In the context of hominin activity, the identification of wooded grassland in association with nearby freshwater drainages and Oldowan artifacts significantly extends our paleoenvironmental purview on the basal parts of Lower Bed I, and highlights the hitherto underrated role of the yet poorly explored western Olduvai Gorge area as a potential ecologically attractive setting and habitat for early hominins.

  19. Spinal cord stimulation or prostacyclin in unrevascularizable arteriopathy of lower limbs (SPINAL study: interim analysis results

    Directory of Open Access Journals (Sweden)

    Pedrini L


    Full Text Available Luciano Pedrini,1 Maria Sandra Ballestrazzi,1 Fabio Chierichetti,2 Luigi Comandatore,3 Filippo Magnoni,1 Reinhold Perkmann,4 Tommaso Castrucci,5 Domenico Palombo6On behalf of the SPINAL Study Group1Operative Unit of Vascular Surgery, Maggiore Hospital of Bologna, Bologna, Italy; 2Operative Unit of Vascular Surgery, Circle Hospital of Busto Arsizio, Busto Arsizio, Italy; 3Operative Unit of Vascular Surgery, AEO Morelli of Sondalo, Sondalo, Italy; 4Operative Unit of Vascular and Thoracic Surgery, Hospital of Bolzano, Bolzano, Italy; 5Operative Unit of Vascular Surgery of Sant'Eugenio Hospital, Rome, Italy; 6Operative Unit of Vascular and Endovascular Surgery, IRCCS San Martino, Genoa, ItalyObjective: The aim of this study was to compare the clinical efficacy and the safety of spinal cord stimulation (SCS plus medical treatment versus iloprost plus medical treatment in patients with severe unrevascularizable ischemia of the lower limbs due to atherosclerotic disease of the limbs and to identify predictive parameters for a positive outcome of SCS.Methods: A multicenter randomized controlled trial (RCT with central randomization and core laboratory evaluation of angiography, subdivided into two treatment arms (SCS and iloprost and two subgroups (rest pain and ulcer/gangrene. After the 15-day clinical efficacy evaluation, responder patients continued follow-up in their arm, while nonresponders could change arms or decline participation. The primary endpoint was 1-year limb salvage. Principal secondary endpoints were: survival rate; minor amputations and stump healing; ulcer healing; pain relief and analgesic intake; and predictive criteria for SCS treatment.Results: The trial was stopped at 35.6% of the expected sample due to low accrual rate. Fifty-two patients (55 legs entered the study. At the 15-day efficacy evaluation, responders (reduced pain, no increase of ulcer area comprised 74% of the SCS arm and 26% of the iloprost arm, (P=0.003. Nine

  20. Spinal Cord Injury Model System Information Network (United States)

    ... Go New to Website Managing Bowel Function After Spinal Cord Injury Resilience, Depression and Bouncing Back after SCI Getting ... the UAB-SCIMS Contact the UAB-SCIMS UAB Spinal Cord Injury Model System Newly Injured Health Daily Living Consumer ...

  1. Suicide in a spinal cord injured population

    DEFF Research Database (Denmark)

    Hartkopp, A; Brønnum-Hansen, Henrik; Seidenschnur, A M;


    To determine the relation between functional status and risk of suicide among individuals with spinal cord injury (SCI).......To determine the relation between functional status and risk of suicide among individuals with spinal cord injury (SCI)....

  2. Timing of Surgery After Spinal Cord Injury. (United States)

    Piazza, Matthew; Schuster, James


    Although timing for surgical intervention after spinal cord injury remains controversial, there is accumulating evidence suggesting that early surgery may improve neurologic outcomes, particularly with incomplete spinal cord injury, and may reduce non-neurologic complications and health care resource utilization. Moreover, even in patients with complete spinal cord injury, minor improvement in neurologic function can lead to significant changes in quality of life. This article reviews the experimental and clinical data examining surgical timing after spinal cord injury.

  3. MRI Findings in Spinal Canal Stenosis


    Maryam Barzin


    Spinal canal stenosis results from progressive narrowing of the central spinal canal and the lateral recesses. Primary (congenital) lumbar spinal stenosis is associated with achondroplastic dwarfism. The spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposus posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the facet joints, hypertrophy of the ligamentum flavum, epidural fat deposition, spon...

  4. Evaluation of spinal cord injury animal models

    Institute of Scientific and Technical Information of China (English)

    Ning Zhang; Marong Fang; Haohao Chen; Fangming Gou; Mingxing Ding


    Because there is no curative treatment for spinal cord injury, establishing an ideal animal model is important to identify injury mechanisms and develop therapies for individuals suffering from spinal cord injuries. In this article, we systematically review and analyze various kinds of animal models of spinal cord injury and assess their advantages and disadvantages for further studies.

  5. Functional outcome after a spinal fracture

    NARCIS (Netherlands)

    Post, Richard Bernardus


    This thesis takes a closer look at the functional outcome after a spinal fracture. An introduction to different aspects regarding spinal fractures is presented in Chapter 1. The incidence of traumatic thoracolumbar spinal fractures without neurological deficit in the Netherlands is approximately 1.2


    Directory of Open Access Journals (Sweden)

    Maksim Sergeevich Eliseev


    Full Text Available Spinal injury in gout occurs rarely at a young age. In the past 5 years, the Pubmed has published only 44 papers on this site of tophi mainly in gouty patients over 40 years of age. We report two such cases in patients with chronic tophaceous gout in a 28-year-old man with a 3-year history of gout and in a 30-year-old man with its 7-year history. In both cases, spinal injury with tophus masses gave rise to neurological symptomatology. Computed tomography and magnetic resonance imaging were of informative value in identifying the causes of pain. In one case, the patient underwent laminectomy; histological evidence confirmed the gouty genesis of spinal injury.

  7. Spinal reflexes in brain death. (United States)

    Beckmann, Yesim; Çiftçi, Yeliz; Incesu, Tülay Kurt; Seçil, Yaprak; Akhan, Galip


    Spontaneous and reflex movements have been described in brain death and these unusual movements might cause uncertainties in diagnosis. In this study we evaluated the presence of spinal reflexes in patients who fulfilled the criteria for brain death. Thirty-two (22 %) of 144 patients presented unexpected motor movements spontaneously or during examinations. These patients exhibited the following signs: undulating toe, increased deep tendon reflexes, plantar responses, Lazarus sign, flexion-withdrawal reflex, facial myokymia, neck-arm flexion, finger jerks and fasciculations. In comparison, there were no significant differences in age, sex, etiology of brain death and hemodynamic laboratory findings in patients with and without reflex motor movement. Spinal reflexes should be well recognized by physicians and it should be born in mind that brain death can be determined in the presence of spinal reflexes.

  8. Recurrent Primary Spinal Hydatid Cyst

    Directory of Open Access Journals (Sweden)

    Okan Turk


    Full Text Available Primary hydatid disease of spine is rare and spinal hydatitosis constitute only 1% of all hydatitosis. We report a case of recurrent primary intraspinal extradural hydatid cyst of the thoracic region causing progressive paraparesis. The patient was operated 16 years ago for primary spinal hydatid disease involvement and was instrumented dorsally for stabilization. The magnetic resonance imaging (MRI of thoracic spine showed a cystic lesion at T11-12 level and compressed spinal cord posterolaterally. Intraspinal cyst was excised through T11-12 laminectomy which made formerly. The early postoperative period showed a progressive improvement of his neurological deficit and he was discharged with antihelmintic treatment consisting of albendazole and amoxicillin-sulbactam combination. [Cukurova Med J 2015; 40(Suppl 1: 84-89

  9. Letak Conus Medularis terhadap Vertebra Menggunakan Hasil Pencitraan Magnetic Resonance Imaging di Rumah Sakit Dr. Hasan Sadikin Bandung untuk Anestesi Spinal

    Directory of Open Access Journals (Sweden)



    Full Text Available The position of conus medullaris is important to be identified by anesthesiologists during spinal anesthesia to avoid serious spinal cord trauma risk. Conus medullaris can be accurately identified through magnetic resonance imaging (MRI images. The aim of this study was to determine the distribution of conus medullaris in Indonesians through a descriptive observation using magnetic resonance imaging (MRI images of lumbosacral. The locations of conus medullaris were observed retrospectively on 135 MRI images scanned, aged 18–65 years, during the period of January 2013 to March 2014 at the Departement of Radiology, Dr. Hasan Sadikin General Hospital Bandung. From this study, it was revealed that the conus medullaris are mostly located at the middle third of L1, ranging from the middle third of T12 to the lower third of L2. With gender as a parameter, it was shown that the distribution of conus medullaris in women tends to be more caudal than in men

  10. Substituição dos ligamentos cruzados cranial e caudal em cães por duplo implante de polipropileno Replacement of the cranial and caudal cruciate ligaments in dogs by double t polypropylene implant


    Daniel Curvello de Mendonça Müller; Paula Cristina Basso; Gabriele Maria Callegaro Serafini; Maurício Borges da Rosa; Arícia Gomes Sprada; João Paulo Monteiro Carvalho Mori da Cunha; Ney Luis Pippi


    O objetivo deste trabalho é salientar uma alternativa eficaz no tratamento da ruptura dos ligamentos cruzados cranial e caudal de cães, sem associação de imobilização externa. Foram atendidos seis animais portadores de ruptura de ambos os ligamentos cruzados. Optou-se pela correção cirúrgica intracapsular, utilizando-se dois implantes sintéticos de polipropileno, para a estabilização da articulação. Os pacientes retornaram ao apoio completo do membro em 11,8±3,5 dias e não mantiveram i...

  11. Time course of immediate early gene protein expression in the spinal cord following conditioning stimulation of the sciatic nerve in rats. (United States)

    Bojovic, Ognjen; Panja, Debabrata; Bittins, Margarethe; Bramham, Clive R; Tjølsen, Arne


    Long-term potentiation induced by conditioning electrical stimulation of afferent fibers is a widely studied form of synaptic plasticity in the brain and the spinal cord. In the spinal cord dorsal horn, long-term potentiation is induced by a series of high-frequency trains applied to primary afferent fibers. Conditioning stimulation (CS) of sciatic nerve primary afferent fibers also induces expression of immediate early gene proteins in the lumbar spinal cord. However, the time course of immediate early gene expression and the rostral-caudal distribution of expression in the spinal cord have not been systematically studied. Here, we examined the effects of sciatic nerve conditioning stimulation (10 stimulus trains, 0.5 ms stimuli, 7.2 mA, 100 Hz, train duration 2 s, 8 s intervals between trains) on cellular expression of immediate early genes, Arc, c-Fos and Zif268, in anesthetized rats. Immunohistochemical analysis was performed on sagittal sections obtained from Th13- L5 segments of the spinal cord at 1, 2, 3, 6 and 12 h post-CS. Strikingly, all immediate early genes exhibited a monophasic increase in expression with peak increases detected in dorsal horn neurons at 2 hours post-CS. Regional analysis showed peak increases at the location between the L3 and L4 spinal segments. Both Arc, c-Fos and Zif268 remained significantly elevated at 2 hours, followed by a sharp decrease in immediate early gene expression between 2 and 3 hours post-CS. Colocalization analysis performed at 2 hours post-CS showed that all c-Fos and Zif268 neurons were positive for Arc, while 30% and 43% of Arc positive neurons were positive for c-Fos and Zif268, respectively. The present study identifies the spinal cord level and time course of immediate early gene (IEGP) expression of relevance for analysis of IEGPs function in neuronal plasticity and nociception.

  12. Bone marrow stem cells delivered into the subarachnoid space via cisterna magna improve repair of injured rat spinal cord white matter. (United States)

    Marcol, Wiesław; Slusarczyk, Wojciech; Sieroń, Aleksander L; Koryciak-Komarska, Halina; Lewin-Kowalik, Joanna


    The influence of bone marrow stem cells on regeneration of spinal cord in rats was investigated. Young adult male Wistar rats were used (n=22). Focal injury of spinal cord white matter at Th10 level was produced using our original non-laminectomy method by means of high-pressured air stream. Cells from tibial and femoral bone marrow of 1-month old rats (n=3) were cultured, labeled with BrdU/Hoechst and injected into cisterna magna (experimental group) three times: immediately after spinal cord injury and 3 as well as 7 days later. Neurons in brain stem and motor cortex were labeled with FluoroGold (FG) delivered caudally from the injury site a week before the end of experiment. Functional outcome and morphological features of regeneration were analyzed during 12-week follow-up. The lesions were characterized by means of MRI. Maximal distance of expansion of implanted cells in the spinal cord was measured and the number of FG-positive neurons in the brain was counted. Rats treated with stem cells presented significant improvement of locomotor performance and spinal cord morphology when compared to the control group. Distance covered by stem cells was 7 mm from the epicenter of the injury. Number of brain stem and motor cortex FG-positive neurons in experimental group was significantly higher than in control. Obtained data showed that bone marrow stem cells are able to induce the repair of injured spinal cord white matter. The route of cells application via cisterna magna appeared to be useful for their delivery in spinal cord injury therapy.

  13. Terminations of reticulospinal fibers originating from the gigantocellular reticular formation in the mouse spinal cord. (United States)

    Liang, Huazheng; Watson, Charles; Paxinos, George


    The present study investigated the projections of the gigantocellular reticular nucleus (Gi) and its neighbors--the dorsal paragigantocellular reticular nucleus (DPGi), the alpha/ventral part of the gigantocellular reticular nucleus (GiA/V), and the lateral paragigantocellular reticular nucleus (LPGi)--to the mouse spinal cord by injecting the anterograde tracer biotinylated dextran amine (BDA) into the Gi, DPGi, GiA/GiV, and LPGi. The Gi projected to the entire spinal cord bilaterally with an ipsilateral predominance. Its fibers traveled in both the ventral and lateral funiculi with a greater presence in the ventral funiculus. As the fibers descended in the spinal cord, their density in the lateral funiculus increased. The terminals were present mainly in laminae 7-10 with a dorsolateral expansion caudally. In the lumbar and sacral cord, a considerable number of terminals were also present in laminae 5 and 6. Contralateral fibers shared a similar pattern to their ipsilateral counterparts and some fibers were seen to cross the midline. Fibers arising from the DPGi were similarly distributed in the spinal cord except that there was no dorsolateral expansion in the lumbar and sacral segments and there were fewer fiber terminals. Fibers arising from GiA/V predominantly traveled in the ventral and lateral funiculi ipsilaterally. Ipsilaterally, the density of fibers in the ventral funiculus decreased along the rostrocaudal axis, whereas the density of fibers in the lateral funiculus increased. They terminate mainly in the medial ventral horn and lamina 10 with a smaller number of fibers in the dorsal horn. Fibers arising from the LPGi traveled in both the ventral and lateral funiculi and the density of these fibers in the ventral and lateral funiculi decreased dramatically in the lumbar and sacral segments. Their terminals were present in the ventral horn with a large portion of them terminating in the motor neuron columns. The present study is the first demonstration

  14. Effects of Reducing Suppressors of Cytokine Signaling-3 (SOCS3 Expression on Dendritic Outgrowth and Demyelination after Spinal Cord Injury.

    Directory of Open Access Journals (Sweden)

    Keun Woo Park

    Full Text Available Suppressors of cytokine signaling-3 (SOCS3 is associated with limitations of nerve growth capacity after injury to the central nervous system. Although genetic manipulations of SOCS3 can enhance axonal regeneration after optic injury, the role of SOCS3 in dendritic outgrowth after spinal cord injury (SCI is still unclear. The present study investigated the endogenous expression of SOCS3 and its role in regulating neurite outgrowth in vitro. Interleukin-6 (IL-6 induces SOCS3 expression at the mRNA and protein levels in neuroscreen-1 (NS-1 cells. In parallel to SOCS3 expression, IL-6 induced tyrosine phosphorylation of signal transducer and activator of transcription 3 (STAT3 in NS-1 cells. Lentiviral delivery of short hairpin RNA (shSOCS3 (Lenti-shSOCS3 to decrease SOCS3 expression into NS-1 cells enhanced IL-6-induced tyrosine phosphorylation of STAT3 (P-STAT3 Tyr705 and promoted neurite outgrowth. In addition, we determined if reduction of SOCS3 expression by microinjection of Lenti-shSOCS3 into spinal cord enhances dendrite outgrowth in spinal cord neurons after SCI. Knocking down of SOCS3 in spinal cord neurons with Lenti-shSOCS3 increased complete SCI-induced P-STAT3 Tyr705. Immunohistochemical analysis showed that complete SCI induced a significant reduction of microtubule association protein 2-positive (MAP-2+ dendrites in the gray and white matter at 1 and 4 weeks after injury. The SCI-induced reduction of MAP-2+ dendrites was inhibited by infection with Lenti-shSOCS3 in areas both rostral and caudal to the lesion at 1 and 4 weeks after complete SCI. Furthermore, shSOCS3 treatment enhanced up-regulation of growth associated protein-43 (GAP-43 expression, which co-localized with MAP-2+ dendrites in white matter and with MAP-2+ cell bodies in gray matter, indicating Lenti-shSOCS3 may induce dendritic regeneration after SCI. Moreover, we demonstrated that Lenti-shSOCS3 decreased SCI-induced demyelination in white matter of spinal cord both

  15. Effects of simulated microgravity on circadian rhythm of caudal arterial pressure and heart rate in rats and their underlying mechanism

    Directory of Open Access Journals (Sweden)

    Li CHEN


    Full Text Available Objective  To explore the effects of simulated microgravity on the circadian rhythm of rats' caudal arterial pressure and heart rate, and their underlying mechanism. Methods  Eighteen male SD rats (aged 8 weeks were randomly assigned to control (CON and tail suspension (SUS group (9 each. Rats with tail suspension for 28 days were adopted as the animal model to simulate microgravity. Caudal arterial pressure and heart rate of rats were measured every 3 hours. The circadian difference of abdominal aorta contraction was measured by aortic ring test. Western blotting was performed to determine and compare the protein expression level of clock genes such as Per2 (Period2, Bmal1 (Aryl hydrocarbon receptor nuclear translocatorlike and dbp (D element binding protein in suprachiasmatic nucleus (SCN and abdominal aorta of rats in CON and SUS group at different time points. Results  Compared with CON group, the caudal arterial pressure, both systolic and diastolic pressure, decreased significantly and the diurnal variability disappeared, meanwhile the heart rate increased obviously and also the diurnal variability disappeared in rats of SUS group. Compared with CON group, the contraction reactivity of abdominal aorta decreased with disappearence of the diurnal variability, and also the clock genes expression in SCN and abdominal aorta showed no diurnal variability in rats of SUS group. Conclusion  Simulated microgravity may lead to circadian rhythm disorders in rats' cardiovascular system, which may be associated with the changes of the clock genes expression. DOI: 10.11855/j.issn.0577-7402.2016.04.06


    Directory of Open Access Journals (Sweden)

    Diez Hernández Juan Manuel


    Full Text Available La explotación creciente de los recursos hídricos en Colombia requiere una reglamentación avanzada para determinar los Regímenes de Caudales Ambientales (RCA que fundamentan los Planes de Ordenación y Manejo de Cuencas Hidrográficas (POMCA. Entre la diversidad de enfoques propuestos para evaluar RCA, el más utilizado y aceptado científicamente es la conocida metodología «Instream Flow Incremental Methodology» (IFIM, cuya aplicabilidad en los ríos de Colombia se ensaya por primera vez en este trabajo. La modelación IFIM del río Palacé aguas abajo de la nueva captación de 500 l/s para el acueducto de Popayán (Cauca revela que el efecto de la detracción limitada del 6.78% del caudal medio anual sobre la integridad ecosistémica fluvial es muy leve. Las simulaciones eco­ hidráulica y eco­ hidrológica del tramo fluvial representativo (longitud 500m, anchura 18m, pendiente 5% y granulometría gruesa con el programa RHABSIM 3.0, detectaron disminuciones poco significativas del hábitat disponible para la ictiofauna y los macroinvetebrados acuáticos. En consecuencia, el manejo de caudales actual del Palacé vinculado a la captación del nuevo acueducto de Popayán es corroborado, según este análisis avanzado IFIM, como un RCA satisfactorio. Este trabajo sugiere investigaciones dirigidas al perfeccionamiento y particularización de IFIM para las condiciones fluviales de Colombia.

  17. Effects of ketamine and midazolam on emergence agitation after sevoflurane anaesthesia in children receiving caudal block: a randomized trial

    Directory of Open Access Journals (Sweden)

    Ayse Ozcan


    Full Text Available Background and objectives: Emergence agitation is a common postanaesthetic problem in children after sevoflurane anaesthesia. We aimed to compare the effects of ketamine and midazolam administered intravenously, before the end of surgery, for prevention of emergence agitation in children who received caudal block for pain relief under sevoflurane anaesthesia. Methods: 62 American Society of Anesthesiologists patient classification status I children, aged 2–7 years, scheduled for inguinal hernia repair, circumcision or orchidopexy were enrolled to the study. Anaesthesia was induced with sevoflurane 8% in a mixture of 50% oxygen and nitrous oxide. After achieving adequate depth of anaesthesia, a laryngeal mask was placed and then caudal block was performed with 0.75 mL kg−1, 0.25% bupivacaine. At the end of the surgery, ketamine 0.25 mg kg−1, midazolam 0.03 mg kg−1 and saline were given to ketamine, midazolam and control groups, respectively. Agitation was assessed using Paediatric Anaesthesia Emergence Delirium scale and postoperative pain was evaluated with modified Children's Hospital of Eastern Ontario Pain Scale. Results and conclusions: Modified Children's Hospital of Eastern Ontario Pain Scale scores were found higher in control group than in ketamine and midazolam groups. Paediatric Anaesthesia Emergence Delirium scores were similar between groups. Modified Children's Hospital of Eastern Ontario Pain Scale and Paediatric Anaesthesia Emergence Delirium scores showed a significant decrease by time in all groups during follow-up in postanaesthesia care unit. The present study resulted in satisfactory Paediatric Anaesthesia Emergence Delirium scores which are below 10 in all groups. As a conclusion, neither ketamine nor midazolam added to caudal block under sevoflurane anaesthesia did show further effect on emergence agitation. In addition, pain relief still seems to be the major factor in preventing emergence agitation after

  18. Ontogeny of head and caudal fin shape of an apex marine predator: The tiger shark (Galeocerdo cuvier). (United States)

    Fu, Amy L; Hammerschlag, Neil; Lauder, George V; Wilga, Cheryl D; Kuo, Chi-Yun; Irschick, Duncan J


    How morphology changes with size can have profound effects on the life history and ecology of an animal. For apex predators that can impact higher level ecosystem processes, such changes may have consequences for other species. Tiger sharks (Galeocerdo cuvier) are an apex predator in tropical seas, and, as adults, are highly migratory. However, little is known about ontogenetic changes in their body form, especially in relation to two aspects of shape that influence locomotion (caudal fin) and feeding (head shape). We captured digital images of the heads and caudal fins of live tiger sharks from Southern Florida and the Bahamas ranging in body size (hence age), and quantified shape of each using elliptical Fourier analysis. This revealed changes in the shape of the head and caudal fin of tiger sharks across ontogeny. Smaller juvenile tiger sharks show an asymmetrical tail with the dorsal (upper) lobe being substantially larger than the ventral (lower) lobe, and transition to more symmetrical tail in larger adults, although the upper lobe remains relatively larger in adults. The heads of juvenile tiger sharks are more conical, which transition to relatively broader heads over ontogeny. We interpret these changes as a result of two ecological transitions. First, adult tiger sharks can undertake extensive migrations and a more symmetrical tail could be more efficient for swimming longer distances, although we did not test this possibility. Second, adult tiger sharks expand their diet to consume larger and more diverse prey with age (turtles, mammals, and elasmobranchs), which requires substantially greater bite area and force to process. In contrast, juvenile tiger sharks consume smaller prey, such as fishes, crustaceans, and invertebrates. Our data reveal significant morphological shifts in an apex predator, which could have effects for other species that tiger sharks consume and interact with.

  19. Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain

    Directory of Open Access Journals (Sweden)

    Manchikanti L


    Full Text Available Laxmaiah Manchikanti,1,2 Kimberly A Cash,1 Carla D McManus,1 Vidyasagar Pampati11Pain Management Center of Paducah, Paducah, 2Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USABackground: Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections.Methods: A randomized, double-blind, actively controlled trial was conducted. The objective was to evaluate the ability to assess the effectiveness of caudal epidural injections of local anesthetic with or without steroids for managing chronic low back pain not caused by disc herniation, radiculitis, facet joints, or sacroiliac joints. A total of 120 patients were randomized to two groups; one group did not receive steroids (group 1 and the other group did (group 2. There were 60 patients in each group. The primary outcome measure was at least 50% improvement in Numeric Rating Scale and Oswestry Disability Index. Secondary outcome measures were employment status and opioid intake. These measures were assessed at 3, 6, 12, 18, and 24 months after treatment.Results: Significant pain relief and functional status improvement (primary outcome defined as a 50% or more reduction in scores from baseline, were observed in 54% of patients in group 1 and 60% of patients in group 2 at 24 months. In contrast, 84% of patients in group 1 and 73% in group 2 saw significant pain relief and functional status improvement in the successful groups at 24 months.Conclusion: Caudal epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and


    Institute of Scientific and Technical Information of China (English)



    @@ Caudal pain is a relatively special disease of orthopedics and refers to the pain around the coccyx region, the lower part of sacral bone and its surrounding soft tissues including muscles, etc.. The serious case is usually caused by trauma and accompanied with dropping and distending sensation in the local region. The author of the present paper adopted moxibustion of Changqiang (GV 1) point in combination with massage around the inside of the anus and achieved an obviously curative effect. The results are reported as follows.

  1. Systematization, description, and territory of the caudal cerebral artery in surface of the brain of the ostrich (Struthio camelus). (United States)

    Nazer, Manoel; Campos, Rui


    Brain specimens from 30 ostriches were injected with red-dyed latex via the internal carotid arteries, and the caudal cerebral arteries and their branches were systematically described. On the right side, the caudal cerebral artery was double-, triple-, quadruple-, and single-branched in 73.5%, 23.3%, 3.3%, and 3.3% of cases, respectively; on the left side, it was double-, triple-, quadruple-, and single-branched in 76.7%, 20%, 3.3%, and 3.3% of cases, respectively. The dorsal tectal mesencephalic artery appeared as a single vessel in 96.7% of cases, emerging as a collateral branch of the caudal cerebral artery. The dorsal mesencephalic tectal artery originated from the right dorsal cerebellar artery in 40% of cases and from the left side in 63.3% of cases. On the right side, there were four and three medial occipital hemispheric branches in 46.7% and 20% of cases, respectively; on the left side, there were four and three branches in 30% and 26.7% of cases. On the right side, the pineal artery was double-, single-, triple-, and quadruple-branched in 50%, 23.3%, 20%, and 6.7% of cases, respectively; on the left side, this artery was double-, single-, triple-, and quadruple-branched in 50%, 23.3%, 16.7%, and 10% of cases, respectively. The diencephalic artery was on the right side in 43.3% of cases and on the left side in 56.7% of cases. The interhemispheric artery was on the right side in 56.7% of cases and on the left side in 43.3% of cases; four, three, two, five, and one dorsal hemispheric trunks branched off of the interhemispheric artery in 40%, 40%, 10%, 6.7%, and 26.7% of cases, respectively. The caudal cerebral artery was classified as Type I in 56.7% of cases (subtype IA in 33.3% of cases and IB in 23.3% of cases), Type II in 40% of cases (subtype IIA in 20% of cases and IIB in 20% of cases), and Type III in 3.3% of cases.

  2. Predicción de caudales medios mensuales en ríos de Colombia usando RNA y MARS.


    Velásquez Girón, Nicolás; SÁNCHEZ MOLINA, JOANY; Carvajal Serna, Luis Fernando


    Se implementan dos metodologías para el pronóstico de caudales medios mensuales en ríos de Colombia: (i) MARS ("Multivariate Adaptative Regresion Splines"), y (ii) RNA (Redes Neuronales Artificiales). El método no paramétrico de MARS y el método RNA, permiten incorporar la persistencia hidrológica y la influencia de fenómenos macroclimáticos como el ENSO. Las predicciones se hicieron durante el período 1996-2007 para seis ríos de Colombia, los cuales son importantes en la generación de ener...

  3. Spinal angiography: vascular anatomy, technique, indications; Spinale Angiographie: Gefaessanatomie, Technik und Indikationsstellung

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    Grunwald, I.; Reith, W. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. fuer Neuroradiologie; Thron, A. [Universitaetsklinik der RWTH Aachen (Germany). Abteilung fuer Neuroradiologie


    The indication for spinal angiography has to be closely set as in case of inadequate handling this procedure bares the risk of paraplegia. In unclear spinal symptoms lasting over a longer periode of time, spinal vascular malformation have to be considered. Spinal vascular malformations are often reversibel, especially if diagnosed early. Diagnostic methods have to include spinal angiography if other non-invasive methods do not lead to results. The main point is to consider spinal vascular malformations in unclear cases. (orig.) [German] Die Indikation zu einer spinalen Angiographie muss streng gestellt werden, da bei unsachgemaesser Durchfuehrung dieser Untersuchung die Gefahr einer bleibenden Querschnittsymptomatik besteht. Bei unklarer spinaler Symptomatik, die ueber einen laengeren Zeitraum progredient ist, muss jedoch immer auch an eine spinale Gefaessfehlbildung gedacht werden. Die durch alle diagnostischen Moeglichkeiten einschliesslich der spinalen Angiographie diagnostizierten spinalen Gefaessfehlbildungen sind haeufig kurabel, insbesondere bei frueher Diagnosestellung. Der wichtigste Punkt ist jedoch, dass differenzialdiagnostisch auch an eine spinale Gefaessfehlbildung gedacht wird. (orig.)

  4. Addition of clonidine or fentanyl to local anaesthetics prolongs the duration of surgical analgesia after single shot caudal block in children. (United States)

    Constant, I; Gall, O; Gouyet, L; Chauvin, M; Murat, I


    Caudal anaesthesia is indicated for surgical procedures lasting less than 90 min. Fentanyl and clonidine are known to prolong postoperative caudal analgesia, but there are no data on their effect on duration of surgical analgesia. We evaluated if the addition of clonidine or fentanyl to local anaesthetics prolonged the duration of surgical analgesia after single shot caudal block in children in a randomized, double-blind study. We studied 64 children, aged 6-108 months, undergoing bilateral correction of vesicoureteral reflux which was expected to last more than 90 min. Patients were allocated to one of four groups: group O received 1 ml kg-1 of a mixture of 0.25% bupivacaine with epinephrine and 1% lidocaine in equal parts; group F received the same mixture of local anaesthetics in addition to fentanyl 1 microgram kg-1; group C received the same mixture of local anaesthetics in addition to clonidine 1.5 micrograms kg-1; and group C + F received the same mixture of local anaesthetics in addition to fentanyl 0.5 microgram kg-1 and clonidine 0.75 microgram kg-1. Single shot caudal block was sufficient in only 57% of children in group O compared with 93% in groups C and F and 86% in group C + F (P = 0.035). Global assessment of anaesthesia, defined as the time from caudal injection to the first administration of analgesic (either during or after surgery), was significantly longer in the three groups of children who received additives compared with local anaesthetics alone (P = 0.035), but there were no differences between the three additive groups. Vomiting was observed only in children who received fentanyl. Addition of clonidine or fentanyl to local anaesthetics prolonged the duration of surgical analgesia of caudal block, allowing single shot caudal anaesthesia to be recommended for surgery lasting 90-150 minutes. Clonidine had some advantages over fentanyl as it did not produce clinically significant side effects.

  5. Spinal cord injury at birth

    DEFF Research Database (Denmark)

    Fenger-Gron, Jesper; Kock, Kirsten; Nielsen, Rasmus G;


    UNLABELLED: A case of perinatally acquired spinal cord injury (SCI) is presented. The foetus was vigorous until birth, the breech presented and delivery was performed by a non-traumatic Caesarean section. The infant displayed symptoms of severe SCI but diagnosis was delayed due to severe co...

  6. Functional evaluation using several evoked spinal cord potentials in elderly patients with cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Zhenglin Li


    spinal cord lesion with respect to the corticospinal tract in white matter. The abnormalities of Spinal-ESCPs were defined as marked reduction in the size of negative peak (reduction of over 50%). The most caudal intervertebral level showing abnormal Spinal-ESCPs was considered as the lower level of the spinal cord lesion with respect to the dorsal column pathway in white matter. The abnormalities of MN-ESCPs were defined as attenuation of the N13 amplitude,which was considered as the lesion level of the spinal cord with respect to the dorsal horn in gray matter. Radiological investigation: Lateral view of plain X-ray films was obtained in flexion and extension of the cervical spine. Instability of the cervical intervertebral level was determined as horizontal displacement of the vertebral body of over 3 mm.MAIN OUTCOME MEASURES: The results of examination of TCE-ESCPs, Spinal-ESCPs and MN-ESCPs in elderly patients with CSM.RESULTS: The 23 elderly patients with CSM were participated in the result analysis. ①TCE-ESCPs: The impairment of the corticospinal tract in white matter at single intervertebral level was revealed in 18 of 23 patients by recordings of TCE-ESCPs (sensitivity 78%). In the 18 patients, the lesion level was shown at the upper cervical segment in 14 patients (C3-4 n=10 and C4-5 n=4), and at the lower cervical segment in 4 patients (C5-6 n=4). ②Spinal-ESCPs: The impairment of the dorsal column pathway of white matter at single interverte bral level was revealed in 17 of 23 patients, by recordings of Spinal-ESCPs (sensitivity 74%). In the 17 patients, the lesion level was presented at the upper cervical segment in 14 patients (C3-4 n=10 and C4-5 n=4),and at the lower cervical segment in 3 patients (C5-6 n=3). ③MN-ESCPs: All patients revealed abnormal MN-ESCPs at one or more intervertebral levels (sensitivity 100%). The impairment at single intervertebral level was demonstrated in 17 patients, and the impairment at multiple intervertebral levels was

  7. Evaluation of the anatomical and functional consequences of repetitive mild cervical contusion using a model of spinal concussion. (United States)

    Jin, Ying; Bouyer, Julien; Haas, Christopher; Fischer, Itzhak


    the lesion epicenter. Reactive astrocytes were present in both groups, with the majority found at the lesion epicenter in the C1 group, whereas the C2 group demonstrated increased reactive astrocytes extending 1mm caudal to the lesion epicenter. Macrophages accumulated within the injured, dorsal and ipsilateral spinal cord, with significant increases at 2 and 3mm rostral to the epicenter in the C2 group. Our model is designed to represent the clinical presentation of spinal cord concussion, and highlight the susceptibility and functional sequelae of repeated injury. Future experiments will examine the temporal and spatial windows of vulnerability for repeated injuries.

  8. Spaceflight-induced bone loss alters failure mode and reduces bending strength in murine spinal segments. (United States)

    Berg-Johansen, Britta; Liebenberg, Ellen C; Li, Alfred; Macias, Brandon R; Hargens, Alan R; Lotz, Jeffrey C


    Intervertebral disc herniation rates are quadrupled in astronauts following spaceflight. While bending motions are main contributors to herniation, the effects of microgravity on the bending properties of spinal discs are unknown. Consequently, the goal of this study was to quantify the bending properties of tail discs from mice with or without microgravity exposure. Caudal motion segments from six mice returned from a 30-day Bion M1 mission and eight vivarium controls were loaded to failure in four-point bending. After testing, specimens were processed using histology to determine the location of failure, and adjacent motion segments were scanned with micro-computed tomography (μCT) to quantify bone properties. We observed that spaceflight significantly shortened the nonlinear toe region of the force-displacement curve by 32% and reduced the bending strength by 17%. Flight mouse spinal segments tended to fail within the growth plate and epiphyseal bone, while controls tended to fail at the disc-vertebra junction. Spaceflight significantly reduced vertebral bone volume fraction, bone mineral density, and trabecular thickness, which may explain the tendency of flight specimens to fail within the epiphyseal bone. Together, these results indicate that vertebral bone loss during spaceflight may degrade spine bending properties and contribute to increased disc herniation risk in astronauts.

  9. Experimental Model of Proximal Junctional Fracture after Multilevel Posterior Spinal Instrumentation (United States)

    Levasseur, Annie; Parent, Stefan; Petit, Yvan


    There is a high risk of proximal junctional fractures (PJF) with multilevel spinal instrumentation, especially in the osteoporotic spine. This problem is associated with significant morbidity and possibly the need for reoperation. Various techniques have been proposed in an attempt to decrease the risk of PJF but there is no experimental model described for in vitro production of PJF after multilevel instrumentation. The objective of this study is to develop an experimental model of PJF after multilevel posterior instrumentation. Initially, four porcine specimens including 4 vertebrae and instrumented at the 3 caudal vertebrae using a pedicle screw construct were subjected to different loading conditions. Loading conditions on porcine specimens involving cyclic loading along the axis of the center vertebral body line, with constrained flexion between 0° and 15° proximally, and fully constraining the specimen distally resulted in a fracture pattern most representative of a PJF seen clinically in humans, so to undergo human cadaveric testing with similar loading conditions was decided. Clinically relevant PJF were produced in all 3 human specimens. The experimental model described in this study will allow the evaluation of different parameters influencing the incidence and prevention of PJF after multilevel posterior spinal instrumentation. PMID:27610381

  10. FGF-dependent Notch signaling maintains the spinal cord stem zone (United States)

    Akai, Jun; Halley, Pam A.; Storey, Kate G.


    Generation of the spinal cord relies on proliferation of undifferentiated cells located in a caudal stem zone. Although fibroblast growth factor (FGF) signaling is required to maintain this cell group, we do not know how it controls cell behavior in this context. Here we characterize an overlooked expression domain of the Notch ligand, Delta1, in the stem zone and demonstrate that this constitutes a proliferative cell group in which Notch signaling is active. We show that FGF signaling is required for expression of the proneural gene cash4 in the stem zone, which in turn induces Delta1. We further demonstrate that Notch signaling is required for cell proliferation within the stem zone; however, it does not regulate cell movement out of this region, nor is loss of Notch signaling sufficient to drive neuronal differentiation within this tissue. These data identify a novel role for the Notch pathway during vertebrate neurogenesis in which signaling between high Delta1-expressing cells maintains the neural precursor pool that generates the spinal cord. Our findings also suggest a mechanism for the establishment of the cell selection process, lateral inhibition: Mutual inhibition between Delta/Notch-expressing stem zone cells switches to single Delta1-presenting neurons as FGF activity declines in the newly formed neuroepithelium. PMID:16287717

  11. Mini-Open Anterior Lumbar Interbody Fusion Combined with Lateral Lumbar Interbody Fusion in Corrective Surgery for Adult Spinal Deformity (United States)

    Lee, Chong-Suh; Chung, Sung-Soo; Lee, Jun-Young; Yum, Tae-Hoon; Shin, Seong-Kee


    Study Design Prospective observational study. Purpose To introduce the techniques and present the surgical outcomes of mini-open anterior lumbar interbody fusion (ALIF) at the most caudal segments of the spine combined with lateral lumbar interbody fusion (LLIF) for the correction of adult spinal deformity Overview of Literature Although LLIF is increasingly used to correct adult spinal deformity, the correction of sagittal plane deformity with LLIF alone is reportedly suboptimal. Methods Thirty-two consecutive patients with adult spinal deformity underwent LLIF combined with mini-open ALIF at the L5–S1 or L4–S1 levels followed by 2-stage posterior fixation. ALIF was performed for a mean 1.3 levels and LLIF for a mean 2.7 levels. Then, percutaneous fixation was performed in 11 patients (percutaneous group), open correction with facetectomy with or without laminectomy in 16 (open group), and additional pedicle subtraction osteotomy (PSO) in 5 (PSO group). Spinopelvic parameters were compared preoperatively and postoperatively. Hospitalization data and clinical outcomes were recorded. Results No major medical complications developed, and clinical outcomes improved postoperatively in all groups. The mean postoperative segmental lordosis was greater after ALIF (17.5°±5.5°) than after LLIF (8.1°±5.3°, p sagittal balance and reducing the necessity of more extensive surgery. PMID:27994777

  12. Pressure changes in spinal canal and evaluation of spinal cord injuries in spinal section subjected to impact

    Institute of Scientific and Technical Information of China (English)


    Objective: To observe pressure changes in the spinal canal of the vertebrarium subjected to impact. From the point of view of impact, pressure changes and spinal cord injuries, the relationship between the type of spinal fracture and the severity of spinal cord injuries were analyzed and some experimental data were provided for early evaluation of severity of spinal cord injuries.   Methods: An experimental model of spinal burst fracture was made with Type BIM-I bio-impact machine and techniques of high velocity vertical loading in static pattern and stress shielding were adopted. Vertebral sections T10-L4 taken from fresh cadavers were impacted and pressure changes in the spinal canal were observed. The types and severity of spinal fracture were studied with gross and radiography examination.   Results: Great positive pressure wave (wave A) in the spinal canal of the 4 vertebral specimens with burst fracture was recorded. The peak value of pressure was correlated with the severity of posterior column injuries. Generally, the peak value of pressure was low in the samples with posterior column injuries, but high in the samples without injuries. The predominant features of fractures were burst fractures of vertebral body and severe destruction of the skeletal and fiber structure of the spinal canal. Positive and negative pressure waves (wave B) were recorded in 2 vertebral samples in which no significant abnormal changes were found by radiography examination, however, a little liquid effusion in the vertebral body was found by gross examination.   Conclusions: The type of pressure wave in the spinal canal is related to the deformation or the destruction of the spinal canal structure. The peak value of the pressure is non-linearly related to the obstruction in the spinal canal, but related to posterior column injuries.

  13. Acetylcarnitine metabolism and the partial purification and characterization of an acetylcarnitine hydrolase from bovine caudal epididymal spermatozoa

    Energy Technology Data Exchange (ETDEWEB)

    Bruns, K.A.


    Epididymal spermatozoa are capable of utilizing extracellular substrates for energy, but carbohydrates and free or esterified fatty acids are present in only very low concentrations in epididymal fluid. Acetyl-L-carnitine has been identified in epididymal fluid in low mM concentrations in several mammalian species and could possibly be an energy substrate for epididymal spermatozoa. Evidence that extracellular acetyl-L-carnitine can be used by intact caudal epididymal spermatozoa for energy, and a model for the metabolism of acetyl-L-carnitine by epididymal spermatozoa are presented here. Intact bovine and hamster caudal epididymal spermatozoa oxidized (1-{sup 14}C) acetyl-L-carnitine to {sup 14}CO{sub 2} in a time-, cell number-, and substrate concentration-dependent manner. No concomitant uptake of acetyl-D,L-(N-methyl-{sup 3}H) carnitine was observed by cells from the same preparations. Half-maximal rates of oxidation were observed at 8 mM and 4.5 mM acetyl-L-carnitine for the two species, respectively; the rates of oxidation at these concentrations were 15.3 nmol/10{sup 8} cells{centered dot}h and 2.9 nmol/10{sup 7} cells{centered dot}h. Intact spermatozoa in incubation with ({sup 3}H) acetyl-L-carnitine were observed to produce ({sup 3}H) acetate in the medium, and addition of sodium acetate competed for the uptake of radioactive acetate by these cells.

  14. Hemodynamic and respiratory responses to microinjection of ATP into the intermediate and caudal NTS of awake rats. (United States)

    Antunes, Vagner R; Bonagamba, Leni G H; Machado, Benedito H


    The nucleus tractus solitarii (NTS) is the site of integration of the peripheral chemoreceptor afferents in the brainstem. Previous studies from our laboratory have shown that microinjection of ATP into the intermediate NTS produced increases in arterial pressure and bradycardia. In the present study, we evaluated the hemodynamic and respiratory responses to microinjection of ATP into the intermediate and caudal commissural NTS. In the same group of rats the responses were compared with cardiorespiratory responses to chemoreflex activation (KCN, i.v.). The data show that microinjection of ATP into the intermediate NTS produced pressor and bradycardic responses similar to those observed in response to chemoreflex activation but apnoea instead of tachypnoea. Microinjection of ATP into caudal commissural NTS produced increase in arterial pressure and tachypnoea similar to the chemoreflex but a minor bradycardia. The data show that microinjection of ATP into different sub-regions of the NTS produces a diverse pattern of hemodynamic and respiratory responses and suggest the involvement of this purine in the neurotransmission of the cardiovascular reflex in the NTS.


    Directory of Open Access Journals (Sweden)



    Full Text Available Urethroplasty surgery is a painful procedure demanding high doses of analgesics, which may be associated with adverse effects and associated with significant blood loss. Caudal blockade provides good analgesia and hemodynamic stability and is probably a useful supplement in these surgeries. OBJECTIVES To compare the heart rate, blood pressure response to surgical stimuli and the incidence of blood transfusion rate post-operatively between 2 groups – A General Anaesthesia only. B General Anaesthesia with caudal block. SETTINGS AND DESIGN Study was conducted in 100 children, randomly divided into two groups A and B. Only ASA grade 1 patients aged 2-5yrs. undergoing urethroplasty for hypospadias were included. MATERIALS AND METHODS 1ml/kg of 0.125% bupivacaine was used for caudal blockade in group B (GA+CAUDAL and compared with group A (Only GA. Heart rate and blood pressure were recorded for every 5 min. Blood loss and requirement of blood transfusions were recorded at the end of the surgery. RESULTS There were statistically significant haemodynamic changes and blood transfusion requirement during surgery in group A. In Group B haemodynamic parameters were stable (P value 0 and blood transfusion requirement was also less (p value 0.00054 (P<0.01. CONCLUSION Caudal blockade when supplemented with general anaesthesia reduces blood loss, decreases requirement for blood transfusion and maintains haemodynamic stability.

  16. Cryptorchidism as a caudal developmental field defect. A new description of cryptorchidism associated with malformations and dysplasias of the kidneys, the ureters and the spine from T10 to S5

    DEFF Research Database (Denmark)

    Cortes, D; Thorup, J M; Beck, B L;


    to S5. The description of this association is new. The association was seen in 18% of cryptorchid boys younger than 3 years of age in a department of paediatric surgery, in 34% of cryptorchid foetuses who died in the third trimester, in 65% of cryptorchid patients with imperforate anus, and in all...... individuals with tritonmelia, the male variant of sirenomelia. Sirenomelia/tritonmelia is an extreme degree of abnormal differentiation of the caudal developmental field, also called caudal dysplasia, the caudal regression syndrome and the caudal regression malformation sequence. Caudal developmental field...... defects were also the predominant abnormalities in the other groups of patients. Thus, cryptorchidism may be a feature of abnormal differentiation of the caudal developmental field. Position and histology of the undescended testes of the patients included in the association were similar...

  17. Neuroimaging for spine and spinal cord surgery

    Energy Technology Data Exchange (ETDEWEB)

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


    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)

  18. Pathogenesis of spinally mediated hyperalgesia in diabetes. (United States)

    Ramos, Khara M; Jiang, Yun; Svensson, Camilla I; Calcutt, Nigel A


    Hyperalgesia to noxious stimuli is accompanied by increased spinal cyclooxygenase (COX)-2 protein in diabetic rats. The present studies were initiated to establish causality between increased spinal COX-2 activity and hyperalgesia during diabetes and to assess the potential involvement of polyol pathway activity in the pathogenesis of spinally mediated hyperalgesia. Rats with 1, 2, or 4 weeks of streptozotocin-induced diabetes exhibited significantly increased levels of spinal COX-2 protein and activity, along with exaggerated paw flinching in response to 0.5% paw formalin injection. Increased flinching of diabetic rats was attenuated by intrathecal pretreatment with a selective COX-2 inhibitor immediately before formalin injection, confirming the involvement of COX-2 activity in diabetic hyperalgesia. Chronic treatment with insulin or ICI222155, an aldose reductase inhibitor (ARI) previously shown to prevent spinal polyol accumulation and formalin-evoked hyperalgesia in diabetic rats, prevented elevated spinal COX-2 protein and activity in diabetic rats. In contrast, the ARI IDD676 had no effect on spinal polyol accumulation, elevated spinal COX-2, or hyperalgesia to paw formalin injection. In the spinal cord, aldose reductase immunoreactivity was present solely in oligodendrocytes, which also contained COX-2 immunoreactivity. Polyol pathway flux in spinal oligodendrocytes provides a pathogenic mechanism linking hyperglycemia to hyperalgesia in diabetic rats.

  19. Collateral development and spinal motor reorganization after nerve injury and repair. (United States)

    Yu, Youlai; Zhang, Peixun; Han, Na; Kou, Yuhui; Yin, Xiaofeng; Jiang, Baoguo


    Functional recovery is often unsatisfactory after severe extended nerve defects or proximal nerve trunks injuries repaired by traditional repair methods, as the long regeneration distance for the regenerated axons to reinnervate their original target end-organs. The proximal nerve stump can regenerate with many collaterals that reinnervate the distal stump after peripheral nerve injury, it may be possible to use nearby fewer nerve fibers to repair more nerve fibers at the distal end to shorten the regenerating distance. In this study, the proximal peroneal nerve was used to repair both the distal peroneal and tibial nerve. The number and location of motor neurons in spinal cord as well as functional and morphological recovery were assessed at 2 months, 4 months and 8 months after nerve repair, respectively. Projections from the intact peroneal and tibial nerves were also studied in normal animals. The changes of motor neurons were assessed using the retrograde neurotracers FG and DiI to backlabel motor neurons that regenerate axons into two different pathways. To evaluate the functional recovery, the muscle forces and sciatic function index were examined. The muscles and myelinated axons were assessed using electrophysiology and histology. The results showed that all labeled motor neurons after nerve repair were always confined within the normal peroneal nerve pool and nearly all the distribution of motor neurons labeled via distal different nerves was disorganized as compared to normal group. However, there was a significant decline in the number of double labeled motor neurons and an obvious improvement with respect to the functional and morphological recovery between 2 and 8 months. In addition, the tibial/peroneal motor neuron number ratio at different times was 2.11±0.05, 2.13±0.08, 2.09±0.12, respectively, and was close to normal group (2.21±0.09). Quantitative analysis showed no significant morphological differences between myelinated nerve fibers

  20. Spinal tuberculoma in a patient with spinal myxopapillary ependymoma

    Directory of Open Access Journals (Sweden)

    Arora Brijesh


    Full Text Available Intramedullary spinal tuberculosis is a clinical curiosity. A 19-year-old female was diagnosed and treated for lumbosacral myxopapllary ependy moma (MPE. Three years later, she presented with back pain and hypoesthesia of the left upper limb. Besides revealing local recurrence, the MRI demonstrated a fresh lesion in the cervicomedullary area. The latter was operated and the histopathology revealed a tuberculoma.

  1. 应用木腐菌处理松材线虫病疫木伐桩的研究%Study on Using Wood-rotting Fungi to Treat Stumps of Dead Wood Caused by PWN (Bursaphelenchus xylophilus)

    Institute of Scientific and Technical Information of China (English)

    邓习金; 刘晖; 罗惠文; 黄燕洪


    Diseased stumps is cure difficulty of pine wood nematode disease, it is an environmental protection, control technology effectively that using wood rotting fungi treated pine wood nematode infected stumps. In th is study, the 13 kinds of wood-rotting fungi were chosen to evaluate the irrelation with Bursaphelenchus xylophilus ( PWN ) , the ability to decompose the wood specimens of Pinus massoniana and the stumps of dead pine trees caused by PWN, by screening and propagating good strains of the wood-rotting fungi, and using to field test, the results showed that all the wood-rotting fungi tested had certa in nematicidal effects on PWN except Schizophyllum commune and Coriolus versicolor, and 6 strains could completely inhibit the pine wood nematode, they are Tremellodon gelatinosum, Fomitopsis pinicola, Pleurotus ostreatus, Laetiporus sulphureus, Poria cocos, Ganoderma lucidum. The test results of decomposing pine wood and disease stumps showed that they had played some decomposition effect to the diseased stumps, after treating stumps inoculating above 6 strains for 70 d, especially, Laetiporus sulphureus showed higher ability to decomposing and colonising the stumps,and inhibiting and killing nematodes, it could be used to treat stumps of dead wood caused by PWN in the future.%疫木伐桩是松材线虫病除治中的难点,利用木腐菌处理松材线虫病疫木伐桩是一项环保、有效的伐桩处理技术。本试验研究了13种木腐菌对松材线虫的抑制作用以及对马尾松木块和松材线虫病疫木伐桩的分解能力,通过对木腐菌的筛选、优良菌株的扩繁,将优良木腐菌应用于松材线虫病疫木伐桩野外试验,结果表明,供试菌株除裂褶菌和杂色云芝外,其他菌都能抑制松材线虫的生长与繁殖,其中虎掌菌、松生拟层孔菌、粗皮侧耳、硫磺菌、茯苓和灵芝等6个菌能完全抑制松材线虫的数量。对马尾松木块及疫木伐桩的分解试

  2. 上肢残肢的常规康复治疗和肌电信号反馈训练%The prosthetic rehabilitation and training of myoelectric signal for upper limb stumps

    Institute of Scientific and Technical Information of China (English)

    武继祥; 刘宏亮; 周贤丽; 林永辉; 赵正福; 陈东; 吴宗耀


    Objective To evaluate the effect of prosthetic rehabilitation and analyze the exercise training program with myoelectric signal for upper limb stumps.Methods Twenty canes with 22 upper limb stumps were treated with exercise for strength training,muscle contraction and control training and the complication of stump were managed.The myoelectrlc signal of upper limb stumps were detected and the stumps were trained with electronic biofeedback software system,including basic signal of biofeedback training and visual biofeedback training.Then the myoelectric prostheses were assembled.Results After prosthetic rehabilitation and myoelectfic signal training,there Wan no significant atrophy of muscle of stumps,muscle strength and range of motion of these twenty limb stumps increased.The amputees could control muscle contraction and grasp,pinch,wrist rotation,elbow extension or flexion consciously.Twenty myoelectrie prostheses were assembled.Conclusion The prosthetic rehabilitation and myoelectric signal training of limb stump is important for assembling myoelectric prosthesis.%目的 探讨上肢截肢患者的常规康复治疗、残肢肌电信号训练程序以及装配肌电假肢的方法 ,并观察其效果.方法 对20例截肢患者(22个残肢)进行常规康复治疗,包括肌力训练、肌肉收缩控制训练和残肢并发症的处理.采用德国Otto Bock公司提供的肌电信号检测和训练软件系统进行肌电信号训练(分为基础肌电信号训练和视觉反馈训练两个阶段),并装配肌电假肢.观察患者的治疗效果.结果 20例截肢患者22个残肢肌肉无明显萎缩,肌力好,关节活动范围无明显受限,患者能较好地控制残肢肌肉收缩.装配肌电假肢20例(20个),所有残肢均能有意识地引出肌电信号,控制假肢的手指打开、闭合以及腕关节的旋转或肘关节的屈伸.结论 残肢常规康复治疗和肌电信号训练对装配肌电假肢,实现有意识地控制假肢功能极为重要.

  3. "NIMS technique" for minimally invasive spinal fixation using non-fenestrated pedicle screws: A technical note

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    Alugolu Rajesh


    Full Text Available Study Design: Case series. Objective: To reduce the cost of minimally invasive spinal fixation. Background: Minimally invasive spine (MIS surgery is an upcoming modality of managing a multitude of spinal pathologies. However, in a resource-limited situations, using fenestrated screws (FSs may prove very costly for patients with poor affordability. We here in describe the Nizam′s Institute of Medical Sciences (NIMS experience of using routine non-FSs (NFSs for transpedicular fixation by the minimally invasive way to bridge the economic gap. Materials and Methods: A total of 7 patients underwent NFS-minimally invasive spine (MIS surgery. Male to female distribution was 6:1. The average blood loss was 50 ml and the mean operating time was 2 and 1/2 h. All patients were mobilized the very next day after confirming the position of implants on X-ray/computed tomography. Results: All 7 patients are doing well in follow-up with no complaints of a backache or fresh neurological deficits. There was no case with pedicle breach or screw pullout. The average cost of a single level fixation by FS and NFS was `1, 30,000/patient and `32,000/patient respectively ($2166 and $530, respectively. At the end of 1-year follow-up, we had two cases of screw cap loosening and with a displacement of the rod cranio-caudally in one case which was revised through the same incisions. Conclusions: Transpedicular fixation by using NFS for thoracolumbar spinal pathologies is a cost-effective extension of MIS surgery. This may extend the benefits to a lower socioeconomic group who cannot afford the cost of fenestrated screw (FS.

  4. Clinical outcome after traumatic spinal fractures in patients with ankylosing spinal disorders compared with control patients.

    NARCIS (Netherlands)

    Westerveld, L.A.; van Bemmel, J.C.; Dhert, W.J.A.; Öner, F.C.; Verlaan, J.J.


    Background context The clinical outcome of patients with ankylosing spinal disorders (ASDs) sustaining a spinal fracture has been described to be worse compared with the general trauma population. Purpose To investigate clinical outcome (neurologic deficits, complications, and mortality) after spina

  5. Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study

    Directory of Open Access Journals (Sweden)

    Arif Ahmed


    Full Text Available Introduction: The phantom limb pain (PLP and phantom limb sensation (PLS are very common among amputated cancer patients, and they lead to considerable morbidity. In spite of this, there is a lack of epidemiological data of this phenomenon among the Asian population. This study was done to provide the data from Indian population. Methods: The prevalence of PLP, stump pain (SP, and PLS was prospectively analyzed from the amputated cancer patients over a period of 2 years in Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi. The risk factors and the impact of phantom phenomenon on patients were also noted. Results: The prevalence of PLP was 41% at 3 and 12 months and 45.3% at 6 months, whereas that of SP and PLS was 14.4% and 71.2% at 3 months, 18.75% and 37.1% at 6 months, 15.8% and 32.4% at 12 months, respectively. There was higher prevalence of PLP and PLS among the patients with history of preamputation pain, smoking with proximal level of amputation, receiving general anesthesia, receiving intravenous (IV opioid postoperative analgesia, and developing neuroma or infection. Conclusion: The prevalence of PLP and PLS was higher among the cancer amputees as compared to SP, and a few risk factors responsible for their higher prevalence were found in our study. The PLP and PLS lead to considerable morbidity in terms of sleep disturbance and depression.

  6. 自制残肢伤口固定套在截肢患者中的应用%Application of homemade stump wound fixed sets for amputees

    Institute of Scientific and Technical Information of China (English)

    唐翠; 许月萍; 王刚


    目的:利用自制残肢伤口固定套固定残肢伤口,探讨其临床应用效果。方法选择急诊行截肢手术的肢体毁损伤患者68例,随机分为观察组35例,术后利用自制残肢伤口固定套固定;对照组33例采用敷料外U型石膏固定。比较两组患者术后伤口引流量、局部肿胀程度、残肢皮肤压疮、伤口感染、邻近关节活动功能情况。结果观察组感染率为5.71%,皮肤压疮坏死率为8.57%,肿胀发生率为28.57%,均低于对照组(18.18%,15.15%,54.55%),差异有统计学意义(χ2值分别为3.810,3.340,4.790;P<0.05)。观察组患者术后伤口引流量为(46.80±12.35) ml,邻近关节活动度为(145.68±13.20)°,对照组分别为(89.81±10.61)ml,(112.46±9.21)°,两组比较差异有统计学意义(t值分别为24.721,11.330;P<0.05)。结论利用自制残肢伤口固定套固定残肢伤口,能减少伤口术后出血,促进肿胀消退,减少皮肤压疮,有利于早期邻近关节功能锻炼。%Objective To discuss the clinical effect of homemade stump wound fixed sets for amputees. Methods From January 2010 to November 2013 we treated sixty eight cases of patients with smashed wound, who received emergency amputation surgery.We randomly selected thirty five cases of using homemade stump wound fixed sets as experimental group, and chosenthirty three cases of using the U-shaped plaster dressingmethodto dress outside wound as control group, comparing two groups with postoperative wound drainage, local swelling, stump skin pressure sores, wound infection, joint function close to the situation. Results In the experimental group, the infection rate was 5.71%, skin necrosis rate 8.57%, incidence of swelling 28.57%,while those rate in the control group were 18.18%,15.15% and 54.55% respectively, the differences were statistically signifcant (χ2 =3

  7. 腹腔镜手术治疗残胃癌7例分析%Laparoscopic gastrectomy for gastric stump cancer:analysis of 7 cases

    Institute of Scientific and Technical Information of China (English)

    张人超; 徐晓武; 牟一平; 周育成; 周家瑜; 黄超杰; 许芸芸


    目的:探讨腹腔镜手术治疗残胃癌的安全性和可行性。方法回顾性分析2008年1月至2015年7月间在浙江省人民医院胃肠胰外科接受腹腔镜手术治疗的7例残胃癌患者的临床和随访资料。结果7例患者中男性5例,女性2例;年龄(62.1±10.7)岁;胃良性病变术后残胃癌4例,距胃首次手术时间6~30年;胃癌术后残胃再发癌3例,距胃首次手术时间11~15年。首次手术行BillrothⅡ术式者6例,Roux-en-Y术式者1例。本次手术分离腹腔粘连及探查腹腔后确定肿瘤位置后,行残胃切除加淋巴清扫术,然后进行食管空肠Roux-en-Y吻合。1例使用圆形吻合器行食管空肠端侧吻合;2例使用内镜直线切割闭合器食管空肠侧侧吻合;4例行手工缝合食管空肠吻合。手术时间(247.1±17.5) min;术中出血量(100.0±30.8) ml;术中均未输血。淋巴结清扫(19.1±4.8)枚。术后肛门排气时间(3.3±1.5) d;进食流质时间(3.7±0.8) d,住院时间(9.4±2.6) d。1例患者术后出现消化道出血,保守治疗后痊愈;无围手术期死亡者。术后7例均获得随访,随访时间截至2016年1月。随访6~38月。1例术后17月死于腹腔转移,1例术后19月死于阿尔茨海默病。存活的5例至今无肿瘤复发或转移。结论腹腔镜手术治疗残胃癌安全可行。%Objective To evaluate the safety and feasibility of laparoscopic gastrectomy for gastric stump cancer. Methods Clinical and follow-up data of 7 patients who underwent laparoscopic gastrectomy for gastric stump cancer in our department from January 2008 to July 2015 were analyzed retrospectively. Results There were 5 male and 2 female patients, with a mean age of (62.1 ±10.7) years. Initial gastrectomy was performed for gastric cancer in 3 patients and peptic ulceration in 4. The initial surgery was B-Ⅱ gastrojejunostomy in 6 patients and Roux-en-Y gastrojejunostomy in 1

  8. Transgenic inhibition of astroglial NF-κB leads to increased axonal sparing and sprouting following spinal cord injury (United States)

    Brambilla, Roberta; Hurtado, Andres; Persaud, Trikaldarshi; Esham, Kim; Pearse, Damien D.; Oudega, Martin; Bethea, John R.


    We previously showed that NF-κB inactivation in astrocytes leads to improved functional recovery following spinal cord injury (SCI). This correlated with reduced expression of pro-inflammatory mediators and chondroitin sulphate proteoglycans, and increased white matter preservation. Hence we hypothesized that inactivation of astrocytic NF-κB would create a more permissive environment for axonal sprouting and regeneration. We induced both contusive and complete transection SCI in GFAP-IκBα-dn and WT mice and performed retrograde (fluorogold) and anterograde (biotinylated dextran amine) tracing eight weeks after injury. Following contusive SCI, more fluorogold-labeled cells were found in motor cortex, reticular formation, and raphe nuclei of transgenic mice. Spared and sprouting biotinylated dextran amine-positive corticospinal axons were found caudal to the lesion in GFAP-IκBα-dn mice. Higher numbers of fluorogold-labeled neurons were detected immediately rostral to the lesion in GFAP-IκBα-dn mice, accompanied by increased expression of synaptic and axonal growth-associated molecules. After transection, however, no fluorogold-labeled neurons or biotinylated dextran amine-filled axons were found rostral and caudal to the lesion, respectively, in either genotype. These data demonstrated that inhibiting astroglial NF-κB resulted in a growth-supporting terrain promoting sparing and sprouting, rather than regeneration, of supraspinal and propriospinal circuitries essential for locomotion, hence contributing to the improved functional recovery observed after SCI in GFAP-IκBα-dn mice. PMID:19522780

  9. FGF signaling enhances a sonic hedgehog negative feedback loop at the initiation of spinal cord ventral patterning. (United States)

    Morales, Aixa V; Espeso-Gil, Sergio; Ocaña, Inmaculada; Nieto-Lopez, Francisco; Calleja, Elena; Bovolenta, Paola; Lewandoski, Mark; Diez Del Corral, Ruth


    A prevalent developmental mechanism for the assignment of cell identities is the production of spatiotemporal concentration gradients of extracellular signaling molecules that are interpreted by the responding cells. One of such signaling systems is the Shh gradient that controls neuronal subtype identity in the ventral spinal cord. Using loss and gain of function approaches in chick and mouse embryos, we show here that the fibroblast growth factor (FGF) signaling pathway is required to restrict the domains of ventral gene expression as neuroepithelial cells become exposed to Shh during caudal extension of the embryo. FGF signaling activates the expression of the Shh receptor and negative pathway regulator Patched 2 (Ptch2) and therefore can enhance a negative feedback loop that restrains the activity of the pathway. Thus, we identify one of the mechanisms by which FGF signaling acts as a modulator of the onset of Shh signaling activity in the context of coordination of ventral patterning and caudal axis extension. © 2015 Wiley Periodicals, Inc. Develop Neurobiol 76: 956-971, 2016.

  10. Spastic Paraparesis Due to a Spinal Arachnoid Cyst Associated with Herniation of Cerebellar Tonsils After a Ventriculoperitoneal Shunt

    Directory of Open Access Journals (Sweden)

    Nargess Afzali


    Full Text Available  Secondary intradural arachnoid cysts involving the spine are uncommon and can be due to trauma, surgery, lumbar puncture, intrathecal injection and arachnoiditis (TB meningitis, chemical meningitis. Caudal dislocation of the cerebellar tonsils may be associated with known clinical conditions such as intracranial mass lesions or Chiari I and II malformations. It may also be acquired after repeated lumbar punctures or lumboperitoneostomy and traumatic CSF leaks. In rare cases it is reported after supratentorial shunting. "nHere a 16 year old boy is presented with progressive spastic paraparesis 18months after a ventriculoperitoneal shunt. Brain MRI revealed acquired post surgical cerebellar herniation and the spinal MRI showed a large intradural arachnoid cyst. TB laboratory tests were negative. Laminectomy, cyst drainage and suboccipsital craniectomy were performed. Despite the surgery, the disease progression continued to severe paraparesis. 

  11. Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)


    We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

  12. Spinal deformities in tall girls. (United States)

    Skogland, L B; Steen, H; Trygstad, O


    In a prospective study, 62 girls who consulted the paediatric department because of tall stature were examined for spinal deformities. Thirteen cases of scoliosis measuring 10 degrees or more were found. Eighteen girls had a thoracic kyphosis of more than 40 degrees and 11 had additional vertebral abnormalities indicating Scheuermann's disease. The incidence of scoliosis and Scheuermann's disease was much higher in our material than normal.

  13. Spinal trauma. An imaging approach

    Energy Technology Data Exchange (ETDEWEB)

    Cassar-Pullicino, V.N. [The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire (United Kingdom). Dept. of Radiology; Imhof, H. [University and General Hospital Vienna (Austria). Dept. of Radiodiagnostics


    The diagnosis of trauma to the spine - where the slightest oversight may have catastrophic results - requires a thorough grasp of the spectrum of resultant pathology as well as the imaging modalities used in making an accurate diagnosis. In Spinal Trauma, the internationally renowned team of experts provides a comprehensive, cutting-edge exposition of the current vital role of imaging in the diagnosis and treatment of injuries to the axial skeleton. Beginning with a valuable clinical perspective of spinal trauma, the book offers the reader a unique overview of the biomechanics underlying the pathology of cervical trauma. Acute trauma topics include: - Optimization of imaging modalities - Malalignment - signs and significance - Vertebral fractures - detection and implications - Classification of thoraco-lumbar fractures - rationale and relevance - Neurovascular injury. Distilling decades of clinical and teaching expertise, the contributors further discuss the current role of imaging in special focus topics, which include: - The pediatric spine - Sports injuries - The rigid spine - Trauma in the elderly - Vertebral collapse, benign and malignant - Spinal trauma therapy - Vertebral fractures and osteoporosis - Neuropathic spine. All throughout the book, the focus is on understanding the injury, and its implications and complications, through 'an imaging approach'. Lavishly illustrated with hundreds of superb MR images and CT scans, and clear full-color drawings, the authors conclude with a look into the future, defining clinical trends and research directions. Spinal Trauma - with its broad scope, practical imaging approach, and current focus - is designed to enhance confidence and accuracy, making it essential reading for clinicians and radiologists at all levels. (orig.)

  14. Plasticity of TRPV1-expressing sensory neurons mediating autonomic dysreflexia following spinal cord injury

    Directory of Open Access Journals (Sweden)

    Leanne M Ramer


    Full Text Available Spinal cord injury (SCI triggers profound changes in visceral and somatic targets of sensory neurons below the level of injury. Despite this, little is known about the influence of injury to the spinal cord on sensory ganglia. One of the defining characteristics of sensory neurons is the size of their cell body: for example, nociceptors are smaller in size than mechanoreceptors or proprioceptors. In these experiments, we first used a comprehensive immunohistochemical approach to characterize the size distribution of sensory neurons after high- and low-thoracic SCI. Male Wistar rats (300g received a spinal cord transection (T3 or T10 or sham injury. At 30 days post-injury, dorsal root ganglia (DRGs and spinal cords were harvested and analyzed immunohistochemically. In a wide survey of primary afferents, only those expressing the capsaicin receptor (TRPV1 exhibited somal hypertrophy after T3 SCI. Hypertrophy only occurred caudal to SCI and was pronounced in ganglia far distal to SCI (i.e., in L4-S1 DRGs. Injury-induced hypertrophy was accompanied by a small expansion of central territory in the lumbar spinal dorsal horn and by evidence of TRPV1 upregulation. Importantly, hypertrophy of TRPV1-positive neurons was modest after T10 SCI. Given the specific effects of T3 SCI on TRPV1-positive afferents, we hypothesized that these afferents contribute to autonomic dysreflexia (AD. Rats with T3 SCI received vehicle or capsaicin via intrathecal injection at 2 or 28 days post-SCI; at 30 days, AD was assessed by recording intra-arterial blood pressure during colo-rectal distension. In both groups of capsaicin-treated animals, the severity of AD was dramatically reduced. While AD is multi-factorial in origin, TRPV1-positive afferents are clearly involved in AD elicited by colo-rectal distension. These findings implicate TRPV1-positive afferents in the initiation of AD and suggest that TRPV1 may be a therapeutic target for amelioration or prevention of AD

  15. Genetics Home Reference: spinal and bulbar muscular atrophy (United States)

    ... Kennedy spinal and bulbar muscular atrophy Kennedy's disease SBMA X-linked spinal and bulbar muscular atrophy Related ... Natural history of spinal and bulbar muscular atrophy (SBMA): a study of 223 Japanese patients. Brain. 2006 ...

  16. Advanced Restoration Therapies in Spinal Cord Injury (United States)


    including but not limited to traumatic brain injury , Alzheimer’s disease, cerebrovascular insults, and leukodystrophy. SECTION 2 – KEYWORDS Spinal...Spinal Cord Injury Annual Report to change our proposed anesthesia method from isofluorane to medetomidine. We have made the appropriate changes and...McKinley, W., and Tulsky, D. (2004). Late neurologic recovery after traumatic spinal cord injury . Arch Phys Med Rehabil 85, 1811-1817. Lorenz, D.J

  17. An atypical case of segmental spinal dysgenesis

    Energy Technology Data Exchange (ETDEWEB)

    Zana, Elodie; Chalard, Francois; Sebag, Guy [Hopital Robert Debre, Department of Paediatric Imaging, Paris (France); Mazda, Keyvan [Hopital Robert Debre, Department of Paediatric Orthopaedic Surgery, Paris (France)


    Spinal segmental dysgenesis is a complex closed dysraphism. The diagnostic criteria are: lumbar or thoracolumbar vertebral dysgenesis causing kyphosis, focal spinal cord narrowing without exiting roots, deformity of the lower limbs and paraplegia or paraparesis. We present a newborn who showed atypical features of bifocal spinal cord narrowing, without any vertebral abnormality at the proximal level. This seems to be a variant of this rare entity, whose early diagnosis is important, as surgical stabilisation of the spine is required. (orig.)

  18. MRI Findings in Spinal Canal Stenosis

    Directory of Open Access Journals (Sweden)

    Maryam Barzin


    Full Text Available Spinal canal stenosis results from progressive narrowing of the central spinal canal and the lateral recesses. Primary (congenital lumbar spinal stenosis is associated with achondroplastic dwarfism. The spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposus posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the facet joints, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins and uncovertebral joint hypertrophy in the neck. The central canal and the neurorecess may be compromised by tumor infiltration, such as metastatic disease, or by infectious spondylitis."nAP diameter of the normal adult cervical canal has a mean value of 17-18 mm at vertebral levels C3-5. The lower cervical canal measures 12-14 mm. Cervical stenosis is associated with an AP diameter of less than 10 mm. The thoracic spinal canal varies from 12 to 14 mm in diameter in the adult. The diameter of the normal lumbar spinal canal varies from 15 to 27 mm. Lumbar stenosis results from a spinal canal diameter of less than 12 mm in some patients; a diameter of 10 mm is definitely stenotic."nSpinal MRI is the most suitable technique for the diagnosis of spinal stenosis. The examination should be performed using thin sections (3 mm and high resolution, including the axial and sagittal planes using T1-weighted, proton-density, and T2-weighted techniques. The bony and osteophytic components are seen best using a T2-weighted gradient-echo technique."nOn MRI, findings of spinal stenosis have a variable presentation depending on the specific disease. The goal of spinal imaging is to localize the site and level of disease and to help differentiate between conditions in which patients require surgery or conservative treatment."nIn this presentation, different kinds of spinal canal stenosis and their MRI findings would be discussed.



    Meher Kumar; Rakesh


    Quadriplegia following spinal anaesthesia due to spinal epidural haematoma is a rare but critical complication that usually occurs within 24 hours to a few days of the procedure. I report a case of a 32 year old male who underwent Uretero - Renal Scopy (URS) and double ‘J’ (DJ) stenting for right ureteric calculus under spinal ...

  20. Artérias mesentéricas cranial e caudal em mocós Kerodon rupestris (Wied, 1820

    Directory of Open Access Journals (Sweden)

    Paula V.S. Queiroz


    Full Text Available No estudo sobre a origem e ramificações das artérias mesentéricas cranial (AMCr e caudal (AMCa do mocó, foram utilizados 20 animais (18 machos e 2 fêmeas de diferentes idades, que, após morte natural, foram dissecados rebatendo-se as paredes torácica e abdominal, pelo antímero esquerdo, expondo-se a aorta que foi então canulada em seu trajeto pré-diafragmático, procedendo-se a injeção de neoprene látex corado, no sentido caudal. A seguir, foram fixados em solução aquosa de formol a 10%, durante 48 horas, e posteriormente dissecados. Os resultados mostraram que em 18 animais (90%, a AMCr originou-se da aorta abdominal isoladamente, logo após a artéria celíaca, emitindo as artérias cólica média (CoM, pancreaticoduodenal caudal (PDC, duodenojejunal (DJ, jejunal (J e ileocecocólica (ICeCo. Em um mocó (5%, as AMCr e AC se originaram da aorta abdominal em um tronco comum. Neste caso, a AMCr originou às artérias CoM, PDC, ICeCo e J. Em uma observação (5%, as artérias AMCr e AMCa surgiram em tronco comum. Neste animal, as artérias PDC, DJ, ICeCo, CoM e J foram originadas da AMCr, enquanto as aterias cólica esquerda (CoE e retal cranial (ARCr derivaram da AMCa. Dois animais (10% apresentaram como colaterais da AMCr as artérias CoM, PDC, DJ, J e o tronco ICeCo, que originou às artérias CoD e ileocecal (ICe. No que diz respeito a AMCa, nos 20 casos (100% originou as artérias CoE e RCr.

  1. Spinal cord compression due to ethmoid adenocarcinoma. (United States)

    Johns, D R; Sweriduk, S T


    Adenocarcinoma of the ethmoid sinus is a rare tumor which has been epidemiologically linked to woodworking in the furniture industry. It has a low propensity to metastasize and has not been previously reported to cause spinal cord compression. A symptomatic epidural spinal cord compression was confirmed on magnetic resonance imaging (MRI) scan in a former furniture worker with widely disseminated metastases. The clinical features of ethmoid sinus adenocarcinoma and neoplastic spinal cord compression, and the comparative value of MRI scanning in the neuroradiologic diagnosis of spinal cord compression are reviewed.

  2. Transplantation of low-power laser-irradiated olfactory ensheathing cells to promote repair of spinal cord injury in rats

    Institute of Scientific and Technical Information of China (English)

    Haoxian Chen; Xinfeng Zheng; Weibin Sheng; Qin Wei; Tao Jiang; Gele Jin


    functions of rat lower limbs.RESULTS: Structural disturbances were observed following spinal cord injury in each group, and a large amount of scar tissue covered the broken ends, accompanied by porosis and inflammatory cell infiltration. Following OEC transplantation, the distal end connected to the proximal end. nerve growth factor receptor p75 and glial fibrillary acidic protein immunohistochemistry revealed positive OECs in the cephalad and caudal area of rats that received LPL-irradiated OEC transplantation. In the OECs group, only glial fibrillary acidic protein staining was observed. No staining was found in the control group. Neural fibers labeled with Fluorogold extended across the lesion area and into the cephalad and caudal area in the OECs and LPL-irradiated OECs groups,but were not present in the control group. BBB scores revealed statistically significant differences among the three groups (P OECs group > control group.CONCLUSION: Transplantation of OECs and LPL-irradiated OECs promoted functional repair in the injured spinal cord of rats, although LPL-irradiated OECs resulted in greater beneficial effects.

  3. Rebrota de cepas de Acacia mearnsii em diferentes idades, épocas do ano e alturas de corte Resprouting of Acacia mearnsii stumps under different ages, seasons and cut heights

    Directory of Open Access Journals (Sweden)

    Edison Rogério Perrando


    Full Text Available O objetivo deste trabalho foi avaliar o efeito da idade, da época do ano e da altura de corte sobre a capacidade de rebrota de cepas de Acacia mearnsii De Wild. O trabalho foi conduzido em delineamento de blocos ao acaso e parcelas subdivididas no tempo. Em árvores de quatro e sete anos, foram avaliadas as alturas de corte de 0,15; 0,30; 0,45; 0,60; 1,2 e 2 m aos 15, 30, 45, 60, 75 e 90 dias depois do corte, nas quatro estações do ano. Obteve-se interação significativa entre a altura de corte e a época de avaliação, em ambas as idades avaliadas. As maiores médias, quanto ao número de brotações por cepa, foram constatadas a 1,2 e 2 m de altura, na idade de quatro anos. Elevados porcentuais de mortalidade foram registrados em cepas com sete anos, independentemente da altura de corte. A capacidade de rebrota em cepas de acácia-negra é estimulada, quando o corte é realizado no período entre o outono e a primavera. O verão é a estação menos adequada à rebrota de cepas dessa espécie.The objective of this work was to evaluate the effect of age, time of the year and cut height on the resprouting capacity of Acacia mearnsii De Wild. stumps. The work was conducted in stands of four and seven years of age, in randomized blocks design and time subdivided plots. Different cut heights (0.15; 0.30; 0.45; 0.60; 1.2 and 2 m, and evaluation times (15, 30, 45, 60, 75 and 90 days after cutting, in the four seasons of the year were evaluated. A significant interaction between cut height and evaluation time was found in both ages. The higher averages due to stumps in each strain were verified in 1.2 and 2 m height, in the age of four years. High death percentages were registered in seven years-old stumps, independently of cut height. The resprouting capacity of black wattle stumps is stimulated when cut is conducted between autumn and spring; summer is the least suitable season to stumps resprouting of this specie.

  4. Lateral upper arm retrograde island flap transfer for coverage of stump wound after forearm amputation%上臂外侧逆行岛状皮瓣修复前臂截肢后残端创面

    Institute of Scientific and Technical Information of China (English)

    许亚军; 陈政; 包岳丰; 周晓; 张辉; 周建东; 陈学明


    目的 介绍上臂外侧逆行岛状皮瓣修复前臂近端截肢后残端创面的临床经验.方法 对前臂近端截肢后残端创面采用上臂外侧逆行岛状皮瓣修复.结果 临床应用共10例,术后皮瓣8例顺利存活,2例血流稍许受限,拆除蒂部缝线后完全存活.有6例获得3个月的随访,残端伤口愈合佳,皮瓣外形满意,不臃肿,肘关节伸屈活动基本正常,能满足接装义肢的需要.结论 采用上臂外侧逆行岛状皮瓣是修复前臂残端创面的好方法.%Objective To introduce the clinical experience of the application of lateral upper arm retrograde island flap for coverage of stump wound after forearm amputation.Methods The lateral upper arm retrograde island flap was transferred to cover the wound at the stump that was resulted from forearm amputation.Results This flap was applied in a total of 10 cases.Flaps in 8 cases survived uneventfully.Compromised perfusion was observed in 2 cases which were remedied by removing stitches at the pedicle.These 2 flaps also survived completely.Sufficient follow-up was obtained in 6 cases for 3 months.The stump wounds healed well.The flaps were not bulky.The appearance and elbow function were satisfactory.The stump met requirements for prosthetic fitting.Conclusion Lateral upper arm retrograde island flap is a good option for coverage of stump wound after forearm amputation.

  5. Peripheral type facial palsy in a patient with dorsolateral medullary infarction with infranuclear involvement of the caudal pons. (United States)

    Park, Jong-Ho; Yoo, Han-Uk; Shin, Hyung-Woo


    The corticobulbar tract fibers descend near the corticospinal tract, mostly to the upper medulla, where they decussate and ascend in the dorsolateral medulla to connect with the contralateral facial nucleus. Therefore, central type facial palsy can be present in patients with ipsilateral dorsolateral upper medullar lesion. We describe a 71-year-old man with lateral medullary infarction who showed ipsilateral peripheral type facial palsy. Brain diffusion-weighted image showed hyperintensities on the left dorsolateral portion of upper medulla and adjacent inferomedial tegmentum of the lower pons. Transfemoral cerebral angiography depicted prominence of ipsilateral posterior inferior cerebellar artery with focal stenosis. Left posterior inferior cerebellar artery might supply the inferolateral tegmentum of the lower pons, which is usually supplied from anterior inferior cerebellar artery. The peripheral type facial palsy in our patient may have resulted from facial infranuclear involvement of the caudal pons extended from dorsolateral upper medullary lesion in ascending pathway of corticobulbar tract fibers.

  6. Caudal Ganglionic Eminence Precursor Transplants Disperse and Integrate as Lineage-Specific Interneurons but Do Not Induce Cortical Plasticity

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    Phillip Larimer


    Full Text Available The maturation of inhibitory GABAergic cortical circuits regulates experience-dependent plasticity. We recently showed that the heterochronic transplantation of parvalbumin (PV or somatostatin (SST interneurons from the medial ganglionic eminence (MGE reactivates ocular dominance plasticity (ODP in the postnatal mouse visual cortex. Might other types of interneurons similarly induce cortical plasticity? Here, we establish that caudal ganglionic eminence (CGE-derived interneurons, when transplanted into the visual cortex of neonatal mice, migrate extensively in the host brain and acquire laminar distribution, marker expression, electrophysiological properties, and visual response properties like those of host CGE interneurons. Although transplants from the anatomical CGE do induce ODP, we found that this plasticity reactivation is mediated by a small fraction of MGE-derived cells contained in the transplant. These findings demonstrate that transplanted CGE cells can successfully engraft into the postnatal mouse brain and confirm the unique role of MGE lineage neurons in the induction of ODP.

  7. [Aneurysm of the internal carotid artery--a differential diagnosis of paralysis of the caudal cranial nerves]. (United States)

    Koscielny, S; Koch, J; Behrendt, W


    Paralysis of the caudal cranial nerves, e. g. the nervus glossopharyngeus, vagus and accessorius, may cause disorders in swallowing and speaking leading to a reduction in the patient's quality of life. Glomus tumors or malignant lesions of the skull base are a frequent cause of such lesions. We report on the case of a 48 year old patient who presented an acute lesion of these cranial nerves in combination with paresis of the nervus hypoglossus as a result of an aneurysm of the internal carotid artery directly underneath the base of the skull. The aneurysm was treated by parent vessel occlusion. The results of this procedure were a shrinkage of the aneurysm and an improvement in the neurological symptoms.

  8. Transplantation of tissue engineering neural network and formation of neuronal relay into the transected rat spinal cord. (United States)

    Lai, Bi-Qin; Che, Ming-Tian; Du, Bao-Ling; Zeng, Xiang; Ma, Yuan-Huan; Feng, Bo; Qiu, Xue-Chen; Zhang, Ke; Liu, Shu; Shen, Hui-Yong; Wu, Jin-Lang; Ling, Eng-Ang; Zeng, Yuan-Shan


    Severe spinal cord injury (SCI) causes loss of neural connectivity and permanent functional deficits. Re-establishment of new neuronal relay circuits after SCI is therefore of paramount importance. The present study tested our hypothesis if co-culture of neurotrophin-3 (NT-3) gene-modified Schwann cells (SCs, NT-3-SCs) and TrkC (NT-3 receptor) gene-modified neural stem cells (NSCs, TrkC-NSCs) in a gelatin sponge scaffold could construct a tissue engineering neural network for re-establishing an anatomical neuronal relay after rat spinal cord transection. Eight weeks after transplantation, the neural network created a favorable microenvironment for axonal regeneration and for survival and synaptogenesis of NSC-derived neurons. Biotin conjugates of cholera toxin B subunit (b-CTB, a transneuronal tracer) was injected into the crushed sciatic nerve to label spinal cord neurons. Remarkably, not only ascending and descending nerve fibers, but also propriospinal neurons, made contacts with b-CTB positive NSC-derived neurons. Moreover, b-CTB positive NSC-derived neurons extended their axons making contacts with the motor neurons located in areas caudal to the injury/graft site of spinal cord. Further study showed that NT-3/TrkC interactions activated the PI3K/AKT/mTOR pathway and PI3K/AKT/CREB pathway affecting synaptogenesis of NSC-derived neurons. Together, our findings suggest that NT-3-mediated TrkC signaling plays an essential role in constructing a tissue engineering neural network thus representing a promising avenue for effective exogenous neuronal relay-based treatment for SCI.

  9. Wnt3 and Wnt3a are required for induction of the mid-diencephalic organizer in the caudal forebrain

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    Mattes Benjamin


    Full Text Available Abstract Background A fundamental requirement for development of diverse brain regions is the function of local organizers at morphological boundaries. These organizers are restricted groups of cells that secrete signaling molecules, which in turn regulate the fate of the adjacent neural tissue. The thalamus is located in the caudal diencephalon and is the central relay station between the sense organs and higher brain areas. The mid-diencephalic organizer (MDO orchestrates the development of the thalamus by releasing secreted signaling molecules such as Shh. Results Here we show that canonical Wnt signaling in the caudal forebrain is required for the formation of the Shh-secreting MD organizer in zebrafish. Wnt signaling induces the MDO in a narrow time window of 4 hours - between 10 and 14 hours post fertilization. Loss of Wnt3 and Wnt3a prevents induction of the MDO, a phenotype also observed upon blockage of canonical Wnt signaling per se. Pharmaceutical activation of the canonical Wnt pathways in Wnt3/Wnt3a compound morphant embryos is able to restore the lack of the MDO. After blockage of Wnt signaling or knock-down of Wnt3/Wnt3a we find an increase of apoptotic cells specifically within the organizer primordium. Consistently, blockage of apoptosis restores the thalamus organizer MDO in Wnt deficient embryos. Conclusion We have identified canonical Wnt signaling as a novel pathway, that is required for proper formation of the MDO and consequently for the development of the major relay station of the brain - the thalamus. We propose that Wnt ligands are necessary to maintain the primordial tissue of the organizer during somitogenesis by suppressing Tp53-mediated apoptosis.


    Directory of Open Access Journals (Sweden)

    Mónica Lucía Izquierdo Santacruz


    Full Text Available En el presente artículo de revisión se consolidó información sobre el Régimen de Caudal Ecológico, al constituirse en una herramienta de gestión en la conservación de la Biota Acuática. De esta manera, se considera relevante informar a la comunidad académica y actores de gestión, sobre la importancia de la gestión del recurso hídrico, el análisis de conceptos sobre el caudal ambiental y ecológico, la descripción de las diferentes metodologías que permiten su determinación y la normatividad ambiental que lo protege. Finalmente, se hace especial énfasis, en la metodología ecohidráulica en la que se aplica el modelo IFIM-PHABSIM, considerada la modelación del hábitat fluvial, que precisa de información sobre la relación entre la densidad de organismos acuáticos y variables hidráulicas de velocidad, profundidad y sustrato; obteniendo como resultado curvas de idoneidad de hábitat e índices de idoneidad, que permitirán entender el funcionamiento de los ecosistemas acuáticos, utilizando dicha información en el manejo y planificación del recurso hídrico.

  11. Cranial-to-caudal approach for radical lymph node dissection along the surgical trunk in laparoscopic right hemicolectomy. (United States)

    Matsuda, Takeru; Iwasaki, Takeshi; Mitsutsuji, Masaaki; Hirata, Kenro; Maekawa, Yoko; Tanaka, Tomoko; Shimada, Etsuji; Kakeji, Yoshihiro


    Complete mesocolic excision with central vascular ligation is considered to contribute to superior oncological outcomes after colon cancer surgery [1]. For advanced right-sided colon cancer, this surgery sometimes requires lymph node (LN) dissection along the superior mesenteric vein (SMV), with division of the middle colic vessels, or their right branches, at origin [2]. Here, we present cranially approached radical LN dissection along the surgical trunk during laparoscopic right hemicolectomy. The omental bursa is first opened wide, and the gastrocolic trunk of Henle is exposed, using the right gastroepiploic vessels and the accessory right colic vein (ARCV) as landmarks. After division of ARCV, SMV and middle colic vein (MCV) are identified. After dividing MCV at its root, LN dissection along SMV is conducted in a cranial-to-caudal manner. Concurrently, the middle colic artery, or its right branch, is exposed and divided at origin. The transverse colon is then raised ventrally, and LN dissection along SMV using a cranial-to-caudal approach is again performed. The ileocolic and right colic vessels are divided at origin. The ascending and transverse mesocolon, including the pedicles, are then separated from the retroperitoneal tissues, pancreatic head, and duodenum, using a medial approach. The key characteristics in this procedure consist of easy access to pancreas, early division of ARCV and middle colic vessels at origin, and easy dissection along SMV. We performed a laparoscopic colectomy using this approach for 18 patients with right-sided colon cancer. The mean operative time and blood loss were 288 min and 83 ml, respectively. The mean number of harvested LNs was 24. There were 6 cases with positive LN metastasis. There were no recurrent cases at a median follow-up period of 24 months. We consider this approach to be safe and useful for radical LN dissection along SMV for right-sided colon cancers.

  12. Dispositivo electrónico de medición del caudal de agua para canales abiertos

    Directory of Open Access Journals (Sweden)

    Julio Cesar Ayala López


    Full Text Available El método de riego por inundación, que desplaza el agua mediante canales abiertos y surcos ha sido usado durante años en la producción agrícola, aunque requiere una gran cantidad de agua y su eficacia no es muy alta ya que la mayoría del agua no se puede extraer directamente en las raíces de las plantas. Siendo de vital importancia lograr datos de campo confiables y lo suficientemente precisos que nos permitan estudiar y proyectar manejos del agua con el menor grado de incertidumbre posible. Para poder aplicar conocimientos actuales de la relación agua-suelo-planta debemos conocer la cantidad de agua en el campo o en regiones específicas del mismo, para así poder prever un uso eficiente del agua mediante la aplicación en el momento oportuno y en volúmenes adecuados, Por lo que en el Centro de Mecanización Agropecuaria (CEMA diseñ ó un dispositivo electrónico de medición e indicación de caudales y consumo de agua para canales abiertos, apli - cable para cualquier estructura hidráulica que relacione el nivel de agua de una sección de área conocida, con el caudal de agua que pasa por la misma sección, con el propósito de crear un dispositivo preciso y económico, capaz de realizar mediciones en el campo.

  13. [Vascular and autonomic disorders of the spinal cord in dystopia of the spinal motor segment]. (United States)

    Gongal'skiĭ, V V; Kuftyreva, T P


    Microcirculation disorders may cause functional deviation in gray matter cells of the spinal cord. One of the setting moments of the disorders is the subluxation of a vertebra as a result of the disturbance in carrying ability of the spinal disc in case of spinal osteochondrosis. In this position the soft tissues of the spinal motional well innervated segment are stretched, which induces irritation in the segmental part of the spinal cord including vegetative nervous structures. Subluxation of a vertebra causes changes in the structures and in the microcirculation vessels which grow simultaneously and this permits supposing their interrelation.

  14. 神经端侧缝合治疗手指顽固性残端痛性神经瘤%Treatment of refractory stump pain caused by neuroma by end-to-side neurorrhaphy

    Institute of Scientific and Technical Information of China (English)

    芮永军; 张志海; 施海峰; 吴权; 柯尊山; 寿奎水


    目的 介绍一种治疗顽固性残端痛性神经瘤的手术方法.方法 2006年1月至2010年6月,采用神经端侧缝合的方法治疗手指顽固性残端痛性神经瘤共5例6指,术中彻底切除残端神经瘤直至正常神经组织.其中3例将修整后的神经残端直接与邻指正常指神经作端侧缝合;2例(3指)行腓肠神经移植修复,一端与修整后的神经残端作端端缝合,另一端与邻指指神经作端侧缝合.结果 术后经过12~ 63个月的随访,3例残端神经痛完全消失,2年后未复发;1例随访12个月,疼痛无复发;1例环、小指残端痛,术前已有过4次手术,本次术后环指疼痛消失,小指仍有疼痛,术后1个月小指再次行神经松解,随访63个月小指自发性疼痛减轻,但仍有触痛,环指疼痛消失.参照Burchid的疗效评定标准,优良率为83.3%(5/6).结论 神经端侧缝合的方法可有效治疗残端痛性神经瘤.%Objective To introduce a new method to treat refractory stump pain caused by neuroma.Methods From January 2006 to June 2010,6 fingers in 5 patients with refractory stump pain caused by neuroma were treated by end-to-side neurorrhaphy.The surgical technique included neurolysis,neuroma resection and end-to-side neurorrhaphy.The nerve stump was sutured to the uninjured nerve of the neighboring finger directly in an end-to-side fashion in 3 cases.In the other 3 fingers of 2 cases a sural nerve gnat was used,while one end of the graft was attached to the nerve stump by end-to-end neurorrhaphy and the other end was sutured to the digital nerve of the neighboring finger by end-to-side neurorrhaphy.Results Postoperative follow-up interval ranged from 12 to 63 months.Three patients experienced complete pain relief.There was no recurrence 2 years postoperatively.One patient was follow-up for 12 months when no recurrence of stump pain was observed.Another patient who suffered from stump pain of ring and little fingers experienced full pain relief

  15. Experimental study on spinal cord injury treated by embryonic spinal cord transplantation and greater omental transposition

    Institute of Scientific and Technical Information of China (English)

    Hao Dingjun(郝定均); Zheng Yonghong(郑永宏); Yuan Fuyong(袁福镛); He Liming; Wang Rong; Yuan Yong


    Objective: To observe the clinical efficacy of the embryonic spinal cellular transplantation and greater omental transposition for treatment of the spinal cord injury in 24 mongrel dogs. Methods: 24 adult mongrel dogs, weighing 10 ~ 13kg,bryonic spinal cellular transplantation and greater omental transposition group (group D). Each group consisted of 6 dogs. SEP(somatosensory evoked potential) and MEP (motor evoked potential) of the spinal cord were examed prior to the spinal cord injury and 2 months after the treatment to observe the changes of the animals' behavior. All dogs were killed 2 months after surgery and the spinal cord sections were obtained from T12 to L1 level for pathological analysis and observation under the electron microscope.Results: There was an obvious difference in the spinal somatosensory evoked potential and the motor evoked potential between the group D and the other three groups (group A, B, and C). Recovery of the behavior was noted. The spinal cells had survived for two months following the transplantation. Conclusion: Transplantation of the embryonic spinal cell and greater omentum for treatment of the spinal cord injury in dogs can gain a better outcome than the other groups in behavior and spinal somatosensory and motor evoked potential, but the further study is still essential to confirm its clinical efficacy.

  16. Recurrent spinal adhesive arachnoiditis: a case report

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    James Pitágoras de Mattos


    Full Text Available Spinal adhesive arachnoiditis is not an uncommon disease, usually having a monophasic course. We studied an atypical patient with recurrent spinal adhesive arachnoiditis nine years after intrathecal anesthesia and the first attack of the disease. Also noteworthy was the favorable evolution after surgery.

  17. Spinal gout: A review with case illustration (United States)

    Elgafy, Hossein; Liu, Xiaochen; Herron, Joseph


    AIM To summarize clinical presentations and treatment options of spinal gout in the literature from 2000 to 2014, and present theories for possible mechanism of spinal gout formation. METHODS The authors reviewed 68 published cases of spinal gout, which were collected by searching “spinal gout” on PubMed from 2000 to 2014. The data were analyzed for clinical features, anatomical location of spinal gout, laboratory studies, imaging studies, and treatment choices. RESULTS Of the 68 patients reviewed, the most common clinical presentation was back or neck pain in 69.1% of patients. The most common laboratory study was elevated uric acid levels in 66.2% of patients. The most common diagnostic image finding was hypointense lesion of the gout tophi on the T1-weighted magnetic resonance imaging scan. The most common surgical treatment performed was a laminectomy in 51.5% and non-surgical treatment was performed in 29.4% of patients. CONCLUSION Spinal gout most commonly present as back or neck pain with majority of reported patients with elevated uric acid. The diagnosis of spinal gout is confirmed with the presence of negatively birefringent monosodium urate crystals in tissue. Treatment for spinal gout involves medication for the reduction of uric acid level and surgery if patient symptoms failed to respond to medical treatment. PMID:27900275


    NARCIS (Netherlands)



    This paper deals with the effect of motion upon the stenotic lumbar spinal canal and its contents. A review is presented of personal investigations and relevant data from the literature. The normal spinal canal and its lateral recesses are naturally narrowed by retroflexion and/or axial loading, as

  19. Therapeutic approaches for spinal cord injury

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    Alexandre Fogaça Cristante


    Full Text Available This study reviews the literature concerning possible therapeutic approaches for spinal cord injury. Spinal cord injury is a disabling and irreversible condition that has high economic and social costs. There are both primary and secondary mechanisms of damage to the spinal cord. The primary lesion is the mechanical injury itself. The secondary lesion results from one or more biochemical and cellular processes that are triggered by the primary lesion. The frustration of health professionals in treating a severe spinal cord injury was described in 1700 BC in an Egyptian surgical papyrus that was translated by Edwin Smith; the papyrus reported spinal fractures as a ''disease that should not be treated.'' Over the last biological or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at minimum, allow for partial functional recoveries for these patients, which could improve their quality of life.

  20. Psychological Aspects of Spinal Cord Injury (United States)

    Cook, Daniel W.


    Reviewing literature on the psychological impact of spinal cord injury suggests: (a) depression may not be a precondition for injury adjustment; (b) many persons sustaining cord injury may have experienced psychological disruption prior to injury; and (c) indexes of rehabilitation success need to be developed for the spinal cord injured. (Author)

  1. Remote cerebellar hemorrhage after lumbar spinal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Cevik, Belma [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)], E-mail:; Kirbas, Ismail; Cakir, Banu; Akin, Kayihan; Teksam, Mehmet [Baskent University Faculty of Medicine, Department of Radiology, Fevzi Cakmak Cad. 10. sok. No: 45, Bahcelievler, Ankara 06490 (Turkey)


    Background: Postoperative remote cerebellar hemorrhage (RCH) as a complication of lumbar spinal surgery is an increasingly recognized clinical entity. The aim of this study was to determine the incidence of RCH after lumbar spinal surgery and to describe diagnostic imaging findings of RCH. Methods: Between October 1996 and March 2007, 2444 patients who had undergone lumbar spinal surgery were included in the study. Thirty-seven of 2444 patients were scanned by CT or MRI due to neurologic symptoms within the first 7 days of postoperative period. The data of all the patients were studied with regard to the following variables: incidence of RCH after lumbar spinal surgery, gender and age, coagulation parameters, history of previous arterial hypertension, and position of lumbar spinal surgery. Results: The retrospective study led to the identification of two patients who had RCH after lumbar spinal surgery. Of 37 patients who had neurologic symptoms, 29 patients were women and 8 patients were men. CT and MRI showed subarachnoid hemorrhage in the folia of bilateral cerebellar hemispheres in both patients with RCH. The incidence of RCH was 0.08% among patients who underwent lumbar spinal surgery. Conclusion: RCH is a rare complication of lumbar spinal surgery, self-limiting phenomenon that should not be mistaken for more ominous pathologic findings such as hemorrhagic infarction. This type of bleeding is thought to occur secondary to venous infarction, but the exact pathogenetic mechanism is unknown. CT or MRI allowed immediate diagnosis of this complication and guided conservative management.

  2. Classical eyeblink conditioning using electrical stimulation of caudal mPFC as conditioned stimulus is dependent on cerebellar interpositus nucleus in guinea pigs

    Institute of Scientific and Technical Information of China (English)

    Guang-yan WU; Juan YAO; Zheng-li FAN; Lang-qian ZHANG; Xuan LI; Chuang-dong ZHAO; Zhen-hua ZHOU; Jian-feng SUI


    Aim:To determine whether electrical stimulation of caudal medial prefrontal cortex (mPFC) as conditioned stimulus (CS) paired with airpuff unconditioned stimulus (US) was sufficient for establishing eyeblink conditioning in guinea pigs,and whether it was dependent on cerebellar interpositus nucleus.Methods:Thirty adult guinea pigs were divided into 3 conditioned groups,and trained on the delay eyeblink conditioning,short-trace eyeblink conditioning,and long-trace eyeblink conditioning paradigms,respectively,in which electrical stimulation of the right caudal mPFC was used as CS and paired with corneal airpuff US.A pseudo conditioned group of another 10 adult guinea pigs was given unpaired caudal mPFC electrical stimulation and the US.Muscimol (1 μg in 1 μL saline) and saline (1 μL) were infused into the cerebellar interpositus nucleus of the animals through the infusion cannula on d 11 and 12,respectively.Results:The 3 eyeblink conditioning paradigms have been successfully established in guinea pigs.The animals acquired the delay and short-trace conditioned responses more rapidly than long-trace conditioned responses.Muscimol infusion into the cerebellar interpositus nucleus markedly impaired the expression of the 3 eyeblink conditioned responses.Conclusion:Electrical stimulation of caudal mPFC is effective CS for establishing eyeblink conditioning in guinea pigs,and it is dependent on the cerebellar interpositus nucleus.

  3. An optimized method for measuring hypocretin-1 peptide in the mouse brain reveals differential circadian regulation of hypocretin-1 levels rostral and caudal to the hypothalamus

    DEFF Research Database (Denmark)

    Justinussen, Jessica; Holm, A; Kornum, B R


    as does prepro-hypocretin mRNA in the hypothalamus. However, in midbrain and brainstem tissue caudal to the hypothalamus, there was less circadian fluctuation and a tendency for higher levels during the light phase. These data suggest that regulation of the hypocretin system differs between brain areas....

  4. Estimación de caudales ecológicos en dos cuencas de Andalucía. Uso conjunto de aguas superficiales y subterráneas

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    D. Baeza Sanz


    Full Text Available Las líneas de actuación que en políticas de aguas emanan de la Directiva Marco de Aguas (Directiva 2000/60/CE obligan a considerar nuevos enfoques en las metodologías hasta ahora empleadas en la gestión del agua, incluyendo elementos innovadores y de mayor eficacia como la utilización conjunta de aguas superficiales, subterráneas y los caudales ambientales. Varias instituciones y administraciones estatales yandaluzas están llevando a cabo una serie de trabajos de investigación en dos sistemas deexplotación de recursos hídricos que se localizan en la Comunidad Autónoma de Andalucía. Localizados en la provincia de Jaén y Granada ambos presentan peculiaridadesinteresantes en cuanto a la circulación del agua subterránea. El objetivo de estos trabajos es desarrollar y aplicar tecnologías que integren criterios medioambientales (caudales ecológicos, económicos (coste del agua suministrada y degestión. Los resultados muestran como, aplicando criterios de eficacia y uso conjunto, es posible mantener unos caudales ambientales en el primer sistema, y como los caudales ambientales que se proponen en el segundo sistema serían fundamentales para mantener laestructura y composición del ecosistema ripario de la cuenca estudiada.

  5. The Effects of Single-Dose Rectal Midazolam Application on Postoperative Recovery, Sedation, and Analgesia in Children Given Caudal Anesthesia Plus Bupivacaine

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    Sedat Saylan


    Full Text Available Background. This study aimed to compare the effects of rectal midazolam addition after applying bupivacaine and caudal anesthesia on postoperative analgesia time, the need for additional analgesics, postoperative recovery, and sedation and to find out its adverse effects in children having lower abdominal surgery. Methods. 40 children between 2 and 10 years of ASA I-II were randomized, and they received caudal anesthesia under general anesthesia. Patients underwent the application of caudal block in addition to saline and 1 mL/kg bupivacaine 0.25%. In the postoperative period, Group C (n = 20 was given 5 mL saline, and Group M (n = 20 was given 0.30 mg/kg rectal midazolam diluted with 5 mL saline. Sedation scale and postoperative pain scale (CHIPPS of the patients were evaluated. The patients were observed for their analgesic need, first analgesic time, and adverse effects for 24 hours. Results. Demographic and hemodynamic data of the two groups did not differ. Postoperative sedation scores in both groups were significantly lower compared with the preoperative period. There was no significant difference between the groups in terms of sedation and sufficient analgesia. Conclusions. We conclude that caudal anesthesia provided sufficient analgesia in peroperative and postoperative periods, and rectal midazolam addition did not create any differences. This trial is registered with NCT02127489.

  6. Rostrocaudal location of sympathetic preganglionic neurones within the third thoracic segment of the cat spinal cord investigated by the retrograde transport of horseradish peroxidase and by recording of antidromic field potentials. (United States)

    Dembowsky, K; Czachurski, J; Seller, H


    The rostrocaudal location of sympathetic preganglionic neurones (SPNs) in the intermediolateral cell column of the third thoracic segment was studied in the cat by the retrograde transport of horseradish peroxidase and by recording of antidromic field potentials in the spinal cord in response to stimulation of white ramus T3. By both methods, the position of the rostral and caudal border of SPNs was determined in relation to the entry of segmental dorsal roots. It was found that SPN's are confined in the spinal cord to the length of one segment (9494 +/- 823 micron), but are shifted rostrally by about 3 mm with respect to the point of entry of the dorsal roots of segment T3.

  7. Ambulation and spinal cord injury. (United States)

    Hardin, Elizabeth C; Kobetic, Rudi; Triolo, Ronald J


    Walking is possible for many patients with a spinal cord injury. Avenues enabling walking include braces, robotics and FES. Among the benefits are improved musculoskeletal and mental health, however unrealistic expectations may lead to negative changes in quality of life. Use rigorous assessment standards to gauge the improvement of walking during the rehabilitation process, but also yearly. Continued walking after discharge may be limited by challenges, such as lack of accessibility in and outside the home, and complications, such as shoulder pain or injuries from falls. It is critical to determine the risks and benefits of walking for each patient.

  8. Galactorrhea: a complication of spinal cord injury. (United States)

    Yarkony, G M; Novick, A K; Roth, E J; Kirschner, K L; Rayner, S; Betts, H B


    Galactorrhea, a secretion of milk or milk-like products from the breast in the absence of parturition, has been reported to occur in women with spinal cord injuries in association with amenorrhea and hyperprolactinemia. Four cases of galactorrhea in association with spinal cord injury are reported. Galactorrhea developed in four spinal cord injured women who had thoracic paraplegia. The onset of galactorrhea was from one month to five months after injury. Although the onset of galactorrhea may have been related to prescribed medications in all four cases, insufficient data exist to draw conclusions. The three women whose galactorrhea persisted declined treatment and galactorrhea continuing for more than two years in one instance. We conclude that galactorrhea with or without amenorrhea may develop after a spinal cord injury and that spinal cord injured women may have an enhanced sensitivity to medication-induced galactorrhea.

  9. Contiguous spinal metastasis mimicking infectious spondylodiscitis

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    Lee, Chul Min; Lee, Seung Hun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Bae, Ji Yoon [Dept. of Pathology, National Police Hospital, Seoul (Korea, Republic of)


    Differential diagnosis between spinal metastasis and infectious spondylodiscitis is one of the occasional challenges in daily clinical practice. We encountered an unusual case of spinal metastasis in a 75-year-old female breast cancer patient that mimicked infectious spondylodiscitis. Magnetic resonance imaging (MRI) showed diffuse bone marrow infiltrations with paraspinal soft tissue infiltrative changes in 5 contiguous cervical vertebrae without significant compression fracture or cortical destruction. These MRI findings made it difficult to differentiate between spinal metastasis and infectious spondylodiscitis. Infectious spondylodiscitis such as tuberculous spondylodiscitis was regarded as the more appropriate diagnosis due to the continuous involvement of > 5 cervical vertebrae. The patient's clinical presentation also supported the presumptive diagnosis of infectious spondylodiscitis rather than spinal metastasis. Intravenous antibiotics were administered, but clinical symptoms worsened despite treatment. After pathologic confirmation by computed tomography-guided biopsy, we were able to confirm a final diagnosis of spinal metastasis.

  10. Oriental Medical Treatment of Lumbar Spinal Stenosis

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    Hae-Yeon Lee


    Full Text Available Lumbar spinal stenosis results from the progressive combined narrowing of the central spinal canal, the neurorecesses, and the neuroforaminal canals. In the absence of prior surgery, tumor, or infection, the spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposis posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins, or a combination of two or more of the above factors. Patients with spinal stenosis become symptomatic when pain, motor weakness, paresthesia, or other neurologic compromise causes distress. In one case, we administrated oriental medical treatment with acupuncture treatment and herb-medicine. Oriental medical treatment showed desirable effect on lumbar spinal stenosis.

  11. Spinal morphine anesthesia and urinary retention. (United States)

    Mahan, K T; Wang, J


    Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented.

  12. Spinal cord ischemia secondary to hypovolemic shock. (United States)

    Oh, Jacob Yl; Kapoor, Siddhant; Koh, Roy Km; Yang, Eugene Wr; Hee, Hwan-Tak


    A 44-year-old male presented with symptoms of spinal cord compression secondary to metastatic prostate cancer. An urgent decompression at the cervical-thoracic region was performed, and there were no complications intraoperatively. Three hours postoperatively, the patient developed acute bilateral lower-limb paralysis (motor grade 0). Clinically, he was in class 3 hypovolemic shock. An urgent magnetic resonance imaging (MRI) was performed, showing no epidural hematoma. He was managed aggressively with medical therapy to improve his spinal cord perfusion. The patient improved significantly, and after one week, he was able to regain most of his motor functions. Although not commonly reported, spinal cord ischemia post-surgery should be recognized early, especially in the presence of hypovolemic shock. MRI should be performed to exclude other potential causes of compression. Spinal cord ischemia needs to be managed aggressively with medical treatment to improve spinal cord perfusion. The prognosis depends on the severity of deficits, and is usually favorable.

  13. Degenerative spinal disease in large felids. (United States)

    Kolmstetter, C; Munson, L; Ramsay, E C


    Degenerative spinal disorders, including intervertebral disc disease and spondylosis, seldom occur in domestic cats. In contrast, a retrospective study of 13 lions (Panthera leo), 16 tigers (Panthera tigris), 4 leopards (Panthera pardis), 1 snow leopard (Panthera uncia), and 3 jaguars (Panthera onca) from the Knoxville Zoo that died or were euthanatized from 1976 to 1996 indicated that degenerative spinal disease is an important problem in large nondomestic felids. The medical record, radiographic data, and the necropsy report of each animal were examined for evidence of intervertebral disc disease or spondylosis. Eight (three lions, four tigers, and one leopard) animals were diagnosed with degenerative spinal disease. Clinical signs included progressively decreased activity, moderate to severe rear limb muscle atrophy, chronic intermittent rear limb paresis, and ataxia. The age at onset of clinical signs was 10-19 yr (median = 18 yr). Radiographic evaluation of the spinal column was useful in assessing the severity of spinal lesions, and results were correlated with necropsy findings. Lesions were frequently multifocal, included intervertebral disc mineralization or herniation with collapsed intervertebral disc spaces, and were most common in the lumbar area but also involved cervical and thoracic vertebrae. Marked spondylosis was present in the cats with intervertebral disc disease, presumably subsequent to vertebral instability. Six of the animals' spinal cords were examined histologically, and five had acute or chronic damage to the spinal cord secondary to disc protrusion. Spinal disease should be suspected in geriatric large felids with decreased appetite or activity. Radiographic evaluation of the spinal column is the most useful method to assess the type and severity of spinal lesions.

  14. Cholecalciferol (vitamin D₃) improves functional recovery when delivered during the acute phase after a spinal cord trauma. (United States)

    Gueye, Yatma; Marqueste, Tanguy; Maurel, Fanny; Khrestchatisky, Michel; Decherchi, Patrick; Feron, François


    In a previous study, based on a rat model of thoracic spinal cord compression, we demonstrated that cholecalciferol (Vitamin D3), delivered at the dose of 200 IU/kg/day, significantly improved ventilatory frequency and spasticity. In order to confirm the restorative potential of vitamin D, we performed a new study, using a rat model of left cervical hemisection (C2). From Day 1 or Day 7, animals received, during three months, a weekly oral bolus of either cholecalciferol, at the dose of 500 IU/kg/day, or vehicle, namely triglycerides. Rats were assessed every month, using a ladder test for sensori-locomotor ability and neuromuscular capacity. Three months after injury, H-reflex was recorded from left extensor digitorum muscle in order to measure the reflexivity of the sub-lesional region. Ventilatory frequency was also monitored during an electrically induced muscle fatigue of the hindlimb known to enhance muscle metaboreflex and increase respiratory rate. After recording the phrenic nerve activity, ipsilateral to the lesion, during spontaneous breathing, animals were artificially ventilated while paralyzed with a neuromuscular blocking agent and then the brainstem respiratory centres were provoked to maximal output by temporarily stopping the ventilator. Spinal cords were immunostained with an anti-neurofilament antibody to evaluate axon numbers. We show here that vitamin D-treated animals display i) an enhanced locomotor activity, ii) an improved breathing when hindlimb muscle was electrically stimulated to induce fatigue, iii) an H-reflex depression similar to control animals, iv) a phrenic nerve activity response to a temporary asphyxial stress and v) a non significant decreased number of axons in the proximal stump when compared with the Sham group. This new set of data confirms that vitamin D is a potent molecule that could be tested in clinical trials assessing functional recovery in para-/tetra-plegic patients, shortly after a trauma.

  15. Assessment of Effectiveness of Percutaneous Adhesiolysis in Managing Chronic Low Back Pain Secondary to Lumbar Central Spinal Canal Stenosis

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    Laxmaiah Manchikanti, Kimberly A. Cash, Carla D. McManus, Vidyasagar Pampati


    Full Text Available Background: Chronic persistent low back and lower extremity pain secondary to central spinal stenosis is common and disabling. Lumbar surgical interventions with decompression or fusion are most commonly performed to manage severe spinal stenosis. However, epidural injections are also frequently performed in managing central spinal stenosis. After failure of epidural steroid injections, the next sequential step is percutaneous adhesiolysis and hypertonic saline neurolysis with a targeted delivery. The literature on the effectiveness of percutaneous adhesiolysis in managing central spinal stenosis after failure of epidural injections has not been widely studied.Study Design: A prospective evaluation.Setting: An interventional pain management practice, a specialty referral center, a private practice setting in the United States.Objective: To evaluate the effectiveness of percutaneous epidural adhesiolysis in patients with chronic low back and lower extremity pain with lumbar central spinal stenosis.Methods: Seventy patients were recruited. The initial phase of the study was randomized, double-blind with a comparison of percutaneous adhesiolysis with caudal epidural injections. The 25 patients from the adhesiolysis group continued with follow-up, along with 45 additional patients, leading to a total of 70 patients. All patients received percutaneous adhesiolysis and appropriate placement of the Racz catheter, followed by an injection of 5 mL of 2% preservative-free lidocaine with subsequent monitoring in the recovery room. In the recovery room, each patient also received 6 mL of 10% hypertonic sodium chloride solution, and 6 mg of non-particulate betamethasone, followed by an injection of 1 mL of sodium chloride solution and removal of the catheter.Outcomes Assessment: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS, the Oswestry Disability Index 2.0 (ODI, employment status, and opioid intake with assessment at 3, 6

  16. Clinical radiology of the spine and spinal cord

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    Banna, M.


    This book is a source of information about aspects of radiology of the spine and spinal column. It presents coverage of both normal and abnormal conditions. Contents: Spinal fractures and dislocations. Degenerative diseases of the spine. Gross anatomy of the spinal cord and meninges. Intraspinal mass lesions. Spinal dysraphism. Congenital anomalies. Tumors of the vertebral column, and more.

  17. Repetitive transcranial magnetic stimulation improves open field locomotor recovery after low but not high thoracic spinal cord compression-injury in adult rats. (United States)

    Poirrier, Anne-Lise; Nyssen, Yves; Scholtes, Felix; Multon, Sylvie; Rinkin, Charline; Weber, Géraldine; Bouhy, Delphine; Brook, Gary; Franzen, Rachelle; Schoenen, Jean


    Electromagnetic fields are able to promote axonal regeneration in vitro and in vivo. Repetitive transcranial magnetic stimulation (rTMS) is used routinely in neuropsychiatric conditions and as an atraumatic method to activate descending motor pathways. After spinal cord injury, these pathways are disconnected from the spinal locomotor generator, resulting in most of the functional deficit. We have applied daily 10 Hz rTMS for 8 weeks immediately after an incomplete high (T4-5; n = 5) or low (T10-11; n = 6) thoracic closed spinal cord compression-injury in adult rats, using 6 high- and 6 low-lesioned non-stimulated animals as controls. Functional recovery of hindlimbs was assessed using the BBB locomotor rating scale. In the control group, the BBB score was significantly better from the 7th week post-injury in animals lesioned at T4-5 compared to those lesioned at T10-11. rTMS significantly improved locomotor recovery in T10-11-injured rats, but not in rats with a high thoracic injury. In rTMS-treated rats, there was significant positive correlation between final BBB score and grey matter density of serotonergic fibres in the spinal segment just caudal to the lesion. We propose that low thoracic lesions produce a greater functional deficit because they interfere with the locomotor centre and that rTMS is beneficial in such lesions because it activates this central pattern generator, presumably via descending serotonin pathways. The benefits of rTMS shown here suggest strongly that this non-invasive intervention strategy merits consideration for clinical trials in human paraplegics with low spinal cord lesions.

  18. TRPV1 receptor in the human trigeminal ganglion and spinal nucleus: immunohistochemical localization and comparison with the neuropeptides CGRP and SP. (United States)

    Quartu, Marina; Serra, Maria Pina; Boi, Marianna; Poddighe, Laura; Picci, Cristina; Demontis, Roberto; Del Fiacco, Marina


    This work presents new data concerning the immunohistochemical occurrence of the transient receptor potential vanilloid type-1 (TRPV1) receptor in the human trigeminal ganglion (TG) and spinal nucleus of subjects at different ontogenetic stages, from prenatal life to postnatal old age. Comparisons are made with the sensory neuropeptides calcitonin gene-related peptide (CGRP) and substance P (SP). TRPV1-like immunoreactive (LI) material was detected by western blot in homogenates of TG and medulla oblongata of subjects at prenatal and adult stages of life. Immunohistochemistry showed that expression of the TRPV1 receptor is mostly restricted to the small- and medium-sized TG neurons and to the caudal subdivision of the spinal trigeminal nucleus (Sp5C). The extent of the TRPV1-LI TG neuronal subpopulation was greater in subjects at early perinatal age than at late perinatal age and in postnatal life. Centrally, the TRPV1 receptor localized to fibre tracts and punctate elements, which were mainly distributed in the spinal tract, lamina I and inner lamina II of the Sp5C, whereas stained cells were rare. The TRPV1 receptor colocalized partially with CGRP and SP in the TG, and was incompletely codistributed with both neuropeptides in the spinal tract and in the superficial laminae of the Sp5C. Substantial differences were noted with respect to the distribution of the TRPV1-LI structures described in the rat Sp5C and with respect to the temporal expression of the receptor during the development of the rat spinal dorsal horn. The distinctive localization of TRPV1-LI material supports the concept of the involvement of TRPV1 receptor in the functional activity of the protopathic compartment of the human trigeminal sensory system, i.e. the processing and neurotransmission of thermal and pain stimuli.

  19. Asymptomatic spinal arachnoiditis in patients with tuberculous meningitis

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    Srivastava, T. [Department of Neurology, CN Centre, All India Institute of Medical Sciences, New Delhi (India); Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India); Kochar, D.K. [Department of Medicine, S.P. Medical College, Bikaner, Rajasthan (India)


    Spinal arachnoiditis is one of the common and disabling complication of tuberculous meningitis (TBM). We focused on early diagnosis of spinal arachnoiditis by spinal MRI in asymptomatic patients in whom neurological examination was normal. We studied 16 patients with a diagnosis of probable or highly probable TBM with symptoms for less than 1 month; three had radiological evidence of spinal arachnoiditis. High cerebrospinal fluid protein appeared to be a risk factor for development of spinal arachnoiditis. MRI is sensitive to detect early spinal arachnoiditis. Earlier diagnosis may be helpful in management of spinal arachnoiditis in TBM. (orig.)

  20. Differential Gene Expression Profile in the Rat Caudal Vestibular Nucleus is Associated with Individual Differences in Motion Sickness Susceptibility.

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    Jun-Qin Wang

    Full Text Available To identify differentially expressed genes associated with motion sickness (MS susceptibility in the rat caudal vestibular nucleus.We identified MS susceptible (MSS and insusceptible (inMSS rats by quantifying rotation-induced MS symptoms: defecation and spontaneous locomotion activity. Microarray analysis was used to screen differentially expressed genes in the caudal vestibular nucleus (CVN after rotation. Plasma stress hormones were identified by radioimmunoassay. Candidate genes were selected by bioinformatics analysis and the microarray results were verified by real-time quantitative-PCR (RT-qPCR methods. By using Elvax implantation, receptor antagonists or recombinant adenovirus targeting the candidate genes were applied to the CVN to evaluate their contribution to MS susceptibility variability. Validity of gene expression manipulation was verified by RT-qPCR and western blot analysis.A total of 304 transcripts were differentially expressed in the MSS group compared with the inMSS group. RT-qPCR analysis verified the expression pattern of candidate genes, including nicotinic cholinergic receptor (nAchR α3 subunit, 5-hydroxytryptamine receptor 4 (5-HT4R, tachykinin neurokinin-1 (NK1R, γ-aminobutyric acid A receptor (GABAAR α6 subunit, olfactory receptor 81 (Olr81 and homology 2 domain-containing transforming protein 1 (Shc1. In MSS animals, the nAchR antagonist mecamylamine significantly alleviated rotation-induced MS symptoms and the plasma β-endorphin response. The NK1R antagonist CP99994 and Olr81 knock-down were effective for the defecation response, while the 5-HT4R antagonist RS39604 and Shc1 over-expression showed no therapeutic effect. In inMSS animals, rotation-induced changes in spontaneous locomotion activity and the plasma β-endorphin level occurred in the presence of the GABAAR antagonist gabazine.Our findings suggested that the variability of the CVN gene expression profile after motion stimulation might be a putative