WorldWideScience

Sample records for cervical arterial injuries

  1. Vertebral artery injuries in cervical spine surgery

    OpenAIRE

    Schroeder, Gregory D.; Hsu, Wellington K.

    2013-01-01

    Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least ri...

  2. Factors for vertebral artery injury accompanied by cervical trauma

    Energy Technology Data Exchange (ETDEWEB)

    Murata, Masaaki; Shingu, Hikosuke; Kimura, Isao; Nasu, Yoshiro; Shiotani, Akihide [San-in Rosai Hospital, Yonago, Tottori (Japan). Spine and Low Back Pain Center

    2001-09-01

    Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

  3. Factors for vertebral artery injury accompanied by cervical trauma

    International Nuclear Information System (INIS)

    Injury of the vertebral artery with cerebellar and brain stem infarction is a complication of cervical vertebral trauma. However, the pathogenesis and etiological factors remain to be clarified. In this study, we investigated patients with cervical vertebral and cord injury. This study included 51 patients with cervical vertebral and cord injury who were treated in our department. In these patients, plain X-ray, CT, MRI, and MRA findings were examined. The incidence of vertebral arterial injury was 33.3% (17 of 51 patients with cervical vertebral trauma). In 11 of the 17 patients, dislocation fracture was noted, comprising a markedly high percentage (64.7%). Particularly, vertebral arterial injury was commonly observed in patients with a large dislocation distance and severe paralysis. Cerebellar and brain stem infarction related to vertebral arterial injury was observed in 5 of the 17 patients (29.4%). No infarction developed in patients 50 years old or younger. Infarction was detected in relatively elderly patients. Vertebral arterial injury and cerebellar/brain stem infarction related to cervical vertebral trauma were frequently observed in patients with high energy injury. However, these disorders commonly occurred in elderly patients. Therefore, age-related factors such as arteriosclerosis may also be closely involved. In the acute stage, the state of the vertebral artery should be evaluated by MRA and MRI. Among patients with vertebral arterial injury, caution is needed during follow-up those with risk factors such as high energy injury and advanced age. (author)

  4. The pattern and prevalence of vertebral artery injury in patients with cervical spine fractures

    Directory of Open Access Journals (Sweden)

    Farzanah Ismail

    2013-06-01

    Full Text Available Aim: It is not uncommon for vertebral artery injury to occur when there are fractures through the transverse foraminae of the first to the sixth vertebral bodies. Other important risk factors for vertebral artery injury include facet joint dislocations and fractures of the first to the third cervical vertebral bodies. The aim of this study was to determine the pattern and prevalence of vertebral artery injury on CT angiography (CTA in patients with cervical spine fractures.Method: A retrospective review of patients who had undergone CTA of the vertebral arteries was undertaken. Reports were reviewed to determine which patients met the inclusion criteria of having had both cervical spine fractures and CTA of the vertebral arteries. Images of patients who met the inclusion criteria were analysed by a radiologist.Results: The prevalence of vertebral artery injury was 33%. Four out of the 11 patients who had vertebral artery injury, had post-traumatic spasm of the artery, with associated thrombosis or occlusion of the vessel. In terms of blunt carotid vertebral injury (BCVI grading, most of the patients sustained grade IV injuries. Four patients who had vertebral artery injury had fractures of the upper cervical vertebrae, i.e. C1 to C3. Fifteen transverse process fractures were associated with vertebral artery injury. No vertebral artery injury was detected in patients who had facet joint subluxations.Conclusion: Patients with transverse process fractures of the cervical spine and upper cervical vertebral body fractures should undergo CTA to exclude vertebral artery injury.

  5. Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury

    Institute of Scientific and Technical Information of China (English)

    JIANG Tao; REN Xian-jun; WANG Wei-dong; ZHANG Xia; LI Chang-qing; HAO Yong

    2010-01-01

    Objective: To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.Methods: This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF)magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.Results: There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.Conclusions: Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.

  6. Embolic brain infarction related to posttraumatic occlusion of vertebral artery resulting from cervical spine injury: a case report

    OpenAIRE

    Nakao, Yaoki; Terai, Hiroshi

    2014-01-01

    Introduction The frequency of vertebrobasilar ischemia in patients with cervical spine trauma had been regarded as low in many published papers. However, some case reports have described cervical spine injury associated with blunt vertebral artery injury. Many aspects of the management of vertebral artery injuries still remain controversial, including the screening criteria, the diagnostic modality, and the optimal treatment for various lesions. The case of a patient who had a brain infarctio...

  7. Significance of magnetic resonance imaging in the diagnosis of vertebral artery injury associated with blunt cervical spine trauma

    International Nuclear Information System (INIS)

    Vertebral artery injury associated with non-penetrating cervical trauma is rare. We report 11 cases of vertebral artery injury diagnosed with magnetic resonance imaging (MRI) after blunt trauma to the cervical spine and discuss about the importance of MRI in the diagnosis of this injury. Seven cases were caused by motor vehicle accidents, three by diving accidents, and one by static compression of the neck. All of the patients had documented cervical spine fractures and dislocations. In three patients, the diagnosis of complete occlusion of the vertebral artery was made on the basis of MRI and digital subtraction angiography (DSA). In the other patients, mural injuries of the vertebral artery were demonstrated with DSA. These 11 patients presented with acute, nonspecific changes in neurological status. Two had infarctions of the cerebellum and brainstem. None were treated with anticoagulants. All of them survived and were discharged to other hospitals for physical and occupational therapy. Although DSA remains the gold standard for diagnosing vertebral artery injuries, MRI is a newer modality for assessing cervical cord injury, and it may be useful for evaluating the presence of vertebral injury after blunt cervical spine trauma. (author)

  8. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

    2014-01-15

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  9. CrossFit-related cervical internal carotid artery dissection.

    Science.gov (United States)

    Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

    2015-08-01

    CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients.

  10. CrossFit-related cervical internal carotid artery dissection.

    Science.gov (United States)

    Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

    2015-08-01

    CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients. PMID:25917634

  11. Imaging of cervical spine injuries of childhood

    Energy Technology Data Exchange (ETDEWEB)

    Khanna, Geetika; El-Khoury, Georges Y. [University of Iowa Hospitals and Clinics, Department of Radiology, 3951 JPP, Iowa, IA (United States)

    2007-06-15

    Cervical spine injuries of children, though rare, have a high morbidity and mortality. The pediatric cervical spine is anatomically and biomechanically different from that of adults. Hence, the type, level and outcome of cervical spine injuries in children are different from those seen in adults. Normal developmental variants seen in children can make evaluation of the pediatric cervical spine challenging. This article reviews the epidemiology of pediatric cervical spine trauma, normal variants seen in children and specific injuries that are more common in the pediatric population. We also propose an evidence-based imaging protocol to avoid unnecessary imaging studies and minimize radiation exposure in children. (orig.)

  12. Sport injuries of the cervical spine

    International Nuclear Information System (INIS)

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

  13. The clinical characteristics and therapy of syndrome of craniocerebral- cervical vertebral injury

    Institute of Scientific and Technical Information of China (English)

    LIU Sheng; LIU Yuan-xin; WANG Cheng

    2005-01-01

    Objective: To explore the clinical characteristics and new treatment for syndrome of craniocerebral-cervical vertebral injury. Methods: The clinical data of 52 patients with head injury accompanied by neck injury were analyzed retrospectively. Results: Craniocerebral injury could result in damage to cervical vertebrae, muscles, vessels and nerves, and even cause vertebral artery injury, which may lead to insufficient blood-supply of vertebral-basal artery. All patients were treated with cervical vertebral traction and the results were good. Conclusions: Acute craniocerebral injury with symptom of insufficient blood-supply of vertebral-basal artery, evident neurosis and atlas-axis half-dislocation in X-ray should be treated by cervical vertebral traction, which will yield better outcome.

  14. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    OpenAIRE

    Zhang, Ling; Chen, Hai-Bin; Wang, Yi; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, ...

  15. Cervical Artery Dissection: Emerging Risk Factors

    OpenAIRE

    Micheli, S.; Paciaroni, M; Corea, F; Agnelli, G.; M. Zampolini; Caso, V

    2010-01-01

    Cervical artery dissection (CAD) represents an increasingly recognized cause of stroke and the most common cause of ischemic stroke in young adults. Many factors have been identified in association with CAD such as primary disease of arterial wall (fibrodysplasia) and other non-specific diseases related to CAD like Ehlers Danlos-syndrome IV, Marfan’s syndrome, vessel tortuosity. Moreover, an underlying arteriopathy which could be in part genetically determined, has been suspected. The rule of...

  16. Diagnosis and treatment of vertebral artery injury in cervical spine surgery%颈椎手术中并发椎动脉损伤的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    王少波; 孙宇; 刁垠泽; 李迈; 张凤山

    2012-01-01

    目的 探讨颈椎手术中并发椎动脉损伤的发生原因、治疗及预防.方法 回顾性分析2002年10月至2012年4月颈椎手术中并发椎动脉损伤的7例患者资料,男6例,女1例;年龄23~65岁,平均48.9岁;脊髓型颈椎病5例,颈椎外伤合并C4.5半脱位1例,氟骨症致颈椎管狭窄1例.椎动脉损伤均为单侧,左侧4例,右侧3例.分析颈椎手术中并发椎动脉损伤的原因、处理过程及预后.结果 颈椎前路手术4例,其中2例用环钻减压时偏离中线损伤椎动脉,1例切除稚间盘时刮匙过于偏外损伤椎动脉,1例颈椎外伤患者由于C4,5半脱位造成椎动脉迂曲,减压时冲击式咬骨钳损伤椎动脉.颈椎后路手术3例,其中2例为行C4侧块螺钉固定时钻头偏外损伤椎动脉;1例氟骨症致颈椎管狭窄者在切除寰椎后弓时咬骨钳损伤椎动脉,术中出现椎动脉损伤后,迅速填塞压迫止血并关闭伤口,但术后4周发生迟发性出血,采用椎动脉栓塞止血及颈后路血肿清除术治疗.7例患者均未发生脑梗塞,其中2例患者术后出现-过性头晕.结论 椎动脉损伤是颈椎手术的严重并发症,其损伤原因与手术失误、解剖变异等有关;采用直接压迫及椎动脉栓塞治疗效果确切.%Objective To investigate cause,diagnosis,treatment and prevention of vertebral artery injury in cervical spine surgery.Methods Data of 7 patients with vertebral artery injury caused by cervical spine surgery from October 2002 to April 2012 were retrospectively analyzed.There were 6 males and 1 female,aged from 23 to 65 years (average,48.9 years).The reasons of cervical spine surgery were as follows:cervical spondylotic myelopathy (5 cases),traumatic subluxation of C4 and C5 (1 case),and cervical spinal stenosis due to skeletal fluorosis (1 case).All cases had unilateral vertebral artery injury,including 4 cases in the left side and 3 cases in the right side.The cause,treatment and prognosis of

  17. Acute Hydrocephalus Following Cervical Spinal Cord Injury

    OpenAIRE

    Son, Seong; Lee, Sang Gu; Park, Chan Woo; Kim, Woo Kyung

    2013-01-01

    We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drow...

  18. Cervical spine injuries in rugby players.

    Science.gov (United States)

    Sovio, O M; Van Peteghem, P K; Schweigel, J F

    1984-03-15

    Nine patients with serious cervical spine injuries that occurred while they were playing rugby were seen in a British Columbia acute spinal cord injury unit during the period 1975-82. All the injuries had occurred during the "scrum" or the "tackle". Two of the patients were rendered permanently quadriplegic, and one patient died. There is a need for a central registry that would record all cervical spine injuries in rugby players as well as for changes in the rules of the game. PMID:6697282

  19. Cervical artery dissection following a turbulent flight.

    LENUS (Irish Health Repository)

    Quinn, Colin

    2012-01-31

    BACKGROUND: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors while other cases may be precipitated by an event involving head or neck movement or associated with direct neck trauma. CASE REPORT: We present the case of a previously well young woman with a history of migraine who developed internal carotid artery dissection following a turbulent short-haul commercial flight while restrained using a seatbelt. DISCUSSION: We propose that repetitive flexion-hyperextension neck movements encountered during the flight were the most likely precipitant of carotid artery dissection in this case and review the therapeutic options available.

  20. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  1. [Medical management of cervical arterial dissections].

    Science.gov (United States)

    Vuillier, F; Tatu, L; Moulin, T

    2002-12-01

    Medical management of cervical arterial dissections is not standardized and has not been the subject of randomized trials. Management is mainly based on the presumed pathophysiology of secondary cerebral infarcts associated with dissections and the individual experience of each treating team. First, a review of the literature regarding medical management of acute and chronic dissections is presented. Then, results from a national study sponsored by the Société Française Neuro-Vasculaire and the Société Française de Neuro-Radiologie evaluating the medical management of this pathology in French neuro-vascular centers will be presented. These data will be useful to generate practical management recommendations and establish guidelines for further studies.

  2. Classification of acute subaxial cervical spine injury

    OpenAIRE

    2012-01-01

    Abstract Study Design Literature review Objective The aim of this thesis is to compare the main classification systems available for classifying acute subaxial cervical spinal injury and compare their relative strengths and weaknesses, especially in their ability to guide treatment and predict prognosis. Methods A PICO question was formulated and used to select search terms. The search terms were used to search the online database Pubmed/Medline for English language revi...

  3. Cervical spine injury in child abuse: report of two cases

    International Nuclear Information System (INIS)

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

  4. Cervical spine injuries in the pediatric and adolescent athlete.

    Science.gov (United States)

    Herman, Martin J

    2006-01-01

    Injuries of the cervical spine in the pediatric and adolescent athlete are less common than other musculoskeletal injuries. Although many of these injuries are relatively minor, serious and potentially unstable or progressive spinal injury must be excluded. Important anatomic differences between the child younger than 10 years and older children and adolescents influence the types of injuries sustained and make assessment of the child's cervical spine sometimes difficult for practitioners accustomed to treating adolescent and adult athletes. Stable soft-tissue injuries of the cervical spine are the most common injuries that occur in all athletes. These injuries are responsive to symptomatic treatment and aggressive rehabilitation. Stingers are injuries of the brachial plexus and upper cervical roots that result from stretching or compressive forces associated with collision sports. Rapid return of sensory and motor dysfunction of a single upper extremity characterizes this entity; long-term disability is rare. Cervical cord neurapraxia (CCN) with transient quadriplegia is most commonly seen in football players. Most athletes fully recover. Cervical canal stenosis as defined by a Pavlov/Torg ratio of less than or equal to 0.8 is predictive of recurrent CCN. Young athletes sustain CCN secondary to hypermobility of the immature cervical spine. Return to play after these injuries is controversial. The athlete with Down syndrome and potential cervical hypermobility requires a careful cervical and neurologic evaluation prior to clearance for participation in sports. PMID:16958497

  5. Lateral Pectoral Nerve Injury Mimicking Cervical Radiculopathy.

    Science.gov (United States)

    Aktas, Ilknur; Palamar, Deniz; Akgun, Kenan

    2015-07-01

    The lateral pectoral nerve (LPN) is commonly injured along with the brachial plexus, but its isolated lesions are rare. Here, we present a case of an isolated LPN lesion confused with cervical radiculopathy. A 41-year-old man was admitted to our clinic because of weakness in his right arm. Previous magnetic resonance imaging (MRI) examination revealed right posterolateral protrusion at the C6-7 level. At the initial assessment, atrophy of the right pectoralis major muscle was evident, and mild weakness of the right shoulder adductor, internal rotator, and flexor muscles was observed. Therefore, electrodiagnostic evaluation was performed, and a diagnosis of isolated LPN injury was made. Nerve injury was thought to have been caused by weightlifting exercises and traction injury. Lateral pectoral nerve injury can mimic cervical radiculopathy, and MRI examination alone may lead to misdiagnosis. Repeated physical examinations during the evaluation and treatment phase will identify the muscle atrophy that occurs 1 or more months after the injury. PMID:25290103

  6. A hitherto unreported disruption of cervical branches of facial artery

    Directory of Open Access Journals (Sweden)

    Sharma P

    2011-03-01

    Full Text Available According to its course, the branches of the facial artery are arranged under two headings; cervical component (branches in the digastric triangle and facial component (branches on the face.Variations in the branches of the facial component of the facial artery have been frequently studied and reported. However, variations in the cervical component are rare. A hitherto unreported variant of the cervical component of the facial artery was observed in a 55-year-old male cadaver during routine undergraduate dissection. The facial artery was arising from the external carotid artery as a common trunk with the lingual artery in the right carotid triangle and its ascending palatine and tonsillar branches were arising from the external carotid artery. It is important for surgeons and radiologists to be aware of the normal anatomy of the facial artery and the external carotid artery. Herein, we describe the detailed anatomical features of the variant branching pattern of the right facial artery and its clinical implications.

  7. Antithrombotic therapy and outcomes of cervical arterial dissection in the trauma patient: a case series

    OpenAIRE

    Yarbrough Karen L; Furuno Jon P; Stallmeyer M JB; Hinson Holly E; Cole John W

    2010-01-01

    Abstract Background The use of antithrombotic therapy (anticoagulants and/or antiplatelets) in the setting of traumatic cervical arterial dissection (CAD) for the prevention of stroke remains controversial. This issue is further complicated by the frequent co-existence of intracranial hemorrhage (ICH) and other intracranial injuries, and also the wide variability in treatment due to a lack of evidence-based guidance. To address these controversies, a registry in a major Level I trauma center ...

  8. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

    Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery. PMID:1315578

  9. Phrenic Nerve Injury during Coronary Artery Bypass

    OpenAIRE

    Guinn, Gene A.; Beall, Arthur C.; Lamki, Neela; Heibig, Jacques; Thornby, John

    1990-01-01

    After coronary artery bypass, some patients have diaphragmatic elevation, usually on the left side. To test our hypothesis that this phenomenon is due to phrenic nerve injury resulting from either 1) dissection of the proximal portion of the left internal mammary artery or 2) topical cooling of the heart with icy slush, we performed the following 2-part study. First, we reviewed our hospital records of 99 coronary artery bypass patients, 55 of whom had received left internal mammary artery gr...

  10. Significance of prevertebral soft tissue measurement in cervical spine injuries

    Energy Technology Data Exchange (ETDEWEB)

    Dai Liyang E-mail: lydai@etang.com

    2004-07-01

    Objective: The objective of this study was to evaluate the diagnostic value of prevertebral soft tissue swelling in cervical spine injuries. Materials and methods: A group of 107 consecutive patients with suspected injuries of the cervical vertebrae were reviewed retrospectively to identify the presence of prevertebral soft tissue swelling and to investigate the association of prevertebral soft tissue swelling with the types and degrees of cervical spine injuries. Results: Prevertebral soft tissue swelling occurred in 47 (43.9%) patients. Of the 47 patients, 38 were found with bony injury and nine were without. The statistic difference was significant (P<0.05). No correlation was demonstrated between soft tissue swelling and either the injured level of the cervical vertebrae or the degree of the spinal cord injury (P>0.05). Anterior element injuries in the cervical vertebrae had widening of the prevertebral soft tissue more than posterior element injuries (P<0.05). Conclusion: The diagnostic value of prevertebral soft tissue swelling for cervical spine injuries is significant, but the absence of this sign does not mean that further image evaluation can be spared.

  11. Direct cervical arterial access for intracranial endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Blanc, R. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); APHP, Hopital Henri Mondor, Service de Neuroradiologie Diagnostique et Therapeutique, Creteil Cedex (France); Piotin, M.; Mounayer, C.; Spelle, L. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Moret, J. [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Hopital de la Fondation Ophtalmologique Adolphe de Rothschild, Service de Neuroradiologie Interventionnelle, Paris Cedex 19 (France)

    2006-12-15

    Tortuous vasculature is a cause of failure of endovascular treatment of intracranial vascular lesions. We report our experience of direct cervical accesses in patients in whom the arterial femoral route was not attainable. In this retrospective study, 42 direct punctures of the carotid or the vertebral arteries at the neck were performed in 38 patients. The vessel harboring the intracranial lesion was punctured at the neck above the main tortuosity, a sheath was then positioned under fluoroscopic control to allow a stable access to the intracranial circulation. After the procedure, the sheath was removed and hemostasis was gained either by manual compression or by an arterial closure device (4 of 42, 9%). The cervical route allowed access to all intracranial lesions in all 42 procedures. A complication was encountered in six procedures (14%) related to the direct puncture. In 2 of the 42 procedures (4%), a transient vasospasm was encountered. A cervical hematoma formed in 3 of the 42 procedures (7%) after sheath withdrawal (one patient in whom an 8F sheath had been used, required surgical evacuation of a hematoma compressing the upper airways; the other patients did well without surgical evacuation). In the remaining patient (1 of 42 procedures, 2%), a small asymptomatic aneurysm at the puncture site was seen on the follow-up angiogram. Direct cervical arterial approaches to accessing the intracranial circulation is effective in patients in whom the femoral route does not allow the navigation and stabilization of guiding catheters. (orig.)

  12. Traumatic Knee Dislocation with Acute Artery Injury

    OpenAIRE

    Hüseyin Şahin1; Mustafa Uzkeser2; Ayhan Aköz; et al.

    2014-01-01

    Traumatic knee dislocation is very rare injury in patients presenting to the emergency room. The complications associated with knee dislocation such as amputation of extremities and die is required emergency response. We discussed a case, that he has only knee dislocation and popliteal artery injury and mortal as soon as possible.

  13. Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Mortele, B.; Lemmerling, M.; Mortele, K.; Verstraete, K.; Defreyne, L.; Kunnen, M. [Department of Radiology, University Hospital, Gent (Belgium); Vandekerckhove, T. [Department of Neurosurgery, University Hospital, Gent (Belgium)

    2000-06-01

    A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

  14. Cervical chordoma with vertebral artery encasement mimicking neurofibroma: MRI findings

    International Nuclear Information System (INIS)

    A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side and enlargement of the right intervertebral foramen at C2-C3 level. Tumor encasement of the vertebral artery was demonstrated by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment. (orig.)

  15. Copy number variation in patients with cervical artery dissection

    OpenAIRE

    Grond-Ginsbach, Caspar; Chen, Bowang; Pjontek, Rastislav; Wiest, Tina; Jiang, Yanxiang; Burwinkel, Barbara; Tchatchou, Sandrine; Krawczak, Michael; Schreiber, Stefan; Brandt, Tobias; Kloss, Manja; Arnold, Marie-Luise; Hemminki, Kari; Lichy, Christoph; Lyrer, Philippe A.

    2012-01-01

    Cervical artery dissection (CeAD) occurs in healthy young individuals and often entails ischemic stroke. Skin biopsies from most CeAD-patients show minor connective tissue alterations. We search for rare genetic deletions and duplication that may predispose to CeAD. Forty-nine non-traumatic CeAD-patients with electron microscopic (EM) alterations of their dermal connective tissue (EM+ patients) and 21 patients with normal connective tissue in skin biopsies (EM− patients) were analyzed. Affyme...

  16. Angiographic features of unilateral nonbifurcating cervical carotid artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    En, Na Lae [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Seung Koo [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-08-15

    Nonbifurcating cervical carotid artery is a rare anomaly of the common carotid artery (CCA), in which the branches of the external carotid artery (ECA) arise directly from the CCA or proximal internal carotid artery without bifurcation, and therefore there is no proximal main trunk of the ECA. We report a unilateral nonbifurcating cervical carotid artery of a 67-year-old woman, incidentally found during cerebral aneurismal treatment.

  17. Uterine artery embolization for cervical ectopic pregnancy

    Directory of Open Access Journals (Sweden)

    Qiao Zhou, MD

    2015-12-01

    Full Text Available A 36-year-old woman with 3 prior C-sections is diagnosed with a caesarean scar ectopic pregnancy. Despite receiving intramuscular and transvaginal methotrexate injection 2 months before presentation, the beta human chorionic gonadotropin was recorded to be 73 mIU/mL at the time of encounter. The patient complained of vaginal bleeding with a significant drop in hematocrit from 40% to 33%. Transvaginal ultrasound confirmed retroplacental hemorrhage and because of the patient's desire to retain fertility, interventional radiology was consulted to perform an uterine artery embolization. The uterine artery embolization was successful in achieving hemostasis and resulted in a decrease of betaHCG to 46 on postprocedure day 1 to <1 mIU/mL by postoperative week 3.

  18. Exertion and acute coronary artery injury.

    Science.gov (United States)

    Black, A; Black, M M; Gensini, G

    1975-12-01

    Twelve cases of myocardial infarction as related to strenuous exertion are presented with the pathological findings in several of these cases. Three cases with coronary arteriography are also presented. The pathology of coronary arteriosclerotic plaques and the vulnerability to acute injury is reviewed and discussed. It is concluded that strenuous exertion can cause acute injury to coronary artery plaques due to the unusual stressful whip-like action to which coronary arteries are subject. These injuries may initiate as cracks in the plaques or subintimal hemorrhages and proceed to coronary occlusion and ultimate myocardial infarction. With this concept in mind we use the term of "crack in the plaque" (Black's Crack in the Plaque) to account for the sudden appearance of clinical coronary artery disease appearing during or shortly after exertion, or other stressful situations in patients without previous existing evidence of clinical coronary artery disease. This could also account for exacerbation of symptoms or death occurring after exertion in previously quiescent asymptomatic known coronary artery disease subjects. This concept may explain some of the puzzling features of coronary disease.

  19. A case of traumatic intracranial vertebral artery injury presenting with life-threatening symptoms

    Directory of Open Access Journals (Sweden)

    Kishi S

    2012-04-01

    Full Text Available Seiji Kishi1, Kenji Kanaji2, Toshio Doi1, Tadashi Matsumura21Department of Nephrology, Tokushima University Hospital, Kuramoto-cho Tokushima, 2Department of General Internal Medicine, Rakuwakai Otowa Hospital, Otowachinji-cho Yamashina-ku Kyoto, JapanAbstract: Traumatic intracranial vertebral artery injury is a relatively rare but potentially fatal disease. We present a case of a 63-year-old man who presented with sudden onset of loss of consciousness after hitting his head. After immediate resuscitation, he showed quadriplegia and absence of spontaneous breathing. Brain and cervical spine magnetic resonance imaging revealed an atlantoaxial subluxation, fractured C2 odontoid process, left vertebral artery occlusion, and bilateral extensive ischemia in the medulla oblongata and high cervical spinal cord. Digital subtraction angiography demonstrated left vertebral artery dissection just below the level of vertebral body C2.Keywords: vertebral artery dissection, brainstem infarction, bilateral spinal cord infarction, neck trauma

  20. [Biomechanics of whiplash injuries of the cervical spine].

    Science.gov (United States)

    Schmidt, G

    1989-07-01

    1. The whiplash injury of the cervical spine is a typical, but not very often observed injury of occupants of automotive vehicles involved in moderate collisions. 2. There still exist great uncertainties in the elaboration of expertises concerning the minor whiplash injury, so that the great part of the disturbances cannot be objectivated under a clinical point of view. And on the other hand, serious whiplash injuries often are superposed or veiled by secondary injuries. 3. Thus, the aim of the present paper was to point out injury mechanisms, to give a rough scaling of the whiplash severity under biomechanical aspects and finally to set these injury mechanisms in correlation to the following criteria of accident: a) vehicle velocity change (energy equivalent speed--EES); b) deformation of vehicles on the impact-exposed structure; c) loading of occupants by acceleration or deceleration. 4. The tolerance limit of the cervical spine generally decreases to a lower limit, if the cervical spine is changed in a pathological way, e.g. by preexisting diseases. 5. It is evident and important, that the difficult work of giving an expert's opinion on this field must be performed in an interdisciplinary collaboration of engineers for collision-analysis and physicians experienced in accident-traumatology. PMID:2669311

  1. Comparison of Three Prehospital Cervical Spine Protocols for Missed Injuries

    Directory of Open Access Journals (Sweden)

    Rick Hong

    2014-07-01

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

  2. MRI of cervical spine injuries complicating ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

    2008-09-15

    The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

  3. Arterial hypertension as risk factor for spontaneous cervical artery dissection. A case–control study

    OpenAIRE

    Pezzini, A; Caso, V; Zanferrari, C; Del Zotto, E; Paciaroni, M; Bertolino, C; Grassi, M.(INFN Sezione di Roma, Roma, Italy); Agnelli, G.; Padovani, A

    2006-01-01

    Because of the presumed non‐atherosclerotic pathogenesis, the potential link between spontaneous cervical artery dissection (sCAD) and common risk factors for atherosclerosis has never been investigated systematically. Therefore, this prospective, multicentre, case–control study compared the frequency of tobacco use, hypertension, diabetes mellitus, and hypercholesterolaemia among a group of consecutive patients with sCAD (n  =  153), a group of patients with ischaemic stroke, not related to ...

  4. Cervical Spine Involvement in Mild Traumatic Brain Injury: A Review.

    Science.gov (United States)

    Morin, Michael; Langevin, Pierre; Fait, Philippe

    2016-01-01

    Background. There is a lack of scientific evidence in the literature on the involvement of the cervical spine in mTBI; however, its involvement is clinically accepted. Objective. This paper reviews evidence for the involvement of the cervical spine in mTBI symptoms, the mechanisms of injury, and the efficacy of therapy for cervical spine with concussion-related symptoms. Methods. A keyword search was conducted on PubMed, ICL, SportDiscus, PEDro, CINAHL, and Cochrane Library databases for articles published since 1990. The reference lists of articles meeting the criteria (original data articles, literature reviews, and clinical guidelines) were also searched in the same databases. Results. 4,854 records were screened and 43 articles were retained. Those articles were used to describe different subjects such as mTBI's signs and symptoms, mechanisms of injury, and treatments of the cervical spine. Conclusions. The hypothesis of cervical spine involvement in post-mTBI symptoms and in PCS (postconcussion syndrome) is supported by increasing evidence and is widely accepted clinically. For the management and treatment of mTBIs, few articles were available in the literature, and relevant studies showed interesting results about manual therapy and exercises as efficient tools for health care practitioners. PMID:27529079

  5. [Magnetic resonance tomography in injuries of the cervical spine].

    Science.gov (United States)

    Meydam, K; Sehlen, S; Schlenkhoff, D; Kiricuta, J C; Beyer, H K

    1986-12-01

    Twenty patients who had suffered spinal trauma were examined by magnetic resonance tomography. Fifteen patients with first degree trauma in Erdmann's classification showed no abnormality. Magnetic resonance tomography of the cervical spine appears to be a suitable method for investigating patients with whiplash injuries. It is indicated following severe flexion injuries with subluxations and neurological symptoms, since it is the only method that can demonstrate the spinal cord directly and completely and show the extent of cord compression. For patients with thoracic trauma and rapidly developing neurological symptoms, magnetic resonance tomography is ideal for showing post-traumatic syringomyelia. Magnetic resonance tomography following whiplash injuries is recommended if plain films of the cervical spine show any abnormalities, as well as for the investigation of acute or sub-acute neurological abnormalities. The various findings are discussed. PMID:3025951

  6. HOMICIDE BY CERVICAL SPINAL CORD GUNSHOT INJURY WITH SHOTGUN FIRE PELLETS: CASE REPORT

    OpenAIRE

    Dana Turliuc, Serban Turliuc, Iustin Mihailov, Andrei Cucu, Gabriel Dumitrescu,Claudia Costea

    2015-01-01

    This case present a rare forensic case of cervical spinal gunshot injury of a female by her husband, a professional hunter, during a family fight with a shotgun fire pellets. The gunshot destroyed completely the cervical spinal cord, without injury to the neck vessels and organs and with the patient survival for seven days. We discuss notions of judicial ballistics, assessment of the patient with spinal cord gunshot injury and therapeutic strategies. Even if cervical spine gunshot injuries ar...

  7. Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management

    Directory of Open Access Journals (Sweden)

    M. Zafrullah Arifin

    2012-06-01

    Full Text Available Analysis of the Functional Independence Measure Value of Cervical Spine Injury Patients with Conservative Management. Cervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in the United States of America (2008, sixty seven percent involve cervical spine injury. American Spinal Cord Injury Association (ASIA impairment score is used as an initial assessment but not enough attention prognostic outcome of these patients was paid to. The objective of this study is to analyze the value of functional independence measure (FIM cervical spine injury patients with conservative management and its correlation with age, sex, type of trauma, onset of trauma, cervical abnormalities, type of cervical spine lesion and ASIA impairment score. A prospective cohort study was performed to all patients with cervical spine injury treated inNeurosurgery Department of Dr. Hasan Sadikin Hospital Bandung that fullfiled the inclusion criteria. The subjects were classified based on age, sex, single/multiple trauma, acute /chronic, cervical abnormalities, complete/incomplete lesion and ASIA impairment score. The FIM examination was performed in Outpatient clinic of Neurosurgery. T-test and chi-square test was done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital during April 2009–April 2010. The average FIM value of cervical spine injury in those patients is 4+ 1.63 by cohort prospective study. There were no correlation between FIM value with age, sex, type of trauma, onset of trauma and cervical abnormalities. Significant correlations were found between FIM value with type of cervical spine lesion and ASIA impairment score in cervical spine patients. Type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 6 months after cervical injury.

  8. Rugby union injuries to the cervical spine and spinal cord.

    Science.gov (United States)

    Quarrie, Kenneth L; Cantu, Robert C; Chalmers, David J

    2002-01-01

    Injuries to the cervical spine are among the most serious injuries occurring as a result of participation in rugby. Outcomes of such injuries range from complete recovery to death, depending on the degree of spinal cord damage sustained. Much information has been gained regarding the mechanisms and frequency of such injuries, from case reports and case series studies. The most commonly reported mechanism of injury has been hyperflexion of the cervical spine, resulting in fracture dislocation of C4-C5 or C5-C6. Tracking both the trends of incidence of spinal injuries, and the effectiveness of injury prevention initiatives has proved difficult because of a lack of properly conducted epidemiological studies. Within the constraints of the research published to date, it appears that hookers and props have been at disproportionate risk of cervical spine injury, predominantly because of injuries sustained during scrummaging. While the scrum was the phase of play most commonly associated with spinal injuries throughout the 1980s in most rugby playing countries, there has been a trend through the 1990s of an increasing proportion of spinal injuries occurring in the tackle situation. The majority of injuries have occurred early in the season, when grounds tend to be harder, and players are lacking both practice and physical conditioning for the physical contact phases of the sport. A number of injury prevention measures have been launched, including changes to the laws of the game regarding scrummaging, and education programmes aimed at enforcing safe techniques and eliminating illegal play. Calls for case-registers and effective epidemiological studies have been made by researchers and physicians in most countries where rugby is widespread, but it appears to be only recently that definite steps have been made towards this goal. Well-designed epidemiological studies will be able to provide more accurate information about potential risk factors for injury such as age, grade

  9. Extracranial Vertebral Artery Aneurysm Presenting as a Chronic Cervical Mass Lesion

    Directory of Open Access Journals (Sweden)

    Lampis C. Stavrinou

    2010-01-01

    Full Text Available Background. Aneurysms of the extracranial vertebral artery are rare and can provide a diagnostic and therapeutic challenge. Methods. We reviewed the clinical history of a patient presenting with cervical radiculopathy, who harboured an extracranial vertebral artery aneurysm eroding the cervical spine. Results. CT Angiography and MR Angiography set the diagnosis, by revealing a left C5-C6 vertebral artery aneurysm with cervical root impingement. Bony reconstruction depicted enlargement of the C6 transverse foramen and a marked enlargement of the C6-C7 intravertebral foramen. The lesion was treated by intravascular proximal vertebral artery occlusion. Conclusions. Extracranial vertebral artery aneurysms require a high index of clinical suspicion. This is the first report of a vertebral artery pseudoaneurysm presenting with bony erosion, which supports a less minacious portrayal of vertebral artery aneurysms.

  10. Acute arterial infarcts in patients with severe head injuries

    Directory of Open Access Journals (Sweden)

    Deepak Agrawal

    2012-01-01

    Full Text Available Aims and Objectives: To study the incidence, demographic profile, and outcome of patients with severe closed head injuries who develop acute arterial infarcts. Materials and Methods: Patients with severe head injury (Glasgow coma score (GCS ≤8 presenting within 8 h of injury in the Department of Neurosurgery over a period of 5 months were enrolled in the study. Patients with penetrating head injury, infarct due to herniation and iatrogenic arterial injuries were excluded from the study. Only arterial infarcts developing within 8 h of injury were included in the study. A computed tomography (CT head was done on all patients within 8 h of injury and repeated if necessary. Arterial infarct was defined as well-demarcated wedge-shaped hypodensity corresponding to an arterial territory on plain CT of the head. Outcome was assessed using Glasgow outcome score (GOS at 1 month post-injury or at death (whichever came earlier. Results: Forty-four patients of severe head injury were included in the study during the above period. Of these, four patients (9.1% had arterial infarcts on the initial CT scan. The male:female ratio was 1:3. The mean age was 54 years (range 3-85 years. Two patients had infarcts in the middle cerebral artery distribution and two in the superior cerebellar artery distribution. Poor outcome (GOS 1-3 was seen in 100% of the patients with arterial infarct compared to 52.5% (n=21 in patients with severe head injury without arterial infarct. Conclusions: A significant percentage of patients with severe head injury have arterial infarcts on admission, which may imply arterial injury. Our study shows that these patients have a poorer prognosis vis-a-vis patient without these findings.

  11. Occurrence of cervical spine injuries during the rugby scrum.

    Science.gov (United States)

    Wetzler, M J; Akpata, T; Laughlin, W; Levy, A S

    1998-01-01

    A retrospective study of cervical spine injuries that occurred during the rugby scrum in the United States was undertaken. In the U.S., from 1970 to 1996, 36 (58%) of the 62 documented injured players injured their cervical spines during the scrum. Thirty-five men (97%) and one woman (3%) were injured. Twenty-three of the injuries (64%) occurred when the opposing packs came together (engagement), and 13 (36%) occurred when the scrum collapsed. Twenty-eight (78%) hookers, seven (19%) props, and one (3%) second-row player were injured. Twenty (56%) hookers and three (8%) props were hurt during engagement. Eight hookers (22%), four props (11%), and one second-row player (3%) were injured when the scrum collapsed. Significantly more injuries occurred during engagement than during collapse, and hookers were injured significantly more than props. We conclude that in the rugby scrum in the U.S., the hooker suffers most of the cervical spine injuries (78% in this study) and this position is by far the most vulnerable. This study should be used to develop rugby law (rule) changes and educate players, coaches, and referees in United States rugby. PMID:9548109

  12. Induced Pluripotent Stem Cell Therapies for Cervical Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Vanessa M. Doulames

    2016-04-01

    Full Text Available Cervical-level injuries account for the majority of presented spinal cord injuries (SCIs to date. Despite the increase in survival rates due to emergency medicine improvements, overall quality of life remains poor, with patients facing variable deficits in respiratory and motor function. Therapies aiming to ameliorate symptoms and restore function, even partially, are urgently needed. Current therapeutic avenues in SCI seek to increase regenerative capacities through trophic and immunomodulatory factors, provide scaffolding to bridge the lesion site and promote regeneration of native axons, and to replace SCI-lost neurons and glia via intraspinal transplantation. Induced pluripotent stem cells (iPSCs are a clinically viable means to accomplish this; they have no major ethical barriers, sources can be patient-matched and collected using non-invasive methods. In addition, the patient’s own cells can be used to establish a starter population capable of producing multiple cell types. To date, there is only a limited pool of research examining iPSC-derived transplants in SCI—even less research that is specific to cervical injury. The purpose of the review herein is to explore both preclinical and clinical recent advances in iPSC therapies with a detailed focus on cervical spinal cord injury.

  13. Induced Pluripotent Stem Cell Therapies for Cervical Spinal Cord Injury.

    Science.gov (United States)

    Doulames, Vanessa M; Plant, Giles W

    2016-01-01

    Cervical-level injuries account for the majority of presented spinal cord injuries (SCIs) to date. Despite the increase in survival rates due to emergency medicine improvements, overall quality of life remains poor, with patients facing variable deficits in respiratory and motor function. Therapies aiming to ameliorate symptoms and restore function, even partially, are urgently needed. Current therapeutic avenues in SCI seek to increase regenerative capacities through trophic and immunomodulatory factors, provide scaffolding to bridge the lesion site and promote regeneration of native axons, and to replace SCI-lost neurons and glia via intraspinal transplantation. Induced pluripotent stem cells (iPSCs) are a clinically viable means to accomplish this; they have no major ethical barriers, sources can be patient-matched and collected using non-invasive methods. In addition, the patient's own cells can be used to establish a starter population capable of producing multiple cell types. To date, there is only a limited pool of research examining iPSC-derived transplants in SCI-even less research that is specific to cervical injury. The purpose of the review herein is to explore both preclinical and clinical recent advances in iPSC therapies with a detailed focus on cervical spinal cord injury. PMID:27070598

  14. Damage control of multiple injuries headed by cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    LIU Si-hai; WANG Ai-min; DU Quan-yin; ZHAO Yu-feng; WANG Zi-ming; GUO Qing-shan; SHEN Yue

    2008-01-01

    Objective: To explore the strategy of damage control in clinical treatment of multiple injuries headed by cervical spinal cord injury.Methods: A retrospective analysis was performed in 32 patients. Cervical fractures associated with tetraplegia occurred in 18 patients, traumatic intervertebral disk hernia associated with tetraplegia in 2 patients, and cervical fractures and dislocation associated with tetraplegia in 12 patients. Seventeen cases were combined with craniocerebral injury, 7 combined with pulmonary contusion, multi-fractures of rib or hemopneumothorax, 2 combined with pelvic fracture and other 8 combined with fracture of limbs. The neural function was assessed by the American Spinal Injury Association (ASIA) scale.Results:Thirty-one patients were followed up for an average of 14 months. Of them, 10 got complete recovery, 13 obtained improvement of more than one ASIA grade, 8 did not improve, and 1 died.Conclusions: For the emergency treatment of multiple injuries headed by cervical spinal cord injury, the damage control strategy is the principle to follow. The final operations are preferably performed within 5 to 10 days after injury so as to raise the successful rate of remedy.

  15. Therapeutic intraspinal microstimulation improves forelimb function after cervical contusion injury

    Science.gov (United States)

    Kasten, M. R.; Sunshine, M. D.; Secrist, E. S.; Horner, P. J.; Moritz, C. T.

    2013-08-01

    Objective. Intraspinal microstimulation (ISMS) is a promising method for activating the spinal cord distal to an injury. The objectives of this study were to examine the ability of chronically implanted stimulating wires within the cervical spinal cord to (1) directly produce forelimb movements, and (2) assess whether ISMS stimulation could improve subsequent volitional control of paretic extremities following injury. Approach. We developed a technique for implanting intraspinal stimulating electrodes within the cervical spinal cord segments C6-T1 of Long-Evans rats. Beginning 4 weeks after a severe cervical contusion injury at C4-C5, animals in the treatment condition received therapeutic ISMS 7 hours/day, 5 days/week for the following 12 weeks. Main results. Over 12 weeks of therapeutic ISMS, stimulus-evoked forelimb movements were relatively stable. We also explored whether therapeutic ISMS promoted recovery of forelimb reaching movements. Animals receiving daily therapeutic ISMS performed significantly better than unstimulated animals during behavioural tests conducted without stimulation. Quantitative video analysis of forelimb movements showed that stimulated animals performed better in the movements reinforced by stimulation, including extending the elbow to advance the forelimb and opening the digits. While threshold current to elicit forelimb movement gradually increased over time, no differences were observed between chronically stimulated and unstimulated electrodes suggesting that no additional tissue damage was produced by the electrical stimulation. Significance. The results indicate that therapeutic intraspinal stimulation delivered via chronic microwire implants within the cervical spinal cord confers benefits extending beyond the period of stimulation, suggesting future strategies for neural devices to promote sustained recovery after injury.

  16. Anatomical Study of Variation of Vertebral Artery Entering the Foramen Transversarium of Cervical Vertebrae

    Directory of Open Access Journals (Sweden)

    Rawal Jitendra D

    2012-04-01

    Full Text Available Introduction: The vertebral artery is unique among the cervico-cephalic vessels by virtue of its position and relationship to the adjacent structures. The advent of new techniques and materials for surgical treatment of lower cervical spinal condition has come along with possible potential complications. As vertebral artery normally passes through transverse foramen of sixth cervical vertebra, these procedures can safely be done on seventh cervical vertebra. Aim: To study the anatomical variation of vertebral artery entering the transverse foramen of cervical vertebrae. Material & Methods: 50 vertebral arteries were dissected in 25 embalmed cadavers, out of which 19 cadavers were male and 6 were female. Vertebral artery was dissected from its origin to its entry into foramen magnum. Results: 4 (8 % cases were found where vertebral artery entered into transverse foramen of 7th cervical vertebrae out of which 1 was bilateral, and 2 was on left side. In 46 cases (92% it entered through transverse foramen of 6th cervical vertebrae. Conclusion: In 8% cases as vertebral artery enters through C7 transverse foramina, the relation is important while performing transpedicular fixation or other spinal surgeries. [National J of Med Res 2012; 2(2.000: 199-201

  17. Does cervical kyphosis relate to symptoms following whiplash injury?

    DEFF Research Database (Denmark)

    Johansson, Mats Peter; Baann Liane, Martin Skogheim; Bendix, Tom;

    2011-01-01

    The mechanisms for developing long-lasting neck pain after whiplash injuries are still largely unrevealed. In the present study it was investigated whether a kyphotic deformity of the cervical spine, as opposed to a straight or a lordotic spine, was associated with the symptoms at baseline, and...... with the prognosis one year following a whiplash injury. MRI was performed in 171 subjects about 10 d after the accident, and 104 participated in the pain recording at 1-year follow-up. It was demonstrated that postures as seen on MRI can be reliably categorized and that a straight spine is the most...

  18. TREATMENT OF VERTEBRAL-ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE-KNIFE THERAPY

    Institute of Scientific and Technical Information of China (English)

    LI Dianning; YE Ping

    2002-01-01

    In the present paper, 62 cases of vertebral-artery type cervical spondylopathy were treated with needie-knife therapy (acupotomy). After 2- 6 sessions of treatment, 23 cases (37. 1%) were cured, 19 (30. 7%)showed marked improvement, 15 (24.2%) had some improvement and 5 (8.1 % ) failed in the treatment. The total effective rate was 91.9 %. It indicates that acupotomy therapy is a highly effective remedy for treating vertebral-artery type cervical spndylopathy.

  19. Damage control management of innominate artery injury with tracheostomy.

    Science.gov (United States)

    Okada, Yohei; Narumiya, Hiromichi; Ishii, Wataru; Ryoji, Iiduka

    2016-12-01

    Innominate artery injury is a rare, but catastrophic complication of tracheostomy. We present a case of severe hemorrhagic shock in a 79-year-old male with innominate artery injury that occurred during tracheostomy. Despite temporary innominate artery isolation, the regional forehead saturation was 60 % without laterality. Because adequate cerebral blood flow was apparently maintained through collateral flow, we ligated the innominate, right carotid, and subclavian arteries. We confirmed adequate blood flow to the brain and the right subclavian artery through collateral circulation after ligation using computed tomographic angiography. A damage control management, which involves ligating the injured innominate artery to arrest hemorrhage and monitoring regional forehead saturation for brain ischemia, can be a considerable procedure for the treatment of severe hemorrhagic shock due to innominate artery injury. PMID:26943693

  20. Imaging diagnosis of cervical spine and spinal cord injuries in children

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To provide the experience in imaging diagnosis of cervical spine and spinal cord injuries in children.Methods: Imaging data of cervical spine and spinal cord injuries in 62 children were retrospectively reviewed.The routine radiography including the lateral,anteroposterior and open-mouth odontoid views were performed in all the patients. Tomography was available for 25 patients, and flexion-extension lateral views for 28patients, CT scanning for 21 patients, MRI for 26 patients.Results: Of these patients, 46 patients were identified with injuries of upper cervical spine (9 with atlantal arch fracture, seven with axial fracture, 21 with odontoid fracture, 1 with atlantal arch fracture combining with odontoid fracture, and 1 with atlantal transverse ligament disruption); 7 patients sustained injuries of lower cervical spine (3 fractures of vertebral body, 2 dislocations and 6fracture-dislocations ); 2 patients had multiple noncontiguous cervical injuries; and 3 had cervical spinal cord injury without radiographic abnormalities (SCIWORA).Conclusions: Imaging assessment is of great importance in the diagnosis of cervical spine and spinal cord injuries in children. Whenever cervical spine and spinal cord injuries are suspected for children patients, and the three-views should be routinely indicated. MRI should be routinely performed in all children with cervical SCIWORA.

  1. Juvenile Stroke: Cervical Artery Dissection in a Patient after a Polytrauma

    Directory of Open Access Journals (Sweden)

    Nicole Marschner-Preuth

    2013-01-01

    Full Text Available Dissections of the cervical arteries cause about 20% of total juvenile strokes. Approximately 4% of the carotid artery dissections are due to a (polytrauma such as car accidents. Despite improved diagnostic facilities, traumatic dissections are often underdiagnosed or diagnosed too late due to a lack of awareness of potential initial signs and symptoms.We report here a case of a delayed embolic stroke after a car accident caused by a dissection of the carotid artery and subsequent pseudoaneurysm.To reduce the long-term morbidity or mortality of multiple trauma patients, an early detection of cervical carotid and vertebral dissections is strictly necessary.

  2. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    Science.gov (United States)

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2015-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations. PMID:26835412

  3. Cervical Posterior Spinal Artery Syndrome: A Case Report and Literature Review.

    Science.gov (United States)

    Sakurai, Takeo; Wakida, Kenji; Nishida, Hiroshi

    2016-06-01

    We report a case of left upper cervical posterior spinal artery (PSA) syndrome caused by atherosclerosis of the left vertebral artery. A 70-year-old female experienced sudden dizziness and paralysis of the left upper and lower limbs. Diffusion-weighted magnetic resonance imaging (DWI) of the brain showed high signal intensity at the vermis and lower left hemisphere of the cerebellum, and magnetic resonance angiography showed that the entire left vertebral artery was thin. The patient was treated with an intravenous infusion of tissue plasminogen activator 2 hours after symptom onset and made a full recovery. Repeat DWI, fluid-attenuated inversion recovery images, and T2-weighted images showed high signal intensity in the left upper cervical PSA area from the lower medulla oblongata to the C2 level in addition to the cerebellum. Previously reported cases of cervical posterior artery syndrome are reviewed. PMID:27012218

  4. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    OpenAIRE

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2016-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery ter...

  5. Fatal outcome after brain stem infarction related to bilateral vertebral artery occlusion - case report of a detrimental complication of cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Beauchamp Kathryn M

    2011-07-01

    Full Text Available Abstract Background Vertebral artery injury (VAI after blunt cervical trauma occurs more frequently than historically believed. The symptoms due to vertebral artery (VA occlusion usually manifest within the first 24 hours after trauma. Misdiagnosed VAI or delay in diagnosis has been reported to cause acute deterioration of previously conscious and neurologically intact patients. Case presentation A 67 year-old male was involved in a motor vehicle crash (MVC sustaining multiple injuries. Initial evaluation by the emergency medical response team revealed that he was alert, oriented, and neurologically intact. He was transferred to the local hospital where cervical spine computed tomography (CT revealed several abnormalities. Distraction and subluxation was present at C5-C6 and a comminuted fracture of the left lateral mass of C6 with violation of the transverse foramen was noted. Unavailability of a spine specialist prompted the patient's transfer to an area medical center equipped with spine care capabilities. After arrival, the patient became unresponsive and neurological deficits were noted. His continued deterioration prompted yet another transfer to our Level 1 regional trauma center. A repeat cervical spine CT at our institution revealed significantly worsened subluxation at C5-C6. CT angiogram also revealed complete occlusion of bilateral VA. The following day, a repeat CT of the head revealed brain stem infarction due to bilateral VA occlusion. Shortly following, the patient was diagnosed with brain death and care was withdrawn. Conclusion Brain stem infarction secondary to bilateral VA occlusion following cervical spine trauma resulted in fatal outcome. Prompt imaging evaluation is necessary to assess for VAI in cervical trauma cases with facet joint subluxation/dislocation or transverse foramen fracture so that treatment is not delayed. Additionally, multiple transportation events are risk factors for worsening when unstable cervical

  6. Upper cervical injuries: Clinical results using a new treatment algorithm

    Directory of Open Access Journals (Sweden)

    Andrei F Joaquim

    2015-01-01

    Full Text Available Introduction: Upper cervical injuries (UCI have a wide range of radiological and clinical presentation due to the unique complex bony, ligamentous and vascular anatomy. We recently proposed a rational approach in an attempt to unify prior classification system and guide treatment. In this paper, we evaluate the clinical results of our algorithm for UCI treatment. Materials and Methods: A prospective cohort series of patients with UCI was performed. The primary outcome was the AIS. Surgical treatment was proposed based on our protocol: Ligamentous injuries (abnormal misalignment, facet perched or locked, increase atlanto-dens interval were treated surgically. Bone fractures without ligamentous injuries were treated with a rigid cervical orthosis, with exception of fractures in the dens base with risk factors for non-union. Results: Twenty-three patients treated initially conservatively had some follow-up (mean of 171 days, range from 60 to 436 days. All of them were neurologically intact. None of the patients developed a new neurological deficit. Fifteen patients were initially surgically treated (mean of 140 days of follow-up, ranging from 60 to 270 days. In the surgical group, preoperatively, 11 (73.3% patients were AIS E, 2 (13.3% AIS C and 2 (13.3% AIS D. At the final follow-up, the American Spine Injury Association (ASIA score was: 13 (86.6% AIS E and 2 (13.3% AIS D. None of the patients had neurological worsening during the follow-up. Conclusions: This prospective cohort suggested that our UCI treatment algorithm can be safely used. Further prospective studies with longer follow-up are necessary to further establish its clinical validity and safety.

  7. [Cervical cord infarction associated with unilateral vertebral artery dissection due to golf swing].

    Science.gov (United States)

    Tokumoto, Kazuki; Ueda, Nobuhiko

    2014-01-01

    A-68-year-old man experienced nuchal pain and bilateral shoulder weakness that occurred suddenly after he performed a golf swing. He was conscious. His cranial nerves were normal, but bilateral deltoid and biceps muscle strengths weakened. Magnetic resonance image (MRI) showed no brain stem infarctions or cervical epidural hematoma. We tentatively diagnosed him with concussion of the spinal cord because of mild recovery of his bilateral upper limb weakness after several hours; he was later discharged. The next day, he suddenly developed serious tetraplegia and was admitted to the emergency department. His breathing was controlled by a respirator as he had expectoration difficulty and respiratory muscle paralysis. A lesion in the cervical cord became apparent on MRI; the right vertebral artery was not detected on magnetic resonance angiography. Cervical MRI showed the intimal flap and a lack of flow void in the right vertebral artery. These findings revealed a right vertebral artery dissection. Cervical cord infarction due to unilateral vertebral artery dissection is rarer than posterior cerebral infarction due to the same pathogenesis; however, some such cases have been reported. We consider the present case to be caused by cervical cord infarction associated with unilateral vertebral artery dissection resulting from golf swing. PMID:24583591

  8. HOMICIDE BY CERVICAL SPINAL CORD GUNSHOT INJURY WITH SHOTGUN FIRE PELLETS: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Dana Turliuc, Serban Turliuc, Iustin Mihailov, Andrei Cucu, Gabriel Dumitrescu,Claudia Costea

    2015-10-01

    Full Text Available This case present a rare forensic case of cervical spinal gunshot injury of a female by her husband, a professional hunter, during a family fight with a shotgun fire pellets. The gunshot destroyed completely the cervical spinal cord, without injury to the neck vessels and organs and with the patient survival for seven days. We discuss notions of judicial ballistics, assessment of the patient with spinal cord gunshot injury and therapeutic strategies. Even if cervical spine gunshot injuries are most of the times lethal for majority of patients, the surviving patients need the coordination of a multidisciplinary surgical team to ensure the optimal functional prognostic.

  9. Copy number variation in patients with cervical artery dissection.

    Science.gov (United States)

    Grond-Ginsbach, Caspar; Chen, Bowang; Pjontek, Rastislav; Wiest, Tina; Jiang, Yanxiang; Burwinkel, Barbara; Tchatchou, Sandrine; Krawczak, Michael; Schreiber, Stefan; Brandt, Tobias; Kloss, Manja; Arnold, Marie-Luise; Hemminki, Kari; Lichy, Christoph; Lyrer, Philippe A; Hausser, Ingrid; Engelter, Stefan T

    2012-12-01

    Cervical artery dissection (CeAD) occurs in healthy young individuals and often entails ischemic stroke. Skin biopsies from most CeAD-patients show minor connective tissue alterations. We search for rare genetic deletions and duplication that may predispose to CeAD. Forty-nine non-traumatic CeAD-patients with electron microscopic (EM) alterations of their dermal connective tissue (EM+ patients) and 21 patients with normal connective tissue in skin biopsies (EM- patients) were analyzed. Affymetrix 6.0 microarrays (Affymetrix) from all patients were screened for copy number variants (CNVs). CNVs absent from 403 control subjects and from 2402 published disease-free individuals were considered as CeAD-associated. The genetic content of undentified CNVs was analyzed by means of the Gene Ontology (GO) Term Mapper to detect associations with biological processes. In 49 EM+ patients we identified 13 CeAD-associated CNVs harboring 83 protein-coding genes. In 21 EM- patients we found five CeAD-associated CNVs containing only nine genes (comparison of CNV gene density between the groups: Mann-Whitney P=0.039). Patients' CNVs were enriched for genes involved in extracellular matrix organization (COL5A2, COL3A1, SNTA1, P=0.035), collagen fibril organization COL5A2, COL3A1, (P=0.0001) and possibly for genes involved in transforming growth factor beta (TGF)-beta receptor signaling pathway (COL3A1, DUPS22, P=0.068). We conclude that rare genetic variants may contribute to the pathogenesis of CeAD, in particular in patients with a microscopic connective tissue phenotype. PMID:22617347

  10. Cervical Spine Alignment and Motion in the Acute Management of Potential Catastrophic Cervical Spine Injuries in Sport

    Institute of Scientific and Technical Information of China (English)

    Erik E Swartz

    2008-01-01

    @@ The incidence of spinal cord injury in the United States is estimated to be 11,000 new cases each year[1].Sport participation constitutes the fourth most common cause[1](approximately 8. 7%) of these injuries overall but is the second most common cause for those under the age of 30[2]. The majority of all cervical spine injuries since 2000 have occurred in individuals between the ages of 16 and 30[1].

  11. 'Crashing' the rugby scrum -- an avoidable cause of cervical spinal injury. Case reports.

    Science.gov (United States)

    Scher, A T

    1982-06-12

    Deliberate crashing of the opposing packs prior to a rugby scrum is an illegal but commonly practised manoeuvre which can lead to abnormal flexion forces being applied to players in the front row, with resultant cervical spine and spinal cord injury. Two cases of cervical spinal cord injury sustained in this manner are presented. The mechanism of injury, the forces involved and preventive measures are discussed. PMID:7089756

  12. Embolization of uterine artery as an emergency treatment for vaginal bleeding due to ectopic cervical pregnancy

    OpenAIRE

    Hari A; Indira B; Venkateswarlu J

    2015-01-01

    A 25-year-old, primigravida presented with a history of vaginal bleeding since 3 days. Two months ago she had conceived spontaneously. Pelvic ultrasonography revealed cervical pregnancy of 8 weeks duration. Parenteral methotrexate failed to terminate pregnancy and serum beta- human chorionic gonadotropin levels continued to rise. In order to achieve haemostasis, catheter angiography and bilateral uterine artery embolization were done followed by curettage of cervical canal. The patient recove...

  13. Effect of neoadjuvant chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion

    Institute of Scientific and Technical Information of China (English)

    Chen; Aiping; Ding; Zhaoxia; Xu; Bing; Zhao; Shuping; Dai; Shuzhen

    2007-01-01

    Objective:To evaluate the effect of preoperative chemotherapy on locally advanced cervical cancer by internal iliac arterial infusion.Methods:Sixty two patients with bulky or locally advanced cervical cancer from 1999 to 2004 were underwent internal iliac arterial infusion chemotherapy by using Seldinger technique.Combined regimens were applied including cisplatin as the major drug.Two weeks later,all patients received radical hysterectomy.Results:The local tumor regression rate was 93.55%.Postoperative pathologic examination showed that no cervical tumor residue in stumps were found in 61 of 62 patients who underwent radical hysterectomy.Large quantity of necrotic tissue appeared on primary tumor.In 16 patients with positive lymph nodes,15 demonstrated necrotic lymph nodes.Conclusion:Internal iliac arterial infusion chemotherapy could effectively reduce tumor volume,increase surgical success rate and decrease lymph nodes and subclinical metastasis rates.

  14. TREATMENT OF VERTEBRAL-ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE-KNIFE THERAPY

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In the present paper,62 cases of vertebral-artery type cervical spondyiopathy were treated with needle-knife therapy (acupotomy).After 2-6 sessions of treatment,23 cases (37.1%) were cured,19(30.7%) showed marked improvement,15(24.2%) had some improvement and 5(8.1%) failed in the treatment.The total effective rate was 91.9%.It indicates that acupotomy therapy is a highly effective remedy for treating vertabral-artery type cervical spndylopathy.

  15. Sub-axial cervical spine injuries: Modified Stellerman′s algorithm

    Directory of Open Access Journals (Sweden)

    Arjun Shetty

    2011-01-01

    Conclusion: We feel that on table decompression and reduction followed by anterior stabilization can be used as the initial surgical approach to manage most types of cervical injuries. In rotation/translational cases where reduction cannot be achieved, monitored cervical traction on the decompressed spine can safely achieve reduction and hence avoid the need for a posterior facetectomy in a large percentage of cases.

  16. Risk factors for cervical spine injury among patients with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Tomoko Fujii

    2013-01-01

    Full Text Available Background: Diagnosis of cervical spine injury (CSI is difficult in patients with an altered level of consciousness as a result of a traumatic brain injury (TBI. Patients with TBI and older adults are at increased risk for CSI. This study examined the various risk factors for CSI among trauma patients with TBI and whether adults who were older (≥55 years were at higher risk for CSI when they sustained a fall-related TBI. Materials and Methods: Data used was the 2007 National Trauma Data Bank (NTDB, National Sample Project (NSP for adults who sustained a TBI. This dataset contains 2007 admission records from 82 level I and II trauma centers. Logistic regression was used to identify potential risk factors for CSI and to test for interaction between age and injury mechanism. Additional model variables included gender, race, Glasgow Coma Score, multiple severe injuries, hypotension and respiratory distress. Results: An analysis of the NTDB NSP identified 187,709 adults with TBI, of which 16,078 were diagnosed with a concomitant CSI. In motor vehicle traffic injuries, the older age group had significantly higher odds of CSI (odds ratio [OR] = 1.26 [1.15-1.39]. In fall-related injuries the older age group did not have a higher odds of CSI compared to the younger age group. Skull/face fracture, other spine fracture/dislocation, upper limb injury, thorax injury, and hypotension were significantly associated with CSI. Pelvic injuries had an inverse association with CSI (OR = 0.60 [0.54-0.67]. Black had significantly higher odds of CSI compared to Whites (OR = 1.25 [1.07-1.46]. Conclusion: The identification of associated injuries and factors may assist physicians in evaluating CSI in patients with TBI.

  17. Dissections of the cervical brain supplying arteries; Dissektionen der zervikalen hirnversorgenden Gefaesse

    Energy Technology Data Exchange (ETDEWEB)

    Jensen-Kondering, U. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer Radiologie und Neuroradiologie

    2015-12-15

    Dissections of the cervical brain supplying arteries are rare but are an important cause of stroke in young and middle aged patients. Furthermore, recognition of dissections is crucial to prevent recurring embolic events by adequate choice of therapy. In this article the anatomical and pathophysiological basics, diagnostic and treatment options will be discussed with an emphasis on cross sectional imaging and typical imaging findings.

  18. Value of intramuscular methotrexate and bilateral uterine artery embolization for treating cervical ectopic pregnancy

    International Nuclear Information System (INIS)

    Objective: To assess the clinical value of bilateral uterine artery chemotherapy embolization (UACE) for cervical ectopic pregnancy analyzed. Methods: Clinical records of 40 patients with cervical ectopic pregnancy treated using UACE were retrospectively analyzed. Results: 8 patients with severe active vaginal bleeding after curettage were treated urgently with UACE. The remaining 32 patients were treated with UACE combined with sequential ultrasound-guided curettage. Active vaginal bleeding was stopped after UACE. There was no recurrent hemorrhage with the sequential ultrasound-guided curettage procedure. The β-HCG levels of all patients were normalized after 1 month. Conclusion: Bilateral uterine artery chemotherapy embolization is valuable as emergency treatment for patients with severe vaginal bleeding from cervical ectopic pregnancy. UACE combined with sequential ultrasound-guided curettage may be more effective. (authors)

  19. Association of cervical artery dissection with connective tissue abnormalities in skin and arteries.

    Science.gov (United States)

    Brandt, T; Morcher, M; Hausser, I

    2005-01-01

    Spontaneous cervical artery dissections (sCAD) often occur in otherwise healthy individuals without known risk factors for stroke and frequently develop spontaneously without relevant trauma. An underlying arteriopathy leading to a so-called 'weakness of the vessel wall' and predisposing certain individuals to dissection has often been postulated. Therefore, the morphology of connective tissue, a main component of vessel wall and environment, was investigated in carotids and skin. While the overall morphology of dermal connective tissue is normal, about half of patients with sCAD show mild ultrastructural connective tissue alterations. These ultrastructural morphological aberrations can be designated either as 'Ehlers-Danlos syndrome (EDS) III-like', resembling mild findings in patients with the hypermobility type of EDS (EDS III); or coined 'EDS IV-like' with collagen fibers containing fibrils with highly variable diameters resembling mild findings in vascular EDS; or the abnormalities are restricted to the elastic fibers (with fragmentation and minicalcifications) without significant alterations in the morphology of the collagen fibrils. These findings had some similarity with the morphology found in heterozygous carriers of pseudoxanthoma elasticum. A grading scale according to the severity of the findings has been introduced. Similar connective tissue abnormalities were detected in some first-degree relatives of patients with sCAD showing hereditary at least in a subgroup. They can serve as a phenotypic marker for further genetic studies in patients with sCAD and large families to possibly identify the underlying basic molecular defect(s). Very few of patients (connective tissue abnormalities have clinical manifestations of skin, joint, or skeletal abnormalities of a defined heritable connective tissue disorder. In specimens of arterial walls of carotid, aortic, and renal arteries of patients with sCAD, pronounced systemic, histopathological, and

  20. Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury

    OpenAIRE

    West, CR; Goosey-Tolfrey, VL; Campbell, IG; Romer, LM

    2014-01-01

    West CR, Goosey-Tolfrey VL, Campbell IG, Romer LM. Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury. J Appl Physiol 117: 36–45, 2014. First published May 22, 2014; doi:10.1152/japplphysiol.00218.2014.—We asked whether elastic binding of the abdomen influences respiratory mechanics during wheelchair propulsion in athletes with cervical spinal cord injury (SCI). Eight Paralympic wheelchair rugby players with m...

  1. Look away: arterial and venous intravascular embolisation following shotgun injury

    OpenAIRE

    Vedelago, John; Dick, Elizabeth; Thomas, Robert; Jones, Brynmor; Kirmi, Olga; Becker, Jennifer; Alavi, Afshin; Gedroyc, Wladyslaw

    2014-01-01

    We describe two cases of intravascular embolization of shotgun pellets found distant to the entry site of penetrating firearm injury. The cases demonstrate antegrade embolization of a shotgun pellet from neck to right middle cerebral artery, and antegrade followed by retrograde venous embolization through the left lower limb to pelvis. Radiologists and Trauma Physicians should be aware that post shotgun injury, the likelihood of an embolised shot pellet is increased compared to other types of...

  2. Superselective intraarterial chemotherapy into bilateral uterine arteries in uterine cervical carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Hyun Jung; Choi, Guk Myeong; Park, Sun Won; Kim, Tae Kyoung; Chung, Jin Wook; Park, Jae Hyung [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    To assess the efficacy of superselective intra-arterial chemotherapy(SSIAC) via the bilateral uterine arteries in cases of cervical carcinoma. Eighteen patients with stage 2 {sub a}(n=10), 2 {sub b}(n=7), or 3 {sub a}(n=1) cervical carcinoma underwent one(n=2) or two(n=16) courses of preoperative SSIAC with Vincristine, Cisplatin, and Mitomycin C. We estimated the extent of reduction of tumor volume and improvement of stage, comparing pre-SSIAC MRI to postoperative results. Tumor vascularity, as seen on uterine arteriography, and procedural complications, were also evaluated. A marked reduction in tumor volume was observed in all patients, an average reduction volume of 94.7%. Improvement of stage was noted in 16 patients, and in six of these, no residual viable tumor or microinvasive residual tumor was seen. On angiography, tumor hypervascularity was demonstrated in seven patients, but its degree was not substantially related to therapeutic response. In no case did significant systemic complications of result from chemotherapy; in one patient, however, we experienced a serious complication of necrotizing cystitis due to malpositioning of a catheter in the superior vesical artery. SSIAC via the bilateral uterine arteries is an effective complementary modality for the treatment of various stages of cervical carcinoma.

  3. Reconstruction of Low Speed Rear-End collisions - Technical Means of Assessing Cervical Spine Injuries

    OpenAIRE

    Hitzemann, Martin

    2003-01-01

    In recent years, an increasing number of cervical spine injuries sustained by vehicle occupants in collisions at comparatively low speeds have been reported to insurance companies and in civil litigation. The reported injuries occur in both rear-end and side impact collisions. The paper describes how a detailed assessment of such cases requires interdisciplinary teamwork involving technical, biomechanical and medical experts.

  4. Iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus:A rare injury

    Institute of Scientific and Technical Information of China (English)

    Kumar Vishal; R.H.H.Arjun; Aggarwal Sameer; John Rakesh; Kishan Rama

    2015-01-01

    Complications following supracondylar fracture of humerus are well-known.Pre-and post-operative complications have been documented in the literature.Neurovascular injury due to fracture fragments following this type of fracture is described,Iatrogenic brachial artery during surgical treatment of this fracture is unknown to the literature.So we report a rare case of iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus and try to create awareness to the surgeons that such injuries can occur with improper operative techniques.

  5. Epidemiology and risk factors of cervical spine injury during heating season in the patients with cervical trauma: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Sidong Yang

    Full Text Available PURPOSE: The purpose of this study was to describe the epidemiology of cervical spine injury in the patients with cervical trauma and analyze its associated risk factors during the special heating season in North China. METHODS: This cross-sectional study investigated predictors for cervical spine injury in cervical trauma patients using retrospectively collected data of Hebei Provincial Orthopaedic Hospital from 11/2011 to 02/2012, and 11/2012 to 02/2013. Binary logistic regression analysis was used to determine risk factors for cervical fractures/dislocations or cord injury. RESULTS: A total of 106 patients were admitted into this study. Of all, 34 patients (32.1% were treated from 11/2011 to 02/2012 and 72 patients (67.9% from 11/2012 to 02/2013. The mean age was 41.9±13.3 years old; 85 patients (80.2% were male and 82 (77.4% from rural areas. Eighty patients (75.5% were caused by fall including 45 (42.5% by severe fall (>2 m. Sixty-five patients (61.3% of all suffered injuries to other body regions and 32 (30.2% got head injury. Thirty-one patients (29.2% sustained cervical cord injury with cervical fractures/dislocations. Twenty-six (83.9% of cervical cord injury patients were from rural areas and 24 (77.4% of those resulted from fall including 15 (48.4% from severe fall (>2 m. Logistic regression displayed that age (OR, 1.47; 95% CI, 1.05-2.07, head injury (OR, 5.63; 95% CI, 2.23-14.26, were risk factors for cervical cord injury and snowing (OR, 8.25; 95% CI, 2.26-30.15 was a risk factor for cervical spine injury due to severe fall (>2 m. CONCLUSIONS: The elder male patients and patients with head trauma are high-risk population for cervical cord injury. As a seasonal factor, snowing during heating season is of note a risk factor for cervical spine injury resulting from severe fall (>2 m in the patients with cervical trauma in North China.

  6. Arterial Injury and Endothelial Repair: Rapid Recovery of Function after Mechanical Injury in Healthy Volunteers

    Directory of Open Access Journals (Sweden)

    Lindsey Tilling

    2014-01-01

    Full Text Available Objective. Previous studies suggest a protracted course of recovery after mechanical endothelial injury; confounders may include degree of injury and concomitant endothelial dysfunction. We sought to define the time course of endothelial function recovery using flow-mediated dilation (FMD, after ischaemia-reperfusion (IR and mechanical injury in patients and healthy volunteers. The contribution of circulating CD133+/CD34+/VEGFR2+ “endothelial progenitor” (EPC or repair cells to endothelial repair was also examined. Methods. 28 healthy volunteers aged 18–35 years underwent transient forearm ischaemia induced by cuff inflation around the proximal biceps and radial artery mechanical injury induced by inserting a wire through a cannula. A more severe mechanical injury was induced using an arterial sheath and catheter inserted into the radial artery of 18 patients undergoing angiography. Results. IR and mechanical injury produced immediate impairment of FMD (from 6.5 ± 1.2% to 2.9 ± 2.2% and from 7.4 ± 2.3% to 1.5 ± 1.6% for IR and injury, resp., each P<0.001 but recovered within 6 hours and 2 days, respectively. FMD took up to 4 months to recover in patients. Circulating EPC did not change significantly during the injury/recovery period in all subjects. Conclusions. Recovery of endothelial function after IR and mechanical injury is rapid and not associated with a change in circulating EPC.

  7. Neural Precursor Cell Transplantation Enhances Functional Recovery and Reduces Astrogliosis in Bilateral Compressive/Contusive Cervical Spinal Cord Injury

    OpenAIRE

    Wilcox, Jared T.; Satkunendrarajah, Kajana; Zuccato, Jeffrey A.; Nassiri, Farshad; Fehlings, Michael G.

    2014-01-01

    This study examined the effects of neural precursor cell (NPC) transplants in a rodent model of bilateral cervical contusion-compression spinal cord injury. Transplantation of NPCs in the bilaterally injured cervical spinal cord resulted in significantly improved spinal cord tissue composition and forelimb function and warrants study in preclinical cervical models to improve this treatment paradigm for clinical translation.

  8. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures.

    Science.gov (United States)

    Yoon, Sang-Youl; Park, Seong-Hyun; Hwang, Jeong-Hyun; Hwang, Sung-Kyoo

    2016-04-01

    We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery. Neck CT angiography showed left VAD starting at the C5 level. Brain MRI revealed acute, multiple cerebral infarctions involving the pons, midbrain, thalamus, corpus callosum, and parietal and frontal lobes on diffusion weighted images. The patient was treated conservatively at the intensive care unit in the acute stage to prevent extent of stroke. Aspirin was started for antiplatelet therapy in the chronic stage. The possibility of symptomatic cerebral infarctions due to traumatic VAD following cervical fracture should be considered. PMID:27182500

  9. Double Bolus Application in TWIST-MR-Angiography of the Cervical Arteries

    Directory of Open Access Journals (Sweden)

    Andreas Korn

    2012-01-01

    Full Text Available Purpose. The aim of the present work was to test the feasibility of the time-resolved MR-angiography (TWIST-MRA of cervical arteries using double bolus injection. Material and Methods. TWIST-MRA with a temporal resolution of 8.4 seconds for each frame and a spatial resolution with a voxel size of   was performed in 24 patients. A biphasic bolus injection protocol was used with the second injection being started 21 seconds after the first contrast dye bolus. Diagnostic image quality was rated according to a 4-point scale. Results. In 12 patients (50% no clear separation between the cervical venous and arterial vessels was evident after the first bolus injection. Using TWIST-MRA data acquired after the second bolus a sufficient diagnostic image quality (rating , mean 3.5 could be obtained in 22 of 24 patients (92%. Discussion. The double bolus injection protocol using TWIST-MRA allows for very good separation of the cervical arteries.

  10. Efficacy of Transcatheter Arterial Embolization in the Traumatic Injury

    Energy Technology Data Exchange (ETDEWEB)

    Park, Dae Hong; Kim, Jeong Ho; Byun, Sung Su; Kim, Hyung Sik [Dept. of Radiology, Gachon University School of Medicine, Gil Hospital, Incheon (Korea, Republic of)

    2012-09-15

    This study evaluated technical and clinical outcomes and identified factors associated with clinical success in trauma patients that underwent transcatheter arterial embolization (TAE) in a single regional hospital. A retrospective study was performed of 106 patients with a variety of trauma who were suspected of active arterial bleeding and underwent angiography. Technical success was defined as non-visualization of extravasation and pseudoaneurysm in injured arteries. Clinical success was defined as the patient was not expired within 30 days from the date of TAE. Electronic medical records were reviewed. The risk factors between groups of clinical success and failure were analyzed statistically. Technical and clinical success rates of TAE were 96% (102/106) and 70% (74/106) respectively. Of the factors we assessed, age, older than 60 years, systolic blood pressure and heart rate at admission and after TAE, and combined brain injury were statistically significant (p < 0.05). Old age, low systolic blood pressure after TAE, and combined brain injury were significant predictors of poor prognosis in multivariate analysis. TAE is an effective treatment for active arterial bleeding of the traumatic injury patient.

  11. Cervical spinal cord injury:tailoring clinical trial endpoints to relfect meaningful functional improvements

    Institute of Scientific and Technical Information of China (English)

    Lisa M Bond; Lisa McKerracher

    2014-01-01

    Cervical spinal cord injury (SCI) results in partial to full paralysis of the upper and lower extrem-ities. Traditional primary endpoints for acute SCI clinical trials are too broad to assess functional recovery in cervical subjects, raising the possibility of false positive outcomes in trials for cervical SCI. Endpoints focused on the recovery of hand and arm control (e.g., upper extremity motor score, motor level change) show the most potential for use as primary outcomes in upcoming trials of cervical SCI. As the field moves forward, the most reliable way to ensure meaningful clinical testing in cervical subjects may be the development of a composite primary endpoint that measures both neurological recovery and functional improvement.

  12. Motoneuron BDNF/TrkB Signaling Enhances Functional Recovery after Cervical Spinal Cord Injury

    OpenAIRE

    Mantilla, Carlos B.; Gransee, Heather M.; Zhan, Wen-Zhi; Sieck, Gary C.

    2013-01-01

    A C2 cervical spinal cord hemisection (SH) interrupts descending inspiratory-related drive to phrenic motoneurons located between C3 and C5 in rats, paralyzing the ipsilateral hemidiaphragm muscle. There is gradual recovery of rhythmic diaphragm muscle activity ipsilateral to cervical spinal cord injury over time, consistent with neuroplasticity and strengthening of spared, contralateral descending premotor input to phrenic motoneurons. Brainderived neurotrophic factor (BDNF) signaling throug...

  13. Embolization of Isolated Lumbar Artery Injuries in Trauma Patients

    International Nuclear Information System (INIS)

    Purpose. The purpose of the study was to evaluate the angiographic findings and results of embolotherapy in the management of lumbar artery trauma. Methods. All patients with lumbar artery injury who underwent angiography and percutaneous embolization in a state trauma center within a 10-year period were retrospectively reviewed. Radiological information and procedural reports were reviewed to assess immediate angiographic findings and embolization results. Long-term clinical outcome was obtained by communication with the trauma physicians as well as with chart review. Results. In a 10-year period, 255 trauma patients underwent abdominal aortography. Eleven of these patients (three women and eight men) suffered a lumbar artery injury. Angiography demonstrated active extravasation (in nine) and/or pseudoaneurysm (in four). Successful selective embolization of abnormal vessel(s) was performed in all patients. Coils were used in six patients, particles in one and gelfoam in five patients. Complications included one retroperitoneal abscess, which was treated successfully. One patient returned for embolization of an adjacent lumbar artery due to late pseudoaneurysm formation. Conclusions. In hemodynamically stable patients, selective embolization is a safe and effective method for immediate control of active extravasation, as well as to prevent future hemorrhage from an injured lumbar artery

  14. Assessing the Validity of a Novel Model of Vertebral Artery Type of Cervical Syndrome Induced by Injecting Sclerosing Agent Next to Transverse Process of Cervical Vertebra

    Institute of Scientific and Technical Information of China (English)

    寿折星; 沈霖; 熊鹏程

    2010-01-01

    The efficacy of injecting sclerosing agent next to transverse process of cervical vertebra to induce vertebral artery type of cervical syndrome(CSA)was observed.Twenty rabbits were randomly divided into two groups:the model group and the control group.The rabbits in the model group were injected with sclerosing agent next to transverse process of cervical vertebray,on the contrary,the rabbits in the control group were injected with nothing.Transcranial Doppler(TCD)was used to detect the average speed of blo...

  15. Brachial artery injury following opened elbow dislocation associated with accessory brachial artery: two rare entities in a 17-year –old girl: case report

    OpenAIRE

    Hajji, Rita; Zrihni, Youssef; Naouli, Hamza; Bouarhroum, Abdellatif

    2015-01-01

    Elbow dislocations are the most frequently encountered after shoulder dislocations. In their vast majority, these injuries carry a good prognosis. Although, concomitant arterial injury is rare and make them more serious. In this paper, we report a case of a 17 year old woman with opened elbow dislocation with arterial injury associated to an artery variation: "accessory brachial artery"

  16. Therapeutic effect of intra-arterial chemotherapy with DDP and 5-FU via bilateral uterine arteries for advanced uterine cervical cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic effect of intra-arterial chemotherapy with Ddp and 5-Fu via bilateral uterine arteries for advanced uterine cervical cancer. Methods: During the period of Jan. 2006-Jan. 2009, initial intra-arterial chemotherapy by using a combination of Ddp and 5-Fu via bilateral uterine arteries was performed in 72 patients (mean age 42.9 years) with advanced uterine cervical caner. Of 72 patients, stage I b2 cervical cancer was confirmed in 28, stage II a in 12 and stage II b in 32. Pathologically, cervical squamous cell carcinoma was seen in 56 and cervical adenocarcinoma in 16 patients. Ultrasonography and physical examination were conducted both before and after intra-arterial chemotherapy. The therapeutic results,complications,the surgical resection rate and the pathologic findings were observed and statistically analyzed. Results: Fifty-four patients received one treatment course and 18 patients received two treatment courses. The over all response rate was 77.8%. The response rates of patients with I b2, II a and II b cervical cancer were 92.9%, 83.3% and 62.5% respectively, the difference between three groups was statistically significant (P < 0.05). And the response rates of patients with squamous cell carcinoma and adenocarcinoma were 85.7% and 50.0% respectively, the difference between the two was statistically significant (P < 0.05). The most common side-effects included gastrointestinal symptoms and bone marrow suppression. Thirty-four patients received radical hysterectomy,among them, 22 (78.6%) had stage I b2, 8 (66.7%) had stage II a and 4 (12.5%) had stage II b cervical cancer (P < 0.05). Pathologic exam found no vaginal invasion and ovarian metastasis in all 34 patients. The occurrence of metastasis to lymph nodes and para uterine infiltration were 17.6% and 11.8% respectively. Conclusion: Intra-arterial chemotherapy with a combination of DDP and 5-Fu via bilateral uterine arteries can safely and effectively reduce the

  17. Injuries of the upper cervical spine: A series of 28 cases

    Directory of Open Access Journals (Sweden)

    Basu Saumyajit

    2007-01-01

    Full Text Available Background: There are very few published reports of upper cervical spine injuries from our country and there is a heavy bias towards operative treatment of these injuries. We present below our experience of upper cervical injuries over the last four years. Materials and Methods: Twenty eight patients (20 males, 8 females with upper cervical spine injury (including Occiput, Atlas and Axis were treated and were followed-up for an average of 11.2 months. The data was analyzed retrospectively with regards to the location and type of injury, the treatment offered (conservative or operative as well as the final clinical and radiological outcome. Results: The clinico-radiological outcome of treatment of these injuries is mostly very good with few complications. Other than a single case of mortality due to associated head injury there were no major complications. Conclusion: Management of these patients needs a proper evaluation to arrive at the type of injury and prompt conservative or operative treatment. Treatment is usually safe and effective with good clinical and radiological outcome.

  18. Hepatic artery injury during left hepatic trisectionectomy for colorectal liver metastasis treated by portal vein arterialization.

    Science.gov (United States)

    Hokuto, Daisuke; Nomi, Takeo; Yamato, Ichiro; Yasuda, Satoshi; Obara, Shinsaku; Yamada, Takatsugu; Kanehiro, Hiromichi; Nakajima, Yoshiyuki

    2015-01-01

    Portal vein arterialization (PVA) has been applied as a salvage procedure in hepatopancreatobiliary surgeries, including transplantation and liver resection, with revascularization for malignancies. Here we describe the use PVA as a salvage procedure following accidental injury of the hepatic artery to the remnant liver occurred during left hepatic trisectionectomy for colorectal liver metastases (CRLM). A 60-year-old man with cancer of the sigmoid colon and initially unresectable CRLM received 11 cycles of hepatic arterial infusion chemotherapy with 5-fluorouracil (1500mg/week), after which CRLM was downstaged to resectable. One month after laparoscopic sigmoidectomy, a left trisectionectomy and wedge resection of segment 6 were performed. The posterior branch of the right hepatic artery, the only feeding artery to the remnant liver, was injured and totally dissected. Because microsurgical reconstruction of the artery was impossible, PVA was used; PVA is the sole known procedure available when hepatic artery reconstruction is impossible. The patient then suffered portal hypertension, and closure of arterio-portal anastomosis using an interventional technique with angiography was eventually performed on postoperative day 73. Therefore, it is considered that because PVA is associated with severe postoperative portal hypertension, closure of the arterio-portal shunt should be performed as soon as possible on diagnosing portal hypertension. PMID:26197094

  19. Subclavian artery injury following blunt trauma: A report of three cases

    Directory of Open Access Journals (Sweden)

    Amr Fares

    2012-04-01

    Full Text Available Subclavian artery injuries are rare in blunt chest trauma, constituting just 1-2 percent of all acute vascular injuries. The diagnosis of injury to the subclavian artery is challenging as a good percentage of patients with such vascular injuries have palpable distal pulses, no signs of any external local trauma and associated injuries often divert the attention of treating physicians. Subclavian artery injuries are the second most common injuries to occur to the aortic arch vessels. The mechanism of injury to these vessels varies from deceleration to traction on upper extremity and neck. Angiography is vital in diagnosis and surgical planning of these patients depends on the site and side of the vascular injuries. Early surgical treatment is an important part of management of these patients. Endovascular treatment is of value in a selected subgroup of subclavian artery injury patients. Reported mortality of subclavian artery injuries varies according to haemodynamic status of patient, time of presentation and other associated injuries. A high degree of suspicion is key to diagnosing these vascular injuries. Early appropriate surgical repair of vascular injury, in combination with aggressive treatment of associated injuries, is important for the optimal outcome of these cases. Here we report three cases of subclavian artery injury, which were successfully treated in Hamad General Hospital by vascular surgery and intensive care teams.

  20. Hepatocellular carcinoma with extensive hepatic artery injury: transcatheter arterial chemoembolization through collaterals after coil embolizatoin of gastric arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gab Choul; Yoon, Hyun Ki; Hwang, Jae Cheol; Lee, Duck Hee; Song, Ho Young; Suh, Dong Jin; Lee, Yung Sang; Chung, Young Hwa; Sung, Gyu Bo [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Ko, Ki Young [Catholic Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To evaluate the efficacy and safety of transcatheter arterial chemoembolization(TACE) after coil embolization of the gastroduodenal artery in hepatocellular carcinoma cases with multiple collateral arteries caused by proper hepatic artery injury. Between March 1997 and November 1998, a prospective trial of transcatheter arterial chemoembolization (TACE) was performed through collaterals from the gastroduodenal artery of 31 hepatocellular carcinoma patients with extensive proper hepatic artery injury due to repeated TACE. Among this number, 16 (group A) underwent TACE after coil embolization of the right gastric and gastroduodenal artery. The other 15 patients (group B) underwent TACE without coil embolization. The two groups had the same TNM stage and Clild-Pugh status. During the follow-up period, group A underwent additional TACE 3.3 times, and group B 2.8 times. The therapeutic effect of TACE was evaluated with computed tomography and by measuring alpha-fetoprotein levels. Complications were evaluated by means of gastrofibroscopy, laboratory data, and evaluation of the patients' clinical symptoms. The results obtained after six months and one year were compared within and between each group. At six months follow-up, CT findings had improved or were unchanged in 11 patients(69 %) in group A, and four patients(27 %) in group B(p = 0.032). In ten patients in each group, the level of alpha-fetoprotein was above 200 ng/ml. Its level was decreased in five patients(50 %) and three patients(30 %), respectively. The six-month survival rate was 81 % (13/16) in group A and 67% (10/15) in group B (p 0.43), while the one-year survival figures for these two groups were 50 % (8/16) and 20 % (3/15), respectively(p = 0.135). In group A, the CT findings were steady in five out of eight patients(63 %), while in groupB, CT findings showed that tumors with increased alpha-fetoprotein levels had increased in size and/or number. In group A, it was found that in two (33 %) of six

  1. Research progress of iatrogenic vertebral artery injury%医源性椎动脉损伤的研究进展

    Institute of Scientific and Technical Information of China (English)

    潘杰; 邹乐; 谭军

    2009-01-01

    医源性椎动脉损伤是颈椎手术中一种罕见的并发症,一旦发生,后果严重.随着颈椎手术的广泛开展以及多种新的颈椎内固定方式的应用,出现医源性椎动脉损伤的潜在可能性会增加,应引起临床上的重视.本文就目前对医源性椎动脉损伤的发生率、原因及处理等作一综述.%Iatrogenic vertebral artery injury is a rare complication in cervical spine surgeries,the consequences of which may be catastrophic.With the extensive development of cervical spine surgeries and application of diverse new internal fixations of cervical spine,there is a potential increase of risk of iatrogenic vertebral artery injury,which should be paid attention to.This article reviews the rate,cause and management etc.of iarogenic vertebral artery injury.

  2. Reconstruction of Low Speed Rear-End collisions - Technical Means of Assessing Cervical Spine Injuries

    Directory of Open Access Journals (Sweden)

    Martin Hitzemann

    2003-01-01

    Full Text Available In recent years, an increasing number of cervical spine injuries sustained by vehicle occupants in collisions at comparatively low speeds have been reported to insurance companies and in civil litigation. The reported injuries occur in both rear-end and side impact collisions. The paper describes how a detailed assessment of such cases requires interdisciplinary teamwork involving technical, biomechanical and medical experts.

  3. Antiplatelets versus anticoagulants for the treatment of cervical artery dissection: Bayesian meta-analysis.

    Directory of Open Access Journals (Sweden)

    Hakan Sarikaya

    Full Text Available OBJECTIVE: To compare the effects of antiplatelets and anticoagulants on stroke and death in patients with acute cervical artery dissection. DESIGN: Systematic review with Bayesian meta-analysis. DATA SOURCES: The reviewers searched MEDLINE and EMBASE from inception to November 2012, checked reference lists, and contacted authors. STUDY SELECTION: Studies were eligible if they were randomised, quasi-randomised or observational comparisons of antiplatelets and anticoagulants in patients with cervical artery dissection. DATA EXTRACTION: Data were extracted by one reviewer and checked by another. Bayesian techniques were used to appropriately account for studies with scarce event data and imbalances in the size of comparison groups. DATA SYNTHESIS: Thirty-seven studies (1991 patients were included. We found no randomised trial. The primary analysis revealed a large treatment effect in favour of antiplatelets for preventing the primary composite outcome of ischaemic stroke, intracranial haemorrhage or death within the first 3 months after treatment initiation (relative risk 0.32, 95% credibility interval 0.12 to 0.63, while the degree of between-study heterogeneity was moderate (τ(2 = 0.18. In an analysis restricted to studies of higher methodological quality, the possible advantage of antiplatelets over anticoagulants was less obvious than in the main analysis (relative risk 0.73, 95% credibility interval 0.17 to 2.30. CONCLUSION: In view of these results and the safety advantages, easier usage and lower cost of antiplatelets, we conclude that antiplatelets should be given precedence over anticoagulants as a first line treatment in patients with cervical artery dissection unless results of an adequately powered randomised trial suggest the opposite.

  4. HAVE RECENT CHANGES TO THE RUGBY UNION LAWS OF SCRUMMAGE REDUCED SERIOUS CERVICAL SPINE INJURIES?

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    Terence F. McLoughlin

    2009-03-01

    Full Text Available All areas of play in rugby union are acknowledged to be potentially dangerous but it is in the scrum where the most frequent and serious spinal injuries occur (McIntosh & McCrory, 2005. This letter addresses the questions: what is it about the scrum which accounts for the alleged increased frequency of scrummage associated spinal cord injury (particular in the cervical region and what has the Rugby Football Union [RFU] done to minimise the chance of cervical cord damage by changes to the Laws? Scrums are used to restart play after infringement of Law 20.1. The team which is successful in winning the ball from the scrum can provide quality possession and space to their attacking backs (IRB, 2005.The three front row players are especially vulnerable to serious cervical spine injury. The majority of neck injuries are caused by heads not being properly aligned when opposing front row players make initial contact as the scrum is being formed. If the scrum collapses then excessive forward flexion/rotation of the cervical spine can occur and by wheeling the scrum this can result in increased abnormal lateral flexion/rotation. Added to these possible abnormal increases in directional movement of the cervical spine is the force generated at engagement. It has been calculated that in the front row a static weight of up to 1600kg is placed on each player's neck. Fracture dislocation (usually between C4/C6 of the spine can be the resulting injury which if the cord is involved can cause tetra paresis.In response to this evidence the IRB amended the law of scrummage which was put into effect 2007 in the hope of reducing the incidence of serious cervical spine injury. This is summarised as a 4 step Law of engagement which is: "crouch, touch, pause, engage". The distance between the front rows must now be less than arms length before making contact. Prior to the introduction of this Law with the stipulated distance apart before engagement, the front row

  5. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

    Science.gov (United States)

    Pahl, Felix Hendrik; de Oliveira, Matheus Fernandes; Rotta, Marcus Alexandre Cavalcanti; Dias, Guilherme Marcos Soares; Rezende, André Luiz; Rotta, José Marcus

    2014-01-01

    Background: Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge. Case Description: We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection. Conclusion: We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive. PMID:25317354

  6. [Reflex dystrophy following so-called whiplash injury of the cervical spine].

    Science.gov (United States)

    Bühring, M

    1984-01-01

    In bad cases of whiplash injury of the cervical spine the post-accidental course is complicated by pain, vegetative dysfunctional syndromes and by psychic and psychiatric disorders over many years. There is no satisfactory concept to understand the pathophysiology of these processes. The paper deals with the possibility of a reflex dystrophy. Sympathetic reflex dystrophy syndromes are seen principally in patients with joint, tendon or vascular lesions. In case of whiplash injury, it would concern the cervical spine itself as well as visceral organs including the central nervous system. For the CNS the lymphostatic encephalopathy is a well defined entity. Above all, a reflex dystrophy develops on the basis of a special personality structure. In case of psychic and psychiatric complaints after whiplash injury patients with a so called Sudeck-personality should not be suspected to aggravate; in contrast, especially in these patients complications by reflex dystrophy are credible. Consequences for the assessment and for rehabilitation are discussed. PMID:6475217

  7. Utility of flexion-extension radiography for the detection of ligamentous cervical spine injury and its current role in the clearance of the cervical spine.

    Science.gov (United States)

    Oh, Jason Jaeseong; Asha, Stephen Edward

    2016-04-01

    Detecting the presence of injuries to the cervical spine is an important component of the initial assessment of patients sustaining blunt trauma. A small proportion of cervical spine injuries consists of ligamentous disruption. Accurate detection of ligamentous injury is essential as it may result in sequelae including radiculopathy, quadriplegia and death. Flexion-extension (FE) radiography has traditionally been utilised for the detection of ligamentous injury in patients who have been cleared of bony injury. There are controversies surrounding the use of FE for alert patients with neck pain. There are studies that call into question the diagnostic accuracy of FE, the high proportion of inadequate FE images due to muscle spasm and the adverse effects of prolonged cervical collar immobilisation while awaiting FE. Other literature indicates that FE provides no additional diagnostic information following a multi-detector helical computed tomography. This review evaluates the literature on the utility of FE for the detection of ligamentous injury and explores alternate strategies for clearing the cervical spine of ligamentous injury.

  8. Estudo anatômico do trajeto da artéria vertebral na coluna cervical inferior humana Anatomical study of the vertebral artery path in human lower cervical spine

    Directory of Open Access Journals (Sweden)

    Ben Hur Junitiro Kajimoto

    2007-01-01

    Full Text Available O aumento da utilização de novas técnicas e materiais de síntese para o tratamento cirúrgico de afecções da coluna cervical baixa foi acompanhado da crescente preocupação em relação às complicações que podem ocorrer. A técnica de fixação transpedicular, amplamente utilizada para os outros níveis da coluna vertebral, quando realizada na coluna cervical, apesar de conferir maior estabilidade quando comparada a outras técnicas, pode cursar com complicações graves como lesão da artéria vertebral, lesão de raiz nervosa, além de lesão da articulação facetária. A vértebra C7, no entanto, é considerada mais segura para a realização de tal procedimento, já que, na grande maioria das pessoas, segundo os estudos anatômicos disponíveis, esta não possui a artéria vertebral dentro de seu forame transverso, pois este vaso irá penetrar tal estrutura apenas na vértebra C6. Como hoje existem apenas estudos de imagem para avaliação do trajeto desta artéria e suas variações anatômicas, realizamos este estudo anatômico dissecando 40 artérias vertebrais de cadáveres para avaliar a incidência das variações anatômicas. Encontramos 3 casos onde a artéria vertebral penetrou o forame transverso já em C7 (7,5%, o que aumentaria o risco de uma técnica transpedicular neste nível. O restante das peças anatômicas possuíam anatomia habitual.The increasing use of new techniques and materials for surgical treatment of lower cervical spine conditions has come along with an increasing concern regarding potential complications that might occur. The transpedicular fixation technique, frequently used in other spine levels, is used on the cervical spine, while providing more stability than other techniques, it may cause serious complications such as vertebral artery injury, nervous root injury, or facet joint injuries. However, the C7 vertebra is considered safer for performing this procedure, since, in the vast majority of

  9. Rugby injuries to the cervical spine and spinal cord: a 10-year review.

    Science.gov (United States)

    Scher, A T

    1998-01-01

    A 10-year review (1987-1996) of injuries sustained to the spine and spinal cord in rugby players with resultant paralysis has been undertaken. This article reviews that the incidence of serious rugby spine and spinal cord injuries in South Africa has increased over the 10-year period reviewed, despite stringent new rules instituted in an attempt to decrease the incidence of these injuries. The mechanisms of injury, as previously reported, remain the same as well as the phases of game responsible for injury of the tight scrum, tackle, rucks, and mauls. Two new observations are reported: the first is related to the occurrence of spinal cord concussion with transient paralysis, and the second is related to the increased incidence of osteoarthritis of the cervical spine in rugby players. PMID:9475983

  10. Cognitive deficits in patients after soft tissue injury of the cervical spine.

    Science.gov (United States)

    Radanov, B P; Dvorák, J; Valach, L

    1992-02-01

    Fifty-one patients suffering from soft tissue injury of the cervical spine underwent clinical and psychometric examination. Clinical interview evaluated subjective complaints and formal testing of self-estimated cognitive impairment, divided attention, and speed of information processing. Results indicated at least two different syndromes: 1) the "cervicoencephalic syndrome," characterized by headache, fatigue, dizziness, poor concentration, disturbed accommodation, and impaired adaptation to light intensity; and 2) the "lower cervical spine syndrome," which is accompanied by cervical and cervicobrachial pain. When comparing patients with either of these two syndromes, those suffering from cervicoencephalic syndrome had significantly poorer results when tested for divided attention. Speed of information processing was reduced to a comparable extent in both syndromes. These findings were not related to the length of the post-traumatic interval. Reduced processing of working memory is assumed, which may account for more global cognitive problems as well as secondary neurotic reaction. PMID:1553581

  11. [Injury of femoral artery complicated with infection from injection of heroine].

    Science.gov (United States)

    Zhao, X; Li, L; Zhao, H

    1998-11-01

    Drug addiction has been one of the serious social problems. The peripheral phlebitis caused by drug injection is common, but the occurrence of pseudoaneurysm with infection of femoral artery from injection injury was rarely reported in China. From January 1995 to March 1996, six cases of injury of femoral artery with infection from heroine injection were admitted. The characteristics of the injury were described. The therapeutic measures and details of attention to be needed were discussed. It was concluded that this type of injury was different from the injury caused in agricultural, industrial or traffic accidents. The treatment of choice depended upon the type of injury.

  12. Renal artery injury during robot-assisted renal surgery.

    Science.gov (United States)

    Lee, Jae Won; Yoon, Young Eun; Kim, Dae Keun; Park, Sung Yul; Moon, Hong Sang; Lee, Tchun Yong

    2010-07-01

    Laparoscopic partial nephrectomy (LPN) is becoming the standard of care for incidentally diagnosed, small renal tumors. With its seven degrees of freedom and three-dimensional vision, the DaVinci robotic surgical system has been used to assist in LPNs. The main disadvantage of robot-assisted surgery, however, is the lack of tactile feedback. We present a case of renal artery injury during robot-assisted renal surgery. Robot-assisted partial nephrectomy (RPN) was planned for 47-year-old man with a 3.5-cm right renal mass. After standard bowel mobilization, renal hilar dissection was performed. In the attempt to complete the dissection posteriorly, however, there was sudden profuse bleeding. The intraperitoneal pressure immediately increased to 20 mm Hg, and an additional suction device was inserted through the 5-mm liver retractor port. On inspection, there was an injury at the takeoff of the posterior segmental artery. A decision was made to convert to robot-assisted laparoscopic radical nephrectomy. The main renal artery and renal vein were controlled with Hem-o-Lok clips. The estimated blood loss was 2,000 mL. Four units of packed red blood cells were transfused intraoperatively. The post-transfusion hemoglobin level was 12.6 g/dL. There were no other perioperative complications. The surgeon should keep in mind that the robotic arms are very powerful and can easily injure major vessels because of lack of tactile feedback. A competent and experienced tableside surgeon is very important in robot-assisted surgery because the unsterile console surgeon cannot immediately react to intraoperative complications.

  13. Cervical myelography of nerve root avulsion injuries using water-soluble contrast media.

    Science.gov (United States)

    Cobby, M J; Leslie, I J; Watt, I

    1988-08-01

    Eight cases of cervical nerve root avulsion injury are presented which were investigated by cervical myelography using a water-soluble contrast medium. The previous literature describes the appearances of this lesion using an oil-based agent and has resulted in emphasis being placed on looking for a traumatic meningocele rather than an abnormality of the roots themselves. The excellent definition of the nerve rootlets and axillary pouch that are obtained with a water-soluble contrast medium resulted in more root lesions per patient being detected than with an oil-based medium. There was complete correlation with the surgical findings at all but one root level explored. The appearances of root avulsion injuries and the advantages of using a water-soluble contrast medium are discussed. PMID:3416107

  14. Management of iatrogenic RV injury - RV packing and CPB through PTFE graft attached to femoral artery

    Directory of Open Access Journals (Sweden)

    Chirantan V Mangukia

    2015-01-01

    Full Text Available Cardiac injuries during repeat sternotomy are rare. While undergoing debridement for chronic osteomyelitis (post arterial septal defect closure, a 4-year-old girl sustained significant right ventricular (RV injury. Bleeding from the RV was controlled by packing the injury site, which helped in maintaining stable hemodynamics till arrangements were made for instituting cardiopulmonary bypass (CPB. Since the femoral artery was very small and unsuitable for direct cannulation, a polytetrafluoroethylene (PTFE graft sutured end-to-side to the femoral artery was used for establishing CPB. The injury was successfully repaired.

  15. Pseudoaneurysm of the occipital artery: an unusual cause of persisting headache after minor head injury.

    LENUS (Irish Health Repository)

    Aquilina, K

    2012-02-03

    Post-traumatic pseudoaneurysms of the extracranial arteries in the scalp are uncommon sequelae of head injury. We report on a patient who presented four weeks after a minor head injury with a tender, pulsating and enlarging mass in the course of the left occipital artery. There was associated headache radiating to the vertex. Computed tomographic angiography confirmed the lesion to be a pseudoaneurysm of the occipital artery. The lump was resected with complete resolution of symptoms.

  16. MRI and clinical symptoms in chronic cervical cord injury

    Energy Technology Data Exchange (ETDEWEB)

    Soeda, Shuichi; Maruiwa, Hirofumi; Yokoi, Masahiro; Saitoh, Seiya (Tsukigase Rehabilitation Center, Shizuoka (Japan)); Yamauchi, Kenji

    1992-08-01

    To assess the ability of magnetic resonance (MR) imaging to determine the prognosis of spinal cord injury in the chronic stage and to detect the injured myelomere, 39 patients were examined with MR images obtained by T1-weighted spin echo method 5 months to 4 years and 8 months (mean, one year and 5 months) after they had sustained spinal cord injury. According to hypointensity area of the ventrodorsad diameter of the spinal cord, MR images were classified as non-hypointensity (I), discrete (II), central (III), large cavity (IV), and transverse (V). The most common type was III (25%), followed by IV (26%), II (18%), V (15%), and I (13%). In 21 patients with bone injury, 14 (67%) had type IV or V, in contrast to 2 (11%) of 18 patients without bone injury. Increased hypointensity on MR images was associated with severer injury of the spinal cord. When hypointensity accounted for less than 1/2 of the ventrodorsad diameter of the spinal cord, walking ability was recovered in more than 80% of the patients. When less than 1/3 of the ventrodorsad diameter of the spinal cord was seen as hypointensity, arm function was well preserved, and the anterior horn of gray matter was found less injured. In 60% of the patients, there was difference in the injured level of myelomere between MR images and the neurological examination; the injured level of myelomere tended to be more cephalad level in the neurological examination than MR appearance.(N.K.).

  17. MRI and clinical symptoms in chronic cervical cord injury

    International Nuclear Information System (INIS)

    To assess the ability of magnetic resonance (MR) imaging to determine the prognosis of spinal cord injury in the chronic stage and to detect the injured myelomere, 39 patients were examined with MR images obtained by T1-weighted spin echo method 5 months to 4 years and 8 months (mean, one year and 5 months) after they had sustained spinal cord injury. According to hypointensity area of the ventrodorsad diameter of the spinal cord, MR images were classified as non-hypointensity (I), discrete (II), central (III), large cavity (IV), and transverse (V). The most common type was III (25%), followed by IV (26%), II (18%), V (15%), and I (13%). In 21 patients with bone injury, 14 (67%) had type IV or V, in contrast to 2 (11%) of 18 patients without bone injury. Increased hypointensity on MR images was associated with severer injury of the spinal cord. When hypointensity accounted for less than 1/2 of the ventrodorsad diameter of the spinal cord, walking ability was recovered in more than 80% of the patients. When less than 1/3 of the ventrodorsad diameter of the spinal cord was seen as hypointensity, arm function was well preserved, and the anterior horn of gray matter was found less injured. In 60% of the patients, there was difference in the injured level of myelomere between MR images and the neurological examination; the injured level of myelomere tended to be more cephalad level in the neurological examination than MR appearance.(N.K.)

  18. A Discussion of the Issue of Football Helmet Removal in Suspected Cervical Spine Injuries

    OpenAIRE

    Segan, Ross D.; Cassidy, Christine; Bentkowski, Jamie

    1993-01-01

    In some areas, it is a commonly accepted emergency medical technician protocol to remove a helmet during the initial management of suspected cervical spine injures. After a comprehensive survey of relevant literature, four primary reasons why Emergency Medical Services professionals would desire to remove a helmet emerge. Sources suggest that the presence of a helmet might: 1) interfere with immobilization of the athlete; 2) interfere with the ability to visualize injuries; 3) cause hyperflex...

  19. Spinal cord injury of cervical vertibrae and early diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    陈扬; 李振宇; 等

    1999-01-01

    Objective:To sum up clinical data and CT and MRI examination in 22 patients with spinal cord injury of cervical vertebrae.Methods:CT and MRI examination of the 22 patients with spinal cord injury of cervical vertebrae revealed that 16 patients had spinal comprssion caused by fracture dislocation and protrusion of intervertebral disc,5 suffered from intramedullary hemorrhage and 1 had complete spinal cord injury.A combined modality therapy of intramedullary and extramedullary decompression for spinal cord,skull traction and avoiding reinjury to spinal cord were used. Results:According to Frankel Classification,before operation 3 cases were classified as A degree,2 as B degree,5as C degree,8 as D degree and 4 as Edegree;after operation 2 were classified as A degree,1 as B degree,6 as C degree,6 as D degree and 7 as E degree.Conclusions:Early diagnosis and timely treatmetn,clear mechanism and degree of injury and early selection of effective treatment are very important in raising the rate of curing spinal cord injury.

  20. A non-contact complete knee dislocation with popliteal artery disruption, a rare martial arts injury

    OpenAIRE

    Viswanath, Y; Rogers, I

    1999-01-01

    Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein byp...

  1. First aid and treatment for cervical spinal cord injury with fracture and dislocation

    Science.gov (United States)

    Yisheng, W; Fuying, Z; Limin, W; Junwei, Li; Guofu, P; Weidong, W

    2007-01-01

    Background: Traumatic cervical spinal cord injury with subaxial fracture and dislocation not only indicates a highly unstable spine but can also induce life-threatening complications. This makes first aid critically important before any definitive operative procedure is undertaken. The present study analyzes the various first aid measures and operative procedures for such injury. Materials and Methods: Two hundred and ninety-five patients suffered from cervical spinal cord injury with fracture and dislocation. The average period between injury and admission was 4.5 days (range 5 h-12 weeks). The injury includes burst fractures (n = 90), compression fractures with herniated discs (n = 50), fractures and dislocation (n = 88) and pure dislocation (n = 36). Other injuries including developmental spinal canal stenosis and/or multi-segment spinal cord compression associated with trauma (n = 12), lamina fractures compressing the spinal cord (n = 6), ligament injuries (n = 7) and hematoma (n = 6) were observed in the present study. The injury level was C4 (n = 17), C5 (n = 29), C6 (n = 39), C7 (n = 35), C4-5 (n = 38), C5-6 (n = 58), C6-7 (n = 49), C4-6 (n = 16) and C5-7 (n = 14). According to the Frankel grading system, grade A was observed in 20 cases, grade B in 91, grade C in 124 and grade D in 60. One hundred and eighteen (40%) patients had a high fever and difficulty in breathing on presentation. First aid measures included early reduction and immobilization of the injured cervical spine, controlling the temperature, breathing support, and administration of high-dose methylprednisolone within eight hours of the injury (n = 12) and administration of dehydration and neurotrophy medicine. Oxygen support was given and tracheotomy was performed for patients with serious difficulty in breathing. Measures were taken to prevent bedsores and infections of the respiratory and urological systems. Two hundred and thirty six patients were treated with anterior decompression, 31

  2. First aid and treatment for cervical spinal cord injury with fracture and dislocation

    Directory of Open Access Journals (Sweden)

    Yisheng W

    2007-01-01

    Full Text Available Background: Traumatic cervical spinal cord injury with subaxial fracture and dislocation not only indicates a highly unstable spine but can also induce life-threatening complications. This makes first aid critically important before any definitive operative procedure is undertaken. The present study analyzes the various first aid measures and operative procedures for such injury. Materials and Methods: Two hundred and ninety-five patients suffered from cervical spinal cord injury with fracture and dislocation. The average period between injury and admission was 4.5 days (range 5 h-12 weeks. The injury includes burst fractures ( n = 90, compression fractures with herniated discs ( n = 50, fractures and dislocation ( n = 88 and pure dislocation ( n = 36. Other injuries including developmental spinal canal stenosis and/or multi-segment spinal cord compression associated with trauma ( n = 12, lamina fractures compressing the spinal cord ( n = 6, ligament injuries ( n = 7 and hematoma ( n = 6 were observed in the present study. The injury level was C4 ( n = 17, C5 ( n = 29, C6 ( n = 39, C7 ( n = 35, C4-5 ( n = 38, C5-6 ( n = 58, C6-7 ( n = 49, C4-6 ( n = 16 and C5-7 ( n = 14. According to the Frankel grading system, grade A was observed in 20 cases, grade B in 91, grade C in 124 and grade D in 60. One hundred and eighteen (40% patients had a high fever and difficulty in breathing on presentation. First aid measures included early reduction and immobilization of the injured cervical spine, controlling the temperature, breathing support,and administration of high-dose methylprednisolone within eight hours of the injury ( n = 12 and administration of dehydration and neurotrophy medicine. Oxygen support was given and tracheotomy was performed for patients with serious difficulty in breathing. Measures were taken to prevent bedsores and infections of the respiratory and urological systems. Two hundred and thirty six patients were treated with anterior

  3. Comparison of tracheal intubation using the Airtraq® and Mc Coy laryngoscope in the presence of rigid cervical collar simulating cervical immobilisation for traumatic cervical spine injury

    Directory of Open Access Journals (Sweden)

    Padmaja Durga

    2012-01-01

    Full Text Available Background: It is difficult to visualise the larynx using conventional laryngoscopy in the presence of cervical spine immobilisation. Airtraq® provides for easy and successful intubation in the neutral neck position. Objective: To evaluate the effectiveness of Airtraq in comparison with the Mc Coy laryngoscope, when performing tracheal intubation in patients with neck immobilisation using hard cervical collar and manual in-line axial cervical spine stabilisation. Methods: A randomised, cross-over, open-labelled study was undertaken in 60 ASA I and II patients aged between 20 and 50 years, belonging to either gender, scheduled to undergo elective surgical procedures. Following induction and adequate muscle relaxation, they were intubated using either of the techniques first, followed by the other. Intubation time and Intubation Difficulty Score (IDS were noted using Mc Coy laryngoscope and Airtraq. The anaesthesiologist was asked to grade the ease of intubation on a Visual Analogue Scale (VAS of 1-10. Chi-square test was used for comparison of categorical data between the groups and paired sample t-test for comparison of continuous data. IDS score and VAS were compared using Wilcoxon Signed ranked test. Results: The mean intubation time was 33.27 sec (13.25 for laryngoscopy and 28.95 sec (18.53 for Airtraq (P=0.32. The median IDS values were 4 (interquartile range (IQR 1-6 and 0 (IQR 0-1 for laryngoscopy and Airtraq, respectively (P=0.007. The median Cormack Lehane glottic view grade was 3 (IQR 2-4 and 1 (IQR 1-1 for laryngoscopy and Airtraq, respectively (P=0.003. The ease of intubation on VAS was graded as 4 (IQR 3-5 for laryngoscopy and 2 (IQR 2-2 for Airtraq (P=0.033. There were two failures to intubate with the Airtraq. Conclusion: Airtraq improves the ease of intubation significantly when compared to Mc Coy blade in patients immobilised with cervical collar and manual in-line stabilisation simulating cervical spine injury.

  4. A non-contact complete knee dislocation with popliteal artery disruption, a rare martial arts injury.

    Science.gov (United States)

    Viswanath, Y K; Rogers, I M

    1999-09-01

    Complete knee dislocation is a rare injury and an associated incidence of popliteal artery damage ranges from 16-60% of cases. It occurs commonly in road traffic accidents and in high velocity trauma where significant contact remains as the usual mode of injury. We describe a rare case of non-contact knee dislocation with popliteal artery injury sustained while practising Aikido, a type of martial art. This patient successfully underwent closed reduction of the knee with an emergency vein bypass graft. Similar injury in association with Aikido has not been described in the English literature previously. Various martial art injuries are briefly discussed and safety recommendations made.

  5. 上颈椎损伤合并不连续下颈椎损伤的一期手术治疗%One-stage operative treatment of upper cervical injury combined with noncontiguous lower cervical fracture

    Institute of Scientific and Technical Information of China (English)

    王迎松; 解京明; 张颖; 刘路平; 鲁宁; 陈鸿

    2009-01-01

    Objective To explore the clinical features and operative strategy of upper cervical injury combined with noncontiguous lower cervical fracture. Methods From May 2004 to August 2007,9 cases of upper cervical injury combined noncontiguous lower cervical fracture were treated by one-stage operation. Posterior instrumentation was chosen for the upper cervical injury,including 8 cases of transpedicular screw fixation and fusion on the atlantoaxial vertebra and 1 case of occipital-cervical fixation,Lower cervical fractures were managed by posterior transpedicular screw fixation in 6 cases,including 4 cases of short segmental fix-ation with noncontiguous screws and 2 cases of long segmental fixation with contiguous upper cervical screws. The other 3 cases were treated by anterior lower cervical decompression and titanic plate fixation. Results They were followed up for an average of 13.7 months (from 6 to 48 months) . No injury to the vertebral artery occurred during operation. After operation,no tracheotomy was needed and intubation was not pro-longed. Satisfactory reduction and fusion were obtained,without post-operative complications such as severe pulmonary infection,respiratory failure and stress gastric ulcer. Two lower cervical pedicle screws were bro-ken. Neural function was not improved in 2 cases of preoperative Frankel A and the Frankel scores were E in the other cases. Conclusions Upper cervical injury combined with noncontiguous lower cervical fracture often leads to the utmost instability of the cervical spine and lower cervical neural dysfunction. Appropriate one-stage operative technique,which includes posterior transpedicular screw fixation in the upper and lower cervical spine or anterior lower cervical decompression,is advocated because of its safety and efficacy.%目的 探讨上颈椎损伤合并不连续的下颈椎损伤的临床特点及手术治疗策略.方法 2004年5月至2007年8月,对上颈椎损伤合并不连续的下颈椎损伤9例患

  6. Klippel-Feil syndrome – the risk of cervical spinal cord injury: A case report

    Directory of Open Access Journals (Sweden)

    Singh Gurpreet

    2002-04-01

    Full Text Available Abstract Background Klippel-Feil syndrome is defined as congenital fusion of two or more cervical vertebrae and is believed to result from faulty segmentation along the embryo's developing axis during weeks 3–8 of gestation. Persons with Klippel-Feil syndrome and cervical stenosis may be at increased risk for spinal cord injury after minor trauma as a result of hypermobility of the various cervical segments. Persons with Klippel-Feil Syndrome often have congenital anomalies of the urinary tract as well. Case presentation A 51-year male developed incomplete tetraplegia in 1997 when he slipped and fell backwards hitting his head on the floor. X-rays of cervical spine showed fusion at two levels: C2 and C3 vertebrae, and C4 and C5 vertebrae. Intravenous urography (IVU revealed no kidneys in the renal fossa on both sides, but the presence of crossed, fused renal ectopia in the left ilio-lumbar region. This patient had a similar cervical spinal cord injury about 15 years ago, when he developed transient numbness and paresis of the lower limbs following a fall. Discussion and Conclusion 1 Persons with Klippel-Feil syndrome should be made aware of the increased risk of sustaining transient neurologic deterioration after minor trauma if there is associated radiographic evidence of spinal stenosis. 2 Patients with Klippel-Feil syndrome often have congenital anomalies of the urinary tract. Our patient had crossed, fused, ectopia of kidney. 3 When patients with Klippel-Feil syndrome sustain tetraplegia they have increased chances of developing urinary tract calculi. Treatment of kidney stones may pose a challenge because of associated renal anomalies. 4 Health professionals caring for cervical spinal cord injury patients with Klippel-Feil syndrome and renal anomalies should place emphasis on prevention of kidney stones. A large fluid intake is recommended for these patients, as a high intake of fluids is still the most powerful and certainly the most

  7. Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

    International Nuclear Information System (INIS)

    In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

  8. Five-level noncontiguous spinal injuries of cervical region:report of a case and literature review

    Institute of Scientific and Technical Information of China (English)

    GUO Hong-gang; MA Xin-long; LI Feng-tan; FENG Shi-qing

    2012-01-01

    The incidence of multiple noncontiguous spinal injuries (MNSI) in the cervical spine is rare but has catastrophic consequences.The patient in this report was a 34-year-old woman with five-level cervical MNSI.CT and MRI showed that injuries included atlantoaxial instability,burst fracture of C6,dislocation of G6/7,rupture of the intervertebal disc or ligamentous complex,and irreversible cord damage.The mechanism for this case was a combined pattern of hyperflexion,compression,and hyperextension injuries.A review of the literature revealed that this case is the first report in the literature of a vehicle related accident causing five-level noncontiguous injuries of the cervical spine.

  9. Usefulness of MRI detection of cervical spine and brain injuries in the evaluation of abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Kadom, Nadja [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Boston University Medical Center, Boston, MA (United States); Khademian, Zarir; Vezina, Gilbert; Shalaby-Rana, Eglal [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Rice, Amy [Independent Consultant (Biostatistics), Chevy Chase, MD (United States); Hinds, Tanya [Children' s National Medical Center, Child and Adolescent Protection Center, Washington, DC (United States)

    2014-07-15

    In the evaluation of children younger than 3 years with intracranial hemorrhage it can be difficult to determine whether the cause of hemorrhage was traumatic, and if so, whether abusive head trauma (AHT) is a possibility. Cervical spine MRI is not a routine part of the nationally recommended imaging workup for children with suspected abusive head trauma. There is increasing evidence that spinal injuries are found at autopsy or MRI in abused children. However the prevalence of cervical spine injuries in children evaluated for abusive head trauma is unknown. We sought to determine both the incidence and the spectrum of cervical spine and brain injuries in children being evaluated for possible abusive head trauma. We also examined the relationship between cervical and brain MRI findings and selected study outcome categories. This study is a 3-year retrospective review of children evaluated for abusive head trauma. Inclusion criteria were: children with head trauma seen at our institution between 2008 and 2010, age younger than 36 months, availability of diagnostic-quality brain and cervical spine MRI, and child abuse team involvement because abusive head trauma was a possibility. A child abuse pediatrician and pediatric radiologists, all with board certification, were involved in data collection, image interpretation and data analysis. Statistical analysis was performed using Stata v12.1. The study included 74 children (43 boys, 31 girls) with a mean age of 164 days (range, 20-679 days). Study outcomes were categorized as: n = 26 children with accidental head trauma, n = 38 with abusive head trauma (n = 18 presumptive AHT, n = 20 suspicious for AHT), and n = 10 with undefined head trauma. We found cervical spine injuries in 27/74 (36%) children. Most cervical spine injuries were ligamentous injuries. One child had intrathecal spinal blood and two had spinal cord edema; all three of these children had ligamentous injury. MRI signs of cervical injury did not show a

  10. Passive cigarette smoking induces inflammatory injury in human arterial walls

    Institute of Scientific and Technical Information of China (English)

    ZOU Ni; HONG Jiang; DAI Qiu-yan

    2009-01-01

    Background Epidemiological studies have shown that both active and passive cigarette smoking increase the risk of atherosclerosis. But very little is known about the biological processes induced by passive cigarette smoking that contribute to atheresclerosis. We observe the expression of a few of biological and inflammatory markers in human arterial walls in vitro which were treated with the second-hand smoke solution (sidestream whole, SSW), and discuss the possible mechanism of inflammatory injury induced by second-hand smoke.Methods The biological markers (platelet endothelial cell adhesion molecule-1, PECAM-1; α-smooth muscle actin, α-SMA; collagen Ⅳ, Col Ⅳ) and inflammatory markers (vascular cell adhesion molecule-1, VCAM-1; monocyte chemoattractant protein-1, MCP-1; interleukin-8, IL-8) of human aortal wall were tested by immunofluorescence staining. The levels of MCP-1 and IL-8 mRNA expression were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results No distinct difference was observed between SSW and the control group on the expression of biological markers as assessed by the light microscope. But the inflammatory markers VCAM-1, MCP-1 and IL-8 on the subendothelial layer and smooth muscle cell layers, which are near the endothelium of arterial wall, were strongly stained in the SSW group compared with the control group. Their fluorescence intensities in the 1:40 SSW group (VCAM-1: 0.35±0.04, MCP-1: 0.34±0.05, IL-8: 0.37±0.05) and the 1:20 SSW group (VCAM-1: 0.40±0.04, MCP-1: 0.52±0.09, IL-8: 0.51±0.07) were significantly stronger than the control group (VCAM-1: 0.12±0.04, MCP-1: 0.06±0.02, IL-8: 0.24±0.03) by semi-quantitative analysis of immunofluorescence (P <0.001 vs control). MCP-1 mRNA expression in the 1:40 SSW (0.15±0.04) and the 1:20 SSW (0.19±0.06) group was significantly higher than in the control group (0.09±0.03) (P <0.05, P <0.01 vs control); IL-8 mRNA expression in the 1:40 SSW (0.64±0.12) and 1

  11. Diagnosis and management of traumatic cervical central spinal cord injury: A review

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2015-01-01

    Full Text Available Background: The classical clinical presentation, neuroradiographic features, and conservative vs. surgical management of traumatic cervical central spinal cord (CSS injury remain controversial. Methods: CSS injuries, occurring in approximately 9.2% of all cord injuries, are usually attributed to significant hyperextension trauma combined with congenital/acquired cervical stenosis/spondylosis. Patients typically present with greater motor deficits in the upper vs. lower extremities accompanied by patchy sensory loss. T2-weighted magnetic resonance (MR scans usually show hyperintense T2 intramedullary signals reflecting acute edema along with ligamentous injury, while noncontrast computed tomography (CT studies typically show no attendant bony pathology (e.g. no fracture, dislocation. Results: CSS constitute only a small percentage of all traumatic spinal cord injuries. Aarabi et al. found CSS patients averaged 58.3 years of age, 83% were male and 52.4% involved accidents/falls in patients with narrowed spinal canals (average 5.6 mm; their average American Spinal Injury Association (ASIA motor score was 63.8, and most pathology was at the C3-C4 and C4-C5 levels (71%. Surgery was performed within 24 h (9 patients, 24-48 h (10 patients, or after 48 h (23 patients. In the Brodell et al. study of 16,134 patients with CSS, 39.7% had surgery. In the Gu et al. series, those with CSS and stenosis/ossification of the posterior longitudinal ligament (OPLL exhibited better outcomes following laminoplasty. Conclusions: Recognizing the unique features of CSS is critical, as the clinical, neuroradiological, and management strategies (e.g. conservative vs. surgical management: early vs. late differ from those utilized for other spinal cord trauma. Increased T2-weighted MR images best document CSS, while CT studies confirm the absence of fracture/dislocation.

  12. Multimodal decoding and congruent sensory information enhance reaching performance in subjects with cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    Elaine Anna Corbett

    2014-05-01

    Full Text Available Cervical spinal cord injury (SCI paralyzes muscles of the hand and arm, making it difficult to perform activities of daily living. Restoring the ability to reach can dramatically improve quality of life for people with cervical SCI. Any reaching system requires a user interface to decode parameters of an intended reach, such as trajectory and target. A challenge in developing such decoders is that often few physiological signals related to the intended reach remain under voluntary control, especially in patients with high cervical injuries. Furthermore, the decoding problem changes when the user is controlling the motion of their limb, as opposed to an external device. The purpose of this study was to investigate the benefits of combining disparate signal sources to control reach in people with a range of impairments, and to consider the effect of two feedback approaches. Subjects with cervical SCI performed robot-assisted reaching, controlling trajectories with either shoulder electromyograms (EMGs or EMGs combined with gaze. We then evaluated how reaching performance was influenced by task-related sensory feedback, testing the EMG-only decoder in two conditions. The first involved moving the arm with the robot, providing congruent sensory feedback through their remaining sense of proprioception. In the second, the subjects moved the robot without the arm attached, as in applications that control external devices. We found that the multimodal decoding algorithm worked well for all subjects, enabling them to perform straight, accurate reaches. The inclusion of gaze information, used to estimate target location, was especially important for the most impaired subjects. In the absence of gaze information, congruent sensory feedback improved performance. These results highlight the importance of proprioceptive feedback, and suggest that multi-modal decoders are likely to be most beneficial for highly impaired subjects and in tasks where such

  13. Improved internal iliac artery chemotherapy combined with radiotherapy for the treatment of stage Ⅲ-Ⅳa cervical cancers

    International Nuclear Information System (INIS)

    Objective: To investigate the efficacy of modified internal iliac artery chemotherapy combined with radiotherapy for the treatment of stage Ⅲ-Ⅳa cervical cancers. Methods: A total of 70 patients with stage Ⅲ-Ⅳa cervical cancer, who were admitted to the authors' hospital (Department of Obstetric and Gynecology, Oncology) during the period from May 2005 to August 2009, were enrolled in this study. The clinical data were retrospectively analyzed. Modified internal iliac artery chemotherapy combined with radiotherapy was carried out in 32 patients (study group), and simple radiotherapy was adopted in 38 patients (control group). For patients in study group, puncturing of right femoral artery using Seldinger's technique was performed, which was followed by right uterine artery chemoembolization and subsequent super-selective left iliac artery chemotherapy, which lasted for three days. The chemotherapeutic drugs included cisplatin and fluorouracil. Distance external beam linear accelerator was used for radiotherapy together with 192 Ir high dose rate brachytherapy. For patients in control group, only distance external beam linear accelerator radiotherapy with 192 Ir high dose rate brachytherapy was employed, with the radioactive dose being a little bit smaller than that used in the study group. Results: The one-year survival rate for the study group and the control group was 78.1% and 55.3%, respectively (P0.05). The difference in the occurrence of radiotherapy-related complications was not significant between the two groups (P>0.05). Conclusion: For the treatment of stage Ⅲ-Ⅳa cervical cancers, modified internal iliac artery chemotherapy combined with radiotherapy is more effective than that of simple radiotherapy for a short-term period. The living quality of the patients can be markedly improved. Nevertheless, the five-year survival rate of chemotherapy combined with radiotherapy is not statistically difference from that of simple radiotherapy. (authors)

  14. Prognostic study of acute cervical cord injury by plain and enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Eiji; Shiba, Keiichiro; Ueda, Takayoshi [Spinal Injuries Center, Iizuka, Fukuoka (Japan)] [and others

    1995-09-01

    Ninety-six patients with cervical cord injury underwent MR imaging 10 days (early phase) and 2 weeks after injury to predict the pathophysiology of injury at 2 weeks. The subjects were divided into the following 3 groups based on the findings of T2-weighted images at the early phase: Group I, patients showing a low signal intensity area in the injured spinal cord; Group II, patients showing only a high intensity area; Group III, patients showing no changes in the signal intensity. The images taken at 2 weeks after injury were classified into the following 3 types: type R, images with a rim-enhanced site in the periphery of the injured spinal cord; type NR, images with no rim-enhanced site; type N, images with no enhanced area. Most of the Group I patients (more than 80%) had palsy, and all Group III patients had paresis. All type R patients had palsy, and all type N patients had paresis. The difference in the morphology of contrast site was useful in differentiating palsy and paresis in type NR cases in the Group II. Although it is possible to predict the pathophysiology of injury based on the findings of T2-weighted images taken at early phase, images taken at 2 weeks after injury provided more accurate prognosis. (S.Y.).

  15. Evaluation of the SLICS use in the treatment of subaxial cervical spine injuries

    Directory of Open Access Journals (Sweden)

    Halisson Y. F. da Cruz

    2015-05-01

    Full Text Available The SLICS (Sub-axial Cervical Spine Injury Classification System was proposed to help in the decision-making of sub-axial cervical spine trauma (SCST, even though the literature assessing its safety and efficacy is scarce. Method We compared a cohort series of patients surgically treated based on surgeon’s preference with patients treated based on the SLICS. Results From 2009-10, 12 patients were included. The SLICS score ranged from 2 to 9 points (mean of 5.5. Two patients had the SLICS < 4 points. From 2011-13, 28 patients were included. The SLICS score ranged from 4 to 9 points (mean of 6. There was no neurological deterioration in any group. Conclusion After using the SLICS there was a decrease in the number of patients with less severe injuries that were treated surgically. This suggests that the SLICS can be helpful in differentiating mild from severe injuries, potentially improving the results of treatment.

  16. Iliac Artery and Vein Injury Without Pelvic Fracture Due To Blunt Trauma: A Rare Case

    Directory of Open Access Journals (Sweden)

    Mustafa Cuneyt Cicek

    2014-08-01

    Full Text Available Iliac vascular injuries have high morbidity and mortality rates. Penetrant abdominal and pelvic vascular injuries are more common compared to blunt traumas. Pelvic vascular injuries associated with blunt trauma are quite likely to occur in accompaniment with pelvic fracture. A 23 year old male patient was admitted to the emergency room due to a motorcycle accident. Shock picture was prevalent in the patient. Shaft fracture was present in left femur and flow was not detected in arterial and venous colour Doppler ultrasonography. Patient underwent emergency surgery. Left main iliac artery and vein were normal, however, external iliac vein was lacerated in two spots, and blood vessel wall integrity was damaged in one part of left external iliac artery. Clinical presentation and traumatic retroperitoneal hematoma management of iliac artery and venous injuries due to blunt trauma without pelvic fracture are discussed in the presented case.

  17. Propranolol Use in PHACE Syndrome with Cervical and Intracranial Arterial Anomalies: Collective Experience in 32 Infants

    Science.gov (United States)

    Metry, Denise; Frieden, Ilona J.; Hess, Christopher; Siegel, Dawn; Maheshwari, Mohit; Baselga, Eulalia; Chamlin, Sarah; Garzon, Maria; Mancini, Anthony J.; Powell, Julie; Drolet, Beth A.

    2016-01-01

    1. Objective Combine collective clinical experience using oral propranolol therapy in PHACE syndrome infants with cerebrovascular anomalies. 2. Design Retrospective study of patients evaluated between July 2008 and October 2011. 3. Setting Seven pediatric dermatology centers. 4. Patients 32 infants with definite PHACE syndrome and cervical and/or intracranial arterial anomalies. 5. Intervention Oral propranolol: average dose of 1.8 mg/kg/day divided t.i.d. or b.i.d., for an average duration of 12.3 months. 6. Main Outcome Measure Adverse neurologic events. 7. Results 7/32 (22%) patients were categorized as higher-risk for stroke, defined on MRA as severe, long-segment narrowing or non-visualization of major cerebral or cervical vessels without anatomic evidence for collateral circulation, often in the presence of concomitant cardiovascular comorbidities. Only 1 patient developed a change in neurologic status during propranolol treatment: a mild right hemiparesis that remained static and improved while propranolol was continued. An additional 3 patients had worsening hemangioma ulceration and/or tissue necrosis during therapy. 8. Conclusions This is the largest report thus far of PHACE patients treated with propranolol. While no catastrophic neurologic events occurred, serious complications, particularly severe ulcerations were seen in a minority of patients, and given the sample size we cannot negate the possibility that propranolol could augment the risk of stroke in this population. We continue to advise caution in using systemic beta-blockers, particularly for children with vascular anomalies at higher risk for stroke. Use of the lowest possible dosage, slow dosage titration, and t.i.d. dosing in order to minimize abrupt changes in blood pressure and close follow-up, including neurologic consultation as needed, are recommended. PMID:22994362

  18. Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

    Energy Technology Data Exchange (ETDEWEB)

    Goltz, J.P.; Kickuth, R. [Universitaetsklinikum Wuerzburg (Germany). Inst. fuer Roentgendiagnostik; Bastuerk, P.; Hoppe, H.; Triller, J. [Universitaetsspital Bern (Switzerland). Inst. fuer Diagnostische, Interventionelle und Paediatrische Radiologie

    2011-07-15

    Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)

  19. Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

    International Nuclear Information System (INIS)

    Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)

  20. A comparison of ballon injury models of endovascular lesions in rat arteries

    NARCIS (Netherlands)

    E.E.E. Gabeler; R. van Hillegersberg (Richard); R.G. Statius van Eps (Randolph); W.J. Sluiter (Wim); E.J. Gussenhoven (Elma); P.G.H. Mulder (Paul); H. van Urk (Hero)

    2002-01-01

    textabstractBackground: Balloon injury (BI) of the rat carotid artery (CCA) is widely used to study intimal hyperplasia (IH) and decrease in lumen diameter (LD), but CCA's small diameter impedes the evaluation of endovascular therapies. Therefore, we validated BI in the aorta (AA) and iliac artery (

  1. Recurrent laryngeal nerve injury following reoperative anterior cervical discectomy and fusion: a meta-analysis.

    Science.gov (United States)

    Erwood, Matthew S; Hadley, Mark N; Gordon, Amber S; Carroll, William R; Agee, Bonita S; Walters, Beverly C

    2016-08-01

    OBJECTIVE Recurrent laryngeal nerve (RLN) injury is one of the most frequent complications of anterior cervical discectomy and fusion (ACDF) procedures. The frequency of RLN is reported as 1%-11% in the literature. (4 , 15) The rate of palsy after reoperative ACDF surgery is not well defined. This meta-analysis was performed to review the current medical evidence on RLN injury after ACDF surgery and to determine a relative rate of RLN injury after reoperative ACDF. METHODS MEDLINE, PubMed, and Google Scholar searches were performed using several key words and phrases related to ACDF surgery. Included studies were written in English, addressed revisionary ACDF surgery, and studied outcomes of RLN injury. Statistical analysis was then performed using a random-effects model to calculate a pooled rate of RLN injury. The heterogeneity of the studies was assessed using Cochran's Q statistic and I(2) statistic, and a funnel plot was constructed to evaluate publication bias. RESULTS The search initially identified 345 articles on this topic. Eight clinical articles that met all inclusion criteria were included in the meta-analysis. A total of 238 patients were found to have undergone reoperative ACDF. Thirty-three of those patients experienced an RLN injury. This analysis identified a rate of RLN injury in the literature after reoperative ACDF of 14.1% (95% confidence interval [CI] 9.8%-19.1%). CONCLUSIONS The rate of RLN palsy of 14.1% was greater than any published rate of RLN injury after primary ACDF operations, suggesting that there is a greater risk of hoarseness and dysphagia with reoperative ACDF surgeries than with primary procedures as reported in these studies. PMID:27015129

  2. Regeneration of the rat carotid artery after clipping injury. Part I. A morphological study.

    Science.gov (United States)

    Tsukahara, T; Yonekawa, Y; Yamamoto, M; Kaku, Y; Ogata, N; Taniguchi, T

    1993-01-01

    We investigated the natural course of the morphological regeneration of the endothelium and smooth muscle of the rat carotid artery after clipping injury. Vascular damage was produced by clipping the right carotid arteries of Wistar rats. Endothelial regeneration was confirmed by the injection of Evans blue dye and the detection of factor VIII-related antigen. The volume of the smooth muscle cell layer and the luminal size were measured by computer-assisted morphometric analysis. Immediately after arterial injury, Evans blue dye freely permeated the smooth muscle layer, suggesting that complete endothelial denudation had occurred. Endothelial regrowth started within 24 hours and was fastest on the third and fourth days after injury. The endothelial injury was repaired within 5 days. The area of the smooth muscle layer did not change immediately after clipping injury, but it gradually increased within a month. The luminal area of the injured artery increased during the 3-month recovery period. These findings suggest that endothelial regrowth is completed within a week after clipping injury, whereas smooth muscle cell regrowth is slower. In addition, arteriosclerotic luminal narrowing did not occur during recovery of the rat carotid artery from clipping injury.

  3. Aberrations of dermal connective tissue in patients with cervical artery dissection (sCAD).

    Science.gov (United States)

    Uhlig, Phillip; Bruckner, Peter; Dittrich, Ralf; Ringelstein, E Bernd; Kuhlenbäumer, Gregor; Hansen, Uwe

    2008-03-01

    Spontaneous cervical artery dissection (sCAD) is a common cause of stroke in patients below 55 years of age. Hereditary connective tissue disorders, including Ehlers-Danlos syndrome type IV, have been associated with sCAD and suprastructural abnormalities of both collagen fibrils and elastic fibers have been found by transmission electron microscopy in the dermis of about 50% of sCAD patients. Here, we investigated dermal connective tissue abnormalities using a novel method. Transmission and immunogold electron microscopy were used to study mechanically generated fragments of dermal matrix suprastructures, in particular collagen fibrils. Analysis of dermal tissue of sCAD patients revealed structurally abnormal collagen fibrils with irregularly contoured surfaces and increased diameters, often associated with a faint or absent banding pattern. Interestingly, only a small number of fibrils displayed short abnormal sections along the length of the fibril. Collagens I and III were present in normal as well as abnormal sections of the fibrils.However, immunogold labeling for the two proteins was strongly increased in abnormal sections.A systematic blinded investigation of skin biopsies of 31 sCAD patients and 17 controls revealed abnormal collagen fibrils in 7 sCAD patients but none of the controls. We conclude that approximately 20% of sCAD patients show collagen fibril alterations, establishing a promising basis for further investigation of connective tissue aberrations in skin biopsies of sCAD patients.

  4. Different types of connective tissue alterations associated with cervical artery dissections.

    Science.gov (United States)

    Hausser, Ingrid; Müller, Uta; Engelter, Stefan; Lyrer, Philippe; Pezzini, Alessandro; Padovani, Alessandro; Moormann, Birgit; Busse, Otto; Weber, Ralf; Brandt, Tobias; Grond-Ginsbach, Caspar

    2004-06-01

    This study describes the technical handling and the diagnostic evaluation of skin biopsies in order to standardize the assessment of the delicate morphologic abnormalities that are found in patients with spontaneous cervical artery dissections (sCAD). Skin biopsies from 126 patients with sCAD and from 29 healthy relatives were analyzed. The morphology of the connective tissue was normal in 54 patients with sCAD (43%) and aberrant in 72 patients with sCAD (57%). These latter patients were classified into three groups: in 43 patients, we repeatedly observed composite collagen fibrils and elastic fibers with fragmentation and minicalcifications. In 13 further patients, the dermis was significantly thinner than in healthy subjects. The collagen fibers contained fibrils with highly variable diameters. In a third group of 16 sCAD patients, the abnormalities were restricted to the elastic fibers (with fragmentation and minicalcifications) without significant alterations in the morphology of the collagen fibrils. The finding of different morphologic classes of aberrations among patients suggests that the connective tissue defects are genetically heterogeneous. The segregation of the connective tissue phenotype in three families suggested an autosomal dominant pattern of inheritance.

  5. Novel use of a supraclavicular transverse cervical artery customised perforator flap: a paediatric emergency.

    LENUS (Irish Health Repository)

    Dolan, R T

    2013-08-01

    Perforation of the piriform fossa is a rare, potentially life-threatening paediatric emergency. Prompt diagnosis and early operative intervention is key to patient survival, yet restoring aerodigestive continuity can pose a significant reconstructive challenge. A seven-month old baby girl presented to an emergency department acutely unwell with a twenty-four-hour history of haemoptysis, cough and worsening respiratory distress. A contrast swallow demonstrated extension of contrast into the retropharyngeal region necessitating immediate surgical intervention. A 3.0 cm×1.0 cm perforation within the left posterolateral piriform fossa was identified. The defect was repaired with a supraclavicular transverse cervical artery customised perforator flap. This was inset into the piriform fossa luminal defect as a life-saving procedure. Following a stormy post-operative course, the child was discharged home on day 28 of admission and admitted electively 6 weeks later for division of flap pedicle. This case highlights the novel use of this fasciocutaneous island flap to reconstruct an extensive, potentially fatal, piriform fossa defect in an acute paediatric setting. This simple flap design offers timely mobilisation, reliable blood supply, adequate tenuity and surface area, to reconstruct this extensive defect as a life-saving intervention in a profoundly septic child.

  6. Distinct Differences on Neointima Formation in Immunodeficient and Humanized Mice after Carotid or Femoral Arterial Injury

    Science.gov (United States)

    Moser, Jill; van Ark, Joris; van Dijk, Marcory C.; Greiner, Dale L.; Shultz, Leonard D.; van Goor, Harry; Hillebrands, Jan-Luuk

    2016-01-01

    Percutaneous coronary intervention is widely adopted to treat patients with coronary artery disease. However, restenosis remains an unsolved clinical problem after vascular interventions. The role of the systemic and local immune response in the development of restenosis is not fully understood. Hence, the aim of the current study was to investigate the role of the human immune system on subsequent neointima formation elicited by vascular injury in a humanized mouse model. Immunodeficient NOD.Cg-PrkdcscidIL2rgtm1Wjl(NSG) mice were reconstituted with human (h)PBMCs immediately after both carotid wire and femoral cuff injury were induced in order to identify how differences in the severity of injury influenced endothelial regeneration, neointima formation, and homing of human inflammatory and progenitor cells. In contrast to non-reconstituted mice, hPBMC reconstitution reduced neointima formation after femoral cuff injury whereas hPBMCs promoted neointima formation after carotid wire injury 4 weeks after induction of injury. Neointimal endothelium and smooth muscle cells in the injured arteries were of mouse origin. Our results indicate that the immune system may differentially respond to arterial injury depending on the severity of injury, which may also be influenced by the intrinsic properties of the arteries themselves, resulting in either minimal or aggravated neointima formation. PMID:27759053

  7. CAN A SPECIFIC NECK STRENGTHENING PROGRAM DECREASE CERVICAL SPINE INJURIES IN A MEN'S PROFESSIONAL RUGBY UNION TEAM? A RETROSPECTIVE ANALYSIS

    Directory of Open Access Journals (Sweden)

    Robert Naish

    2013-09-01

    Full Text Available Cervical spine injuries in Rugby Union are a concerning issue at all levels of the game. The primary aim of this retrospective analysis conducted in a professional Rugby Union squad was to determine whether a 26-week isometric neck strengthening intervention program (13-week strengthening phase and 13-week maintenance phase was effective in reducing the number and severity of cervical spine injuries. The secondary aim was to determine whether at week five, where the program had been the similar for all players, there was increased isometric neck strength. All 27 players who were common to both the 2007-2008 and 2008-2009 seasons were included in this analysis and data was extracted from a Sports Medicine/Sports Science database which included the squad's injury records. Primary outcome variables included; the number of cervical spine injuries and the severity of these injuries as determined by the total number of days lost from training and competition. Secondary outcome variables included isometric neck strength in flexion, extension and left and right lateral flexion. Using non-parametric statistical methods, no significant differences were evident for the total number of cervical spine injuries (n = 8 in 2007-2008, n = 6 in 2008-2009 or time loss due to these injuries (100 days in 2007-2008, 40 days in 2008-2009. However, a significant (p = 0.03 reduction in the number of match injuries was evident from 2007-2008 (n = 11 to 2008-09 (n = 2. Non-significant increases in isometric neck strength were found in all directions examined. A significant reduction in the number of match injuries was evident in this study. However, no other significant changes to primary outcome variables were achieved. Further, no significant increases in isometric neck strength were found in this well-trained group of professional athletes

  8. Imaging suspected cervical spine injury: Plain radiography or computed tomography? Systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Cain, Gavin [Diagnostic Radiographer, Colchester Hospital University NHS Foundation Trust, Colchester General Hospital, Turner Road, Colchester, CO4 5JL Essex (United Kingdom)], E-mail: gavincain8@hotmail.com; Shepherdson, Jane; Elliott, Vicki; Svensson, Jon [Faculty of Health and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 9PT Cambridgeshire (United Kingdom); Brennan, Patrick [UCD School of Medicine and Medical Sciences, Health Science Building, Belfield, Dublin 4 (Ireland)

    2010-02-15

    Aim: (1) to establish which modality offers the greatest accuracy in the detection of cervical spine injury (CSI) Following trauma: plain radiography or computed tomography (CT), and (2) make an evidence-based recommendation for the initial imaging modality of choice. Method: A systematic literature review was performed to identify primary research studies which compare the diagnostic accuracy of plain radiography and CT with the results of a reference standard in the detection of CSI. A search of MEDLINE, EMBASE, CINAHL, Science Direct and Pubmed Central databases was conducted. Results: Ten studies were identified. Critical appraisal identified limitations among all studies. There was heterogeneity in the sensitivity estimates for plain radiography, whereas estimates for CT were consistently high. Examination of the reported sensitivities shows that CT outperforms plain radiography in the detection of CSI. Conclusion: CT is superior to plain radiography in the detection of CSI. However, the optimal imaging strategy depends on the patients' relative risk of injury. If at high-risk cervical CT is indicated. If at low-risk the increased cost and radiation exposure mean that screening CT may not be warranted, good-quality plain radiographs are sufficient.

  9. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    Energy Technology Data Exchange (ETDEWEB)

    Buch, Karen; Nguyen, Thanh; Norbash, Alex; Mian, Asim [Boston University School of Medicine, Department of Radiology, Boston Medical Center, Boston, MA (United States); Mahoney, Eric; Burke, Peter [Boston University School of Medicine, Department of Surgery, Boston Medical Center, Boston, MA (United States); Libby, Brandon; Calner, Paul [Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA (United States)

    2016-02-15

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  10. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    International Nuclear Information System (INIS)

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  11. Functional electrical stimulation therapy improves grasping in chronic cervical spinal cord injury: Two case studies

    Directory of Open Access Journals (Sweden)

    Miller Rosalynn C.

    2008-01-01

    Full Text Available OBJECTIVE AND IMPORTANCE: To present case studies of two individuals with chronic cervical spinal cord injury (SCI who participated in functional electrical stimulation (FES therapy with the objective to restore voluntary grasp function. CLINICAL PRESENTATION: Both individuals (right hand dominant males, age 24 and 31 had a sustained a cervical SCI (C6 and C4-5, respectively at least 8 years prior to participation in this study. INTERVENTION: Both individuals participated in an individualized FES therapy program for 6 weeks. FES therapy was administered through a regimen of three, one-hour sessions, per week for three months. A single arm of each participant (n = 2 was treated. FES therapy is an integrative intervention strategy combining muscle strengthening, functional movement training and stretching. The participant's hand movement abilities were assessed pre and post FES therapy using the Manual Muscle Test (MMT, a modified Sollerman Hand Function Test (mSHFT, and the Reach, Grasp, Transport and Release Task (RGTR. DISCUSSION: As the injuries of participants in the current study were chronic and thus neurologically stable, no spontaneous improvements/recovery in hand function was expected. However, FES as part of an integrated therapeutic approach affected restoration and improvement of hand function in both participants. CONCLUSION: The concurrent improvement in strength, integrated motor function and object contact following FES therapy, demonstrated that there is potential for affecting change in hand function of individuals with chronic SCI.

  12. Epicritic sensation in cervical spinal cord injury: diagnostic gains beyond testing light touch.

    Science.gov (United States)

    Velstra, Inge-Marie; Bolliger, Marc; Baumberger, Michael; Rietman, Johan Swanik; Curt, Armin

    2013-08-01

    Abstract Applied as a bedside test of gross dorsal column function, the testing of light touch (LT) sensation is of high clinical value in the diagnosis of human spinal cord injury (SCI). However, the assessment of overall dorsal column deficit by testing only LT may be limited, because the dorsal column pathway conveys several large diameter afferent modalities (e.g., sensation of touch, two-point discrimination, and proprioception). Therefore, the objective of this study was to compare the epicritic sensation assessed by LT, Semmes-Weinstein monofilament (SWM), and electrical perception threshold (EPT) across cervical dermatomes (C3-C8) in individuals with cervical SCI. A multicenter cross-sectional study was performed at 6 months after cervical SCI, applying combined measures of LT, SWM, and EPT, bilaterally over predefined key sensory points (C3-C8). A total of 300 left- and right-sided dermatomes were tested for each outcome measure in 25 participants. The percentage agreement between classifications according to LT and SWM/EPT testing for all dermatomes between C3 and C8 ranged from 95.5% to 36.2%. The degree of agreement showed considerably variable κ coefficients (-0.1≥kw≤0.7) for each dermatome between C3 and C8. The additional measurements of epicritic sensation by SWM and EPT increased sensitivity by detecting and quantifying differences in sensory thresholds above, at, and below the LT level of injury. This is relevant for early clinical trials (phase 1/2), in which disclosing any biological activity of an intervention may be revealed by subtle sensory changes that might gain a clinical relevance.

  13. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; do Val Sella, Guilherme; Checchia, Caio Santos; Checchia, Sergio Luiz

    2016-01-01

    An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature) of an association between these injuries (and the treatment implemented) in a 27-year-old male patient is reported. These injuries were sustained through physical assault. PMID:27069896

  14. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2016-04-01

    Full Text Available An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature of an association between these injuries (and the treatment implemented in a 27-year-old male patient is reported. These injuries were sustained through physical assault.

  15. Preoperative evaluation of vertebral and posterior communicating arteries using 3-dimensional CT angiography before cervical posterior instrumentation surgery

    International Nuclear Information System (INIS)

    We preoperatively examined 45 patients to investigate the frequency of an anomalous vertebral artery (VA) and the presence of a posterior communicating artery (PCOM) using 3-dimensional CT angiography (3D-CTA). Asymmetry of the VAs was detected in eight patients (18%). Anomalous VAs in the intra- or extraosseous region, including a high-riding VA, persistent 1st intersegmental artery, and ponticulus posticus, were found in a total of 8 patients (18%). Nineteen patients (42%) did not have a PCOM on either side. When a VA, especially the VA on the dominant side, is injured during cervical instrumentation, catastrophic vascular complications occur in approximately 7% of patients who have asymmetrical VAs without collateral circulation. Preoperative 3D-CTA provides information on anomalous VAs and collateral circulation that is crucial to preventing vascular complications. (author)

  16. Cervical sympathetic trunk transection affects inducible nitric oxide synthase expression in rat hippocampus following focal cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Liangzhi Xiong; Yan Wang; Qingxiu Wang; Qingshan Zhou

    2008-01-01

    BACKGROUND: The stellate ganglion block (SGB) plays a protective role in focal cerebral ischemia/reperfusion injury. The human SGB can be simulated by transection of the cervical sympathetic trunk (TCST) in rats.OBJECTIVE: To observe the effects of TCST on inducible nitric oxide synthase (iNOS) levels and cerebral infarct wolume in the hippocampus of rats with cerebral ischemia/reperfusion injury, and to analyze the mechanism of action.DESIGN, TIME AND SETTING: A completely randomized, controlled, neuropathological experiment was performed at the Institute of Neurological Disease, Taihe Hospital, Yunyang Medical College between March and September 2006.MATERIALS: A total of 93 Wistar rats, aged 17-18 weeks, of either gender, were used for this study. 2, 3, 5-triphenyl tetrazolium chloride was purchased from Changsha Hongyuan Biological Reagent Company, China. Rabbit iNOS antibody and goat anti-rabbit lgG antibody were the products of Wuhan Boster Biological Reagent Co., Ltd., China.METHODS: Ten rats were randomly selected for the sham-operated group. Cerebral ischemia/reperfusion injury was induced by middle cerebral artery occlusion (MCAO) using the suture method in the remaining rats. Forty successful rat models were randomly and equally divided into the following two groups: (1) TCST group: subsequent to TCST, MCAO was performed for 2 hours, followed by 24 hours reperfusion; (2) model group: rats underwent experimental procedures similar to the TCST group, with the exception of TCST. Rats in the sham-operated group were subjected to experimental procedures similar to the model group; however, the thread was only introduced to a depth of 10 mm.MAIN OUTCOME MEASURES: Following 24 hours of reperfusion, functional neurological deficits were scored. Brain tissue sections from ten rats of each group were used to measure cerebral infarct volume by TTC staining. Hippocampal tissue sections of an additional ten rats from each group were used to detect iNOS levels using

  17. MR imaging evaluation of the temporomandibular joint following cervical extension-flexion injury (whiplash)

    International Nuclear Information System (INIS)

    To determine abnormalities of the temporomandibular joint (TMJ) associated with cervical extension-flexion injury (whiplash) with use of MR imaging. Sixteen patients (32 joints) with TMJ syndrome-related symptoms after whiplash injuries from automobile accidents were evaluated by MR imaging. None of the patients had direct trauma to the jaw, mouth, or face. T1-weighted closed- and opened-mouth views were obtained in the sagittal plane, and closed-mouth views were obtained in the coronal plane. T2-weighted closed-mouth views obtained in the sagittal plane were also obtained to optimize identification of fluid/edema. Fourteen (87%) of 16 patients had one or more of the following TMJ abnormalities: 11 (34%) had anterior displacement of the disk with reduction and 2 (6%) had anterior displacement of the disk without reduction. On T2-weighted images, 17 TMJs (53%) had joint fluid and 5 (16%) had fluid localized to the capsule and/or pterygoid muscle. These data demonstrated a high incidence of TMJ abnormalities related to whiplash injury. The predominant finding was associated fluid/edema, suggesting that T2-weighted images are particularly useful for the evaluation of patients who present with whiplash injury

  18. [Whiplash injury of the cervical spine--on the role of pre-existing degenerative diseases].

    Science.gov (United States)

    Meenen, N M; Katzer, A; Dihlmann, S W; Held, S; Fyfe, I; Jungbluth, K H

    1994-06-01

    Radiological investigations contribute little in differentiating the problems of patients with whiplash injuries. Nevertheless the more prolonged cases of whiplash injuries must not be attributed to preexisting degenerative disease, despite radiologically-proven medicolegal opinion. In this study, 60 patients who were seen for whiplash injuries in the Department for Trauma and Reconstructive Surgery at the University Hospital Hamburg-Eppendorf for clinical and radiological evaluation, an average of 5.7 years post injury, were divided into two groups (n = 30) depending on radiologically-proven preexisting degenerative changes of the cervical spine. On average the patients with degenerative changes were 11.2 years older than those with healthy vertebral columns and also demonstrated an increase in acute symptoms in the lower cervical spine (cervicobrachial syndrome). The chronicity of individual symptoms such as neck-pain, dizziness, nausea and psychological illness was also observed in both groups. Problems such as paresthesias as well as pain in the shoulder-arm-area appeared to increase in subsequent check-ups, irrespective of the earlier degenerative changes. Patients with typical posterior headaches recovered faster when they had radiologically normal spines. Presenting late, there was a significant accumulation of patients with pre-existing degenerative changes complaining merely of tinnitus. The earlier changes in any individual motion segment do not determine the clinical course of whiplash injuries, but merely represent an area of increased vulnerability to trauma. On the other hand, trauma has not been proven to influence the development or aggravation of degenerative changes in normal or diseased spines. We are not able to differentiate the posttraumatic course from the natural history of the degenerative process, either clinically or radiologically. Considering the involvement of sensitive neurological structures the classical objective organic diagnosis

  19. Changes in Strenght, Sensation, and Prehension in Acute Cervical Spinal Cord Injury: European Multicenter Responsiveness Study of the GRASSP

    NARCIS (Netherlands)

    Velstra, I.; Curt, A.; Frotzler, A.; Abel, R.; Kalsi-Ryan, S.; Rietman, J.S.; Bolliger, M.

    2015-01-01

    Objective: To investigate the internal and external responsiveness and recovery profiles of the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) instrument in revealing changes in upper limb function within the first year following cervical spinal cord injury (SCI). Met

  20. Percutaneous cervical carotid artery access with stenting of the left internal carotid artery in an elderly patient

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient's refusal for surgery, direct carotid access was his only option.

  1. Perivascular delivery of Notch 1 siRNA inhibits injury-induced arterial remodeling.

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    Eileen M Redmond

    Full Text Available To determine the efficacy of perivascular delivery of Notch 1 siRNA in preventing injury-induced arterial remodeling.Carotid artery ligation was performed to induce arterial remodeling. After 14 days, morphometric analysis confirmed increased vSMC growth and subsequent media thickening and neointimal formation. Laser capture microdissection, quantitative qRT-PCR and immunoblot analysis of medial tissue revealed a significant increase in Notch1 receptor and notch target gene, Hrt 1 and 2 expression in the injured vessels. Perivascular delivery of Notch 1 siRNA by pluronic gel inhibited the injury-induced increase in Notch 1 receptor and target gene expression when compared to scrambled siRNA controls while concomitantly reducing media thickening and neointimal formation to pre-injury, sham-operated levels. Selective Notch 1 knockdown also reversed the injury-induced inhibition of pro-apoptotic Bax expression while decreasing injury-induced anti-apoptotic Bcl-XL expression to sham-operated control levels. In parallel experiments, proliferative cyclin levels, as measured by PCNA expression, were reversed to sham-operated control levels following selective Notch 1 knockdown.These results suggest that injury-induced arterial remodeling can be successfully inhibited by localized perivascular delivery of Notch 1 siRNA.

  2. Assessment of ultrasound as a diagnostic modality for detecting potentially unstable cervical spine fractures in pediatric severe traumatic brain injury: A feasibility study

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    Deepak Agrawal

    2015-01-01

    Full Text Available Background: Early cervical spine clearance is extremely important in unconscious trauma patients and may be difficult to achieve in emergency setting. Objectives: The aim of this study was to assess the feasibility of standard portable ultrasound in detecting potentially unstable cervical spine injuries in severe traumatic brain injured (TBI patients during initial resuscitation. Materials and Methods: This retro-prospective pilot study carried out over 1-month period (June-July 2013 after approval from the institutional ethics committee. Initially, the technique of cervical ultrasound was standardized by the authors and tested on ten admitted patients of cervical spine injury. To assess feasibility in the emergency setting, three hemodynamically stable pediatric patients (≦18 years with isolated severe head injury (Glasgow coma scale ≤8 coming to emergency department underwent an ultrasound examination. Results: The best window for the cervical spine was through the anterior triangle using the linear array probe (6-13 MHz. In the ten patients with documented cervical spine injury, bilateral facet dislocation at C5-C6 was seen in 4 patients and at C6-C7 was seen in 3 patients. C5 burst fracture was present in one and cervical vertebra (C2 anterolisthesis was seen in one patient. Cervical ultrasound could easily detect fracture lines, canal compromise and ligamental injury in all cases. Ultrasound examination of the cervical spine was possible in the emergency setting, even in unstable patients and could be done without moving the neck. Conclusions: Cervical ultrasound may be a useful tool for detecting potentially unstable cervical spine injury in TBI patients, especially those who are hemodynamically unstable.

  3. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

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    John Tran

    2016-05-01

    Full Text Available Introduction: The National Emergency X-radiography Utilization Study (NEXUS criteria are used extensively in emergency departments to rule out C-spine injuries (CSI in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. Methods: This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. Results: We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101. The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4% cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100] with a negative predictive value of 100 (98.7-100. Conclusion: Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  4. 颈横动脉颈段皮支皮瓣修复颈部瘢痕挛缩%Repair of cervical scar contracture with flaps containing cervical cutaneous branch of the transverse cervical artery

    Institute of Scientific and Technical Information of China (English)

    马显杰; 李杨; 王璐; 李威扬; 董立维

    2012-01-01

    Objective To observe the therapeutic effect of repairing cervical scar contracture using flaps carrying cervical cutaneous branch of the transverse cervical artery. Methods Sixty-six patients with scar contracture after burn in anterior region of neck hosptalized from 1988 to 2011.The scars were excised and repaired with flaps containing the cervical cutaneous branch of transverse cervical artery.They included 55 island flaps (with 9 flaps pre-expanded) and 11 non-island flaps (with 1 flap pre-expanded).After removing the scar and releasing the contracture,flaps with the cervical cutaneous branch of transverse cervical artery were designed and raised in the supraclavicular and infraclavicular regions and the anterior thoracic region.The axial vessel of the flap was the cutaneous artery,which perforated in the crossing area of sternocleidomastoid muscle and omohvoid muscle and originated from the transverse cervical artery.The posterior borderline of the flap reached the anterior border of the trapezius muscle.Its exterior borderline reached the middle part of deltoid muscle,and its interior borderline ended at the midsternal line.The lower borderline was located 3.0-4.0 cm below the nipple.The incisions at the interior,lower,and exterior borders of the flap were first made.Then after sharp dissection to the clavicle,blunt dissection was performed to the pedicle to allow the flaps to be able to cover the wound after rotation without undue tension.The pre-expanded donor sites were sutured directly,while the un-expanded ones were covered with skin graft. Results Out of the 66 flaps,64 flaps survived.Two flaps showed partial necrosis at the distal end due to sub-flap hematoma,and they healed after skin grafting. All the donor sites healed. The color and texture of all flaps matched well with the surrounding skin tissue.The flaps regained sensation pertaining to the chest in the early stage,and complete sensation pertaining to the neck appeared 6 months after surgery

  5. Alteration of forebrain neurogenesis after cervical spinal cord injury in the adult rat.

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    Marie-Solenne eFELIX

    2012-04-01

    Full Text Available Spinal cord injury (SCI triggers a complex cellular response at the injury site, leading to the formation of a dense scar tissue. Despite this local tissue remodeling, the consequences of SCI at the cellular level in distant rostral sites (i.e. brain, remain unknown. In this study, we asked whether cervical SCI could alter cell dynamics in neurogenic areas of the adult rat forebrain. To this aim, we quantified BrdU incorporation and determined the phenotypes of newly generated cells (neurons, astrocytes, or microglia during the subchronic and chronic phases of injury. We find that subchronic SCI leads to a reduction of BrdU incorporation and neurogenesis in the olfactory bulb and in the hippocampal dentate gyrus. By contrast, subchronic SCI triggers an increased BrdU incorporation in the dorsal vagal complex of the hindbrain, where most of the newly generated cells are identified as microglia. In chronic condition 90 days after SCI, BrdU incorporation returns to control levels in all regions examined, except in the hippocampus, where SCI produces a long-term reduction of neurogenesis, indicating that this structure is particularly sensitive to SCI. Finally, we observe that SCI triggers an acute inflammatory response in all brain regions examined, as well as a hippocampal-specific decline in BDNF levels, which could explain the SCI-mediated distant effects on forebrain neurogenesis. This study provides the first demonstration that forebrain neurogenesis is vulnerable to a distal SCI.

  6. Effect of systemic vein chemotherapy and internal iliac arterial embolization infusion chemotherapy on angiogenesis and malignant degree of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Gang Chen

    2016-01-01

    Objective:To analyze the effect of systemic vein chemotherapy and internal iliac arterial chemoembolization on angiogenesis and malignant degree of cervical cancer.Methods: A total of 108 cases of patients with middle and advanced cervical cancer were included in the research, and the time range of the research was from February 2014 to December 2015. According to different means of chemotherapy, included patients were divided into observation group 54 cases and control group 54 cases, control group received systemic vein chemotherapy, observation group received internal iliac arterial infusion chemotherapy and embolization treatment, and then differences in the levels of angiogenesis-related indicators, blood flow parameters within tumor, serum illness-related indicators, cervical tumor tissue proliferation-related indicators,etc. were compared between two groups after treatment.Results:Serum VEGFR-2, HIF-1α, vWF and Lam values of observation group after chemotherapy were lower than those of control group; PI, VI, FI, VFI and Vmax values of observation group after treatment were lower than those of control group while RI value was higher than that of control group; serum SCC-Ag, TK1, HE4, CYFRA21-1, IGF-Ⅱ and Gal-9 values of observation group after chemotherapy were lower than those of control group; miR-26b, SCD-1, Cyclin D1 and TLR4 protein expression levels in tumor tissue of observation group after treatment were lower than those of control group while miR-99b protein expression level was higher than that of control group.Conclusions: Internal iliac arterial infusion chemotherapy and embolization can significantly decrease tumor angiogenesis and inhibit tumor cell proliferation, and it is a perfect means of interventional chemotherapy.

  7. Functional recovery after cervical spinal cord injury: Role of neurotrophin and glutamatergic signaling in phrenic motoneurons.

    Science.gov (United States)

    Gill, Luther C; Gransee, Heather M; Sieck, Gary C; Mantilla, Carlos B

    2016-06-01

    Cervical spinal cord injury (SCI) interrupts descending neural drive to phrenic motoneurons causing diaphragm muscle (DIAm) paralysis. Recent studies using a well-established model of SCI, unilateral spinal hemisection of the C2 segment of the cervical spinal cord (SH), provide novel information regarding the molecular and cellular mechanisms of functional recovery after SCI. Over time post-SH, gradual recovery of rhythmic ipsilateral DIAm activity occurs. Recovery of ipsilateral DIAm electromyogram (EMG) activity following SH is enhanced by increasing brain-derived neurotrophic factor (BDNF) in the region of the phrenic motoneuron pool. Delivery of exogenous BDNF either via intrathecal infusion or via mesenchymal stem cells engineered to release BDNF similarly enhance recovery. Conversely, recovery after SH is blunted by quenching endogenous BDNF with the fusion-protein TrkB-Fc in the region of the phrenic motoneuron pool or by selective inhibition of TrkB kinase activity using a chemical-genetic approach in TrkB(F616A) mice. Furthermore, the importance of BDNF signaling via TrkB receptors at phrenic motoneurons is highlighted by the blunting of recovery by siRNA-mediated downregulation of TrkB receptor expression in phrenic motoneurons and by the enhancement of recovery evident following virally-induced increases in TrkB expression specifically in phrenic motoneurons. BDNF/TrkB signaling regulates synaptic plasticity in various neuronal systems, including glutamatergic pathways. Glutamatergic neurotransmission constitutes the main inspiratory-related, excitatory drive to motoneurons, and following SH, spontaneous neuroplasticity is associated with increased expression of ionotropic N-methyl-d-aspartate (NMDA) receptors in phrenic motoneurons. Evidence for the role of BDNF/TrkB and glutamatergic signaling in recovery of DIAm activity following cervical SCI is reviewed.

  8. Functional recovery after cervical spinal cord injury: Role of neurotrophin and glutamatergic signaling in phrenic motoneurons.

    Science.gov (United States)

    Gill, Luther C; Gransee, Heather M; Sieck, Gary C; Mantilla, Carlos B

    2016-06-01

    Cervical spinal cord injury (SCI) interrupts descending neural drive to phrenic motoneurons causing diaphragm muscle (DIAm) paralysis. Recent studies using a well-established model of SCI, unilateral spinal hemisection of the C2 segment of the cervical spinal cord (SH), provide novel information regarding the molecular and cellular mechanisms of functional recovery after SCI. Over time post-SH, gradual recovery of rhythmic ipsilateral DIAm activity occurs. Recovery of ipsilateral DIAm electromyogram (EMG) activity following SH is enhanced by increasing brain-derived neurotrophic factor (BDNF) in the region of the phrenic motoneuron pool. Delivery of exogenous BDNF either via intrathecal infusion or via mesenchymal stem cells engineered to release BDNF similarly enhance recovery. Conversely, recovery after SH is blunted by quenching endogenous BDNF with the fusion-protein TrkB-Fc in the region of the phrenic motoneuron pool or by selective inhibition of TrkB kinase activity using a chemical-genetic approach in TrkB(F616A) mice. Furthermore, the importance of BDNF signaling via TrkB receptors at phrenic motoneurons is highlighted by the blunting of recovery by siRNA-mediated downregulation of TrkB receptor expression in phrenic motoneurons and by the enhancement of recovery evident following virally-induced increases in TrkB expression specifically in phrenic motoneurons. BDNF/TrkB signaling regulates synaptic plasticity in various neuronal systems, including glutamatergic pathways. Glutamatergic neurotransmission constitutes the main inspiratory-related, excitatory drive to motoneurons, and following SH, spontaneous neuroplasticity is associated with increased expression of ionotropic N-methyl-d-aspartate (NMDA) receptors in phrenic motoneurons. Evidence for the role of BDNF/TrkB and glutamatergic signaling in recovery of DIAm activity following cervical SCI is reviewed. PMID:26506253

  9. Estimated Probability of a Cervical Spine Injury During an ISS Mission

    Science.gov (United States)

    Brooker, John E.; Weaver, Aaron S.; Myers, Jerry G.

    2013-01-01

    Introduction: The Integrated Medical Model (IMM) utilizes historical data, cohort data, and external simulations as input factors to provide estimates of crew health, resource utilization and mission outcomes. The Cervical Spine Injury Module (CSIM) is an external simulation designed to provide the IMM with parameter estimates for 1) a probability distribution function (PDF) of the incidence rate, 2) the mean incidence rate, and 3) the standard deviation associated with the mean resulting from injury/trauma of the neck. Methods: An injury mechanism based on an idealized low-velocity blunt impact to the superior posterior thorax of an ISS crewmember was used as the simulated mission environment. As a result of this impact, the cervical spine is inertially loaded from the mass of the head producing an extension-flexion motion deforming the soft tissues of the neck. A multibody biomechanical model was developed to estimate the kinematic and dynamic response of the head-neck system from a prescribed acceleration profile. Logistic regression was performed on a dataset containing AIS1 soft tissue neck injuries from rear-end automobile collisions with published Neck Injury Criterion values producing an injury transfer function (ITF). An injury event scenario (IES) was constructed such that crew 1 is moving through a primary or standard translation path transferring large volume equipment impacting stationary crew 2. The incidence rate for this IES was estimated from in-flight data and used to calculate the probability of occurrence. The uncertainty in the model input factors were estimated from representative datasets and expressed in terms of probability distributions. A Monte Carlo Method utilizing simple random sampling was employed to propagate both aleatory and epistemic uncertain factors. Scatterplots and partial correlation coefficients (PCC) were generated to determine input factor sensitivity. CSIM was developed in the SimMechanics/Simulink environment with a

  10. Epidemiological and Clinical Features of Cervical Column and Cord Injuries; A 2-Year Experience from a Large Trauma Center in Southern Iran

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    Hamid Reza Kamravan

    2014-01-01

    Full Text Available Objective: To describe the epidemiological characteristics of patients with cervical spine injury admitted to Rajaee hospital, Shiraz, Iran. Methods: This cross-sectional study includes all patients admitted with impression of cervical column injury with or without cervical cord injury from October 2009 to March 2012 to our level I trauma center in Shiraz. We recorded the patients’ characteristics including age, sex, marital status, mechanism of injury, level of injury, concomitant injury, treatment(non-operative or operative and clinical outcome. The data were described and compared with the international literature. Results: Among 261 patients referred with impression of spinal cord injury, the diagnosis of spinal column injury (with or without spine cord injury was confirmed in 206 patients. The mean age of patients was 37.2±15.9 years with Male/Female ratio of 3:1. Car turn-over and car-collisions were the leading causes of injury. The most common spine fracture was C6 vertebra involving 60 (29.1% patients. Fracture of upper and lower extremities were the most concomitant fractures observed in 31(15.1% patients. Open surgery was performed in 65(31.6%.Mortality rate was 7.3% (15 patients.Patients with brain, lung and cord injuries had increased risk of death, among 15 deaths,9 patients had brain injury, 5 individuals had lung injury and 10 patients suffered from cord injury. Conclusion: Cervical spine injuries mostly affect young males, and comprise 206 (10% cases out of 2100 spine injuries in our country. Preventive measures should be taken to reduce cervical spine injuries especially in young age group.

  11. latrogenic brachial artery injury during anterolateral plating of humeral shaft fracture

    Institute of Scientific and Technical Information of China (English)

    Vishal Kumar; Prateek Behera; Sameer Aggarwal; Umesh Kumar Meena

    2013-01-01

    There are several well defined indications for surgical management of humeral shaft fractures.Operative procedures on the humerus are associated with their own complications.Iatrogenic brachial artery injury as a complication of humeral shaft plating has not been reported previously.We report a case of a 48 years old femalewho received operation at a district hospital and was referred to us when the surgeon could not palpate the pulse.CT angiogram showed that there was segmental non-opacification of the brachial artery.There was distal reformation and the thrombosis was decided to be managed conservatively.We believe that the arterial injury was a result ofimproper surgical technique and the segmental block might be due to improper use of plate holding forceps.This case report makes us aware of a rare complication of operative management of humeral shaft fractures and that basic principles of surgery must be always followed to prevent such injuries.

  12. Alterations in multidimensional motor unit number index of hand muscles after incomplete cervical spinal cord injury.

    Science.gov (United States)

    Li, Le; Li, Xiaoyan; Liu, Jie; Zhou, Ping

    2015-01-01

    The objective of this study was to apply a novel multidimensional motor unit number index (MD-MUNIX) technique to examine hand muscles in patients with incomplete cervical spinal cord injury (SCI). The MD-MUNIX was estimated from the compound muscle action potential (CMAP) and different levels of surface interference pattern electromyogram (EMG) at multiple directions of voluntary isometric muscle contraction. The MD-MUNIX was applied in the first dorsal interosseous (FDI), thenar and hypothenar muscles of SCI (n = 12) and healthy control (n = 12) subjects. The results showed that the SCI subjects had significantly smaller CMAP and MD-MUNIX in all the three examined muscles, compared to those derived from the healthy control subjects. The multidimensional motor unit size index (MD-MUSIX) demonstrated significantly larger values for the FDI and hypothenar muscles in SCI subjects than those from healthy control subjects, whereas the MD-MUSIX enlargement was marginally significant for the thenar muscles. The findings from the MD-MUNIX analyses provide an evidence of motor unit loss in hand muscles of cervical SCI patients, contributing to hand function deterioration. PMID:26005410

  13. Alterations in multidimensional motor unit number index of hand muscles after incomplete cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    Le eLi

    2015-05-01

    Full Text Available The objective of this study was to apply a novel multidimensional motor unit number index (MD-MUNIX technique to examine hand muscles in patients with incomplete cervical spinal cord injury (SCI. The MD-MUNIX was estimated from the compound muscle action potential (CMAP and different levels of surface interference pattern electromyogram (EMG at multiple directions of voluntary isometric muscle contraction. The MD-MUNIX was applied in the first dorsal interosseous (FDI, thenar and hypothenar muscles of SCI (n=12 and healthy control (n=12 subjects. The results showed that the SCI subjects had significantly smaller CMAP and MD-MUNIX in all the three examined muscles, compared to those derived from the healthy control subjects. The multidimensional motor unit size index (MD-MUSIX demonstrated significantly larger values for the FDI and hypothenar muscles in SCI subjects than those from healthy control subjects, whereas the MD-MUSIX enlargement was marginally significant for the thenar muscles. The findings from the MD-MUNIX analyses provide an evidence of motor unit loss in hand muscles of cervical SCI patients, contributing to hand function deterioration.

  14. Aberrant right vertebral artery originating from the aortic arch distal to the left subclavian artery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Soo Heui; Baek, Hye Jin [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2014-03-15

    We present a rare case of an aberrant right vertebral artery originated from the distal aortic arch. This issue has been incidentally detected on a preoperative CT angiography after a stabbing injury of the cervical spinal cord. Normally, the right vertebral artery originates from the right subclavian artery. Therefore, in this case report we will review the incidence and the embryological mechanism of this aberrant course of the right vertebral artery and we will discuss as well the clinical importance of this variation.

  15. Ferimento de hipofaringe no trauma cervical penetrante Hypopharyngeal injuries in penetrating neck trauma

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    Paulo Roberto Corsi

    1998-02-01

    Full Text Available O tratamento dos ferimentos de hipofaringe ainda é controvertido na literatura. A maior parte dos autores acredita que o tratamento preferencial consiste na exploração cirúrgica imediata, com reparo primário da lesão e drenagem ou somente a drenagem, e que o tratamento conservador estaria indicado em casos selecionados. Entre 157 ferimentos cervicais penetrantes, num período de quatro anos, encontramos sete (4,4% casos de perfuração de hipofaringe. Destes, seis (85,7% foram tratados cirurgicamente, cinco (71 ,4% com sutura primária e drenagem. A taxa de mortalidade foi nula e a morbidade foi de 28,6%, sendo de 11,2 dias o tempo médio de internação.Hypopharyngeal perforation in penetrating cervical trauma occurs rarely. The treatment of hypopharyngeal wounds is controversial. The mainstay in treatment according to the majority of authors is immediate surgical exploration with primary repair of the lesion and drainage or only drainage. Conservative treatment would be indicated only in selected cases. The authors studied 157 penetrating cervical wounds in four years period and found seven (4.4% cases with hypopharyngeal perforation. There were male patients from 18 to 45 years old. Five injuries (71.4% were stab wounds and two of them (28.6% were caused by gunshot. Only one patient had jugular vein associated injury. Six patients (85.7% were treated surgically, five (71.4% with primary suture and drainage. The mortality rate was null and morbidity was 28.6%, mean hospital stay was 11.2 days.

  16. Macrophage depletion reduced brain injury following middle cerebral artery occlusion in mice

    OpenAIRE

    Ma, Yuanyuan; Li, Yaning; Jiang, Lu; Wang, Liping; Jiang, Zhen; Wang, Yongting; Zhang, Zhijun; Yang, Guo-Yuan

    2016-01-01

    Background Macrophages are involved in demyelination in many brain diseases. However, the role of macrophages in the recovery phase of the ischemic brain is unknown. The present study aims to explore the role of macrophages in the ischemic brain injury and tissue repair following a 90-min transient middle cerebral artery occlusion in mice. Methods Clodronate liposomes were injected into mice to deplete periphery macrophages. These mice subsequently underwent middle cerebral artery occlusion. ...

  17. Injury to the coronary arteries and related structures by implantation of cardiac implantable electronic devices.

    Science.gov (United States)

    Pang, Benjamin J; Barold, S Serge; Mond, Harry G

    2015-04-01

    Damage to the coronary arteries and related structures from pacemaker and implantable cardioverter-defibrillator lead implantation is a rarely reported complication that can lead to myocardial infarction and pericardial tamponade that may occur acutely or even years later. We summarize the reported cases of injury to coronary arteries and related structures and review the causes of troponin elevation in the setting of cardiac implantable electronic device implantation. PMID:25564549

  18. Accelerated reendothelialization, increased neovascularization and erythrocyte extravasation after arterial injury in BAMBI-/- mice.

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    Nicolas Guillot

    Full Text Available BACKGROUND: Intimal injury rapidly activates TGFβ and enhances vascular repair by the growth of endothelial (EC and vascular smooth muscle cells (VSMC. The response to the TGFβ family of growth factors can be modified by BAMBI (BMP, Activin, Membrane Bound Inhibitor acting as a non-signaling, competitive antagonist of TGFβ type I receptors such as ALK 1 and 5. In vivo the effect of BAMBI will depend on its cell-specific expression and of that of the ALK type receptors. We recently reported EC restricted BAMBI expression and genetic elimination of BAMBI resulting in an in vitro and in vivo phenotype characterized by endothelial activation and proliferation involving alternative pathway activation by TGFβ through ALK 1. METHODOLOGY/PRINCIPAL FINDINGS: To test the hypothesis that BAMBI modulates arterial response to injury via its effects on endothelial repair and arterial wall neovascularization we used a model of femoral arterial denudation injury in wild type (WT and BAMBI(-/- mice. Arterial response was evaluated at 2 and 4 weeks after luminal endothelial denudation of femoral arteries. The BAMBI(-/- genotype mice showed accelerated luminal endothelial repair at 2 weeks and a highly unusual increase in arterial wall neovascularization compared to WT mice. The exuberant intimal and medial neovessel formation with BAMBI(-/- genotype was also associated with significant red blood cell extravasation. The bleeding into the neointima at 2 weeks transiently increased it's area in the BAMBI(-/-genotype despite the faster luminal endothelial repair in this group. Vascular smooth muscle cells were decreased at 2 weeks in BAMBI(-/- mice, but comparable to wild type at 4 weeks. CONCLUSIONS/SIGNIFICANCE: The absence of BAMBI results in a highly unusual surge in arterial wall neovascularization that surprisingly mimiks features of intra-plaque hemorrhage of advanced atheroma in a mechanical injury model. This suggests important effects of BAMBI on

  19. CXCL16 regulates renal injury and fibrosis in experimental renal artery stenosis.

    Science.gov (United States)

    Ma, Zhiheng; Jin, Xiaogao; He, Liqun; Wang, Yanlin

    2016-09-01

    Recent studies have shown that inflammation plays a critical role in the initiation and progression of hypertensive kidney disease, including renal artery stenosis. However, the signaling mechanisms underlying the induction of inflammation are poorly understood. We found that CXCL16 was induced in the kidney in a murine model of renal artery stenosis. To determine whether CXCL16 is involved in renal injury and fibrosis, wild-type and CXCL16 knockout mice were subjected to renal artery stenosis induced by placing a cuff on the left renal artery. Wild-type and CXCL16 knockout mice had comparable blood pressure at baseline. Renal artery stenosis caused an increase in blood pressure that was similar between wild-type and CXCL16 knockout mice. CXCL16 knockout mice were protected from RAS-induced renal injury and fibrosis. CXCL16 deficiency suppressed bone marrow-derived fibroblast accumulation and myofibroblast formation in the stenotic kidneys, which was associated with less expression of extracellular matrix proteins. Furthermore, CXCL16 deficiency inhibited infiltration of F4/80(+) macrophages and CD3(+) T cells in the stenotic kidneys compared with those of wild-type mice. Taken together, our results indicate that CXCL16 plays a pivotal role in the pathogenesis of renal artery stenosis-induced renal injury and fibrosis through regulation of bone marrow-derived fibroblast accumulation and macrophage and T-cell infiltration.

  20. Quantification of Adventitial Vasa Vasorum Vascularization in Double-injury Restenotic Arteries

    Institute of Scientific and Technical Information of China (English)

    Meng Ye; Bai-Gen Zhang; Lan Zhang; Hui Xie; Hao Zhang

    2015-01-01

    Background:Accumulating evidence indicates a potential role of adventitial vasa vasorum (VV) dysfunction in the pathophysiology of restenosis.However,characterization ofVV vascularization in restenotic arteries with primary lesions is still missing.In this study,we quantitatively evaluated the response of adventitial VV to vascular injury resulting from balloon angioplasty in diseased arteries.Methods:Primary atherosclerotic-like lesions were induced by the placement of an absorbable thread surrounding the carotid artery of New Zealand rabbits.Four weeks following double-injury induced that was induced by secondary balloon dilation,three-dimensional patterns of adventitial VV were reconstructed;the number,density,and endothelial surface of VV were quantified using micro-computed tomography.Histology and immunohistochemistry were performed in order to examine the development of intimal hyperplasia.Results:Results from our study suggest that double injured arteries have a greater number of VV,increased luminal surface,and an elevation in the intima/media ratio (I/M),along with an accumulation ofmacrophages and smooth muscle cells in the intima,as compared to sham or single injury arteries.I/M and the number of VV were positively correlated (R2 =0.82,P < 0.001).Conclusions:Extensive adventitial VV neovascularization occurs in injured arteries after balloon angioplasty,which is associated with intimal hyperplasia.Quantitative assessment of adventitial VV response may provide insight into the basic biological process of postangioplasty restenosis.

  1. Internal carotid artery dissection after anterior cervical disc replacement: first case report and literature review of vascular complications of the approach.

    Science.gov (United States)

    Loret, Jean-Edouard; Francois, Patrick; Papagiannaki, Chrysanthi; Cottier, Jean-Philippe; Terrier, Louis-Marie; Zemmoura, Ilyess

    2013-07-01

    We report the case of a 41-year-old woman who underwent cervical total disc replacement at C4C5 and C5C6 levels and fusion at C6C7 level through an anterior right-side approach. After anesthesia recovery, the patient presented left hemiparesia and facial palsy due to large right hemispheric stroke. Diffusion-weighted magnetic resonance imaging was performed as soon as the patient developed neurologic symptoms of stroke and revealed a right internal carotid artery dissection. Digital substraction angiography, endovascular stenting, angioplasty and thrombectomy were performed. Six months after treatment, clinical examination showed mild left-arm spasticity. To the best of our knowledge, only two cases of internal carotid artery stroke without dissection or thrombosis are reported. In conclusion, although vascular complications are rare after anterior cervical spine procedure, internal carotid artery dissection can occur. Suspected risk factors are prolonged retraction of the carotid artery and neck extension.

  2. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  3. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    International Nuclear Information System (INIS)

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m2; CDDP, total 100-150 mg/m2) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3 metastatic

  4. Possibility of Independence in ADL (Activities of Daily Living) for Patients with Cervical Spinal Cord Injuries : An Evaluation based on the Zancolli Classification of Residual Arm Functions

    OpenAIRE

    Yoshimura, Osamu; Takayanagi, Kiyomi; Kobayashi, Ryuji; Hosoda, Masataka; Minematsu, Akira; Sasaki, Hisato; Maejima, Hiroshi; Matsuda, Yuiti; Tanaka, Satiko; Matsuo, Akihisa; Kanemura, Naohiko

    1998-01-01

    For patients with cervical spinal cord injuries to become independent in their ADL (Activities of Daily Living), residual arm function is very important. Also, age, sex, physical strength, obesity, spasticity, pain, contracture and motivation are related. We investigated the possibility of independence in ADL for patients with cervical spinal cord injuries, carrying out our evaluation based on the Zancolli Classification of Residual Arm Functions. Zancolli classification C6BII is taken as the...

  5. Awake behaving electrophysiological correlates of forelimb hyperreflexia, weakness and disrupted muscular synchronization following cervical spinal cord injury in the rat.

    Science.gov (United States)

    Ganzer, Patrick Daniel; Meyers, Eric Christopher; Sloan, Andrew Michael; Maliakkal, Reshma; Ruiz, Andrea; Kilgard, Michael Paul; Robert, LeMoine Rennaker

    2016-07-01

    Spinal cord injury usually occurs at the level of the cervical spine and results in profound impairment of forelimb function. In this study, we recorded awake behaving intramuscular electromyography (EMG) from the biceps and triceps muscles of the impaired forelimb during volitional and reflexive forelimb movements before and after unilateral cervical spinal cord injury (cSCI) in rats. C5/C6 hemicontusion reduced volitional forelimb strength by more than 50% despite weekly rehabilitation for one month post-injury. Triceps EMG during volitional strength assessment was reduced by more than 60% following injury, indicating reduced descending drive. Biceps EMG during reflexive withdrawal from a thermal stimulus was increased by 500% following injury, indicating flexor withdrawal hyperreflexia. The reduction in volitional forelimb strength was significantly correlated with volitional and reflexive biceps EMG activity. Our results support the hypothesis that biceps hyperreflexia and descending volitional drive both significantly contribute to forelimb strength deficits after cSCI and provide new insight into dynamic muscular dysfunction after cSCI. The use of multiple automated quantitative measures of forelimb dysfunction in the rodent cSCI model will likely aid the search for effective regenerative, pharmacological, and neuroprosthetic treatments for spinal cord injury. PMID:27033345

  6. One stage anterior-posterior approach for traumatic at- lantoaxial instability combined with subaxial cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    WANG Chang-sheng

    2011-06-01

    Full Text Available 【Abstract】 Objectives: To explore the clinical fea- tures of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI, and to analyze the feasibility, indication and therapeutic effects of ante- rior-posterior approach in such cases. Methods: From March 2004 to September 2009, 16 cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixa- tion and bone graft fusion were conducted to manage trau- matic atlantoaxial instability . As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied. Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All pa- tients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA scores ranged from 10 to 16 one year postoperatively, 13.95±2.06 on average (improvement rate=70.10%. X-rays, spiral CT and MRI con- firmed normal cervical alignments, complete decompression and fine implants’ position. There was no breakage or loos- ening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed. Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immedi- ately restore the normal alignments and stability of the cer- vical spine and effectively

  7. A comprehensive subaxial cervical spine injury severity assessment model using numeric scores and its predictive value for surgical intervention.

    Science.gov (United States)

    Tsou, Paul M; Daffner, Scott D; Holly, Langston T; Shamie, A Nick; Wang, Jeffrey C

    2012-02-10

    Multiple factors contribute to the determination for surgical intervention in the setting of cervical spinal injury, yet to date no unified classification system exists that predicts this need. The goals of this study were twofold: to create a comprehensive subaxial cervical spine injury severity numeric scoring model, and to determine the predictive value of this model for the probability of surgical intervention. In a retrospective cohort study of 333 patients, neural impairment, patho-morphology, and available spinal canal sagittal diameter post-injury were selected as injury severity determinants. A common numeric scoring trend was created; smaller values indicated less favorable clinical conditions. Neural impairment was graded from 2-10, patho-morphology scoring ranged from 2-15, and post-injury available canal sagittal diameter (SD) was measured in millimeters at the narrowest point of injury. Logistic regression analysis was performed using the numeric scores to predict the probability for surgical intervention. Complete neurologic deficit was found in 39 patients, partial deficits in 108, root injuries in 19, and 167 were neurologically intact. The pre-injury mean canal SD was 14.6 mm; the post-injury measurement mean was 12.3 mm. The mean patho-morphology score for all patients was 10.9 and the mean neurologic function score was 7.6. There was a statistically significant difference in mean scores for neural impairment, canal SD, and patho-morphology for surgical compared to nonsurgical patients. At the lowest clinical score for each determinant, the probability for surgery was 0.949 for neural impairment, 0.989 for post-injury available canal SD, and 0.971 for patho-morphology. The unit odds ratio for each determinant was 1.73, 1.61, and 1.45, for neural impairment, patho-morphology, and canal SD scores, respectively. The subaxial cervical spine injury severity determinants of neural impairment, patho-morphology, and post-injury available canal SD have

  8. Management of ischemic-type biliary injury induced by hepatic artery stricture after orthotopic liver transplantation

    International Nuclear Information System (INIS)

    Objective: To discuss the treatment of ischemic-type biliary injury due to hepatic artery stricture after orthotopic liver transplantation and to estimate its prognosis. Methods: The clinical data of 11 patients with ischemic-type biliary injury due to hepatic artery stricture after orthotopic liver transplantation encountered during the period of June 2004-June 2008, who underwent hepatic artery stenting together with endoscopic retrograde cholangiopancreatography (ERCP) and/or percutaneous transhepatic cholangial drainage (PTCD), were retrospectively analyzed. Results: A total of 12 balloon-expandable coronary stents was successfully implanted in 11 patients. In 5 patients only ERCP was adopted and in 3 patients only PTCD was used. The remaining 3 patients received PTCD after they failed to respond to ERCP. During a follow-up period of 4 months-4 years, 6 cases died of infection, of which 5 died within one year. Three patients accepted liver transplantation once more. The other 2 patients survived so far. Conclusion: The overall therapeutic result of ischemic-type biliary injury due to hepatic artery stricture after orthotopic liver transplantation is not ideal at present. Hepatic artery stenting combined with longstanding PTCD may prolong the survival time of the grafted liver and, therefore, provide opportunity for re-transplantation. (authors)

  9. Arterial pressure during cardiopulmonary bypass is not associated with acute kidney injury

    DEFF Research Database (Denmark)

    Kandler, K; Jensen, M E; Nilsson, J C;

    2015-01-01

    BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is common and is associated with increased mortality. We wanted to investigate if the arterial pressure or the use of norepinephrine during cardiopulmonary bypass were associated with AKI. METHODS: A retrospective analysis of patients who...

  10. Urgent endarterectomy using pretreatment with free radical scavenger, edaravone, and early clamping of the parent arteries for cervical carotid artery stenosis with crescendo transient ischemic attacks caused by mobile thrombus and hemodynamic cerebral ischemia. Case report.

    Science.gov (United States)

    Kobayashi, Masakazu; Ogasawara, Kuniaki; Inoue, Takashi; Saito, Hideo; Komoribayashi, Nobukazu; Suga, Yasunori; Ogawa, Akira

    2007-03-01

    A 68-year-old man with left cervical internal carotid artery stenosis suffered crescendo transient ischemic attacks caused by mobile thrombus detected by carotid echography and secondary impairment of cerebral hemodynamic reserve demonstrated by positron emission tomography. Urgent carotid endarterectomy (CEA) was performed following pretreatment with edaravone and early clamping of the carotid arteries without intraluminal shunting. The postoperative course was uneventful, and postoperative magnetic resonance imaging and single-photon emission computed tomography revealed no new cerebral ischemic lesions and no findings of cerebral hyperperfusion, respectively. The risks associated with CEA are higher for patients with evolving stroke or crescendo transient ischemic attacks than that for patients with stable disease. This case demonstrates that urgent endarterectomy for cervical carotid artery stenosis with crescendo transient ischemic attacks caused by mobile thrombi and hemodynamic cerebral ischemia can be successfully performed following pretreatment with edaravone and early clamping of the carotid arteries.

  11. In situ cephalic vein bypasses from axillary to the brachial artery after catheterization injuries.

    Science.gov (United States)

    Hudorovic, Narcis; Lovricevic, Ivo; Ahel, Zaky

    2010-07-01

    The need to bypass to the brachial artery is rare. Over a five-year period, 16 patients had suffered iatrogenic post-catheterization injuries of the upper extremity. We have performed 16 bypasses, in 16 patients, mean age was 65 years (range 47-75), to the brachial artery originating from an artery proximal to the shoulder joint. In all cases, the axillary artery was the donor artery. All bypasses were created by using the cephalic vein with the in situ technique and distal anastomoses were made to a distance-free section of brachial artery. No operative mortality, neurological complications or major upper-extremity amputation was associated with the procedure. Life-long-conduit analysis showed 75% patency in the five-year period. After iatrogenic post-catheterization trauma of arterial system of upper extremity, bypasses from axillary to brachial artery with the cephalic vein with the in situ technique is a safe operation with satisfactory long-term patency. PMID:20395248

  12. Covered stents for endovascular repair of iatrogenic injuries of iliac and femoral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kufner, Sebastian, E-mail: kufners@dhm.mhn.de [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Cassese, Salvatore; Groha, Philipp; Byrne, Robert A. [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Schunkert, Heribert; Kastrati, Adnan [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Ott, Ilka; Fusaro, Massimiliano [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany)

    2015-04-15

    Background: The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. A strategy of percutaneous transluminal angioplasty (PTA) with covered stent (CS) may represent a valuable alternative to open surgery. However, systematic evaluations of CS in this setting represent a scientific gap. In the present study, we investigate the procedural and clinical outcomes associated with PTA and CS implantation to repair iatrogenic injuries of peripheral arteries. Methods: All patients undergoing PTA with CS for endovascular repair of iatrogenic injuries of peripheral arteries between August 2010 and July 2013 at our Institution were retrospectively analyzed. The primary endpoint was the technical success. Secondary endpoints were in-hospital mortality and cumulative death, target lesion revascularization (TLR), amputation and major stroke at 12-month follow-up. Results: During the period of observation, a total of 30 patients underwent PTA with either self-expandable (43.3%) or balloon-expandable CS (56.7%) for iatrogenic injuries of peripheral arteries. Injuries consisted of perforation/rupture (76.7%), arteriovenous fistula (16.7%) and pseudoaneurysm (6.7%) of iliac–femoral arteries. Technical success was achieved in all cases. Median follow-up was 409 days [210–907]. The incidence of in-hospital mortality was 10.0%. At 12-month follow-up, the incidence of death, TLR, amputation and major stroke was 20.0%, 17.0%, 3.3% and 6.7%, respectively. Conclusion: The use of covered stents for endovascular repair of iatrogenic injuries of peripheral arteries shows a high technical success and may be alternative to surgery. Further studies with larger populations are needed to confirm these preliminary findings. - Highlights: • The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. • Percutaneous transluminal angioplasty with

  13. Isolated hepatic artery injury in blunt abdominal trauma presenting as upper gastrointestinal bleeding: treatment with transcatheter embolisation.

    Science.gov (United States)

    Taslakian, Bedros; Ghaith, Ola; Al-Kutoubi, Aghiad

    2012-11-15

    Liver injury in blunt abdominal trauma is common. However, not often does blunt trauma cause injury to the anatomical structures of the porta hepatis. Isolated injury of the hepatic artery has been rarely reported in the literature. Such injury may be lethal and requires immediate diagnosis and management. This report describes an unusual case of blunt abdominal trauma resulting in hepatic and gastroduodenal artery dissection, with pseudoaneurysm formation complicated by active upper gastrointestinal bleeding. The injury was managed by transcatheter embolisation. Awareness of this diagnosis should facilitate management of similar trauma cases.

  14. Analyse of 18 cases with cervical injury without fracture and dislocation%无骨折脱位型颈髓损伤18例分析

    Institute of Scientific and Technical Information of China (English)

    孟庆波; 刘俊山; 项永胜

    2003-01-01

    @@ BACKGROUND: Traditionaly , operation should not be performed on patients suffered from cervical injury without fracture and dislocation during rehabilitation or patients with complete paralysis. Dang Gengting suggested that although external force resulting cervical injury is slight, fracture and dislocation are rare, spinal damage is severe. So, doctors should consider risk factors of vertebral canal affecting spinal cord. Acute nerve and spinal injury, for example, will progress into chronic spinal disease or nerve root disease if not properly managed. So, once diagnosis was confirmed, traction, mobilization should be carried out to prevent other injury. Treatment protocol should be determined according to type of injury. If object increasing pressure, operation should be done to remove pressure. Additionaly, stability of cervical cord must be ensured.

  15. Cervical spondylosis

    Science.gov (United States)

    ... Past neck injury (often several years before) Past spine surgery Ruptured or slipped disk Severe arthritis Small fractures ... Kshettry VR. Cervical spondylosis. In: Benzel EC, ed. Spine Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ...

  16. A game of two discs: a case of non-contiguous and occult cervical spine injury in a rugby player

    OpenAIRE

    O'Sullivan, Michael D.; Piggot, Robert; Jaddan, Mutaz; McCabe, John P.

    2016-01-01

    The aim of this case report was to highlight the application of magnetic resonance imaging (MRI) in elucidating serious and occult injuries in a single case of hyperflextion injury of a patient cervical spine (C-Spine). A chart and radiology review was performed to establish the sequence of care and how the results of imaging studies influenced the clinical management in this trauma case. Plain radiographs and computed tomography (CT) imaging modalities of the C-Spine revealed bilateral C4/C5...

  17. A game of two discs: a case of non-contiguous and occult cervical spine injury in a rugby player.

    Science.gov (United States)

    O'Sullivan, Michael D; Piggot, Robert; Jaddan, Mutaz; McCabe, John P

    2016-01-01

    The aim of this case report was to highlight the application of magnetic resonance imaging (MRI) in elucidating serious and occult injuries in a single case of hyperflextion injury of a patient cervical spine (C-Spine). A chart and radiology review was performed to establish the sequence of care and how the results of imaging studies influenced the clinical management in this trauma case. Plain radiographs and computed tomography (CT) imaging modalities of the C-Spine revealed bilateral C4/C5 facetal subluxation with no obvious fractures; however, the MR imaging of the C-Spine revealed a non-contiguous and occult injury to C6/C7 disc with a posterior annular tear and associated disc extrusion. This altered the operative intervention that was initially planned. MR imaging proved an invaluable diagnostic addition in this particular case of cervical trauma in a rugby player following a hyperflextion injury, by revealing a serious non-contiguous and occult injury of the C-Spine. PMID:26980714

  18. Treatment of cervical artery dissections%颈部动脉夹层分离的治疗

    Institute of Scientific and Technical Information of China (English)

    颜艳; 周志明

    2015-01-01

    颈部动脉夹层分离(cervical artery dissection, CeAD )是青年缺血性卒中发病的重要原因,临床表现常为局部面部疼痛、Horner 综合征和缺血性卒中。随着无创性影像学的发展,很多CeAD 患者得到早期诊断。血栓栓塞是其发病的重要机制,及时予以抗凝治疗是合理的。然而,抗凝药有可能导致壁内血肿扩大,因此也有人支持抗血小板治疗。不过,这2种治疗方案的有效性尚待随机试验证实。最近完成的卒中患者颈部动脉夹层分离研究(Cervical Artery Dissection in Stroke Study, CADISS)是第1项针对该问题的前瞻性研究,结果显示抗血小板或抗凝治疗的效果无显著差异。急性期 CeAD 患者予以溶栓不会增高出血风险,而且功能转归良好率与对照组相近,因此可作为急性期治疗方法。对于抗栓治疗无效或存在禁忌证以及反复再发卒中的患者,可行血管内介入或手术治疗。CeAD 患者通常预后良好,卒中复发率较低,半数以上患者动脉管壁异常会在3~6个月时消退。%Cervical artery dissection (CeAD) is an important cause of ischemic stroke in young adults w ith ischemic stroke. The clinical manifestations are often local facial pain, Horner syndrome, and ischemic stroke. With the development of noninvasive imaging, many patients w ith CeAD have got early diagnosis. Thromboembolism is an important mechanism of its pathogenesis. Timely giving anticoagulation therapy is reasonable. How ever, anticoagulants may lead to intramural hematoma expansion; therefore, there are also people w ho support antiplatelet therapy. How ever, the effectiveness of the 2 regimens needs to be confirmed by randomized trials. The recently completed Cervical Artery Dissection in Stroke Study (CADISS) in patients w ith stroke is the first prospective study aiming at the problem. The results have show ed that there w as no significant difference in efficacy betw

  19. Circulating endothelial progenitor cells do not contribute to regeneration of endothelium after murine arterial injury

    DEFF Research Database (Denmark)

    Hagensen, Mette; Raarup, Merete Krog; Mortensen, Martin Bødtker;

    2012-01-01

    into endothelial cells (ECs). We tested this theory in a murine arterial injury model using carotid artery transplants and fluorescent reporter mice. METHODS AND RESULTS: Wire-injured carotid artery segments from wild-type mice were transplanted into TIE2-GFP transgenic mice expressing green fluorescent protein...... (GFP) in ECs. We found that the endothelium regenerated with GFP(+) ECs as a function of time, evolving from the anastomosis sites towards the centre of the transplant. A migration front of ECs at Day 7 was verified by scanning electron microscopy and by bright-field microscopy using recipient TIE2-lac......Z mice with endothelial β-galactosidase expression. These experiments indicated migration of flanking ECs rather than homing of circulating cells as the underlying mechanism. To confirm this, we interposed non-injured wild-type carotid artery segments between the denuded transplant and the TIE2-GFP...

  20. The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

    Energy Technology Data Exchange (ETDEWEB)

    Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo [Wonju Christian Hospital, College of Medicine, Yonsei University, Wonju (Korea, Republic of)

    2000-07-01

    To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or {sup 99m}Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of

  1. Healing arterial ulcers: Endothelial lining regeneration upon vascular denudation injury.

    Science.gov (United States)

    McDonald, Austin I; Iruela-Arispe, M Luisa

    2015-09-01

    Thrombosis and restenosis are the most prevalent late complications of coronary artery stenting. Current standards of clinical care focus on prevention of smooth muscle cell proliferation by the use of drug-eluting stents able to release anti-proliferative drugs. Unfortunately, these drugs also block endothelial cell proliferation and, in this manner, prevent recovery of endothelial cell coverage. Continued lack of endothelial repair leaves the root cause of thrombosis and restenosis unchanged, creating a vicious cycle where drug-mediated prevention of restenosis simultaneously implies promotion of thrombosis. In this issue of Vascular Pharmacology, Hussner and colleagues provide in vitro evidence and a mechanistic basis for the use of atorvastatin in stents as a way to bypass this roadblock. Here we review the pathological mechanisms and therapeutic approaches to restore flow in occluded arteries. We argue that rational design of drug eluting stents should focus on specific inhibition of smooth muscle cell proliferation with concurrent stimulation of endothelial regeneration. We comment on the current poor understanding of the cellular and molecular regulation of endothelial cell proliferation in the context of a functional artery, and on the pitfalls of extrapolating from the well-studied process of neovascularization by sprouting vessel formation.

  2. Spontaneous healing of cervical pseudoaneurysm in vertebral artery dissection under anticoagulant therapy

    International Nuclear Information System (INIS)

    We report a 41-year-old woman with embolic stroke of the mid-pons attributed to embolism from vertebral artery dissection. Angiography revealed an occluded artery on one side and an incidental pseudoaneurysm of the midcervical portion of the vertebral artery on the other. After 3 months of warfarin therapy control angiography showed complete occlusion of the pseudoaneurysm. We discuss therapeutic choices and review the literature. (orig.)

  3. Proximal tibial and fibular physeal fracture causing popliteal artery injury and peroneal nerve injury: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Uday Guled; Nirmal Raj Gopinathan; Vijay G.Goni; Arjun Rhh; Rakesh John; Prateek Behera

    2015-01-01

    Either proximal tibial or tibial physeal injuries are rare.The combination of both is even rarer,let alone causes a vascular injury.Early intervention is the key for management.We hereby present an interesting case of simultaneous proximal tibiofibular physeal injury with popliteal arterial occlusion and common peroneal nerve injury.The present case is important in two aspects:firstly it reports a very rare occurrence of simultaneous proximal tibiofibular physeal injury associated with vascular insult and common peroneal nerve injury;secondly it highlights that with timely intervention excellent results can be achieved in paediatric patients.

  4. Pulse-wave timing between the cervical carotid and intracranial arteries by means of wavelet transform

    NARCIS (Netherlands)

    Journee, HL; de Jonge, AB; Hamoen, DJ; Smit, A; van Bruggen, AC; Mooij, JJA; Boom, H; Robinson, C; Rutten, W; Neuman, M; Wijkstra, H

    1997-01-01

    Wavelet Transform (WT) is applied in a method for timing the blood pulse wave between the internal carotid artery: and one of the intracranial arteries. The required accuracy is a few milliseconds. In contrast to the Fourier Transform (FT), WT is an appropriate technique for the detection of non-sta

  5. Identifying Homogeneous Subgroups in Neurological Disorders: Unbiased Recursive Partitioning in Cervical Complete Spinal Cord Injury.

    Science.gov (United States)

    Tanadini, Lorenzo G; Steeves, John D; Hothorn, Torsten; Abel, Rainer; Maier, Doris; Schubert, Martin; Weidner, Norbert; Rupp, Rüdiger; Curt, Armin

    2014-07-01

    Background The reliable stratification of homogeneous subgroups and the prediction of future clinical outcomes within heterogeneous neurological disorders is a particularly challenging task. Nonetheless, it is essential for the implementation of targeted care and effective therapeutic interventions. Objective This study was designed to assess the value of a recently developed regression tool from the family of unbiased recursive partitioning methods in comparison to established statistical approaches (eg, linear and logistic regression) for predicting clinical endpoints and for prospective patients' stratification for clinical trials. Methods A retrospective, longitudinal analysis of prospectively collected neurological data from the European Multicenter study about Spinal Cord Injury (EMSCI) network was undertaken on C4-C6 cervical sensorimotor complete subjects. Predictors were based on a broad set of early (homogeneous subgroups. The partitioning is carried out in a data-driven manner, independently from a priori decisions or predefined thresholds. Conclusion Unbiased recursive partitioning techniques may improve prediction of future clinical endpoints and the planning of future SCI clinical trials by providing easily implementable, data-driven rationales for early patient stratification based on simple decision rules and clinical read-outs.

  6. One stage anterior-posterior approach for traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    WANG Chang-sheng; LIU Mou-jun; LIN Jian-hua; XU Wei-hong; LUO Hong-bin

    2011-01-01

    Objectives: To explore the clinical features of traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury (CSCI), and to analyze the feasibility, indication and therapeutic effects of anterior-posterior approach in such cases.Methods: From March 2004 to September 2009, 16cases with this trauma were admitted and surgically treated in our department. Before surgery, skull traction was performed. Posterior atlantoaxial pedicle screw internal fixation and bone graft fusion were conducted to manage traumatic atlantoaxial instability. As for subaxial CSCI, anterior cervical corpectomy or discectomy decompression, bone grafting and internal fixation with steel plates were applied.Results: All operations were successful. The average operation time was 3 hours and operative blood loss 400 ml. Satisfactory reduction of both the upper and lower cervical spine and complete decompression were achieved. All patients were followed up for 12 to 36 months. Their clinical symptoms were improved by various levels. The Japanese Orthopaedic Association (JOA) scores ranged from 10to 16 one year postoperatively, 13.95±2.06 on average (improvement rate= 70.10% ). X-rays, spiral CT and MRI confirmed normal cervical alignments, complete decompression and fine implants' position. There was no breakage or loosening of screws, nor exodus of titanium mesh or implanted bone blocks. The grafted bone achieved fusion 3-6 months postoperatively and no atlantoaxial instability was observed.Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal

  7. Delayed rupture of common carotid artery following rugby tackle injury: a case report

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    Abbas Saleh

    2008-03-01

    Full Text Available Abstract Background Common Carotid Artery (CCA is an uncommon site of injury following a blunt trauma, its presentation with spontaneous delayed rupture is even more uncommon and a rugby tackle leading to CCA injury is a rare event. What makes this case unique and very rare is combination of all of the above. Case presentation Mr H. presented to the Emergency Department with an expanding neck haematoma and shortness of breath. He was promptly intubated and had contrast CT angiography of neck vessels which localized the bleeding spot on posteromedial aspect of his Right CCA. He underwent emergency surgery with repair of the defect and made an uneventful recovery post operatively. Conclusion Delayed post traumatic rupture of the CCA is an uncommon yet potentially life threatening condition which can be caused by unusual blunt injury mechanism. A high index of suspicion and low threshold for investigating carotid injuries in the setting of blunt trauma is likely to be beneficial.

  8. Effects of transection of cervical sympathetic trunk on cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury

    Institute of Scientific and Technical Information of China (English)

    Liangzhi Xiong; Yongxia Shi; Feng Xiao; Qingxiu Wang

    2008-01-01

    BACKGROUND: Stellate ganglion block (SGB) plays a protective role on the brain, but the precise mechanism of action is not clear.OBJECTIVE: To simulate SGB by transection of the cervical sympathetic trunk (TCST) and to investigate the TCST effects on changes in cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury.DESIGN, TIME AND SETTING: A complete randomized control animal experiment was performed at the Institute of Neurological Diseases of Taihe Hospital, Yunyang Medical College from February to December 2005.MATERIALS: A total of 101 healthy Wistar rats, weighing 280-320g, of both genders, aged 17-18 weeks, were used in this study. 2,3,5-triphenyltetrazolium chloride (TTC) was purchased from Changsha Hongyuan Biological Company. Superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) assay kits were provided by Nanjing Jiancheng Bioengineering Institute.METHODS: Rats were randomly divided into a TCST group, a model group and a sham operation group. Successful models were included in the final analysis, with at least 20 rats in each group. After TCST, rat models of focal cerebral ischemia/reperfusion injury were established in the TCST group by receiving middle cerebral artery occlusion (MCAO) by the intraluminal suture method for 2 hours, followed by 24 hours of reperfusion. Rat models of focal cerebral ischemia/reperfusion injury were made in the model group. Rats in the sham operation group underwent experimental procedures as for the model group, threading depth of 10mm, and middle cerebral artery was not ligated.MAIN OUTCOME MEASURES: Brain tissue sections of ten rats from each group were used to measure cerebral infarct volume by TTC staining. Brain tissue homogenate of another ten rats from each group was used to detect SOD activities, MDA contents and NO levels. Rat neurological function was assessed by neurobehavioral measures.RESULTS: Cerebral infarct volume was bigger in the

  9. The Preliminary Study about the Relevance between Cervical Curvature and Vertebral Artery CTA of Cervical Spondylosis of Vertebral Artery Type%椎动脉型颈椎病颈椎曲度与椎动脉CTA相关性的初步研究

    Institute of Scientific and Technical Information of China (English)

    李中万; 潘锰; 黄曼妮

    2013-01-01

      目的:初步探求椎动脉型颈椎病颈椎曲度与椎动脉CTA的相关性.方法:选用2012年1月到6月我院13例椎动脉型颈椎病患者,其中男性3例,女性10例,年龄27~36岁,平均年龄为32.08岁,分别进行颈椎X线和椎动脉CTA检查.结果:颈椎曲度变直左侧CTA为2.04±0.41,右侧为2.01±0.33,颈椎曲度反弓左侧CTA为1.01±0.14,右侧为1.08±0.13,颈椎曲度正常左侧CTA为4.24±0.11,右侧为3.56±0.28;颈椎曲度异常,双侧椎动脉CTA与正常组存在显著的统计学差异,明显比正常椎动脉狭窄;7例颈椎曲度变直患者CTA进行相关性分析发现,曲度与左侧CTA的Pearson值为0.895,P<0.05,与右侧CTA的Pearson值为0.782,P<0.05,说明,当颈椎曲度变直后,曲度与椎动脉直径存在正相关性,曲度越小,椎动脉直径越小.结论:椎动脉型颈椎病颈椎曲度与椎动脉CTA存在相关性.%Objective:To preliminary study the relevance between cervical curvature and verte-bral artery CTA of cervical spondylosis of vertebral artery type. Methods:12 patients with cervical spondylosis of vertebral artery type were selected in hospital from January to lune 2012. 3 cases were male, and 10 cases were female. They were 27 to 36 years old, and the average age was 32.08. They all were checked up by the cervical X-ray and vertebral artery CTA. Results:Cervical curva-ture straightening at the left was 2.04±0.41, the right was 2.01±0.33; cervical curvature inverse arch-shaped at the left was 1.01±0.14, the right was 1.08±0.13;cervical curvature normal at the left was 4.24±0.11, the right was 3.56±0.28. It was significant statistical difference between abnormal and normal group about cervical curvature abnormal and bilateral vertebral artery CTA. It was obvi-ously narrower than the normal vertebral artery. 7 patients with cervical curvature straightening were conducted correlative Analysis, found that the Pearson of curvature and the left CTA was 0.895, P<0.05, the

  10. Intravenous Transplantation of Mesenchymal Progenitors Distribute Solely to the Lungs and Improve Outcomes in Cervical Spinal Cord Injury.

    Science.gov (United States)

    White, Seok Voon; Czisch, Chris E; Han, May H; Plant, Christine D; Harvey, Alan R; Plant, Giles W

    2016-07-01

    Cellular transplantation strategies utilizing intraspinal injection of mesenchymal progenitor cells (MPCs) have been reported as beneficial for spinal cord injuries. However, intraspinal injection is not only technically challenging, but requires invasive surgical procedures for patients. Therefore, we investigated the feasibility and potential benefits of noninvasive intravenous injection of MPCs in two models of cervical spinal cord injury, unilateral C5 contusion and complete unilateral C5 hemisection. MPCs isolated from green fluorescence protein (GFP)-luciferase transgenic mice compact bone (1 × 10(6) cells), or vehicle Hank's Buffered Saline Solution (HBSS), were intravenously injected via the tail vein at D1, D3, D7, D10, or D14. Transplanted MPCs were tracked via bioluminescence imaging. Live in vivo imaging data showed that intravenously injected MPCs accumulate in the lungs, confirmed by postmortem bioluminescence signal-irrespective of the time of injection or injury model. The results showed a rapid, positive modulation of the inflammatory response providing protection to the injured spinal cord tissue. Histological processing of the lungs showed GFP(+) cells evenly distributed around the alveoli. We propose that injected cells can act as cellular target decoys to an immune system primed by injury, thereby lessening the inflammatory response at the injury site. We also propose that intravenous injected MPCs modulate the immune system via the lungs through secreted immune mediators or contact interaction with peripheral organs. In conclusion, the timing of intravenous injection of MPCs is key to the success for improving function and tissue preservation following cervical spinal cord injury. Stem Cells 2016;34:1812-1825. PMID:26989838

  11. Effects of rosiglitazone on contralateral iliac artery after vascular injury in hypercholesterolemic rabbits

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    Baroncini Liz

    2008-05-01

    Full Text Available Abstract Background The objective was to evaluate the effects of rosiglitazone on iliac arteries of hypercholesterolemic rabbits undergoing balloon catheter injury in the contralateral iliac arteries. Methods White male rabbits were fed a hypercholesterolemic diet for 6 weeks and divided into two groups as follows: rosiglitazone group, 14 rabbits treated with rosiglitazone (3 mg/Kg body weight/day during 6 weeks; and control group, 18 rabbits without rosiglitazone treatment. All animals underwent balloon catheter injury of the right iliac artery on the fourteenth day of the experiment. Results There was no significant difference in intima/media layer area ratio between the control group and the rosiglitazone group. Rosiglitazone did not reduce the probability of lesions types I, II, or III (72.73% vs. 92.31%; p = 0.30 and types IV or V (27.27% vs. 7.69%; p = 0.30. There were no differences in the extent of collagen type I and III deposition or in the percentage of animals with macrophages in the intima layer. The percentage of rabbits with smooth muscle cells in the intima layer was higher in rosiglitazone group (p = 0.011. Conclusion These findings demonstrate that rosiglitazone given for 6 weeks did not prevent atherogenesis at a vessel distant from the injury site.

  12. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Makino, Masahiro [Kyoto Prefectural Univ. of Medicine (Japan). Research Inst. for Neurological Diseases and Geriatrics

    2001-12-01

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9{+-}9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with {>=}50% luminal narrowing was detected in 29.2% of the subjects, and that with {>=}75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing {>=}50% luminal narrowing was detected in 38.2% of subjects, and that showing {>=}75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid

  13. Risk factors for cervical carotid and intracranial cerebrovascular lesions in patients undergoing coronary artery bypass grafting. Preoperative evaluation using magnetic resonance imaging and angiography

    International Nuclear Information System (INIS)

    Recently neurologic complications after coronary artery bypass grafting (CABG) have received increasing attention. There is no detailed report about the risk factors for these complications, although stenosis in the cervical and intracranial arteries, especially in Japanese patients, latent ischemic brain lesions and preoperative neurological conditions are related to these events. In this prospective study, we evaluated occlusive lesions in the cervical carotid and intracranial arteries, silent brain infarction and cerebral deep white matter lesion with MRA and MRI in patients scheduled to undergo CABG to determine the prevalence of occlusive diseases in cervical carotid and intracranial arteries, latent ischemic change in the brain in this population and to identify preoperative risk factors for these patients. The subjects were 144 consecutive patients (103 men and 41 women, mean age 65.9±9.2 years old) who were scheduled for CABG under elective conditions and who were examined by the same MRI apparatus using the same protocol between November 1998 and March 2001. After routine neurological examination and Mini-Mental State Examination (MMSE) were completed, MRI and MRA were obtained, then the prevalence of abnormalities on MRI and MRA studies and risk factors were evaluated. Cervical carotid artery stenosis with ≥50% luminal narrowing was detected in 29.2% of the subjects, and that with ≥75% luminal narrowing was detected in 16.0% of the subjects. Intracranial arterial stenosis showing ≥50% luminal narrowing was detected in 38.2% of subjects, and that showing ≥75% luminal narrowing was detected in 19.4% of subjects. Brain infarction was observed in 74.3% of subjects, cerebral deep white matter lesion showing grade 2 or higher on Fazekas classification was observed in 17.4% of the subjects. The characteristics, including possible risk factors of subjects with and without these abnormal findings, were compared. Patients with cervical carotid lesions were

  14. Cervical Spine Instrumentation in Children.

    Science.gov (United States)

    Hedequist, Daniel J; Emans, John B

    2016-06-01

    Instrumentation of the cervical spine enhances stability and improves arthrodesis rates in children undergoing surgery for deformity or instability. Various morphologic and clinical studies have been conducted in children, confirming the feasibility of anterior or posterior instrumentation of the cervical spine with modern implants. Knowledge of the relevant spine anatomy and preoperative imaging studies can aid the clinician in understanding the pitfalls of instrumentation for each patient. Preoperative planning, intraoperative positioning, and adherence to strict surgical techniques are required given the small size of children. Instrumentation options include anterior plating, occipital plating, and a variety of posterior screw techniques. Complications related to screw malposition include injury to the vertebral artery, neurologic injury, and instrumentation failure. PMID:27097300

  15. Time course of arterial remodelling in diameter and wall thickness above and below the lesion after a spinal cord injury

    NARCIS (Netherlands)

    Thijssen, D.H.J.; Groot, P.C. de; Bogerd, A. van den; Veltmeijer, M.; Cable, N.T.; Green, D.J.; Hopman, M.T.E.

    2012-01-01

    Physical inactivity in response to a spinal cord injury (SCI) represents a potent stimulus for conduit artery remodelling. Changes in conduit artery characteristics may be induced by the local effects of denervation (and consequent extreme inactivity below the level of the lesion), and also by syste

  16. Time course of arterial remodelling in diameter and wall thickness above and below the lesion after a spinal cord injury

    OpenAIRE

    Dick H J Thijssen; de Groot, Patricia C. E.; van den Bogerd, Arne; Veltmeijer, Matthijs; Cable, N. Timothy; Green, Daniel J.; Hopman, Maria T. E.

    2012-01-01

    Physical inactivity in response to a spinal cord injury (SCI) represents a potent stimulus for conduit artery remodelling. Changes in conduit artery characteristics may be induced by the local effects of denervation (and consequent extreme inactivity below the level of the lesion), and also by systemic adaptations due to whole body inactivity. Therefore, we assessed the time course of carotid (i.e. above lesion) and common femoral artery (i.e. below lesion) lumen diameter and wall thickness a...

  17. Traumatic extremity arterial injury in children: Epidemiology, diagnostics, treatment and prognostic value of Mangled Extremity Severity Score

    Directory of Open Access Journals (Sweden)

    Lange Nadine

    2010-04-01

    Full Text Available Abstract Background Traumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present study was to investigate their epidemiology, diagnostic and therapeutic options and complications. Furthermore, the prognostic value of the Mangled Extremity Severity Score (MESS was evaluated. Methods In a retrospective clinical study 44 children aged 9.0 ± 3.2 years treated for traumatic extremity arterial lesions in our Level I trauma center between 1971 and 2006 were enrolled. Exclusion criteria were age > 14, venous and iatrogenic vascular injury. Demographic data, mechanism of injury, severity of arterial lesions (by Vollmar and MESS, diagnostic and therapeutic management, complications and outcome were evaluated. Results The most commonly injured vessel was the femoral artery (25% followed by the brachial artery (22.7%. The mechanism of injury was penetrating (31.8%, isolated severe blunt extremity trauma (29.6%, multiple trauma (25% and humeral supracondylar fractures (13.6%. In 63.6% no specific vascular diagnostic procedure was performed in favour of emergency surgery. Surgical reconstructive strategies were preferred (68.2%. A MESS Conclusions Traumatic paediatric vascular injuries are very rare. The most common situations of vascular lesions in childhood were penetrating injuries and fractures of the extremities either as isolated injuries or in multiply injured patients. In paediatric patients, the MESS could serve as a basis for decision making for limb salvage or amputation.

  18. Illness experience of adults with cervical spinal cord injury in Japan: a qualitative investigation

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    Ide-Okochi Ayako

    2013-01-01

    Full Text Available Abstract Background There is growing recognition that healthcare policy should be guided by the illness experience from a layperson’s or insider’s perspective. One such area for exploration would include patient-centered research on traumatic Spinal Cord Injury (SCI, a condition associated with permanent physical disability requiring long-term and often complex health care. The chronicity of SCI can, in turn, affect individuals’ sense of self. Although previous research in Western countries suggests that people with SCI find a way to cope with their disability through social participation and family bonds, the process of adjustment among people with cervical SCI (CSCI living in Japan may be different because of the restrained conditions of their social participation and the excessive burden on family caregivers. The purpose of this study was to examine the impact of injury and the process of accommodation in people with CSCI in Japan. Methods Semi-structured home interviews were conducted with 29 participants who were recruited from a home-visit nursing care provider and three self-help groups. Interviews were recorded, transcribed and analyzed based on the grounded theory approach. Results Five core categories emerged from the interview data: being at a loss, discrediting self by self and others, taking time in performance, restoring competency, and transcending limitations of disability. Overall, the process by which participants adjusted to and found positive meaning in their lives involved a continuous search for comfortable relationships between self, disability and society. Conclusions The results of this study suggest that persons with CSCI do not merely have disrupted lives, but find positive meaning through meaningful interactions. Family members added to the discredit of self by making the injured person entirely dependent on them. Gaining independence from family members was the key to restoring competency in people with CSCI

  19. Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock

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    L.L. Li

    2014-05-01

    Full Text Available The intestinal lymph pathway plays an important role in the pathogenesis of organ injury following superior mesenteric artery occlusion (SMAO shock. We hypothesized that mesenteric lymph reperfusion (MLR is a major cause of spleen injury after SMAO shock. To test this hypothesis, SMAO shock was induced in Wistar rats by clamping the superior mesenteric artery (SMA for 1 h, followed by reperfusion for 2 h. Similarly, MLR was performed by clamping the mesenteric lymph duct (MLD for 1 h, followed by reperfusion for 2 h. In the MLR+SMAO group rats, both the SMA and MLD were clamped and then released for reperfusion for 2 h. SMAO shock alone elicited: 1 splenic structure injury, 2 increased levels of malondialdehyde, nitric oxide (NO, intercellular adhesion molecule-1, endotoxin, lipopolysaccharide receptor (CD14, lipopolysaccharide-binding protein, and tumor necrosis factor-α, 3 enhanced activities of NO synthase and myeloperoxidase, and 4 decreased activities of superoxide dismutase and ATPase. MLR following SMAO shock further aggravated these deleterious effects. We conclude that MLR exacerbates spleen injury caused by SMAO shock, which itself is associated with oxidative stress, excessive release of NO, recruitment of polymorphonuclear neutrophils, endotoxin translocation, and enhanced inflammatory responses.

  20. Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock

    Energy Technology Data Exchange (ETDEWEB)

    Li, L.L.; Zhang, C.H.; Liu, J.C.; Yang, L.N.; Niu, C.Y.; Zhao, Z.G. [Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei, China, Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei (China)

    2014-04-15

    The intestinal lymph pathway plays an important role in the pathogenesis of organ injury following superior mesenteric artery occlusion (SMAO) shock. We hypothesized that mesenteric lymph reperfusion (MLR) is a major cause of spleen injury after SMAO shock. To test this hypothesis, SMAO shock was induced in Wistar rats by clamping the superior mesenteric artery (SMA) for 1 h, followed by reperfusion for 2 h. Similarly, MLR was performed by clamping the mesenteric lymph duct (MLD) for 1 h, followed by reperfusion for 2 h. In the MLR+SMAO group rats, both the SMA and MLD were clamped and then released for reperfusion for 2 h. SMAO shock alone elicited: 1) splenic structure injury, 2) increased levels of malondialdehyde, nitric oxide (NO), intercellular adhesion molecule-1, endotoxin, lipopolysaccharide receptor (CD14), lipopolysaccharide-binding protein, and tumor necrosis factor-α, 3) enhanced activities of NO synthase and myeloperoxidase, and 4) decreased activities of superoxide dismutase and ATPase. MLR following SMAO shock further aggravated these deleterious effects. We conclude that MLR exacerbates spleen injury caused by SMAO shock, which itself is associated with oxidative stress, excessive release of NO, recruitment of polymorphonuclear neutrophils, endotoxin translocation, and enhanced inflammatory responses.

  1. Methodological systematic review: mortality in elderly patients with cervical spine injury: a critical appraisal of the reporting of baseline characteristics, follow-up, cause of death, and analysis of risk factors.

    NARCIS (Netherlands)

    Middendorp, J.J. van; Albert, T.J.; Veth, R.P.H.; Hosman, A.J.F.

    2010-01-01

    STUDY DESIGN: Methodologic systematic review. OBJECTIVE: To determine the validity of reported risk factors for mortality in elderly patients with cervical spine injury. SUMMARY OF BACKGROUND DATA: In elderly patients with cervical spine injury, mortality has frequently been associated with the type

  2. Systemic bisperoxovanadium activates Akt/mTOR, reduces autophagy, and enhances recovery following cervical spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Chandler L Walker

    Full Text Available Secondary damage following primary spinal cord injury extends pathology beyond the site of initial trauma, and effective management is imperative for maximizing anatomical and functional recovery. Bisperoxovanadium compounds have proven neuroprotective effects in several central nervous system injury/disease models, however, no mechanism has been linked to such neuroprotection from bisperoxovanadium treatment following spinal trauma. The goal of this study was to assess acute bisperoxovanadium treatment effects on neuroprotection and functional recovery following cervical unilateral contusive spinal cord injury, and investigate a potential mechanism of the compound's action. Two experimental groups of rats were established to 1 assess twice-daily 7 day treatment of the compound, potassium bisperoxo (picolinato vanadium, on long-term recovery of skilled forelimb activity using a novel food manipulation test, and neuroprotection 6 weeks following injury and 2 elucidate an acute mechanistic link for the action of the drug post-injury. Immunofluorescence and Western blotting were performed to assess cellular signaling 1 day following SCI, and histochemistry and forelimb functional analysis were utilized to assess neuroprotection and recovery 6 weeks after injury. Bisperoxovanadium promoted significant neuroprotection through reduced motorneuron death, increased tissue sparing, and minimized cavity formation in rats. Enhanced forelimb functional ability during a treat-eating assessment was also observed. Additionally, bisperoxovanadium significantly enhanced downstream Akt and mammalian target of rapamycin signaling and reduced autophagic activity, suggesting inhibition of the phosphatase and tensin homologue deleted on chromosome ten as a potential mechanism of bisperoxovanadium action following traumatic spinal cord injury. Overall, this study demonstrates the efficacy of a clinically applicable pharmacological therapy for rapid initiation of

  3. Coronary arterial BK channel dysfunction exacerbates ischemia/reperfusion-induced myocardial injury in diabetic mice.

    Science.gov (United States)

    Lu, Tong; Jiang, Bin; Wang, Xiao-Li; Lee, Hon-Chi

    2016-09-01

    The large conductance Ca(2+)-activated K(+) (BK) channels, abundantly expressed in coronary artery smooth muscle cells (SMCs), play a pivotal role in regulating coronary circulation. A large body of evidence indicates that coronary arterial BK channel function is diminished in both type 1 and type 2 diabetes. However, the consequence of coronary BK channel dysfunction in diabetes is not clear. We hypothesized that impaired coronary BK channel function exacerbates myocardial ischemia/reperfusion (I/R) injury in streptozotocin-induced diabetic mice. Combining patch-clamp techniques and cellular biological approaches, we found that diabetes facilitated the colocalization of angiotensin II (Ang II) type 1 receptors and BK channel α-subunits (BK-α), but not BK channel β1-subunits (BK-β1), in the caveolae of coronary SMCs. This caveolar compartmentation in vascular SMCs not only enhanced Ang II-mediated inhibition of BK-α but also produced a physical disassociation between BK-α and BK-β1, leading to increased infarct size in diabetic hearts. Most importantly, genetic ablation of caveolae integrity or pharmacological activation of coronary BK channels protected the cardiac function of diabetic mice from experimental I/R injury in both in vivo and ex vivo preparations. Our results demonstrate a vascular ionic mechanism underlying the poor outcome of myocardial injury in diabetes. Hence, activation of coronary BK channels may serve as a therapeutic target for cardiovascular complications of diabetes. PMID:27574914

  4. Morphology of Donor and Recipient Nerves Utilised in Nerve Transfers to Restore Upper Limb Function in Cervical Spinal Cord Injury

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    Aurora Messina

    2016-09-01

    Full Text Available Loss of hand function after cervical spinal cord injury (SCI impacts heavily on independence. Multiple nerve transfer surgery has been applied successfully after cervical SCI to restore critical arm and hand functions, and the outcome depends on nerve integrity. Nerve integrity is assessed indirectly using muscle strength testing and intramuscular electromyography, but these measures cannot show the manifestation that SCI has on the peripheral nerves. We directly assessed the morphology of nerves biopsied at the time of surgery, from three patients within 18 months post injury. Our objective was to document their morphologic features. Donor nerves included teres minor, posterior axillary, brachialis, extensor carpi radialis brevis and supinator. Recipient nerves included triceps, posterior interosseus (PIN and anterior interosseus nerves (AIN. They were fixed in glutaraldehyde, processed and embedded in Araldite Epon for light microscopy. Eighty percent of nerves showed abnormalities. Most common were myelin thickening and folding, demyelination, inflammation and a reduction of large myelinated axon density. Others were a thickened perineurium, oedematous endoneurium and Renaut bodies. Significantly, very thinly myelinated axons and groups of unmyelinated axons were observed indicating regenerative efforts. Abnormalities exist in both donor and recipient nerves and they differ in appearance and aetiology. The abnormalities observed may be preventable or reversible.

  5. A Study of the Relationship between Syncope Attacks and Diminished Carotid and Vertebral Artery Flow Using Doppler Ultrasonography of Cervical Vessels

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    V Shaygan Nejad

    2005-03-01

    Full Text Available Background:Syncope or drop attack is a common and potentially serious condition and prompt evaluation of the affected patients should be evaluated prompting for cardiac disease, seizure, structural lesions of the brain or peripheral nerves, as well as drug induced and metabolic disturbances. This study was conducted to evaluate carotid and vertebral arteries blood flow in patients with syncope in which other etiologies had been ruled out. Methods: This one-year retrospective case-control study involved 33 patients (case group and 33 normal individuals (control group. Carotid and vertebral arteries blood flow was measured in all subjects (ml/min and SPSS was used for data analysis. Results: Mean blood flow in vertebral arteries in the case group was significantly lower than in the control group (P<0.001, however mean carotid artery flow was not significantly different between them (P=0.58. Conclusion: Based on our results and findings of some other studies, we recommend duplex ultrasonography of vertebral and cervical arteries in patients suffering from drop attacks, after ruling out the prominent etiologies, such as seizure, heart disease, etc. Keywords: syncope, ultrasound, carotid artery, vertebral artery

  6. Popliteal artery injuries in an urban trauma center with a rural catchment area: do delays in definitive treatment affect amputation?

    Science.gov (United States)

    Simmons, Jon D; Gunter, Joseph W; Schmieg, Robert E; Manley, Justin D; Rushton, Fred W; Porter, John M; Mitchell, Marc E

    2011-11-01

    Extended length of time from injury to definitive vascular repair is considered to be a predictor of amputation in patients with popliteal artery injuries. In an urban trauma center with a rural catchment area, logistical issues frequently result in treatment delays, which may affect limb salvage after vascular trauma. We examined how known risk factors for amputation after popliteal trauma are affected in a more rural environment, where patients often experience delays in definitive surgical treatment. All adult patients admitted to the Level I trauma center, the University of Mississippi Medical Center, with a popliteal artery injury between January 2000 and December of 2007 were identified. Demographic information management and outcome data were collected. Body mass index, mangled extremity severity score (MESS), Guistilo open fracture score, injury severity score, and time from injury to vascular repair were examined. Fifty-one patients with popliteal artery injuries (53% blunt and 47% penetrating) were identified, all undergoing operative repair. There were nine amputations (17.6%) and one death. Patients requiring amputation had a higher MESS, 7.8 versus 5.3 (P amputation rate compared with those with penetrating trauma, 25.9 per cent versus 8.3 per cent (P = non significant). MESS, though not perfect, is the best predictor of amputation in patients with popliteal artery injuries. Morbid obesity is not a significant predictor for amputation in patients with popliteal artery injuries. Time from injury to repair of greater than 6 hours was not predictive of amputation. This study further demonstrates that a single scoring system should be used with caution when determining the need for lower extremity amputation.

  7. Role of the p21 Cyclin-Dependent Kinase Inhibitor in Limiting Intimal Cell Proliferation in Response to Arterial Injury

    Science.gov (United States)

    Yang, Zhi-Yong; Simari, Robert D.; Perkins, Neil D.; San, Hong; Gordon, David; Nabel, Gary J.; Nabel, Elizabeth G.

    1996-07-01

    Arterial injury induces a series of proliferative, vasoactive, and inflammatory responses that lead to vascular proliferative diseases, including atherosclerosis and restenosis. Although several factors have been defined which stimulate this process in vivo, the role of specific cellular gene products in limiting this response is not well understood. The p21 cyclin-dependent kinase inhibitor affects cell cycle progression, senescence, and differentiation in transformed cells, but its expression in injured blood vessels has not been investigated. In this study, we report that p21 protein is induced in porcine arteries following balloon catheter injury and suggest that p21 is likely to play a role in limiting arterial cell proliferation in vivo. Vascular endothelial and smooth muscle cell growth was arrested through the ability of p21 to inhibit progression through the G1 phase of the cell cycle. Following injury to porcine arteries, p21 gene product was detected in the neointima and correlated inversely with the location and kinetics of intimal cell proliferation. Direct gene transfer of p21 using an adenoviral vector into balloon injured porcine arteries inhibited the development of intimal hyperplasia. Taken together, these findings suggest that p21, and possibly related cyclin-dependent kinase inhibitors, may normally regulate cellular proliferation following arterial injury, and strategies to increase its expression may prove therapeutically beneficial in vascular diseases.

  8. Intraoperative radial nerve injury during coronary artery surgery – report of two cases

    Directory of Open Access Journals (Sweden)

    Tsivgoulis Georgios

    2006-12-01

    Full Text Available Abstract Background Peripheral nerve injury and brachial plexopathy are known, though rare complications of coronary artery surgery. The ulnar nerve is most frequently affected, whereas radial nerve lesions are much less common accounting for only 3% of such intraoperative injuries. Case presentations Two 52- and 50-year-old men underwent coronary artery surgery. On the first postoperative day they both complained of wrist drop on the left. Neurological examination revealed a paresis of the wrist and finger extensor muscles (0/5, and the brachioradialis (4/5 with hypoaesthesia on the radial aspect of the dorsum of the left hand. Both biceps and triceps reflexes were normoactive, whereas the brachioradialis reflex was diminished on the left. Muscles innervated from the median and ulnar nerve, as well as all muscles above the elbow were unaffected. Electrophysiological studies were performed 3 weeks later, when muscle power of the affected muscles had already begun to improve. Nerve conduction studies and needle electromyography revealed a partial conduction block of the radial nerve along the spiral groove, motor axonal loss distal to the site of the lesion and moderate impairment in recruitment with fibrillation potentials in radial innervated muscles below the elbow and normal findings in triceps and deltoid. Electrophysiology data pointed towards a radial nerve injury in the spiral groove. We assume external compression as the causative factor. The only apparatus attached to the patients' left upper arm was the sternal retractor, used for dissection of the internal mammary artery. Both patients were overweight and lying on the operating table for a considerable time might have caused the compression of their left upper arm on the self retractor's supporting column which was fixed to the table rail 5 cm above the left elbow joint, in the site where the radial nerve is directly apposed to the humerus. Conclusion Although very uncommon, external

  9. Conditional expression of the type 2 angiotensin II receptor in mesenchymal stem cells inhibits neointimal formation after arterial injury.

    Science.gov (United States)

    Feng, Jian; Liu, Jian-Ping; Miao, Li; He, Guo-Xiang; Li, De; Wang, Hai-Dong; Jing, Tao

    2014-10-01

    Percutaneous coronary interventions (PCIs) are an effective treatment for obstructive coronary artery diseases. However, the procedure's success is limited by remodeling and formation of neointima. In the present study, we engineered rat mesenchymal stem cells (MSCs) to express type 2 angiotensin II receptor (AT2R) using a tetracycline-regulated system that can strictly regulate AT2R expression. We tested the ability of the modified MSCs to reduce neointima formation following arterial injury. We subjected rats to balloon injury, and reverse transcriptase polymerase chain reaction (RT-PCR) indicated no significant AT2R expression in normal rat arteries. Low expression of AT2R was observed at 28 days after balloon-induced injury. Interestingly, MSCs alone were unable to reduce neointimal hyperplasia after balloon-induced injury; after transplantation of modified MSCs, doxycycline treatment significantly upregulated neointimal AT2R expression and inhibited osteopontin mRNA expression, as well as neointimal formation. Taken together, these results suggest that transplantation of MSCs conditionally expressing AT2R could effectively suppress neointimal hyperplasia following balloon-induced injury. Therefore, MSCs with a doxycycline-controlled gene induction system may be useful for the management of arterial injury after PCI. PMID:25119854

  10. Early Treatment of Cervical Spinal Cord Injury%颈脊髓损伤的早期处理

    Institute of Scientific and Technical Information of China (English)

    卢林俊; 刘建平; 张特

    2011-01-01

    目的:探讨临床对颈脊髓损伤的早期处理方法及原则.方法:随机选取来我院进行治疗的颈脊髓损伤患者86例,根据患者的适应情况分别行外固定术、药物治疗、高压氧、颅骨牵引、手术等治疗,并对其评价并发症和预后恢复情况.结果:经随访观察,86例病例中,住院期间死亡7例(8.1%),其中4例死于颈脊髓损伤并发症,3例死于脑出血、休克等其他合并伤;65例均获得随访,5例死于脊髓损伤后期并发症;Frank分级14例,6例神经功能有1-2级改善,8例无明显改善.结论:对脊髓损伤患者进行正确规范的早期处理及院前救治可相应减少死亡发生的几率,对患者的预后有重要的临床意义.%Objective: To explore the early stage of cervical spinal cord injury treatment and principles. Methods: A randomly selected to our hospital for treatment of 86 cases of cervical spinal cord injury patients, according to the adaptation of patients with external fixation were performed, drug therapy, hyperbaric oxygen, skull traction, surgery and other treatment, and recovery of its evaluation and prognosis of complications situation. Results: The follow-up observation, 86 cases in 7 patients died during hospitalization (8. 1%),of which 4 died of complications of spinal cord injury, 3 patients died of cerebral hemorrhage, shock and other associated injuries; 65 patients were followed up,5 patients died of late complications of spinal cord injury; Frank classification in 14 cases,6 cases of grade (1~2) to improve neurological function, 8 patients without significant improvement. Conclusion:The correct specification of spinal cord injury patients with early treatment and pre-hospital treatment may be a corresponding reduction in risk of death occurred, the prognosis of patients has important clinical significance.

  11. Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury An explorative study

    NARCIS (Netherlands)

    Kloosterman, Marieke G. M.; Snoek, Govert J.; Kouwenhoven, Mirjam; Nene, Anand V.; Jannink, Michiel J. A.

    2010-01-01

    Many interventions in upper-limb rehabilitation after cervical spinal cord injury (CSCI) use arm support (gravity compensation), however, its specific effects on kinematics and muscle activation characteristics in subjects with a CSCI are largely unknown We conducted a cross-sectional explorative st

  12. Operative strategy of complex internal carotid artery-posterior communicating artery aneurysms Defensive effect on perioperative nerve injury

    Institute of Scientific and Technical Information of China (English)

    Xinmin Wang; Wende Xiong; Xuqin Li

    2007-01-01

    BACKGROUND: The two problems in treating intracranial aneurysm are the vascular reconstruction and brain protection, especially for complex internal carotid artery-posterior communicating artery (ICA-PComA)aneurysms.OBJECTIVE: To analyze the anatomic features and operative technique of complex ICA-PComA aneurysms, and investigate how to better protect the brain tissue.DESIGN: A retrospective case analysis.SETTING: Department ofNeurosurgery, Dalian Central Hospital.PARTICIPANTS: Totally 154 inpatients with ICA-PComA aneurysms were selected from the Department of Neurosurgery, Dalian Central Hospital from January 1998 to December 2006, including 19 cases (12.3%)of complex ICA-PComA aneurysms, 8 males and 11 females, 38 - 67 years of age. Informed contents for surgery and observation were obtained from all the patients or their relatives.METHODS: The clinical manifestations, including initial symptoms and Hunt&Hess grading, were observed. Corresponding strategies were selected for different types of ICA-PComA aneurysms. The patients were followed up at 3 months postoperatively. According to the results of Glasgow scoring, the curative effects were classified as good (4 - 5 points), bad (2 - 3 points) and dead (1 point). The results at discharge were taken as early results, whereas the follow-up results as late results.MAIN OUTCOME MEASURES: Clinical manifestations and curative effects of the patients.RESULTS: All the 19 patients with ICA-PComA were involved in the analysis of results. For clinical manifestations, the initial symptoms were subarachnoid hemorrhage (n =15), paralysis of oculomotor nerve (n =3), and occasional attack (n =1); The Hunt&Hess grading was grade Ⅰ in 4 cases, grade Ⅱ in 6 cases,grade Ⅲ in 6 cases, grade Ⅳ in 2 cases, and grade Ⅴ in 1 case. The curative effects were that aneurysm breakage and bleeding occurred in 6 cases perioperatively, uncomplete clipping of aneurysm in 2 cases and constriction of parent artery in 1 case. The

  13. PUVB-mediated prevention of luminal narrowing after arterial wall injury: modulation of mechanical arterial properties as a putative mechanism of action

    Science.gov (United States)

    Perree, Jop; Kerindongo, Raphaela P.; van Leeuwen, Ton G. J. M.

    2001-10-01

    In a previous study we have found that the photodynamic modality PUVB (8-methoxy-Psoralen + UVB) reduces luminal narrowing after arterial endovascular injury. We hypothesized that PUVB may modulate the arterial mechanical properties and tested this hypothesis by measuring the stress as a function of the strain in segments of carotid artery. Furthermore, we have investigated the potential for PUVB-induced cross-linking of extracellular matrix proteins by gel electrophoresis. It was found that both techniques were suitable for testing our hypotheses as evidenced by a statistically significant difference for the positive control. However, no differences between A) control, B) sensitizer only, C) light only and D) PUVB-treated samples could be found with respect to macro- and micro-mechanical properties. Therefore, the hypothesis that PUVB mediates its luminal narrowing reduction effect by directly changing the arterial mechanical properties should be rejected.

  14. Smooth Muscle Specific Overexpression of p22phox Potentiates Carotid Artery Wall Thickening in Response to Injury

    Directory of Open Access Journals (Sweden)

    Michael R. Manogue

    2015-01-01

    Full Text Available We hypothesized that transgenic mice overexpressing the p22phox subunit of the NADPH oxidase selectively in smooth muscle (Tgp22smc would exhibit an exacerbated response to transluminal carotid injury compared to wild-type mice. To examine the role of reactive oxygen species (ROS as a mediator of vascular injury, the injury response was quantified by measuring wall thickness (WT and cross-sectional wall area (CSWA of the injured and noninjured arteries in both Tgp22smc and wild-type animals at days 3, 7, and 14 after injury. Akt, p38 MAPK, and Src activation were evaluated at the same time points using Western blotting. WT and CSWA following injury were significantly greater in Tgp22smc mice at both 7 and 14 days after injury while noninjured contralateral carotids were similar between groups. Apocynin treatment attenuated the injury response in both groups and rendered the response similar between Tgp22smc mice and wild-type mice. Following injury, carotid arteries from Tgp22smc mice demonstrated elevated activation of Akt at day 3, while p38 MAPK and Src activation was elevated at day 7 compared to wild-type mice. Both increased activation and temporal regulation of these signaling pathways may contribute to enhanced vascular growth in response to injury in this transgenic model of elevated vascular ROS.

  15. Vancomycin treatment and butyrate supplementation modulate gut microbe composition and severity of neointimal hyperplasia after arterial injury

    OpenAIRE

    Ho, Karen J.; Xiong, Liqun; Hubert, Nathaniel J.; Nadimpalli, Anuradha; Wun, Kelly; Chang, Eugene B; Kibbe, Melina R.

    2015-01-01

    Abstract Gut microbial metabolites are increasingly recognized as determinants of health and disease. However, whether host–microbe crosstalk influences peripheral arteries is not understood. Neointimal hyperplasia, a proliferative and inflammatory response to arterial injury, frequently limits the long‐term benefits of cardiovascular interventions such as angioplasty, stenting, and bypass surgery. Our goal is to assess the effect of butyrate, one of the principal short chain fatty acids prod...

  16. Endothelial Injury Associated with Cold or Warm Blood Cardioplegia during Coronary Artery Bypass Graft Surgery

    Directory of Open Access Journals (Sweden)

    Elmar W. Kuhn

    2015-01-01

    Full Text Available The aim of this investigation was to analyze the impact of intermittent cold blood cardioplegia (ICC and intermittent warm blood cardioplegia (IWC on endothelial injury in patients referred to elective on-pump coronary artery bypass graft (CABG surgery. Patients undergoing CABG procedures were randomized to either ICC or IWC. Myocardial injury was assessed by CK-MB and cardiac troponin T (cTnT. Endothelial injury was quantified by circulating endothelial cells (CECs, von Willebrand factor (vWF, and soluble thrombomodulin (sTM. Perioperative myocardial injury (PMI and major adverse cardiac events (MACE were recorded. Demographic data and preoperative risk profile of included patients (ICC: n=32, IWC: n=36 were comparable. No deaths, PMI, or MACE were observed. Levels of CK-MB and cTnT did not show intergroup differences. Concentrations of CECs peaked at 6 h postoperatively with significantly higher values for IWC-patients at 1 h (ICC: 10.1 ± 3.9/mL; IWC: 18.4 ± 4.1/mL; P=0.012 and 6 h (ICC: 19.3 ± 6.2/mL; IWC: 29.2 ± 6.7/mL; P<0.001. Concentrations of vWF (ICC: 178.4 ± 73.2 U/dL; IWC: 258.2 ± 89.7 U/dL; P<0.001 and sTM (ICC: 3.2 ± 2.1 ng/mL; IWC: 5.2 ± 2.4 ng/mL; P=0.011 were significantly elevated in IWC-group at 1 h postoperatively. This study shows that the use of IWC is associated with a higher extent of endothelial injury compared to ICC without differences in clinical endpoints.

  17. Femoral artery neointimal hyperplasia is reduced after wire injury in Ref-1+/- mice.

    Science.gov (United States)

    Basi, David L; Adhikari, Neeta; Mariash, Ami; Li, Qinglu; Kao, Esther; Mullegama, Sureni V; Hall, Jennifer L

    2007-01-01

    Redox factor-1 (Ref-1) is a multifunctional protein that regulates redox, DNA repair, and the response to cell stress. We previously demonstrated that Ref-1(+/-) mice exhibit a significantly reduced Ref-1 mRNA and protein levels within the vasculature, which are associated with increased oxidative stress. The goal of this study was to test the hypothesis that partial loss of Ref-1 altered the cellular response to vascular injury. Fourteen days after femoral artery wire injury, we found that vessel intima-to-media ratio was significantly reduced in Ref-1(+/-) mice compared with that in wild-type mice (P Ref-1(+/-) mice. In vitro studies found no significant changes in either serum-induced proliferation or baseline apoptosis in Ref-1(+/-) vascular smooth muscle cells. Exposure to Fas ligand; however, did result in increased susceptibility of Ref-1(+/-) vascular smooth muscle cells to apoptosis (P Ref-1(+/-) mice exhibited an increase in circulating baseline levels of IL-10, IL-1alpha, and VEGF compared with those in wild-type mice but a marked impairment in these pathways in response to injury. In sum, loss of a single allele of Ref-1 is sufficient to reduce intimal lesion formation and to alter circulating cytokine and growth factor expression.

  18. Spontaneous Bilateral Cervical Internal Carotid and Vertebral Artery Dissection in a Japanese Patient without Collagen Vascular Disease with Special Reference to Single-Nucleotide Polymorphisms.

    Science.gov (United States)

    Abe, Arata; Nito, Chikako; Sakamoto, Yuki; Nogami, Akane; Hokama, Hiroyuki; Takahashi, Shiro; Kirita, Kumiko; Ueda, Masayuki; Ishimaru, Yoshiro; Kimura, Kazumi

    2016-08-01

    Spontaneous cervical artery dissection (sCAD) is a major cause of ischemic stroke in young adults. Frequently, sCAD involves multiple neck arteries, accounting for 13%-28% of the total sCAD cases. However, little is known about factors related to multiple sCAD. In this case, a 52-year-old man was admitted due to headache without aura. There was a personal history of migraine with aura and a family history of similar symptoms. The patient's younger brother had a left vertebral artery (VA) dissecting aneurysm and underwent endovascular occlusion of his parent artery at the age of 48. Magnetic resonance imaging of our admitted patient showed hyperintensities in the right internal carotid artery (ICA) without acute infarction, and magnetic resonance angiography revealed a narrowing of the right ICA. Angiography was then performed, which showed a trace of dissection of the left ICA and both VAs as well as the right ICA. The patient did not fulfill any major criteria of collagen vascular disease such as Ehlers-Danlos syndrome type IV or Loeys-Dietz syndrome. The data in our patient are quite similar to those reported in patients with single-nucleotide polymorphism (SNP) of PHACTR1. Obtaining the patient's informed consent, we analyzed a common SNP variation in the rs9349379[G] allele (PHACTR1), which has been reported to be associated with a lower risk of sCAD. PMID:27216377

  19. LECTURE ON ACUPUNCTURE PartⅠ Clinical Acupuncture Lecture Thirty-fiveCervical Spondylopathy

    Institute of Scientific and Technical Information of China (English)

    罗汀; 王卫; 徐力

    2004-01-01

    @@ Cervical spondylopathy, also known as cervical syndrome, is a commonly encountered disease in the middle-aged and elderly people. This disease mostly results from the retrograde affection of the cervical intervertebral disc and hyperosteogeny of the cervical vertebrae. This hyperplastic substance may stimulate and give rise to oppression to the surrounding spinal cord, nerve roots, blood vessels and sympathetic nerves, resulting in a series of symptoms as numbness, pain, etc. in the neck, shoulder and the upper limbs. The cervical vertebra of the human spine is smallest in the size, weakest in the strength, higher in the motor range and frequency, and bigger in the bearing of per unit area. Along with the increasing of people's age and the accumulated aftereffect of chronic and acute injury, the pulpiform nucleus of the cervical intervertebral disc presents retrograde affection, dehydration, bulge and rupture of the fibrous ring, narrowing of the intervertebral space, and reduction in the stability of cervical vertebrae due to injury and slackening of intervertebral ligaments to stretch and to induce compression upon periosteum. All these changes may lead to break of blood vessels to cause bleeding and hematoma. With the organization of hematoma and calcium salt deposit, osteophyte is formed at last. When the protruded intervertebral disc and hyperplastic osteophyte stimulate and oppress the surrounding spinal nerve root, vertebral artery or spinal cord, the resultant injury, aseptic inflammation, reactions after renovation, etc. will generate a series of clinical symptoms of cervical spondylopathy. In Western medicine, there are five types of cervical spondylopathy including stiff-neck type, nerve root type, spinal cord type, vertebral artery type and sympathetic nerve type. The stiff-neck type, nerve root type and vertebral artery type will be introduced in this article.

  20. Remarkable recovery in an infant presenting with extensive perinatal cervical cord injury

    Science.gov (United States)

    Ul Haq, Israr; Gururaj, A K

    2012-01-01

    Cervical-cord damage is a complication of a difficult delivery, and results in spinal shock with flaccidity progressing to spastic paralysis. Conventionally, outlook for such patients is extremely poor and most will recover only slightly from quadriplegia and autonomic dysfunction. Here, we report a case in which the extent of damage considerably contrasted with the outcome and recovery. A full-term baby girl born by difficult vaginal delivery displayed bilateral flaccid paralysis of the lower limbs with absent spontaneous movements, weakness of both upper limbs, hyporeflexia in all limbs and axial hypotonia. MRI of cervicothoracic spine exhibited raised signal intensity in the dorsal aspects of C7 to T1 signifying myelopathy. MRI at 4 months revealed a near-total transection of the cervical cord. However, at 6 months, the child could move all lower limbs independently with a marked increase in power. There was no spasticity, wasting or incontinence. Reflexes had also returned. PMID:23230249

  1. Different patterns of intestinal response to injury after arterial, venous or arteriovenous occlusion in rats

    Institute of Scientific and Technical Information of China (English)

    Francisco Javier Guzmán-de la Garza; Carlos Rodrigo Cámara-Lemarroy; Gabriela Alarcón-Galván; Paula Cordero-Pérez; Linda Elsa Mu(n)oz-Espinosa; Nancy Esthela Fernández-Garza

    2009-01-01

    AIM: To investigate the differences in injury patterns caused by arterial, venous or arteriovenous mesenteric occlusion.METHODS: Male Wistar rats were separated equally into four groups. Occlusion was performed by clamping the superior mesenteric artery (A), the mesenteric vein (V) or both (AV) for 30 min, followed by 60 min of reperfusion. A control group received sham surgery only. Intestinal sections were examined for histological damage and serum tumor necrosis factor-α (TNF-α), endothelin-1 (ET-1), P-selectin, antithrombin Ⅲ (ATⅢ) and soluble intracellular adhesion molecule-1 (ICAM-1) concentrations were measured.RESULTS: All groups showed significant mucosal injury compared to controls. Furthermore, mucosal injury was significantly more severe in the V and AV groups compared to the A group (3.6 ± 0.55, 3.4 ± 0.55 and 2 ± 0.71, respectively, P = 0.01). ICAM-1 was similarly elevated in all groups, with no significant differences between the groups. P-selectin levels were significantly elevated in the V and AV groups but not the A group (1.4 ± 0.5 ng/mL, 2.52 ± 0.9 ng/mL and 0.02 ± 0.01 ng/mL,respectively, P = 0.01) and ET-1 was significantly elevated in the A and V groups but not the AV group (0.32 ± 0.04 pg/mL, 0.36 ± 0.05 pg/mL and 0.29 ± 0.03 pg/mL, respectively, P = 0.01) compared to sham controls. ATⅢ levels were markedly depleted in the V and AV groups, but not in the A group (29.1 ± 5.2 pg/mL,31.4 ± 21.8 pg/mL and 55.8 ± 35.6 pg/mL ,respectively, P = 0.01), compared to controls. Serum TNF-α was significantly increased in all groups compared to sham controls (1.32 ± 0.87 ng/mL, 1.79 ± 0.20 ng/mL and 4.4 ± 0.69 ng/mL, for groups A, V and AV,respectively, P = 0.01), with higher values in the AV group.CONCLUSION: Different patterns of response to ischemia/reperfusion are associated with venous, arterial or arteriovenous occlusion. Venous and arteriovenous occlusion was associated with the most severe alterations.

  2. Pseudo-aneurysm of the anterior tibial artery, a rare cause of ankle swelling following a sports injury

    Directory of Open Access Journals (Sweden)

    McAteer Eamon

    2005-10-01

    Full Text Available Abstract Background Ankle pain and swelling following sports injuries are common presenting complaints to the accident and emergency department. Frequently these are diagnosed as musculoskeletal injuries, even when no definitive cause is found. Vascular injuries following trauma are uncommon and are an extremely rare cause of ankle swelling and pain. These injuries may however be limb threatening and are important to diagnose early, in order that appropriate treatment can be delivered. We highlight the steps to diagnosis of these injuries, and methods of managing these injuries. It is important for clinicians to be aware of the potential for this injury in patients with seemingly innocuous trauma from sports injuries, who have significant ankle pain and swelling. Case presentation A young, professional sportsman presented with a swollen, painful ankle after an innocuous hyper-plantar flexion injury whilst playing football, which was initially diagnosed as a ligamentous injury after no bony injury was revealed on X-Ray. He returned 2 days later with a large ulcer at the lateral malleolus and further investigation by duplex ultrasound and transfemoral arteriogram revealed a Pseudo-Aneurysm of the Anterior Tibial Artery. This was initially managed with percutaneous injection of thrombin, and later open surgery to ligate the feeding vessel. The patient recovered fully and was able to return to recreational sport. Conclusion Vascular injuries remain a rare cause of ankle pain and swelling following sports injuries, however it is important to consider these injuries when no definite musculo-skeletal cause is found. Ultrasound duplex and Transfemoral arteriogram are appropriate, sensitive modalities for investigation, and may allow novel treatment to be directed percutaneously. Early diagnosis and intervention are essential for the successful outcome in these patients.

  3. Single pellet grasping following cervical spinal cord injury in adult rat using an automated full-time training robot.

    Science.gov (United States)

    Fenrich, Keith K; May, Zacincte; Torres-Espín, Abel; Forero, Juan; Bennett, David J; Fouad, Karim

    2016-02-15

    Task specific motor training is a common form of rehabilitation therapy in individuals with spinal cord injury (SCI). The single pellet grasping (SPG) task is a skilled forelimb motor task used to evaluate recovery of forelimb function in rodent models of SCI. The task requires animals to obtain food pellets located on a shelf beyond a slit at the front of an enclosure. Manually training and testing rats in the SPG task requires extensive time and often yields results with high outcome variability and small therapeutic windows (i.e., the difference between pre- and post-SCI success rates). Recent advances in automated SPG training using automated pellet presentation (APP) systems allow rats to train ad libitum 24h a day, 7 days a week. APP trained rats have improved success rates, require less researcher time, and have lower outcome variability compared to manually trained rats. However, it is unclear whether APP trained rats can perform the SPG task using the APP system after SCI. Here we show that rats with cervical SCI can successfully perform the SPG task using the APP system. We found that SCI rats with APP training performed significantly more attempts, had slightly lower and less variable final score success rates, and larger therapeutic windows than SCI rats with manual training. These results demonstrate that APP training has clear advantages over manual training for evaluating reaching performance of SCI rats and represents a new tool for investigating rehabilitative motor training following CNS injury. PMID:26611563

  4. Single pellet grasping following cervical spinal cord injury in adult rat using an automated full-time training robot.

    Science.gov (United States)

    Fenrich, Keith K; May, Zacincte; Torres-Espín, Abel; Forero, Juan; Bennett, David J; Fouad, Karim

    2016-02-15

    Task specific motor training is a common form of rehabilitation therapy in individuals with spinal cord injury (SCI). The single pellet grasping (SPG) task is a skilled forelimb motor task used to evaluate recovery of forelimb function in rodent models of SCI. The task requires animals to obtain food pellets located on a shelf beyond a slit at the front of an enclosure. Manually training and testing rats in the SPG task requires extensive time and often yields results with high outcome variability and small therapeutic windows (i.e., the difference between pre- and post-SCI success rates). Recent advances in automated SPG training using automated pellet presentation (APP) systems allow rats to train ad libitum 24h a day, 7 days a week. APP trained rats have improved success rates, require less researcher time, and have lower outcome variability compared to manually trained rats. However, it is unclear whether APP trained rats can perform the SPG task using the APP system after SCI. Here we show that rats with cervical SCI can successfully perform the SPG task using the APP system. We found that SCI rats with APP training performed significantly more attempts, had slightly lower and less variable final score success rates, and larger therapeutic windows than SCI rats with manual training. These results demonstrate that APP training has clear advantages over manual training for evaluating reaching performance of SCI rats and represents a new tool for investigating rehabilitative motor training following CNS injury.

  5. Temporary arterial stenting in a full-house spaghetti wrist injury in a remote rural setting: benefit for hand perfusion or risk of increased morbidity?

    Science.gov (United States)

    Bauer, Stefan; Savundra, James

    2013-01-01

    We report a case of temporary arterial plastic tube stenting of the ulnar and radial artery in a complete spaghetti wrist injury in a remote rural setting. Exploration in a specialist centre 18 h postinjury revealed that the tubes were clotted off with adjacent thrombi but hand perfusion was maintained. Intimal damage required vein grafting of both arteries 24 h postinjury. Hand perfusion was not compromised at follow-up. This case highlights that arterial hand perfusion can be maintained without the ulnar and radial artery. Arterial manipulation and tube insertion outside a specialist centre bears the risk of increased morbidity and potential microembolism and must therefore not be attempted.

  6. 放疗联合双侧髂内动脉灌注化疗治疗晚期宫颈癌%Analysis of curative effect of radiotherapy combined with bilateral internal iliac arterial infusion chemotherapy on advanced cervical cancer

    Institute of Scientific and Technical Information of China (English)

    苏永强; 刘英杰; 李俊

    2016-01-01

    Objective To analyze the effects of radiotherapy combined with bilateral internal iliac arterial infusion chemotherapy on advanced cervical cancer .Methods Fifty patients with advanced cervical cancer from January 2012 to December 2013 were selected as the research objects .They were randomly divided into two groups , the control group was only given radiotherapy treatment , the observation group were given bilateral internal iliac artery infusion chemotherapy treatment based on the control group , followed-up 1 year after treatment , and then compared the clinical efficacy , adverse reactions and the follow-up results of two groups .Results The effective rate in the observation group was 84%, and 56%in the control group, the difference was significant(P0.05).In addition, the main side effects of observation group were myelosuppression and gastrointestinal tract reaction , major adverse reactions in control group were delayed injury and intestinal injury of urinary system .Conclusions The effect of radiotherapy combined with bilateral in-ternal iliac arterial infusion chemotherapy on advanced cervical cancer is definite , can effectively improve the survival rate of 1 year, significantly reduce the recurrence rate in 1 year, is worth clinical promotion .%目的:分析放疗联合双侧髂内动脉灌注化疗治疗晚期宫颈癌的疗效。方法以解放军第一五二中心医院2012年1月至2013年12月收治的50例晚期宫颈癌患者为研究对象,随机将其分为两组,对照组患者给予单纯放疗治疗,观察组患者在对照组基础上联合双侧髂内动脉灌注化疗治疗,治疗后随访1年,比较两组临床疗效、不良反应及随访结果。结果观察组治疗有效率为84.0%,对照组为56.0%,两组比较差异有统计学意义(P<0.05)。观察组1年复发率、转移率分别为24.0%、16.0%,对照组为52.0%、44.0%,两组比较差异有统计学意义(P<0.05),两组1年生存

  7. Age determination of vessel wall hematoma in spontaneous cervical artery dissection: A multi-sequence 3T Cardiovascular Magnetic resonance study

    Directory of Open Access Journals (Sweden)

    Habs Maximilian

    2011-11-01

    Full Text Available Abstract Background Previously proposed classifications for carotid plaque and cerebral parenchymal hemorrhages are used to estimate the age of hematoma according to its signal intensities on T1w and T2w MR images. Using these classifications, we systematically investigated the value of cardiovascular magnetic resonance (CMR in determining the age of vessel wall hematoma (VWH in patients with spontaneous cervical artery dissection (sCAD. Methods 35 consecutive patients (mean age 43.6 ± 9.8 years with sCAD received a cervical multi-sequence 3T CMR with fat-saturated black-blood T1w-, T2w- and TOF images. Age of sCAD was defined as time between onset of symptoms (stroke, TIA or Horner's syndrome and the CMR scan. VWH were categorized into hyperacute, acute, early subacute, late subacute and chronic based on their signal intensities on T1w- and T2w images. Results The mean age of sCAD was 2.0, 5.8, 15.7 and 58.7 days in patients with acute, early subacute, late subacute and chronic VWH as classified by CMR (p Conclusions Signal intensities of VWH in sCAD vary over time and multi-sequence CMR can help to determine the age of an arterial dissection. Furthermore, findings of this study suggest that the time course of carotid hematomas differs from that of cerebral hematomas.

  8. 颈前路手术治疗脊髓型颈椎病并颈椎外伤所致急性颈髓损伤19例临床分析%Clinical analysis on 19 cases of anterior cervical surgical treatment of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma

    Institute of Scientific and Technical Information of China (English)

    张明友; 陈德元

    2014-01-01

    目的 探讨颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的疗效.方法 回顾性分析采用颈前路椎体次全切并后纵韧带切除减压植骨融合术治疗的脊髓型颈椎病并颈椎外伤所导致的急性颈髓损伤的19例患者病历资料,对患者外伤前(T1)、外伤后(T2)、术后1周内(T3)、术后10个月后(T4)四个时期的颈椎曲度及神经功能评分(JOA)变化进行分析,判断手术疗效.结果 所有患者均获得10~24个月随访,平均(15.2±6.7)个月.T1、T2、T3、T4四个时期的颈椎曲度分别为(28.621±1.850)°、(29.326±2.416)°、(38.384±2.611)°、(37.316±2.521)°.T1、T2、T3、T4四个时期的JOA脊髓型颈椎病评分分别为(12.79±1.316)、(4.00±2.082)、(9.68±3.001)、(11.68±3.334).结论 颈前路椎体次全切并后纵韧带切除减压植骨融合术可达到有效减压效果、可重建颈椎曲度,能提供脊髓型颈椎病并颈椎外伤所导致的颈髓损伤有效康复条件;术后积极康复治疗也是改善神经功能的重要方法.%Objective To explore the effect of anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic in acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma.Methods Retrospective analysis was carried out to 19 cases of acute cervical spinal cord injury caused by cervical spondylotic myelopathy and cervical trauma who used anterior cervical corpectomy and posterior longitudinal ligament resection and decompression and fusion for the therapeutic,and analysis of patients before trauma (T)1,post-traumatic (T2),within 1 week after operation (T3),10 months after operation (T4) these four periods about the changes of cervical curvature and neural function (JOA score) were analyzed,then evaluated the operation curative effect.Results All patients were followed

  9. 颈脊髓损伤的康复训练和疗效评价%Rehabilitation training and effect evaluation of cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    王艳华

    2016-01-01

    Objective:To investigate the rehabilitation training method and its effect of cervical spinal cord injury.Methods:According to the actual situation of patients,17 cases of patients with cervical spinal cord injury as the research object were given comprehensive rehabilitation training,the functional improvement and daily life ability of the patients before and after the treatment were compared.Results:The cervical spinal cord injury of patients were significantly improved and the Barthel index was significantly better than before treatment(P<0.05).Conclusion:Early active rehabilitation training could improve the condition of patients with cervical spinal cord injury and improve the living ability,which could promote the rehabilitation of patients.%目的:探讨颈脊髓损伤的康复训练方法及其效果.方法:收治颈脊髓损伤患者17例作为研究对象,根据患者的实际情况给予综合性康复训练,比较治疗前后患者功能改善情况及日常生活自理能力.结果:患者颈脊髓损伤明显改善,且Barthel指数明显优于治疗前(P<0.05).结论:早期、积极的康复训练可改善颈脊髓损伤患者的病情,提高生活能力,促进患者的康复.

  10. Determination of Vascular Reactivity of Middle Cerebral Arteries from Stroke and Spinal Cord Injury Animal Models Using Pressure Myography.

    Science.gov (United States)

    Anwar, Mohammad A; Eid, Ali H

    2016-01-01

    Stroke and other neurovascular derangements are main causes of global death. They, along with spinal cord injuries, are responsible for being the principal cause of disability due to neurological and cognitive problems. These problems then lead to a burden on scarce financial resources and societal care facilities as well as have a profound effect on patients' families. The mechanism of action in these debilitating diseases is complex and unclear. An important component of these problems arises from derangement of blood vessels, such as blockage due to clotting/embolism, endothelial dysfunction, and overreactivity to contractile agents, as well as alteration in endothelial permeability. Moreover, the cerebro-vasculature (large vessels and arterioles) is involved in regulating blood flow by facilitating auto-regulatory processes. Moreover, the anterior (middle cerebral artery and the surrounding region) and posterior (basilar artery and its immediate locality) regions of the brain play a significant role in triggering the pathological progression of ischemic stroke particularly due to inflammatory activity and oxidative stress. Interestingly, modifiable and non-modifiable cardiovascular risk factors are responsible for driving ischemic and hemorrhagic stroke and spinal cord injury. There are different stroke animal models to examine the pathophysiology of middle cerebral and basilar arteries. In this context, arterial myography offers an opportunity to determine the etiology of vascular dysfunction in these diseases. Herein, we describe the technique of pressure myography to examine the reactivity of cerebral vessels to contractile and vasodilator agents and a prelude to stroke and spinal cord injury. PMID:27604741

  11. Bullet embolization to the external iliac artery after gunshot injury to the abdominal aorta: a case report

    Directory of Open Access Journals (Sweden)

    Jaha Luan

    2011-08-01

    Full Text Available Abstract Introduction Abdominal vascular trauma is fairly common in modern civilian life and is a highly lethal injury. However, if the projectile is small enough, if its energy is diminished when passing through the tissue and if the arterial system is elastic enough, the entry wound into the artery may close without exsanguination and therefore may not be fatal. A projectile captured may even travel downstream until it is arrested by the smaller distal vasculature. The occurrence of this phenomenon is rare and was first described by Trimble in 1968. Case presentation Here we present a case of a 29-year-old Albanian man who, due to a gunshot injury to the back, suffered fracture of his twelfth thoracic and first lumbar vertebra, injury to the posterior wall of his abdominal aorta and then bullet embolism to his left external iliac artery. It is interesting that the signs of distal ischemia developed several hours after the exploratory surgery, raising the possibility that the bullet migrated in the interim or that there was a failure to recognize it during the exploratory surgery. Conclusion In all cases where there is a gunshot injury to the abdomen or chest without an exit wound and with no projectile in the area, there should be a high index of suspicion for possible bullet embolism, particularly in the presence of the distal ischemia.

  12. Long descending cervical propriospinal neurons differ from thoracic propriospinal neurons in response to low thoracic spinal injury

    Directory of Open Access Journals (Sweden)

    Stelzner Dennis J

    2010-11-01

    Full Text Available Abstract Background Propriospinal neurons, with axonal projections intrinsic to the spinal cord, have shown a greater regenerative response than supraspinal neurons after axotomy due to spinal cord injury (SCI. Our previous work focused on the response of axotomized short thoracic propriospinal (TPS neurons following a low thoracic SCI (T9 spinal transection or moderate spinal contusion injury in the rat. The present investigation analyzes the intrinsic response of cervical propriospinal neurons having long descending axons which project into the lumbosacral enlargement, long descending propriospinal tract (LDPT axons. These neurons also were axotomized by T9 spinal injury in the same animals used in our previous study. Results Utilizing laser microdissection (LMD, qRT-PCR, and immunohistochemistry, we studied LDPT neurons (located in the C5-C6 spinal segments between 3-days, and 1-month following a low thoracic (T9 spinal cord injury. We examined the response of 89 genes related to growth factors, cell surface receptors, apoptosis, axonal regeneration, and neuroprotection/cell survival. We found a strong and significant down-regulation of ~25% of the genes analyzed early after injury (3-days post-injury with a sustained down-regulation in most instances. In the few genes that were up-regulated (Actb, Atf3, Frs2, Hspb1, Nrap, Stat1 post-axotomy, the expression for all but one was down-regulated by 2-weeks post-injury. We also compared the uninjured TPS control neurons to the uninjured LDPT neurons used in this experiment for phenotypic differences between these two subpopulations of propriospinal neurons. We found significant differences in expression in 37 of the 84 genes examined between these two subpopulations of propriospinal neurons with LDPT neurons exhibiting a significantly higher base line expression for all but 3 of these genes compared to TPS neurons. Conclusions Taken collectively these data indicate a broad overall down

  13. Epicritic Sensation in Cervical Spinal Cord Injury: Diagnostic Gains Beyond Testing Light Touch

    NARCIS (Netherlands)

    Velstra, Inge-Marie; Bolliger, Marc; Baumberger, Michael; Rietman, Johan Swanik; Curt, Armin

    2013-01-01

    Applied as a bedside test of gross dorsal column function, the testing of light touch (LT) sensation is of high clinical value in the diagnosis of human spinal cord injury (SCI). However, the assessment of overall dorsal column deficit by testing only LT may be limited, because the dorsal column pat

  14. Effect of Fujian tablet on the expression of Nogo-A mRNA in the cervical spinal cord of middle cerebral artery occlusion model rats

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Inhibiting the expression of Nogo-A in cervical spinal cord by use of interaction of antigen and antibody can help the remodeling of corticospinal projection of focal cerebral ischemia model rats to facilitate neurological recovery, which provides a new possible mechanism for drugs to promote neurological recovery. However, the effects of drugs on the expression of Nogo-A in cervical spinal cord are still unclear.OBJECTIVE: To observe the effect of Fujian tablet on the expression of Nogo-A mRNA in cervical spinal cords of middle cerebral artery occlusion (MCAO) rats, and to investigate the possible regulatory effect of Fujian tablet on the regenerated microenvironment of spinal conduction bundle.DESIGN: A randomized and controlled trial taking Wistar rats as experimental animals.SETTING: Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine.MATERIALS: This experiment was carried out in the laboratory of Shandong Academy of Medical Science between June 2005 and July 2006. A total of 40 healthy male Wistar rats, aged 12 weeks, weighing 250 -300 g, were provided by the Experimental Animal Center of Shandong University. Fujian tablets (main components: Heshouwu, Yinyanghuo, etc) were provided by office of Pharmaceutics of Shandong University of traditional Chinese medicine. Nogo-A detection kit was provided by Wuhan Boster Biotechnology Co.,Ltd.,and batch number was 040309009. This experiment was approved by Local Animal Ethics Committee.METHODS: Forty male rats were randomly divided into 4 groups, with 10 in each: normal group,sham-operation group, model group and administration group. Rats in the administration group and model group were subjected to MCAO. Rats in the sham-operation group underwent the same craniotomy, and their middle cerebral arteries (MCA) were not occluded. Rats in the normal group were untouched. Rats in administration group were intragastrically administrated with the solution of Fujian

  15. Surgical treatment of lower cervical injuries combined with cervical congenital abnormalities%合并颈椎先天性畸形的下颈椎损伤的治疗策略

    Institute of Scientific and Technical Information of China (English)

    谢宁; 倪斌; 叶晓健; 陈德玉; 肖建如; 袁文

    2008-01-01

    目的 探讨合并颈椎先天性畸形的下颈椎损伤的治疗策略. 方法 自1998年至2005年收治合并颈椎先天性畸形的下颈椎损伤患者11例,损伤类型包括急性C3/4椎间盘突出症1例,颈椎过伸伤7例,C5骨折1例,C4/5、C5/6脱位各1例.合并的颈椎先天性畸形包括Klippel-Feil综合征2例,颅底凹陷2例,颅底扁平5例,寰椎枕骨化9例,Chiari畸形1例.Frankel分级为A级1例,B级2例,c级5例,D级3例.合并Klippel-Feil综合征者实施了颈前路单间隙减压取髂骨植骨融合带锁钢板固定加后路短节段减压侧块螺钉固定术.1例颈椎过伸伤合并Chiari畸形实施了颈椎后路减压加枕大孔减压枕颈融合后路固定术.余患者依致压物范围和椎管狭窄程度分别实施了颈椎前路减压植骨钢板固定术或颈椎后路减压侧块螺钉固定术. 结果 所有患者获得4个月~6年(平均22个月)随访.术后3个月Frankel分级为B级1例,C级2例,D级3例,E级5例,平均提高1~2级.植骨平均于术后3个月愈合,未出现内置物相关并发症.随访期内未出现颈椎不稳以及颈椎畸形相关的临床症状. 结论 明确没有上颈椎损伤的合并颈椎先天性畸形的下颈椎损伤可以只处理下颈椎损伤,所合并的颈椎畸形根据不同类型区别考虑.对于合并颈椎畸形的下颈椎损伤没有必要为了防止颈椎畸形远期继发的神经症状而融合上颈椎或其他节段.%Objective To discuss strategies of treating lower cervical injuries combined with cervical congenital abnormalities. Methods Eleven cases of lower cervical injuries combined with cervical congenital abnormalities were treated from 1998 to 2005. The injuries included 1 case of C3/4 disc herniation, 7 cases of whiplash injury, 1 case of C5 vertebral body fracture, and 2 cases of C4/5 and C5/6 dislocation.Cervical abnormalities included Klippel-Feil syndrome (2), basilar impression (2), platybasia (5), occipitalization of atlas (9

  16. Cine phase-contrast MRI measurement of CSF flow in the cervical spine: a pilot study in patients with spinal cord injury

    Science.gov (United States)

    Negahdar, MJ; Shakeri, M.; McDowell, E.; Wells, J.; Vitaz, T.; Harkema, S.; Amini, A.

    2011-03-01

    MRI velocimetry (also known as phase-contrast MRI) is a powerful tool for quantification of cerebrospinal fluid (CSF) flow in various regions of the brain and craniospinal junction and has been accepted as a diagnostic tool to assist with the diagnosis of certain conditions such as hydrocephalus and chiari malformations. Cerebrospinal fluid is continually produced in the ventricles of the brain, flows through the ventricular system and then out and around the brain and spinal cord and is reabsorbed over the convexity of the brain. Any disease process which either impedes the normal pattern of flow or restricts the area where flow occurs can change the pattern of these waveforms with the direction and velocity of flow being determined by the pressure transmitted from the pulsation of the heart and circulation of blood within the central nervous system. Therefore, we hypothesized that phase-contrast MRI could eventually be used as a diagnostic aid in determining the degree of spinal cord compression following injury to the cervical or thoracic spine. In this study, we examined CSF flow in 3 normal subjects and 2 subjects with non-acute injuries in the cervical spine using Cine phasecontrast MRI. CSF flow analysis was performed using an in-house developed software. The flow waveform was calculated in both normal subjects (n=3) as well as subjects with spinal cord injury in the cervical spine (n=2). The bulk flow at C2 was measured to be 0.30 +/- 0.05 cc, at 5 cm distal to C2, it was 0.19+/- 0.07 cc, and at 10 cm distal to C2, it was 0.17+/- 0.05 cc. These results were in good agreement with previously published results. In patients with spinal cord injury, at the site of injury in the cervical spine, bulk flow was found to be 0.08 +/- 0.12 cc, at 5 cm proximal to the site of injury it was found to be 0.18 +/- 0.07 cc, and at 5 cm distal to the site of injury, it was found to be 0.12 +/- 0.01 cc.

  17. 上颈椎损伤的诊治进展%Advances in the Diagnosis and Treatment of Upper Cervical Spine Injury

    Institute of Scientific and Technical Information of China (English)

    李柳炳; 顾俊; 董启榕; 沈光思; 陆政峰; 秦建忠; 陈礼(综述); 沈忆新(审校)

    2015-01-01

    位于上颈椎管内的脊髓是中枢神经系统中重要及脆弱的部分。由于其包含神经、血管结构,上颈椎骨性结构的完整性对生存和功能至关重要。由于上颈椎特殊的解剖位置及较大的活动范围,其易遭受不同方向的暴力。上颈椎损伤主要是指寰枢椎及其附属结构由于受到暴力导致骨折、韧带撕裂、脱位等。该文将介绍上颈椎各种常见的损伤类型、治疗原则、手术方式以及研究进展,为临床处理各型上颈椎损伤提供参考。%The spinal cord in upper cervical canal is an essential and vulnerable component of the cen-tral nervous system.The integrity of the upper cervical spine is essential for the survival and function ,because of the neurovascular structures contained in it.Due to its specific anatomical location,large range of rotation, upper cervical spine easily suffers from violence of different directions.The upper cervical spine injuries mainly refer to the fractures,torn ligaments,dislocation of atlantoaxial vertebrae and its accessory structures caused by violence.Here is to make a review of various common types of upper cervical spine injuries,as well as their treatment principles,surgical approaches and research progress,in order to provide reference for clini-cal treatment.

  18. OBSERVATION ON THE THERAPEUTIC EFFECT OF ACPUNCTURE COMBINED WITH MASSAGE FOR CERVICAL SPONDYLOSIS OF VERTEBRAL ARTERIAL TYPE BY USING TRANCRANIAL DOPPLYER ULTRASONOGRAPHY

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-wei; WANG Cheng-wei; HU Ling-xiang; LI Ning; ZHANG Fan; LI Chun-yu; ZHAO Jing-jing; LI Ji; HU Yun-guang; ZHANG Yan

    2006-01-01

    Objective: To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type (CSVAT) patients. Methods:In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage (acu-massage) group (n = 38), acupuncture group ( n = 32) and massage group ( n = 30). Acupoints used were Fengchi (风池 GB 20), cervical Jiaji (颈夹脊 EX-B 2), Baihui (百会 GV 20), and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity (Vp), end-diastolic velocity (Vd), mean velocity (Vm) of blood flow of the vertebral artery (VA) and basilar artery (BA),etc were detected before and after the treatment by using transcranial Doppler (TCD) ultrasonography. Results: After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment ( P < 0.05, 0.01 ), and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group (P < 0.05, 0.01 ). The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment (P <0.05, 0.01), and the therapeutic effects of acu-massage group were significantly superior to those of

  19. Facial nerve paralysis after cervical traction.

    Science.gov (United States)

    So, Edmund Cheung

    2010-10-01

    Cervical traction is a frequently used treatment in rehabilitation clinics for cervical spine problems. This modality works, in principle, by decompressing the spinal cord or its nerve roots by applying traction on the cervical spine through a harness placed over the mandible (Olivero et al., Neurosurg Focus 2002;12:ECP1). Previous reports on treatment complications include lumbar radicular discomfort, muscle injury, neck soreness, and posttraction pain (LaBan et al., Arch Phys Med Rehabil 1992;73:295-6; Lee et al., J Biomech Eng 1996;118:597-600). Here, we report the first case of unilateral facial nerve paralysis developed after 4 wks of intermittent cervical traction therapy. Nerve conduction velocity examination revealed a peripheral-type facial nerve paralysis. Symptoms of facial nerve paralysis subsided after prednisolone treatment and suspension of traction therapy. It is suspected that a misplaced or an overstrained harness may have been the cause of facial nerve paralysis in this patient. Possible causes were (1) direct compression by the harness on the right facial nerve near its exit through the stylomastoid foramen; (2) compression of the right external carotid artery by the harness, causing transient ischemic injury at the geniculate ganglion; or (3) coincidental herpes zoster virus infection or idiopathic Bell's palsy involving the facial nerve.

  20. Pulmonary artery perfusion with HTK solution prevents lung injury in infants after cardiopulmonary bypass

    Institute of Scientific and Technical Information of China (English)

    LI Jian-an; LIU Ying-long; LIU Jin-ping; LI Xiao-feng

    2010-01-01

    Background Pulmonary artery perfusion during cardiopulmonary bypass (CPB) is a novel adjunctive method, which can minimize the lung ischemic-reperfusion injury and inflammatory response. This study evaluated the protective effect of pulmonary perfusion with hypothermic HTK solution in corrections of congenital heart defects with pulmonary hypertension.Methods Between June 2009 and December 2009, 24 consecutive infants with congenital heart defects and pulmonary hypertension were randomly divided into perfused group (n=12) and control group (n=12). Oxygen index, alveolar-arterial O2gradient, serum levels of malondialchehyche (MDA), interleukin (IL)-6, -8, -10, soluble intercellular adhesion molecule-1(slCAM-1), and P-selectin were measured before commencement and serially for 48 hours after termination of bypass.Results Oxygenation values were better preserved in the perfused group than in the control group. The serum levels of IL-6 increased immediately after CPB in both groups and returned to baseline at 48 hours after CPB, but it was restored faster and earlier in the perfused group. The serum levels of IL-8, slCAM-1, and MDA remained at baseline at each point after CPB in the perfused group and elevated significantly immediately after CPB in the control group, except for sICAM-1.The serum level of IL-10 increased immediately after CPB and decreased to baseline at 48 hours after CPB in both groups, but the IL-10 level in the perfused group was significantly higher than in the control group at 12 hours after CPB.The serum P-selectin levels in the control group immediately after CPB were significantly higher than prebypass levels.Moreover, there were no significant differences in postoperative clinical characters, except for the intubated time.Conclusion In infants with congenital heart defects, pulmonary perfusion with hypothermic HTK solution during cardiopulmonary bypass could ameliorate lung function and reduce the inflammatory response.

  1. The study of accuracy of color Doppler ultrasonography in detecting the grade of stenosis of cervical carotid arteries in comparison to angiography

    Directory of Open Access Journals (Sweden)

    Mostaan M

    2000-09-01

    Full Text Available This is retrospective double-blind research, which was carried out in Imam Khomeini hospital in order to study the accuracy of color Doppler ultrasonography for detecting the site and grade of stenosis in cervical carotid artery. 40 patients with mean age of 62 years studied with color Doppler before DSA angiography. The most common sites of stenosis were left internal carotid (39.5% and right internal carotid arteries (38.4%. We measured peak systolic and end-diastolic velocities (PSA and EDV and ratios of PSA and EDV at stenosis sites to CCA (PSV ratio and EDV ratio. Results showed that PSA has the highest sensitivity and accuracy in all grades of stenosis: Mild to moderate stenosis: Sensitivity (90.5%, accuracy (89.5%; Severe stenosis: Sensitivity (82.1%, accuracy (92.8%; Total occlusion: Sensitivity (93.8%, accuracy (96.5%. There is no difference between accuracy of Doppler parameters for detection of total occlusion (96.5% but in other grades after PSV, EDV (Mild-moderate 86%, severe 87.2%. EDV ratio and PSV ratio (Mild-moderate both 84.8%, severe both 86% have the highest accuracies. We concluded that color Doppler sonography can reliability detect stenosis in carotid arteries & PSV has the highest accuracy.

  2. Motor-related cortical activity after cervical spinal cord injury: multifaceted EEG analysis of isometric elbow flexion contractions.

    Science.gov (United States)

    Cremoux, Sylvain; Tallet, Jessica; Berton, Eric; Dal Maso, Fabien; Amarantini, David

    2013-10-01

    Electroencephalographic (EEG) studies have well established that motor cortex (M1) activity ~20 Hz decreases during muscular contraction and increases as soon as contraction stops, which are known as event-related desynchronization (ERD) and event-related synchronization (ERS), respectively. ERD is supposed to reflect M1 activation, sending information to recruited muscles, while the process underlying ERS is interpreted either as active cortical inhibition or as processing of sensory inputs. Investigation of the process behind ERD/ERS in people with spinal cord injury (SCI) would be particularly relevant since their M1 remains effective despite decreased sensorimotor abilities. In this study, we recorded net joint torque and EEG in 6 participants with cervical SCI and 8 healthy participants who performed isometric elbow flexion at 3 force levels. Multifaceted EEG analysis was introduced to assess ERD/ERS according to their amplitude, frequency range and duration. The results revealed that net joint torque increased with the required force level for all participants and time to contraction inhibition was longer in the SCI group. At the cortical level, ERD/ERS frequency ranges increased with the required force level in all participants, indicating that the modulation of cortical activity with force level is preserved after SCI. However, ERS amplitude decreased only in SCI participants, which may be linked to delayed contraction inhibition. All in all, cortical modulation of frequency range and amplitude could reflect two different kinds of neural communication. PMID:23939224

  3. Trendelenburg chest optimization prolongs spontaneous breathing trials in ventilator-dependent patients with low cervical spinal cord injury

    Directory of Open Access Journals (Sweden)

    Charles J. Gutierrez, PhD, RRT, FAARC

    2010-05-01

    Full Text Available Chest optimization, an evidence-based protocol-guided multimodal chest physiotherapy consisting of body positioning, sputum mobilization, bronchodilation, and lung hyperinflation, may be routinely administered to ventilator-dependent patients with low cervical spinal cord injury (CSCI for improving pulmonary functional outcomes that facilitate weaning from mechanical ventilation. We undertook this study to determine whether position-specific chest optimization was associated with changes in spontaneous breathing trial (SBT duration. Cardiac output (CO, alveolar minute volume (MValv, carbon dioxide elimination (VCO2, and static chest compliance (Cst were measured during chest optimization; then MValv and rapid shallow breathing index (RSBI were measured during SBT. Study participants (N = 12 were clinically stable ventilator-dependent patients with low CSCI. Trendelenburg chest optimization (TCO was associated with significant increases in SBT (p < 0.001, CO (p < 0.001, MValv (p < 0.003, VCO2 (p < 0.001, and Cst (p < 0.002. SBT following TCO was associated with significant increases in MValv (p < 0.03 and RSBI (p < 0.002. These preliminary findings suggest the importance of proper recumbent body positioning during evidence-based, protocol-guided multimodal chest physiotherapy for ventilator-dependent patients with low CSCI.

  4. Epicritic sensation in cervical spinal cord injury: diagnostic gains beyond testing light touch

    OpenAIRE

    Velstra, Inge-Marie; Bolliger, Marc; Baumberger, Michael; Rietman, Johan Swanik; Curt, Armin

    2013-01-01

    Abstract Applied as a bedside test of gross dorsal column function, the testing of light touch (LT) sensation is of high clinical value in the diagnosis of human spinal cord injury (SCI). However, the assessment of overall dorsal column deficit by testing only LT may be limited, because the dorsal column pathway conveys several large diameter afferent modalities (e.g., sensation of touch, two-point discrimination, and proprioception). Therefore, the objective of this study was to compare the ...

  5. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

    OpenAIRE

    John Tran; Donald Jeanmonod; Darin Agresti; Khalief Hamden; Jeanmonod, Rebecca K.

    2016-01-01

    Introduction: The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two ...

  6. Mediation of endogenous peroxynitrite in the injury of cultured pulmonary artery endothelial cells induced by lipopolysaccharide

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    This experiment, using cultured bovine pulmonary artery endothelial cells (BPAEC), was undertaken to investigate roles of endogenous ONOO- in lipopolysaccharide (LPS)-caused injury to endothelial cells. The fluorescent intensity of nitrotyrosine (NT), a marker of ONOO- generation, in BPAEC represented content of endogenous ONOO- generation. The fluorescent intensity of NT and number of NT positive cells were detected with flow cytometry, and the percentage of NT positive cells was calculated. Results were as follows. (1) LPS (1 mg/L, 5 mg/L and 10 mg/L) caused marked increase in fluorescent intensity of NT in a dose dependent manner. The number and percentage of NT positive cells were markedly increased (P<0.05). Aminoguanidine (AG), a selective inhibitor of inducible nitric oxide synthase, inhibited the increase in fluorescent intensity of NT in BPAEC induced by LPS. However, the number and percentage of NT positive cells had tendency to reduce. (2) LPS caused the enhancement of MDA content and activity of LDH in cultured supernatant (P<0.01). AG reversed the enhancement of MDA content induced by LPS (P<0.01). In contrast, AG had marginal effect on activity of LDH. (3) LPS induced the increase in apoptotic rate in BPAEC in a dose dependent manner. Some BPAEC stained with fluorescent probe ethidium bromide showed morphological features of apoptosis with chromatin condensation and nuclear fragmentation. AG reduced the apoptotic rate and number of apoptotic cells, both of which were still higher than those of vehicle group (P<0.05). (4) LPS inhibited mitochondrial respiration. Effect of LPS on mitochondrial membrane potential (ΔΨ) depended on the doses of LPS. 1 mg/L LPS led to a little increase in ΔΨ, while 5 mg/L and 10 mg/L LPS significantly reduced ΔΨ. In conclusion, LPS caused injury to cultured BPAEC and increased production of ONOO-. Cytotoxicity of LPS may be mediated by endogenous ONOO-.

  7. Regulation of CCL5 expression in smooth muscle cells following arterial injury.

    Directory of Open Access Journals (Sweden)

    Huan Liu

    Full Text Available Chemokines play a crucial role in inflammation and in the pathophysiology of atherosclerosis by recruiting inflammatory immune cells to the endothelium. Chemokine CCL5 has been shown to be involved in atherosclerosis progression. However, little is known about how CCL5 is regulated in vascular smooth muscle cells. In this study we report that CCL5 mRNA expression was induced and peaked in aorta at day 7 and then declined after balloon artery injury, whereas IP-10 and MCP-1 mRNA expression were induced and peaked at day 3 and then rapidly declined.The expression of CCL5 receptors (CCR1, 3 & 5 were also rapidly induced and then declined except CCR5 which expression was still relatively high at day 14 after balloon injury. In rat smooth muscle cells (SMCs, similar as in aorta CCL5 mRNA expression was induced and kept increasing after LPS plus IFN-gamma stimulation, whereas IP-10 mRNA expression was rapidly induced and then declined. Our data further indicate that induction of CCL5 expression in SMCs was mediated by IRF-1 via binding to the IRF-1 response element in CCL5 promoter. Moreover, p38 MAPK was involved in suppression of CCL5 and IP-10 expression in SMCs through common upstream molecule MKK3. The downstream molecule MK2 was required for p38-mediated CCL5 but not IP-10 inhibition. Our findings indicate that CCL5 induction in aorta and SMCs is mediated by IRF-1 while activation of p38 MAPK signaling inhibits CCL5 and IP-10 expression. Methods targeting MK2 expression could be used to selectively regulate CCL5 but not IP-10 expression in SMCs.

  8. Occlusive thrombi arise in mammals but not birds in response to arterial injury: evolutionary insight into human cardiovascular disease

    OpenAIRE

    Schmaier, Alec A.; Stalker, Timothy J.; Runge, Jeffrey J.; Lee, Dooyoung; Nagaswami, Chandrasekaran; Mericko, Patricia; Chen, Mei; Cliché, Simon; Gariépy, Claude; Brass, Lawrence F.; Hammer, Daniel A.; Weisel, John W.; Rosenthal, Karen; Kahn, Mark L.

    2011-01-01

    Mammalian platelets are small, anuclear circulating cells that form tightly adherent, shear-resistant thrombi to prevent blood loss after vessel injury. Platelet thrombi that form in coronary and carotid arteries also underlie common vascular diseases such as myocardial infarction and stroke and are the target of drugs used to treat these diseases. Birds have high-pressure cardiovascular systems like mammals but generate nucleated thrombocytes rather than platelets. Here, we show that avian t...

  9. A Perfusion-based Human Cadaveric Model for Management of Carotid Artery Injury during Endoscopic Endonasal Skull Base Surgery.

    Science.gov (United States)

    Pham, Martin; Kale, Aydemir; Marquez, Yvette; Winer, Jesse; Lee, Brian; Harris, Brianna; Minnetti, Michael; Carey, Joseph; Giannotta, Steven; Zada, Gabriel

    2014-10-01

    Objective To create and develop a reproducible and realistic training environment to prepare residents and trainees for arterial catastrophes during endoscopic endonasal surgery. Design An artificial blood substitute was perfused at systolic blood pressures in eight fresh human cadavers to mimic intraoperative scenarios. Setting The USC Keck School of Medicine Fresh Tissue Dissection Laboratory was used as the training site. Participants Trainees were USC neurosurgery residents and junior faculty. Main Outcome A 5-point questionnaire was used to assess pre- and posttraining confidence scores. Results High-pressure extravasation at normal arterial blood pressure mimicked real intraoperative internal carotid artery (ICA) injury. Residents developed psychomotor skills required to achieve hemostasis using suction, cottonoids, and muscle grafts. Questionnaire responses from all trainees reported a realistic experience enhanced by the addition of the perfusion model. Conclusions The addition of an arterial perfusion system to fresh tissue cadavers is among the most realistic training models available. This enables the simulation of rare intraoperative scenarios such as ICA injury. Strategies for rapid hemostasis and implementation of techniques including endoscope manipulation, suction, and packing can all be rehearsed via this novel paradigm. PMID:25301092

  10. Arterial Spin Labeling Perfusion Study in the Patients with Subacute Mild Traumatic Brain Injury.

    Directory of Open Access Journals (Sweden)

    Che-Ming Lin

    Full Text Available This study uses a MRI technique, three-dimension pulse continuous arterial spin labeling (3D-PCASL, to measure the patient's cerebral blood flow (CBF at the subacute stage of mild traumatic brain injury (MTBI in order to analyze the relationship between cerebral blood flow and neurocognitive deficits.To provide the relationship between cortical CBF and neuropsychological dysfunction for the subacute MTBI patients.After MTBI, perfusion MR imaging technique (3D-PCASL measures the CBF of MTBI patients (n = 23 within 1 month and that of normal controls (n = 22 to determine the quantity and location of perfusion defect. The correlation between CBF abnormalities and cognitive deficits was elucidated by combining the results of the neuropsychological tests of the patients.We observed a substantial reduction in CBF in the bilateral frontal and left occipital cortex as compared with the normal persons. In addition, there were correlation between post concussive symptoms (including dizziness and simulator sickness and CBF in the hypoperfused areas. The more severe symptom was correlated with higher CBF in bilateral frontal and left occipital lobes.First, this study determined that despite no significant abnormality detected on conventional CT and MRI studies, hypoperfusion was observed in MTBI group using 3D-PCASL technique in subacute stage, which suggested that this approach may increase sensitivity to MTBI. Second, the correlation between CBF and the severity of post concussive symptoms suggested that changes in cerebral hemodynamics may play a role in pathophysiology underlies the symptoms.

  11. Cervical Fracture Dislocation with Spinal Cord Injury Preoperative Observation and Nursing%颈椎骨折脱位合并颈髓损伤的术前观察和护理

    Institute of Scientific and Technical Information of China (English)

    赵勤娟; 蔡梅芬

    2014-01-01

    Objective To study the cervical spine fracture with cervical spinal injury patients combined observation and ef ective nursing methods, improve the cervical spine fracture with cervical spinal injury patients combined nursing level. Methods Analyzed and 1 case of cervical fracture with cervical spinal injury patients combined care, including observation patient's condition carefully, lie the hard bed, prevent infection, the nursing measures such as nutrition support. When merging spinal cord injury, notify the doctor according to the fracture type and line pressure parts needed surgery. Results The patients were cured by surgical treatment. Conclusion The observation patient's condition careful y, positive and appropriate nursing measures are effective treatment for cervical spine fracture dislocation with cervical spinal injury patients and improve the level of care.%目的探讨颈椎骨折脱位合并颈髓损伤患者的观察和有效护理方法,提高颈椎骨折脱位合并颈髓损伤患者的护理水平。方法分析探讨1例颈椎骨折脱位合并颈髓损伤患者的护理,包括严密观察病情变化,卧硬板床,防止感染,营养支持等护理措施。合并脊髓损伤时,通知医生根据骨折类型和受压部位行必要手术治疗。结果本例患者经手术治疗治愈出院。结论严密观察病情变化,采取积极适当的护理措施是有效治疗颈椎骨折脱位合并颈髓损伤患者及提高护理水平的重点。

  12. Effect of Chinese Herbal Fumigation Combined with Tuina on Vertigo and Concentrations of Endothelin and Calcitonin Gene-related Peptide in Patients with Vertebral Artery Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    Zhao Cheng-fei; Liu Xiao-an; Ding Yun

    2014-01-01

    Objective:To observe the effect of Chinese herbal fumigation combined with three-step tuina manipulation on concentration of endothelin (ET) and calcitonin gene-related peptide (CGRP) and vertigo in patients with vertebral artery cervical spondylosis (VACS). Methods:A total of 120 eligible cases were randomly allocated into an observation group and a control group, 60 in each group. Cases in the observation group were treated with Chinese herbal fumigation combined with three-step tuina manipulation, whereas cases in the control group were treated with oral Flunarizine Hydrochloride Capsules. Results: After treatment, vertigo in both groups was alleviated; there were intra-group significant differences in ET decrease and CGRP increase (P Conclusion: Chinese herbal fumigation combined with three-step tuina manipulation can regulate the levels of ET and CGRP and improve vertigo in patients with VACS. Its therapeutic efficacy is superior to oral Flunarizine Hydrochloride Capsules.

  13. Abnormal right hepatic artery injury resulting in right hepatic atrophy: diagnosed by laparoscopic cholecystectomy

    OpenAIRE

    Martino Valter; Ferrarese Alessia; Bindi Marco; Marola Silvia; Gentile Valentina; Rivelli Matteo; Ferrara Yuri; Enrico Stefano; Berti Stefano; Solej Mario

    2015-01-01

    An intact hepatic artery is the gateway to successful hepato-biliary surgery. Introduction of laproscopic cholecystectomy (LC) has stimulated a renewed interest in the anatomy of hepatic artery. In this case report we have highlighted importance of variations of right hepatic artery in terms of origin and course We present a rare asymptomatic case of liver atrophy due to an intraoperative lesion of right hepatic artery. We also performed a literature review about surgical vascular lesions and...

  14. Dissecção espontânea cervical carotídea e verbal: estudo de 48 pacientes Spontaneous cervical carotid and vertebral arteries dissection: study of 48 patients

    Directory of Open Access Journals (Sweden)

    Cynthia Resende Campos

    2004-06-01

    Full Text Available OBJETIVO: Dada a ausência de estudos de séries brasileiras de pacientes com dissecção arterial cervical espontânea, com o objetivo de descrever os fatores de risco, sintomas precedentes, manifestações clínicas, resultados da investigação, tratamento e evolução. MÉTODO: realizamos a análise retrospectiva dos prontuários e laudos radiológicos [angiografia digital(AD, ressonância magnética(RM e ângio-ressonância(ARM] dos pacientes com esse diagnóstico atendidos no Serviço de Neurologia do HC/USP entre 1997 e 2003. RESULTADOS: 48 pacientes (24 homens, média de idade 37,9 anos; 26 pacientes com dissecção carotídea (DC unilateral, 15 com vertebral (DV unilateral e 7 com multiarterial, todos com déficits neurológicos. Os principais fatores de risco para doença vascular foram hipertensão arterial, tabagismo e dislipidemia. Mais de 80% apresentaram pelo menos um sintoma precedente, na maioria cefaléia têmporo-parietal. Cervicalgia foi referida por 44% dos pacientes com DV e por 3,4% dos com DC. O tempo médio entre o primeiro sintoma e o déficit foi 5,4 dias para as DC e 13,5 para as DV. AD foi o principal método diagnóstico (93%, associado a RM e ARM em 42% dos casos. Em 3 pacientes a RM cervical com supressão de gordura foi isoladamente suficiente. 75% dos pacientes receberam anticoagulação. Dois pacientes fizeram trombólise endovenosa sem complicações. A evolução foi boa, exceto por dois óbitos (DC bilateral. CONCLUSÃO: Os resultados são semelhantes aos da literatura, exceto pela baixa freqüência de cervicalgia nos casos de DC e pelo predomínio de cefaléia têmporo-parietal nas dissecções arteriais cervicais. Fatores de risco para doença vascular isquêmica foram frequentes.OBJETIVE: To report a Brazilian series of spontaneous cervical arterial dissections, risk factors, warning symptoms, clinical manifestations, diagnostic tests, treatment and prognosis. METHOD: We performed the retrospective

  15. TCM Minimally Invasive Treatment to Cervical Spondyiosis Related Suboccipitsl Muscle Injury%椎枕肌损伤的中医微创治疗探讨

    Institute of Scientific and Technical Information of China (English)

    叶新苗; 黄雪莲

    2012-01-01

    [Objective] To discuss the curative effect of TCM minimally invasive treatment on suboccipital muscle injury in cervical spondylosis. [Method] Study the relativity among concerned anatomy, pathogeny, pathology, clinical demonstration and acupotomy minimally invasive treatment to suboccipital muscle. [Result] It finds that there're some relative diseases of suboccipital muscle injury and cervical spondylosis. [Conclusion] It has marked curative effect on suboccipital muscle injury with TCM acupotomy treatment.%[目的]探讨颈椎病中医针刀微创治疗法在治疗椎枕肌损伤时的疗效.[方法]对椎枕肌的相关解剖、病因病理、临床表现、针刀微创治疗的相关性予以研究.[结果]研究发现椎枕肌损伤与颈椎病有相关的一些病证.[结论]中医针刀治疗椎枕肌损伤疗效显著.

  16. Supine Cervical Traction Techniques for Treatment of Vertebral Artery Cervical Spondylosis%仰卧位手法牵引在治疗椎动脉型颈椎病中的运用

    Institute of Scientific and Technical Information of China (English)

    金伟; 贾东奇; 李曦光; 陈光

    2012-01-01

    目的 对于行常规器械牵引有不良反应的椎动脉型颈椎病患者,尝试使用仰卧位手法牵引进行治疗,以提高该类疾病的治疗效果.方法 按随机数字表法将45例常规器械牵引有不良反应的椎动脉型颈椎病患者分为观察组(n=22)和对照组(n=23).对照组采用药物、理疗、颈部制动和推拿的方法进行治疗,观察组则在上述方法的基础上增加仰卧位手法牵引,由专人对每位患者的疗效进行评定和记录.结果 经过 30 次治疗后,对观察组和对照组的每位患者进行疗效评定,总有效率分别为90.91%和65.22%;观察组治疗前后采用经颅多普勒超声(TCD)比较血流速度,差异有统计学意义(P<0.05).结论 椎动脉型颈椎病在传统的治疗方法中增加仰卧位手法牵引可以显著改善颈椎牵引有不良反应的患者的颈部动脉血流状态,提高临床治疗效果.%Objective To observe the effect of traction - manipulation in supine position for patients with vertebral artery cervical spondylosis who had had untoward reaction to the conventional mechanical traction. Methods Totally 45 patients who had had untoward reaction to the conventional mechanical traction were divided into control ( n = 22 ) and observation ( n = 23 ) group according to random number table. The patients in the control group were treated by medicine, physical therapy and Chinese traditional massage. The patients in the observation group were additionally done by traction - manipulation in supine position. Before treatment and after 30 times treatment, the results of the therapy were assessed by specially - assigned persons. Results After 30 - time treatment, the total effective rate was 90. 91% for the observation group and 65. 22% for the control group. And the transcranial Doppler ultrasonography ( TCD ) showed that there was significant difference in blood flow speed ( P < 0. 05 ) . Conclusion Traction - manipulation in supine position combined

  17. Pre-existing interleukin 10 in cerebral arteries attenuates subsequent brain injury caused by ischemia/reperfusion.

    Science.gov (United States)

    Liang, Qiu-Juan; Jiang, Mei; Wang, Xin-Hong; Le, Li-Li; Xiang, Meng; Sun, Ning; Meng, Dan; Chen, Si-Feng

    2015-09-01

    Recurrent stroke is difficult to treat and life threatening. Transfer of anti-inflammatory gene is a potential gene therapy strategy for ischemic stroke. Using recombinant adeno-associated viral vector 1 (rAAV1)-mediated interleukin 10 (IL-10), we investigated whether transfer of beneficial gene into the rat cerebral vessels during interventional treatment for initial stroke could attenuate brain injury caused by recurrent stroke. Male Wistar rats were administered rAAV1-IL-10, rAAV1-YFP, or saline into the left cerebral artery. Three weeks after gene transfer, rats were subjected to occlusion of the left middle cerebral artery (MCAO) for 45 min followed by reperfusion for 24 h. IL-10 levels in serum were significantly elevated 3 weeks after rAAV1-IL-10 injection, and virus in the cerebral vessels was confirmed by in situ hybridization. Pre-existing IL-10 but not YFP decreased the neurological dysfunction scores, brain infarction volume, and the number of injured neuronal cells. AAV1-IL-10 transduction increased heme oxygenase (HO-1) mRNA and protein levels in the infarct boundary zone of the brain. Thus, transduction of the IL-10 gene in the cerebral artery prior to ischemia attenuates brain injury caused by ischemia/reperfusion in rats. This preventive approach for recurrent stroke can be achieved during interventional treatment for initial stroke.

  18. Temporary arterial stenting in a full-house spaghetti wrist injury in a remote rural setting: benefit for hand perfusion or risk of increased morbidity?

    OpenAIRE

    Bauer, Stefan; Savundra, James

    2013-01-01

    We report a case of temporary arterial plastic tube stenting of the ulnar and radial artery in a complete spaghetti wrist injury in a remote rural setting. Exploration in a specialist centre 18 h postinjury revealed that the tubes were clotted off with adjacent thrombi but hand perfusion was maintained. Intimal damage required vein grafting of both arteries 24 h postinjury. Hand perfusion was not compromised at follow-up. This case highlights that arterial hand perfusion can be maintained wit...

  19. Increased blood pressure can reduce fatigue of thenar muscles paralyzed after spinal cord injury

    NARCIS (Netherlands)

    Butler, JE; Ribot-Ciscar, E; Zijdewind, Inge; Thomas, CK

    2004-01-01

    The aim of this study was to evaluate whether increases in blood pressure, and presumably muscle perfusion pressure, improve the endurance of thenar muscles paralyzed chronically by cervical spinal cord injury (SCI). Resting mean arterial pressure (MAP) was low in all eight subjects (64 +/- 2 mmHg).

  20. Cervical dysplasia

    Science.gov (United States)

    ... by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. ... Early diagnosis and prompt treatment cures most cases of cervical ... severe cervical dysplasia may change into cervical cancer.

  1. 物理综合疗法治疗椎动脉型颈椎病疗效观察%The Effective Observation of Comprehensive Physical Therapy on Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    赵素萍

    2013-01-01

    目的:探讨物理综合疗法对椎动脉型颈椎病的疗效。方法将120例椎动脉型颈椎病患者随机分为颈椎牵引、干扰组(对照组)、颈椎牵引加超激光、干扰电综合治疗组(治疗组),治疗20次后,进行比较。结果治疗组总有效率98.3%,对照组为85%。治疗组疗效明显优于对照组(P<0.05)。结论采用颈椎牵引、超激光、干扰电综合疗法治疗椎动脉型颈椎病比颈椎牵引、干扰电疗效更好,值得临床推广。%Objective To discuss the ef icacy of combining physical therapy on cervical spondylosis of vertebral artery type. Methods 120 cases of cervical spondylosis of vertebral artery type were divided randomly into control group (cervical traction with interference current therapy) and treatment group (cervical traction combined with super laser and interference current therapy).They compared the ef icacy after 20 times treatment. Results The total ef ective rate was 98.3%in treatment group,the control group is 85%. But the curative ef ect of treatment group was much bet er than control group (P<0.05). Conclusion The curative ef ect is bet er using combination therapy of cervical traction,super laser and interference current than cervical traction with interference current therapy,and it is worth popularizing.

  2. Long-term MRI tracking of dual-labeled adipose-derived stem cells homing into mouse carotid artery injury

    Directory of Open Access Journals (Sweden)

    Qin JB

    2012-10-01

    Full Text Available Jin-Bao Qin,1,5,* Kang-An Li,2,* Xiang-Xiang Li,1,5 Qing-Song Xie,3 Jia-Ying Lin,4 Kai-Chuang Ye,1,5 Mi-Er Jiang,1,5 Gui-Xiang Zhang,2 Xin-Wu Lu1,51Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, 2Department of Radiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 3Department of Neurosurgery, Cixi Municipal People's Hospital, Zhejiang Province, China; 4Clinic for Gynecology, Charite-Universitatsmedizin Berlin, Berlin, Germany; 5Vascular Center, Shanghai Jiao Tong University, Shanghai, China*These two authors contributed equally to this workBackground: Stem cell therapy has shown great promise for regenerative repair of injured or diseased tissues. Adipose-derived stem cells (ADSCs have become increasingly attractive candidates for cellular therapy. Magnetic resonance imaging has been proven to be effective in tracking magnetic-labeled cells and evaluating their clinical relevance after cell transplantation. This study investigated the feasibility of imaging green fluorescent protein-expressing ADSCs (GFP-ADSCs labeled with superparamagnetic iron oxide particles, and tracked them in vivo with noninvasive magnetic resonance imaging after cell transplantation in a model of mouse carotid artery injury.Methods: GFP-ADSCs were isolated from the adipose tissues of GFP mice and labeled with superparamagnetic iron oxide particles. Intracellular stability, proliferation, and viability of the labeled cells were evaluated in vitro. Next, the cells were transplanted into a mouse carotid artery injury model. Clinical 3 T magnetic resonance imaging was performed immediately before and 1, 3, 7, 14, 21, and 30 days after cell transplantation. Prussian blue staining and histological analysis were performed 7 and 30 days after transplantation.Results: GFP-ADSCs were found to be efficiently labeled with superparamagnetic iron oxide

  3. Early therapy of cervical vertigo in head injury%颅脑外伤中颈性眩晕的早期治疗研究

    Institute of Scientific and Technical Information of China (English)

    丁轩; 鲍洪; 吴开华; 招建华; 兰蒙

    2008-01-01

    Objective To discuss early therapy scheme for cervical vertigo in mild and moderate head injury. Methods Eighty-four patients suffering from cervical vertigo in mild or moderate head injury were randomly divided into 2 groups: combined therapy group (n=38) and control group (n=46). In the combined therapy group, patients underwent cervical vertebra traction and stellate ganglion block and early physical therapy for cervix as well as medication; in the control group, simple medication was used. The results were analyzed by nonparametric rank sum test Ridit analysis. Results In the combined therapy group, 29 cases were cured, 8 got better, and 1 remained unchanged, average therapy duration 20 d, while in the control group, 26 were healed, 15 changed better, and 5 did not show a sign of recovery, average therapy duration 30 d. The curative effect was significantly different between the 2 groups, and the combined therapy group was better than the control group (P<0.05). Conclusion The early application of the combined therapy for cervical vertigo in mild and moderate head injury can improve the cure rate and reduce the therapy duration.%目的 探讨轻、中型颅脑外伤中颈性眩晕患者的早期治疗方案.方法 将轻、中型颅脑外伤中颈性眩晕患者84例按随机数字表法分成治疗组(38例)与对照组(46例),治疗组采用颈椎牵引、星状神经节封闭、早期颈部理疗等方法 并结合药物治疗,对照组采用单纯药物治疗,对其疗效进行非参数秩和检验分析.结果 治疗组治愈29例,好转8例,无效1例,平均治疗时间20d;对照组治愈26例,好转15例,无效5例,平均治疗时间30 d;治疗组疗效优于对照组,差异有统计学意义(P<0.05).结论对颅脑外伤中颈性眩晕患者早期采用针对性治疗,其疗效好于单纯药物治疗,且治疗时间缩短.

  4. 儿童颈椎外伤的诊断及治疗%The diagnosis and treatment of cervical spine injuries in children

    Institute of Scientific and Technical Information of China (English)

    熊伟; 李锋; 郭风劲; 陈安民

    2008-01-01

    目的 探讨儿童颈椎外伤的临床特点、诊断、治疗方法及难点和要点.方法 回顾性分析我院1995年1月至2005年12月期间治疗的儿童颈椎外伤病例的临床资料,同时检索分析国内外关于儿童颈椎外伤的文献.结果 11例患儿纳入本研究,其中男8例,女3例;平均年龄(12.1±4.0)岁;受伤机制包括坠落伤(3例),运动伤(3例),车祸伤(2例),直接暴力伤(2例),因娱乐致伤(1例).受伤部位分布为C1-34例,C4-77例.4例合并神经系统症状,其中1例为无骨折脱位型脊髓损伤.4例接受手术治疗,7例行保守治疗.结论 儿童颈椎外伤相对少见,其在临床表现、影像学检查及治疗方法上均存在与年龄相关的特点.熟悉这些特点对儿童颈椎外伤患儿的诊断及治疗至关重要.%Objective To review our experience in diagnosis and treatment of pediatric cervical spine injuries. Methods From January 1995 to December 2005, 11 patients including 8 boys and 3 girls were recruited in this study. Their mean age was 12. 14 years, ranged from 5 to 17 years. The causes for injury included falls (3 cases), sports related injuries (3 cases), traffic accidents (2 cases), direct hit injuries (2 bcases), and entertainment related injuries (1 case). All patients underwent neurological and radiological examinations. The treatments were carried out according to the results of such examinations. Results The injury sites were C1-3 in 4 patients and C4-7 in 7 patients. Neurological function was evaluated according to Frankel score: 1 case of Frankel A, 1 case of Frankel B, 2 cases of Frankel C and 7 cases of Frankel E. One of the 11 patients was affected by spinal cord injury without radiographic abnormality. Seven patients were cured by conservative treatments. The other 4 patients underwent operations, 2 were anterior decompression and fusion operations and the other 2 were posterior approach operations. Among the 2 cases with posterior approach, 1 was

  5. Ipsilateral common iliac artery plus femoral artery clamping for inducing sciatic nerve ischemia/reperfusion injury in rats: a reliable and simple method

    Directory of Open Access Journals (Sweden)

    Barzegar-Fallah Anita

    2008-12-01

    Full Text Available Abstract The aim of this study was to develop a practical model of sciatic ischemia reperfusion (I/R injury producing serious neurologic deficits and being technically feasible compared with the current time consuming or ineffective models. Thirty rats were divided into 6 groups (n = 5. Animal were anesthetized by using ketamine (50 mg/kg and xylazine (4 mg/kg. Experimental groups included a sham-operated group and five I/R groups with different reperfusion time intervals (0 h, 3 h, 1 d, 4 d, 7 d. In I/R groups, the right common iliac artery and the right femoral artery were clamped for 3 hrs. Sham-operated animals underwent only laparotomy without induction of ischemia. Just before euthanasia, behavioral scores (based on gait, grasp, paw position, and pinch sensitivity were obtained and then sciatic nerves were removed for light-microscopy studies (for ischemic fiber degeneration (IFD and edema. Behavioral score deteriorated among the ischemic groups compared with the control group (p

  6. Comparison of the conventional CMAC and the D-blade CMAC with the direct laryngoscopes in simulated cervical spine injury-a manikin study

    Directory of Open Access Journals (Sweden)

    Divya Jain

    2014-07-01

    Full Text Available BACKGROUND: CMAC videolaryngoscope has recently been introduced for videoscope guided intubation. The aim of our study was to compare and evaluate the efficacy of the conventional blade and the angulated D blade of the CMAC videolaryngoscope with the direct laryngoscopes in simulated cervical spine injury patients on the airway manikin. MATERIALS AND METHODS: Following power analysis, 33 resident doctors were enrolled to perform endotracheal intubation using all the 4 different laryngoscopes namely the Macintosh laryngoscope, McCoy laryngoscope, conventional CMAC videolaryngoscope and the D blade of the CMAC videolaryngoscopes on the airway manikin in simulated cervical spine injury. The demographic variables of the resident doctors were recorded. The outcomes measured included vocal cord visualization (Cormack-Lehane grading, time taken to intubate, number of attempts for successful intubation and optimizing maneuvers required. RESULTS: The use of indirect videolaryngoscopes resulted in better glottic visualization in comparison to the direct laryngoscopes (CL-I in 20/33 (60.6% in the Macintosh group, 24/33 (72.7% in McCoy group, 30/33 in (90.9% in Vlc group and 32/33 (96.9% in Vld group. The time taken to intubate averaged to 15.54 ± 2.6 in Macintosh group, 18.90 ± 4.47 in McCoy group, 20.21 ± 7.9 in Vlc group and 27.42 ± 9.09 in Vld group. The 1st attempt intubation success rate was 84.8% (Macintosh, 72.7% (McCoy, 90.9% (Vlc and, 78.7% (Vld. CONCLUSIONS: The overall performance of the conventional CMAC blade proved to be the best when compared with the D-blade CMAC, Macintosh blade and the McCoy blade for intubation in simulated cervical spine patients by anesthesia residents.

  7. 颈椎损伤的X线与CT诊断%The Diagnosis of X-ray and CT for Cervical Spine Injury

    Institute of Scientific and Technical Information of China (English)

    黄金龙; 周鹏; 高雪梅

    2010-01-01

    目的 探讨常规X线和CT扫描对颈椎损伤的诊断价值.方法 对50例X线和CT诊断为颈椎损伤的病例进行分析.结果 本组50例,受损椎体共60个.低位颈椎骨折并(或)脱位27例,寰椎骨折9例,寰枢椎脱位8例,枢椎骨折6例.X线平片显示椎体后缘联线异常24例,CT片根据脊柱三柱结构诊断不稳定骨折28例,椎管0度狭窄22例,1度狭窄17例,2度狭窄8例,3度狭窄3例.外伤性颈椎间盘脱出10例.结论 对于颈椎损伤的患者,应常规行X线和CT扫描检查,以利于为临床提供更全面可靠的信息.CT能对颈椎损伤做出较全面、准确的诊断,有利于治疗方案的选择,可作为颈椎损伤临床术前诊断和治疗的影像学检查的首选方法.%Objective To evaluate the diagnosis value of X-ray and CT for cervical spine injury. Methods The clinical data of 50 cases of vertebral spine injuries which were neglected due to missed diagnosis were analyzed retrospectively. Results 50 cases with cervical spine injury, among of them, 27 cases with fracture and/(or) dislocation of the lower cervical vertebrae,9 cases had atlantal fracture,8 cases had atlantoaxial dislocation and 6 cases had the axoid fracture. 24 cases showed abnormality in the lines of vertebral posterior border in the X-ray plain films. 28 cases were diagnosed instabitity,22 cases vertebral canal 0° stricture, 17 cases Ⅰ°stricture, 8 cases Ⅱ°stricture,3 cases Ⅲ° stricture were diagnosed according CT films. 10 cases traumatic cervicales disc herniation. Conclusion X-ray and CT have their own localization for injured cervical vertebraes. We must perform X-ray and CT examination in order to provide overall and reliable information for clinical diagnosis. CT is becoming an indispensible and best modality of choices in the diagnosis of atloaxoid injuries helpful for the surgeon to decide clinical management. The advantages of CT are suggested that this diagnostic modality may be the standard method for

  8. 枕颈融合联合枕下减压术治疗枕颈畸形并脊髓损伤%Treatment of occipital -cervical deformity and spinal cord injury with foramen magnum decompression combined with occipital -cervical fusion

    Institute of Scientific and Technical Information of China (English)

    喻志; 刘学森; 严鹏辉; 郝志全; 李兵兵; 黄宗强

    2016-01-01

    artery injury during operation.The screws were in good posi-tion,no loosening or broken screws.All of the screws were in the healing of bone.The spinal function got improved in all pa-tients,the preoperative scores of JOA were 5 ~1 2(7.1 ±1 .8)scores,and the JOA scores of postoperative 1 2 months were 8 ~1 7 (1 4.9 ±1 .6)scores.There was a statistically significant difference in JOA scores between pre -operation and post -operation (P <0.05).Conclusion Foramen magnum decompression and occipital -cervical fusion with internal fixation is safe,simple and effective for occipital -cervical deformity and spinal cord injury,worthy of clinical promotion.

  9. Surgical treatment of cervical spinal cord injury without fracture and dislocation%无骨折脱位的颈脊髓损伤的手术治疗

    Institute of Scientific and Technical Information of China (English)

    乔宗瑞

    2014-01-01

    Objective To explore the effect of surgical treatment of cervical spinal cord injury without fracture and dislocation. Methods 45 cases of cervical spinal cord injury without fracture and dislocation were treated with early decompression surgery. The changes in JOA score before and after treatment were compared. Results The excellent rate of surgical treatment reached 82.2%. The average JOA score after surgery (9.31±1.86) was significantly higher than that before surgery (5.24±1.52), with statistical significance(P < 0.01). Conclusion Prompt and correct diagnosis, propoer grasp of the operation time and positive surgical intervention can achieve better clinical effect for spinal cord injury without fracture and dislocation.%目的:探讨无骨折脱位的颈髓损伤的手术治疗效果。方法45例无骨折脱位型颈髓损伤患者,均行早期减压手术治疗。对比治疗前后JOA评分变化。结果手术治疗优良率82.2%。术后JOA平均评分(9.31±1.86)明显高于术前(5.24±1.52),差异有统计学意义(P<0.01)。结论对无骨折脱位型脊髓损伤,及时正确的诊断,正确把握手术时机,积极外科干预可取得较好的临床效果。

  10. The psychological state of the post- hospital patients with quadriplegia caused by cervical spinal cord injury%颈髓损伤并四肢瘫痪患者出院后心理状况的调查分析

    Institute of Scientific and Technical Information of China (English)

    杨绿频; 黄楚君; 陈楚玲

    2010-01-01

    目的 调查颈髓损伤并四肢瘫痪患者出院后的心理状况,寻求相应康复对策.方法 应用症状自评量表(SCL-90)对88例出院后的颈髓损伤并四肢瘫痪患者进行调查.结果 出院后的颈髓损伤并四肢瘫痪患者的SCL各项得分均超出常模.结论 颈髓损伤并四肢瘫痪患者出院后的心理健康状况都不理想,应采取相应措施改变其心理状况.%Objective To investigate the psychological state of the post-hospital patients with quadriplegia caused by cervical spinal cord injury , so as to seek appropriate rehabilitation strategies. Methods SCL (SCL-90) was used to investigate 88 post -hospital patients with quadriplegia caused by cervical spinal cord injury. Results The every SCL score of post - hospital patients with quadriplegia caused by cervical spinal cord injury was beyond the normal. Conclusions The mental health of the post - hospital patients with quadriplegia caused by cervical spinal cord injury has not been satisfied.

  11. Pseudoaneurysm of the internal carotid artery after shrapnel injury in World War II. Demonstration by CT angiography with 3D MIP reconstruction

    International Nuclear Information System (INIS)

    A case of pseudoaneurysm of the left internal carotid artery (ICA) after shrapnel injury is demonstrated by intra-arterial digital subtraction angiography (DSA) and computed tomography angiography (CTA) with subtraction technique. Although the pseudoaneurysm was well demonstrated by intra-arterial DSA, CTA was the only modality to demonstrate the three-dimensional shape of the perfused part of pseudoaneurysm and the aneurysmal neck, which affected the therapeutic strategy. The CTA technique is useful in the assessment of large pseudoaneurysms and for therapeutic planning. (orig.)

  12. Postoperative acute kidney injury defined by RIFLE criteria predicts early health outcome and long-term survival in patients undergoing redo coronary artery bypass graft surgery

    OpenAIRE

    Zakkar, Mustafa; Bruno, Vito D; Guida, Guida A; Angelini, Gianni D; Chivasso, Pierpaolo; Suleiman, M Sadeeh; Bryan, Alan J.; Ascione, Raimondo

    2016-01-01

    OBJECTIVE: To investigate the impact of postoperative acute kidney injury (AKI) on early health outcome and on long-term survival in patients undergoing redo coronary artery bypass grafting (CABG).METHODS: We performed a Cox analysis with 398 consecutive patients undergoing redo CABG over a median follow-up of 7 years (interquartile range, 4-12.2 years). Renal function was assessed using baseline and peak postoperative levels of serum creatinine. AKI was defined according to the risk, injury,...

  13. Traumatic bilateral carotid artery dissection following severe blunt trauma: a case report on the difficulties in diagnosis and therapy of an often overlooked life-threatening injury

    OpenAIRE

    Crönlein, Moritz; Sandmann, Gunther H.; Beirer, Marc; Wunderlich, Silke; Biberthaler, Peter; Huber-Wagner, Stefan

    2015-01-01

    Background Traumatic carotid artery dissections are very rare, often overlooked and life-threatening injuries. Diagnosis and treatment are difficult especially in multiple injured patients. Case presentation We report on a 28-year-old female major trauma patient (injury severity score, ISS 50) who was involved in a motor vehicle accident. She was primarily transferred to a level II trauma center. After initial assessment and operative management, an anisocoria was diagnosed on the intensive c...

  14. Clinical study of combined C2 laminar screw fixation technique for cervical vertebral injury%组合枢椎椎板螺钉固定技术治疗颈椎损伤的临床研究

    Institute of Scientific and Technical Information of China (English)

    胡勇; 马维虎; 徐荣明; 阮永平; 孙韶华

    2009-01-01

    of odontoid process fractures, two with type Ⅲ odontoid process fractures combined with atlanto-axial joint instability and transverse ligament rupture, one with type Ⅱ Hangman fracture combined with instability of C2~3 and one with forward dislocation of atlanto-axial joint combined with transverse ligament rupture. With accomplishment of traction reduction, combined fixation with axis laminar screws and posterior autogenous lilac graft fusion were done based on injury se-verity of the patients. Results The length and height of axis laminar was (26.2±1.2) mm and (12.8±1.6) mm, respectively. The thickness of upper, middle and lower parts of the C2 laminar was (3.0±1.4) mm, (6.0±1.6) mm and (5.6±1.2) mm, respectively. The mean angle between the axial ray and sagittal plane was 43.5°. All patients were followed up for 6-14 months ( mean 6 months), which showed that all patients obtained favourable bone union and all screws remained at sound position, without deflexion of the screws or any perioperative or postoperative complications. No screw loosening or breakage occurred. Conclusions C2 laminar screw fixation technique can prevent the risk of vertebral artery injury during screw insertion. In the meantime, such technique is simple to operate and free from limitation of the vertebral artery in the cervical foramen. Whole course of visualization during C2 laminar screw insertion may facilitate it as a supplementary method for conventional posterior C2 screw fixation.

  15. Deep arterial injury during experimental angioplasty: relation to a positive indium-111-labeled platelet scintigram, quantitative platelet deposition and mural thrombosis

    International Nuclear Information System (INIS)

    Although it is not clear why coronary occlusion and restenosis occur after successful coronary angioplasty, factors related to the procedure may influence early and late results. The possible adverse effects of a medial tear documented histologically and produced during balloon angioplasty of the common carotid arteries were studied in 30 fully heparinized (100 U/kg body weight) normal pigs. Scanning electron microscopy showed endothelial denudation and extensive platelet deposition in all dilated arterial segments. Visible macroscopic mural thrombus was present within an hour of the procedure in 29 (91%) of the 32 arteries that had a medial tear documented by histologic study; the tear produced an indium-111-labeled platelet deposition of 116.4 +/- 26.5 X 10(6)/cm2 (mean +/- SE) and total thrombotic occlusion in 2 arteries (4%). None of the 24 arteries without a medial tear had a thrombus, and the mean platelet deposition in that group was 7.0 +/- 0.5 X 10(6)/cm2 (p less than 0.0008). In 12 pigs scanned with a gamma camera, visible thrombus was associated with platelet deposition in excess of 20 X 10(6)/cm2 in 12 arteries, 9 of which had a positive indium-111-labeled platelet scintigram. Thus, arterial angioplasty causes deep arterial injury, which appears to be a major cause of mural thrombosis, heavy platelet deposition, a positive indium-111-labeled platelet scintigram and acute arterial occlusion. A positive indium-111-labeled platelet scintigram was always associated with macroscopic thrombus of at least 20 > 10(6) platelets/cm2 and underlying deep arterial injury

  16. Utility of CT angiography in cervical spine trauma: analysis of radiation and cost

    Directory of Open Access Journals (Sweden)

    Waqas Shuaib

    2014-12-01

    Full Text Available Purpose: Vertebral artery injuries (VAIs can be seen in cervical injuries. This investigation was conducted to assess the impact of head and neck computed tomography (CT angiography (CTA on planning treatment of vertebral artery injuries, if these tests were ordered appropriately, and to estimate cost and associated exposure to radiation and contrast material. Methods: This retrospective review included all patients who underwent CT of the cervical spine and CTA of the head and neck from March 2011 to October 2012 at a single institution. Patients were divided into two groups, those with and those without cervical spine fracture appreciated on CT of the cervical spine. The frequency of vascular injury on CTA in those with a cervical fracture was assessed. The frequency of vascular injury treatment and modifications owed to a positive CTA of head and neck were also assessed. A study was considered appropriate if it was ordered in accordance with the modified Denver Screening criteria. Effective radiation dose (mSv was calculated by multiplying dose length product (DLP from the scanner with the standard conversion coefficient (k (k = 0.0021 mSv/mGy x cm.Results: In the 387 CTAs of head and neck, a cervical injury was recorded in 128 patients. Twenty CTA scans were correctly ordered for non-spinal indications, and 19 were ordered off protocol. CTA was found positive in 1 patient for whom the imaging was off protocol and 1 for whom the clinical indication was non-cervical. There were 19 positive CTA cases of head and neck, none of which underwent surgical intervention. CTA was positive in 13 of 48 patients who had suffered a C2 fracture; this accounted for 13 of the 19 positive CTA studies (p < 0.01. Estimated fee for CTA was $3783, and radiation exposure was 4 mSv with a standard deviation (±1.3. Conclusion: CTA of head and neck ordered off an institutional imaging protocol has a low probability of being positive. Adherence to protocols for CTA of

  17. Potential Role of Axonal Chemorepellent Slit2 in Modulating Adventitial Inflammation in a Rat Carotid Artery Balloon Injury Model.

    Science.gov (United States)

    Liu, Dong; Xiao, Yan; Subramanian, Romesh R; Okamoto, Ei-Ichi; Wilcox, Josiah N; Anderson, Leonard; De Leon, Hector

    2016-05-01

    Leukocyte infiltration of adventitial and perivascular tissues is an early event in the development of vascular remodeling after injury. We investigated whether Slit/Robo-an axonal chemorepellent system in vertebrate and invertebrate development-is activated during the inflammatory phase that follows endothelial denudation. Using the rat carotid artery model of angioplasty, we conducted a time course analysis of mRNAs encoding Slit ligands (Slit2 and Slit3) and Robo receptors (Robo1, Robo2, and Robo4), as well as proinflammatory cell adhesion molecule (CAM) genes. Adventitial inflammatory cells were counted in immunostained arterial sections. E-selectin, vascular CAM-1, and intercellular CAM-1 were upregulated 2-3 hours after injury, followed by infiltration of neutrophils and monocytes as evidenced by real-time polymerase chain reaction, in situ hybridization, and immunohistochemistry. Slit2, Slit3, and Robo genes exhibited no expression changes at 3 hours; however, they were markedly upregulated 1 day after angioplasty. Intercellular CAM-1 expression was reduced by 50%, and the number of adventitial neutrophils decreased by >75% 1 day after angioplasty. Slit2 has been shown to be a potent chemorepelent of leukocytes, endothelial cells, and smooth muscle cells. Thus, we decided to further investigate the localization of Slit2 in injured vessels. Immunohistochemical stainings revealed the presence of Slit2 within the vessel wall and in the perivascular vasa vasorum of naive and injured arteries. Double immunohistochemical analyses showed that infiltrating monocytes expressed Slit2 in the perivascular and adventitial tissues of injured arteries 1 and 3 days postangioplasty. In addition, recombinant full-length Slit2 and Slit2-N/1118, an N-terminal fragment of Slit2, inhibited stromal cell-derived factor 1-mediated migration of circulating rat peripheral blood mononuclear cells. In summary, adventitial activation of CAM genes and neutrophil infiltration preceded

  18. Diagnosis of Intracranial Artery Dissection

    Science.gov (United States)

    KANOTO, Masafumi; HOSOYA, Takaaki

    2016-01-01

    Cerebral arterial dissection is defined as a hematoma in the wall of a cervical or an intracranial artery. Cerebral arterial dissection causes arterial stenosis, occlusion, and aneurysm, resulting in acute infarction and hemorrhage. Image analysis by such methods as conventional angiography, computed tomography, magnetic resonance imaging, and so on plays an important role in diagnosing cerebral arterial dissection. In this study, we explore the methods and findings involved in the diagnosis of cerebral arterial dissection. PMID:27180630

  19. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Łukasz Wiktor

    2015-01-01

    Full Text Available The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of “halo-vest” system. We established that clinical effect after completed treatment is very good. Control MRI evaluation was performed 12 months after removal of “halo-vest” traction, and clinically silent extradural meningeal spinal cysts were detected at the ventral side of the spinal cord in the cervical segment of the spine. Due to clinically silent course of the disease, we decided to use the conservative treatment. The patient remains under control of our department.

  20. Tratamento endovascular de lesões arteriais traumáticas Endovascular management of traumatic arterial injuries

    Directory of Open Access Journals (Sweden)

    Ruy Fernandes e Fernandes

    2011-03-01

    . Todos os procedimentos foram realizados com sucesso. Não se verificou mortalidade. No doente com RAS houve necessidade de cirurgia de descorticação pulmonar esquerda, por hematoma organizado, e o doente com FAV foi submetido com sucesso a nova embolização com coils por recorrência precoce de hematúria. Conclusão: O tratamento endovascular é, em casos seleccionados, uma alternativa válida e menos invasiva de lesões traumáticas complexas em regiões anatómicas de difícil acesso e morbi-mortalidade cirúrgica elevada.Introduction: Traumatic vascular injuries are present in less than 10% of patients with multi-organ trauma and, in western countries, the incidence of iatrogenic vascular lesions has been increasing. Conventional surgery in the approach of these lesions usually requires extended surgical exposure, presents increased technical challenges and has high morbidity and mortality. Recently, several authors have described the successful management of traumatic injuries with endovascular techniques with diminished surgical risk. Endovascular surgery has also been increasingly applied in management of chronic traumatic injuries like chronic post-traumatic thoracic aneurysms with significant improved outcomes. The authors present clinical cases with several acute and chronic traumatic vascular injuries treated with endovascular techniques, Clinical reports: Seven patients (21-77 years with traumatic vascular injuries were treated. Four patients presented acute injuries: 1 case of traumatic aortic injury in a patient with multi-organ trauma after automobile crash; 1 case of iatrogenic subclavian artery rupture after inadvertent subclavian artery catheterization during attempted venous central access ; 1 case of iatrogenic renal artery rupture during renal angioplasty and stenting; 1 case of iatrogenic intra-renal arterio-venous fistula (AVF after laparoscopic resection of a renal tumour. Three patients presented with chronic post-traumatic thoracic aneurysms

  1. Spike the PCHA! Overuse injury of the Posterior Circumflex Humeral Artery in elite volleyball

    NARCIS (Netherlands)

    D. van de Pol

    2016-01-01

    In 1993, professor Reekers of the Academic Medical Center (AMC) Radiology department was the first to describe a traumatic aneurysm of the posterior circumflex humeral artery (PCHA) in a volleyball player, suggesting a causal relationship. Fifteen years later, between 2008 and 2010, several elite ma

  2. Popliteal artery injury following traumatic knee joint dislocation in a 14-year-old boy: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Cvetković Slobodan

    2014-01-01

    Full Text Available Introduction. Posterior knee joint dislocation associated with injury of the popliteal artery in children is an extremely rare condition. Rapid diagnosis and treatment are essential for limb salvage and function. Case report. We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. The diagnosis was confirmed using Doppler and duplex ultrasonography and digital substraction transfemoral arteriography. The urgent surgical procedure was performed using posterior approach to the popliteal artery. During the surgical exploration, rupture of the posterior cruciate ligament associated with thrombosed popliteal artery have been found. The damaged popliteal artery was resected and replaced with autologous saphenous vein graft. The last stage of the procedure was a transosseous femoral fixation of posterior circuate ligament. A 3-year-follow-up after the surgery demonstrated intact arterial perfusion and very good function of the knee with a minimal difference as compared with the contralateral knee. Conclusion. Combined orthopedic and vascular injuries are very rare in children. They require combined treatment. [Projekat Ministarstva nauke Republike Srbije, br. 175008

  3. Intravenous thrombolysis or endovascular therapy for acute ischemic stroke associated with cervical internal carotid artery occlusion: the ICARO-3 study.

    Science.gov (United States)

    Paciaroni, Maurizio; Inzitari, Domenico; Agnelli, Giancarlo; Caso, Valeria; Balucani, Clotilde; Grotta, James C; Sarraj, Amrou; Sung-Il, Sohn; Chamorro, Angel; Urra, Xabier; Leys, Didier; Henon, Hilde; Cordonnier, Charlotte; Dequatre, Nelly; Aguettaz, Pierre; Alberti, Andrea; Venti, Michele; Acciarresi, Monica; D'Amore, Cataldo; Zini, Andrea; Vallone, Stefano; Dell'Acqua, Maria Luisa; Menetti, Federico; Nencini, Patrizia; Mangiafico, Salvatore; Barlinn, Kristian; Kepplinger, Jessica; Bodechtel, Ulf; Gerber, Johannes; Bovi, Paolo; Cappellari, Manuel; Linfante, Italo; Dabus, Guilherme; Marcheselli, Simona; Pezzini, Alessandro; Padovani, Alessandro; Alexandrov, Andrei V; Shahripour, Reza Bavarsad; Sessa, Maria; Giacalone, Giacomo; Silvestrelli, Giorgio; Lanari, Alessia; Ciccone, Alfonso; De Vito, Alessandro; Azzini, Cristiano; Saletti, Andrea; Fainardi, Enrico; Orlandi, Giovanni; Chiti, Alberto; Gialdini, Gino; Silvestrini, Mauro; Ferrarese, Carlo; Beretta, Simone; Tassi, Rossana; Martini, Giuseppe; Tsivgoulis, Georgios; Vasdekis, Spyros N; Consoli, Domenico; Baldi, Antonio; D'Anna, Sebastiano; Luda, Emilio; Varbella, Ferdinando; Galletti, Giampiero; Invernizzi, Paolo; Donati, Edoardo; De Lodovici, Maria Luisa; Bono, Giorgio; Corea, Francesco; Sette, Massimo Del; Monaco, Serena; Riva, Maurizio; Tassinari, Tiziana; Scoditti, Umberto; Toni, Danilo

    2015-02-01

    The aim of the ICARO-3 study was to evaluate whether intra-arterial treatment, compared to intravenous thrombolysis, increases the rate of favourable functional outcome at 3 months in acute ischemic stroke and extracranial ICA occlusion. ICARO-3 was a non-randomized therapeutic trial that performed a non-blind assessment of outcomes using retrospective data collected prospectively from 37 centres in 7 countries. Patients treated with endovascular treatment within 6 h from stroke onset (cases) were matched with patients treated with intravenous thrombolysis within 4.5 h from symptom onset (controls). Patients receiving either intravenous or endovascular therapy were included among the cases. The efficacy outcome was disability at 90 days assessed by the modified Rankin Scale (mRS), dichotomized as favourable (score of 0-2) or unfavourable (score of 3-6). Safety outcomes were death and any intracranial bleeding. Included in the analysis were 324 cases and 324 controls: 105 cases (32.4 %) had a favourable outcome as compared with 89 controls (27.4 %) [adjusted odds ratio (OR) 1.25, 95 % confidence interval (CI) 0.88-1.79, p = 0.1]. In the adjusted analysis, treatment with intra-arterial procedures was significantly associated with a reduction of mortality (OR 0.61, 95 % CI 0.40-0.93, p = 0.022). The rates of patients with severe disability or death (mRS 5-6) were similar in cases and controls (30.5 versus 32.4 %, p = 0.67). For the ordinal analysis, adjusted for age, sex, NIHSS, presence of diabetes mellitus and atrial fibrillation, the common odds ratio was 1.15 (95 % IC 0.86-1.54), p = 0.33. There were more cases of intracranial bleeding (37.0 versus 17.3 %, p = 0.0001) in the intra-arterial procedure group than in the intravenous group. After the exclusion of the 135 cases treated with the combination of I.V. thrombolysis and I.A. procedures, 67/189 of those treated with I.A. procedures (35.3 %) had a favourable outcome, compared to 89/324 of

  4. Relationship between bulbocavernosus reflex, patellar reflex and rehabilitation during acute stage of cervical spinal injury%颈髓损伤急性期球海绵体反射、膝反射与康复的关系

    Institute of Scientific and Technical Information of China (English)

    杨茂伟; 朱悦; 吕刚; 范广宇; 薛明

    2003-01-01

    AIM: To investigate the relationship between bulbocavemous refiex(BTR),patallar reflex(PTR) and rehabilitation during acute stage of cervical spinalinjury. METHODS: 73 cases of a class frankel cervical spinal injury patientswere examined with BTR and PTR and recorded the time of the two reflexes,then follow-up after 6 months to monitor recovery situation. RESUULTS: Therewere 28 cases of positive BCR within the first 72 h (38%), 7 cases of improvedcondifions(25% ); there were 13 cases of PTR positive (17%), 13 cases ofimproved status(100% ). CONCLUSION: BCR and PTR are the sign of ima-proved status and better rehabilitation during the acute stage.

  5. Impact of intravenous acetaminophen therapy on the necessity of cervical spine imaging in patients with cervical spine trauma

    Institute of Scientific and Technical Information of China (English)

    Koorosh Ahmadi; Amir Masoud Hashemian; Elham Pishbin; Mahdi Sharif-Alhoseini; Vafa Rahimi-Movaghar

    2014-01-01

    Objective:We evaluated a new hypothesis of acetaminophen therapy to reduce the necessity of imaging in patients with probable traumatic cervical spine injury.Methods:Patients with acute blunt trauma to the neck and just posterior midline cervical tenderness received acetaminophen (15 mg/kg) intravenously after cervical spine immobilization.Then,all the patients underwent plain radiography and computerized tomography of the cervical spine.The outcome measure was the presence of traumatic cervical spine injury.Sixty minutes after acetaminophen infusion,posterior midline cervical tendemess was reassessed.Results:Of 1 309 patients,41 had traumatic cervical spine injuries based on imaging.Sixty minutes after infusion,posterior midline cervical tenderness was eliminated in 1 041 patients,none of whom had abnormal imaging.Conclusion:Patients with cervical spine trauma do not need imaging if posterior midline cervical tendemess is eliminated after acetaminophen infusion.This analgesia could be considered as a diagnostic and therapeutic intervention.

  6. Perivenous application of fibrin glue prevents the early injury of jugular vein graft to arterial circulation in rabbits

    Institute of Scientific and Technical Information of China (English)

    WAN Li; LI Dian-yuan; YANG Bing; WU Qing-yu

    2006-01-01

    Background Placement of an external support has been reported to prevent intimal hyperplasia of vein grafts. However, it is limited by potential complications. In the present study, we investigated the effect of fibrin glue on preventing vein graft failure as perivenous application. Methods Twenty-four rabbits were divided into non-supported group (n=12) and fibrin glue group (n=12). All animals underwent unilateral jugular vein into common carotid artery interposition grafting and then fibrin glue was applied as perivenous support. Samples of tissues were harvested after 4 weeks. Results The vein grafts with fibrin glue demonstrated a statistically significant decrease in proliferating cell nuclear antigen in the medial/intimal region [13.38% (11.26%-15.11%)] compared with non-supported vein grafts [31.22% (27.15%-35.98%)] (P<0.001). Light microscopy showed remarkable attenuation of endothelial cell loss and numerous microvessels in neoadventitia in the fibrin glue group compared with the non-supported group. The smooth muscle cells migrated into adventitia significantly in fibrin glue group, whereas the smooth muscle cells migrated into intima in non-supported group.Conclusion Perivenous support of vein graft with fibrin glue in vivo can attenuate the severe injury encountered in the non-supported vein grafts exposed to artery.

  7. Risco de tração excessiva nas lesões tipo distração-flexão da coluna cervical baixa Risk of excessive traction on distraction-flexion-type injuries of the low cervical spine

    Directory of Open Access Journals (Sweden)

    Tarcísio Eloy Pessoa de Barros Filho

    2006-01-01

    Full Text Available O estudo em questão visa avaliar a relação entre risco e benefício do uso de tração com halo craniano como alternativa para estabilização nas fraturas-luxações por mecanismo de distração-flexão tipo IV de Allen e Ferguson, considerando a natureza da lesão, seu extenso dano ligamentar e o risco de apresentar distração excessiva e conseqüente lesão da medula espinhal. Para tanto, realizamos uma análise retrospectiva no IOT-HC-FMUSP envolvendo um período de 10 anos, quando 34 casos foram diagnosticados como fratura-luxação por distração-flexão da coluna cervical baixa, sendo 12 deles do tipo IV. Todos foram submetidos à tração esquelética com halo craniano num momento inicial. Durante o controle radiográfico seqüencial, observou-se distração excessiva em sete casos, mesmo com baixo peso inicial (4 kg. Em dois pacientes houve surgimento de nistagmo. Em todos os casos a tração foi retirada e seguiu-se normalização do quadro clínico.This study aims to evaluate the risk/ benefit ratio in the use of traction with cranial halo as an alternative to stabilize fractures-dislocations by Allen & Ferguson's type IV- distraction-flexion mechanism, considering the nature of the injury, its extensive ligament damage and the risk of presenting excessive distraction and resultant spinal cord injury. Thus, we performed a retrospective analysis at IOT-HC-FMUSP comprising a period of 10 years, when 34 cases were diagnosed as fractures-dislocations due to distraction-flexion of the low cervical spine, of which 12 were IV-type. All individuals have been submitted to skeletal traction with cranial halo at an early phase. During sequential X-ray management, an excessive distraction was seen in seven cases, even with initial light weight (4 kg. In two patients, the onset of nistagmus was seen. In all cases, traction was removed, which was followed by stabilization of the clinical picture.

  8. Surgical Treatment for No Fracture Dislocation Cervical Spinal Cord Injury%无骨折脱位型颈脊髓损伤的手术治疗

    Institute of Scientific and Technical Information of China (English)

    项惠灿; 叶君健; 欧国潮; 卢生香; 赵庆淞

    2011-01-01

    目的 探讨无骨折脱位型颈脊髓损伤的手术治疗方法 与效果.方法 我科自2000年10月至2007年10月手术治疗无骨折脱位型颈脊髓损伤21 例,其中单节段椎间盘突出4 例,双节段椎间盘突出10 例,三节段及多节段突出7 例,合并椎体后缘骨赘6 例,黄韧带肥厚5 例,先天性椎体融合2 例.合并先天性和发育性颈椎管狭窄9 例.致压物主要来源于脊髓前方的单节段、二节段压迫脊髓,采用颈前路椎体次全切除减压自体髂骨植骨融合、带锁钛板内固定术14 例.三节段及以上多节段压迫脊髓,采用颈后路单开门或双开门颈椎管扩大椎板成型术7 例.结果 21 例经平均30个月随访,2 例完全性颈脊髓损伤术后难以忍受胸腹部束带感缓解,但四肢肌力、大小便功能无恢复.19 例按JOA评分,术前平均5.58分,术后提高到11.46分.结论 无骨折脱位型颈脊髓损伤,根据脊髓致压部位节段争取早期手术治疗,选择适当的手术方法,可较好地改善脊髓功能,提高病人的生活质量.%Objective To investigate the method and effect of surgical treatment for non fracture-dislocation of cervical spinal cord injury. Methods 21 patients with no fracture dislocation cervical spinal cord injury were underwent surgical treatment,among them four cases were single segment discintervertebral disk hernia, 10 cases were two disc segment intervertebral disk hernia, 7 cases were three paragraphs and mutti-segmentintervertebral disk hernia, 6 cases of combined posterior marginal osteophytes, 5 cases of hypertrophy ligamentum flavum,congenital vertebral fusion in 2 cases. And development and congenital neck Spinal stenosis in 9 cases. Compression was mainly caused by objects in front of the spinal cord,a single segment or two segments of spinal cord compression. Using ante-cervical approach sub-total removal of cervical vertebrae for decompression and fusion with autologous iliac bone graft ,locking by

  9. Analysis of Instability Factors for the Cervical Stenosis with Cervical Spinal Cord Injury without Fracture and Dislocation%颈椎管狭窄伴无骨折脱位型颈脊髓损伤颈椎不稳定因素分析

    Institute of Scientific and Technical Information of China (English)

    罗彬; 冯浩; 杨晓茂; 蒲敏; 王清

    2015-01-01

    Objectiv To observe the MRI findings and intra-operative discovery of cervical spinal stenosis accompanied with cervical spinal cord injury without fracture and dislocation( CSCIWFD),and to discuss its instability factors and the func-tion of MRI in assessing cervical instability. Methods Between May 2002 and August 2013,58 patients with cervical spinal stenosis accompanied with CSCIWFD were treated with posterior C3 to C7 expansive open-door laminoplasty combined with one stage anterior decompression,fusion and fixation. There were 21 females and 37 males with an average age of(51. 7 ± 8. 2) years(range,34~71 years). All cases were patients with incomplete spinal cord injury. Among them,26 were central cord syndrome,14 were anterior spinal cord syndrome,6 were Brown-Sequard syndrome,and 12 were mixed type. The mean preop-erative JOA score was(7. 2 ± 2. 3)(range,4 to 13). The mean time interval between injury and admission to hospital was(24 ± 12( hours,and 47 cases were less than 3 days. The injury of soft tissues and bone-ligaments structure and cervical instabili-ty were recorded. Preoperative MRI findings and intra-operative finding were compared. Results Most cervical spinal cord injury site was located in intervertebral space. There was no significant difference between cervical spinal cord injury and local cervical instability incidence rate of corresponding intervertebral space(P﹥0. 05). Most of corresponding intervertebral space of cervical spinal cord injury were accompanied with local cervical instability. Local cervical instability of cervical spinal steno-sis accompanied with CSCIWFD was related to the injury of anterior and posterior longitudinal ligaments and discs( APLLD) and cervical spinal cord and the degeneration of intervertebral disc. Conclusion Although MRI had false negative results in assessing cervical tissues injury,it can provide rich clinical information in assessing cervical instability. Using skull traction un-der general

  10. Hippophae salicifolia D.Don berries attenuate cerebral ischemia reperfusion injury in a rat model of middle cerebral artery occlusion

    Institute of Scientific and Technical Information of China (English)

    Santhrani Thakur; Pradeepthi Chilikuri; Bindu Pulugurtha; Lavanya Yaidikar

    2015-01-01

    Objective: To investigate the protective effect of Hippophae salicifolia D.Don (H. salicifolia) berries extract against cerebral reperfusion injury induced neurobehavioral and neurochemical changes in a rat model of middle cerebral artery occlusion (MCAO). Methods: Rats were pretreated with alcoholic extract of H. salicifolia (250 and 500 mg/kg) for 14 d and focal cerebral ischemia was induced by MCAO. After 60 min of MCAO, reperfused for 24 h, a battery of behavioral tests were assessed the extent of neurological deficits. Infarct volume and brain edema were measured in 2,3,5-triphenyltetrazolium chloride stained brain sections. TNF-α, oxidative stress parameters like reduced glutathione, calcium, glutamate, malondialdehyde and apoptotic parameters like caspase-3, and caspase-9 were estimated in the brain homogenates. Results:Pretreatment with alcoholic extract of H. salicifolia at doses of 250 and 500 mg/kg significantly improved the neurobehavioral alterations and reduced the infarct volume, edema induced by ischemia reperfusion injury. H. salicifolia significantly prevented ischemia induced increase in malondialdehyde, glutamate, calcium, caspase-3, caspase-9 and TNF-αlevels as compared to ischemic animals. Conclusions: Our results indicate that H. salicifolia mitigated the ischemia reperfusion induced neuronal damage.

  11. Hypoxia-induced pulmonary arterial hypertension augments lung injury and airway reactivity caused by ozone exposure.

    Science.gov (United States)

    Zychowski, Katherine E; Lucas, Selita N; Sanchez, Bethany; Herbert, Guy; Campen, Matthew J

    2016-08-15

    Ozone (O3)-related cardiorespiratory effects are a growing public health concern. Ground level O3 can exacerbate pre-existing respiratory conditions; however, research regarding therapeutic interventions to reduce O3-induced lung injury is limited. In patients with chronic obstructive pulmonary disease, hypoxia-associated pulmonary hypertension (HPH) is a frequent comorbidity that is difficult to treat clinically, yet associated with increased mortality and frequency of exacerbations. In this study, we hypothesized that established HPH would confer vulnerability to acute O3 pulmonary toxicity. Additionally, we tested whether improvement of pulmonary endothelial barrier integrity via rho-kinase inhibition could mitigate pulmonary inflammation and injury. To determine if O3 exacerbated HPH, male C57BL/6 mice were subject to either 3 weeks continuous normoxia (20.9% O2) or hypoxia (10.0% O2), followed by a 4-h exposure to either 1ppm O3 or filtered air (FA). As an additional experimental intervention fasudil (20mg/kg) was administered intraperitoneally prior to and after O3 exposures. As expected, hypoxia significantly increased right ventricular pressure and hypertrophy. O3 exposure in normoxic mice caused lung inflammation but not injury, as indicated by increased cellularity and edema in the lung. However, in hypoxic mice, O3 exposure led to increased inflammation and edema, along with a profound increase in airway hyperresponsiveness to methacholine. Fasudil administration resulted in reduced O3-induced lung injury via the enhancement of pulmonary endothelial barrier integrity. These results indicate that increased pulmonary vascular pressure may enhance lung injury, inflammation and edema when exposed to pollutants, and that enhancement of pulmonary endothelial barrier integrity may alleviate such vulnerability. PMID:27286659

  12. Sex Steroids Do Not Modulate TRPM2-Mediated Injury in Females following Middle Cerebral Artery Occlusion(1,2,3).

    Science.gov (United States)

    Quillinan, Nidia; Grewal, Himmat; Klawitter, Jelena; Herson, Paco S

    2014-01-01

    Calcium-permeable transient receptor potential M2 (TRPM2) ion channel activation contributes to cerebral ischemic injury specifically in males. In male mice, circulating androgens are required for TRPM2 inhibition with clotrimazole (CTZ) to provide protection following experimental stroke. Sufficient levels of circulating androgens are necessary to support ischemia-induced activation of poly ADP ribose polymerase (PARP) and consequent activation of TRPM2 channels. In this study, we tested whether differences in sex steroids contribute to the lack of CTZ neuroprotection in females. Middle cerebral artery occlusion (MCAO) was performed using adult female mice that were hormonally intact, ovariectomized (OVX) or dihydrotestosterone (DHT) treated. CTZ or vehicle was administered at the time of reperfusion, animals were euthanized 24 h later and brains and serum were collected. Infarct analysis revealed no effect of CTZ in intact females or females lacking endogenous sex steroids (OVX). Interestingly, treatment of female mice with the potent androgen receptor agonist DHT had no effect on ischemic injury and did not permit CTZ neuroprotection. Similarly, DHT-treated females did not exhibit increased levels of ADPribose, the TRPM2 ligand generated by PARP, following ischemia. No differences in TRPM2 or androgen receptor expression were observed between males and females. These data suggest that the lack of TRPM2 activation in females following experimental stroke is not due to the presence of estrogen or the absence of androgens. In conclusion, our data demonstrate that while circulating androgens are necessary for PARP-mediated TRPM2 injury in males, they are not sufficient to produce TRPM2 activation in females. PMID:26464961

  13. Correlation of mid-pregnancy uterine artery notch with preeclampsia incidence risk as well as serum endothelial injury and placental hypoperfusion

    Institute of Scientific and Technical Information of China (English)

    Xue-Jing Guo; Xin Ni; Ying Huang; Hang Gu

    2016-01-01

    Objective:To study the correlation of mid-pregnancy uterine artery notch with preeclampsia incidence risk as well as serum endothelial injury and placental hypoperfusion.Methods:A total of 2 800 cases of singleton primiparas who received antenatal examination in Maternal and Child Health Hospital of Pudong New Area Shanghai between April 2014 and October 2015 were selected for prospective study and divided into notch group and non-notch group according to the uterine artery notch at 22-24 weeks of gestation, serum was collected at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation respectively to determine endothelial injury indexes VEGF, PLGF, sFlt-1 and sEng in serum, ultrasonography was conducted to determine uterine spiral arterial resistance index (RI) and pulsatility index (PI), and the levels of apoptosis molecules in placenta tissue were determined after delivery.Results: Preeclampsia incidence rate of notch group was significantly higher than that of non-notch group; at 24-30 weeks, 31-36 weeks and 37-41 weeks of gestation, serum VEGF and PLGF levels of notch group were significantly lower than those of non-notch group, sFlt-1 and sEng levels were significantly higher than those of non-notch group, and uterine spiral artery PI and RI were significantly higher than those of non-notch group; after delivery, p57kip2, Bax, Caspase-3, Fas and FasL levels in placenta tissue of notch group were significantly higher than those of non-notch group.Conclusion: The risk of preeclampsia is high in pregnant women with mid-pregnancy (22-24 weeks of gestation) uterine artery notch and it will cause maternal endothelial injury, spiral artery remodeling dysfunction and placental hypoperfusion.

  14. Valoración médico forense del esguince cervical Medico legal evaluation of whyplash injury

    Directory of Open Access Journals (Sweden)

    E. Dorado Fernández

    2005-07-01

    Full Text Available El esguince cervical es la patología traumática más frecuente en el ámbito de la valoración médico forense. Se realiza una aproximación a la misma a través de las peritaciones realizadas por 22 médicos forenses de 15 partidos judiciales españoles, sobre un total de 572 lesionados. Se concluye la mayor incidencia en el sexo femenino (57.52%, en el rango de edades entre 21 y 40 años (58%, siendo conductor de un turismo (54.7% que recibe un golpe posterior (59%. Con un tiempo de sanidad entre los 31 y 90 días (52%, resultando en un mayor porcentaje con secuelas (64,3%, comúnmente SPC o cervicalgia, generalmente (56% de grado leve.Whiplash is the leading traumatic cause concerning the evaluation in forensic activity. It has been carried out an approximation through the reports done by 22 forensic examiners working in 15 Spanish jurisdictions, over a total amount of 572 injured people. In fact there is a bigger incidence of damage in female gender (57.52%, in the age ranging from 21 to 40 years (58%, driving a car (54.7%, following a rear-end collision (59%. The healing time varies from 31 to 90 days (52%, and mostly with sequels (64.3%, commonly Cervical Post-Traumatic Syndrome or cervical pain, usually (56% in a low degree.

  15. Late coronary artery and tricuspid valve injury post pectus excavatum surgery.

    Science.gov (United States)

    Bibiloni Lage, Ignacio; Khan, Khalid; Kaabneh, Ahmed; Kendall, Simon

    2013-10-01

    We report the surgical case of a 25-year old man admitted because of progressive dyspnoea and stabbing chest pain, who had undergone a pectus excavatum correction using a retrosternal strut 8 years previously. The computerized tomography scan showed that the right tip of the pectus bar had migrated across his right ventricle and tricuspid valve into the right atrium. Intraoperatively, it was confirmed that in its path, the right coronary artery and the posterior leaflet of the tricuspid valve had been damaged. After removing the bar and repairing the tricuspid valve, the patient made a full recovery.

  16. Anterior approach for lower cervical spine fractures and dislocations combined with spinal cord injury%下颈椎骨折脱位并脊髓损伤的前路手术治疗

    Institute of Scientific and Technical Information of China (English)

    贺宝荣; 许正伟; 郝定均; 郭华

    2013-01-01

    Objectives:To discuss the clinical outcome of anterior surgical treatment for lower cervical spine fractures and dislocations combined with spinal cord injury.Methods:From January 2006 to January 2011,196 patients suffering from lower cervical spine fractures and dislocations combined with spinal cord injury in our hospital were reviewed retrospectively.168 cases were data integrity and obtained follow-up,there were 123 males and 45 females with an average age of 38.7 years old(range,18-71 years).21 cases were in ASIA grade A,46 cases in B,60 cases in C,41 cases in D.According to the degree of dislocation,79 cases were in Ⅰ,42 cases in Ⅱ,31 cases in

  17. 颈髓损伤后呼吸肌功能障碍修复的研究进展%Advance in Restoration of Respiratory Muscle Dysfunction after Cervical Spinal Cord Injury (review)

    Institute of Scientific and Technical Information of China (English)

    周雅; 洪毅; 姜树东; 白金柱

    2014-01-01

    颈髓损伤后呼吸功能障碍是伤后早期死亡的首要原因,可通过电刺激、磁刺激、神经移位术、细胞移植等手段对患者的呼吸功能进行修复。本文将颈髓损伤后呼吸肌功能障碍的解剖基础、临床表现、修复技术方法等做一综述。%Respiratory dysfunction is the primary cause of death early after cervical spinal cord injury, and it can be restored by electri-cal stimulation, magnetic stimulation, nerve transfer surgery, and cell transplantation. This paper reviewed the anatomy, clinical manifesta-tions, and associated restoration techniques of respiratory muscle dysfunction after cervical spinal cord injury.

  18. Anti-apoptotic effect of morphine-induced delayed preconditioning on pulmonary artery endothelial cells with anoxia/reoxygenation injury

    Institute of Scientific and Technical Information of China (English)

    DING Weng-ang; ZHOU Hua-cheng; CUI Xiao-guang; LI Wen-zhi; GUO Yue-ping; ZHANG Bing; LIU Wei

    2008-01-01

    Background Opioid preconditioning (PC) reduces anoxiaJreoxygenation (NR) injury to various cells. However, it remains unclear whether opioid-induced delayed PC would show anti-apoptotic effects on pulmonary artery endothelial cells (PAECs) suffering from A/R injury. The present study was conducted to elucidate this issue and to investigate the potential mechanism of opioid-induced delayed PC.Methods Cultured porcine PAECs underwent 16-hour anoxia followed by 1-hour reoxygenation 24 hours after pretreatment with saline (NaCI; 0.9%) or morphine (1 μmol/L). To determine the underlying mechanism, a non-selective KATP channel inhibitor glibenclamide (Glib; 10 μmol/L), a nitric oxide (NO) synthase blocker NG-nitro-L-arginine methyl ester (L-NAME; 100 μmol/L), and an opioid receptor antagonist naloxone (Nal; 10 pmol/L) were given 30 minutes before the A/R load. The percentage of apoptotic cells was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining, eNOS mRNA level was measured by real-time polymerase chain reaction (PCR). NO content of PAECs supernatants was measured with the Griess reagent.Results Compared to the A/R PAECs, morphine-induced delayed PC significantly reduced PAECs apoptosis ((18.1±1.9)% vs (5.5±0.3)%; P <0.05), increased NO release ((11.4±1.3) μmol/L vs (20.5±2.1) μmol/L, P <0.05), and up-regulated eNOS gene expression nearly 9 times (P<0.05). The anti-apoptosis effect of morphine was abolished by pretreatment with Glib, L-NAME and Nal, but the three agent-selves did not aggravate the A/R injury. Furthermore, L-NAME and Nal offset the enhanced release of NO caused by pretreatment with morphine.Conclusions Morphine-induced delayed PC prevents A/R injury of PAECs. This effect may be mediated by activation of KATP channel via opioid receptor and NO signaling pathways.

  19. Study of position control to cervical spinal cord injury of hemiplegic patients during functional activities%颈髓挫伤致偏瘫患者功能锻炼中抗肌痉挛体位的研究

    Institute of Scientific and Technical Information of China (English)

    何瑞琼

    2009-01-01

    目的 抗痉挛体位对颈髓挫伤致瘫痪患者功能锻炼中降低肌痉挛的效果.方法 观察82例颈髓挫伤致偏瘫患者功能锻炼时肌痉挛情况及抗痉挛降低肌痉挛的情况.结果 颈髓挫伤致瘫痪患者,体位转换、移动活动、平衡活动及一些力量性训练过程中发生患侧上肢屈肌痉挛(不自主屈肘或握拳)和下肢伸肌痉挛(不自主膝过伸或踝趾屈)的阳性率,以及采取对抗痉挛体位1个月后,患者肌痉挛被抑制.结论 颈髓挫伤致瘫痪患者早期一些功能活动可以诱发肌肉痉挛产生,抗痉挛抑制体位对此有控制效果.%Objective To study position control to cervical spinal cord injury of hemiplegic patients during functional activities. Methods 82 cases of cervical spinal cord injury of hemiplegic patients functional activities and position control was observated. Results The cervical spinal cord injury of hemiplegic patients while body transfer, balance and strengthening, functional activities easily induced muscles spasticity, against muscles spasticity can in-crease the muscles spasticity. Conclusion The inhibition of muscles spasticity can increased the muscles spasticity the patients of cervical spinal cord injury of hemiplegic.

  20. The relationship between arterial carbon dioxide tension and end-tidal carbon dioxide tension in intubated adults with traumatic brain injuries who required emergency craniotomies.

    Science.gov (United States)

    Dyer, Brett A; White, William A; Lee, Doohee; Elkins, Laurie; Slayton, Donna J

    2013-01-01

    Anesthetic management of patients who have suffered traumatic brain injuries can be challenging. We investigated the relationship between arterial to end-tidal carbon dioxide partial pressure gradients (Pa-etCO₂) and 3 predictor variables: (1) injury severity score, (2) use of positive end-expiratory pressure, and (3) presence of rib fractures. Using a convenient sampling method, we sampled 56 patients who arrived to the operating room intubated after traumatic brain injuries between 2005 and 2011. Two groups were compared retrospectively: those with Pa-etCO₂ greater than 10 mm Hg (case group) (n = 37) and those with Pa-etCO₂ gradients of 10 mm Hg or less (control group) (n = 19). Descriptive and inferential statistics were employed to identify any differences between the groups. Stepwise regression was also performed. Cross tabulation analysis revealed that injury severity score of 30 or more was a predictor of Pa-etCO₂ gradient. Stepwise regression analysis revealed the presence of rib fracture and body mass index to be significant predictors of Pa-etCO₂ gradient (P < .011). This study identified coexisting conditions in which the patients' Pa-etCO₂ gradients were large. Results showed that injury severity score of 30 or more, the presence of rib fractures, and higher body mass index were statistically significant predictors of Pa-etCO₂ gradients greater than 10 mm Hg. These observations should be considered when evaluating PetCO₂ in conjunction with arterial blood gas analysis to determine optimal ventilation status of these patients.

  1. Prognostic analysis of cervical spinal cord injury without fracture or dislocation%无骨折脱位型颈脊髓损伤的预后分析

    Institute of Scientific and Technical Information of China (English)

    尹飞; 朱灏宇; 朱庆三; 赵昆池; 李然; 赵东旭; 孟春阳

    2014-01-01

    Objective To compare the effect of conservative and operative treatment for cervical spinal cord injury without fracture and dislocation (CSCIWFD)and to detect mechanism of injury as well as its relationship to outcome.Methods A retrospective review was conducted on 688 patients with CSCIWFD treated from August 1994 to March 2013.There were 155 patients managed conservatively (conservation group) and 533 surgically (operation group).Neurological function improvement was compared between two groups to detect the correlation of patents' age and treatment methods with outcome.Results The patients were followed up for mean 17.9 months (range,3-36 months).Neurological function was estimated using Japanese Orthopedic Association (JOA) score:(1) the recovery rate of patients aged over 40 years in operation group was better than that in conservation group (P <0.05) ; (2) the recovery rate in patients aged under 39 years was unsatisfactory in both groups,with insignificant difference between the two groups (P > 0.05).Conclusions Different age of patients with CSCIWFD has different injury mechanism,injury severity and outcome.Surgery provides better results than conservative treatment for patients aged over 40 years,but both results are poor for patients aged under 39 vears.%目的 比较无骨折脱位型颈髓损伤(cervical spinal cord injury without fracture or dislocation,CSCIWFD)非手术治疗和手术治疗的疗效,分析其发生机制及其与预后的关系. 方法 回顾性分析1994年8月-2013年3月收治的CSCIWFD患者688例,对不同年龄段患者采用非手术治疗(非手术组,155例)和手术治疗(手术组,533例)后神经功能的恢复结果进行比较,分析不同年龄组患者、不同治疗方法与预后的相关性. 结果 随访3 ~ 36个月,平均17.9个月.两组患者神经功能改善程度按日本骨科学会(Japanese Orthopedic Association,JOA)评分:(1)40岁以上各年龄段患者神经功能改善率手

  2. The effects of cervical traction combined with cerebellar electrical stimulation in the treament of the cervical spondylosis of vertebral artery type%颈椎牵引联合电刺激小脑治疗椎动脉型颈椎病的观察

    Institute of Scientific and Technical Information of China (English)

    徐蔚华; 马燕红; 赵华昆; 宋玉兰

    2013-01-01

    Objective To discuss and analyse the clinical effects of Cervical Traction combined with Cerebellar Electrical Stimulation (CES)in the treament of the Cervical Spondylosis of Vertebral Artery type (CSA). Methods From May 2010 to June 2011,84 patients with Cervical Spondylosis of Vertebral Artery type were divided into united group and traction group by a randomizing digital table,of which 39 patients in united group treated with cervical traction combined with Cerebellar Electrical Stimulation,39 patients in traction group treated with cervical traction,6 cases dropped-out. The Transcranial Doppler (TCD) and the functional scale for CSA( FS-CSA) were used to observe the change of blood velocity and assess the functionality of the patients before the rehabilitation therapy and 20 times later. Results The blood velocity accelerated and the comprehensive functional score reduced after the continues treatment 20 times, Compared with before,the two groups all had obvious statistical significance (P<0.05). The clinic effect of the united group was better than that in cervical traction group (P<0.05). Conclusion Cervical Traction combined with Cerebellar Electrical Stimulation can effectively improve the blood circulation of vertebra BA and the comprehensive function in the patients with the Cervical Spondylosis of Vertebral Artery type.%目的 探讨和分析颈椎牵引联合电刺激小脑治疗对椎动脉型颈椎病的疗效影响.方法 2010-05-2011-06,采用电脑随机数字表法,将84例椎动脉型颈椎病患者随机分为联合组(颈椎牵引联合电刺激小脑治疗组)和牵引组(颈椎牵引治疗组),联合组39例,牵引组39例,失访6例.治疗前后均采用经颅多普勒(TCD)观察双侧椎动脉、基底动脉、双侧大脑后动脉的血流速度情况,及应用椎动脉型颈椎病功能评定量表(FS-CSA)评定综合功能.结果 治疗后,两组患者的双侧椎动脉、基底动脉、双侧大脑后动脉平均血流速度均改善,

  3. [Role of multislice computed tomography in the diagnosis of acute rupture of the thoracic aorta and hepatic artery in a patient with severe concomitant injury].

    Science.gov (United States)

    Muslimov, R Sh; Sharifullin, F A; Chernaia, N R; Novruzbekov, M S; Kokov, L S

    2015-01-01

    Acute traumatic aortic rupture is associated with extremely high mortality rates and requires emergency diagnosis and treatment. This clinical example shows the role of multislice spiral computed tomography in the emergency diagnosis of rupture of two large arterial vessels in severe concomitant injury. It presents the benefits of this rapid and noninvasive imaging technique, an algorithm of the study and the semiotics of injuries in patients with suspected traumatic aortic rupture. The paper also shows the importance of this method in defining treatment policy and then in the assessment of the results of the performed correction. PMID:25864362

  4. Use of a Javid™ shunt in the management of axillary artery injury as a complication of fracture of the surgical neck of the humerus: a case report

    Directory of Open Access Journals (Sweden)

    Suttie Stuart A

    2008-08-01

    Full Text Available Abstract Introduction Axillary artery injury is a rare but severe complication of fractures of the surgical neck of the humerus. Case presentation We present a case of axillary artery pseudoaneurysm secondary to such a fracture, in a 82-year-old white woman, presenting 10 weeks after the initial injury, successfully treated with subclavian to brachial reversed vein bypass together with simultaneous open reduction and internal fixation of the fracture. We discuss the use of a Javid™ shunt during combined upper limb revascularisation and open reduction and internal fixation of the fractured humerus. Conclusion This case highlights the usefulness of a Javid™ shunt, over other forms of vascular shunts, in prompt restoration of blood flow to effect limb salvage. It can be considered as a temporary measure whilst awaiting definitive revascularisation which can be performed following fracture fixation.

  5. Surgical approaches for 107 cases of lower cervical spine injuries%手术治疗下颈椎创伤107例

    Institute of Scientific and Technical Information of China (English)

    康照利; 邹三明; 黄笃; 喻亮; 冯华明; 张小舟; 高彪; 王盛; 张宇博

    2012-01-01

    Objective To analyze the outcome of surgical treament for lower spine injuries. Methods The shirty involved 107 patients including 68 patients treated with anterior appoaches, 9 patients treated with posterior approaches , and 30 patients treated with anterior-posterior approaches. Neural function was evaluated by using Frankle classification grades. Results All patients were operated with no early serious complications related to surgery. All 107 patients were followed up for 6-18 months. The graft bone was fused and X-ray films showed normal height of vertebral space and normal sequence of cervical spine affter operation. Except for 2 patients of 9 patients( Frankel A ), other patients got 1-3 grate neural funcion recovery according to Frankle classification. Conclusions Good out-come of treament for lower cervical spine injuries depends on patients selection , correct surgical approach and complications prevention%目的 探讨手术治疗下颈椎创伤的策略.方法 手术治疗下颈椎创伤107例:前路手术68例,后路手术9例,前后联合入路手术30例.评价神经功能Frankel分级情况.结果 患者均顺利完成手术.107例均获随访,时间6~18个月.植骨融合,颈椎序列较好.神经功能恢复情况:除2例高位截瘫患者没有明显恢复外,其余患者的神经功能均.有1~3级恢复.结论 对下颈椎创伤的患者应严格把握手术适应证,选择合适的手术入路,积极预防并发症,采用手术治疗可以取得较好的疗效.

  6. Restoration of glomerular haemodynamics and renal injury independent of arterial hypertension in rats with subtotal renal ablation.

    Science.gov (United States)

    Herrera-Acosta, Jaime; Tapia, Edilia; Sánchez-Lozada, Laura G; Franco, Martha; Striker, Liliane J; Striker, Gary E; Rodríguez, Iturbe Bernardo

    2002-06-01

    To study whether prevention of renal injury using the anti-inflammatory drugs pentosan polysulphate (PPS) and mycophenolate mofetil (MMF) is associated with improvement of glomerular haemodynamics, PPS and MMF were compared with losartan. The awake systolic blood pressure (SBP), proteinuria (Uprot) and micropuncture studies were performed 30 days after five-sixths nephrectomy in untreated rats and in rats treated with PPS (100 mg/kg per day), MMF (30 mg/kg per day) or losartan (30 mg/kg per day). In the rats receiving no treatment, there was a rise in SBP (to 180-200 mmHg) and in Uprot, which were prevented by losartan. In the PPS and MMF groups, the SBP was elevated but the Uprot did not increase. In the untreated rats the total glomerular filtration rate (GFR) decreased (-80%) and the single-nephron GFR (37-42%), plasma flow (67-127%) and glomerular pressure (10-15 mmHg) increased. These changes were prevented by PPS and MMF to the same extent as by losartan: the rise in single-nephron GFR and plasma flow were reduced by 50% and the glomerular pressure was normal. In rats receiving losartan, this was due to the fall in arterial pressure, whereas in PPS- and MMF-treated rats it was due to a rise in afferent resistance, indicating autoregulatory capacity. Total GFR was similar, despite the lower single-nephron GFR in treated groups, suggesting a larger proportion of functioning nephrons. Losartan, PPS and MMF significantly reduced glomerular sclerosis and tubular dilation and atrophy in association with a reduction in the lymphocyte and macrophage infiltrate. These results suggest an interaction between the haemodynamic and inflammatory changes that perpetuate each other during progression of renal injury. Renal protection provided by anti-inflammatory drugs is partially mediated by the prevention of glomerular haemodynamic alterations. PMID:12184053

  7. Predictive value of upper limb muscles and grasp patterns on functional outcome in cervical spinal cord injury

    NARCIS (Netherlands)

    Velstra, I.; Bolliger, M.; Krebs, J.; Rietman, J.S.; Curt, A.

    2015-01-01

    Objective: To determine which single or combined upper limb muscles as defined by the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP),

  8. 无骨折脱位型颈脊髓损伤法医学鉴定25例分析%Forensic Identification of Cervical Spinal Cord Injury without Fracture or Dislocation in 25 Cases

    Institute of Scientific and Technical Information of China (English)

    顾晓峰

    2011-01-01

    目的 探讨无骨折脱位型颈脊髓损伤案例中外伤与损害后果因果关系法医学鉴定的要点.方法 收集25例无骨折脱位型颈脊髓损伤的法医学鉴定案例资料,总结被鉴定人的年龄、致伤方式、影像学检查结果、自身颈椎退变情况、临床表现、主要诊疗情况、预后情况等,按照损伤与损害后果相关程度分为直接原因、主要原因、同等原因、次要原因、无原因进行伤病关系分析.结果 年龄、致伤方式、颈椎退变及椎管狭窄等是伤病关系分析的重要因素,年龄≤8岁者,一般均认为外伤是损害后果的直接原因,而在其他年龄段,一般均需全面分析上述各种因素,综合评定.结论 综合被鉴定人的年龄、致伤方式、颈椎退变及椎管狭窄等因素,有助于准确分析、判定无骨折脱位型颈脊髓损伤者损伤与损害后果的因果关系.%Objective To explore forensic identification of causality between injury and the consequence in cases of cervical spinal cord injury without fracture or dislocation. Methods Twenty-five cases of cervical spinal cord injury without fracture or dislocation were collected. The age, mode of injury, imaging reports, cervical vertebral degeneration, clinical manifestations, diagnosis, treatment and injury consequences were summarized. The causality between injury and its consequence were classified as direct cause, main cause, same cause, minor cause and no cause. Results Age, mode of injury, cervical vertebral degeneration and spinal stenosis were important factors in the analysis of causality. In the injured younger than 8-year-old trauma was generally the direct cause to the damage. While in other injured, it was needed to analyze the various factors comprehensively. Conclusion Comprehensive analysis of age, mode of injury, cervical vertebral degeneration, spinal stenosis and other factors would contribute to accurate identification of the causality between the

  9. Posterior cervical spine arthrodesis with laminar screws: a report of two cases

    Directory of Open Access Journals (Sweden)

    Sugimoto,Yoshihisa

    2007-04-01

    Full Text Available We performed fixation using laminar screws in 2 patients in whom lateral mass screws, pedicle screws or transarticular screws could not be inserted. One was a 56-year-old woman who had anterior atlantoaxial subluxation (AAS. When a guide wire was inserted using an imaging guide, the hole bled massively. We thought the re-insertion of a guide wire or screw would thus increase the risk of vascular injury, so we used laminar screws. The other case was an 18-year-old man who had a hangman fracture. Preoperative magnetic resonance angiography showed occlusion of the left vertebral artery. A laminar screw was inserted into the patent side (i.e., the right side of C2. Cervical pedicle screws are the most biomechanically stable screws. However, their use carries a high risk of neurovascular complications during screw insertion, because the cervical pedicle is small and is adjacent laterally to the vertebral artery, medially to the spinal cord, and vertically to the nerve roots. Lateral mass screws are also reported to involve a risk of neurovascular injuries. The laminar screw method was thus thought to be useful, since arterial injuries could thus be avoided and it could also be used as a salvage modality for the previous misinsertion.

  10. Relationship between arterial vascular calcifications seen on screening mammograms and biochemical markers of endothelial injury

    Energy Technology Data Exchange (ETDEWEB)

    Pidal, Diego [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: dpidal@hotmail.com; Sanchez Vidal, M Teresa [Servicio de Medicina Interna, Hospital de Jove (Spain)], E-mail: medicinainterna@hospitaldejove.com; Rodriguez, Juan Carlos [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Servicio de Cirugia General, Hospital de Jove (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: investigacion@hospitaldejove.com; Corte, M Daniela [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: mdanielac@hotmail.com; Pravia, Paz [Servicio de Radiodiagnostico, Hospital de Jove (Spain)], E-mail: radiologia@hospitaldejove.com; Guinea, Oscar [Servicio de Radiodiagnostico, Hospital de Jove (Spain)], E-mail: oscarfguinea@seram.org; Pidal, Ivan [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: ivanpida@hotmail.com; Bongera, Miguel [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: mbchoppy@hotmail.com; Escribano, Damaso [Servicio de Medicina Interna, Hospital de Jove (Spain)], E-mail: medicinainterna@hospitaldejove.com; Gonzalez, Luis O. [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain)], E-mail: lovidiog@telefonica.net; Diez, M Cruz [Servicio de Cirugia General, Hospital de Jove (Spain)], E-mail: cirugiageneral@hospitaldejove.com; Venta, Rafael [Servicio de Analisis Clinicos, Hospital de San Agustin, Aviles (Spain); Departamento de Bioquimica y Biologia Molecular, Universidad de Oviedo (Spain)], E-mail: rafael.venta@sespa.princast.es; Vizoso, Francisco J. [Unidad de Investigacion del, Hospital de Jove, Gijon (Spain); Servicio de Cirugia General, Hospital de Jove (Spain); Instituto Universitario de Oncologia del Principado de Asturias, Oviedo (Spain)], E-mail: fjvizoso@telefonica.net

    2009-01-15

    To assess whether breast arterial calcifications (BAC) are associated with altered serum markers of cardiovascular risk, mammograms and records from 1759 women (age range: 45-65 years) screened for breast cancer were revised. One hundred and forty seven (8.36%) women showed BAC. A total of 136 women with BAC and controls (mean age: 57 and 55 years, respectively) accepted entering the study. There were no significant differences in serum levels of urea, glucose, uric acid, creatinine, total cholesterol, HDL-C, LDL-C, folic acid, vitamin B{sub 12}, TSH or cysteine, between both groups of patients. However, women with BAC showed higher serum levels of triglycerides (p = 0.006), homocysteine (p = 0.002) and hs-CRP (p = 0.003) than women without BAC. Likewise, we found a significantly higher percentage of cases with an elevated LDL-C/HDL-C ratio (coronary risk index >2) amongst women with BAC than in women without BAC (56.7 and 38.2%, respectively; p = 0.04). Our results indicate that the finding of BAC identify women showing altered serum markers of cardiovascular risk.

  11. Perspective: Does laboratory-based maximal incremental exercise testing elicit maximum physiological responses in highly-trained athletes with cervical spinal cord injury?

    Directory of Open Access Journals (Sweden)

    Christopher R West

    2016-01-01

    Full Text Available The physiological assessment of highly-trained athletes is a cornerstone of many scientific support programs. In the present article, we provide original data followed by our perspective on the topic of laboratory-based incremental exercise testing in elite athletes with cervical spinal cord injury. We retrospectively reviewed our data on Great Britain Wheelchair Rugby athletes collected during the last two Paralympic cycles. We extracted and compared peak cardiometabolic (heart rate and blood lactate responses between a standard laboratory-based incremental exercise test on a treadmill and two different maximal field tests (4 min and 40 min maximal push. In the nine athletes studied, both field tests elicited higher peak responses than the laboratory-based test. The present data imply that laboratory-based incremental protocols preclude the attainment of true peak cardiometabolic responses. This may be due to the different locomotor patterns required to sustain wheelchair propulsion during treadmill exercise or that maximal incremental treadmill protocols only require individuals to exercise at or near maximal exhaustion for a relatively short period of time. We acknowledge that both field- and laboratory-based testing have respective merits and pitfalls and suggest that the choice of test be dictated by the question at hand: if true peak responses are required then field-based testing is warranted, whereas laboratory-based testing may be more appropriate for obtaining cardiometabolic responses across a range of standardised exercise intensities.

  12. Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury: an explorative study.

    Science.gov (United States)

    Kloosterman, Marieke G M; Snoek, Govert J; Kouwenhoven, Mirjam; Nene, Anand V; Jannink, Michiel J A

    2010-01-01

    Many interventions in upper-limb rehabilitation after cervical spinal cord injury (CSCI) use arm support (gravity compensation); however, its specific effects on kinematics and muscle activation characteristics in subjects with a CSCI are largely unknown. We conducted a cross-sectional explorative study to study these effects. Nine subjects with a CSCI performed two goal-directed arm movements (maximal reach, reach and retrieval) with and without gravity compensation. Angles at elbow and shoulder joints and muscle activation were measured and compared. Seven subjects reduced elbow extension (range 1.8°-4.5°) during the maximal reaching task with gravity compensation. In the reach and retrieval task with gravity compensation, all subjects decreased elbow extension (range 0.1°-11.0°). Eight subjects executed movement closer to the body. Regarding muscle activation, gravity compensation did not influence timing; however, the amplitude of activation decreased, especially in antigravity muscles, namely mean change +/- standard deviation of descending part of trapezius (18.2% +/- 37.5%), anterior part of deltoid (37.7% +/- 16.7%), posterior part of deltoid (32.0% +/- 13.9%), and long head biceps (49.6% +/- 20.0%). Clinical implications for the use of gravity compensation in rehabilitation (during activities of daily living or exercise therapy) should be further investigated with a larger population.

  13. Influence of gravity compensation on kinematics and muscle activation patterns during reach and retrieval in subjects with cervical spinal cord injury: An explorative study

    Directory of Open Access Journals (Sweden)

    Marieke G . M. Kloosterman, PT, MSc

    2010-09-01

    Full Text Available Many interventions in upper-limb rehabilitation after cervical spinal cord injury (CSCI use arm support (gravity compensation; however, its specific effects on kinematics and muscle activation characteristics in subjects with a CSCI are largely unknown. We conducted a cross-sectional explorative study to study these effects. Nine subjects with a CSCI performed two goal-directed arm movements (maximal reach, reach and retrieval with and without gravity compensation. Angles at elbow and shoulder joints and muscle activation were measured and compared. Seven subjects reduced elbow extension (range 1.8°-4.5° during the maximal reaching task with gravity compensation. In the reach and retrieval task with gravity compensation, all subjects decreased elbow extension (range 0.1°-11.0°. Eight subjects executed movement closer to the body. Regarding muscle activation, gravity compensation did not influence timing; however, the amplitude of activation decreased, especially in antigravity muscles, namely mean change +/- standard deviation of descending part of trapezius (18.2% +/- 37.5%, anterior part of deltoid (37.7% +/- 16.7%, posterior part of deltoid (32.0% +/- 13.9%, and long head biceps (49.6% +/- 20.0%. Clinical implications for the use of gravity compensation in rehabilitation (during activities of daily living or exercise therapy should be further investigated with a larger population.

  14. Cervical Cancer

    Centers for Disease Control (CDC) Podcasts

    2007-03-06

    Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

  15. 类固醇激素治疗急性颈髓损伤的临床观察%The clinical study of steroid hormone on the treatment in acute cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    张建宏; 范建中; 杨哲

    2002-01-01

    Objective To observe the therapeutic effect of methylprednisolone and dexamethasone on acute cervical spinal cord injury, and to explore the function and mechanism of steroid. Methods 59 patients with cervical spinal cord injury and post operation were divided into the methylprednisolone group (19 cases), the dexamethasone group (25 cases) and routine treatment group (15 cases). Based on the neural and functional grade standard of spinal cord injury, the degree of damage were assessed and the clinical data and complications were recorded. Results The function of sensory and motor in the three groups were all improved remarkably (P< 0.05). The sensory improvement of the methylprednisolone group was better than the other two groups and the motor improvement of the methylprednisolone group was better than routine treatment group. There was no difference in the treatment effect between the dexamethasone group and routine treatment group. There was no different in the complications among the three groups. Conclusion The steroid hormone can improve the function of sensory and motor in the patients with acute spinal cord injury. The theraputic effect of the methylprednisolone was better than that of the dexamethasone.

  16. Cervical mimic coronary artery disease treated by tuina and chiropractic therapy in 30 cases%推拿配合整脊手法治疗颈型类冠心病30例

    Institute of Scientific and Technical Information of China (English)

    叶勇

    2012-01-01

    Objective To observe the clinical efficacy of tuina and chiropractic therapy in treating cervical mimic coronary artery disease. Methods Treatment group were treated by tuina and chiropractic therapy and control group were treated by traditional tuina therapy. The clinical efficacy? Score of symptoms and signs 、cervical vertebra physiology degree of curve were observed and compared between two groups. Results The total effective rate was 90.0% in treatment group and 66. 67% in control group after 1 treatment course,two groups of the difference was statistically significant (P<0.05); There was a statistically significant difference in the score of symptoms and signs and cervical vertebra physiology degree of curve between two groups after 1 treatment course(P<0.05). Conclusion Tuina and chiropractic therapy is effective to treat cervical mimic coronary artery disease.%目的 观察推拿配合颈椎整脊手法治疗颈型类冠心病的临床疗效.方法 试验组采用推拿配合颈椎整脊手法调整,对照组采用传统推拿手法,1个疗程后比较临床疗效、症状、体征积分及颈椎生理曲度.结果 2组治疗后,试验组总有效率90.0%,对照组总有效率66.67%,两组比较有显著性差异(P<0.05);症状、体征积分比较、颈椎生理曲度比较均有显著性差异(P<0.05).结论 推拿手法配合颈椎整脊手法治疗颈型类冠心病优于单纯推拿手法.

  17. 小儿颈椎损伤62例临床分析%Clinical analyses of cervical spine injury in 62 children

    Institute of Scientific and Technical Information of China (English)

    陶春生; 倪斌; 徐朋; 吴冰; 曲良; 王连嘉

    2014-01-01

    Objective To discuss the characteristics,strategies and methods of individualized diagnosis and surgical treatment of cervical spine injury in children.Methods A total of 62 children of cervical spinal injury were analyzed retrospectively from March 2002 to December 2012.There were 48 boys and 14 girls with an average age of 7.5 (3-12) years.Among them,the ages were 3-6 years (n =25) and 7-12 years (n =37).The average visiting time after injury was 5.5 weeks (1 day to 50 weeks).Among 36 cases at C0-3,there were atlas transverse ligament rupture (n =2) ; atlantoaxial rotatory fixation or dislocation (n =26) and odontoid synchondrosis fracture (n =4) ; for 17 cases at C4-7; spinal cord injuries without any fracture and dislocation were found in 9 cases.According to different conditions,they received Glission belt or skull traction and Halo-Vest support,head-neckchest plaster,Dick splint or Philadelphia collar external fixation,methylprednisolone (MP) impact therapy and surgery.Results The interventions included surgical operation (n =14),skull traction or head and neck chest orthosis (n =45) and no special measure (n =3).The average hospitalization stay was 16 (9-40) days.During an average follow-up period of 25 (2-69) months,all patients achieved excellent clinical efficacies.Conclusions Anatomical structure and biomechanics of cervical spine in children undergo dynamic developments.Therefore injury mechanism,clinical representation and surgical strategy in children are different from those in adults.Surgery should be individualized and operative indication strictly controlled.%目的 探讨小儿颈椎损伤的个体化诊断特点、外科治疗策略及方法.方法 回顾性分析2002年3月至2012年12月收治的颈椎损伤患儿62例.男48例,女14例;年龄3~12岁,其中3~6岁25例,7~12岁37例,平均7.5岁.外伤至就诊时间为1 d~50周,平均5.5周.损伤节段为C0~3患儿36例,其中寰椎横韧带断裂2例,寰

  18. Differences in left ventricular global function and mechanics in Paralympic athletes with cervical and thoracic spinal cord injuries

    Directory of Open Access Journals (Sweden)

    Katharine Dianne Currie

    2016-03-01

    Full Text Available Following a spinal cord injury, there are changes in resting stroke volume (SV and its response to exercise. The purpose of the following study was to characterize resting left ventricular structure, function and mechanics in Paralympic athletes with tetraplegia (TETRA and paraplegia (PARA in an attempt to understand whether the alterations in SV are attributable to inherent dysfunction in the left ventricle. This retrospective study compared Paralympic athletes with a traumatic, chronic (>1 year post-injury, motor-complete spinal cord injury (American Spinal Injury Association Impairment Scale A-B. Eight male TETRA wheelchair rugby players (34±5 years, C5-C7 and eight male PARA alpine skiers (35±5 years, T4-L3 were included in the study. Echocardiography was performed in the left lateral decubitus position and indices of left ventricular structure, global diastolic and systolic function, and mechanics were derived from the average across three cardiac cycles. Blood pressure was measured in the supine and seated positions. All results are presented as TETRA vs. PARA. There was no difference in left ventricular dimensions between TETRA and PARA. Additionally, indices of global diastolic function were similar between groups including isovolumetric relaxation time, early (E and late (A transmitral filling velocities and their ratio (E/A. While ejection fraction was similar between TETRA and PARA (59±4 % vs. 61±7 %, p=0.394, there was evidence of reduced global systolic function in TETRA including lower SV (62±9 ml vs. 71±6 ml, p=0.016 and cardiac output (3.5±0.6 L/min vs. 5.0±0.9 L/min, p=0.002. Despite this observation, both systolic and diastolic mechanics were maintained in TETRA, while several indices were lower in PARA including circumferential strain at the level of the papillary muscle (-23±4% vs. -15±6%, p=0.010 and apex (-36±10% vs. -23±5%, p=0.010 and their corresponding diastolic strain rates (papillary: 1.90±0.63 s-1 vs. 1

  19. Observation of Zhuang medicine tendons therapy combined with cervical traction treatment on vertebral ar-tery type cervical spondylosis%壮医经筋疗法联合颈椎牵引治疗椎动脉型颈椎病51例疗效观察

    Institute of Scientific and Technical Information of China (English)

    黎文杰; 赵旭敬; 梁斌清

    2013-01-01

    Objective To observe the therapeutic effect of Zhuang medicine tendons therapy combined with cervical traction treatment on vertebral artery type cervical spondylosis .Methods 102 cases of vertebral artery type cervical spondylosis were randomly divided into two groups .51 cases in control group received acupuncture of neck jiaji.51 cases in treatment group were treated by Zhuang medicine tendons therapy combined with cervical traction treatment .The course was 10 days in two groups .The therapeutic effect was evaluated after a course.Immediate symp-tom scores and long-term symptom score before and after treatment were observed in two groups .Results The total effective rate in treatment group (98.0%) was superior to that in control group (82.4%,P<0.05).Immediate symptom scores and long -term symptom score after treatment were decreased (P<0.05).The decreases in treat-ment group was superior to that in control group (P<0.05).Conclusion Zhuang medicine tendons therapy com-bined with cervical traction treatment has obvious effect on vertebral artery type cervical spondylosis .%目的:观察壮医经筋疗法联合颈椎牵引治疗椎动脉型颈椎病的临床疗效。方法将102例椎动脉型颈椎病患者随机分为2组。治疗组51例采用壮医经筋疗法联合颈椎牵引治疗;对照组51例以针刺颈夹脊穴为主治疗。2组均10 d为1个疗程,1个疗程后统计临床疗效,并观察2组治疗前后即刻症状评分、长期症状评分。结果治疗组总有效率98.0%,对照组总有效率82.4%,2组比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后即刻症状评分、长期症状评分均降低(P<0.05),治疗组降低优于对照组( P<0.05)。结论壮医经筋疗法联合颈椎牵引治疗椎动脉型颈椎病疗效确切。

  20. Recurrent Autonomic Dysreflexia due to Chronic Aortic Dissection in an Adult Male with Cervical Spinal Cord Injury

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2008-01-01

    Full Text Available Autonomic dysreflexia is a hypertensive clinical emergency for persons with spinal cord injury at T-6 level or above. Recurrent autonomic dysreflexia is uncommon in spinal cord injury patients and is usually caused by noxious stimuli that cannot be removed promptly, e.g., somatic pain, abdominal distension. A 61-year-old man, who sustained tetraplegia at C-5 (ASIA-A 38 years ago, was admitted with chest infection. Computerised tomography (CT of the chest showed the ascending aorta to measure 4 cm in anteroposterior diameter; descending thoracic aorta measured 3.5 cm. No dissection was seen. Normal appearances of abdominal aorta were seen. He was treated with noninvasive ventilation, antibiotics, and diuretics. Nineteen days later, when there was sudden deterioration in his clinical condition, CT of the pulmonary angiogram was performed to rule out pulmonary embolism. This showed no pulmonary embolus, but the upper abdominal aorta showed some dissection with thrombosis of the false lumen. Blood pressure was controlled with perindopril 2 mg, once a day, doxazosin 4 mg, twice a day, and furosemide 20 mg, twice a day. Since this patient did not show clinical features of mesenteric or lower limb ischaemia, the vascular surgeon did not recommend subdiaphragmatic aortic replacement.

  1. 术中椎间盘造影辅助确定无骨折脱位型颈脊髓损伤的责任节段%Intraoperative discography for determining responsible segments in cervical spinal cord injury without fracture and dislocation

    Institute of Scientific and Technical Information of China (English)

    张继东; 夏群; 吉宁; 刘艳成; 宁尚龙

    2013-01-01

    time was 110 minutes and blood loss was 120 ml.Three patients had pain on shoulder and back and one patient had hoarse voice,but all the patients were relieved in two weeks after conservative treatments.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury or internal fixation failure were noticed intra-or post-operatively.Conclusion For the intradiscal rupture that is hard to be determined by the conventional imaging methods,intraoperative discography can be used as an auxiliary method of imaging diagnosis in early surgical determination of responsible segments for cervical spinal cord injury without fracture and dislocation.

  2. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

    YU Ze-sheng; James J.Yue; WEI Feng; LIU Zhong-jun; CHEN Zhong-qiang; DANG Geng-ting

    2007-01-01

    Background Lower cervical dislocation with locked facets is common in cervical injury. The locked facets include unilateral and bilateral types. Different successful closed reduction rates has been achieved between unilateral and bilateral types by using rapid skull traction, which was commonly used to reduce the cervical dislocation. It is important to investigate a suitable management specific to patients with different types of cervical locked facets.Methods A total of 38 patients with cervical dislocation with locked facet due to cervical injury treated by rapid skull traction and operation from 1988 to 2005 were reviewed. Rapid skull traction was used in all the patients. Successful closed reduction rate was 88.0% in patients with bilateral cervical locked facets and that was 15.4% in those with unilateral cervical locked facets. These data were then statistically compared by Chi-square test. Patients who were reduced successfully underwent anterior cervical discectomy and fusion at the injured level, and those who failed in closed reduction received posterior open reduction and fixation.Results In this series, there was statistically significant difference (P<0.05) in the rate of successful closed skull traction reduction between unilateral and bilateral locked facets dislocation. Unilateral cervical locked facets dislocation was not easily reduced by skull traction which was suitable for reduction of bilateral cervical locked facets dislocation. However,unilateral cervical locked facets dislocation can be reduced by posterior open reduction.Conclusions Unilateral cervical locked facets dislocation should be treated immediately with posterior open reduction and instrumentation. Bilateral cervical locked facets dislocation can be reduced by rapid skull traction firstly and anterior cervical discectomy and interbody fusion later.

  3. 旋提手法治疗椎动脉型颈椎病的临床研究%Clinical Research of Rotation-traction Manipulation on Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    高景华; 刘秀芹; 张威; 赵国东; 王海军; 金秀钧; 张跃; 王红东; 朱立国; 谢利民; 李俊杰; 罗杰; 王尚全; 张清; 杨克新; 李金学

    2011-01-01

    目的:探讨旋提手法治疗椎动脉型颈椎病的临床疗效。方法:选用多中心、随机对照研究方法治疗椎动脉型颈椎痛,符合方案数据177例,随机分为旋提手法治疗组87例,颈椎牵引治疗组90例;男性43例,女性134例;年龄35~55岁,平均年龄47.2岁;病程最长5年,最短1月;疗程14d,旋提手法治疗组隔日1次,共7次,颈椎牵引组每日1次,共14次。通过观察治疗前后头晕、颈椎活动度、头痛、等指标的变化,经统计学分析进行疗效评定,并对两种方法的疗效进行比较。结果:治疗2周后的总体疗效,手法组总有效率为98.8%,牵引组总有效率为84.09%,手法组优于牵引组,旋提手法组对改善眩晕症状、颈椎活动度、头痛症状的效果优于牵引组。结论:旋提手法治疗椎动脉型颈椎病是一种值得选择的治疗方法。%Objective:To detect the effects of rotation-traction manipulation in the treatment of cervical spondylosis of vertebral artery type. Methods: A multi-center, randomized control study was conducted. A total of 177 cases of cervical spondylosis of vertebral artery type were randomly divided into manipulation group (87 cases) and traction group (90 cases). There were 43 males and 134 females, with a mean age of 47. 2 years (range 35 to 55 years). The course of disease was from 1 month to 5 years, while, the course of treatment was 14 days. The patients were treatment once every two days with 7 treatments in manipulation group, and treatment every day with 14 treatments in the traction group. The indexes of dizziness, active degree of cervical vertebrate, and headache were recorded and analyzed before and after treatment for evaluating the curative effect. Results:The total effective rate in the manipulation group (98. 8%) was significantly higher than the traction group (84.09%) two weeks after treatment. Rotation-traction manipulation was superior to

  4. 椎动脉型颈椎病康复介入87例%Rehabilitation intervention on 87 cases of vertebral artery type of cervical syndrome

    Institute of Scientific and Technical Information of China (English)

    郝焕平; 卫珍梅; 耿建红

    2003-01-01

    @@ INTRODUCTION The reason for physical rotation compression on vertebral artery atG is that there isn' t intervertebral joints between at-lantoepistrophic transverse processes. At rear of vertebral artery be-tween atlantoepistrophic transverse processes is covered by inferioroblique muscle which originates from spinous process of axis andended at transverse process of atlas. When head rotates towardsright, inferior oblique muscle of left side will rotate towards left andforward which muscle belly enters interspace of first transverse pro-cess and compress vertebral artery. At the same time, right vertebralartery enters rear of atlantoepistrophic spinous process and isn' tcompressed that ensures blood supply of basal artery. When head andneck resume neutral position, inferior obhque muscle is replaced andcompression on left vertebral artery is decompressed, so inferioroblique muscle is the anatomic base of physical compression onvertebral compression.

  5. 无骨折脱位型急性中央型颈脊髓损伤治疗心得%Type type of acute central cervical spinal cord injury without fracture dislocation treatment result

    Institute of Scientific and Technical Information of China (English)

    谢海明; 陈胜; 李勇; 金正帅

    2014-01-01

    Objective Explore type of acute central type spinal cord injury without fracture dislocation treatment. Methods Type of 32 cases of acute central cervical spinal cord injury patients, upper limbs of 17 cases, limbs 15 cases. Admitted to hospital after skul traction, braking, dehydration. 20 underwent surgical treatment, 12 routine non-surgical treatment. Results 32 patients had no serious complications occurred, 29 cases of patients with injury after 3 months to 18 months folow-up, no complications occurred, neural function classification method (ASIA) are 1 ~ 2 levels of recovery. 23 patients work, the life can provide for oneself, cervical spine MRI review, 14 patients had different degrees of syringomyelia imaging findings. Conclusions For cervical spondylosis, cervical intervertebral disc herniation, cervical stenosis and spinal canal without obstruction of acute central spinal cord injury (edema) appropriate USES non-surgical treatment. Continued to pressure on the spinal cord or type cervical instability in the middle of the spinal cord injury patients should be timely surgical decompression, reconstruction of cervical stability.%目的:探讨无骨折脱位型急性中央型脊髓损伤治疗方法。方法32例急性中央型颈脊髓损伤患者,上肢型17例,四肢型15例。入院后行颅骨牵引、制动、脱水。20例行手术治疗,12例行非手术治疗。结果32例患者均无严重手术并发症发生,29例患者伤后3月-18月获随访,未见手术并发症发生,神经功能(ASIA法分类)均获1~2级的恢复。23例患者工作,生活可自理,颈椎MRI复查,14例患者有不同程度的脊髓空洞影像学表现。结论对无颈椎病、颈椎间盘突出、颈椎管狭窄、椎管内无梗阻的急性中央型脊髓损伤(水肿型)宜采用非手术治疗。对脊髓的持续存在致压物或颈椎失稳的中央型脊髓损伤患者应及时行手术减压,重建颈椎稳定性。对脊髓前方

  6. Pseudo-aneurysm of the anterior tibial artery, a rare cause of ankle swelling following a sports injury

    OpenAIRE

    McAteer Eamon; Johnston Ruth; McKay Damian; Marron Conor D; Stirling WJ Ivan

    2005-01-01

    Abstract Background Ankle pain and swelling following sports injuries are common presenting complaints to the accident and emergency department. Frequently these are diagnosed as musculoskeletal injuries, even when no definitive cause is found. Vascular injuries following trauma are uncommon and are an extremely rare cause of ankle swelling and pain. These injuries may however be limb threatening and are important to diagnose early, in order that appropriate treatment can be delivered. We hig...

  7. Clinical values of surgery plus superselective arterial infusion chemotherapy on treating cervical cancer%介入化疗联合手术在子宫颈癌治疗中的价值

    Institute of Scientific and Technical Information of China (English)

    李环; 吴瑞芳; 马喆; 杨瑞; 李瑞珍; 楼宝阳; 曾荔苹

    2012-01-01

    目的 探讨超选择动脉插管灌注化疗(介入化疗)联合手术在子宫颈癌治疗中的临床应用价值.方法 将北京大学深圳医院自2002年4月至2010年1月间收治的ⅠB2~ⅡB期患者共84例作为介入化疗组,采取先介入化疗后手术的方案(8例未行手术),同期ⅠB1~ⅡA期直接手术的对照组82例患者作比较.结果 介入化疗有效76例,占90.5%;药物血液系统毒副反应中,白细胞无减少者47例(61.8%),血红蛋白无下降者59例(77.6%);所有患者手术切除顺利,手术后按照相同的标准辅以化放疗.两组患者手术时间、出血量、并发症等比较,差异无统计学意义(P>0.05).介入化疗组术后患者5年存活率达83.9%%.结论 介入化疗联合手术在临床上应用于局部晚期子宫颈癌,安全、有效,为ⅡB期的患者创造手术条件,可提高宫颈癌患者的治疗效果,改善患者的生活质量,具有良好的应用前景.%Objective To study the clinical significance of surgery plus superselective arterial infusion chemotherapy in the treatment of cervical carcinoma. Methods 84 cervical cancer patients of stage ⅠB2, ⅡB and ⅡB. who underwent operation after arterial infusion chemotherapy form April 2002 to January of 2010 consisted integrated treatment group (8 cases without surgery) (AIC group), while 82 patients who only received surgery in the same time were served as control group. Results The effective rate of arterial infusion chemotherapy was 90.5%. The toxicity including 61.8% grade 0 leucopenia and 77. 6% grade 0 anemia. After arterial infusion chemotherapy, all the surgery were satisfied. There was no significant difference between the two groups in the operation time, bleeding volume and complications (P>0.05). The 5 years survival rate in AIC group was over 83.9%. Conclusion Surgery plus superselective arterial infusion chemotherapy is safe and effective for treating advanced stage cervical cancer. It can

  8. 机械通气在颈椎损伤术后合并呼吸衰竭的临床应用%Clinical application of mechanical ventilation in cervical spine injury surgery with respiratory failure

    Institute of Scientific and Technical Information of China (English)

    崔艳; 王辉

    2012-01-01

    目的 探讨机械通气在颈椎术后合并呼吸衰竭的应用.方法 回顾性分析32例颈椎损伤术后合并呼吸衰竭应用机械通气患者的疗效.结果 26例患者安全度过急性期,2例患者抢救无效死亡,4例患者因经费原因放弃治疗而自动出院.结论 颈椎损伤术后合并呼吸衰竭有效地应用机械通气可使患者顺利度过围术期,提高手术疗效,降低患者病死率,是一种有效的辅助治疗措施.%Objective To investigate the application of mechanical ventilation in cervical spine injury with postoperative respiratory failure.Methods The effects of mechanical ventilation on 32 cases of cervical spine injury with respiratory failure were retrospectively analyzed.Results Twenty-six patients survived the acute period safely,2 patients died,4 patients gave up the treatment due to financial reasons and discharged automatically.Conclusions Effective application of mechanical ventilation in cervical spine injury complicated with postoperative respiratory failure,can make the patients pass through perioperative period,improve operation effectively,reduce the morbidity and mortality.It is an effective adjunctive treatment measure.

  9. Cervical radiculopathy.

    Science.gov (United States)

    Iyer, Sravisht; Kim, Han Jo

    2016-09-01

    Cervical radiculopathy is a common clinical scenario. Patients with radiculopathy typically present with neck pain, arm pain, or both. We review the epidemiology of cervical radiculopathy and discuss the diagnosis of this condition. This includes an overview of the pertinent findings on the patient history and physical examination. We also discuss relevant clinical syndromes that must be considered in the differential diagnosis including peripheral nerve entrapment syndromes and shoulder pathology. The natural history of cervical radiculopathy is reviewed and options for management are discussed. These options include conservative management, non-operative modalities such as physical therapy, steroid injections, and operative intervention. While the exact indications for surgical intervention have not yet been elucidated, we provide an overview of the available literature regarding indications and discuss the timing of intervention. The surgical outcomes of anterior cervical decompression and fusion (ACDF), cervical disc arthroplasty (CDA), and posterior cervical foraminotomy (PCF) are discussed. PMID:27250042

  10. Transplantation of autologous bone marrow stem cells via hepatic artery for the treatment of acute hepatic injury: an experimental study in rabbits

    International Nuclear Information System (INIS)

    Objective: To evaluate the transplantation of autologous bone marrow stem cells via hepatic artery in treating acute hepatic injury in experimental rabbit models and to clarify the synergistic effect of hepatocyte growth-promoting factor (pHGF) in stem cell transplantation therapy for liver injury. Methods Acute hepatic injury models were established in 15 experimental rabbits by daily subcutaneous injection of CCl4 olive oil solution with the dose of 0.8 ml/kg for 4 days in succession. The experimental rabbits were randomly and equally divided into three groups: study group A (stem cell transplant, n = 5), study group B (stem cell transplant + pFHG, n = 5), and control group (n = 5). Bone marrow of 5 ml was drawn from the tibia in all rabbits of both study groups, from which bone marrow stem cells were isolated by using density gradient centrifugation, and 5 ml cellular suspension was prepared. Under fluoroscopic guidance, catheterization through the femoral artery was performed and the cellular suspension was infused into the liver via the hepatic artery. Only injection of saline was carried out in the rabbits of control group. For the rabbits in group B, pFHG (2.0 mg/kg) was administered intravenously every other day for 20 days. At 2, 4 and 8 weeks after stem cell transplantation, hepatic function was determined. Eight weeks after the transplantation all the rabbits were sacrificed and the liver specimens were collected and sent for pathological examination. Results After stem cell transplantation, the hepatic function was gradually improved.Eight weeks after the transplantation, the activity of AST, ALT and the content of ALB, TBIL were significantly lower than that before the procedure, while the content of GOLB was markedly increased in all rabbits. In addition, the difference in the above parameters between three groups was statistically significant (P < 0.05). Pathologically, the hepatocyte degeneration and the fiberous hyperplasia in the study groups were

  11. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report.

    Science.gov (United States)

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-01-01

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous injury and subsequently these were confirmed on surgery.Although it is a rare syndrome, early diagnosis and treatment prevents permanent neurological deficits and improve patient's quality of life. PMID:20076781

  12. Análise radiográfica do tratamento cirúrgico da fratura cervical baixa por via posterior Evaluación radiográfica de la fijación posterior de la fractura de la columna cervical baja Radiographic evaluation of the posterior fixation in the subaxial cervical spine injury

    Directory of Open Access Journals (Sweden)

    Nelson Astur Neto

    2012-01-01

    érdida de la reducción, la cifosis segmentaria, la degeneración de nivel adyacente y la pseudoartrosis. RESULTADOS: En comparación con el método de síntesis, 60,8% de los pacientes se sometieron a fijación por cableado interespinoso, 26% a la placa con tornillos de masa lateral y 13% a la barra con tornillos de masa lateral. De los pacientes sometidos a fijación con tornillos, ninguno presentó complicaciones radiográficas y 35,7% de los pacientes sometidos a la fusión con el cableado interespinoso presentaron complicaciones, siendo la cifosis segmentaria la más frecuente. CONCLUSIÓN: Las lesiones de columna cervical sometidas a la fusión con el tornillo de masa lateral presentaron una evolución radiográfica mejor que las de quienesfueron sometidos a fijación con cableado interespinoso, esta última presentó una mayor incidencia de complicaciones en la artrodesis.OBJECTIVE: To perform a radiographic evaluation of the cervical spine injury treated with posterior fixation techniques only. METHODS: From 2000 to 2008, twenty three patients were included in the study, of which 91,3% were men, with a mean age of thirty-four years and four months. The mean follow-up time was 82 months. The type of implant used, the radiographic arthrodesis consolidation, implant failure, lost of reduction, segmental kyphosis and pseudarthrosis were evaluatedin the preoperative period, the immediate postoperative period and after six months of evolution, based on the patients records. RESULTS: When it comes to the type of implant used, there were 60,8% of the patients who underwent interspinous wire fixation, 26% with lateral mass screws and plate and 13% with lateral mass screws and rods. Of the lateral mass screws patients, none had radiographic complications and 35,7% of the interspinous wire patients had complications being the segmental kyphosis the most frequent of them. CONCLUSIONS: The cervical spine injuries that underwent lateral mass screw fixation showed better

  13. The Postoperative Application of Percutanous Dilatational Tracheostomy for Patients with Serious Cervical Spinal Cord Injury Undergoing Anterior or Combined Anterior-posterior Cervical Spine Fixation%经皮扩张气管切开术在重度颈髓损伤颈椎前路或前后路联合手术后人工气道中的应用

    Institute of Scientific and Technical Information of China (English)

    李强; 安卫红; 白宇; 刘飞; 么改琦; 朱曦

    2013-01-01

    Objective To investigate the feasibility of percutanous dilatational tracheostomy on patients undergoing anterior and anterior-posterior cervical spine fixation.Methods A retrospective analysis was done on 17 patients with cervical spinal cord injury who were admitted to ICU of Peking University Third Hospital from January 2012 to March 2013,including 12 cases of anterior and 5 cases of combined anterior-posterior cervical spine fixation.All patients received percutanous dilatational tracheostomy after anterior or anterior-posterior cervical spine fixation.The duration between the percutanous dilatational tracheostomy and the anterior/anterior-posterior cervical spine fixation were 5 to 11 days.Results The procedure of percutanous dilatational tracheostomy was smooth in all 17 cases,with no intraoperative impairment to the vital organs,no postoperative heavy blood loss and no fistula infection.No concurrent anterior and anterior-posterior cervical incision infection occurred.Conclusions Percutanous dilatational tracheostomy is a safe and efficient way of building the artificial airway 5 days after the anterior and anterior-posterior cervical spine fixation.%目的 探讨颈椎前路和颈椎前后路联合颈椎切开复位内固定手术后行经皮扩张气管切开术的安全性. 方法 回顾性分析2012年1月~2013年3月颈脊髓损伤17例,行颈前路(12例)或颈前后路(5例)切开复位内固定手术,术后5 ~11d行经皮扩张气管切开术. 结果 17例经皮扩张气管切开术均过程顺利,无颈前部重要器官损伤、术后局部大量出血、造瘘区域感染、颈前路手术切口及切口深层感染. 结论 颈前路手术5日后行经皮扩张气管切开术是安全高效的建立人工气道的方法.

  14. High b-value diffusion tensor imaging of unilateral middle cerebral artery occlusive disease: evaluation of white matter injury

    International Nuclear Information System (INIS)

    Objective: To investigate the value of diffusion tensor imaging (DTI) at high b value for unilateral middle cerebral artery (MCA) occlusive disease in patients without obvious infarct lesions on conventional MR imaging. Methods: DTI at high b value (2200 s/mm2) was performed using a 3.0 Tesla MR scanner in 34 patients with unilateral middle cerebral artery occlusion, who had no obvious infarct lesions on conventional MR imaging. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (eigenvalue λ1) and radial diffusivity (eigenvalues λ2, λ3) were measured at the ipsilateral and contralateral corona radiata, anterior and posterior limbs of the internal capsule, cerebral peduncle and pons in all subjects. Mean ADC, FA, λ1, λ2 and λ3 values of corona radiata, anterior and posterior limbs of the internal capsule, cerebral peduncle and pons were compared between the ipsilateral and contralateral MCA territory by t test. Results: Among the 34 patients, left MCA occlusion in M1 segment occurred in 16 patients and right MCA occlusion in Ml segment occurred in 18 patients. At the ipsilateral corona radiata, mean FA, ADC, λ1, λ2 and λ3 were 0.419 ±0.032, (5.975 ±0.272) × 10-3, (5.704 ±0.365) ×10-3, (6.412 ±0.368) × 10-3 and (6.605 ±0.343) × 10-3 mm2/s, respectively. At the contralateral corona radiata, mean FA, ADC, λ1, λ2 and λ3 were 0.443 ± 0.033, (5.804 ± 0.282) × 10-3,(5.651 ±0.350) × 10-3, (6.099 ±0.353) × 10-3 and (6.372 ±0.355) × 10-3 mm2/s, respectively. At the ipsilateral corona radiata, mean FA was significantly decreased (t=11.614, P<0.01), and mean ADC (t=12.421, P<0.01), λ1 (t=7.447, P<0.01), λ2 (t=10.244, P<0.01) and λ3 (t=9.890, P<0.01) were significantly increased. At the ipsilateral anterior and posterior limb of the internal capsule,mean FA were 0.609 ±0.026 and 0.674 ±0.033, λ1 were (5.330 ±0.462) × 10-3 and(5.171 ±0.456) ×10-3 mm2/s, respectively. At the contralateral anterior and

  15. Report of an unusual combination of arterial, venous and neural variations in a cadaveric upper limb.

    Science.gov (United States)

    Troupis, Theodore G; Michalinos, Adamantios; Manou, Vasiliki; Vlastos, Dimitrios; Johnson, Elizabeth O; Demesticha, Theano; Skandalakis, Panayiotis

    2014-01-01

    In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery. Multiple variations in typical axillary artery branches were present including existence of inferior pectoral artery. Cephalic vein was absent. A variety of interventions, from relative simple as central venous catheter placement to most complicated as brachial plexus injury repair demand thorough knowledge of area's regional anatomy. Familiarity with anatomic variations allows more precise and careful interventions. Research on these variations is valuable for anatomists and embryologists but also for clinicians because it may provide useful information for non - typical cases but also helps in raising a high level of suspicion.

  16. Potential Effect of L-Carnitine on the Prevention of Myocardial Injury after Coronary Artery Bypass Graft Surgery

    Directory of Open Access Journals (Sweden)

    Farzaneh Dastan

    2015-10-01

    Full Text Available Background: L-carnitine has been demonstrated to confer cardiac protection against ischemia reperfusion injury in animals. This study evaluates the effects of L-carnitine administration on cardiac biomarkers after coronary artery bypass graft (CABG surgery.Methods: One hundred thirty-four patients undergoing elective CABG surgery, without a history of myocardial ischemia or previous L-carnitine treatment, were enrolled and randomly assigned to an L-carnitine group ([n = 67], 3000 mg/d, started 2 days preoperatively and continued for 2 days after surgery or a control group (n = 67. CK-MB (creatine kinase, muscle- brain subunits and troponin T (TnT levels were assessed in all the patients before surgery as baseline levels and at 8 and 24 hours postoperatively.Results: Our study included 134 patients (99 [73.8%] males at a mean ± SD age of 59.94 ± 8.61 years who were candidates for CABG and randomized them into control or L-carnitine groups. The baseline demographic characteristics, including age (60.01 ± 9.23 in the L-carnitine group vs. 59.88 ± 7.98 in the control group and sex (54 [80.6%] in the L-carnitine group vs. 45 [67.2%] in the control group did not show any significant differences (p value=0.93 and 0.08, respectively. Patients in the L-carnitine group had lower levels of CK-MB (mean ± SD, 25.06 ± 20.29 in the L-carnitine group vs. 24.26 ± 14.61 in the control group, but the difference was not significant (p value = 0.28. TnT levels also showed no significant differences between the two groups (399.50 ± 378.91 in the L-carnitine group vs. 391.48 ± 222.02 in the control group; p value = 0.34. Conclusion: In this population of intermediate- to high-risk patients undergoing CABG surgery, L-carnitine did not reduce CK-MB and TnT levels.

  17. The effect of pulmonary artery catheter use on costs and long-term outcomes of acute lung injury.

    Directory of Open Access Journals (Sweden)

    Gilles Clermont

    Full Text Available BACKGROUND: The pulmonary artery catheter (PAC remains widely used in acute lung injury (ALI despite known complications and little evidence of improved short-term mortality. Concurrent with NHLBI ARDS Clinical Trials Network Fluid and Catheters Treatment Trial (FACTT, we conducted a prospectively-defined comparison of healthcare costs and long-term outcomes for care with a PAC vs. central venous catheter (CVC. We explored if use of the PAC in ALI is justified by a beneficial cost-effectiveness profile. METHODS: We obtained detailed bills for the initial hospitalization. We interviewed survivors using the Health Utilities Index Mark 2 questionnaire at 2, 6, 9 and 12 m to determine quality of life (QOL and post-discharge resource use. Outcomes beyond 12 m were estimated from federal databases. Incremental costs and outcomes were generated using MonteCarlo simulation. RESULTS: Of 1001 subjects enrolled in FACTT, 774 (86% were eligible for long-term follow-up and 655 (85% consented. Hospital costs were similar for the PAC and CVC groups ($96.8k vs. $89.2k, p = 0.38. Post-discharge to 12 m costs were higher for PAC subjects ($61.1k vs. 45.4k, p = 0.03. One-year mortality and QOL among survivors were similar in PAC and CVC groups (mortality: 35.6% vs. 31.9%, p = 0.33; QOL [scale: 0-1]: 0.61 vs. 0.66, p = 0.49. MonteCarlo simulation showed PAC use had a 75.2% probability of being more expensive and less effective (mean cost increase of $14.4k and mean loss of 0.3 quality-adjusted life years (QALYs and a 94.2% probability of being higher than the $100k/QALY willingness-to-pay threshold. CONCLUSION: PAC use increased costs with no patient benefit and thus appears unjustified for routine use in ALI. TRIAL REGISTRATION: www.clinicaltrials.gov NCT00234767.

  18. Brainstem ischemic stroke without permanent sequelae during the course of spontaneous internal carotid artery dissection – case report

    International Nuclear Information System (INIS)

    Internal carotid artery dissection (ICAD) is a frequent cause of a stroke in young patients. Risk factors which can lead to dissection include neck injury and diseases of the inner wall of the artery. Common symptoms in ICAD are cervical pain and headache, Horner’s syndrome, paralysis of the cranial nerves and subsequently cerebral and retinal ischemia. MR angiography in TOF technique and brain MRI in T1- and T2-weighted images, FLAIR and DWI sequences are the method of choice in patients with ICAD but contrast-enhanced multislice computed tomography remains the fastest and the most available diagnostic method. A 39-year old woman, previously healthy, presented to the Hospital Emergency Department because of increasing neck pain on the right side and difficulty in swallowing. The neurological examination revealed: drooping of the right eyelid with narrow palpebral fissure, dysarthria, anisocoria (narrower pupil on the right side), unilateral hypoesthesia on the left side, weak palatal and pharyngeal reflexes on both sides, paresthesia within the left half of the body. Seven days before, the patient felt a sudden, severe neck pain radiating to the temporal apophysis. CT angiography revealed a defect in contrast filling within the left internal carotid artery and right vertebral artery. MRI of the head with MR angiography showed internal carotid artery dissection on the left side and dissection of the right vertebral artery and no ischemic changes within the brain. CT and MR angiography are methods characterized by high sensitivity in detecting dissection of the cervical arteries

  19. Clinical Research on Jingling Mixture with Massage for Treating Vertebral Artery Type of Cervical Disease%颈灵合剂配合推拿整复治疗椎动脉型颈椎病的临床研究

    Institute of Scientific and Technical Information of China (English)

    胡卫玉; 刘智宇; 杨松柏; 许可; 孙思杰; 刘盛华; 张万桂

    2012-01-01

    Objective: The clinical efficacy of Jingling mixture combined with massage for treating vertebral artery type cervical spondylosis was obsevered. Methods :500 patients were randomly divided into three groups, 200 patients in the treatment group took Jingling mixture and massage; 150 cases in the control group 1 only took Jingling mixture treatment. 150 cases in the control group 2 were only given massage therapy, 10 days was a course treatment and al) patients were treated for 3 courses. Three groups were observed including mainly clinical effect, hemodynamic changes color Doppler( TCD, CDFl) ,the main symptom scores before and after treatment and blood rheology (plasma viscosity) of the indicators. Results: The total efficiency of Jingling mixture combined with massage of treating vertebral artery type cervical spondylosis was 100% ( cure rate 69. 5% ) , significantly higher than control group 1( Jingling mixture group)90% (cure rate 38. 7% )and control group 2(massage group)78. 8% (cure rate 30. 7%) (P<0. 01). Conclusion: Jingling mixture and massage treatment has significant clinical effect on vertebral artery type cervical spondylosis. The treatment can effectively relieve spasm and reduce blood viscosity so as to improve the symptoms of vertebral artery insufficiency.%目的:观察颈灵合剂配合推拿整复法治疗椎动脉型颈椎病临床疗效.方法:将500例患者随机分为3组,治疗组200例服用颈灵合剂配合推拿整复;对照组(1)150例仅服用颈灵合剂治疗.对照组(2)150例仅以推拿整复治疗,3组均以10天为1疗程,治疗3个疗程.主要观察3组临床疗效、彩色多普勒血流动力学变化( TCD、CDFI)、治疗前后主要症状积分及血液流变学(血浆黏度值)各项指标的变化.结果:颈灵合剂配合推拿整复治疗推动脉型颈椎病的总有效率100%(治愈率69.5%),显著高于对照组(1)(颈灵合剂组)的90%(治愈率38.7%)及对照组(2)(推拿整复组)的78.8

  20. Diagonosis and treatment of iatrogenic subclavian artery injury%医源性锁骨下动脉损伤的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    唐烽; 唐胜军; 谭益; 张俭荣

    2011-01-01

    Objective To research the diagonosis and effective treatments of iatrogenic subclavian artery injuries. Methods From July 1997 to January 2009, the clinical data of 11 cases of subclavian vascular injury were analysed retrospectively. There were 7 cases treated by direct suture,2 cases by artificial vascular prosthesis graft, 1 case by autogenous saphaneous vein graft and 1 case by endto-end anastomosis. Ther cause of injury,classifications and conplications were analyzed. Results Extremities survived and got good function in 10 cases. One cases died in this group. Incomplete recovery of the brachial nerve was abserved in 1 cases. After subclavian vessels reconstruction, clear pulses is observed in radial arteries. There was no visible tumefaction of extrimities after repair of injured the veins when examined at the time of follow-up. Conclusion Iatrogenic subclavian artery injury is serious and complicated. Amlost all operative injuries of iatrogenic subclavian artery are preventable. For subclavian vascular injuries, most imporrant thing is correct diagnosis, quick hemostasis and proper treatment. The management such as direct suture, artificial vascular prosthesis graft,autogenous saphaneous vein graft and endto-end anastomosis should be selected according to the type of vascular injuries. To improve the therapeutic effectiveness,The selection of a reasonable incision approach and a suitable surgery method is the key of a safe and successful operation.%目的 探讨医源性锁骨下动脉损伤的诊断和有效治疗方法.方法 对1997年7月至2009年1月,11例医源性锁骨下动脉损伤的救治进行回顾性分析,本组7例行血管修补,2例行人造血管移植,1例行大隐静脉桥接,l例行直接端-端吻合.结果 手术修复成功10例,死亡1例.动脉修复术后l年随访,均可清晰地触及桡动脉搏动.其中1例并发臂丛神经损伤,术后1年随访未完全恢复.结论 医源性锁骨下动脉损伤是一种严重而复杂

  1. Study Effect of Different Endotracheal Intubation General Anesthesia in High Cervical Spine Fracture With Cervical Spinal Cord Injury%不同气管插管全麻方式应用于高位颈椎骨折伴颈髓损伤的效果研究

    Institute of Scientific and Technical Information of China (English)

    刘卫忠

    2015-01-01

    Objective To investigate the effect of different endotracheal intubation and general anesthesia in high cervical spine fracture with cervical spinal cord injury.Methods 75 patients were randomly divided into three groups, and compared the cervical lfexion degree change, intubation time, the time of the exposure and the success rate of one intubation. Results The three groups of intubation time and glottic exposure time,t he laryngeal mask group intubation time and glottis exposure for the longest time, shikani laryngoscope group was the shortest,P0.05, had no difference statistically significance.Conclusion Shikani laryngoscope in high cervical spine fracture with cervical spinal cord injury of tracheal intubation with intubation laryngeal mask and direct laryngoscope has more advantages.%目的 探讨不同气管插管全麻方式应用于高位颈椎骨折伴颈髓损伤的效果.方法 将75例患者随机分为3组,并比较颈椎屈曲度变化、插管时间、声门显露时间和一次插管成功率.结果 3组插管时间和声门暴露时间比较,插管型喉罩组插管时间和声门暴露时间最长,视可尼喉镜组最短,P<0.05,差异具有统计学意义;在暴露声门时,视可尼喉镜组和插管型喉罩组颈椎屈曲度变化低于直接喉镜组,P<0.05,差异具有统计学意义,气管插入后,视可尼喉镜组颈椎屈曲度变化低于直接喉镜组,P < 0.05,差异具有统计学意义.三种方式在一次插管成功率方面对比,P > 0.05,差异不具有统计学意义.结论 视可尼喉镜在高位颈椎骨折伴颈髓损伤气管插管中较插管性喉罩和直接喉镜有更优势.

  2. 颈脊髓外伤后气管切开指征的影响因素分析%Factors influencing the indication for tracheostomy following cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    刘瑞端; 靳安民

    2015-01-01

    Objective To determine the factors influencing the indication for tracheostomy following cervical spinal cord injury.Methods A retrospective study was performed to analyze the 118 patients who had been treated for cervical fracture/dislocation along with cervical spinal cord injury from July 2004 to June 2014 and whose abbreviated injury scale score (AISS) was lower than 3.They were 96 men and 22 women,19 to 68 years of age (average,45.2 years).The patients were divided into a tracheostomy group (n = 28) and a non-tracheostomy group (n =90).The 2 groups were compared in terms of gender,age,presence or absence of complete spinal cord injury at admission,injured segment,injury mechanism,smoking history,injury severity score (ISS),motor AISS,systolic pressure at admission,hospital stay,and ICU stay to determine the factors influencing allocation of tracheostomy.Results Compared with the non-tracheostomy group,the tracheostomy group had a higher rate of complete spinal cord injury at admission,a higher rate of smoking,a higher ISS at admission,a lower motor AISS,and longer hospital and ICU stay,with statistically significant differences (P < 0.05).There were no significant differences between the 2 groups in gender,age,injured segment,injury mechanism,or systolic pressure at admission (P > 0.05).Increased severity of cervical spinal cord injury was associated with significantly decreased motor AISA,increased rate of tracheostomy and increased ISS (P < 0.05).Conclusion The influencing factors for indication of tracheostomy after cervical spinal cord injury are complete cervical spinal cord injury irrespective of the level of injury,ISS,motor AISS,and history of smoking.%目的 分析颈脊髓外伤后气管切开指征的影响因素. 方法 回顾性研究2004年7月至2014年6月收治的颈椎以外的部位简明损伤评分小于3分的118例颈椎骨折脱位伴有脊髓损伤患者资料,男96例,女22例;年龄19 ~68岁,平均45.2岁.将患者根据

  3. Management of delayed posttraumatic cervical kyphosis.

    Science.gov (United States)

    Lopez, Alejandro J; Scheer, Justin K; Abode-Iyamah, Kingsley; Smith, Zachary A; Hitchon, Patrick W; Dahdaleh, Nader S

    2016-01-01

    We describe three patients with misdiagnosed unstable fractures of the cervical spine, who were treated conservatively and developed kyphotic deformity, myelopathy, and radiculopathy. All three patients were then managed with closed reductions by crown halo traction, followed by instrumented fusions. Their neurologic function was regained without permanent disability in any patient. Unstable fractures of the cervical spine will progress to catastrophic neurologic injuries without surgical fixation. Posttraumatic kyphosis and the delayed reduction of partially healed fracture dislocations by preoperative traction are not well characterized in the subaxial cervical spine. The complete evaluation of any subaxial cervical spine fracture requires CT scanning to assess for bony fractures, and MRI to assess for ligamentous injury. This allows for assessment of the degree of instability and appropriate management. In patients with delayed posttraumatic cervical kyphosis, preoperative closed reduction provided adequate realignment, facilitating subsequent operative stabilization. PMID:26321304

  4. Pontine infarction caused by medial branch injury of the basilar artery as a rare complication of cisternal drain placement

    OpenAIRE

    Horiuchi, Tetsuyoshi; Yamamoto, Yasunaga; Kuroiwa, Masafumi; Rahmah, Nunung Nur; Hongo, Kazuhiro

    2012-01-01

    We present a rare complication of cisternal drain placement during aneurysm surgery. A ruptured anterior communicating artery aneurysm was clipped through a right pterional approach. A cisternal drain was inserted from the retro-carotid to the prepontine cistern. Postoperatively, a left-sided paresis of the upper extremity had developed. A CT brain scan revealed that the drain was located between the pons and the basilar artery, resulting in a pontine infarction. Vascular neurosurgeons should...

  5. Risk of spinal cord injury in patients with cervical spondylotic myelopathy and ossification of posterior longitudinal ligament: a national cohort study.

    Science.gov (United States)

    Chen, Li-Fu; Tu, Tsung-Hsi; Chen, Yu-Chun; Wu, Jau-Ching; Chang, Peng-Yuan; Liu, Laura; Huang, Wen-Cheng; Lo, Su-Shun; Cheng, Henrich

    2016-06-01

    OBJECTIVE This study aimed to estimate the risk of spinal cord injury (SCI) in patients with cervical spondylotic myelopathy (CSM) with and without ossification of posterior longitudinal ligament (OPLL). Also, the study compared the incidence rates of SCI in patients who were managed surgically and conservatively. METHODS This retrospective cohort study covering 15 years analyzed the incidence of SCI in patients with CSM. All patients, identified from the National Health Insurance Research Database, were hospitalized with the diagnosis of CSM and followed up during the study period. These patients with CSM were categorized into 4 groups according to whether they had OPLL or not and whether they received surgery or not: 1) surgically managed CSM without OPLL; 2) conservatively managed CSM without OPLL; 3) surgically managed CSM with OPLL; and 4) conservatively managed CSM with OPLL. The incidence rates of subsequent SCI in each group during follow-up were then compared. Kaplan-Meier and Cox regression analyses were performed to compare the risk of SCI between the groups. RESULTS Between January 1, 1999, and December 31, 2013, there were 17,258 patients with CSM who were followed up for 89,003.78 person-years. The overall incidence of SCI in these patients with CSM was 2.022 per 1000 person-years. Patients who had CSM with OPLL and were conservatively managed had the highest incidence of SCI, at 4.11 per 1000 person-years. Patients who had CSM with OPLL and were surgically managed had a lower incidence of SCI, at 3.69 per 1000 person-years. Patients who had CSM without OPLL and were conservatively managed had an even lower incidence of SCI, at 2.41 per 1000 person-years. Patients who had CSM without OPLL and were surgically managed had the lowest incidence of SCI, at 1.31 per 1000 person-years. The Cox regression model demonstrated that SCIs are significantly more likely to happen in male patients and in those with OPLL (HR 2.00 and 2.24, p risk for approximately 50

  6. Pharmacokinetic Comparison of Scutellarin and Paeoniflorin in Sham-Operated and Middle Cerebral Artery Occlusion Ischemia and Reperfusion Injury Rats after Intravenous Administration of Xin-Shao Formula.

    Science.gov (United States)

    Li, Yueting; Lu, Yuan; Hu, Jianchun; Gong, Zipeng; Yang, Wu; Wang, Aimin; Zheng, Jiang; Liu, Ting; Chen, Tingting; Hu, Jie; Mi, Ling; Li, Yongjun; Lan, Yanyu; Wang, Yonglin

    2016-01-01

    Xin-Shao formula is a folk remedy widely used in China to prevent and cure stroke. Cerebral ischemic reperfusion (I/R) injury often takes place during the treatment of stroke. Information about the pharmacokinetic behavior of the remedy under cerebral I/R injury conditions is lacking. The present study aimed to compare the pharmacokinetic properties of scutellarin and paeoniflorin, two major bioactive components of Xin-Shao formula, under physiological state in cerebral I/R injury rats. Neurobehavioral dysfunction was evaluated and cerebral infarcted volume was measured in middle cerebral artery occlusion I/R injury (MCAO) rats. Plasma samples were collected at various time points after a single dose (intravenous, i.v.) of Xin-Shao formula. The levels of plasma scutellarin and paeoniflorin at the designed time points were determined by a UPLC-MS/MS method, and drug concentration versus time plots were constructed to estimate pharmacokinetic parameters. Increase in terminal elimination half-life (t1/2z) and mean residence time (MRT(0-t)) of scutellarin as well as elevation in area under the plasma drug concentration-time curve from 0 h to the terminal time point (AUC(0-t)) and maximum plasma drug concentration (Cmax) of paeoniflorin, along with decreased clearance of paeoniflorin and scutellarin as well as reduced apparent volume of distribution (Vz) of paeoniflorin, were observed in MCAO rats, compared with those in sham-operated animals. The elimination of scutellarin and paeoniflorin were reduced in cerebral I/R injury reduced rats. PMID:27617986

  7. Acute liver failure due to concomitant arterial, portal and biliary injury during laparoscopic cholecystectomy: is transplantation a valid life-saving strategy? A case report

    Directory of Open Access Journals (Sweden)

    Goldaracena Nicolas

    2009-09-01

    Full Text Available Abstract Background Combined iatrogenic vascular and biliary injury during cholecystectomy resulting in ischemic hepatic necrosis is a very rare cause of acute liver failure. We describe a patient who developed fulminant liver failure as a result of severe cholestasis and liver gangrene secondary to iatrogenic combine injury or the hepatic pedicle (i.e. hepatic artery, portal vein and bile duct during laparoscopic cholecystectomy. Case presentation A 40-years-old woman underwent laparoscopic cholecystectomy for acute cholecystitis. During laparoscopy, a severe bleeding at the liver hilum motivated the conversion to open surgery. Many sutures were placed across the parenchyma for bleeding control. After 48 hours, she rapidly deteriorated with encephalopathy, coagulopathy, persistent hypotension and progressive organ dysfunction including acute renal failure requiring hemodialysis and mechanical ventilation. An angiography documented an occlusion of right hepatic artery and right portal vein. In the clinical of acute liver failure secondary to liver gangrene, severe coagulopathy and progressive secondary multi-organ failure, the patient was included in the waiting list for liver transplantation. Two days later, the patient was successfully transplanted with initial adequate liver graft function. However, she developed bilateral pneumonia and severe gastrointestinal bleeding and finally died 24 days after transplantation due to bilateral necrotizing pneumonia. Conclusion The occurrence of acute liver failure due to portal triad injury during laparoscopic cholecystectomy is a catastrophic complication. Probably, the indication of liver transplantation as a life-saving strategy in patients with late diagnosis, acute liver failure, severe coagulopathy and progressive secondary multi-organ failure could be considered but only minimizing immunosuppressive regimen to avoid postoperative infections.

  8. 祛痛膏对椎动脉型颈椎病祛痛的临床疗效分析%A clinical analysis of treating vertebral artery type of cervical spondylosis with the Qutong ointment

    Institute of Scientific and Technical Information of China (English)

    韩福祥; 秘兴锋; 司俊梅; 李清云; 田秀华; 李忠伟; 赵雪艳; 赵广声

    2014-01-01

    Objective: To study clinical efficacy of the Qutong ointment on vertebral artery type of cervical spondylosis. Methods: 60 patients with vertebral artery type of cervical spondylosis, according to the odd and even number method, were randomly divided into control group and observation group, 30 cases respectively. The control group was given the Jingfukang granule, the observation group was treated by the Qutong ointment. Clinical effects and symptoms were compared in both. Results: The total efficacy in the control (66.67%) was obviously lower than that in the observation (93.33%). The difference was statistically significant (P<0.05). Symptomatic rates of vertigo, discomfort in neck, headache, blurred vision, fatigue, amnesia, instability of gait, purple tongue, white tongue fur and deep thready pulse were observed in both, the difference was statistically significant (P<0.05). Conclusion: The Qutong ointment was effective on vertical artery type of cervical spondylosis, showed lower symptomatic rate, and was worthy of clinical recommending.%目的:探讨祛痛膏对椎动脉型颈椎病祛痛的临床疗效。方法:将60例椎动脉型颈椎病患者按照奇偶数字法随机地均分为对照组与观察组,各30例。对照组口服颈复康颗粒治疗,观察组则采用自制祛痛膏治疗。比较两组临床治疗效果及治疗前后症状发生率。结果:对照组临床治疗总有效率为66.67%,显著低于观察组(93.33%)(P<0.05);两组治疗前后眩晕、颈部不适、头痛、视物模糊、倦怠乏力、健忘、步态不稳、舌暗、舌苔白及脉沉细等症状发生率差异均具有统计学意义(P<0.05~0.01),且观察组治疗后上述症状发生率均显著低于对照组治疗后(P<0.05)。结论:祛痛膏对椎动脉型颈椎病祛痛的临床疗效显著,且临床症状发生率也显著降低,值得在临床上加以推广及应用。

  9. Therapeutic Observation of Acupuncture at Myofascial Trigger Points for Cervical Spondylosis of Vertebral Artery Type%针刺肌筋膜触发点治疗椎动脉型颈椎病疗效观察

    Institute of Scientific and Technical Information of China (English)

    王翀敏; 陈红薇; 王延武; 岳红; 朱敏

    2015-01-01

    目的:观察针刺肌筋膜触发点治疗椎动脉型颈椎病的临床疗效。方法将98例椎动脉型颈椎病患者随机分为治疗组51例和对照组47例。治疗组采用针刺肌筋膜触发点治疗,对照组采用注射消炎镇痛液治疗。比较两组治疗前后旋颈试验阳性率、眩晕评分及头项部疼痛VAS评分。结果两组治疗后VAS评分、旋颈试验阳性率及眩晕评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后VAS评分、旋颈试验阳性率及眩晕评分与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为96.1%,对照组为76.6%,两组比较差异具有统计学意义(P<0.05)。结论针刺肌筋膜触发点能改善椎动脉型颈椎病患者眩晕及头项部疼痛症状。%Objective To observe the therapeutic efficacy of acupuncture at myofascial trigger points (MTrPs) in treating cervical spondylosis of vertebral artery type. Methods Ninety-eight patients with cervical spondylosis of vertebral artery type were randomized into a treatment group of 51 cases and a control group of 47 cases. The treatment group was intervened by acupuncture at the MTrPs, while the control group was by injection of medical solution for anti-inflammation and analgesia. The positive rate of rotate-cervix test, dizziness score, and visual analogue scale (VAS) of the head and neck pain were compared before and after intervention. Results After intervention, the positive rate, dizziness score, and VAS score were significantly changed in both groups (P<0.05). There were significant differences in comparing the positive rate, dizziness score, and VAS score between the two groups after intervention (P<0.05). The total effective rate was 96.1%in the treatment group versus 76.6%in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupuncture at the MTrPs can improve the dizziness and head-neck pain in patients with

  10. Xuesetong Tablets Combined with Traction Physiotherapy for Treating 80 Cases of Cervical Spondylosis of Vertebral Artery Type%血塞通片联合牵引理疗治疗椎动脉型颈椎病80例

    Institute of Scientific and Technical Information of China (English)

    贺红霞

    2012-01-01

    Objective To investigate the efficacy of Xuesetong Tablets combined with the traction physiotherapy for treating 80 cases of cervical spondylosis of vertebral artery type. Methods 160 cases of cervical spondylosis of vertebral artery type were randomly divided into 2 groups, 80 cases in each group. The control group was given the traction physiotherapy combined with oral Betahistine Tablets 6 mg once,3 times daily,while the treatment group was treated with the traction physiotherapy combined with Xuesetong Tablets 50-100 mg once,3 times daily,for successive 4 weeks. The clinical symptoms,therapy efficacy and side effects were observed and recorded by transcranial Doppler (TCD ) detection before and after treatment. Results After 4 - week treatment,the clinical symptoms detected by TCD were significantly improved in the treatment group compared to the control group with statistical difference between the two groups ( P < 0. 05 ). The total effective rate was 90.00% in the treatment group,which was significantly higher than 73.75% in the control group, showing statistical difference between them(P < 0. 05 ). There are no obvious adverse reactions in the course of treatment. Conclusion Traction physiotherapy combined with Xuesetong Tablets has a significant clinical effect in the treatment of cervical spondylosis of vertebral artery type with less side effects,which can be popularized in clinical practice.%目的 观察应用血塞通片联合牵引理疗治疗椎动脉型颈椎病80例.方法 将诊断明确的160例患者随机均分为2组各80例.对照组采用牵引理疗联合口服倍他司汀片每次6mg、3次/d.治疗组采用牵引理疗联合血塞通片口服治疗,1次50~100mg、3次/d,连续治疗4周.观察并记录两组患者经颅多普勒检查(TCD)治疗前后变化情况、疗效以及药物副作用.结果 治疗4周后,治疗组患者症状TCD检查显示比对照组均显著改善,且差异有统计学意义(P<0.05).治疗组总有效率为90

  11. 小针刀治疗椎动脉型颈椎病眩晕的临床观察%Clinical Observation on Small Needle- knife for Treatment of Vertigo Caused by Cervical Spondylosis of Vertebral Artery Type

    Institute of Scientific and Technical Information of China (English)

    林海瑞

    2012-01-01

    目的:探讨小针刀治疗椎动脉型颈椎病眩晕症的临床疗效和治疗机理.方法:将160例椎动脉型颈椎病眩晕症患者随机分为小针刀组(80例)和传统组(80例),小针刀组采用小针刀松解治疗,传统组采用常规体针进行操作,连续治疗两个疗程后两组进行疗效对比,并观察两组治疗前后症状积分的变化.结果:小针刀组总有效率95%,传统组为80%,差异有统计学意义(P<0.01),治疗后两组临床症状积分比较差异有统计学意义(P<0.01).结论:小针刀对椎动脉型颈椎病眩晕症疗效确切,优于常规针刺疗法.%Objective: To explore the clinical therapeutic effect and mechanisms of small needle - knife for treating the vertigo caused by cervical spondylosis of vertebral artery type. Methods:One hundred sixty cases were randomly divided into small needle - knife group and traditional group, 80 cases in each group. The small needle - knife group was treated by small needle - knife releasing therapy. The traditional group was treated by common acupuncture. After two courses of treatment,observe the clinical effect between two groups, and clinical symptom score of both groups were observed before and after treatment. Results: The total effective rate in small needle - knife group and traditional group were 95% and 80% , and there was a significant difference between groups(P <0. 01 ).. After treatment clinical symptom score in both groups had a significant difference ( P < 0. 01). Conclusion: Small needle - knife has a definite therapeutic effect on vertigo caused by cervical spondylosis of vertebral artery type. Small needle - knife is superior to the common acupuncture.

  12. Comparison of pathological characteristics in young and senile cervical spondylosis of vertebral artery type%青年与老年椎动脉型颈椎病的病变特征对比

    Institute of Scientific and Technical Information of China (English)

    张东君; 屈传强; 郭洪志

    2004-01-01

    BACKGROUND: The incidence of young cervical spondylosis has a gradually increasing tendency in recent years. However, as a common type of cervical spondylosis of vertebral artery type(CSA), there is little analysis in the differences between young and senile patients clinically.OBJECTIVE: To discuss the clinical characteristics and different pathogenesis of young and senile CSA patients.DESIGN: A retrospective study based on diagnosis.SETTING and PARTICIPANTS: Totally 154 young and senile CSA patients were selected from the outpatient of Neurological Department of Qilu Hospital Affiliated to Shandong University. There were 58 cases in young group and 96 cases in senile group.METHODS: To observe the different clinical manifestations, X-ray characters, blood flow rate and electroencephalogram variability in two groups.MAIN OUTCOME MEASURES: Main clinical manifestations, cervical vertebral X-ray manifestations, blood flow rates of vertebral artery and basal artery, and electroencephalogram variability.bral space, osseous hyperplnsia, and soft tissue calcification in senile group (x2 = 10. 387, 55. 250, 6.311, P = 0. 001, 0. 000, 0. 012); significant unultrasound scanning via cranium: Systolic blood flow rate in left vertebral artery and mean blood flow rate in basal artery were significantly slow in senile group ( t =2. 633, 2. 538, P < 0. 05), which suggested an arterial stenosis; a rapid blood flow rate was found in young group, which suggested a electroencephalogram between groups.CONCLUSION: Young patients mostly suffer from flexure stralghtness,neural root agitation and vascular spasm; while senile patients suffer from narrowing intervertebral space, nerve compression caused by osseous calcification with slight neural root agitation but mostly arterial stenosis.%背景:近年来青年人颈椎病的发病率有逐渐增高的趋势,但作为常见类型的椎动脉型颈椎病,临床上对青年与老年椎动脉型颈椎病的不同特点分析较少.目的:

  13. MicroRNA-24 Attenuates Neointimal Hyperplasia in the Diabetic Rat Carotid Artery Injury Model by Inhibiting Wnt4 Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Jian Yang

    2016-05-01

    Full Text Available The long-term stimulation of hyperglycemia greatly increases the incidence of vascular restenosis (RS after angioplasty. Neointimal hyperplasia after vascular injury is the pathological cause of RS, but its mechanism has not been elucidated. MicroRNA-24 (miR-24 has low expression in the injured carotid arteries of diabetic rats. However, the role of miR-24 in the vascular system is unknown. In this study, we explore whether over-expression of miR-24 could attenuate neointimal formation in streptozotocin (STZ-induced diabetic rats. Adenovirus (Ad-miR-24-GFP was used to deliver the miR-24 gene to injured carotid arteries in diabetic rats. The level of neointimal hyperplasia was examined by hematoxylin-eosin (HE staining. Vascular smooth muscle cell (VSMC proliferation in the neointima was evaluated by immunostaining for proliferating cell nuclear antigen (PCNA. The mRNA levels of miR-24, PCNA, wingless-type MMTV integration site family member 4 (Wnt4, disheveled-1 (Dvl-1, β-catenin and cell cycle-associated molecules (Cyclin D1, p21 were determined by Quantitative Real-Time PCR (qRT-PCR. PCNA, Wnt4, Dvl-1, β-catenin, Cyclin D1 and p21 protein levels were measured by Western blotting analysis. STZ administration decreased plasma insulin and increased fasting blood glucose in Sprague-Dawley (SD rats. The expression of miR-24 was decreased in the carotid artery after a balloon injury in diabetic rats, and adenoviral transfection (Ad-miR-24-GFP increased the expression of miR-24. Over-expression of miR-24 suppressed VSMC proliferation and neointimal hyperplasia in diabetic rats at 14 days. Furthermore, compared with Sham group, the mRNA and protein levels of PCNA, Wnt4, Dvl-1, β-catenin, and Cyclin D1 were strikingly up-regulated in the carotid arteries of diabetic rats after a balloon injury. Interestingly, up-regulation of miR-24 significantly reduced the mRNA and protein levels of these above molecules. In contrast, the change trend in p21 m

  14. Expanding Hematoma's Life-Threatening Neck and Face Emergency Management of Ballistic Injuries.

    Science.gov (United States)

    Shuker, Sabri T

    2016-07-01

    This article aims to bring attention to the morbidity and fatality of hemorrhage, how expanding hematoma and air compromise neck/face N/F injuries and present challenges. Large neck vessel ballistic injuries may lead to hemorrhage and expanding hematoma, resulting in airway compromise, due to injuries to the internal and/or external carotid arteries, internal jugular veins "internal carotid artery, external carotid artery, internal jugular vein," and the external carotid artery deep branches. This also leads to injuries to the cervical fascial layers (barriers of deep spaces) that facilitate pooling blood and hematoma into compartmental and large potential space which effects the pharynx, larynx, esophagus, and trachea.The expanding hematomas distort neck anatomical landmarks so "no neck zones" classifications are applicable. As the spectrum of injuries continues to evolve, the clinical characterization needs a new categorization based on compartmental hematoma and potential space anatomical location like retropharyngeal, parapharyngeal, sublingual, submandibular spaces, retrobulbar, and cheek compartment space hematomas.Presence of symptoms and location of the hematoma generally dictate what type of procedure is needed and how urgently it needs to be appropriately performed.Two unusual patients of pseudoaneurysms facial artery injuries with extravasation of blood producing a pulsating hematoma are referred to. Another patient considers large internal carotid artery injuries pseudoaneurysms revealed in angiography.The immediate management of life-saving patients requires aggressive airway maintenance at the scene, conscious victim will often obtain a posture that clears his airway and the semiconscious or unconscious put him in prone position. Air compromise may need emergency intubation, large bore cannula cricothyroidotomy, cricothyrotomy and at medical facilities tracheostomy. PMID:27315316

  15. Cervical Stenosis

    Science.gov (United States)

    ... Accumulation of pus in the uterus is called pyometra. Symptoms Before menopause, cervical stenosis may cause menstrual ... present but not cause symptoms. A hematometra or pyometra can cause pain or cause the uterus to ...

  16. Cervical Cancer

    Science.gov (United States)

    ... Cervical cancer is caused by a virus called HPV. The virus spreads through sexual contact. Most women's bodies are able to fight HPV infection. But sometimes the virus leads to cancer. You're at higher risk ...

  17. Cervical Cancer

    Science.gov (United States)

    ... 162 KB) This information in Spanish (en español) Female reproductive system Select image to view larger Related ... D., FACS, Captain, U.S. Public Health Service Medical Director, National Breast and Cervical Cancer Early Detection Program, ...

  18. Multiple integrin-ligand interactions synergize in shear-resistant platelet adhesion at sites of arterial injury in vivo

    DEFF Research Database (Denmark)

    Grüner, Sabine; Prostredna, Miroslava; Schulte, Valerie;

    2003-01-01

    intravital fluorescence microscopy that platelet adhesion and thrombus growth on the exposed ECM of the injured carotid artery is not significantly altered in alpha2-null mice and even in mice with a Cre/loxP-mediated loss of all beta1 integrins on their platelets. In contrast, inhibition of alphaIIbbeta3...

  19. Analysis of risk factors of respiratory failure after cervical spinal cord injury%颈脊髓损伤合并呼吸衰竭的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    穆智平; 张正丰; 刘超; 李杰

    2015-01-01

    Objective To analyze the risk factors of respiratory failure after cervical spinal cord injury ( SCI) . Methods A total of 294 patients with cervical spinal cord injury from January 2009 and December 2013 were analyzed. 52 cases were rolled into the respiratory failure group, 242 cases were rolled into group without respiratory failure. The epidemiological factors in two groups were analyzed to find the the factors of respiratory failure. Results The differences in indexes of smoking, injury reason, injury level, grade of ASIA, fracture dislo-cation were significant (P<0. 05), which suggested the above factors were associated with the occurrence of respiratory failure. The multi-factor regression analysis in respiratory group found that factors such as aged over 60 years, smoking, multiple trauma, fracture dislocation, spinal cord injury above C4 level and pamplegia were of statistically significance (P<0. 10). Conclusion Advanced age, smoking, pample-gia, spinal cord injury above C4 leve, multiple trauma and fracture dislocation are the high risk factors of the respiratory failure after cervical spinal cord injury.%目的:探讨颈脊髓损伤各种危险因素与呼吸衰竭的相关性。方法回顾分析我院2009年1月至2013年12月颈脊髓损伤患者294例,根据是否合并呼吸衰竭分组,合并呼吸衰竭组52例,未合并呼吸衰竭组242例。比较2组各项流行病学指标的差异,分析导致呼吸衰竭的危险因素。结果合并呼吸衰竭组与未合并呼吸衰竭组比较,吸烟史、不同受伤原因、颈脊髓损伤不同平面、ASIA分级、骨折脱位指标具有显著性差异(P<0.05),提示上述因素与呼吸衰竭的发生关系密切。合并呼吸衰竭组的多因素Logistic回归分析结果提示,年龄大于60岁、吸烟史、合并多发伤、骨折脱位、颈4损伤平面以上、全瘫指标具有统计学意义(P<0.10)。结论高龄、吸烟、全瘫、颈4损伤平面以上、合并多

  20. Clinical Observation on Surgery in the Treatment of Traumatic Cervical Spinal Column and Spinal Cord Injury%手术治疗外伤性颈段脊柱、脊髓损伤的临床观察

    Institute of Scientific and Technical Information of China (English)

    宋善新

    2015-01-01

    目的:观察前路植骨钢板内固定法在外伤性颈椎间盘突出疾病治疗中的临床疗效。方法将31例外伤性颈椎间盘突出伴脊髓损伤的患者根据Franke功能分别分为A、B、C、D、E级,采取前路手术方法减压,观察并记录临床疗效。结果多数患者术后恢复1~2个等级,平均随访(15±0.4)个月,未出现植骨不融合或钢板松动、断裂的现象。结论治疗外伤性颈椎间盘突出伴脊髓损伤最有效的手段是前路植骨钢板内固定法,减压效果显著,术后损伤脊柱、脊髓恢复效果良好。%Objective To observe the clinical efficacy of anterior bone graft and plate fixation in treatment of traumatic cervical disc disease. Methods The 31 patients with traumatic cervical disc herniation with spinal cord injury were divided into A,B,C,D,E class function according to Franke,taking anterior surgical decompression,observed and recorded the clinical efficacy. Results Most patients recoverred after 1 to 2 grade,with an average fol ow-up of(15±0.4)months,the phenomenon of nonunion or steel loose or broken were not occurred. Conclusion The most effective means of treatment of traumatic cervical disc herniation with spinal cord injury is anterior bone graft and plate fixation,it has significant decompression effect, and good effect of postoperative spine injury and spinal cord recovery.

  1. 无骨折脱位型颈髓损伤的治疗%Treatment of cervical spinal cord injury without fracture or dislocation

    Institute of Scientific and Technical Information of China (English)

    潘海涛; 郑启新; 杨述华

    2011-01-01

    Objective: To explore the treatment strategies and clinical outcomes of cervical spinal cord injury without fracture or dislocation (CSC1WFD). Method:Fifty-one cases of CSCIWFD patients treated in our hospital from Aug 2005 to Dec 2010 were retrospectively analyzed. Their short and middle-term clinical outcomes were assessed according to JOA scale system. Result: All cases were followed up for 6 to 60 months (mean 24 months). Forty-three cases were surgically treated and their average recovery rate of JOA scale was (46. 5±5. 8) % ,and the percentage of receiving "excellent" or "good" ratings was 48. 8%. The other 8 cases were conservatively treated and the same indexes were (25. 6±3. 1)% and 25. 0% respectively, which were significantly lower than those from the surgical group (P0. 05). Conclusion; Appropriate choices of operative method and time according to the radiographic results of the CSCIWFD patients will improve their spinal cord function and achieve relatively satisfactory clinical outcomes.%目的:探讨无骨折脱位型颈髓损伤(CSCIWFD)的治疗策略及临床疗效.方法:回顾性分析我科自2005年8月-2010年12月收治的51例CSCIWFD患者,根据日本骨科学会评分系统(JOA评分)分析CSCIWFD患者治疗的短中期疗效.结果:全部患者随访6~60个月,平均24个月.43例患者采取手术治疗,JOA评分的平均改善率和优良率分别为(46.5±5.8)%和48.8%,均显著高于8例采取保守治疗患者JOA评分的平均改善率(25.6±3.1)%和优良率25.0% (P<0.01).7d内手术的35例患者JOA评分的平均改善率和优良率分别为(50.6±3.6)%和54.3%,均明显高于7d后手术的8例患者JOA评分的平均改善率(37.5土2.9)%和优良率25.0% (P<0.01).采用前路或后路手术的JOA评分平均改善率和优良率差异无统计学意义(P>0.05).结论:根据CSCIWFD患者的影像学结果,选择合适的术式,尽早手术,可较好地改善颈脊髓功能,获得较满意的临床疗效.

  2. Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

    International Nuclear Information System (INIS)

    The aim of this study was to investigate spinal cord structure in patients with cervical spondylosis where conventional MRI fails to reveal spinal cord damage. We performed a cross-sectional study of patients with cervical spondylosis without conventional MRI findings of spinal cord damage and healthy controls. Subjects were studied using spinal diffusion tensor imaging (DTI), precision grip and foot force-tracking tasks, and a clinical examination including assessment of neurological signs. A regional analysis of lateral and medial spinal white matter across multiple cervical levels (C1-C5) was performed. DTI revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the lateral spinal cord at the level of greatest compression (lowest Pavlov ratio) in patients (p < 0.05). Patients with spondylosis had greater error and longer release duration in both grip and foot force-tracking. Similar spinal cord deficits were present in patients without neurological signs. Increased error in grip and foot tracking (low accuracy) correlated with increased RD in the lateral spinal cord at the level of greatest compression (p ≤ 0.01). Spinal DTI can detect subtle spinal cord damage of functional relevance in cervical spondylosis, even in patients without signs on conventional T2-imaging and without neurological signs. (orig.)

  3. Correlation of force control with regional spinal DTI in patients with cervical spondylosis without signs of spinal cord injury on conventional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lindberg, Paavel G. [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Centre de Psychiatrie et Neurosciences, Inserm U894, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Descartes, Service de Radiologie B, APHP, CHU Cochin, Faculte de Medecine, Paris (France); Sanchez, Katherine; Rannou, Francois; Poiraudeau, Serge [Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Service de Medecine Physique et de Readaptation, APHP, CHU Cochin, Paris (France); INSERM U1153 Epidemiologie Clinique des Maladies Osteo-Articulaires, Paris (France); Ozcan, Fidan [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Feydy, Antoine [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Descartes, Service de Radiologie B, APHP, CHU Cochin, Faculte de Medecine, Paris (France); Maier, Marc A. [Universite Paris Descartes, Sorbonne Paris Cite, FR 3636 Neurosciences, Paris (France); Universite Paris Descartes, Sorbonne Paris Cite, Paris (France); Universite Paris Diderot, Sorbonne Paris Cite, Paris (France)

    2016-03-15

    The aim of this study was to investigate spinal cord structure in patients with cervical spondylosis where conventional MRI fails to reveal spinal cord damage. We performed a cross-sectional study of patients with cervical spondylosis without conventional MRI findings of spinal cord damage and healthy controls. Subjects were studied using spinal diffusion tensor imaging (DTI), precision grip and foot force-tracking tasks, and a clinical examination including assessment of neurological signs. A regional analysis of lateral and medial spinal white matter across multiple cervical levels (C1-C5) was performed. DTI revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the lateral spinal cord at the level of greatest compression (lowest Pavlov ratio) in patients (p < 0.05). Patients with spondylosis had greater error and longer release duration in both grip and foot force-tracking. Similar spinal cord deficits were present in patients without neurological signs. Increased error in grip and foot tracking (low accuracy) correlated with increased RD in the lateral spinal cord at the level of greatest compression (p ≤ 0.01). Spinal DTI can detect subtle spinal cord damage of functional relevance in cervical spondylosis, even in patients without signs on conventional T2-imaging and without neurological signs. (orig.)

  4. Cervical vertigo%颈性眩晕

    Institute of Scientific and Technical Information of China (English)

    何及; 樊东升; 孙宇

    2011-01-01

    Cervical vertigo refers to a syndrome with a chief complaint of vertigo arising from cervical verteprae discomfort. In general, cervical vertigo is correlated with but not always caused by cervical spondylopathy,which mainly includes vertebral arterial and sympathetic cervical spondylosis. The vertebral artery insufficiency caused by compression from lateral displacement of the intervertebral dise is very rare, while the sympathetic cervical spondylosis caused by the vertebral instability is much more common. Rigorous criteria have been developed for diagnosis of the latter. Conservative therapy is mainly recommended for treatment of cervical vertigo.%颈性眩晕通常与颈椎病有关,但不一定完全由颈椎病所致.与颈性眩晕有关的主要是椎动脉型和交感型颈椎病.由椎间盘侧突压迫导致的椎动脉供血不足非常罕见,由椎体不稳引起的交感型颈椎病较多,但后者也有其严格的诊断标准.治疗以保守治疗为主.

  5. Passive leg movements and passive cycling do not alter arterial leg blood flow in subjects with spinal cord injury.

    NARCIS (Netherlands)

    Woerds, W. ter; Groot, P.C.E. de; Kuppevelt, D. van; Hopman, M.T.E.

    2006-01-01

    BACKGROUND AND PURPOSE: Subjects with a spinal cord injury (SCI) are at increased risk for cardiovascular disease-related secondary complications, such as pressure ulcers and attenuated wound healing. It has been suggested that passive exercise enhances blood flow via mechanical pump effects or refl

  6. Bionic electrical stimulation of brain with medium frequency electrotherapy for treatment of cervical spondylopathy of vertebral artery type%脑仿生电刺激配合中频电疗治疗椎动脉型颈椎病

    Institute of Scientific and Technical Information of China (English)

    何南

    2012-01-01

    目的:观察脑仿生电刺激配合中频电疗(MFE)对椎动脉型颈椎病(CSA)的治疗作用.方法:CSA患者300例,随机分为观察组和对照组各150例,2组均给予药物对症支持治疗,观察组加用脑仿生电刺激配合MFE.治疗前后采用经颅多普勒(TCD)检测基底动脉(BA)、椎动脉(VA)、大脑中动脉(MCA)、大脑前动脉(ACA)平均血流速度.结果:治疗2周后,观察组BA、VA、MCA及ACA平均血流速度均较治疗前及对照组治疗后明显增快(P<0.05),对照组治疗前后比较差异无统计学意义.治疗后及6个月后随访,2组临床疗效比较,观察组总有效率均明显高于对照组(P<0.01).结论:脑仿生电刺激配合MFE对CSA患者有明显的治疗作用,可有效缓解眩晕等临床症状.%Objective:To observe the curative effectiveness of the brain bionic electrical stimulation in combination with medium frequency electrotherapy (MFE) on cervical spondylosis of vertebral artery type (CSA). Methods; Three hundreds CSA patients were randomly divided into observation group and control group (n = 150 each group). Both groups were given drug administration. The patients in observation group were given the brain bionic electrical stimulation combined with MFE additionally. Before and after treatment, transcranial Doppler (TCD) was used to measure mean blood flow velocity of basilar artery (BA) , vertebral artery (VA), middle cerebral artery (MCA) and the anterior cerebral artery(ACA). Results; After treatment for 2 weeks, the mean blood flow velocity of BA,VA, MCA and ACA in observation group was significantly increased as compared with pretreatment and control group after treatment(P<0. 05). There was no significant difference of the mean blood flow velocity in the control group before and after treatment. During a follow-up period of six months, the overall clinical effective rate in observation group was significantly higher than in control group (P<0. 01). Conclusion;The brain bionic

  7. Hyperoxaluria, Hypocitraturia, Hypomagnesiuria, and Lack of Intestinal Colonization by Oxalobacter formigenes in a Cervical Spinal Cord Injury Patient with Suprapubic Cystostomy, Short Bowel, and Nephrolithiasis

    OpenAIRE

    Subramanian Vaidyanathan; von Unruh, Gerd E.; Watson, Ian D.; Norbert Laube; Steve Willets; Soni, Bakul L.

    2006-01-01

    Although urolithiasis is common in spinal cord injury patients, it is presumed that the predisposing factors for urinary stones in spinal cord injury patients are immobilization-induced hypercalciuria in the initial period after spinal injury and, in later stages, urine infection by urease-producing micro-organisms, e.g., Proteus sp., which cause struvite stones. We describe a patient who sustained C-7 complete tetraplegia in a road traffic accident in 1970, when he was 16 years old. Left ure...

  8. Establishment of the functional scale for cervical spondylosis of vertebral artery type%建立椎动脉型颈椎病的功能评定量表

    Institute of Scientific and Technical Information of China (English)

    魏毅; 梁伟雄; 蔡业峰

    2005-01-01

    BACKGROUND: At present, the scale for evaluating cervical vertigo symptoms and functions applied in clinic can evaluate the overall curative effect in patients with cervical spondylosis of vertebral artery type (CSA).However, this scale lacks the content of functional status and emotional function for evaluating daily life function.OBJECTIVE: To develop a functional scale for cervical spondylosis of vertebral artery type (FS-CSA) including functional status and emotional function based on the vertigo disorder scale made abroad.DESIGN: Cross-sectional survey, interview evaluation after pretest, internal consistency, retest consistency and construct validity were measured by the method of Chronbach's c, Pearson correlation coefficients and factor analysis, respectively.SETTING: Clinical Epidemiology/DME Center, Guangzhou University of Traditional Chinese Medicine.PARTICIPANTS: Totally 111 consecutive patients with CSA, 30 men and 81 women aged 31 to 72 years, in the Clinic for Cervical Spondylosis of Guangdong Provincial Hospital of Traditional Chinese Medicine were recruited from May 2001 to March 2002. Altogether 36 patients had risk factors of vertebral-base artery atherosclerosis. There were 14 cases of mild vertigo, 61 cases of moderate vertigo, and 36 cases of severe vertigo. Informed consent was obtained from the participants.METHODS: FS-CSA was made according to clinical actual condition Functional status (going for a walk during the day by yourself, walking around the house in the dark, doing strenuous housework, social activity,traveling for business or recreation, getting into or out of bed, reading books or newspaper; each item was divided into three categories "No,anxious, worried about your illness, and feeling frustrated; each item consisted of three categories "No, Sometimes, and Yes"). Patients with CSA were evaluated by means of interview and 14 of them were retested. Internal consistency, construct validity and correlation coefficients of the scale

  9. Acetylbritannilactone Inhibits Neointimal Hyperplasia after Balloon Injury of Rat Artery by Suppressing Nuclear Factor-{kappa}B Activation.

    Science.gov (United States)

    Liu, Bin; Han, Mei; Wen, Jin-Kun

    2008-01-01

    Based on our previous observations that 1-O-acetylbritannilactone (R)-4((3aS,4S,7aR)-4-hydroxy-6-methyl-3-methylene-2-oxo-2,3,3a,4,7,7a-hexahydrobenzofuran-5-yl)pentyl acetate (ABL) suppresses prostaglandin E(2) and nitric oxide synthesis in macrophages, the present study was designed to explore the effect of ABL on neointimal hyperplasia after balloon injury and its mechanism of action. In male Sprague-Dawley rats, 26 mg/kg ABL or polyglycol (control) was administered daily from 3 days before injury to 2 weeks after conventional balloon injury. ABL administration led to a significant reduction in neointimal formation (neointima to media ratio, 1.94 +/- 0.43 versus 0.84 +/- 0.29, P < 0.01) and proliferative activity of vascular smooth muscle cells after balloon injury in rats. Western blot analysis revealed that this is correlated to the inhibition of nuclear factor (NF)-kappaB activation and to the reduced expression of cyclooxygenase-2. Investigation of potential signaling pathways demonstrated that ABL inhibited NF-kappaB activation via the blockade of the inhibitor of NF-kappaB kinase-beta activation and the suppression of the degradation of the inhibitors of NF-kappaB-alpha. These findings suggest that ABL is a potential inhibitor of neointimal formation because it blocks injury-induced NF-kappaB activation and may have beneficial effects in reducing the risk of restenosis after angioplasty. PMID:17911374

  10. Transplantation of human umbilical cord-derived endothelial progenitor cells promotes re-endothelialization of the injured carotid artery after balloon injury in New Zealand white rabbits

    Institute of Scientific and Technical Information of China (English)

    HU Cheng-heng; KE Xiao; CHEN Kui; YANG Da-ya; DU Zhi-min; WU Gui-fu

    2013-01-01

    Background Cell transplantation has great potential for promoting endothelial repair and reducing the complications of percutaneous coronary intervention (PCI).The aim of this study was to investigate the effect of transplantation of human umbilical cord blood endothelial progenitor cells (EPCs) on injured arteries.Methods Umbilical cord blood mononuclear cells were obtained from post-partum lying-in women,and EPCs were isolated,cultured,expanded and identified by immunofluorescence.The carotid arterial endothelium of New Zealand white rabbits was injured by dilatation with a 3F balloon,and the EPCs were injected into the lumen of the injured artery in the transplanted group (n=16),while an equal volume of phosphated buffered saline (PBS) was injected into the control group after balloon injury (n=16).The animals were sacrificed after either 2 or 4 weeks,and the grafted cells were identified by double immunofiuorescence staining with human nuclear antigen (HNA) and CD31 antibodies.Arterial cross sections were analyzed by pathology,immunohistochemisty and morphometry to evaluate the reparative effects of EPCs.Proliferating cell nuclear antigen (PCNA) and transforming growth factor (TGF)-β1 mRNA expression were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results Fluorescence-labeled EPCs were found in the neointima.The neointimal area and the neointimal/medial area ratio were significantly lower in the transplanted group than in the control group (P <0.05).von Willebrand factor (vWF)immunohistostaining showed more VWF-positive cells in the transplanted animals than in the controls (8.75±2.92 vs.4.50±1.77,P <0.05).Compared with the control group,the transplanted group had lower expression of PCNA mRNA (0.67±0.11 vs.1.25±0.40,P <0.01) and higher expression of TGF-β1 mRNA (1.10±0.21 vs.0.82±0.07,P <0.05).Conclusions EPCs derived from human umbilical cord blood were successfully transplanted into injured vessels.The transplanted

  11. CERVICAL PLEXUS PUNCTURING PLUS MOXIBUSTION FOR TREATMENT OF 78 CASES OF CERVICAL VERTIGO

    Institute of Scientific and Technical Information of China (English)

    薛西林; 李佩芳

    2001-01-01

    Objective: To observe the effect of puncturing cervical plexus plus moxibustion in treatment of cervica vertigo. Methods: 78 inpatients were randomly divided into acupuncture + moxibustion (acumoxi) group ( n = 40) and Western medicine (control) group (n = 38). Acupuncture needles were inserted separately into the points about 0.5 curt beside the spinous processes of the cervical vertebral1~7. Results: The cure rates and total effective rates of acumoxi group and control group were 70.00%, 95.00%, 31.58% and 92% respectively, with the cure rate of the acumoxi group being significantly higher than that of control group (P<0.05). After treatment, the mean velocity of blood flow of the vertebral artery and basal artery decreased significantly (P<0.05,0.01 ). Conclusion: Acupuncture of cervical plexus plus moxibustion is effective definitely in treatment of cervical vertigo and superior to that of control group.

  12. Delayed Esophageal Perforation after Cervical Spine Plating

    OpenAIRE

    Kim, Seong Jung; Ju, Chang Il; Kim, Dong Min; Kim, Seok Won

    2013-01-01

    Although anterior approaches to the cervical spine are popular and safe, they cause some of complications. Esophageal perforation after anterior spinal fusion is a rare but potentially life-threatening complication. We present a rare case of delayed esophageal perforation caused by a cervical screw placed via the anterior approach. A 43-year-old man, who had undergone surgery for complete cord injury at another orthopedic department 8 years previously, was admitted to our institute due to pai...

  13. Impairment of Proprioception After Whiplash Injury

    OpenAIRE

    Uremović, Melita; Cvijetić, Selma; Bošnjak Pašić, Marija; Šerić, Vesna; Vidrih, Branka; Demarin, Vida

    2007-01-01

    Whiplash injury usually occurs in traffic accidents. Persons experienced this injury might have an impairment of proprioception clinically expressed as inability to determine the exact position of their heads. The aim of this study was to examine the loss of proprioception in people who had a whiplash injury. The study included 60 subjects with cervical spine injury, aged 20 to 50 years and 60 healthy volunteers matched by sex and age. The instrument used for cervical spine mobili...

  14. Human Mannose-Binding Lectin Inhibitor Prevents Myocardial Injury and Arterial Thrombogenesis in a Novel Animal Model

    OpenAIRE

    Pavlov, Vasile I.; Tan, Ying S.; Erin E McClure; La Bonte, Laura R.; Zou, Chenhui; Gorsuch, William B.; Stahl, Gregory L.

    2015-01-01

    Myocardial infarction and coagulation disorders are leading causes of disability and death in the world. An important role of the lectin complement pathway in myocardial infarction and coagulation has been demonstrated in mice genetically deficient in lectin complement pathway proteins. However, these studies are limited to comparisons between wild-type and deficient mice and lack the ability to examine reversal/inhibition of injury after disease establishment. We developed a novel mouse that...

  15. Literature Review of the Role of Ultrasound, Computed Tomography, and Transcatheter Arterial Embolization for the Treatment of Traumatic Splenic Injuries

    International Nuclear Information System (INIS)

    IntroductionThe spleen is the second most frequently injured organ following blunt abdominal trauma. Trends in management have changed over the years. Traditionally, laparotomy and splenectomy was the standard management. Presently, nonoperative management (NOM) of splenic injury is the most common management strategy in hemodynamically stable patients. Splenic injuries can be managed via simple observation (OBS) or with angiography and embolization (AE). Angio-embolization has shown to be a valuable alternative to observational management and has increased the success rate of nonoperative management in many series.DiagnosticsImproved imaging techniques and advances in interventional radiology have led to a better selection of patients who are amenable to nonoperative management. Despite this, there is still a lot of debate about which patients are prone to NOM.Angiography and EmbolizationThe optimal patient selection is still a matter of debate and the role of CT and angio-embolization has not yet fully evolved. We discuss the role of sonography and CT features, such as contrast extravasation, pseudoaneurysms, arteriovenous fistulas, or hemoperitoneum, to determine the optimal patient selection for angiography and embolization. We also review the efficiency, technical considerations (proximal or selective embolization), logistics, and complication rates of AE for blunt traumatic splenic injuries.

  16. Cervical Cancer is Preventable! PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-11-05

    This 60 second Public Service Announcement is based on the November 2014 CDC Vital Signs report. Every visit to a doctor or nurse is an opportunity to prevent cervical cancer. Women can get a Pap test and HPV test to help prevent cervical cancer and adolescent boys and girls can get the HPV vaccination series to help prevent cervical and other cancers.  Created: 11/5/2014 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 11/5/2014.

  17. 手术治疗急性无骨折脱位型颈髓损伤的回顾性分析%Retrospective analysis of treatment of acute cervical spinal cord injury without fracture and dislocation by surgery

    Institute of Scientific and Technical Information of China (English)

    祁文; 唐晓菊; 刘汝专; 潘汉升

    2011-01-01

    [目的] 分析前路和后路内固定治疗急性无骨折脱位型颈髓损伤的临床治疗效果.[方法]对56例急性无骨折脱位型颈髓损伤的患者进行颈椎前路减压、植骨及颈椎前路带锁钢板内固定术或后路减压侧块钢板螺钉内固定术.术后定期X线片观察损伤节段的稳定性和融合情况以及有无内置物并发症,以JOA评分判定脊髓功能恢复情况.[结果]56例获得随访,时间13 ~48个月.平均26个月.56例患者均损伤节段稳定,植骨愈合良好,无内置物并发症,脊髓功能JOA评分平均提高5.78分,取得满意疗效;前路术式与后路术式在改善脊髓功能方面无明显差异(P>0.05).[结论]颈椎前路和后路术式治疗无骨折脱位型颈髓损伤,能使损伤节段获得即刻、坚强的稳定,解除颈髓压迫,为颈髓功能的恢复提供了有利条件.%[Objective] To observe the results of the treatment of acute cervical spinal cord injury without fracture and dislocation by the anterior plate internal fixation the posterior lateral mass plate fixation. [ Method ] Fifty-six cases of acute cervical spinal cord injury without fracture and dislocation were treated by anterior decompression,bone graft,and cervical spine plate fixation, or posterior extensive laminectomy decompression and lateral mass plate fixation. The stability and fusion of the injured segments and the complications of the hardware were observed on the X-ray film postoperatively. The function of the spinal cord was evaluated with JOA scores. [ Result] Fifty-six cases were followed up from 13 to 48 months (average 26 months). The injured segments were stable, the bone grafting fused completely, and the complications of the hardware were not observed. The function of the spinal cord improved by 5. 78 scores. The clinical outcomes were excellent. There were not difference on improving spinal cord function between the anterior plate internal fixation and the posterior lateral mass

  18. Surgical Treatment Experience of Cervical Spine Fracture Complicated With Spinal Cord Injury%颈椎骨折伴脊髓损伤的手术治疗体会

    Institute of Scientific and Technical Information of China (English)

    赵光远

    2015-01-01

    目的:对颈椎骨折伴脊髓损伤的手术治疗效果进行分析,并将手术治疗体会进行总结。方法对于2013年9月~2014年6月期间在我院接受手术治疗的35例颈椎骨折脱位伴脊髓损伤患者的手术资料进行回顾性分析,并对手术治疗方法、临床效果以及治疗体会进行分析总结。结果23例患者行颈前路椎间盘及部分椎体切除脊髓减压术,8例患者行后路双开门椎管扩大减压手术,4例患者行一期后、前路手术;本次治疗的总有效率为91.4%,半年后患者的脊髓功能优良率为94.3%。结论对颈椎骨折脱位伴脊髓损伤患者有针对性的选择适宜的手术方式治疗能够取得显著的治疗效果,有利于患者感觉功能、脊髓功能的恢复。%Objective To analyze surgical effect in treatment of cervical spine fracture complicated with spinal cord injury and then summarizes its surgical treatment experience. Methods Selected from 35 patients of cervical spine fracture complicated with spinal cord injury who were treated with surgical treatment in hospital from September 2013 to June 2014 and then summarized surgical treatment approach,its clinical effect and treatment experience. Results There are 23 cases of patients operated with treatment of anterior cervical disc combined with partial corpectomy decompression of spinal cord,and 8 cases of patients treated with posterior double-door vertebra expanded decompression surgery,and 4 cases of patients underwent anterior operation of 1st stage,treatment efficiency rate was up to 91.4% in current,and patients’spinal function excel ence rate was 94.3% after half a year treatment. Conclusion Adopting proper surgical treatment to cure patients of cervical spine fracture complicated with spinal cord injury is conducive to patients’ sense recovery as wel as spinal function recovery.

  19. Heme oxygenase-1 in cholecystokinin-octapeptipe attenuated injury of pulmonary artery smooth muscle cells induced by lipopolysaccharide and its signal transduction mechanism

    Institute of Scientific and Technical Information of China (English)

    Xin-Li Huang; Yi-Ling Ling; Yi-Qun Ling; Jun-Lin Zhou; Yah Liu; Qiu-Hong Wang

    2004-01-01

    AIM: To study the effect of cholecystokinin-octapeptide (CCK-8) on lipopolysaccharide (LPS) -induced pulmonary artery smooth muscle cell (PASMCs) injury and the role of heme oxygenase-1 (HO-1), and to explore the regulation mechanism of c-Jun N-terminal kinase (JNK) and activator protein-L (AP-1) signal transduction pathway in inducing HO-1 expression further.METHODS: Cultured PASMCs were randomly divided into 4 or 6 groups: normal culture group, LPS (10 mg/L), CCK-8(10-6 mol/L) plus LPS (10 mg/L) group, CCK-8 (10-6 mol/L)group, zinc protoporphyrin 9 (ZnPPIX) (10-6 mol/L) plus LPS (10 mg/L) group, CCK-8 (10-6 mol/L) plus ZnPPIX and LPS (10 mg/L) group. Seven hours after LPS administration,ulterstructrual changes and content of malondialdehyde (MDA) of PASMCs in each group were investigated by electron microscopy and biochemical assay respectively.HO-1 mRNA and protein of PASMCs in the former4 groups were examined by reverse transcriptase polymerase chain reaction (RT-PCR) and immunocytochemistry staining.Changes of c-fos expression and activation of JNK of PASMCs in the former 4 groups were detected with immunocytochemistry staining and Western blot 30 min after LPS administration.RESULTS: The injuries of PASMCs and the increases of MDA content induced by LPS were alleviated and significantly reduced by CCK-8 (P<0.05). The specific HO-1 inhibitorZnPPIX could worsen LPS-induced injuries and weaken the protective effect of CCK-8. The expressions of c-fos,p-JNK protein and HO-1 mRNA and protein were all slightly increased in LPS group, and significantly enhanced by CCK-8 further (P<0.05).CONCLUSION: HO-1 may be a key factor in CCK-8attenuated injuries of PASMCs induced by LPS, and HO-1expression may be related to the activation of JNK and activator protein (AP-1).

  20. Hough Forest-based Corner Detection for Cervical Spine Radiographs

    OpenAIRE

    Al-Arif, S. M.; Asad, M; Knapp, K.; Gundry, M.; Slabaugh, G. G.

    2015-01-01

    The cervical spine (neck region) is highly sensitive to trauma related injuries, which must be analysed carefully by emergency physicians. In this work, we propose a Hough Forest-based corner detection method for cervical spine radiographs, as a first step towards a computer-aided diagnostic tool. We propose a novel patch-based model based on two-stage supervised learning (classification and regression) to estimate the corners of cervical vertebral bodies. Our method is evaluated using 106 ce...

  1. Effects of cervical self-stretching on slow vital capacity

    OpenAIRE

    Han, Dongwook; Yoon, Nayoon; Jeong, Yeongran; Ha, Misook; Nam, Kunwoo

    2015-01-01

    [Purpose] This study investigated the effects of self-stretching of cervical muscles, because the accessory inspiratory muscle is considered to improve pulmonary function. [Subjects] The subjects were 30 healthy university students 19–21 years old who did not have any lung disease, respiratory dysfunction, cervical injury, or any problems upon cervical stretching. [Methods] Spirometry was used as a pulmonary function test to measure the slow vital capacity before and after stretching. The slo...

  2. 颈椎创伤合并脊髓损伤手术治疗的预后和影响因素%Prognosis and influencing factors of cervical spinal cord injury patients with trauma operation

    Institute of Scientific and Technical Information of China (English)

    何小勇

    2015-01-01

    Objective Observation and analysis of influencing factors of spinal cord injury, provides references for the clinical treatment. Methods 237 patients of in our hospital in last 10 years of with cervical trauma complicated with spinal cord injury were collected, multiple factor correlation analysis was used to analyze the prognosis through the age, sex, cause of injury, the time of referral, operation start time, the injury site (section), complications, spinal canal encroachment rate, hormone applicationuse of hormones within the 8h, prehospital cervical support, preoperative traction, and the operation mode of this injury prognosis. Results By single factor analysis of 12 factors influenced, the referral time, preoperative history of injury, operation start time, spinal canal encroachment rate and hormone application within 8h, pre hospital neck support, whether preoperative traction (P≤0.1), the other factors had poor correlation with the prognosis of the patients:age (P=0.203), gender (P=0.982), the damage stage (P=0.774), operation mode(P=0. 189). The influencing factors on screening of multiple factor Logistic regression analysis found that referral time, operation start time, spinal canal encroachment rate and hormone use application within 8h were cClosely related to the prognosis (P<0.05). Conclusion The main factors that influence the prognosis of patients with cervical spine trauma complicated with spinal cord injury were: the referral time, operation start time, spinal canal encroachment rate and hormone application within 8h. Fast and effective pre-hospital aid, the appropriate operation time, timely decompression of the spinal cord and the early application of hormone could effectively improve the prognosis of cervical vertebra trauma complicated with spinal cord injury.%目的 观察分析颈椎创伤合并脊髓损伤手术治疗的预后和影响因素,为临床治疗该类疾病提供参考. 方法 收集本院10年来颈椎创

  3. 兔无骨折脱位型颈脊髓挥鞭伤致伤平台的研制%Development of Cervical Spinal Cord Whiplash Injury Without Dislocation Platform for Rabbit

    Institute of Scientific and Technical Information of China (English)

    李颉; 李国华; 刘英; 部一; 吴春云

    2016-01-01

    目的:研制物理参数可控的简易致伤平台,从而实现挥鞭伤研究从静态到动态全方位模拟,为交通伤动物实验提供新的简易实验装置。方法在现有生物力学实验室基础上,研制简易摆锤及框架结构、动物固定台车、滑动轨道等装置,充分利用实验室现有设备,建立可以用于小动物的致伤平台。结果空载碰撞和追尾实验均未见小型台车结构及轨道发生变形和损坏,碰撞过程中兔颈椎产生了挥鞭样动作。结论兔无骨折脱位型颈脊髓挥鞭伤致伤平台与生物力学实验室目前现有条件匹配良好,满足实验要求。%Objective To aim at development of simple platform which physical parameter can be controlled, and realize the whole simulation of cervical spinal cord whiplash injury without dislocation in dynamic condition.Methods Based on present condition of lab, simple devices were developed. Existing equipment were used to establish a platform for small animal injury.Results The structures of sled and rail were not damaged in no-load crash and collision experiments. Whiplash movement of rabbit cervical spine occurred during crash.Conclusion The injury platform matched present condition of lab well. Different collision conditions were duplicated using pendulum bob. This platform had been rationally designed. It could stimulate many trafifc processes.

  4. Multilevel decompressive laminectomy and transpedicular instrumented fusion for cervical spondylotic radiculopathy and myelopathy: A minimum follow-up of 3 years

    Directory of Open Access Journals (Sweden)

    Kadir Kotil

    2011-01-01

    Full Text Available Objective: Cervical laminectomies with transpedicular insertion technique is known to be a biomechanically stronger method in cervical pathologies. However, its frequency of use is low in the routine practice, as the pedicle is thin and risk of neurovascular damage is high. In this study, we emphasize the results of cervical laminectomies with transpedicular fixation using fluoroscopy in degenerative cervical spine disorder. Materials and Methods: Postoperative malposition of the transpedicular screws of the 70 pedicles of the 10 patients we operated due to degenerative stenosis in the cervical region, were investigated. Fixation was performed between C3 and C7, and we used resected lamina bone chips for fusion. Clinical indicators included age, gender, neurologic status, surgical indication, and number of levels stabilized. Dominant vertebral artery of all the patients was evaluated with Doppler ultrasonography. Preoperative and postoperative Nurick grade of each patient was documented. Results: No patients experienced neurovascular injury as a result of pedicle screw placement. Two patients had screw malposition, which did not require reoperation due to minor breaking. Most patients had 32-mm screws placed. Postoperative computed tomography scanning showed no compromise of the foramen transversarium. A total of 70 pedicle screws were placed. Good bony fusion was observed in all patients. At follow-up, 9/10 (90% patients had improved in their Nurick grades. The cases were followed-up for an average of 35.7 months (30-37 months. Conclusions: Use of the cervical pedicular fixation (CPF provides a very strong three-column stabilization but also carries vascular injury without nerve damage. Laminectomies technique may reduce the risk of malposition due to visualization of the spinal canal. CPF can be performed in a one-stage posterior procedure. This technique yielded good fusion rate without complications and can be considered as a good

  5. Fresh frozen plasma transfusion for the treatment of hyponatremia after cervical spinal cord injury%输入新鲜冰冻血浆治疗颈脊髓损伤后低钠血症★

    Institute of Scientific and Technical Information of China (English)

    张圣飞; 王永祥; 冯新民; 陶玉平

    2013-01-01

      背景:课题组考虑到新鲜冰冻血浆在临床上有综合治疗的价值,如抗休克、免疫、止血和解毒等,并能纠正胶体渗透压。如果在限水、补钠的同时补充新鲜冰冻血浆能提高脊髓损伤患者血钠水平,将为临床治疗脊髓损伤后低钠血症找到一个新的突破点。  目的:建立家兔颈脊髓损伤并发低钠血症动物模型,观察输入新鲜冰冻血浆治疗颈脊髓损伤并发低钠血症的疗效。  方法:健康成年家兔60只,采用改良ALLen氏打击法制作家兔颈脊髓损伤模型,将幸存且合并低钠血症的40只家兔随机分为2组,对照组20只,实验组20只,再按取标本时间不同依次分为1,3,6,10,15 d组,共10组,每组4只。实验组家兔出现低钠血症后每24 h静脉输入20 mL新鲜冰冻血浆(即1 d组输入1次,3 d组输入3次,6 d组输入6次,10 d组输入10次,15 d组输入15次)。对照组家兔每24 h静脉输入20 mL生理盐水。各组动物分别于术前及输入血浆后24 h采取标本分别进行血清钠离子及脊髓组织钠离子测定。  结果与结论:①术后3 d和术后6 d时实验组及对照组家兔的平均血钠浓度较术前明显降低(P OBJECTIVE:To establish a rabbit model of cervical spinal cord injury combined with hyponatremia, and to observe the effectiveness of fresh frozen plasma transfusion for hyponatremia after cervical spinal cord injury. METHODS:Sixty healthy adult rabbits subjected a Al en’s punch method to establish rabbit models of cervical spinal cord injury. Forty survived and hyponatremia rabbits were randomly divided into two groups:control group and experimental group, 20 rabbits in each group, and then each group was divided into 1, 3, 6, 10 and 15 days group according to time for taking the specimens, a total of 10 sub-groups and 4 rabbits in each sub-group. The rabbits in the experimental group were injected with 20 mL fresh

  6. Laminoplasty for Cervical Myelopathy

    OpenAIRE

    Ito, Manabu; Nagahama, Ken

    2012-01-01

    This article reviews cervical laminoplasty. The origin of cervical laminoplasty dates back to cervical laminectomy performed in Japan ~50 years ago. To overcome poor surgical outcomes of cervical laminectomy, many Japanese orthopedic spine surgeons devoted their lives to developing better posterior decompression procedures for the cervical spine. Thanks to the development of a high-speed surgical burr, posterior decompression procedures for the cervical spine showed vast improvement from the ...

  7. [Cervical radiculopathy].

    Science.gov (United States)

    Kuijper, B

    2014-10-01

    Cervical radiculopathy is a common cause of pain in the arm. It is caused by nerve root compression in the neck, as a consequence of a herniated disc, or spondyliotic foraminal stenosis. It causes severe pain, especially during the first few weeks, and paraesthesias in the forearm and hand. Patients also suffer from neck pain and loss of strength in the relevant arm. The arm pain can be exacerbated by certain movements of the head; these should be avoided as much as possible. Diagnosis can be made on the basis of history and physical examination. The pain generally disappears without active patient treatment. A semi-rigid cervical collar is recommended to accelerate pain relief. In cases of persistent pain, surgery will be considered. In such cases an MRI should be performed to show the cause and level of nerve root compression. PMID:26185991

  8. The clinical study of volumetric CT in cervical spondylosis of vertebral artery type%容积CT对椎动脉型颈椎病的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    周俊芬; 王仁法; 刘玉林; 陈宪; 张照喜

    2014-01-01

    目的:探讨多层螺旋CT(MSCT)后重组技术显示椎动脉型颈椎病(CSA)病因的应用价值。方法:对128例临床诊断为CSA的患者进行 MSCT检查,将原始数据进行高级血管分析(AVA)、容积再现(VR)、最大密度投影(MIP)等后处理技术重组并结合原始图像进行分析。采用卡方检验评价上述3种后处理方法对CSA病因的显示率。结果:128例CSA患者重组结果及统计学分析显示,AVA与VR对钩椎关节增生的显示率,AVA 分别与 VR、MIP 对椎动脉(VA )钙化的显示率,AVA与 MIP 对 VA 狭窄的显示率间差异均有统计学意义(P<0.05)。结论:MSCT 可作为无创性诊断CSA的一种简便、优良的影像学检查方法。各种后处理方法显示病因均有其优势,AVA能提高病因的显示率,最终诊断需结合原始图像进行综合分析。%Objective:To explore the application value of multislice spiral CT (MSCT)angiography in diagnosis of cervical spondylosis of vertebral artery type (CSA).Methods:Enhanced 64-MDCT scanning was performed in 128 clinically diagnosed patients with CSA.Images were post-processed by using volume rendering (VR),maximum intensity projection (MIP)and advanced vessel analysis (AVA).The display rate of pathological changes of CSA was compared withχ2 test. Results:AVA,MIP and VR were performed in 128 patients.The differences of display rate were statistically significant be-tween AVA and VR in proliferation of Luschka joint (P<0.05).In demonstration of vertebral artery calcification,there was statistical significant difference between AVA and VR,and between AVA and MIP (P<0.05).In demonstration of vertebral artery stenosis,there was statistical significant difference between AVA and MIP (P<0.05).Conclusion:MDCT is an effective,noninvasive and simple imaging technique with high image quality.Every kind of post-processing method has its advantages.AVA can improve the display rate of

  9. Is dysphonia permanent or temporary after anterior cervical approach?

    OpenAIRE

    Kahraman, Serdar; Sirin, Sait; Erdogan, Ersin; Atabey, Cem; Daneyemez, Mehmet; Gonul, Engin

    2007-01-01

    The rate, causes and prognosis of dysphonia after anterior cervical approach (ACA) were investigated in our clinical series. During a 10-year interval, 235 consecutive patients with cervical disc disease underwent surgical treatment using anterior approach. Retrospective chart reviews showed recurrent laryngeal nerve (RLN) injury in 3 (1.27%) patients. All three patients were men and only one patient had multilevel surgery. These patients had RLN injury after virgin surgery. Laryngoscopic exa...

  10. Chronic methamphetamine exposure prior to middle cerebral artery occlusion increases infarct volume and worsens cognitive injury in Male mice.

    Science.gov (United States)

    Zuloaga, Damian G; Wang, Jianming; Weber, Sydney; Mark, Gregory P; Murphy, Stephanie J; Raber, Jacob

    2016-08-01

    Emerging evidence indicates that methamphetamine (MA) abuse can impact cardiovascular disease. In humans, MA abuse is associated with an increased risk of stroke as well as an earlier age at which the stroke occurs. However, little is known about how chronic daily MA exposure can impact ischemic outcome in either humans or animal models. In the present study, mice were injected with MA (10 mg/kg, i.p.) or saline once daily for 10 consecutive days. Twenty-four hours after the final injection, mice were subjected to transient middle cerebral artery occlusion (tMCAO) for one hour followed by reperfusion. Mice were tested for novel object memory at 96 h post-reperfusion, just prior to removal of brains for quantification of infarct volume using 2,3,5-Triphenyltetrazolium Chloride (TTC) staining. Mice treated with MA prior to tMCAO showed decreased object memory recognition and increased infarct volume compared to saline-treated mice. These findings indicate that chronic MA exposure can worsen both cognitive and morphological outcomes following cerebral ischemia. PMID:27021292

  11. 寰枕膜松解术配合颈椎调衡术治疗椎动脉型颈椎病216例%Treatment of cervical spondylopathy of carotid type with relaxation of atloido- occipital membrane combing cervical vertebrae rebalancing operation

    Institute of Scientific and Technical Information of China (English)

    姜永庆; 杨显声; 陈立民

    2002-01-01

    @@ Background:Cervical spondylopathy is generally called for a series of symptoms because of ischemia of the head caused by compression of stimulation of the carotid artery by proliferated osteophyte around cervical vertebrae or spasmic muscle or tissue cord.

  12. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three months of operation and six months of operation in the observation group were respectively (12.38± 1.69)points and (15.96±2.33)points, which were obviously higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The curative effect of anterior cervical decompression and bone graft fusion with locking plate internal fixation in treatment of SCIWORA is definite.%目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协

  13. Clinical Observation on Anterior Cervical Decompression and Bone Graft Fusion with Locking Plate Internal Fixation in Treatment of Cervical Spinal Cord Injury without Fracture and Dislocation%颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤的临床探讨

    Institute of Scientific and Technical Information of China (English)

    孙海中

    2016-01-01

    目的 探讨颈前路减压植骨融合带锁钛板内固定治疗无骨折脱位型颈脊髓损伤(SCIWORA)的效果. 方法 整群选取该院2011年3月—2014年3月收治的无骨折脱位型颈脊髓损伤(SCIWORA)患者60例作为研究对象,采用数字随机对照表将患者分为对照组和观察组,对照组行颈前路减压植骨融合术治疗,观察组在对照组基础上加锁钛板内固定治疗,手术前后均行日本骨科协会(JOA)评分,评估两组术后临床症状好转率及半年后植骨融合率.结果 观察组术后半年后植骨融合率为96.67%显著高于对照组80.0%,差异具有统计学意义(P<0.05);观察组术后3、6个月JOA评分分别为(12.38±1.69)分、(15.96±2.33)分均显著高于对照组,差异具有统计学意义(P<0.05). 结论 颈前路减压植骨融合带锁钛板内固定治疗SCIWORA疗效确切.%Objective To discuss the effect of anterior cervical decompression and bone graft fusion with locking plate inter-nal fixation in treatment of cervical spinal cord injury without fracture and dislocation (SCIWORA). Methods 60 cases of patients with SCIWORA treated in our hospital from March 2011 to March 2014 were selected as the research object and randomly divided into two groups, the control group were given anterior cervical decompression and bone graft treatment, and the observation group were given anterior cervical decompression and bone graft fusion with locking plate internal fixa-tion treatment, both groups were scored by Japan department of orthopedics association (JOA)before and after operation, and the improvement rates of clinical symptoms after operation and the intervertebral fusion rates after half a year of the two groups were evaluated. Results Six months later after operation, the intervertebral fusion rate in the observation group was obviously higher than that in the control group (96.67%vs 80.0%), the difference was statistically significant (P<0.05), the JOA scores after three

  14. 颈脊髓损伤患者营养状况变化及其与死亡率的关系%Nutritional status changes of patients with cervical spinal cord injury and its relation with mortality

    Institute of Scientific and Technical Information of China (English)

    陈晓斌; 刘智; 孙天胜; 郑龙龙; 王晓伟

    2013-01-01

    目的 研究颈脊髓损伤患者营养状况的动态变化,分析其对患者死亡率的影响.方法 将128例颈脊髓损伤依治疗结果分为非死亡组和死亡组.记录两组一般信息和血清总蛋白、血清白蛋白和血清前白蛋白水平.比较两组血清蛋白水平动态变化,分析其与死亡的关系.结果 入院早期,血清总蛋白水平在死亡组降低;3~5 d后,3种蛋白水平在死亡组均低于非死亡组(P<0.05),死亡组下降幅度较大;患者较低的血清蛋白水平是死亡的危险因素.结论 颈脊髓损伤患者伤后低蛋白血症在死亡患者中更为明显;低蛋白血症是此类患者死亡的危险因素.%Objective To assess the nutrition status changes in patients after cervical spinal cord injury, and determine which influences on the mortality. Methods All of 128 patients with cervical spinal cord injury were divided into two groups, death group and survivor group. For each patient, the general conditions and the serum biochemical parameters including serum total protein, serum albumin, serum prealbumin were measured after hospitalization. The dynamic changes of nutrition status were compared between the two groups, and a multivariate logistic regression analyses were done to identify the contribution of nutrition status on mortality. Results During the 14 days after hospitalization, the serum total protein level presented a decreased trend in the death group. After the 3~5 days of hospitalization, all the three serum protein level in death group were significantly lower than which in survivor group, an apparently reduce were found in the death group compared with survivor group. In the two groups, the averaged level of the three serum protein were both lower than the criterion standard of the hypoproteinemia and the malnutrition, and the death group were lower (P <0.05). Multivariate logistic regression identified the lower serum total protein level, serum albumin and serum prealbumin

  15. Effects of the Patients with Cervical Spinal Cord Injury undergoing Tracheal Intubation with Cervical Spine Manual-in-line Immobilizationunder Videolaryngoscopy%可视喉镜下手工中立位气管插管对颈髓损伤患者的影响

    Institute of Scientific and Technical Information of China (English)

    伍元川; 姚爱军; 熊珠取

    2013-01-01

    目的:观察可视喉镜下手工中立位全麻气管插管对颈椎颈髓手术患者术中血流动力学以及术后并发症的影响.方法:选择60例全麻手术患者,随机分为两组,每组30例,即直视喉镜组(对照组),手工中立位可视喉镜组(研究组).对两组患者分别使用直视喉镜、手工中立位可视喉镜进行气管插管,比较两组患者首次插管成功率、围插管期血流动力学及术后24h咽喉部并发症发生率.结果:与直视喉镜组比较,可视喉镜组首次插管成功率明显提高(P <0.05)、围插管期血流动力学波动幅度更小(P <0.05),术后咽喉部并发症发生率降低(P <0.05).结论:与直接喉镜相比,手工中立位可视喉镜可以缩短气管插管的用时,改善围插管期血流动力学波动,减轻咽喉部的损伤.%Objective: To investigate the effects of postoperative laryngopharyngeal complications of the patients with cervical spine surgery undergoing tracheal intubation with cervical spine manual-in-line immobilization under videolaryngoscopy. Method: 60 patients requiring general anesthesia were randomly divided into two groups( n = 30 each ), namely, direct laryngoscopy group ( group A ), videolaryngoscopy group ( group B ). Patients were randomly allocated to intubation with videolaryngoscopy or direct laryngoscopy. The number of intubation attempts, hemodynamic parameters and the incidence of postoperative laryngopharyngeal complications were recorded. Result: Compared with group A, patients' airways were successfully managed on the first attempt in group B ( P<0. 05 ), hemodynamic instability were better during intubation ( P<0. 05 ), and the incidence of postoperative laryngopharyngeal complications decreased ( P<0. 05 ). Conclusion : Compared with direct laryngoscopy, cervical spine manual-in-line immobilization under videolaryngoscopy can improve the speed or ease of intubations and attenuate the laryngopharyngeal injury.

  16. Cervical spine trauma: Radiologic manifestations and imaging algorithms

    International Nuclear Information System (INIS)

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

  17. Treatment of hyperexsion injury with severe cervical spondylotic myelopathy by early posterior laminectomy and fusion.%颈椎过伸伤伴颈椎管狭窄症的早期后路手术治疗

    Institute of Scientific and Technical Information of China (English)

    谭俊铭; 王金鑫; 来津; 王朝阳; 陈德纯; 邢顺民; 申练兵; 苏加向; 廖腾; 时国华; 何翔

    2012-01-01

    Objective To retrospectively evaluate lite therapeutic effect of 18 patients with hy — percxsion injury and severe multilevel cervical spondylotic myelopathy treated by early posterior laminectomy and fusion. Methods All patients had. preoperative radiographs,computed tomography and magnetic resonance imaging,and noted 11 patients had abnormal T2—weighted MR] signal. Neurologic function and clinical assessment of myelopathy were graded preoperatively and postoperative— ly by the grading system of Nurick and Niu respectively. The mean follow—up period were 26 months (from 6 months to 5.5 years ). Results Mean Niu score improved from 6.221, range 5—7) to 4.72 (range 3—7.) postoperatively. Fifteen patients (83.3%) had improvement in Nurick grade of at least one level,and three showed no improvement. There were 6 cases had residual abnormal T2 — weighted MRI signal postoperatively. Conclusion Good clinical effectiveness are obtained from early laminectomy and fusion in hyperexsion injury with severe multilevel cervical myelopathy and obviously improvement of myelopalhy are observed, with low complication rales were.%目的 回顾分析了早期颈后路切除减压融合治疗18 例颈椎过伸伤伴颈椎管狭窄患者.方法 术前常规X 线、CT 和MRI 检查,其中11 例患者存在异常T2加权MRI 信号,手术前后分别行Nurick 和Niu 系统评估.随访6 个月~5.5 年,平均2.4 年.结果 平均Niu 评分由术前6.22(5~7)提高到术后4.72(3~7),15 例患者(83.3%)的最后随访示Nurick 评分至少提高Ⅰ级,3 例无明显改善和恶化.术后6 例患者仍存在T2加权MRI 信号异常.结论 颈椎过伸伤伴颈椎管狭窄症患者行早期后路椎板切除减压融合可取得较好的临床效果,术后疗效改善明显,并发症发生率较低.

  18. Post laminoplasty cervical kyphosis—Case report

    Science.gov (United States)

    Dugoni, D.E.; Mancarella, C.; Landi, A.; Tarantino, R.; Ruggeri, A.G.; Delfini, R.

    2014-01-01

    INTRODUCTION Cervical kyphosis is a progressive cervical sagittal plane deformity that may cause a reduction in the ability to look horizontally, breathing and swallowing difficulties, sense of thoracic oppression and social isolation. Moreover, cervical kyphosis can cause myelopathy due to a direct compression by osteo-articular structures on the spinal cord or to a transitory ischaemic injury. The treatment of choice is surgery. The goals of surgery are: nervous structures decompression, cervical and global sagittal balance correction and vertebral stabilization and fusion. PRESENTATION OF CASE In October 2008 a 35 years old woman underwent surgical removal of a cervical-bulbar ependymoma with C1–C5 laminectomy and a C2–C5 laminoplasty. Five months after surgery, the patient developed a kyphotic posture, with intense neck and scapular girdle pain. The patients had a flexible cervical kyphosis. Therefore, we decided to perform an anterior surgical approach. We performed a corpectomy C4–C5 in order to achieve the anterior decompression; we placed a titanium expansion mesh. DISCUSSION Cervical kyphosis can be flexible or fixed. Some authors have reported the use of anterior surgery only for flexible cervical kyphosis as discectomy and corpectomy. This approach is useful for anterior column load sharing however it is not required for deformity correction. CONCLUSION The anterior approach is a good surgical option in flexible cervical kyphosis. It is of primary importance the sagittal alignment of the cervical spine in order to decompress the nervous structures and to guarantee a long-term stability. PMID:25462050

  19. The protective effects of curcumin on dog liver injury caused by hepatic artery embolism%姜黄素对犬肝动脉栓塞性肝损伤保护作用的实验研究

    Institute of Scientific and Technical Information of China (English)

    孟巍; 曹海利; 白彬; 徐伟; 王凯冰; 崔立明; 周坦洋

    2012-01-01

    目的 探讨姜黄素(curcumin,CUR)对犬碘化油肝动脉栓塞性肝损伤的保护作用.方法 采用碘化油栓塞犬肝动脉建立急性肝损伤模型.取健康家犬12只,随机分为3组.A组经导管肝动脉注入生理盐水;B组注入碘化油;C组注入碘化油+CUR溶液.测定各组犬血清中丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平和丙二醛(MDA)的含量,同时进行病理学检查,观察姜黄素对肝脏的作用.结果 姜黄素能显著降低碘化油肝动脉栓塞性肝损伤犬血清ALT、AST值,降低MDA含量,并减轻碘化油肝动脉栓塞对肝组织的病理损伤.结论 姜黄素对碘化油肝动脉栓塞性肝损伤犬具有保护作用.%Objective To explore the protective effects of curcumin (CUR) on dog liver injury caused by hepatic artery embolism with lipiodol. Methods Acute injury model of dog liver was established. The model was induced by hepatic artery embolism with lipiodoi Twelve healthy native dogs were divided into three groups at random: Group A (normal control) transcatheter hepatic arterial infusion physiological saline) Group B (model group) transcatheter hepatic arterial infusion lipiodol and Group C (trial group) transcatheter hepatic arterial infusion lipiodol and CUR solution. The blood serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and malondialdehyde (MDA) value of all the groups were surveyed and evaluated. And liver pathological results were also observed in those groups. Results CUR can significantly lower the levels of ALT, AST and MDA in serum and simultaneously reduce pathological injury of liver tissue. Conclusion Curcumin can effectively prevent liver injury induced by hepatic artery embolism with lipiodol.

  20. Imaging of acute cervical spine trauma: when to obtain which modality.

    Science.gov (United States)

    Ulbrich, Erika J; Carrino, John A; Sturzenegger, Matthias; Farshad, Mazda

    2013-09-01

    The current knowledge and evidence around the merits of different imaging modalities for the evaluation of cervical spine injuries are reviewed. The National Emergency X-Radiography Use Study, Canadian Cervical Spine rule, and American College of Radiology appropriateness criteria are reviewed and summarized. The advantages and disadvantages of available imaging modalities for selected cervical spine injury patterns are also illuminated to simplify the decision making on when to use which modality. PMID:24101178

  1. 下颈椎椎弓根相邻解剖结构的应用研究%Application research of adjacent anatomic structure of lower cervical pedicle

    Institute of Scientific and Technical Information of China (English)

    周树成; 张鹏

    2016-01-01

    目的:通过观测下颈椎椎弓根及其与相邻的脊髓、硬脊膜、神经根和椎动脉的关系,特别是与硬脊膜、硬膜外窦的关系,为安全、准确地置入下颈椎弓根螺钉提供数据支持。方法用游标卡尺和量角器对32具成人C3~C7段颈椎标本进行测量,内容包括:椎弓根与其上下神经根的距离、与硬脊膜的距离、与椎动脉和硬膜外窦的关系。结果椎弓根与其上神经根的间距为1.18~1.40 mm,与其下神经根间距为2.33~3.11 mm,与硬脊膜的间距为2.75~3.33 mm;椎弓根与椎动脉和硬膜外窦几乎没有距离。结论颈椎弓根内邻脊髓、硬膜窦,外邻椎动静脉,上下有神经跨越,且椎弓根较狭小,充分评估且个体化,才能防止损伤周围重要解剖结构。%Objective To provide data support for safe and accurate lower cervical pedicle screw implantation by observing the lower cervical pedicle and its relationship between the adjacent spinal cord, endorhachis, nerve root and vertebral artery, particularly its relation-ship between the endorhachis and epidural sinus. Methods Measured the C3 ~ C7 cervical sample of 32 adult with vernier caliper and pro-tractor, including the distance between cervical pedicle and its upper and lower nerve root, the distance between cervical pedicle and en-dorhachis, the distance between cervical pedicle and vertebral artery, and the distance between cervical pedicle and epidural sinus. Results The distance betweencervical pedicle and its upper nerve root was 1. 18~1. 40 mm, the distance between cervical pedicle and its lower nerve root was 2. 33~3. 11 mm;the distance between cervical pedicle and endorhachis was 2. 75~3. 33 mm;and there was nearly no distance be-tween cervical pedicle and vertebral artery and epidural sinus. Conclusion Cervical pedicle has a very close relationship with spinal cord, endorhachis, vertebral artery and nerve root, and the cervical pedicle is narrow and small. Therefore, it

  2. Bilateral accessory thoracodorsal artery.

    Science.gov (United States)

    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2006-09-01

    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  3. The course of the V1 segment of the vertebral artery

    Directory of Open Access Journals (Sweden)

    Ranganatha Sastry V

    2006-01-01

    Full Text Available Background: It has become important to know the exact origin and course of the vertebral artery as well as the percentage of the abnormalities of these variations from the point of view of surgery, angiography and in all non-invasive procedures. In decompressive procedures and for subsequent stabilization procedures of the cervical spine, thorough knowledge of the anatomy of the vertebral artery is mandatory to avoid a potentially catastrophic injury to the vertebral artery. Aims of the Study: The present study was aimed at investigating the frequency of occurrence of the variations of the pre-transverse segment of the vertebral artery especially concerning the level of its entry into the foramen transversarium, tortuosity and size in formalin fixed adult cadavers and fetuses with the view of keeping the surgeons alert regarding the frequency of occurrence of these variations in the local subjects. Materials and Methods: The pre-transverse segment of the vertebral artery (V1 segment was studied in 19 formalin fixed cadavers (6 females and 13 males and ten formalin fixed newborn fetuses. The total length and the diameter of the V1 segment of the vertebral artery were measured in adult cadavers to the nearest millimeter using a sliding caliper. Variations in the level of entry of the vertebral artery in to the foramen transversarium and also tortuosity of the artery were noted down. Results: The vertebral artery measured a mean length of 4.9 ± 1.24 cms and a mean diameter of 3.58 ±1.59 mms. In over 71% of the cases the vertebral artery entered the foramen transversarium at the level of C6. The next highest frequency was C7 (18.42% and in small percentage of the cases at C5 (5.3%, C4 (2.6% and C3 (2.6%. The vertebral artery was found to be tortuous in nine cases (23.7%. Conclusions: Data derived from gross anatomical studies serve as an indicator of prevalence of variations within a population group. But it would be safest for the surgeon to

  4. 颈夹脊穴盐酸青藤碱电致孔透皮给药治疗椎动脉型颈椎病的临床观察%Clinical Observation on Cervical Spondylosis of Vertebral Artery Type by Electroporation Transdermal Drug Delivery in Cervical Jiaji Points with Sinomenine Hydrochloride

    Institute of Scientific and Technical Information of China (English)

    梁粤; 皮敏; 黄少(王莹)

    2015-01-01

    目的:观察颈夹脊穴盐酸青藤碱电致孔透皮给药治疗椎动脉型颈椎病的临床疗效.方法:将98例椎动脉型颈椎病患者随机分为3组,盐酸青藤碱透药组(青藤碱组)33例、盐水透药组(盐水组)32例和对照组33例.青藤碱组在常规西药治疗的基础上给予颈夹脊穴盐酸青藤碱电致孔透皮给药治疗,盐水组在常规西药治疗的基础上给予颈夹脊穴生理盐水电致孔透皮给药治疗,对照组予氟桂利嗪治疗.3组疗程均为10 d.结果:总有效率青藤碱组为93.5%,盐水组为77.4%,对照组为61.3%.青藤碱组优于盐水组、对照组,差异有统计学意义(P<0.05或P<0.01);盐水组优于对照组,差异有统计学意义(P<0.05);3组治疗后ESCV积分均降低,差异有统计学意义(P<0.05或P<0.01).治疗1个疗程后组间比较,青藤碱组ESCV积分低于盐水组、对照组,差异均有统计学意义(P<0.05或P<0.01),盐水组ESCV积分低于对照组,差异有统计学意义(P<0.05).结论:颈夹脊穴盐酸青藤碱电致孔透皮给药治疗椎动脉型颈椎病有较好疗效.%Objective:To observe the clinical effect of electroporation transdermal drug delivery in Jingjiaji points (颈夹脊穴) on cervical spondylosis of vertebral artery type (CSA) with sinomenine hydrochloride.Methods:The 98 cases of CSA patients were randomly divided into 3 groups,sinomenine group (transdermal sinomenine delivery) with 33 cases,saline group (transdermal saline delivery) with 32 cases and control group with 33 cases.On the basis of conventional western medicine treatment,patients were treated by electroporation transdermal drug treatment in Jingjiaji points with sinomenine hydrochloride in Sinomenine group,electroporation transdermal drug treatment in Cervical Jiaji points with saline in Saline group,and Flunarizine in control group.There were 10 days for a course of treatment.Results:The total effective rate of was 93.5% in sinomenine group,77.4

  5. Analysis of respirator treatment on acute respiratory failure after cervical spinal injury%呼吸机治疗急性颈髓损伤后急性呼吸衰竭的临床体会

    Institute of Scientific and Technical Information of China (English)

    杜志军; 洪云飞; 康智

    2008-01-01

    目的 观察颈髓损伤后用呼吸机治疗急性呼吸衰竭的临床疗效.方法 2005年10月至2007年1月55由椎骨折并脊髓损伤患者,应用药物、手术固定、呼吸机综合治疗.结果 55例病例中,16例出现呼吸衰竭,其中11台情稳定,3例呼吸衰竭死亡,1例因肺部严重感染家属放弃治疗,1例出现心肌梗死转院.结论 对急性颈髓损伤,早期应用呼吸机治疗有较好的疗效.%Objective To study the elinieal effeets of the comprehensive treatments on aeute respiratory failure after eervieal spinal injury. Methods Totally 55 eases of fracture of cervical spine and spinal injury from November 2005 to January 2007 were reviewed and analyzed, while the symptoms of dyspnea commonly existing. The eomprehensive treatments of drugs, surgical fixation and respirator were applied. Results 16cases of aeute respiratory failure resulted that 3 eases be taken worse to death, 1 ease with subsequent severe pulmonary infeetion and 1 case with myoeardial infarction, 11 eases turned out for the best. Conclusion Early intervention with respirator has the better result.

  6. Modified cytoplasmic Ca2+ sequestration contributes to spinal cord injury-induced augmentation of nerve-evoked contractions in the rat tail artery.

    Directory of Open Access Journals (Sweden)

    Hussain Al Dera

    Full Text Available In rat tail artery (RTA, spinal cord injury (SCI increases nerve-evoked contractions and the contribution of L-type Ca2+ channels to these responses. In RTAs from unoperated rats, these channels play a minor role in contractions and Bay K8644 (L-type channel agonist mimics the effects of SCI. Here we investigated the mechanisms underlying the facilitatory actions of SCI and Bay K8644 on nerve-evoked contractions of RTAs and the hypothesis that Ca2+ entering via L-type Ca2+ channels is rapidly sequestered by the sarcoplasmic reticulum (SR limiting its role in contraction. In situ electrochemical detection of noradrenaline was used to assess if Bay K8644 increased noradrenaline release. Perforated patch recordings were used to assess if SCI changed the Ca2+ current recorded in RTA myocytes. Wire myography was used to assess if SCI modified the effects of Bay K8644 and of interrupting SR Ca2+ uptake on nerve-evoked contractions. Bay K8644 did not change noradrenaline-induced oxidation currents. Neither the size nor gating of Ca2+ currents differed between myocytes from sham-operated (control and SCI rats. Bay K8644 increased nerve-evoked contractions in RTAs from both control and SCI rats, but the magnitude of this effect was reduced by SCI. By contrast, depleting SR Ca2+ stores with ryanodine or cyclopiazonic acid selectively increased nerve-evoked contractions in control RTAs. Cyclopiazonic acid also selectively increased the blockade of these responses by nifedipine (L-type channel blocker in control RTAs, whereas ryanodine increased the blockade produced by nifedipine in both groups of RTAs. These findings suggest that Ca2+ entering via L-type channels is normally rapidly sequestered limiting its access to the contractile mechanism. Furthermore, the findings suggest SCI reduces the role of this mechanism.

  7. Non-atheromatous arterial stenoses in atypical haemolytic uraemic syndrome associated with complement dysregulation

    NARCIS (Netherlands)

    C. Loirat; M.A. Macher; M. Elmaleh-Berges; T. Kwon; G. Deschênes; T.H.J. Goodship; C. Majoie; J.C. Davin; R. Blanc; J. Savatovsky; J. Moret; V. Fremeaux-Bacchi

    2010-01-01

    Results. Stenoses of both carotid arteries, left subclavian and vertebral arteries, several intracranial, right humeral, several coronary, and all pulmonary arteries were demonstrated. At the age of 13 years, left subclavian and right cervical carotid arteries were occluded. Right carotid recanaliza

  8. [Successful treatment of a cervical heterotopic pregnancy following an in vitro fertilization procedure].

    Science.gov (United States)

    Elena, Hernán E; Elena, Alfredo F; Miola, Anselmo; Glujovsky, Demian; Sueldo, Carlos E

    2016-01-01

    A 37-year-old nulligravida infertile female had a cervical heterotopic pregnancy following an in vitro fertilization procedure. Early intervention on the 6th week of gestation with a manual vacuum aspirator reached to remove the cervical pregnancy. Ligation of the descending cervical branches of the uterine arteries and a cervical cerclage, were placed before the aspiration, for prevention of possible hemorrhage. Successful removal of the cervical pregnancy was achieved with only mild bleeding. An intrauterine pregnancy progressed to viability without complications, resulting in a vaginal delivery of a preterm live-birth at 35.4 weeks, of a male that weighted 2740 g.

  9. A Study of Vascular Clamps on Crush Injury of Common Carotid Arteries in Rats%血管夹对大鼠颈总动脉挤压损伤的研究

    Institute of Scientific and Technical Information of China (English)

    余宽宽; 梁向党; 孙赓; 郭占芳; 邹秀强; 房卓群

    2015-01-01

    目的:探讨血管夹对大鼠颈总动脉的挤压损伤。方法将40只雄性SD大鼠随机分为两组,每组各20只,用改进后的血管夹分别对两组大鼠的左侧颈总动脉给予30 g和90 g的压力进行15 min的夹闭,右侧颈总动脉作为对照,术后正常饮食喂养3周。通过大体观察、超声血流检测、组织形态学观察、血管创伤评分对血管损伤情况进行评估。结果两组大鼠左侧颈总动脉损伤修复完好,超声血流通畅,HE染色内膜无明显损伤增生,与右侧颈总动脉比较血管创伤评分差异无统计学意义(P>0.05)。结论血管夹在血管吻合的过程中对血管的损伤不可避免,但这种仅因夹闭造成的暂时性损伤可通过自身修复。%Objective To explore vascular clamps on crush injury of common carotid arteries in rats. Methods A total of 40 SD male rats were randomly divided into group A and B ( n=20 for each group) , and left common carotid arteries of rats in group A and B were occluded using improved vascular clamps respectively under 30 g and 90 g pressure for 15 min, while the right common carotid arteries were used as comparison, all the rats were give normal postoperative feeding for 3 weeks. Conditions of vascular injuries were evaluated with general observation of clamping arteries, vascular ultrasound for blood flow, histomorphology observation and vascular traumatic scores. Results The clamping arteries of rats in the two groups recovered well with smooth blood flow, and there was no neointimal formation in the inner layer by HE ( hematoxylin and eosin) staining, and there were no statistically significant differences in vascular traumatic scores between left and right common carotid arteries (P>0. 05). Conclusion Vascular injuries by vascular clamps during the process of vascular anastomosis are inevitable, but the impermanent injures can be repaired by itself.

  10. A pilot evaluation of an educational program that offers visualizations of cervical spine injuries: medical students' self-efficacy increases by training.

    Science.gov (United States)

    Hedman, Leif; Fahlstedt, Madelen; Schlickum, Marcus; Möller, Hans; von Holst, Hans; Felländer-Tsai, Li

    2014-01-01

    In this pilot study, a new method for visualization through imaging and simulation (VIS-Ed) for teaching diagnosis and treatment of cervical spine trauma was formatively evaluated. The aims were to examine if medical students' self-efficacy would change by training using VIS-Ed, and if so these changes were related to how they evaluated the session, and the user interface (UI) of this program. Using a one-group, pre-post course test design 43 Swedish medical students (4th year, 17 males, 26 females) practiced in groups of three participants. Overall the practice and the UI were considered as positive experiences. They judged VIS-Ed as a good interactive scenario-based educational tool. All students' self-efficacy increased significantly by training (p < 0.001). Spearman's rank correlation tests revealed that increased self-efficacy was only associated with: how the session was compared to as expected (p < 0.007). Students' self-efficacy increased significantly by training, but replication studies should determine if this training effect is gender-related.

  11. Delayed Cerebral Ischemia following to Repair of Penetrating Trauma to External Carotid artery Introduction

    Directory of Open Access Journals (Sweden)

    M. Eskandarlou

    2016-01-01

    Full Text Available Introduction: Penetrating trauma to anterior neck can induce cerebral ischemia due to carotid artery injury. Brain ischemia also can present after surgical carotid repairs. Early diagnosis and suitable treatment modality prevent from permanent neurologic deficit post operatively. Case Report: A 30 years old man with stab wound to zone two left side of neck underwent exploration and penrose insertion. Due to excessive bleeding through drain tube, patient was transferred to Besat Hospital of Hamadan. Surgical repair of external carotid artery successfully was done. Four days later patient developed right hemiparesis suddenly. According to MRI and color Doppler sonography finding of thrombosis of left common and internal carotid artery, reoperation was done. After thrombectomy cerebral ischemia and hemi-paralysis improved. Conclusions: Surgical approach to symptomatic penetrating neck trauma is oblique cervical incision, control of bleeding, repair of internal carotid, repair or ligature of external carotid artery base on some factors and preferential repair of internal jugular vein. Meticulous and fine surgical technique for both vascular repair and protection of adjacent normal vessels for avoiding to blunt trauma or compression with retractors is noticeable. Exact postoperative care as repeated clinical examination with goal of early diagnosis of internal carotid artery thrombosis and rapid diagnostic and treatment planning of this complication are important factors for taking of good result in treatment of penetrating trauma to carotid. Sci J Hamadan Univ Med Sci . 2016; 22 (4 :353-357

  12. Value of preoperative cervical discography

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jong Won; Kim, Sung Hyun; Lee, Joon Woo [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)] (and others)

    2006-07-15

    The aim of this study was to describe the method and the value of cervical discography as correlated with the MR findings. Twenty-one discs in 11 consecutive patients who underwent cervical discography were analyzed. MR and CT discography (CTD) were performed in all patients. Discography was performed after swallowing barium for visualizing the pharynx and the esophagus to prevent penetration. We also analyzed the preceding causes of the subjects' cervical pain. The results of the pain provocation test were classified into concordant pain, discordant pain and a negative test. MRI was analyzed according to the T2-signal intensity (SI) of the disc, disc height, annular bulging and disc herniation. The CTD was analyzed for degeneration or radial tear of the disc, epidural leakage of the contrast agent and pooling of the contrast agent at the periphery of the disc. The pain provocation tests were correlated with the MR and CTD findings. We used the chi-square test to analyze the results. Concordant pain was observed in 14 cases, discordant pain in 3 cases and there were negative tests in 4 cases. There were no complications related to the procedure. Four patients had undergone anterior cervical fusion and four patients that developed after traffic injuries. The decreased T2-SI and annular bulging on MRI, disc degeneration and peripheral pooling of the contrast agent on CT were significantly correlated with pain provocation. When the diagnosis of disc disease is difficult with performing MRI, cervical discography with using swallowed barium solution to reduce the penetration of the esophagus or hypopharynx may play be helpful. The decreased T2-SI and annular bulging on MRI correlated significantly with a positive result on the pain provocation test.

  13. General situation of the studies of the mechanism of cervical vertigo%颈性眩晕发病机制的研究概况

    Institute of Scientific and Technical Information of China (English)

    高新(综述); 吕亚南(审校)

    2016-01-01

    We review the mechanism of cervical vertigo in this paper, including cervical proprioception dis-turbance, vertebral artery factors, hook vertebral joint hyperplasia, transverse foramen stenosis, atlas pivot joint dis-orders, cervical soft tissue injury, sympathetic nerve stimulation, vertebra disorder and humoral factors, which pro-vides a guidance for the further study on the mechanism of cervical vertigo.%该文对近年颈性眩晕的发病机制进行分析,从颈椎本体感受器紊乱、椎动脉自身因素、钩椎关节增生、横突孔狭窄、寰枢关节错位、颈椎软组织损伤、交感神经刺激、颈椎失稳、体液因素等方面进行综述,为颈性眩晕发病机制的进一步研究提供基础。

  14. Anterior cervical decompression and fusion with caspar plate fixation

    International Nuclear Information System (INIS)

    Objective: To evaluate the role of anterior cervical decompression and fixation with Caspar plating in cervical spine injury on neurological outcome. Study Design: A case series. Place and Duration of Study: Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2008 to March 2011. Methodology: Thirty patients admitted with cervical spine injuries were inducted in the study. All cases were evaluated for their clinical features, level of injury and degree of neurological injury was assessed using Frankel grading. Pre and postoperative record with X-rays and MRI were maintained. Cervical traction was applied to patients with sub-luxation. All patients underwent anterior cervical decompression, fusion and Caspar plate fixation. The follow-up period was 6 months with clinical and radiological assessment. Results: Among 30 patients, 24 (80%) were males and 6 (20%) were females. Age ranged from 15 to 55 years. Causes of injury were road traffic accident (n = 20), fall (n = 8) and assault (n = 2). Commonest mode of injury was road traffic accident (66.6%). Postoperative follow-up showed that pain and neurological deficit were improved in 21 patients. There was no improvement in 7 patients, one patient deteriorated and one expired. All patients developed pain at donor site. Conclusion: Anterior decompression, fusion and fixation with Caspar plate is an effective method with good neurological and radiological outcome. However, it is associated with pain at donor site. (author)

  15. Aberrant cervical thymus mimicking thyroid on ultrasonography: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Sub; Park, Ju Hyun; Kim, Bong Soo; Park, Ji Kang; Choi, Jae Hyuck [Jeju National Univ. Hospital/Jeju National Univ. School of Medicine, Jeju (Korea, Republic of)

    2012-10-15

    Aberrant cervical thymus is rarely reported in adults. We report a case of solid aberrant cervical thymus in a 27 year old female, which was found incidentally on ultrasonography for the evaluation of the thyroid cancer. On ultrasonography, the lesion was found between the left thyroid and common carotid artery without any remarkable interface echo, and had similar echogenicity to the thyroid. The lesion extended to the upper pole of the left thyroid.

  16. Misdiagnosed bilateral C5-C6 dislocation causing cervical spine instability: a case report

    OpenAIRE

    Gelalis, Ioannis D.; Christoforou, Georgios; Arnaoutoglou, Christina M.; Politis, Angelos N.; Manoudis, Gregory; Xenakis, Theodoros A

    2009-01-01

    Introduction The diagnosis of cervical spine injuries remains a significant problem in many blunt trauma patients. Correct and early diagnosis of these injuries is imperative as delayed or missed diagnoses result in increased morbidity and mortality. Case presentation A 57-year-old Caucasian woman presented with a misdiagnosed bilateral C5-C6 dislocation one month after a fall and head injury, without clearance of the cervical spine in her previous visits to two physicians and having already ...

  17. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, H.J.; Mehring, U.M.; Gissler, H.M.; Mathias, K.D. [Dept. of Diagnostic Radiology, Staedtische Kliniken Dortmund (Germany); Dept. of Radiology and MicroTherapy, Univ. of Witten/Herdecke (Germany)

    2000-11-01

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  18. Biomechanics of whiplash injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Hai-bin; King H YANG; WANG Zheng-guo

    2009-01-01

    Despite a large number of rear-end collisions on the road and a high frequency of whiplash injuries reported, the mechanism of whiplash injuries is not completely understood. One of the reasons is that the injury is not necessarily accompanied by obvious tissue damage detectable by X-ray or MRI. An extensive series of biomechanics studies, including injury epidemiology, neck kinematics,facet capsule ligament mechanics, injury mechanisms and injury criteria, were undertaken to help elucidate these whiplash injury mechanisms and gain a better understanding of cervical facet pain. These studies provide the following evidences to help explain the mechanisms of the whiplash injury: (1) Whiplash injuries are generally considered to be a soft tissue injury of the neck with symptoms such as neck pain and stiffness, shoulder weakness, dizziness, headache and memory loss, etc. (2) Based on kinematical studies on the cadaver and volunteers, there are three distinct periods that have the potential to cause injury to the neck. In the first stage, flexural deformation of the neck is observed along with a loss of cervical lordosis; in the second stage, the cervical spine assumes an S-shaped curve as the lower vertebrae begin to extend and gradually cause the upper vertebrae to extend; during the final stage, the entire neck is extended due to the extension moments at both ends. (3)The in vivo environment afforded by rodent models of injury offers particular utility for linking mechanics, nociception and behavioral outcomes. Experimental findings have examined strains across the facet joint as a mechanism of whiplash injury, and suggested a capsular strain threshold or a vertebral distraction threshold for whiplash-related injury,potentially producing neck pain. (4) Injuries to the facet capsule region of the neck are a major source of post-crash pain. There are several hypotheses on how whiplash-associated injury may occur and three of these injuries are related to strains within

  19. Cervical Cancer Screening

    Science.gov (United States)

    ... Cancer found early may be easier to treat. Cervical cancer screening is usually part of a woman's health ... may do more tests, such as a biopsy. Cervical cancer screening has risks. The results can sometimes be ...

  20. Effects on Levels of Serum Endothelin, Tumor Necrosis Factor Alpha of Cervical Spondylosis of Vertebral Artery Type Treating by Electroporation Transdermal Drug Delivery of Zhengqinfengtongning Injection in Cervical Jiaji Points%颈夹脊穴正清风痛宁透皮给药治疗对椎动脉型颈椎病患者血清内皮素、肿瘤坏死因子水平的影响

    Institute of Scientific and Technical Information of China (English)

    梁粤; 皮敏; 侯冯彬; 翁妍珊; 黄少; 谭毅武; 陈淑兰

    2015-01-01

    s:Objective To observe the clinical effect of electroporation transdermal drug delivery of Zhengqinfengtongning injection in Cervical Jiaji points in treatment of Cervical spondylosis of vertebral artery type(CSA),and its effects on levels of serum endothelin (ET), tumornecrosisfactoralpha(TNF-α).Methods 68caseswererandomlydividedintotwogroups.Fengtongninggroupweregivenelectro-poration transdermal therapy of Zhengqinfengtongning injection in Cervical Jiaji points and flunarizine.Saline group were given electroporation transdermal therapy of saline in Cervical Jiaji points and flunarizine.Both groups treated for 10 days.Results The total efficiency between two groups had significant difference (P<0.05).The ESCV scores and the levels of ET, TNF-αin two groups were decreased(P<0.01,P<0.05), and there was significant difference (P<0.05).Conclusions Electroporation transdermal drug delivery of Zhengqingfengtongn-ing injection in Cervical Jiaji points has good effect in treating CSA, and decreases the level of ET, TNF-α.%目的:观察颈夹脊穴正清风痛宁注射液电致孔透皮给药治疗椎动脉型颈椎病的临床疗效及其对血清内皮素(ET)、肿瘤坏死因子α(TNF-α)水平的影响。方法68例椎动脉型颈椎病患者随机分为两组。风痛宁组口服氟桂利嗪联合颈夹脊穴正清风痛宁注射液电致孔透皮给药治疗,盐水组口服氟桂利嗪联合颈夹脊穴生理盐水电致孔透皮给药治疗,两组疗程均为10d。结果治疗后两组总有效率比较有显著性差异(P<0.05);两组ESCV积分、ET及TNF-α水平与治疗前比较,差异有统计学意义(P<0.01,P<0.05);风痛宁组ESCV积分、ET及TNF-α水平与盐水组比较差异有统计学意义(P<0.05)。结论颈夹脊穴正清风痛宁注射液电致孔透皮给药治疗椎动脉型颈椎病有较好的疗效,可降低血清中ET、TNF-α水平。

  1. Hyperoxaluria, Hypocitraturia, Hypomagnesiuria, and Lack of Intestinal Colonization by Oxalobacter formigenes in a Cervical Spinal Cord Injury Patient with Suprapubic Cystostomy, Short Bowel, and Nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2006-01-01

    Full Text Available Although urolithiasis is common in spinal cord injury patients, it is presumed that the predisposing factors for urinary stones in spinal cord injury patients are immobilization-induced hypercalciuria in the initial period after spinal injury and, in later stages, urine infection by urease-producing micro-organisms, e.g., Proteus sp., which cause struvite stones. We describe a patient who sustained C-7 complete tetraplegia in a road traffic accident in 1970, when he was 16 years old. Left ureterolithotomy was performed in 1971 followed by left nephrectomy in 1972. Probably due to adhesions, this patient developed volvulus of the intestine in 1974. As he had complete tetraplegia, he did not feel pain in the abdomen and there was a delay in the diagnosis of volvulus, which led to ischemia of a large segment of the small bowel. All but 1 ft of jejunum and 1 ft of ileum were resected leaving the large bowel intact. In 1998, suprapubic cystostomy was performed. In 2004, this patient developed calculus in the solitary right kidney. Complete stone clearance was achieved by extracorporeal shock wave lithotripsy. Stone analysis: calcium oxalate 60% and calcium phosphate 40%. Metabolic evaluation revealed hyperoxaluria, hypocitraturia, and hypomagnesiuria. Since this patient had hyperoxaluria, the stool was tested for Oxalobacter formigenes, a specific oxalate-degrading, anerobic bacterium inhabiting the gastrointestinal tracts of humans; absence of this bacterium appears to be a risk factor for development of hyperoxaluria and, subsequently, calcium oxalate kidney stone disease. DNA from the stool was extracted using the QIAamp DNA stool Mini Kit (Qiagen, Chatsworth, CA. The genomic DNA was amplified by polymerase chain reaction using specific primers for oxc gene (developed by Sidhu and associates. The stool sample tested negative for O. formigenes. The patient was prescribed potassium citrate mixture; he was advised to avoid oxalate-rich food, maintain

  2. Renal infarction resulting from traumatic renal artery dissection.

    Science.gov (United States)

    Kang, Kyung Pyo; Lee, Sik; Kim, Won; Jin, Gong Yong; Na, Ki Ryang; Yun, Il Yong; Park, Sung Kwang

    2008-06-01

    Renal artery dissection may be caused by iatrogenic injury, trauma, underlying arterial diseases such as fibromuscular disease, atherosclerotic disease, or connective tissue disease. Radiological imaging may be helpful in detecting renal artery pathology, such as renal artery dissection. For patients with acute, isolated renal artery dissection, surgical treatment, endovascular management, or medical treatment have been considered effective measures to preserve renal function. We report a case of renal infarction that came about as a consequence of renal artery dissection.

  3. Cervical Cancer Stage IA

    Science.gov (United States)

    ... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

  4. Application of magnetic resonance imaging in cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    Chuan; Zhang; Sushant; K; Das; Dong-Jun; Yang; Han-Feng; Yang

    2014-01-01

    Cervical spondylotic myelopathy(CSM) is the most common cause of spinal cord dysfunction and is caused by static or dynamic repeated compression of the spinal cord resulting from degenerative arthritis of the cervical spine and some biological injuries to the cervical spine. The T2 signal change on conventional magnetic resonance imaging(MRI) is most commonly associated with neurological deficits. Diffusion tensor imaging and MR spectroscopy show altered microstructure and biochemistry that reflect patient-specific pathogenesis and can be used to predict neurological outcome and response to intervention. Functional MRI can help to assess the neurological functional recovery after decompression surgery for CSM.

  5. Livergraftvascularvariantwith 3 extra-hepatic arteries

    Institute of Scientific and Technical Information of China (English)

    Paulo N Martins

    2010-01-01

     Vascular anatomy of the liver is varied, and the"standard"anatomy is seen in 55%-80%of cases. It is very important that extrahepatic arteries are identiifed precisely at the time of graft procurement to avoid injuries that might compromise the liver function. In the present case the liver donor had the vascular anatomy of Michels type Ⅶ, e.g. a hepatic artery originating from the celiac trunk and going to the left lobe, an accessory left hepatic artery coming from the left gastric artery, and a replaced right hepatic artery coming from the superior mesenteric artery. This pattern of vascular supply is uncommon, representing less than 5%of cases. The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery, and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.

  6. Análise de fatores associados à lesão do nervo laríngeo recorrente em cirurgias de discectomia cervical via anterior Análisis de factores asociados a la lesión del nervio laríngeo recurrente en cirugías de discectomía cervical por vía anterior Analysis of factors associated with laryngeal nerve injury in anterior disc herniation surgery

    Directory of Open Access Journals (Sweden)

    Erasmo Abreu Zardo

    2011-01-01

    (incisiones de halo craneano. CONCLUSIÓN: El abordaje por el lado derecho presentó mayor índice de complicaciones con el NLR. A pesar de que el número limitado de pacientes no permite conclusiones estadísticas significativas, factores anatómicos intrínsecos del paciente como cuello corto y diámetro aumentado, bien como tiempo quirúrgico y dificultades técnicas que puedan aumentarlo, pueden estar asociados a lesiones en el NLR. Nuevos estudios evaluando las variables arriba estudiadas deben ser considerados.OBJECTIVE: To study other possible factors associated with RLN injury after anterior approach for treatment of disc herniation. METHODS: Between June 2009 and July 2010, we evaluated 30 patients underwent anterior approach for treatment of disc herniation in Hospital Sao Lucas, PUC-RS. At preoperative period, we evaluated the measure of neck circumference (at the level of the cricoid cartilage and cervical height (angle of the jaw to the upper edge of the clavicle. At perioperative period, we evaluated the time and difficulty in endotracheal intubation, surgical time, the approach side , the number of levels operated, and the type of incision (transverse / longitudinal and the use of the cranial halo. An endoscopic evaluation of the larynx was performed preoperatively. In the first 10 days after surgery, it was performed a second evaluation. The patients who had a normal second examination were considered without RLN injury. Patients who showed injuries were followed monthly until a period of six months when injuries were considered as definitive. RESULTS: We found 3/30 (10% cases of temporary RLN injury which recovered to up to 120 days post operate. Related to patients with no RLN injury, these patients had a neck circumference greater than average, their surgical time was above average, as well the number of levels operated, and the neck length was shorter than average. Two injuries occurred in the approach through the right side and one in the left side. All

  7. 护患沟通在颈椎骨折脱位不伴脊髓损伤患者中的应用%The application in the communication between the nurse and patient who have cervical vertebra fracture dislocation without spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    李婷

    2012-01-01

    目的:探讨护患沟通在颈椎骨折脱位不伴脊髓损伤患者护理中的应用.方法:对17例颈椎骨折脱位不伴脊髓损伤患者,给予人文关怀、专业知识宣教、围手术期心理辅导及术后康复指导.结果:17例患者均能接受医疗护理措施,提高配合度,未出现任何并发症,好转出院.结论:加强颈椎骨折脱位不伴脊髓损伤患者护患沟通是保证获得和维持良好治疗效果的有利措施和重要因素.%Objective:To discuss the application of nurse - patient communication during the caring for patients who have cervical vertebra fracture dislocation without spinal cord injury. Methods:Provide guidance on 17 people in the follow aspects:humanistic care, professional knowledge,periopeiative psychological counselling, Postoperative rehabilitation guidance. Results: 17 patients can accept medical miring measures .improve coordination degree, did not appear any complications. Conclution: Strengthen the nurse - patient communication is a favorable measure and important factor for the patients who have cervical vertebra fracture dislocation without Spinal cord injury acquire and maintain a better therapeutic effect.

  8. 高颈段脊髓电刺激促醒颅脑创伤昏迷一例并文献复习%Awoking effects of high cervical spinal cord stimulation on a comatose patient due to traumatic brain injury and literature review

    Institute of Scientific and Technical Information of China (English)

    董月青; 李建国; 张赛

    2011-01-01

    目的 研究高颈段脊髓电刺激对颅脑创伤昏迷的促醒作用.方法 观察1例重型颅脑创伤患者高颈段脊髓电刺激术后清醒时间、脑电图、诱发电位及脑血流的变化.结果 患者术后2个月逐渐清醒,脑电图逐渐转为正常α节律,诱发电位潜伏期延长逐渐改善,脑血流明显增加.结论 高颈段脊髓电刺激可能通过增加脑血流、恢复正常的神经电生理活动促醒颅脑创伤昏迷患者.%Objective To study the awoking effect of high cervical spinal cord stimulation on comatose patients with traumatic brain injury.Methods Recovery time,electroencephalogram ( EEG),evoked patentials,cerebral blood perfusion after cervical spinal cord stimulation in a comatose patient were investigated.Results The patient emerged form coma at 2 months after spinal cord stimulation treatment.EEG gradually turned into a normal ( rhythm,evoked potentials latency improved,and cerebral blood perfusion increased significantly.Conclusions High cervical spinal cord stimulation exerts its beneficial effects to comatose patients with traumatic brain injury by increasing cerebral blood perfusion and restoring normal cerebral electrical activity.

  9. Dexamethasone : Benefit and prejudice for patients undergoing on-pump coronary artery bypass grafting - A study on myocardial, pulmonary, renal, intestinal, and hepatic injury

    NARCIS (Netherlands)

    Morariu, AM; Loef, BG; Aarts, LPHJ; Rietman, GW; Rakhorst, G; van Oeveren, W; Epema, AH

    2005-01-01

    Study objectives: Cardiac surgery with cardiopulmonary bypass (CPB) results in perioperative organ damage caused by the systemic inflammatory response syndrome (SIRS) and ischemia/ reperfusion injury. Administration of corticosteroids before CPB has been demonstrated to inhibit the activation of the

  10. Get Tested for Cervical Cancer

    Science.gov (United States)

    ... Cervical Cancer Print This Topic En español Get Tested for Cervical Cancer Browse Sections The Basics Overview ... be cured. How often should I get screened (tested)? How often you should get screened for cervical ...

  11. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cancer cervix - screening; HPV - cervical cancer screening; Dysplasia - cervical cancer screening ... Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that spreads through sexual contact. Certain ...

  12. Treatment Option Overview (Cervical Cancer)

    Science.gov (United States)

    ... Cancer Prevention Cervical Cancer Screening Research Cervical Cancer Treatment (PDQ®)–Patient Version General Information About Cervical Cancer ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) depends on ...

  13. Amusement park injuries and deaths.

    Science.gov (United States)

    Braksiek, Robert J; Roberts, David J

    2002-01-01

    Media coverage of amusement park injuries has increased over the past several years, raising concern that amusement rides may be dangerous. Amusement park fatalities and increases in reported injuries have prompted proposed legislation to regulate the industry. Since 1979, the medical literature has published reports of 4 subdural hematomas, 4 internal carotid artery dissections, 2 vertebral artery dissections, 2 subarachnoid hemorrhages, 1 intraparenchymal hemorrhage, and 1 carotid artery thrombosis with stroke, all related to roller coaster rides. In this article, we review reports of amusement park injuries in the medical literature and Consumer Product Safety Commission data on the overall risk of injury. We also discuss the physics and the physiologic effects of roller coasters that may influence the type and severity of injuries. Although the risk of injury is low, emergency physicians are advised to include participation on thrill rides as part of their history, particularly when evaluating patients presenting with neurologic symptoms. PMID:11782733

  14. Amusement park injuries and deaths.

    Science.gov (United States)

    Braksiek, Robert J; Roberts, David J

    2002-01-01

    Media coverage of amusement park injuries has increased over the past several years, raising concern that amusement rides may be dangerous. Amusement park fatalities and increases in reported injuries have prompted proposed legislation to regulate the industry. Since 1979, the medical literature has published reports of 4 subdural hematomas, 4 internal carotid artery dissections, 2 vertebral artery dissections, 2 subarachnoid hemorrhages, 1 intraparenchymal hemorrhage, and 1 carotid artery thrombosis with stroke, all related to roller coaster rides. In this article, we review reports of amusement park injuries in the medical literature and Consumer Product Safety Commission data on the overall risk of injury. We also discuss the physics and the physiologic effects of roller coasters that may influence the type and severity of injuries. Although the risk of injury is low, emergency physicians are advised to include participation on thrill rides as part of their history, particularly when evaluating patients presenting with neurologic symptoms.

  15. Posttraumatic radiological diagnostics of the cervical spine

    International Nuclear Information System (INIS)

    The objective of this article is to determine, for each available method, the indications for imaging as well as the associated possibilities and limitations. It furthermore examines the desirability of close co-operation with clinical colleges to avoid unnecessary tests while identifying necessary procedures quickly and effectively. Individual cases are studied systematically and with numerous examples, and additional injuries, for example dissections of cerebral arteries and dural injuries, are highlighted. (orig.)

  16. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  17. Preventing cervical cancer globally.

    Science.gov (United States)

    Schmeler, Kathleen M

    2012-11-01

    Cervical cancer is one of the leading causes of cancer and cancer-related deaths among women worldwide. More than 85% of cases and deaths occur in the developing world where the availability of effective screening is limited. In this issue of the journal, Pierce and colleagues (beginning on page 1273) describe a novel technique using a high-resolution microendoscope (HRME) to diagnose cervical dysplasia. This perspective reviews the limitations of existing cervical cancer screening methods currently in use in low-resource settings and the potential for HRME imaging to contribute to cervical cancer prevention in the developing world.

  18. 探讨采用推拿、牵引、静点天麻素注射液的方法治疗椎动脉型颈椎病的临床疗效%A Study on the Clinical Effect of Manipulation, Traction and Intravenous Drip of Gastrodin Injection for the Treatment of Vertebral Artery Type of Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    丁伟

    2014-01-01

    Objective To investigate the clinical efficacy of manipulation, traction and intravenous drip of Gastrodin Injection in the treatment of vertebral artery type of cervical spondylosis. Methods 160 cases of vertebral artery type of cervical spondylosis patients admitted in our hospital from June, 2011 to June, 2013 were selected as the subjects and randomly divided into observa-tion group and control group and each group had 80 cases. The control group was given Salvia Miltiorrhiza Injection and cervical traction treatment while the observation group was given Gastrodin Injection combined with cervical traction and manipulation. The clinical curative effect, TCD changes and clinical symptom improvement time of two groups were compared in the study. Results After the treatment, the score of dizziness, headache and neck spinning tests in observation group was 2.5 ±0.3 poins, 2.6 ±0.4 points and 2.4±0.5 points, respectively, while the score of these tests in control group was 2.0±0.5 points, 2.1±0.5 points and 1.9± 0.6 points. The data differences between the two groups had statistically significance (P<0.01). Besides, the mean flow rate of verte-bral artery and vertebrobasilar artery in observation group was 31.91 ±2.59 and 28.11 ±1.95, respectively, which was significantly higher than that in control group(27.61±2.52 and 25.72±1.92) and the differences were statistically significant(P<0.01). Conclusion In the clinical application, manipulation, traction and intravenous drip of Gastrodin Injection in the treatment of vertebral artery type of cervical spondylosis have better clinical effect, rapider onset of action with definite efficacy and the value of promotion.%探讨采用推拿、牵引、静点天麻素注射液的方法治疗椎动脉型颈椎病的临床疗效。方法选取该院收治的160例椎动脉型颈椎病患者作为观察对象,将患者随机分为观察组和对照组,80例/组。对对照组进行丹参注射液撇和颈椎牵引

  19. 呼吸道系统管理模式对降低颈脊髓完全损伤气管切开风险的意义%Strengthened respiratory management for lower tracheostomy risks in patients with complete cervical spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    朱巍; 阚利胜; 孙延卿; 陈雄生; 袁文; 贾连顺

    2014-01-01

    目的 分析通过呼吸道系统管理模式降低颈脊髓完全损伤气管切开率的可行性.方法 回顾性分析2006至2012年上海长征医院骨科239例采用呼吸道系统管理模式的颈脊髓完全损伤病例的临床资料包括年龄、性别、受伤原因、颈髓损伤节段、手术情况、气管切开情况及预后情况,统计气管切开率及死亡率,并与1991至2005年大宗病例的回顾性研究数据进行比较.对严重颈脊髓损伤我院近年采用了呼吸道系统管理模式,包括强化体内充足能量及水份、预防或解除支气管痉挛、稀释痰液、加强翻身拍背、经鼻吸痰管或纤支镜吸痰、深呼吸及咳嗽训练、严格气管切开指征、必要时术后可短时间保留气管插管.结果 32例患者被实施气管切开,气管切开率12.6%.10例死亡,死亡率为4.2%.而1991至2005年的气管切开率为19.1%,死亡率为21.4%.颈脊髓完全损伤气管切开率较前明显降低,而存活率明显提高.结论 合理的呼吸道系统管理模式可有效降低颈脊髓完全损伤的气管切开率,提高救治存活率.%Objective To access the feasibility of reducing tracheostomy rates in patients with complete cervical spinal cord injury through a systemic respiratory management mode.Methods A retrospective review was performed for 239 patients on a systemic respiratory management mode after complete cervical spinal cord injury in Shanghai Changzheng Hospital from 2006 to 2012.Their demographic and clinical data,including age,gender,cause of injury,level of cervical spinal cord injuries,surgical approaches,tracheostomy rates and mortality rates,were collected and analyzed.Tracheostomy rates were compared with those of patients with complete cervical spinal cord injury.Tracheostomy rates were compared with those patients with complete cervical spinal cord injury from 1991 to 2005.The new respiratory management mode for patients with severe cervical spinal cord

  20. Treatment for cervical pregnancy : uterine artery embolization(UAE)followed by dilation and curettage (D&C)%子宫动脉栓塞联合灌注化疗及宫颈搔刮治疗宫颈妊娠18例临床分析

    Institute of Scientific and Technical Information of China (English)

    杨虹; 郭映芳

    2012-01-01

    目的 总结经皮动脉灌注氨甲喋呤(MTX)化疗联合子宫动脉栓塞(UAE)及宫颈搔刮治疗宫颈妊娠临床效果及以后妊娠的结局.方法 对2004年5月至2010年12月在我院行UAE并宫颈搔刮的18例宫颈妊娠患者进行回顾性分析及随访.结果 18例宫颈妊娠患者中,有6例活动性阴道出血者行急诊UAE后立即止血.另外12例无活动性出血者择期行UAE.所有患者在UAE后行宫颈搔刮,出血5~10 ml.所有患者均治愈并保留生育功能,无严重并发症.18例患者中,在UAE后自然受孕3例,有1例自然流产,有1例中孕13周人流,1例孕足月顺产,无母婴并发症.结论 动脉灌注MTX化疗联合UAE加宫颈搔刮是治疗活动性、危及生命大出血的宫颈妊娠患者的微创方法,能保留生育功能.%Objective To analyze and summarize clinical effect and outcome of consequent pregnancy of transcatheter intraarterial methotrexate infusion combined with uterine artery embolization (UAE) followed by dilation and curettage as a treatment for cervical pregnancy. Methods The clinical data of 18 patients with cervical ectopic pregnancy who were treated May 2004 to December 2010 were retrospectively reviewed and followed-up. Results Among 18 cases with cervical pregnancy, 6 cases with active vaginal bleeding underwent emergency UAE, and active bleeding can be controlled immediately; the other 12 cases of no active bleeding underwent elective UAE. After UAE and D&C, all the patients were cured succesfully with 5~10 ml minimal blood loss and preserve their fertility. No patients developed severe complications from UAE. Of 18 women, three achieved another pregnancy: one miscarriages, one took vacuum extraction for artificial abortion at 13 week, one was Full-term pregnancy with live birth and no obvious matemal-fetal complications related to treatment occurred. Conclusion Transcatheter intraarterial methotrexate infusion combined with uterine artery embolization followed by

  1. Arterial Ageing

    OpenAIRE

    Lee, Seung-Jun; Park, Sung-Ha

    2013-01-01

    Arterial ageing is characterized by age associated degeneration and sclerosis of the media layer of the large arteries. However, besides ageing, clinical conditions, which enhance oxidative stress and inflammation act to accelerate the degree of arterial ageing. In this review, we summarized the pathophysiology and contributing factors that accelerate arterial ageing. Among them, we focused on hypertension, the renin-angiotensin-aldosterone system and vascular inflammation which are modifiabl...

  2. Extremity-preserving efficacy of vascular prosthesis grafting in repairing arterial injuries of extremities%人造血管移植修复四肢血管损伤的保肢功效

    Institute of Scientific and Technical Information of China (English)

    杜全印; 王爱民; 赵玉峰; 王子明; 郭庆山; 尹良军; 吴思宇; 唐颖

    2006-01-01

    study.SETTING: Department of Orthopedics and Traumatic Surgery, Center for Battle Wound and Trauma of Chinese PLA, Research Institute of Surgery,Daping Hospital, Third Military Medical University of Chinese PLA.PARTICIPANTS: We selected 29 patients with major vascular injuries of the extremities repaired by vascular prosthesis grafting who received the treatment at the Department of Orthopedics and Traumatic Surgery of the Center for Battle Wound and Trauma of the Chinese PLA of the Research Institute of Surgery of, Daping Hospital of the Third Military Medical University of Chinese PLA between January 1989 and December 2000. There were 23 males and 6 females. Injury sites: 9 cases were at subclavian artery, 6 at axillary artery, 2 at brachial artery, 10 at femoral artery, 1 at femoral vein and 1 at popliteal artery. 11 of these 29 cases (37.9%) were complicated with shock, 8 with fractures and dislocations, 5 with peripheral nerve injuries and 3 with infections.METHODS: The vascular prosthesis was anastomosed end to end with the trimmed culprit vessels. As for the 3 cases with infective arterial injuries,the vessels were placed away from the infected region and were bridged together in a non-inf1ammatory region and then muscles or musculo-cutaneous flaps were used to cover the infected regions.The functions of the extremities of the patients were evaluated according to MAS at week 2 and 1 year after the operation.MAIN OUTCOME MEASURES: The vascular patency rate and the extremity-preserving outcomes..RESULTS: All 29 patients entered the stage of result analysis. Extremitypreserving efficacy: All the patients who underwent vascular prosthesis grafting had their extremities preserved. Only 1 patient had the late sequelae of ulcers in the foot sole due to extended extremity ischemia and nerve damage. The rate of 2-week patency rate of the grafted vessels was 100% and the 1-year rate of patency was 96.5%, as revealed by Doppler blood stream scanning. The excellent and good

  3. Radiological case: cervical teratoma

    OpenAIRE

    Macedo, F.

    2011-01-01

    We present a case of a third trimester fetus with a cervical mass. Fetal MRI was performed to better evaluate the extension of the mass and the risk of obstruction of the airway in the neonatal period. MRI is very useful in the evaluation of fetal cervical masses.

  4. CDC's Cervical Cancer Study

    Science.gov (United States)

    ... in Cancer Moonshot Stay Informed CDC’s Cervical Cancer Study Language: English Español (Spanish) Recommend on Facebook Tweet ... year. As part of CDC’s Cervical Cancer (Cx3) Study, we surveyed a sample of both health care ...

  5. Delayed Perilesional Ischemic Stroke after Gamma-knife Radiosurgery for Unruptured Deep Arteriovenous Malformation: Two Case Reports of Radiation-induced Small Artery Injury as Possible Cause

    OpenAIRE

    Kim, Dong-Han; Kang, Dong-Hun; Park, Jaechan; HWANG, Jeong-Hyun; Park, Seong-Hyun; Son, Won-Soo

    2015-01-01

    Radiation-induced vasculopathy is a rare occurrence, however, it is one of the most serious complications that can occur after gamma-knife radiosurgery (GKRS). The authors present two cases of incidentally found deep cerebral arteriovenous malformation (AVM), which were treated by GKRS, where subsequently there occurred delayed-onset cerebral infarction (11 and 17 months after GKRS) at an area adjacent to the AVM. In both cases, perforators of the M1 segment of the middle cerebral artery were...

  6. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report

    OpenAIRE

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-01-01

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous in...

  7. Melatonin Counteracts at a Transcriptional Level the Inflammatory and Apoptotic Response Secondary to Ischemic Brain Injury Induced by Middle Cerebral Artery Blockade in Aging Rats

    OpenAIRE

    Paredes, Sergio D.; Rancan, Lisa; Kireev, Roman; González, Alberto; Louzao, Pedro; González, Pablo; Rodríguez-Bobada, Cruz; García, Cruz; Vara, Elena; Tresguerres, Jesús A.F.

    2015-01-01

    Abstract Aging increases oxidative stress and inflammation. Melatonin counteracts inflammation and apoptosis. This study investigated the possible protective effect of melatonin on the inflammatory and apoptotic response secondary to ischemia induced by blockade of the right middle cerebral artery (MCA) in aging male Wistar rats. Animals were subjected to MCA obstruction. After 24 h or 7 days of procedure, 14-month-old nontreated and treated rats with a daily dose of 10 mg/kg melatonin were s...

  8. Effective observation on treating 53 cases of cervical spondylosis of vertebral artery type with the Pingxuan decoction plus chiropractic%平眩汤联合整脊推拿治疗椎动脉型颈椎病53例的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈荣凯

    2016-01-01

    Objective: To observe clinical efficacy of the Pingxuan decoction plus chiropractic on cervical spondylosis of vertebral artery type. Methods: 53 patients in our hospital were divided into the control group (27 cases) and the observation group (26 cases). The control group was treated by chiropractic; the observation group was given the Pingxuan decoction more. Clinical efficiency in two groups was compared. Results: The total efficiency in the observation group was 96.30%, and 57.69% in the control group. Satisfactory rate in the observation group was 100.00%, and 61.54% in the control group (P﹤0.05). Conclusion: The Pingxuan decoction plus chiropractic on cervical spondylosis of vertebral artery type could relieve clinical symptoms, decrease adverse effects, and was worthy of promotion.%目的::观察分析平眩汤联合整脊推拿治疗椎动脉型颈椎病的临床疗效。方法:选取我院2013年7月-2015年7月收治的椎动脉型颈椎病患者53例为对象,随机分为对照组和观察组,对照组27例,观察组26例。对照组采用传统的推拿治疗,观察组采用平眩汤联合整脊推拿治疗,比较分析两组患者的临床治疗效果。结果:观察组总有效率为96.30%,对照组为57.69%(P﹤0.05);观察组治疗满意度为100.00%,对照组为61.54%(P﹤0.05)。结论:采用平眩汤联合整脊推拿治疗椎动脉型颈椎病,能减轻患者的临床症状,且不良反应发生率较低,具有临床推广价值。

  9. 龙氏治脊疗法结合针刺治疗椎动脉型颈椎病60例临床观察%Clinical observation on treating 60 cases of cervical spondylosis of vertebral artery type by acupuncture plus the Long’s chiropractic therapy

    Institute of Scientific and Technical Information of China (English)

    谭周纯; 洪文

    2016-01-01

    目的:观察龙氏治脊疗法结合针刺治疗椎动脉型颈椎病的临床疗效。方法:将120例椎动脉型颈椎病患者随机分为两组,治疗组采取龙氏治脊疗法结合针灸治疗。对照组采取针刺治疗。结果:治疗组痊愈率与总有效率分别为50.00%和91.67%。而对照组痊愈率与总有效率则分别为26.67%和68.33%。两组比较,差异均有显著性意义(P<0.05),治疗组疗效优于对照组。结论:龙氏治脊疗法结合针刺治疗椎动脉型颈椎病疗效明显优于单用针刺,值得临床进一步推广应用。%Objective: To observe clinical efcacy of acupuncture plus the Long’s chiropractic therapy on cervical spondylosis of vertebral artery type. Methods: 120 patients were randomly divided into two groups; the treatment group was given acupuncture plus the Long’s chiropractic therapy. The control group was treated by acupuncture. Results: The efciency and the total efciency were 50.00%and 91.67% respectively in the treatment group; and were 26.67% and 68.33% respectively in the control group (P<0.05); and efcacy in the treatment group was better. Conclusion: Acupuncture plus the Long’s chiropractic therapy on cervical spondy